Let's focus on original vision of wellness reform

I read Murray Mandryk's May 11 column on the role of primary care, including nurse practitioners, as a key pillar of the 1993 wellness reform with considerable interest.

My late father, Duane Adams, was deputy minister of health from 1992 to 1997, and I believe he would have taken some solace in the acknowledgment that the primary care model — with its emphasis on community-based, preventive health care — can better serve the health needs of Saskatchewan.

At the same time, the ongoing politicization of the decision to convert the 52 rural hospitals to wellness centres, has grown incredibly tiresome.

If we are going to embark on a history lesson, then let us be clear: The decision on hospital closures was not a political one, but a fiscal one. No government would have endured that painful decision in absence of that context.

The reality is that the province was bankrupt and literally facing federal receivership. This fiscal crisis was further exacerbated by federal off-loading from the Chrétien Liberals who reduced health transfers to the provinces.

According to the public accounts, the only time the provincial health budget went down in the last 50 years was in 1992-93. If historians or politicians are to continue to characterize the decision as a political one, then at least acknowledge the true context for the decision.

As Mandryk points out, in 15 years the current government “hasn't found viable reasons to reopen any of those closed rural hospitals.” Most credible scholarship has confirmed that the decision was correct from a health services utilization perspective, and that there has been no negative effect on broader health outcomes.

If one were to look for evidence of politics, consider the legacy of “overbuilding” capacity in rural Saskatchewan in the mere fact that Saskatchewan has 771 municipalities, whereas Ontario, with a population 13 times greater, only has 444.

After 30 years, it is time to move on from the politics of division and focus, again, on the original vision of wellness reform. This should include a renewed focus on many critical POST-COVID needs such as long-term health care, mental health and addictions, and supporting innovative community-based primary care.

Christopher R. Adams, Regina