In the last four issues The Interim has been documenting cases of provincial intrusion
into religiously run hospitals. Catholic hospitals throughout the country are under
increasing pressure from governments to relinquish health-care management to the
province.
The provincial governments of Saskatchewan, New Brunswick and now Newfoundland
contend that these takeovers will save money. The hospitals feel that their medical ethics
will be undermined and that they may be forced to provide services which go against
their moral beliefs. St. Joseph’s Hospital in Estevan, Saskatchewan, mirrors the ongoing
struggle of Religious Hospitals to retain their moral standards in the face of ever-
increasing pressure. Editor
Pressing for changes
As reported in The Interim (June 1992), two doctors on staff at St. Joseph’s hospital in
Estevan are pressing for changes to the hospital’s moral practices. Pastor Wayne Berg of
Trinity Lutheran Church in Estevan took up their cause in a letter to Health Minister
Louise Simard, to which he appended the signatures of other area clergy, including one
Catholic priest.
Sister Therese Roddy, administrator of the hospital, has vigorously defended the
institution’s policies and procedures on both medical and moral grounds. She points out
that it would be impossible to follow a morality acceptable to all the various parties.
“Our philosophy is clear,” she said in a published statement. “We follow Catholic
medico-moral ethics, which upholds natural law. In doing so, we adhere to both our
individual and our corporate conscience. Furthermore, we do not feel we can have a
double standard – one for Catholics and one for Protestants.”
So far, her opponents have kept a low profile. Editor Jonas Weinrauch, of the Estevan
Mercury, has been unable to obtain a public statement from the two doctors, whose
names are common knowledge in the community.
“It hasn’t been a big public issue. You hear griping on coffee row. But we’ve had only
two letters to the editor against the hospital’s policy, one from the Estevan Ministerial
Association and one from an individual,” he told the Interim. He added that his staff
have discussed the pros and cons, but the paper has not taken sides.
NDP steps in
The issue of the ethics and autonomy of St. Joseph’s Hospital has emerged against a
backdrop of provincial NDP government “rationalization” of hospital services. A leaked
draft of the government’s wellness model for health care has caused widespread concern
for the survival of rural hospitals. The draft suggests that up to 66 of these
hospitals could be closed or converted to community health centers or long-term care
facilities. This would happen as part of a system under which 25 to 35 health districts
would replace the 500 boards that now control facilities and programs across the
province.
Health Minister Simard told reporters the draft is out of date and has since been revised.
She stated that a plan for the reform of rural health care will be brought forward soon, but
will not necessarily follow the design laid out in the draft. In any event, she said,
communities will be consulted before anything takes place.
Saskatchewan has the highest number of hospital beds per capita in the world. Faced
with soaring health care costs, the government is determined to make the system more
efficient. There seems little doubt that some form of regional structure is on the way and
that local autonomy will be diminished as a result. Alternative ways of paying doctors,
including salaried positions at regional hospitals, will also be considered, according to the
leaked draft.
Catholics have reason for concern in view of developments in Prince Albert, a city of
some 36,000 90 miles north of Saskatoon. Last June, the city’s five major health-care
institutions, two of them Catholic, signed an agreement that brings them under the
authority of a single board.
The Sisters of Charity of the Immaculate Conception continue to own Holy Family
Hospital and the Prince Albert Catholic Diocese still owns Mont St. Joseph Nursing Home. In addition, the agreement specifies that the Catholic dimension is desired and will be respected. But one wonders how the owners can ensure a Catholic identity when they no longer control the operation of their institutions.
The newly created Prince Albert Health Care Board will merge the administrative
personnel of the five facilities and create a single medical staff for the two hospitals. The
new board will deliver, not merely oversee, health care services, and will have full
financial control of provincial funding. Its top priority is to consider establishing a single
acute care facility for Prince Albert.
Sadly, tubal ligations have been performed at Holy Family Hospital for some years. If
this could happen while it was independent, it is distressing to imagine what the loss of
autonomy might bring. If the board designates Holy Family as the sole facility for acute
care, including obstetrics, the pressure to include abortions could be intense. If it opts for
Victoria Union, the non-Catholic hospital, people seeking acute care in a Catholic setting
would no longer be able to receive it in Prince Albert.
What should worry other Catholic hospitals is Ms. Simard’s enthusiasm for the
arrangement. She told the Prince Albert Herald that the unified board can serve as a
model for similar bodies across the province.
Regina and Saskatoon also recently established unified health care boards. In Regina, the
change was made rather easily as the province already operated the city’s four hospitals.
In Saskatoon the situation was, and remains, significantly different. St. Paul’s Hospital,
which is owned and operated by the Grey Nuns, is not a member of the new Saskatoon
Health Board, but an affiliate.
Under the affiliation agreement, a board of management, appointed by the Grey Nuns,
continues to operate St. Paul’s, which has a defined base of services, including obstetrics,
pediatrics and emergency procedures. The board of management sets policies and
regulations, appoints staff and grants hospital privileges to doctors. What’s more, it has
access to politicians to whom it can voice concerns. While St. Paul’s will cooperate in
the amalgamation of services, it retains its Catholic identity as an autonomous partner
with the Saskatoon Health Board. Saskatoon’s other two major hospitals, one of them
formerly owned by the city, operate under the new board.
The arrangement with St. Paul’s is similar to the relationship between St. Thomas More
College and the University of Saskatchewan. St. Thomas More, a federated arts college,
has retained its autonomy and Catholic identity since it was established in 1936.
Bureaucrats not happy
The Interim has learned from a reliable source that tops provincial bureaucrats are not
happy with the affiliation agreement St. Paul’s negotiated. They seem determined to
prevent similar arrangements elsewhere. They want control, according to this source.
As for St. Joseph’s Hospital, Ms. Simard has not responded publicly to the complaint that
it refuses to do tubal ligations. She did, however authorize her cabinet press officer,
Carol Bentley, to say that the government is not pressuring the hospital to change its
policy. Mrs. Bentley also pointed out that both the health minister and Premier Roy
Romanow are Catholic. She is apparently unaware of the dismal performance of many
Catholic politicians in upholding medical ethics.
Mr. Joe Campbell is a freelance writer in Saskatoon, Saskatchewan.
Editor’s note
The preliminary plan for gathering all Saskatchewan hospitals under 20 to 30 regional
boards were published August 15, 1992. The government says it is seeking input and
reaction from the public.
Alarm bells are also going off in Newfoundland and Ontario where similar threats to
independent hospitals are developing.
The Interim will continue to cover these developments in future issues.
