NORTHWEST TERRITORIES
An amalgamated health-care authority in the Northwest Territories will not result in job losses or centralization in Yellowknife, according to Health Minister Glen Abernethy.
The minister released a discussion paper last August, citing the benefits of combining NWT's eight regional health care authorities into one body serving the entire territory. Since then, he has been visiting various communities across the territory to collect feedback and says overall the reaction has been very positive.
"I've had the opportunity to talk to a lot of professionals ... and residents and I get a strong sense that people are ready for an improved health and social system."
Abernethy was quick to emphasize the proposed model should not be referred to as "centralization" or confused with a past situation in Alberta.
In 2008, Alberta replaced its nine regional authorities with the governing body of Alberta Health Services. Although the restructuring saved the province money, it was widely criticized for marginalizing the needs of small communities. Doctors in particular argued it led to increased emergency room wait times and a communication breakdown between physicians and administration. The province has since begun a transition back to a regional model.
Abernethy says his team examined many different examples of amalgamated healthcare across the country in order to come up with a unique platform envisioned for the Northwest Territories.
"The significant difference is, although we are going to have one board of management, we are going to maintain these advisory councils at the regional level who are going to be the voice of the communities," he said.
The move will also mean more funding and staff will be available on a per needed basis, as currently many regions are running budgetary deficits, making it impossible to pull resources together during a crisis.
"Say there was a whooping cough outbreak in one community that was supported by an authority, they might not have the fiscal or human resources to deal with that challenge, but under the current system that is their responsibility," Abernethy explained. "Under the new system, we'd say, 'we've got a crisis in 'X' community, we're going to move some of our resources, we're going to take some of the people from other communities on a temporary basis to manage this crisis."
The Beaufort-Delta board was replaced by a government-appointed public administrator a number of years ago along with the Stanton Territorial Hospital, Hay River and Deh Cho authorities. Amalgamation will help alleviate staffing shortages in these outlying communities says Beaufort-Delta's chief executive officer Arlene Jorgensen.
"There have been challenges with staffing and finding indeterminate positions certainly throughout the region, in particular nursing and social work and some of the specialized health fields," she said.
Inuvik Mayor Floyd Roland says during his time as premier from 2007 to 2011, health authorities were struggling to stretch resources across all the places they were needed.
"There used to be times when there was a shortage and we'd be given notices from communities outside of Inuvik ... (but) if there was a shortage we weren't able to send doctors," he said.
He says even then, they were challenged to find a better approach to co-ordinating services. However, he noted there was also hesitation about moving to a government-run model if community input would be reduced.
"The concern is always when a board moves on or when, in a sense, the influence you have moves further away, there is a concern there is less of an impact (you) can have from your community or region."
At the end of the day, he says the action that will deliver the best patient care and service is the one that should be taken.
"Whatever changes they are working to implement or go forward on, they need to ensure the level of service is foremost when it comes to being able to access services that are either now available or we will continue to need as we look toward the future," Roland said.
Sahtu MLA Norman Yakeleya says response to amalgamation has been positive across the region. He says he believes the new model will give a voice to the people, not take it away.
"We don't have a voice at the territorial level, there's no voice for us there and so this approach ... will give the Sahtu a voice," he said.
Yakeleya also noted there is a desperate need for specialized services in the outlying communities, particularly when it comes to mental health counselling. He says amalgamation will help decrease wait times which under the current system can be two to four months.
"Can you imagine ... calling a mental health counsellor and saying, 'I want to come for counseling for this issue or that issue' and looking at your calendar and saying, 'OK, in two months I'll be able to see a counsellor,'" he said. "Some communities don't have mental health counselors or are unable to fill those positions (because) we're not sharing resources."
Despite the condensing of some services, job cuts are unlikely, Abernethy insisted, adding he does not expect staff will be relocated to a central office in Yellowknife.
"We're not taking jobs out of communities or regions at all," he said. "We still need the professionals out there, providing the incredible services that they do, but we do need to provide services in a more collaborative and co-ordinated way."
However, after restructuring begins, Abernethy says some job titles may change and responsibilities could shift, but patients should not notice any significant disruption on the front lines during the transition period.
The legislation is currently before MLAs and Abernethy says he expects it to reach third reading during the May session, with implementation in 2016.
Health authorities with boards of directors
- Fort Smith
- Sahtu
- Tlicho
- Yellowknife
Health authorities with only an administrator
- Hay River
- Deh Cho
- Stanton Territorial Hospital
- Beaufort-Delta
Source: Department of Health and Social Services
