Changes to Winnipeg hospitals could hurt patient care: doctors organizations

A pair of Manitoba doctor organizations have concerns about the future of Winnipeg health care in light of sweeping changes announced earlier this month by the city's regional health authority and Manitoba Health.

In a pair of letters sent earlier this week, the president of Doctors Manitoba and the president of the Manitoba College of Family Physicians wrote they're worried the new plan — which includes the closure of three Winnipeg emergency departments, two of which will be converted to urgent care centres — will harm patient care and undercut family doctors.

One letter, sent to the college's roughly 1,200 members from president Dr. Deidre O'Flaherty, said the changes "undermined" family doctors, jeopardizing their ability to provide continuous care to patients in all communities and leaving them out of acute care in the new system.

The other, sent by Doctors Manitoba president Dr. Barbara Kelleher to the Medical Post, says the changes might make it harder for some patients to see a doctor in an emergency. Doctors Manitoba represents more than 3,000 physicians in the province.

"Physicians care first and foremost about the health of their patients," Kelleher wrote in the letter, dated April 21. "Anything that may hinder a patient's ability to see a physician in their time of need is a major concern."

Earlier this month, the WRHA and Manitoba Health Minister Kelvin Goertzen announced the move, which will see the closure of the emergency department at the city's Concordia hospital and convert EDs at the Victoria and Seven Oaks hospitals to 24/7 urgent care centres.

The plan also includes the closure of the Misericordia Health Centre's existing 24-hour urgent care centre, which will be converted to a community intravenous therapy clinic.

The WRHA and Manitoba Health have said it's all part of an effort to streamline Winnipeg health care, on the heels of a 233-page report by health consultant Dr. David Peachey.

- READ THE REPORT: Clinical and Preventive Services Planning for Manitoba

"These changes present all of us with an opportunity to improve care for the patients we serve," the WRHA said in a statement provided to CBC in response to Kelleher's letter.

"We are confident we can address the concerns brought forward by Dr. Kelleher and other concerned parties and we look forward to continuing a dialogue with our partners in order to improve the overall care for and experience of patients across the province."

But Kelleher wrote she's not convinced the EDs and urgent care centres that remain open will get enough resources to keep up with "greater and more acute demand," and echoing O'Flaherty's concerns, wrote the changes will push family doctors out of hospitals.

O'Flaherty wrote she and other college officials met with Goertzen on April 18, and "felt heard."

She says they provided four recommendations, including a request the WRHA consider 24/7 urgent care at all hospitals, and the creation of "an immediate strategy to mitigate the impacts on engagement with Family Physicians to maintain and protect existing relationships between the WRHA, MHSAL and Family Physicians."

Province backs WRHA plan

In her letter, Kelleher alleged the WRHA will end up saving almost $20 million a year due to layoffs as a result of the changes, although the province so far hasn't confirmed if any layoffs will occur and the WRHA denied her claim in its statement.

"We are concerned with some of the comments made by Dr. Kelleher from Doctors Manitoba in her letter to the Medical Post and would like to ensure that patients served by the WRHA and physicians working with us, have accurate information about the plan we've put forward," the WRHA wrote in its statement.

"Most importantly, we do not anticipate any significant reductions in emergency or critical care physician positions. We have indicated that those services will be consolidated to three sites (for emergency and ICU) and two others for urgent care."

Prior to the release of the 2017-18 Manitoba budget, the province mandated the WRHA find $83 million in
savings. The organization has identified $30.9 million in savings from a major hospital overhaul, including the ED closures, and $25.5 million from "staffing efficiencies" — that is, early retirements and cutting overtime costs, but not layoffs.

The health authority said it found an additional $27.2 million in savings from non-clinical plans, including administrative operations.

In a statement provided to the CBC on Monday evening, the province reiterated its support for the WRHA's plan.

"As a member of the Provincial Clinical and Preventive Services Planning steering committee, Doctors Manitoba was provided with multiple opportunities for input and feedback on the various recommendations contained within the Peachey Report," the statement reads.

"We look forward to continued dialogue with all stakeholders as the recommendations are implemented."