Province’s plan to reduce spending worries unions about future quality of care
Unions in Nova Scotia are concerned about the province’s plan to reduce health care costs by sharing some administrative and support services.
The initiative is one of four projects launched by the provincial health ministry aimed at finding efficiencies. It would see nine district health authorities and the IWK Health Centre in Halifax share a range of administrative, support and clinical services, according to Pat Lee, CEO of Pictou County Health Authority and the CEO executive sponsor for the initiative.
“We’re motivated by the need to operate within our means,” he says, adding that the Nova Scotia government has set a larger goal of getting its finances “back to balance” across the board.
The province currently spends more than $243 million a year on 13 areas within administration and support services, including library services, health records, laundry, payroll, and information technology, among others.
It will be up to a consultant to determine which six areas can provide the greatest efficiencies and to implement a plan for improvements and savings.
CUPE, which represents 4,600 workers in these areas, is concerned about what this could mean for them.
“What if the consultant recommends eliminating laboratory services or puts them under one umbrella?” says CUPE president Danny Cavanagh.
The DHAs and IWK Health Centre already share some services, including a single purchasing organization to improve buying power. Other provinces, such as New Brunswick, British Columbia and Ontario, have also implemented shared services.
While Cavanagh said there have been no job losses so far, the union is concerned about the impact of a larger-scale program.
“Anytime we see a government using terms such as ‘alternate service delivery,’ it raises the threat of privatization and contracting out of services and jobs,” he says.
The Nova Scotia Government Employees Union (NSGEU), which represents 12,000 health care workers in the DHAs and IWK, is equally concerned.
“We have no problem in general with any initiative to improve the quality and effectiveness of our members’ services,” says NSGEU president Joan Jessome. “But we do have serious misgivings if any review of these services includes the possibility of contracting out and privatization.”
It’s too early to determine the impact of shared services, according to Lee, but he did not rule out potential job losses.
“We will carefully consider the expert advice of the consultants on the impact on employees and maintaining jobs across the region,” says Lee.
The request for proposal was issued last month. The unions say they were not consulted nor have they been asked to make submissions to the consultant.
“Sometimes they need to ask the people who work on the frontline how to create efficiencies,” says Cavanagh. “I can’t see CEOs throwing administrators under the bus. When you cut from cleaning staff or food services you don’t get better service.”
His concern is shared by Jessome.
“We have to question the value of bringing in yet another outside consultant,” she says. “Why can’t the DHAs and IWK work with health care unions to consider where improvements and cost-savings can be achieved?”
Lee said the unions would be consulted later in the process.
“Provincially and locally there have been discussions with the unions to let them know we are requesting a third-party examination of services,” he says. “Once we have a full report we will have further discussions with all of our partners.”
The consultant’s report is expected by the fall.
