Controlling the deficit monster Solving the CHR's budget woes will take more than simple cuts Calgary Herald - Tuesday, January 08, 2008
The Calgary Health Region's $85-million deficit is a many-tentacled monster, for which there is no quick or simple fix, and one whose origins were spawned more than a decade ago.
No single factor created the problem, although the immediate reaction to the CHR's budgetary woes is a statement proposing a single-factor solution, that usually begins with: "If only they'd -- ."
But if only "they'd" what?
Hire more nurses so they wouldn't have to rely on overtime from their too-small pool of already overworked staff, overtime which is projected to cost $63 million for an expected 940,000 hours in 2007 to 2008?
Where are these nurses to come from, when back in the early to mid-'90s, spaces in Alberta nursing schools were capped, laying the groundwork for a shortage just as Calgary's population was starting to swell?
Figures from the United Nurses of Alberta show the extent of the nursing crisis in the province -- while thousands of nurses retire every year, only 1,400 new nurses graduate and enter the workforce to replace them, and these nurses are now the most highly paid in Canada.
Their last salary hike added $13 million in unplanned-for expenses to the budget.
Cut their salaries or propose a freeze in the next round of contract negotiations and more of them will seek better-paying jobs elsewhere.
To compound the problem, Calgary's rapid growth means the CHR must expand its facilities and its staff.
The new Children's Hospital was built with capital funding, but it had to be staffed and equipped with state-of-the-art technology -- as will the south Calgary hospital when it is built.
Keeping up with rapid technological advancements in health care is a hugely expensive proposition, and the CHR can certainly make judicious decisions as to what technology it will acquire, but it can't go without, either.
If only they'd -- cut their administrative costs? Often cited as an example of excess is the CHR's communications department with its more than 20 employees.
There is always room for improvement in line-by-line budget costs, for trimming the fat in bloated departments and for making cutbacks in discretionary spending, but since administrative costs account for only three per cent of the CHR's $2.8 billion annual budget, any dents made in the deficit will be small ones.
Replacing outgoing CEO Jack Davis with Dr. Chris Eagle is a good first move towards examining the budget from a new perspective -- that of someone who's been on the front lines and has seen in the course of his work where economies can be made.
Solving the staffing and overtime problem is the most burning financial issue if the deficit is to be significantly slashed, but that's not an overnight fix or even a next-year fix.
The creation of spaces in nursing schools simply has not kept up with the need for nurses in a booming economy like Alberta's.
The province must open up opportunities to train nurses and other professionals, so that more are available for full-time employment.
It is completely unacceptable that people who want careers in nursing are turned away from schools year after year because the number of spaces has not expanded, despite the fact their services and skills are urgently needed.
The province must also look at solving the doctor shortage.
While their salaries do not impact the CHR's budget, since they are paid directly by the province, it is vital to fast-track foreign doctors seeking their credentials here and at least begin the debate on a Canadian Medical Association proposal to cut undergraduate medical students' education to three years.
It may not be feasible to slay the deficit monster, but it is possible to bring it to bay.
© The Calgary Herald 2008 |
