Sask. health-care workers want to have a say in how cash infusion from Ottawa should be used

Health-care workers across Saskatchewan want to have their voices heard when the province begins distributing the federal health-care funding announced on Wednesday.

According to the agreement in principle, Saskatchewan will receive a one-time infusion of $61 million and an additional $111 million annually over 10 years in health-care funding. 

Dr. Andries Muller, president of Saskatchewan's College of Family Doctors, says about one in six Saskatchewan residents currently don't have a family doctor, which is leading to longer wait times in the province's emergency rooms and walk-in clinics.

He would like to see a significant portion of the federal funding go toward restructuring the way primary care is delivered in the province.

Muller co-authored an op-ed titled 'Physician-led, team-based care is the path to better access for patients,' with Dr. John Gjevre, president of the Saskatchewan Medical Association.  

Muller says a team-based care model would allow family doctors to have a team of medical practitioners such as nurses, pharmacists and social workers at their clinics to complete tasks that don't necessarily require a family doctor's expertise. 

"Not everything that a patient presents has to be dealt with by a family doctor," Muller said. " For example, flushing wax out of the ear: If you have a good office nurse who can do that, that frees up the family doctor to deal with more complex patients.

"Maybe if I see them early enough I can prevent them from having to go to the emergency room."

Team-based care

 Muller says a transition to a team-based care in clinics would allow family doctors to see more patients.

"We did a rough calculation the other day: If we could have a social worker, a nurse practitioner, pharmacist and maybe a physiotherapist, we [family doctors at Muller's clinic] could probably each take on five to 10 more families in our practice," Muller said.

"If you roll that out to the whole province that can be a significant improvement in care to patients."

Glenn Murray, a pharmacist and the co-owner of Legends Medical Clinic in Warman, says incorporating nurse practitioners into the physician's practice could shorten lengthy wait times at his walk-in clinic.

"The walk-ins continue to fill up with orphaned patients — those who had a family doctor for years and lost them now," Murray said. "We are talking about thousands of patients in the local area in Saskatoon.

"It's overwhelming to the entire system. It's scary."

Murray currently has three physicians at Legends Medical Clinic, but says two might leave shortly.

"Warman has no doctors except the ones in our clinic," Murray said. The recruiting has been done specifically and singularly by us alone."

Murray says he's asked the provincial government to be reimbursed for the clinic's recruiting efforts, but hasn't received a response.

Muller believes a shift to team-based care could result in fewer family doctors leaving the province. 

"It would be beneficial if we can alleviate the overwhelming stress from the current practicing family physicians, then they're more likely to stay," Muller said. 

Retaining nurses is key: union president

Tracy Zambory, president of Saskatchewan's Union of Nurses, says the provincial government should focus on retaining the province's nurses 

"There is not a tertiary facility, regional facility or a municipality that has not been profoundly affected by the nursing crisis in this province," Zambory said. "If we don't retain the late- to mid-career nurses, it won't matter how many nurses that we bring in."

Zambory says that experienced nurses are important in building up confidence in new nurses so that they remain in the field. 

"They're saying 'I did not sign up for this. I did not sign up for having no leadership, to being treated the way I'm treated, to putting my career on the line feeling like I can't give safe care,' " Zambory said.

Zambory says the province's nursing shortage is creating longer surgical wait times, busier emergency rooms and affecting patients' medical outcomes.

She says she would like some federal money to be used to create a provincial nursing task force that focuses on keeping nurses in Saskatchewan. 

"If we don't have enough registered nurses to actually give care, there's no possible way that we're going to be able to improve on anything because there isn't enough staff to do it," Zambory said. 

Saskatchewan Health Minister Paul Merriman said Wednesday part of the $61 million will go toward additional spaces in nursing schools.

Where is the rest of the money going?

Health Canada says the $61-million immediate investment will "address urgent needs, especially in pediatric hospitals and emergency rooms, and long wait times for surgeries."

Merriman called  the agreement "a positive step that will accelerate and enhance work already underway."

"Saskatchewan continues to make record investments into the health-care system to address key priorities such as reducing surgical backlogs and wait times, and expanding access to mental health services," Merriman told reporters on Wednesday.

Besides the one-time $61-million funding injection, Merriman said, the federal government has set support goals for the province to reach specific sectors, such as mental health and addictions, primary care and seniors care.