May 3, 2017

Doing more with less

The shoe didn’t drop on budget day. But that doesn’t mean it won’t.

New budget details released by the Department of Finance shows the regional health authorities have to find $20 million in savings this year.

Factoring in the health budget only increased by 1 per cent, despite inflation sitting at 3 per cent, and that $20 million in cuts actually gets much higher.

Finance Minister Cathy Bennett has repeatedly said government continues to look for “efficiencies” and is “working on a culture of spending.” I can’t argue with finding efficiencies. Given the economic outlook, the province has no choice.

But when it comes to health care, the notion of doing “more with less” is like waving a red flag.

In an interview with James McLeod, political reporter with The Telegram, Premier Dwight Ball said, “We’re going to keep the level of health care spending where it is.”

He wasn’t just talking about this year. This budget. He was talking about the next six years and government’s plan to return to surplus in 2022-23.

Given our aging population and increased demands on our health care system, this plan essentially means six years of cuts to health care.

The Registered Nurses’ Union recognizes government has tough decisions to make on spending, but there are some important truths we simply cannot ignore.

Regardless of our fiscal situation, the basic needs of the people of our province need to be met. This is particularly true when it comes to a person’s health.

The fact is demands on the health care system are increasing, not decreasing.

We have an aging population. A population with a lot of sick people. Our province has some of the highest rates of cardiovascular disease, obesity, and diabetes. Over half of Newfoundland and Labrador residents aged 12 years and older have at least one chronic disease; many people live with more than one.

Patients are coming into the health care system sicker and with more complex needs. Treatments have become more intricate and technology has expanded. Many patients who are cared for in our intensive care units would not have survived their illness 15 years ago. Residents in our long-term care system face more demanding health challenges and require advanced care and treatments. Early discharge means people are recovering in their homes, which increases demand and complexity of home and community care.

The challenges to deliver quality patient care continue to grow. Yet, we already have a work environment where inadequate staffing is the norm. Overtime for registered nurses and other providers is costing the system millions of dollars each year.

It’s hard to fathom how the province feels we can do more (or even the same) with less for the next six years and not negatively impact patient outcomes.

If you speak to a registered nurse today they will tell you they cannot do more with less. They will tell you hospitals operate at over-capacity on a regular basis, patients wait on stretchers in emergency rooms or hallways because there is no bed for them, and residents wait too long for essential care.

Staffing in long-term care facilities is paper thin. The needs of our communities continue to expand, yet the resources do not keep up. Often, health promotion and illness prevention are pushed to the backburner.

Registered nurses will tell you their ability to provide the highest level of care is being compromised. They will tell you patients are already put at risk due to short staffing.

Health Minister John Haggie says he wants better health outcomes.

Significant research studies demonstrate you won’t get better outcomes by cutting registered nurse positions.

When appropriate registered staffing is not in place, changes in patient conditions are missed, pain medications and treatments are delayed, basic care suffers and the risk of patients dying increases.

We may not have been hit hard on budget day, but I have no doubt the shoe will drop. It may not be a big steel-toed boot. I think we’ll see little slippers dropping here and there – reduced service hours, clinic closures, service consolidations, layoffs, and choosing not to fill vacancies.

For certain, these cuts will be felt by patients. They will also be felt by registered nurses and health care providers.

We are watching. And we will push back if patients are put at risk. Because even the drop of one slipper can hurt.

Debbie Forward, RN
Registered Nurses’ Union Newfoundland & Labrador