Winnipeg Free Press

Winnipeg Free Press (Newspaper) - February 7, 2025, Winnipeg, Manitoba FRIDAY, FEBRUARY 7, 2025 A4 ● WINNIPEGFREEPRESS.COM NEWS I TOP NEWS NDP misdiagnose heart of health authority audits I F the NDP government was hoping a series of audits of health author- ities would support its claim that bloated bureaucracies are contributing to poor patient care, it didn’t get it. The Kinew government on Wednes- day released the results of three independent audits of the province’s regional health authorities (except Southern Health). The main finding: most, including Shared Health and the Winnipeg Regional Health Authority, are running deficits virtually every year and it’s hurting patient care. But it’s not because of high adminis- trative costs, at least according to the audits. On the contrary, the consulting firm MNP — which audited Shared Health and the WRHA — found Man- itoba’s health authorities have among the lowest administration costs in Can- ada (eighth out of 12 jurisdictions). Shared Health is an exception. It had the highest administration costs in Manitoba as a percentage of total spending, at 8.34 per cent in 2022-2023. One wonders why that level of bureau- cracy even exists when each region of the province already has its own health authority. CancerCare had the lowest ad- ministrative costs at 3.26 per cent of total spending, followed by Prairie Mountain Health at 3.85 per cent. The WRHA’s administration costs were 3.9 per cent of total spending. The provincial average was 5.16 per cent in 2022-2023. That’s not to say there isn’t bureau- cratic fat to cut. I’ve documented sev- eral times in this column how adminis- tration costs at health authorities have ballooned in recent years. Overall, they’re up 41 per cent over the past five years, from $218.5 million in 2019-2020 to $307.6 million in 2023- 2024. As a percentage of total operating costs, administrative spending has in- creased only slightly. It was 4.3 per cent in 2019-2020 and grew to 4.79 per cent in 2023-2024. Still, it is an increase, and the total dollar value is high. But that was not one of the findings in this week’s audit reports. The NDP campaigned on reducing bureaucratic costs in health care and ordered regional authorities last year to cut administrative costs by eight per cent. And while Health Minister Uzoma Asagwara this week reiterated the government’s claim that “bloated bureaucracies” within health author- ities are taking resources away from front-line care, none of the audits made that finding. They found the opposite. “The WRHA has below-average cor- porate services expenses as compared to other (services delivery organiza- tions) and other jurisdictions national- ly,” the MNP report said. The consulting firm even found that board members at the WRHA and Shared Health are underpaid and rec- ommended they get raises to attract more qualified candidates. What the audits did find is that most health authorities have extremely poor budgeting practices, which is the main reason they run deficits almost every year. They routinely and deliberately underestimate costs and overestimate revenues in order to present govern- ment with a balanced budget at the beginning of the fiscal year. They also fail to take into account population growth and changing demographics. As a result, health authorities find themselves short of resources almost every year, the audits found. “Deficits impede the ability of orga- nizations to make the best decisions for patient care, plan effectively for future health care needs and support front- line staff,” MNP wrote in one of its re- ports. “In addition, the ongoing deficits of the SDOs are incompatible with the government of Manitoba’s overall goal of a balanced summary budget by the end of its current term.” The reports made several recom- mendations on how to improve budget- ing, including adopting more realistic revenue and expenditure projections, building contingencies into budgets (which, shockingly, they don’t already do) and using modern software instead of manual entries. “Shared Health lacks appropriate budgeting and forecasting software leading to resource intensive, manual budgeting processes and a lack of standardization,” MNP found. “Man- ual processes reduce time that can be devoted to investigative analysis to support operational decision-making, scenario analysis, and identifying efficiencies.” Also, many health authority board members don’t have financial back- grounds and struggle to provide proper oversight on budget matters, particu- larly at Shared Health, MNP found. “Given the complexities and finan- cial oversight required, we found a ma- jority of board members in key roles do not possess the necessary skills and experience to provide appropriate financial oversight,” the consulting firm wrote. It also recommended that health au- thorities adopt zero-based budgeting, where all expenditures are thoroughly evaluated every year, rather than using budget figures from previous years. The province’s immediate response to the audits was to announce new interim CEOs for both the WRHA and Shared Health. But it’s going to take a lot more than that to overhaul the financial culture at those organizations, many of which have been running deficits on and off for decades. Sweeping changes to how they budget and how they allocate resourc- es are desperately needed to improve patient care. tom.brodbeck@freepress.mb.ca TOM BRODBECK OPINION Shared Health’s future unclear S HARED Health’s financial-plan- ning failures have renewed ques- tions about its existence — the NDP promised during the 2023 election to abolish the agency — but its chair says the board is focused on the future, not the end. A newly released audit exposes the provincial health authority’s record of flouting financial reporting require- ments, poor internal and external com- munication and failing to identify cost savings on a timely basis. “Historically, extraordinary changes in demand have not been managed in a proactive manner and incorporated into financial forecasts once the related costs become apparent,” states an ex- cerpt of a 97-page report compiled by MNP. The auditing firm was contracted last year to understand why Shared Health — which manages the Health Sciences Centre and co-ordinates ambulances, mental-health services and adminis- trative support for regions — regularly operated in a deficit between 2019-2020 and 2023-2024. Among its findings, board members expressed concerns they were too far from decision-making and could not provide effective oversight. Board chair Brian Postl said his team has, for the better part of the last year, been actively adjusting how the provin- cial health authority operates, although he acknowledged “there’s big challen- ges in health care.” Postl was appointed to his current position last winter when the province made a slew of board membership changes at the umbrella organization and commissioned retrospective audits of six health-care entities. “As of right now, we’ve had no indi- cation of merging service delivery organizations,” said Postl, a retired pediatrician and founding chief exec- utive officer of the Winnipeg Regional Health Authority — a job he held be- tween 1999 and 2010. As far as the veteran health-care leader is concerned, the way a system performs overall and how its entities collaborate is far more important than its structure, in and of itself. “One of the comments that I noted (in the audits) was that there hasn’t been sufficient collaboration between the SDOs, and I think that’s correct; I think that’s a major area to focus on,” he said, noting that all recommendations are being reviewed by relevant board com- mittees. MNP completed separate probes into Shared Health and the WRHA. Deloitte was tasked with investigating spending across all remaining regions, except for Southern Health — an outlier in that it has not repeatedly been in the red in recent years. The three reports, each of which are dated last December, were released Wednesday. Minutes beforehand, Shared Health and the WRHA made separate announcements about turfing their respective CEOs. A spokesperson for physicians ad- vocacy group Doctors Manitoba said members see potential for Shared Health to improve front-line care by bolstering recruitment efforts, devel- oping clinical standards and reducing common administrative burdens. “At this point, we aren’t seeing that potential realized. The feedback we hear from physicians is that deci- sion-making has become more central- ized,” the spokesperson said, adding a lack of effective engagement contrib- utes to burnout. Only a third of doctors who partici- pated in the advocacy organization’s 2024 workforce survey indicated they have opportunities to provide input on changes that impact their jobs. Asked Wednesday about whether the NDP is considering merging Shared Health and the WRHA, Manitoba’s health minister said it was “an interest- ing question.” “I remain open to doing whatever is necessary to make sure patients are re- ceiving the best care possible,” Uzoma Asagwara told reporters during a news conference about the audits. Asagwara said the Health Depart- ment’s priority is to make sure the regional authorities and system as a whole have the leadership, capacity and accountability necessary to deliver bet- ter services. Doctors Manitoba said having HSC — the province’s largest hospital — separated from WRHA creates div- isiveness by pitting Winnipeg-area hos- pitals against each other when patients require transfers. “It can be more challenging to move a patient from a WRHA hospital to HSC than it is between two WRHA hospitals,” a spokesperson said in a statement. While the MNP report states deficits impede Shared Health’s ability to plan effectively and make the best decisions for patient care, its recommendations zone in on decision-making processes. One such recommendation would require leaders to propose a list of cost-saving measures equal to three times the reported deficit within 90 days of such disclosures on a quarterly update. The consulting firm also endorsed a zero-based budgeting model that would require managers to justify old, recur- ring and new expenses every year. As for the board’s operations, the re- port suggested mandatory governance training for members, appointee terms be staggered and their stipends be re- viewed and increased. maggie.macintosh@freepress.mb.ca MAGGIE MACINTOSH Board chair keeps eyes on the road ahead, but province has pondered WRHA merger MIKE DEAL / FREE PRESS FILES Shared Health board chair Dr. Brian Postl: ‘There’s big challenges in health care.’ Self-defence claim denied in wrong suite assault AFTER a night of drinking, Liam Bar- ron returned to his Brandon apartment building and fumbled with his keys as he tried to open the door to his suite. When a stranger opened the door from the inside, Barron lunged at the man, grabbed him by the throat and tried to pull him into the hallway. But the stranger was no intruder; Barron had the wrong suite. In a written decision released last week, a judge convicted Barron of one count each of assault and choking to overcome resistance. That Barron mistakenly attempted to enter the wrong suite wasn’t in dispute, said provincial court Judge Shauna Hewitt-Michta. At issue was who as- saulted who. Hewitt-Michta said she rejected Barron’s claim he was acting in self-defence. “No doubt (Barron) subjectively be- lieved the home was his own, but he acted provocatively and aggressively,” she said. “He was persistent. His inten- tions were offensive, not defensive. He wanted in that home. (The victim’s) use of force was measured and appropriate to the threat the accused posed.” Barron, 25, was sentenced to one year of supervised probation and fined $550. The victim lived with his fiancé and infant child in a second-floor suite; Bar- ron lived in a suite directly above them. The victim testified at trial he was asleep on a couch when he awoke to the sound of keys jingling and someone try- ing to unlock his apartment door. The man said he opened the door and told Baron he had the wrong apartment, to which Barron replied: “This is my apartment,” before lunging at the man and grabbing him around the torso. The men grappled with each other as Barron tried to pull the other man into the hallway, the victim testified. Barron grabbed the man by the throat and choked him for 15-20 seconds be- fore the victim’s fiancée came to the door and told Barron he had the wrong apartment. “It was at this point the accused seemed to look at the apartment num- ber, then leave in the direction of a near- by stairwell,” Hewitt-Michta wrote. Barron testified when the man opened the door, Barron asked what he was doing there before the man tackled him into the hallway in a bear hug. Barron said he called out a neigh- bour’s name for help and yelled “fire” hoping to draw someone’s attention. Barron said he tried to push the man away and walk into the apartment be- fore the man took him to the floor and held him down for a short time. He said he managed to break free and ran down the hallway. It was only when he reached the stairwell that he realized he had the wrong apartment. Barron’s testimony was “self-serv- ing” and his alcohol consumption “negatively impacted both his behav- iour and recall of the incident,” Hew- itt-Michta said. “The complainant was in his own apartment…. He just wanted the ac- cused to go away,” Hewitt-Michta said. “The accused wrongly believed there was an intruder in his apartment. He was the one with the motive to instigate the altercation and I am convinced that he did so.” dean.pritchard@freepress.mb.ca DEAN PRITCHARD Educators consider Indigenous identity, ‘pretendians’ at conference HOW should Indigenous people protect their identity, define their identity, and work to prevent “pretendians?” The nuanced question was discussed Thursday at a gathering hosted by the Manitoba Collaborative Indigen- ous Education Blueprint, a collective of post-secondary institutions, school boards, government bodies and In- digenous organizations working toward improving education in the province. Attausikuuluta, which means “work- ing all together” in Inuktitut, was a chance for the groups to collaborate and work to integrate Indigenous ways of learning into their classrooms. “In a way, it’s charting new territory, trying to walk in both worlds and navi- gate that,” said Denise Tardiff, the col- laborative’s manager, at the convention Thursday morning. “It’s definitely ne- cessary, and we learn from each other.” Part of that collaboration comes from a project to create a policy for educa- tional institutions to verify Indigenous identity and find people impersonating that identity for personal gain. In recent years, investigations have led to questions about the Indigenous identity of a number of notable people, including folk singer Buffy Sainte- Marie, former judge Mary Ellen Tur- pel-Lafond and University of Saskatch- ewan professor Carrie Bourassa. Seeing the issue increasingly front and centre in educational institutions and headlines made it clear this was a central issue to address, Tardiff said. “Whether that’s because these things are fashionable for whatever reason, alongside that, (there) are more oppor- tunities,” she said. “With the victories won, there are ac- tually more opportunities for Indigen- ous students, staff, professors, faculty members, all of these things, research- ers … then (impersonating Indigenous heritage) has become an increasing problem. But it’s not black and white.” Looming over the conversation, Tar- diff said, are shifts south of the border. An anti-diversity push by U.S. Presi- dent Donald Trump in part through an executive order ending diversity, equity and inclusion contracting in the federal workforce has resulted in companies pulling their diversity commitments. “I think it reminds us that rights in progress are precarious, and funding could be taken away as quickly as it’s granted,” she said. Advanced education and training Minister Renée Cable, who is Métis, spoke at Thursday’s gathering. She echoed Tardiff’s concerns, but noted in Canada’s push to assert its iden- tity in the face of new U.S. leadership, she believed Manitobans would “be- come even more firmly rooted” in the discussions happening at the gathering. “We’re talking a lot about what makes us Canadian and what makes us strong as Canadians and Manitobans, and part of that is our collective identity, which is rooted in a sense of collaboration, acceptance, belonging and absolutely an acknowledgement of the first people who were here,” she said. University of Manitoba students Jory Thomas-Blanchard and Jonah Harp- er held a panel on Indigenous identity verification and fraud Thursday. Thomas-Blanchard, co-president of the Métis University Students Associ- ation, said the conversation is happening more often with those she speaks with. “You can almost spot it when some- one’s just doing it for their own gain, and that happens, too, when they don’t know their identity and they don’t have the same hardships or experiences that we might have,” she said. Harper, from St. Theresa Point, said such gatherings allow Indigenous people to find solidarity and joy with one other. “You look around, you see people talk- ing, you see people laughing, catching up,” he said. “It’s a nice thing to see.” Attausikuuluta continues today at the Victoria Inn at 1808 Wellington Ave. malak.abas@freepress.mb.ca MALAK ABAS ;