Overdoses a huge concern for SHA
The Saskatchewan Health Authority Is The Biggest Employer In The Province’s History And The Second Largest Health System In Canada. It Faces Several Long-term Challenges. Reporter Pamela Cowan Spoke With Ceo Scott Livingstone About Some Of Them.
Q Since the new health authority was formed there has been a reduction from 120 senior positions across all health regions to the current 56 executive directors, nine vice-presidents and the CEO. What cost savings have been achieved?
A The government’s desire to move to a single health authority, and the advisory panel’s recommendation, was to reduce the administration footprint and the government’s footprint. That includes taking 12 boards of directors down to one and 12 executive leadership teams down to one. It’s a single leadership team that’s spread throughout the province ... We’re still projecting $9.7 million savings annually for the health-care administration reduction.
Q Some executive directors are physicians. What was the rationale behind that decision?
A We know high performing health systems have physicians at the helm ... They work side by side with other folks directly impacting decisions around strategy and operations. Creating those physician executive roles across the SHA was viewed as critical to us in the new structure ... We started at the most senior levels of the organization, but we hope to drive that dyad partnership, the partnership with a physician executive and another health administrator leader, throughout the organization as our organizational structure continues to evolve.
Q A number of Saskatchewan communities have dealt with fentanyl-related drug overdoses over the past month. What actions are the SHA taking to keep residents and staff safe?
A This is a complex problem ... It’s not unique to our province and the province has a strategy that was created under 12 RHAs and under the Mental Health and Addictions Action Plan. That plan is still in place ...
AOne of the advantages of having the SHA is that we can put it to a provincial lens and work together to eliminate some of the variations in how we’re managing this problem ... In Saskatoon, through multiple partners like the Saskatoon Tribal Council, we train folks five days a week on using naloxone kits. I think in Saskatoon we have over 600 people trained. In Prince Albert, they’re doing the same things with their community partners — I think they’ve trained over 300. Those are two really good examples of how we’re trying to bring our community partners together and expand access to naloxone, but it’s also other training. It’s making sure that after those folks have the naloxone or (are) attended to medically, then we bring them into the system to address some of those underlying problems that are leading to this outcome ... This is a very high priority for the organization and it will continue to be in the next few years because we know it’s something that isn’t going to be solved overnight.
QAs part of the transformation of health care, six geographic areas have been created. Does this duplicate the role of the 12 dissolved health regions?
ANo, it doesn’t. With the recreation of the system in moving under a single leadership team, one of the things that we heard from other jurisdictions who have gone before us is the importance of maintaining those links to local communities and also to be able to provide that provincial oversight ... The areas are not independent entities and they have no independent authority because they’re all reporting up to a single structure.
QIn August, the Saskatoon Health Region had a projected $34.3-million deficit while the Regina Qu’Appelle Health Region was sitting at around a $5.8-million deficit. What is the financial picture for the SHA at this point? (According to SHA officials the year-to-date deficit is $17.8 million as of the end of December. The SHA is forecasting to be close to a balanced position by the end of the fiscal year.)
AWe’re in better shape than we were before and one of the reasons is we’re bringing 12 different financial pictures together. Although Saskatoon and Regina were running deficits, not all the RHAs were so we’ve been able to offset some of those structural deficits that Saskatoon and Regina have been facing because of the pressures they’ve been under with some of the other budget surpluses that have existed in other RHAs ... We’ll have lots of work to do to continue to work towards bringing more efficiencies to our system ... Some of the areas that you will see the SHA focusing on in the years to come are appropriateness of the services we’re providing as well as addressing some of the variation we’re seeing in access to care but also in how people are being provided care.
QTo achieve efficiencies, do you expect job loss?
AAt the out-of-scope level there’s been significant job loss ... We will be evaluating each and every position for their applicability to our new structure and the needs of the organization so to say there won’t be job loss, that wouldn’t be truthful. There will be. But do I think there will be whole-scale change at the front lines? Absolutely not.
QIt’s assumed the provincial budget will include austerity measures to ensure the budget is balanced by 2019-20. What are your expectations for funding for the SHA?
AThere’s hope and there’s reality ... Understanding where we are as a province, understanding where health care is in the grand scheme of things, with provincial budgets we often represent over 40 per cent of our total spend, bringing the organization under one envelope will certainly bring efficiencies to our system, but that doesn’t take away from the pressures the system is facing particularly around an aging population and multiple chronic diseases ... I think for sure we’ll see some things in mental health and addictions because it’s such a burning pressure.