Birthplace of medicare braces for more health care reform

A sigh of relief was heard across rural Saskatchewan Dec. 5 after the provincial government announced it will not be shutting 50 small hospitals. Their closure had been recommended in a comprehensive review of the province's medicare system completed last April.

Saskatchewan premier Lorne Calvert said that recommendation was too disruptive and would not save much money. “If we were to select 20 of our smallest community hospitals and close them, I'm told the savings would [amount to] about $14 million. That represents about 2 days of funding for the department of health.”

But Calvert did adopt many of the less controversial recommendations contained in the report, which was prepared by Kenneth Fyke, a former deputy minister of health in Saskatchewan and British Columbia.

Included in the new Action Plan for Saskatchewan Health Care is the creation of primary health care teams — physicians, nurses, mental health professionals, social workers and other health providers — that will serve rural communities. Doctors who voluntarily join a team will be on a contract or salary, rather than receiving fee-for-service payments.

Dr. Bev Karras, president of the Saskatchewan Medical Association (SMA), said this is not a novel approach because many physicians already work in teams. “It is essential that [the SMA be involved] before the programs are implemented,” she said. “Physicians must have a choice and must be able to feel comfortable with the work arrangements, and that would include how they are paid.”

The SMA had criticized the Fyke report because its authors had not consulted physicians, particularly those in rural practice.

Saskatchewan currently spends almost 40% of its budget on health care, a total of $2.2 billion in 2001.