Health unit may have to reduce programs

Following an operational review report released in November, and a dwindling budget, the Northwestern Health Unit is being forced to look at reducing programs in 2002, CEO and Chief Medical Officer Dr. Pete Sarsfield said Monday.
“We have to keep on doing many things within our budget. And as a result of that, we’re going to have to stop some of the 80 percent of mandatory programs we’ve been delivering,” he noted.
“What usually happens in an area which sees these kinds of financial restrictions is the smaller communities are hit first,” Dr. Sarsfield remarked.
“I’d rather hit the larger ones first. They’ve always debated they pay more to the health unit, and have more voices and political clout,” he added.
“Possibly, in the next two to three years, if we don’t get more funding, we’ll have to close offices in Emo, Rainy River, and Atikokan as well as up here,” he continued.
But even if the situation doesn’t end up needing such drastic measures, Dr. Sarsfield said the health unit is looking to tailor some of its services to specific communities.
“We are going to be speaking more with the communities. ‘What can we do without?’ [is a question] Fort Frances is going to answer [differently] than Sioux Lookout,” he remarked.
“If we can adjust our services to the different communities, we can give them only what they really need,” Dr. Sarsfield reasoned.
In 2001, it cost around $7 million to deliver about 80 percent of mandatory public health services in the Northwestern Health Unit. Although the health unit had a balanced budget last year, increases in salary and operating costs are expected to cause a deficit of about $125,000 in 2002.
At the same time, the Ministry of Health expects 100 percent compliance with mandatory programs—and the incremental cost of this increase in service is estimated at more than $1 million.
“We are going to continue to try and attain adequate funding this year,” Dr. Sarsfield said. “But we’re not going to look to the municipalities for it—I’ve banged my head against that wall before.
“It’s the government who wants us to do more and more with less and less. So it’s the government, on both the provincial and federal level, I’m going to be taking on,” he stressed.
Despite funding restrictions, Dr. Sarsfield said the health unit is not lowering its sights on promoting public health care.
“One thing I’m really trying for is to encourage municipalities and employers to respect the public right to be free from second-hand smoke,” he remarked.
“Workers have the right to be protected from second-hand smoke. You can’t just say, ‘If you don’t like it, get a job somewhere else,’ to employees who are forced to work in smoky conditions,” he noted.
“We don’t deal with other occupational hazards that way.”
Dr. Sarsfield added he’d also like to see an increased emphasis on environmental concerns like safe food, clean water, air pollution, and chemical spills.
The health unit board and its administration also will have to work on their relationship after the operational review noted the health unit has suffered as the relationship between Dr. Sarsfield and the board deteriorated, with the board turning its attention to cost control and involvement in administrative and operational detail.
Governance responsibilities, including strategic management of the health unit and directing Dr. Sarsfield, were either unsuccessful or ignored.
The consultants have recommended, among many things, that the board and Dr. Sarsfield should negotiate the terms of their working relationship; refrain from interfering in the operations of the health unit; undertake board development training; and ensure municipal appointees are residents of their communities, but not elected officials who could pose a conflict of interest.
“Unless we can see these recommendations as blatantly wrong, we’re going to treat them as if they’re right,” said Dr. Sarsfield.