MHPAC 2023 Electoral Questionnaire
ARNM is one of multiple partners in the Manitoba Health Professional Associations Coalition (MHPAC). Along with Dentists, Dental Hygienists, Pharmacists, Chiropractors, Physiotherapists, Occupational Therapists, Massage Therapists, Psychologists and Athletic Therapists. Earlier this year, we asked the 4 major parties 5 questions, and we are pleased to share their answers with you.
What and who do you see as part of the publicly funded health system across Manitoba?
Green Party of Manitoba: We see the very wide spectrum of individuals, professions, and institutions as essential parts of the publicly funded health system. This begins with individual Manitobans, both patients and patients’ family members, who are at the very heart of healthcare. Next are the healthcare professionals, across the entire range of expertise areas and specialties, including nurses, therapists (physical, occupational, respiratory, psychological, etc.), physician assistants, pharmacists, dietitians, social workers, dentists, physicians, technicians, aides, and trainees. Institutions and organizations, including small clinics, hospitals, government departments and agencies, and research and training centres at our Universities and colleges, as well as our public K-12 schools, play key parts in our publicly funded health system.
Manitoba NDP: We are proud of Manitoba’s public health care system and believe it needs to be strengthened and supported. For many years under Brian Pallister and Heather Stefanson’s PCs cuts and privatization have eroded our public health care system. Most worryingly, we have seen repeated violations of the Canada Health Act, the cornerstone of our public health care system. We believe a different approach is needed. Manitoba’s publicly funded health care system includes a diversity of health workers and professionals providing care to patients work within our hospitals, health centers and community clinics. We believe in expanding support for public health care and working with community partners and agencies to make that a reality.
Progressive Conservative Party of Manitoba: The importance of our publicly funded health system cannot be overstated, and that is why our government has invested almost $2 Billion more per year than the NDP ever did. That is building both physical and staffing capacity, because the health system is not just beds and equipment, it is Doctors, Nurses, Allied Health Professionals, dedicated admin and support staff, healthcare is a team effort. We are committed to ensuring all Manitobans have access to the care that they deserve.
Manitoba Liberal Party: We see anyone who is receiving public funds to provide care or service in our health care system as part of the public system – Hospitals, clinics, EMS, physiotherapy, doctors, nurses, health care professionals, labs and support teams – and at the centre of it all are patients. There are entirely private clinics that operate entirely outside of the public system. Manitoba Liberals want to rebuild and strengthen Manitoba’s public health care system, for reasons that are both practical and principled. The practical reason is that while anyone can get sick, not everyone can pay for it. By having everyone contribute to pooling our collective resources in public health insurance, we make sure everyone is covered. A well-run public system that focus on prevention can provide service with better outcomes at lower cost than comparable private systems. Ensuring universal coverage for Health Care is not a cost – it is an investment. The public system is the only one that the vast majority of Manitobans will ever be able to afford or use. We also know from talking with plenty of people in health care that private clinics are profitable because they take the “easy” cases and leave the hard and more costly cases for the public system. As an example, eye clinics may perform simple surgeries without a nurse or even anaesthetic. There are shortages and delays for the hard cases where people urgently need care in the public system, but end up on a waiting list. Governments have an obligation to serve all of citizens equally, as a matter of rights and human dignity. That is what Manitoba Liberals believe. When it comes to health care, you should get care based on need, not on the fact that you have money.
How will you invest in preventative care and coordinating services impacting all the social determinants to optimize health and improve the wellness of all Manitobans?
Green Party of Manitoba: Preventative care and an understanding of the root causes, so-called social determinants of health, are fundamental pillars of our platform. In our Health and Healthcare Foundation Policy, we clearly articulate that we need to differentiate “health” from “healthcare”, with significant attention paid to upstream approaches to ensuring Manitobans are healthy, first and foremost. At least 10% of our total health budget should be allocated to health prevention, including both physical and mental health. We firmly believe that the key is that we address poverty, one of the most important determinants of health. Implementing Basic Income is essential to this, something we’ve advocated for many years. This in turn would address our chronic issues of homelessness, addiction and crime, key predictors of individual and community health. We also believe it’s extremely important that we respect and put into practice Indigenous wisdom, as we have much to learn from our Indigenous sisters and brothers. Finally, we must continuously work in the context of the Climate Emergency which has profound impacts on our health.
Manitoba NDP: Manitoba needs to find ways to invest more of our health dollars towards community based primary and preventative health care, to help Manitobans stay healthier longer, and to help them avoid becoming sick and requiring more costly and complex hospital interventions, for as long as possible. Funding supports need to encourage and incentivize expanded patient access to multi-disciplinary teams of professionals in community clinics, to take pressure off of our hospital emergency rooms. In terms of addressing the social determinants of health, and as an immediate first step, the Manitoba NDP is committed to implementing a universal school nutrition programmer students in schools, so that we can feed hungry kids and set them on the right path towards more education, a good job, and a healthy life. This is too important to be left to chance, and an NDP government is ready to step up and make it happen. Additionally, the Manitoba NDP would implement universal coverage for prescription contraceptives if elected. We know that marginalized and financially struggling communities are regularly without birth control coverage. Many young Manitoban women and others face barriers to accessing birth control, putting them at higher risk of unplanned pregnancy. Removing barriers will give Manitobans greater control of their lives, improve their health outcomes and reduce overall costs to the health care system. Under the Manitoba 2 NDP’s plan, the provincial government would cover the full cost of dozens of commonly used birth-control methods, including oral contraceptives, copper and hormonal intrauterine devices (IUDs), hormonal injections and the morning-after pill.
Progressive Conservative Party of Manitoba: We are incredibly proud to lead the nation in providing Diabetes Pump & Glucose Monitor Coverage to All eligible Manitobans, regardless of age. This is a great example of a program that seeks to invest in Manitobans early, realizing that assisting with preventative care not only increases quality of life but limits individuals reliance on the health system in more dramatic ways. We are eager to work with experts to find additional ways to bring this proactive strategy to other health categories.
Manitoba Liberal Party: Our 2023 Health Care Platform makes a major shift towards prevention with an aim to provide a “Health Care Home” for every Manitoban – a family physician or a nurse practitioner. Around the world, health systems that have more family doctors patients are healthier and are lower cost, because as frontline of local community healthcare, family physicians help keep patients out of crisis – out of ERs, Hospitals, ambulances, and medevacs. Ensuring every Manitoban has a family physician or nurse practitioner is a key part of the Manitoba Liberal plan to shift the system to preventative care. We will fund the creation of “health care homes” as clinics and attract family physicians and other team members by having three types of top-ups: - Flexible pay so that family physicians, nurse practitioners can take more time with patients who need it – seniors, patients with diabetes, expecting mothers. - A top-up for working in teams, to encourage clinics with wraparound supports. This would mean a clinic with a psychologist or mental health worker, nurse practitioner, pharmacist or lab tech would all be eligible for collaboration pay.
How would you address retention and recruitment in the health system? Any additional supports for rural and remote areas?
Green Party of Manitoba: A key to any organization is the recruitment and retention of its personnel. We must begin by engaging those health professionals and show our respect to them. We must have plenty of opportunities for health professionals and their representing organizations to ensure their safety and highest levels of career satisfaction. Although, ideally incentives to retain personnel should not be necessary, we recognize that they are often required - be they compensation, flexible time, vacations, and other benefits. We must ensure that these are provided to our health professionals. Absolutely, we need to work much, much harder to provide health services in our rural and remote areas of the province. Incentives to trainees should be made available, such as subsidized, even fully paid, tuition to attract health profession graduates to practice in those areas.
Manitoba NDP: Manitobans can’t trust the PC’s to fix the health care system that they’ve broken. For seven years, under Brian Pallister and now Premier Stefanson, the PCs have refused to listen to the advice and warnings of health professionals while they pursued an agenda of health care cuts. PC decisions to reorganize the health care system was always about cutting funding, and the creation of Shared Health has left a vacuum of accountability and transparency for the responsible for the disorganized state of health care today. 3 The Manitoba NDP is committed to working in collaboration with all front line health care workers, health professional bodies, and will establish regular tables and discussions to work proactively and in an ongoing way on the issues facing your professions and the patients you serve.
Progressive Conservative Party of Manitoba: In 2009 the Canadian Nursing Association predicted that Canada would be short 60,000 RNs by 2022, and unfortunately they were accurate. If the NDP had adopted our recruitment and retention strategies in 2009 when the CNA released their report we would have had over 3,000 more nurses in place during the pandemic. We are addressing that with our Health Human Resources Action Plan, as well as actively recruiting 2,000 doctors, nurses, paramedics and allied health professionals with an investment of $200 million. Recently we have recruited 150 doctors, including 50 in rural communities, and 50 for Northern Manitoba. Rural healthcare is a special focus and our government recognizes that you do not service a community by incentivizing urban healthcare workers into rural communities. You create care for a career by training local individuals to care for their community, which we are now doing- giving Manitobans access to career training and rural community’s local healthcare workers.
Manitoba Liberal Party: We know there are challenges attracting people to live and work in rural and northern Manitoba clinics, so we will offer bonuses to encourage long term settlement in the community, and shift away from reliance on locum and agency placements. To address long-term chronic shortages in rural and northern Manitoba, Manitoba Liberal government will also ensure that Manitoba has the capacity to educate and retain homegrown talent. - We have committed to funding the creation of a new Brandon Campus of the University of Manitoba medical school, dedicated to rural and northern family medicine. This campus will focus on training Manitobans from rural and northern Manitoba who want to return to their home communities to practice family medicine and other rural and northern medical care.
How would you involve health professionals in decision making for changes that impact the health system, and which professionals would you involve?
Green Party of Manitoba: It’s critical that health professionals be actively involved in decision making. All professionals should be involved, covering all fields, both as individuals and through their representing organizations. Regularly scheduled and ad hoc communications processes should be readily available, through to the highest levels of government. One or more Citizen Assemblies on Health and Healthcare in Manitoba should be organized, seeking participation from health professionals, researchers and other experts but also from the general public, particularly from the Indigenous community, to ensure a wide range of perspectives and experiences are shared. Regular town halls should be a part, both conducted for and within the system and also for the general public. There should be open lines of communication and acceptance/protection to “whistle blowers”, in those unfortunate circumstances where communications break down.
Manitoba NDP: For the past seven years, first under Brian Pallister and now Heather Stefanson the PC government has shown disrespect to all professionals working in our health care system – freezing wages, delaying contract negotiations, disregarding professional advice and expertise in favour of their agenda of cuts, and privatization – instead of working in partnership to improve health care. That needs to change, because addressing the staffing crises in health care, including recruitment and retention, is fundamental to fixing what the PCs have broken, and rebuilding our health workforce will take working together. We need a different approach that starts to respect the immense and dedicated work our health care providers do every day in health care. People are the foundation of our health care system and professionals deserve fair compensation, respect for work/life balance and stable predictable funding for the health care services they provide to Manitobans. The Manitoba NDP will ensure there is proper support for training programs, to address staff shortages and vacancies, as well as meet the demands of a growing population. On May 1st, the Manitoba NDP unveiled our five-point plan to start to fix rural health care. It includes incentives and the restoration of recruitment funds which were eliminated under the PCs. It also includes more staff to keep rural health centres open by offering additional incentives to allied health professionals, nurses and nurse practitioners to work in rural communities. We believe a similar approach is needed in Northern and remote areas across our province as well.
Progressive Conservative Party of Manitoba: Healthcare experts are not only at the table for decision making, but they are leading the conversation. Dr. Ed Buchel and Dr. Peter MacDonald have been updating Manitobans on the work of the Diagnostic and Surgical Recovery Task Force regularly. This task force has been eliminating backlogs, and now is tackling waiting lists. Their experts include doctors, representatives from the Nursing Council, and Provincial Specialty leads in their respective fields for a multidisciplinary approach. In addition, there are representatives from frontline services on the Task Force Steering Committee. If any Manitoba health care worker has insight to offer the taskforce, I encourage them to reach out, because all perspectives are important.
Manitoba Liberal Party: In order to rebuild trust in a severely damaged system, we want and need to set up an ongoing collaborative exchange between health professionals and policy makers. First, we want our ideas and policies to work. We want to be able to evaluate whether proposed new ideas and innovations will be effective, and if they do, how we can work with health professionals to best implement them. We will also implement suggestions that would Improve care or reduce spending that is wasted on non health costs, like administration, travel, or delays. After seven years of PC cuts and decades of hallway medicine under previous NDP governments, Manitoba Liberals believe that it is past time to restore stability to our health system. Health professionals have the frontline experience and play a key role in providing strategic advice to the future of healthcare in Manitoba. A Manitoba Liberal Government will always strive to ensure proper consultation and partnership with relevant health professionals for any changes that impact the health system.
What is the action plan for the continued movement of professions into the Regulated Health Professions Act?
Green Party of Manitoba: We are not familiar with this Act and will endeavor to familiarize ourselves with it. As such we have no action plan addressing your concern at this time. We do believe though that government regulation is a very important part of ensuring safety and highest levels of professionalism in any field, especially critical in health and healthcare.
Manitoba NDP: The Manitoba NDP believes that our province needs to accelerate the movement of professions into the Regulated Health Professions Act, and we will work in collaboration with those professions that have been left waiting since the legislation was passed to establish and prioritize timelines to complete this important work and bring everyone on board.
Progressive Conservative Party of Manitoba: We are committed to working with regulated health associations to bring everyone within one framework. This will not only dramatically reduce red tape, it will ensure Manitobans continue to get the care they deserve. We are ensuring this through the Regulated Health Professions Act, which has been a priority for our government. That is why we passed Bill 17, which expands the ability of our Minister of Health to facilitate this process.
Manitoba Liberal Party: One major problem in recent years is the slow pace of moving organizations under the Regulated Health Professions Act. This was caused by the small number of dedicated staff in the department who have been working on this file. This process has taken a very long time, and successive NDP and PC governments have been quick to blame the organizations instead of taking direct responsibility and tackling this issue head-on. Seventeen health professions have been trying to get under the act, including school psychologists and massage therapists. We recognize that greater regulation of health professions is important for professionals in terms of a clear, consistent rules surrounding the governance of their discipline, but also for everyday Manitobans. A Manitoba Liberal Government will provide greater staffing resources within the Department of Health to identify, support, and eventually transition organizations looking to become registered under the Regulated Health Professions Act.