The Manitoba Provincial Politics Discussion

[rrskylar]

Originally Posted by Danny D Oh

The most blatant add of extra bureaucracy in my adult life in this province is Shared Health, created by this PC government. So now we still have MB Health, we still have the health regions (like the WRHA), we still have hospital administration and now we have Shared Health.

And we have a massive shortage of people who can actually provide bedside healthcare. We have a massive bureaucracy trying to pinch pennies at the bedside getting paid six figures themselves.

This is true, PC's made a dent in the bureaucracy but not enough!

[dmacc]

Originally Posted by Danny D Oh

There's absolutely a new layer. Now if you look at any reporting structure for a program or hospital there's a Shared Health manager added to the chart with really no one else gone. There's also a Shared Health executive added to everything, CEO, CFO, Comms staff, chief medical, chief nursing, whole HR department (fastest growing cost in all these organizations with really no results). Each RHA still has these roles. All of these jobs are in the top 100 by pay in the province. There's huge redundancy and constant confusion of who is responsible for what month by month. The "transformation" jobs have seemingly become permanent.

At one point they did promise to cut managers by 15% but that didn't even last into their second term, it kind of happened and then everyone was replaced with additional directors added.

The money is coming out of the frontline, there's no doubt about it. The way they post many jobs ensures they won't be filled for budgetary reasons. It's a massive shell game. They'd rather blow their budgets with OT and agency staff because there's less long-term financial liability by staffing that way even though it costs the taxpayer more and produces worse outcomes (the real long-term costs). Most people don't pay attention to how the budget is actually spent, just how it's announced. Most of the managers and execs with any medical ethics flew the coop because they couldn't stand the directives. Shared Health has been developed to be kind of a gatekeeper on management in duplicate of MB Health but even more distanced from cabinet.

Shared Health did not come about out of nothing, it is the rebranding of Diagnostic Services Manitoba(DSM), essentially a provincial organization that ran all Diagnostic Imagining(DI) and Lab services in the Manitoba. The main theme of the Peachy report was to consolidate all programs and departments in the province to be centralized and provincial in scope.

WRHA's budget since 2018 has actually plummeted while DSM/Shared Health's grew rapidly. Supply Chain, DI, Lab, Cahdam Lab, AFM, HR, Digital Health(IT), Legal Services and others have all been amalgamated into Shared Health so that those services could be provided equitably across the Province and to eliminate the siloed approach that was going on. For example, Northern Health would be paying 3 times as much for certain supplies because their volumes were low and they are so remote. Under Shared Health the hope is that the economies of scale will save them money.

HSC was also transferred to Shared Health as it is considered a Provincial hospital since more then half of the patients it sees are from outside the city.

DSM already had a CEO, CFO, Comms and everything else, it has also eaten up other RHA's departments and budgets. Obviously the idea being that there can be some savings and equitable allocation if it is all managed under one authority.

[dmacc]

Originally Posted by djforsberg

Do you have evidence to support this or are you just basing it off of your feelings? If it’s the latter then perhaps you are someone who shouldn’t be taken seriously.

I have no evidence other then the anecdotal perspectives I have when looking at BC and San Fran which is why I used words such as caution and potential when talking about the outcomes. Could you please enlighten me to the evidence you have that shows that consumption sites lead to a decrease in drug usage?

My original point was to say, just because something is new does not make it progressive. To me progressive is the willingness to observe a shortcoming, observe what other jurisdictions who have suffered the same shortcoming and successfully improved, and implement those best practices. Or if it is truly a novel shortcoming, then determine a potential solution with clear KPI's to gauge whether it is succeeding or not and be contempt in abandoning if those KPI levels aren't met. Obviously this is easier said then done when you're battling the court of public opinion.

[djforsberg]

Originally Posted by dmacc

I have no evidence other then the anecdotal perspectives I have when looking at BC and San Fran which is why I used words such as caution and potential when talking about the outcomes. Could you please enlighten me to the evidence you have that shows that consumption sites lead to a decrease in drug usage?

My original point was to say, just because something is new does not make it progressive. To me progressive is the willingness to observe a shortcoming, observe what other jurisdictions who have suffered the same shortcoming and successfully improved, and implement those best practices. Or if it is truly a novel shortcoming, then determine a potential solution with clear KPI's to gauge whether it is succeeding or not and be contempt in abandoning if those KPI levels aren't met. Obviously this is easier said then done when you're battling the court of public opinion.

No one has ever claimed that safe consumption sites reduce drug usage. It is about harm reduction. In Sask, for example, we have the highest rate of HIV infection in the country which obviously is hard on people as well as the healthcare system. It’s in society’s best interest to keep our people safe and healthy. If they are going to use drugs they are going to use drugs. I have a brother who is a drug addict. Trust me, he isn’t using drugs because they are available. He is using them to cope. He would just move on to alcohol, porn, gambling or something else. I think we have enough evidence to show that criminalizing and prohibiting drugs or alcohol does not reduce their use. Criminalizing it also reduces the chances someone is open to even admitting they have a problem, lest they get thrown in jail for it. Drug addiction needs to be treated like it is: a health issue. There’s also evidence to show that legalizing cannabis in the States, at least, did not result in its use increasing.

[dmacc]

Originally Posted by djforsberg

No one has ever claimed that safe consumption sites reduce drug usage. It is about harm reduction. In Sask, for example, we have the highest rate of HIV infection in the country which obviously is hard on people as well as the healthcare system. It’s in society’s best interest to keep our people safe and healthy. If they are going to use drugs they are going to use drugs. I have a brother who is a drug addict. Trust me, he isn’t using drugs because they are available. He is using them to cope. He would just move on to alcohol, porn, gambling or something else. I think we have enough evidence to show that criminalizing and prohibiting drugs or alcohol does not reduce their use. Criminalizing it also reduces the chances someone is open to even admitting they have a problem, lest they get thrown in jail for it. Drug addiction needs to be treated like it is: a health issue. There’s also evidence to show that legalizing cannabis in the States, at least, did not result in its use increasing.

I can get behind the idea of harm reduction but doing this is not addressing the core issues. The core issue should be where the majority of resources should go. From your experience it sounds like trauma, in some form, is the problem. How do we manage people suffering through trauma?

Perhaps instead of prison, a form of mandatory rehabilitation is required. First "offenders" would require mandatory AFM meetings once a week and repeat "offenders" progressively requiring more restrictive interventions such as extended stays at recovery centre's with additional support in Supportive Recovery Housing.

I don't like the idea of enabling harmful behaviour in hopes that you will catch a few that seek help. In some cases imposed help, though harder to be successful with may(No Evidence) result in a greater number of recoveries.

Again, these ideas are not to be taken as what I think the solution is. The only solution is to have a goal, measure your current state and use best practices from other jurisdictions. All while continuing to measure outcomes and potentially adjust or abandon ideas that aren't working, rinse and repeat. Your goal is to reduce harm, my goal is to reduce use which in reduces overall harm.

[1ajs]

Originally Posted by dmacc

Perhaps instead of prison, a form of mandatory rehabilitation is required. First "offenders" would require mandatory AFM meetings once a week and repeat "offenders" progressively requiring more restrictive interventions such as extended stays at recovery centre's with additional support in Supportive Recovery Housing.

you cant force someone into treatment prevention with understanding culture that leads to people seeking out this crap in the first place.

we need to chase out paycheck chasers from the system and create resources to help workers with their own mental heath as well
and actualy stop paying shit for skilled workers in these feids

[canucklehead2]

Decouple drug addition from the criminal elements please. Free RX for drugs is kind of the best way. Controlled and cleaned. Capital punishment for drug kingpins like where the shit comes from otherwise. Enough letting it slide

[Danny D Oh]

Originally Posted by dmacc

Shared Health did not come about out of nothing, it is the rebranding of Diagnostic Services Manitoba(DSM), essentially a provincial organization that ran all Diagnostic Imagining(DI) and Lab services in the Manitoba. The main theme of the Peachy report was to consolidate all programs and departments in the province to be centralized and provincial in scope.

WRHA's budget since 2018 has actually plummeted while DSM/Shared Health's grew rapidly. Supply Chain, DI, Lab, Cahdam Lab, AFM, HR, Digital Health(IT), Legal Services and others have all been amalgamated into Shared Health so that those services could be provided equitably across the Province and to eliminate the siloed approach that was going on. For example, Northern Health would be paying 3 times as much for certain supplies because their volumes were low and they are so remote. Under Shared Health the hope is that the economies of scale will save them money.

HSC was also transferred to Shared Health as it is considered a Provincial hospital since more then half of the patients it sees are from outside the city.

DSM already had a CEO, CFO, Comms and everything else, it has also eaten up other RHA's departments and budgets. Obviously the idea being that there can be some savings and equitable allocation if it is all managed under one authority.

That's the case for Shared Health. I was leading a program that was absorbed and we just added another layer of reporting. Yes they migrated into Shared Health as an agency. There's two layers of HR now, two layers of "C" suite. They axed one director to meet the 15% reduction required by Cabinet and in the next year hired two more.

The Shared Health executive is not DSM's simply migrated over. You might want to dig more into that. They did absorb some people to help with creation and transition of the new organization but most of the roles were backfilled. All of those agencies you listed still have their own HR, C suite, often IT (some got slammed under WRHA).

Shared Health is a net increase to the cost of healthcare in this province as we're producing worse outcomes and not staffing the front line efficiently. There were mass layoffs as part of the transition and the staffing hasn't recovered to even that insufficient level.

We're paying more for less and the bureaucracy is growing.

[Danny D Oh]

Originally Posted by dmacc

I can get behind the idea of harm reduction but doing this is not addressing the core issues. The core issue should be where the majority of resources should go. From your experience it sounds like trauma, in some form, is the problem. How do we manage people suffering through trauma?

Perhaps instead of prison, a form of mandatory rehabilitation is required. First "offenders" would require mandatory AFM meetings once a week and repeat "offenders" progressively requiring more restrictive interventions such as extended stays at recovery centre's with additional support in Supportive Recovery Housing.

I don't like the idea of enabling harmful behaviour in hopes that you will catch a few that seek help. In some cases imposed help, though harder to be successful with may(No Evidence) result in a greater number of recoveries.

Again, these ideas are not to be taken as what I think the solution is. The only solution is to have a goal, measure your current state and use best practices from other jurisdictions. All while continuing to measure outcomes and potentially adjust or abandon ideas that aren't working, rinse and repeat. Your goal is to reduce harm, my goal is to reduce use which in reduces overall harm.

Treatment will never be the solution to this issue if your goal is reducing use. At that point it's way too late.

Address the root causes of poverty and trauma. Maybe we can do better for the next generation.

[djforsberg]

As far as I’m concerned, the root cause of much of modern society’s ailments is neoliberal capitalism which seeks to destroy the idea of a society (as Margret Thatcher suggested), and hence, will not be solved by those who have an incentive to maintain said system.

[thurmas]

Probe research poll out NDP 45% PC 35% inside Winnipeg its NDP 52 % PC 25 % so basically would be a similar result to the Doer years where the NDP won 25 of the 31 Winnipeg seats. Pc's look to be toast.

[blueandgoldguy]

Since the last election was a snap election and was only 3.5 years after the previous one in the spring of 2016, what is the latest the PCS can wait to call another one? Do they have to call one for the fall of 2023 or can they wait another half year until the spring of 2024?

[Ando]

That has no bearing on the date. According to the Manitoba fixed date legislation, the next election must be held on or before October 23, 2023. The only way it could be postponed is if there were a federal election occurring at the same time, in which case it could be moved to the following spring.

[Ando]

But I don't think that would save Stefanson. She's toast right now.

[thurmas]

Keystone Party of Manitoba registered as a party basically a provincial version of the PPC. This could hurt the PCs in Winkler/Morden and Steinbach possibly.

[dmacc]

Originally Posted by thurmas

Keystone Party of Manitoba registered as a party basically a provincial version of the PPC. This could hurt the PCs in Winkler/Morden and Steinbach possibly.

I don't imagine this new party will have a major impact on the outcome. The PCs are destined for a major collapse next election cycle because of their compounding failures in policy, execution and communication, especially in the last year. Any party that sees gains are mostly because the PCs lost votes, not that the other parties earned them.

[thurmas]

Pcs are toast would be funny if they started losing their rural base too for pissing them off.

[Chrisforpm]

I doubt a new right wing party would impact the PC’s much in rural MB. They might take 5-10% off of their vote total. But when you get 80%+ in Steinbach or Morden-Winkler, you can afford to lose some support. We saw it in the last Federal election, Candice Bergen and Ted Falk still won their seats.

[Kinguni]

Keystone will get support in my riding (Dawson Trail) with the large number of "Freedom" folks we have. That will eat into the PC voting base here. Combine that with the unpopularity of Bob Lagassé (he does absolutely nothing for the riding) and a strong NDP contender coming up and the riding having been held by the NDP in the recent past, there is a strong possibility this riding will return to the NDP.

[Chrisforpm]

What scares me is the average voter. So many people I talk to say they don’t like Heather, but they won’t for a hard leftist govt. Aka the NDP. This isn’t like 1999 with Gary Doer who was a centrist. I have a bad feeling that Heather might squeak out another win.