Desperate to recruit doctors, some Manitoba municipalities are taking matters into their own hands — even though health care is not their responsibility.
“Basically it’s because the job’s not been done well enough,” said Association of Manitoba Municipalities president and CEO Kam Blight.
Inadequate rural recruitment by the province is a longstanding problem that’s grown and festered over many years and administrations, he said earlier this week. The numbers of physicians in rural Manitoba per 100,000 people are well below Winnipeg, which has the fourth-lowest number of doctors among larger Canadian cities.
Rural hospitals are having to close emergency rooms as they struggle to find staff. Last year, emergency departments in Arborg, Morris, Melita and Carberry closed indefinitely. The Leaf Rapids ER closed in 2022. Emergency department schedules posted by health regions across the province show many more rural health centre ERs closed this week or over the weekend.
MIKE DEAL / FREE PRESS Kam Blight, president, Association of Manitoba Municipalities says inadequate rural recruitment by the province is a longstanding problem that’s grown and festered over many years and administrations.
“It’s having a real, negative impact on municipalities — not just to retain the current population that they may have, but it’s also a deterrent, in a sense, for people that are looking to move to some of these communities,” said Blight.
It’s personal for Blight. He lives outside of Portage la Prairie and several years ago was rushed to the hospital emergency department there. Had it been closed, Blight said he would’ve died.
“Municipalities are doing whatever they can to try and keep their hospitals and health-care facilities open because, if they don’t, they’re going to lose population.”
More than 90 per cent report doctor shortages, while nearly 95 per cent are allocating money to recruit and retain health practitioners in local communities — totalling more than $1 million per year, the Association of Manitoba Municipalities says. Blight worries about that cost being offloaded onto municipalities.
Physicians per 100,000 population by health region
- Interlake-Eastern — 92
- Northern — 115
- Prairie Mountain — 149
- Southern — 99
- Winnipeg — 293
— Source: Doctors Manitoba/Canadian Institute for Health Information
“Our concern is, when the province of Manitoba sees that some municipalities are willing to do this, they’re going to allow it to continue: ‘If we don’t provide the necessary funding, we know that the municipality will step up’,” he said. “We need to make sure that that is not happening.”
One southwestern municipality that took matters into its own hands is having some success recruiting doctors from the United Kingdom who are looking for a slower pace and better pay. (The average salary for a general practitioner in Canada is $187,500; in the U.K. it’s $105,459, according to payscale.com.)
The biggest lure, though, may be the promise of a better work-life balance, said Municipality of Killarney Turtle-Mountain Mayor Janice Smith.
“I hear it all the time: ‘work-life balance,’” Smith said.
SUPPLIED Killarney-Turtle Mountain Mayor Janice Smith
The area 240 kilometres southwest of Winnipeg has two full-time physicians but requires a full complement of five to work at the local medical clinic and take turns being on-call at the Tri-Lake Health Centre’s emergency department.
In 2016, the municipality paid a private firm $240,000 to successfully recruit two U.K. physicians. Nearly half of the tab was picked up by the Prairie Mountain Health region.
The municipality hired the same recruiter in 2023 and hosted three physicians from the U.K. for site visits. It successfully lured two candidates. “We have one in the boat and one on the hook,” the mayor quipped.
One doctor — with a wife and five children — has signed a return of service agreement and is set to start in August. Another is in the midst of sorting through the immigration process and planning to come. A third recruited doctor was expected to arrive earlier this year, then balked at working full-time, so the recruitment process has begun anew. This time, interviews will be conducted on Zoom before any visits take place, Smith said.
“It’s very expensive to entertain them during site visits,” said Smith, who has shared their recruitment experience with other municipalities.
The organization advocating on behalf of Manitoba municipalities said they shouldn’t have to pay for health-care recruitment.
“Health care is a provincial and federal responsibility, not a municipal responsibility,” said Blight. “The province of Manitoba just received record amounts of dollars to go towards health care.”
“Health care is a provincial and federal responsibility, not a municipal responsibility. The province of Manitoba just received record amounts of dollars to go towards health care”–Kam Blight
Manitoba is receiving $1.8 billion through the Canada Health Transfer this year. That works out to $4,557 per person, compared to $2,655 per person in federal health dollars in 2015-16. The provincial budget allocates $310 million for retention, recruitment and training to address health-care staffing shortages.
“We need to make sure some of those dollars are being spent in rural Manitoba because if we can have healthy, vibrant, thriving rural communities, that takes the pressure off of our large centres and those health-care facilities,” Blight said. He’s concerned, too, about “pitting one municipality against another” in the hunt to recruit doctors.
Health Minister Uzoma Asagwara said while the government will “never get in the way of municipalities who want to take their own approach to recruitment,” it is keen to work with them.
The health minister said they’re restoring the rural physician recruitment and retention fund that was cut by the Progressive Conservatives in 2017 from $31.5 million to $25.6 million.
“We didn’t get to where we are with health care in rural Manitoba overnight,” said Asagwara. “It was seven and half years of a government that basically turned their back on rural Manitoba.”
The minister’s office did not respond when asked several times how much of the $310 million budgeted for recruitment, retention and training is earmarked for rural Manitoba.
“We didn’t get to where we are with health care in rural Manitoba overnight. It was seven and half years of a government that basically turned their back on rural Manitoba”–Uzoma Asagwara
Meanwhile, regional authorities like Prairie Mountain Health say they’re working with municipalities and pulling out all the stops with recruitment efforts that run the gamut from starting a medical residency program in Neepawa in June to hosting “rural week” with fresh medical school students shadowing rural doctors.
Southern Health says it’s expanding a rural rotating practical nursing program, a student incentive grant and relocation assistance, the “Home for the Summer” program and attending job fairs and campus recruitment events across the region.
The Interlake-Eastern region — that regularly fills more than 36 vacancies a month with locum physicians — says University of Manitoba residency opportunities with doctors in the region are generating new physician graduates who stay to work in the region. It is expecting the arrival of six internationally trained medical graduate physicians to the region later this summer.
Smith acknowledges rural living isn’t for everyone, noting the community has seen many international medical graduates (IMG) pass through.
“You can certainly luck out with an IMG — you might get an IMG that falls madly in love with some nurse in the hospital or the gal at the corner store — you never know.”
Rather than rely on luck, the municipality is betting on recruitment.
“You are not just getting anybody and everybody, you are actually getting someone who knows they’re coming to rural Manitoba (and) well aware of the population, the demographics, the proximity to other places like Brandon and airports and the arts and all of that kind of stuff,” Smith said.
“They are coming in with their eyes wide open.”
carol.sanders@freepress.mb.ca
Carol Sanders
Legislature reporter
After 20 years of reporting on the growing diversity of people calling Manitoba home, Carol moved to the legislature bureau in early 2020.