A View of Restructuring from the Inside, Out

puzzle piecesSome people may debate the notion that change is good. Almost nobody will dispute that change is hard.

We have been hearing from members from Winnipeg and across the province about their concerns and aspirations as the Winnipeg Regional Health Authority continues its process of restructuring. We have received clear signals that our members working in rural and remote communities will hear of restructuring plans for them in the weeks ahead. Some members believe these changes are long overdue, and they are actively involved in leading the process of change. Others have expressed concerns about the lack of consultation with front-line physicians, and have deep fears that the changes are happening without appropriate communication, preparation and concern for the well-being of the patients they serve. And, not surprisingly, there are many physicians in the middle, having shifting sets of feelings as time goes on.

Here is what we know so far:

In Phase I of the WRHA’s restructuring plan, we saw the closure of the Misericordia Urgent Care Centre and the conversion of the Victoria Hospital Emergency Department into an Urgent Care Centre. We have seen the beginning of the transition of some hospitals to sub-acute and transitional facilities, with a corresponding increase of acuity at other sites. The Mature Women’s Centre has closed, and we have seen the development of Clinical Assessment Units. Each one of these changes has had a ripple effect on other aspects of the system.

Some details for Phase II were announced to the public on May 31, 2018, and they include the closure of the Concordia Emergency Department and the conversion of Seven Oakes Emergency Department to an Urgent Care Centre. The expansion of the Grace Hospital Emergency Department has opened, and work continues at HSC and St. Boniface Hospital. Concordia and Seven Oaks will see their ICUs close, and beds shall be transferred to other facilities. Medicine beds at Concordia and Seven Oaks will be designated for lower acuity patients which will shift surgical and anesthesia services among various sites. A consolidation of mental health services is planned at HSC, St. Boniface and Victoria Hospitals. These changes will occur over the course of the next calendar year, and beyond. We encourage members to view materials on the WRHA website that provides estimated target times for the changes to occur.

We know that our members all share a vision for an efficient, sustainable and compassionate health care system, and Doctors Manitoba seeks to play a significant role in ensuring your voices are heard. While it has not always been the tradition of our organization to join planning tables and to actively participate in the dialogue about changes in our system, the time has come for us to do just that. The magnitude of the change being contemplated by the provincial government is too big to ignore, or even to risk being criticized for providing “tacit approval” by engaging with those charged with making the changes. Now more than ever, Doctors Manitoba must proactively engage with system leaders to ensure your voices are heard, and to play a role in offering your best advice to support physicians and the patients you serve.

Simply put, it is much better to be at the table than on the menu.

We welcome information from you, in real time, as these changes are taking place. We want to work with you to help create the conditions for smooth transitions and to understand the potential ripple effects before they happen. We want to do all we can to ameliorate the pain of decisions as they occur. We will strive to be a source of accurate and timely information to enable you to avoid feeling the anxiety that can come from rumours and innuendo. We need you to assist us in being the eyes and ears for physicians and their patients, and we value the sage advice you have to offer.