Health PEI’s new organizational structure has removed east and west-specific representation at the top level of leadership.
The Hospital Services West and East top leadership roles which previously reported directly to Health PEI’s CEO have been removed from the organization’s structure. In their place there is a sole, Island-wide executive director of hospital services.
Another position has been added into the structure between the executive director of hospital services and the CEO - the new chief operating officer.
Regional hospital administrators are farther away from reporting directly to the CEO than in the previous structure.
Health PEI’s CEO Denise Lewis Fleming said this new structure could break down regional silos, promote collaboration as well as regional equity and standardization of care.
Others see the changes as a loss for rural Islanders.
“Moving regional administrators farther from the centre doesn’t give me any confidence that it’s going to lead to better health resources or health outcomes for rural residents,” Alan MacPhee, a long-time advocate for quality health care for rural Islanders, said.
“Lack of community representation does not serve rural PEI well in any field.”
The Souris businessman said this seems like just another step of many toward centralization of health services which seems to have corroded care for rural Islanders in the past, leading to continued doctor shortages and loss of services such as dialysis in Souris.
The highest east and west specific leadership representation lies with positions filled by Edna Miller and Paul Young who are respectively administrators of hospitals east of Charlottetown and of hospitals west of Charlottetown (excluding Prince County Hospital).
The Island-wide executive director of hospital services will be tasked with promoting regional equity and standardization.
“When you have one leader that’s responsible for working with each of the local leaders across the system that’s what promotes equity of access,” Ms Lewis Fleming said.
She is now three steps away from any region-specific representation compared to one step away from regional leadership in the old structure.
Ms Lewis Fleming said this is only on paper, in reality she won’t be out of touch with local leadership or the various needs of communities, nor will her top tier of leaders such as the chief operating officer Dr Michael Gardam.
She believes this structure will help break down other silos such as the disconnect between mental health and addictions and community care or hospital services.
With Dr Gardam at the helm she expects local leaders will be empowered to make decisions for their departments. When decisions lead to positive results the structure will allow health care solutions to be easily shared and adapted system-wide, she said.
Dr Gardam came from Ontario to work in PEI in October. He is a pioneer of applying complexity science-based approaches like a front-line ownership approach and positive deviance approach to improve health care systems.
Trish Altass, the official opposition’s designated health critic, said she is cautiously optimistic about the new structure.
Conversations and explanations from Dr Gardam have especially been encouraging, she said.
“I’m still skeptical as to what real improvements on the ground we will see,” she said, adding it may just be another shuffling of chairs.
Diminished eastern and western rural representation at the top of the leadership structure is one of the main concerns listed in an opinion piece she wrote for her party’s website.
“There is some concern that removal of those two east and west leadership positions may take away some of the focus on the needs of rural communities,” she said. “I’m hopeful that as things continue to evolve we will see representation from those areas.”
Krystyna Pottier of Alberton is a board member of the Western Hospital Foundation.
“Anything that would help access to health care in the rural areas is certainly welcome. The principles they emphasize like renewal of primary care and equitable access seem positive.
“It seems like it will allow easier communication, easier collaboration and all the regional administrators are on an equal footing reporting to one executive director.” For this reason she doesn’t see a particular concern with local representation.
Dr Herb Dickieson of O’Leary is another advocate for quality health care for rural Islanders and a former leader of the Island’s NDP party.
“We’ll have to see how this falls down,” he said. “Right now the provincial policy from the King government appears to be lacking in its emphasis in the provision of rural health care services.”
Dr Dickieson has noticed an increasing divide in services for rural Islanders and those in the more urban centres that needs to be addressed.
“The emphasis needs to be on the government, not the civil servants who are doing their best.”
He said without a government mandating strong provision of health services for rural Islanders, the structure of Health PEI (the working leg serving the Department of Health) will be of relatively little consequence.
Ms Lewis Fleming said with the new Chief Medical Officer role in place, Health PEI and physicians are having conversations about what that leadership structure should look like moving forward.