Physicians to have active role in new health authority, CEO says
As the provincewide transition from 12 health regions to one Saskatchewan Health Authority (SHA) approaches on Dec. 4, CEO Scott Livingstone is leaning heavily on lessons learned by other provinces that have made a similar change.
Nova Scotia, which made a switch two years ago, was especially helpful in pointing out possible pitfalls in creating a mammoth organization, Livingstone said.
“We’re creating the single biggest employer in Saskatchewan history with 43,000 employees and we’re bringing 12 organizations into one. So lesson No. 1: ensure everybody knows who they’re reporting to ... in advance of Day 1,” he told reporters at the fall gathering of the Saskatchewan Medical Association (SMA).
The second lesson is to build provincial structures, through legislation and provincial standards, early on, he said.
Since February, teams across the province have been identifying differences among the regions in every aspect of the business — from finance to facilities management — and mapping them to a single provincial system, such as a chart of accounts or a single provincial standard, Livingstone said.
“On Day 1 we will be able to operate under a single authority bringing those 12 regions together as one. But that’s not the end, it’s the beginning. Building proper structures will take months and years.”
The health region amalgamation was driven in part by the government’s desire to reduce the amount of administration and governance in the system, which currently includes 12 CEOs, boards of directors and sets of vice-presidents, Livingstone said.
“The belief is the old structure was creating barriers for clinicians, staff and patients to receive proper care in a timely fashion.”
The single structure will ensure patients flow across the system seamlessly in a way that provides better, more integrated care, he said.
Dr. Joanne Sivertson, president of the Saskatchewan Medical Association (SMA), said doctors are concerned that moving to a single health authority may diminish the voices of patients and physicians outside the major cities.
The new health authority will be guided by community advisory networks that won’t simply represent different geographic regions; advisory networks co-designed with communities will represent program areas such as mental health, palliative care, cancer, First Nations and Metis health, Livingstone said.
“We’re reducing CEOs and boards by 86 per cent so there will be central strategy ... but we have to enable the system to have decisions made as close to the point of care as is possible or we will paralyze the system.”
Doctors will have an active role in transforming Saskatchewan’s health-care system, alongside seasoned administrators in operations and finances, he said.
“Every high performing health system in the world is recognized that having physicians in the executive leadership roles is critical to the success of the organization.”