Dozens of managers across Newfoundland and Labrador's four regional health authorities and Centre for Health Information are not at work Thursday morning, after getting pink slips Wednesday.
The cuts came from the provincial government's directive to "streamline" for a "flatter, leaner" management structure.
"These are very difficult days for all of us. Certainly if you have concerns about your job, this doesn't help," said Eastern Health CEO David Diamond.
He and other health authority leaders said they were doing their part to find "efficiency" within their systems.
Employees were still receiving their notices as health authority CEOs spoke to reporters Wednesday afternoon, and efforts to redistribute, realign and adjust workflow with fewer managers are underway.
Each CEO said they could not provide specifics as to which exact positions have been lost, out of respect for the affected people and their families.
However, they said the job losses would not hurt patient services.
Diamond said Eastern Health had 550 managers but 46 positions "have been deleted."
Of those, 24 were vacant as the health authority chose not to fill them in anticipation of the cuts.
"They were busy people and they had full-time jobs," Diamond said. "Taking 46 positions out of an organization can't be without impact," but they'll adjust accordingly.
He said some of the 22 people suddenly without jobs are eligible for retirement benefits, while some will be looking for other opportunities within or beyond the health authority.
Just the beginning?
Earlier Wednesday, Health Minister John Haggie alluded to more cuts to health care in the April 6 budget.
He said the province "cannot afford" to keep spending what it does on health care without seeing significant returns.
The current "siloed" system with acute care on one side and community care on the other "needs to be dealt with," said Haggie.
And the leaders of the four regional health authorities are clearly prepared for more cuts.
"Frankly, we don't know what the budget will bring," said Diamond, "but we are anxiously awaiting."
'Very difficult time'
Half of the 93 positions lost fell under Eastern Health, but each of the four regional authorities lost people.
"This is a very difficult time for employees and families whose positions have been eliminated," Western Health CEO Susan Gillam said Wednesday.
It now has 156 management positions with the loss of 19 — three of those vacancies they now won't fill.
Gillam said this is just another step in the process towards creating a sustainable health-care system.
At Central Health, CEO Rosemarie Goodyear said seven of the 19 positions cut were vacant, so 12 employees are affected.
"There is certainly an expectation for us as leaders in the health-care system to be cognizant of the fiscal situation and to be managing our organizations accordingly."
She said it's going to be a challenge, but one they think is manageable as they prepare for more cuts in the budget.
"I think as the minister alluded to in his comments today, we are being challenged every day to find efficiencies to sustain the system. So those conversations, I suspect, will continue."
Awaiting job description
Eight positions have been eliminated at Labrador-Grenfell Health, and two of those were already vacant, according to Tony Wakeham, CEO of the health authority.
"We will realign those programs that they were responsible for to other management people within our organization," he told CBC's Labrador Morning Thursday.
Labrador-Grenfell Health is getting a new position, but Wakeham said the job description is still being worked on.
The province-wide cuts are set to save $7.6 million annually, after the $8 million cost in severance and pay in lieu of notice is paid out this year.