WRHA sharpens budget scalpel
Health body must cut deeper to find $83M in savings
O find the $83 million in annual savings necessary to balance its budget, the Winnipeg Regional Health Authority is planning cuts that are valued at more than $91 million annually.
It’s an unfortunate reality of having to cut a budget partway through the fiscal year, says Mark Jones, a partner with Olafson & Jones, a chartered professional accountants firm in Winnipeg: you can’t unspend what’s already gone, so steeper cuts in what remains of the year are required to meet the new target.
That’s the case for the WRHA, which didn’t receive approval for the vast majority of its service-reduction proposals until early July.
And yet, not accounting for inflation, the WRHA would be looking at annual savings of $91.7 million, rather than the provincially mandated $83 million, if it were to keep the cuts enacted this fiscal year into 2018-19.
This raises the question: which clinical and administrative services were subjected to steeper cuts in order to meet this year’s target, and does the health authority plan to reverse or adjust them?
The WRHA won’t say.
The authority “continues to work towards achievement of the $83-million target,” interim chief executive officer Réal Cloutier said in one of several statements this week that did not answer questions about how deeper service
Tcuts might be adjusted for the next fiscal year, if at all. Cloutier declined an interview with the Free Press. “It’s a great question,” Jones said. “Because sometimes a budgetary cut will be, ‘OK, look, we can manage to work everybody a little bit harder and do without this thing as part of a program for six months, but it can’t be an indefinite savings.’”
In some cases, he said, it can be fairly obvious what cuts are being made as a “permanent savings.”
For programs such as outpatient physiotherapy and occupational therapy, it wouldn’t make financial sense to shutter the program late in the fiscal year for savings of $1.5 million if the plan were to reopen the program later. (It is unclear, however, whether the $1.5 million the WRHA plans to save this fiscal year from closing the as-yet-stillopen program will be realized — and how much it will save each full fiscal year moving forward).
Meanwhile, halfway through the 2017-18 fiscal year, many proposed clinical cuts have yet to be approved or realized across the province.
Health Minister Kelvin Goertzen has indicated he’d rather the rural regional health authorities miss their targets than approve cuts before analyzing their probable impact from a provincial scope, but he’s offered no similar assurances on behalf of the WRHA.
“We expect the regions to manage within their budgets and are confident that all regions are carefully monitoring their progress in this regard,” Goertzen’s spokeswoman said in an email.
The spokeswoman said $6 million worth of proposed WRHA savings — that have yet to be approved — has gone before Shared Health Services Manitoba, because the impact of these cuts could affect the provision of health care across the province.
Because of that, the WRHA says it has identified an additional $6 million worth of potential savings in order to still meet its target — including further reductions to overtime and “other support cost areas.”
It’s unclear whether those will be clawed back should the original $6 million in proposals under review be approved.
In a statement, Cloutier said the WRHA also found an extra $4 million in savings initiatives after it realized $4 million of its original cost-reduction plans wouldn’t be realized until 2018-19. It’s also unclear whether those will be clawed back next fiscal year.
The WRHA describes the newly found $10 million in savings as nonclinical in nature and includes practices such as reducing overtime.
“Manitobans are finding out more and more that it’s all about the money with this premier, this health minister,” Opposition health critic Andrew Swan said. “They are focused on forcing others to reach the bottom line, without worrying about what impact it has on patient care.”