If health officials across the province are being told by the provincial government to cut bureaucratic spending by eight per cent and redirect that money to front-line care, that would probably be a good thing.
The problem with cost-cutting exercises like these, though, is the official edict from government is not always what occurs on the front lines of health care.
Manitoba Nurses Union president Darlene Jackson said this week nurses have been told new cost-cutting measures from the NDP government are on the way that could affect staffing levels, including nurse-to-patient ratios. Government has confirmed there’s a plan to tighten the purse strings but says cuts will come solely from the bureaucracy.
According to the government, the directive is for Shared Health to chop eight per cent from its bureaucratic spending and redirect those resources to clinical services.
That would not necessarily be a bad thing, especially if it’s applied across the board, not only to Shared Health (which runs or oversees much of the health-care system) but to all the regional health authorities in Manitoba, including the Winnipeg Regional Health Authority.
Shared Health follows the Canadian Institute of Health Information guidelines to calculate administrative costs. It’s broken down into three categories: corporate, patient care-related and human resources and recruitment. That applies to Shared Health, the province’s five regional health authorities and CancerCare Manitoba.
The administrative costs for all those entities together in 2023-24 was $307.6 million, according to Shared Health’s 2023-24 annual report. That is 4.79 per cent of total operating costs, Shared Health reports.
If Shared Health, all regional health authorities and CancerCare cut their administrative costs by eight per cent, that would free up $24.6 million for front-line services.
Sounds like a decent plan on paper. It would be consistent with what the NDP promised voters during last year’s provincial election — to redirect bureaucratic spending to front-line care, including hiring more doctors, nurses and other staff.
Administrative costs in health care have grown significantly in recent years. They’re up a staggering 41 per cent over the past five years, from $218.5 million in 2019-20 to $307.6 million in 2023-24.
As a percentage of total operating costs, administrative spending has not increased much. It was 4.3 per cent in 2019-20 and grew slightly to 4.79 per cent in 2023-24. Still, it is an increase, and the total dollar value is excessive.
So an order from government to scale that back and redirect those resources to front-line care would seem prudent.
But is that what’s truly happening? It’s unclear.
The MNU says it’s hearing a different story on the front lines.
“At the end of the day, it doesn’t matter whether the government says, ‘This has to come from bureaucracy,’” the MNU president said. “The message has sort of filtered down from the executive team in the region to nurses through directors, through managers, that there is definitely a look at how savings can be achieved.”
If what government is saying is true, that it’s limiting spending cuts to the bureaucracy, it would be different than the type of cuts implemented by the former Progressive Conservative government. The Tories under former premier Brian Pallister ordered widespread operating cuts to regional health authorities, which filtered down into many areas of health-care delivery and resulted in staffing cuts.
So the question becomes: what specifically is the new spending-cut directive and how will it be implemented? If what the MNU is saying is true, the edict is either broader than what the NDP government is admitting, or regional health authorities are not following orders properly.
All of this presents a significant political problem for the NDP. No matter what the truth is behind the proposed spending cuts, the narrative will be that the NDP is cutting health care, just like the Tories did.
This could have been managed better, starting with how the information was made public.
Government should have made an official announcement that it was directing the health-care system to reduce its administrative costs. It should have done so with representatives from Shared Health and the WRHA, and announced specifically how the edict would be carried out. It’s important to take control of the message when implementing spending cuts of any kind.
Instead, the NDP issued a directive internally and allowed others, including the MNU, to set the narrative. It’s another rookie mistake by a new government.
Either way, the NDP government will have some explaining to do in the coming weeks and months, especially when hospitals start filling up with respiratory-illness cases this winter, and more patients admitted to hospital are waiting days in emergency departments.
New information was released Tuesday by Doctors Manitoba warning that widespread ER closures in rural and northern Manitoba will severely affect patient care over the holidays.
The political errors are starting to pile up for this government.
tom.brodbeck@freepress.mb.ca
Tom Brodbeck
Columnist
Tom Brodbeck is a columnist with the Free Press and has over 30 years experience in print media. He joined the Free Press in 2019. Born and raised in Montreal, Tom graduated from the University of Manitoba in 1993 with a Bachelor of Arts degree in economics and commerce. Read more about Tom.
Tom provides commentary and analysis on political and related issues at the municipal, provincial and federal level. His columns are built on research and coverage of local events. The Free Press’s editing team reviews Tom’s columns before they are posted online or published in print – part of the Free Press’s tradition, since 1872, of producing reliable independent journalism. Read more about Free Press’s history and mandate, and learn how our newsroom operates.
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