'Definitely a surprise': Urgent-care changes caught Misericordia president off guard

A chorus of medical and an administrative professionals have been saying for months that they were blindsided by broad changes to Manitoba's health-care services announced in the spring, and it appears the higher-ups at Misericordia Health Centre also didn't see the changes coming.

"This was definitely a surprise to us," Misericordia president and CEO Rosie Jacuzzi wrote in an April 10 memo to staff. "We thought we'd be helping other ERs transition to urgent care centres, not closing ours."

The memo, one of several obtained by the NDP, was sent out three days after the Winnipeg Regional Health Authority unveiled plans to close three emergency rooms and convert the Misericordia's 24-hour urgent care centre into a community intravenous therapy clinic, among other changes.

Premier Brian Pallister's provincial government has told the WRHA to bring its budget down by $83 million for the 2017-18 fiscal year. Many of the WRHA changes are related to recommendations Dr. David Peachy made in a report, as well as findings from a KPMG study. 

In the memos, Jacuzzi goes on to raise doubts about whether the changes will improve the health-care system, saying she worries about what will happen to the more than 11,500 patients served through Misericordia's urgent care centre annually. 

In a section titled "concerns and reservations," Jacuzzi highlights the Misericordia's history of serving people from marginalized communities who live in Winnipeg's core.

"Closing [urgent care] will mean our most vulnerable patients will seek care at [Health Sciences Centre], which is already over capacity," Jacuzzi writes.

She also notes concerns over what will happen to the roughly 4,500 patients every year who visit Misericordia's eye care clinic for specialized services.

WRHA defends changes

"We did not consult with the sites around any of the changes because we relied on our clinical experts to do that and to give us the advice," Réal Cloutier, interim president and CEO of the Winnipeg Regional Health Authority, told CBC Radio's Up To Speed.

"If you go and ask people, 'Do you want to change what you're doing?' I think the answer would be pretty self-evident," he said.

"While we recognize that this is a difficult change for Misericordia, we had to make sense of the clinical recommendations that were coming forward by our experts."

He defended the changes, including the decision to close Misericordia's urgent-care centre, saying patients will be better served by consolidating services.

"By grouping our patients together in a different way we believe we're going to get better value for patients," he said. "We're going to improve patient care and patient flow, and we're going to be able to do that managing with the dollars that we have in a more effective way."

Manitoba health critic Matt Wiebe, MLA for Concordia, said the memos reveal a deepening distrust among health-care professionals that the changes will make things better.

"What we're hearing from these front-line workers, and from the leadership of the hospital as well, is that, you know, their main concern is patient care and they're not seeing this government fulfilling that obligation," Wiebe said.

"They're making these cuts to meet that target, they're not making the cuts to improve patient care.

"What we've now heard from Misericordia is that they don't see how these changes are going to improve patient care and they don't understand the rationale."