Faced with a growing crisis of health care, finances and accountability, the NWT department of Health and Social Services is proposing sweeping system-wide reforms that would see current regional health authorities amalgamated into one central NWT health authority.
Health Minister Glen Abernethy, who is touring the territory to talk about a new structure for the NWT health system, was in Fort Smith to present to healthcare professionals and the public last week.
On the table for discussion is a proposal that would move away from the current system, broken down into eight separate health authorities working in isolation of one another, and towards an integrated territory-wide authority guided by a council formed of representatives from all the regions.
“This isn’t a final structure, and I don’t want anyone to think that we’ve already made up our minds because we haven’t yet. But based on everything that we’ve heard to date…there seems to be a lot of support for moving towards one health and social services system in the Northwest Territories,” Abernethy said.
The proposed organizational flow would see the minister at the top along with MLAs and Aboriginal governments. Below that level, the department and a health and social services leadership council, composed of chairs from all the regional wellness councils (health boards), would advise the authority on its work.
Though on the surface it may seem like centralization, Abernethy said regional representation at the leadership level will ensure all communities have a voice in the system.
“Sometimes when you talk about going to one system, people get a little panicked because they’ve invested a lot of time in making sure that they have a regional voice, and they don’t want to give up that voice,” Abernethy said. “We’re not talking about going to a superboard. We’re not talking about taking any regional autonomy and abilities to provide guidance and advice to the system away. But we are going to change things.”
At the fore of the push for change, Abernethy said, is a renewed focus on client-centered care. Right now, he said, there are too many bureaucratic barriers to improving healthcare for individuals in the NWT due to the way authorities are arranged in silos. The result has been too many individuals falling through the cracks, scathing reports by the auditor general highlighting a lack of accountability, and a system that won’t be affordable in the long term.
“This is about the sustainability of our system. If we keep providing services the way we’re providing them today, we’ll basically price ourselves out of the ability to provide any services at some point,” the minister said.
“We need to control growth, we need to understand the pressures that are forcing growth, and we need to work together as authorities so we can address issues as they come at us as a larger body, which gets us more economies of scale and hopefully flexibility to deal with issues.”
Rather than working together in the current system, Abernethy said authorities are competing with each other for limited human resources – some more successfully than others. As a result, care is not being delivered equally across the territory.
Similarly, a lack of clinical standards across the board means patients are not getting the same care in every authority, let alone every community, which he said is unacceptable.
By creating a single NWT health authority that is guided by leaders from each region, Abernethy said communities will be able to share resources, remove duplication of personnel and combine their purchasing power for better deals on supplies and equipment, both improving care and controlling expenses.
Furthermore, having a more centralized operation will limit the problems of miscommunication associated with medical travel, patients’ medical records and continuity of care, Abernethy said. As well, regions would finally have a say over the Stanton Health Authority, which serves all residents of the NWT but doesn’t hear from them.
“To me and the group of individuals working on this, the most important part of our guiding principles is that everything has to be focused on the patient,” Abernethy said. “It must improve or support individuals in the families to stay healthy. And we must have equitable access to services across the Northwest Territories.”
A discussion paper on the proposed reforms is now online on the department’s website for public review and comment. Abernethy said the department hopes to be ready to put forward proposed legislation in February and to have that legislation passed by May or June so the new system can go live in April 2016.