The author of a report responsible for sweeping changes to the Manitoba health care system said the province will begin to see positive results sooner rather than later.

In an interview with the Winnipeg Sun, David Peachey said he stands by the “evidence” that led his Nova Scotia-based Health Intelligence, Inc., to recommend the consolidation of acute-care services in the city, a contentious issue that has led to fears of future patients being left out in the cold.

But Peachey argued there’s no “end point” to the recommendations from his report, touting the changes as a “long-term rollout”.

“We have had an enormous amount of physician support for what we’ve done,” Peachey said. “We always anticipate there’s going to be some angst as well. Our work is based on the delivery of services and the end point being quality that can be achieved through models of care and doing things differently.”

Peachey said one of the most contentious issues spawned from the review – the consolidation of ERs into three sites – was left to the provincial government to decide. And Peachey stood by the recommendation of consolidation, saying “three well-equipped acute care sites” would “certainly service a population of Winnipeg very well.”

“The government decided that they were going to choose Grace as the acute care site and they were going to shift the urgent care at the Misericordia into a different type of activity,” Peachey said. “The important distinction with that is we weren’t specific to Grace or Misericordia or anything like that. We just said ‘You’ve got to do the consolidation and here’s why.’”

Peachey said the Health Intelligence report “wasn’t driven by cost,” and added his team didn’t anticipate job loss to be a lingering problem.

“Cutbacks are certainly keeping with where we see the system going but the cutbacks themselves were not specific to us,” he said. “Because of how people can shift responsibilities, the impact on health care providers may be that they’re doing their work in different places, but we weren’t foreseeing that there’d be a lot of net loss of jobs in providers, there’d just be a different way of doing things. Our work was really focused on delivery of care, models of care and what will be the best outcome for the people of Manitoba.”

Peachey’s work has been rolled out in other jurisdictions, including Saskatchewan, Alberta and Yukon.

The Yukon Party, which held government there for 14 years, was defeated in 2016, two years after Peachey’s recommendations were revealed there.

A spokeswoman for the Yukon government said that political shift has altered some of the focus of the system.

“But I think it is fair to say that we continue to use the Peachey report in helping to guide our decisions program wise,” the spokeswoman said in an email.

Peachey hesitated to put a timeline on seeing results in Manitoba.

“The short answer is in Year 1 you can make a lot of progress and people will see change and feel change,” he said. “After that it’s going to depend on the clinical governance ... but certainly by Year 5 everything is history and it’s all functioning.”

dlarkins@postmedia.com

Twitter: @LarkinsWSun

Who's in charge matters little: Peachey

David Peachey doesn’t believe a change in government would be a large driver in how recommendations from his report would have been rolled out.

The Nova Scotia-based doctor who helped author a thorough examination of Manitoba’s health-care system said he doesn’t think an NDP government would have handled recommendations drastically different than the current Progressive Conservatives.

The report was commissioned by the previous NDP prior to the 2016 election.

“It’s interesting speculation,” he said. “I suppose somewhat earlier in my career I thought it made a difference what political stripe was driving the political responsibilities in a jurisdiction, but in fact I think it’s that combination more with the financial constraints that are being faced.”

Peachey said the realities in the evidence tackled in the report are the same regardless of who is in office.

“I don’t think that (the NDP) would look at our work any differently than is being looked at by the Pallister government,” he said. “They may have had a different approach from the physical constraints and the financial implications, but again that’s not us. I don’t think that the sort of work that we do would be handled differently in terms of the outputs regardless of who’s in government, I’m quite convinced of that.”

--Larkins

Open-minded Manitoba

David Peachey estimated he interviewed “something like 225 groups” over a year and a half of compiling a report on Manitoba’s health care system.

Peachey and another colleague spent “half to three quarters” of the time to put the report together doing one-on-one interviews around the province, with five to 20 people in each health authority.

“We were told by our provider groups – more than 200 interviews with groups of providers across the province in addition to looking at very substantial amounts of data – everybody told us they were ready for change and to be bold,” Peachey said, “and that if there wasn’t a boldness in making the change then it wouldn’t have any substantial change in the system because it was well-recognized that change was necessary.”

Peachey said those in charge are open to implementing what he’s recommending.

“In some places – the minority – they have tried to take pieces of it and work with pieces as opposed to work with the whole,” he said. “And if you do that sort of cherry-picking it can make it difficult for implementation. Not impossible, but more difficult.

“I can say that my experience with the ministry in Manitoba they were very good in the whole process.”

-- Larkins