Consultations are under way to safeguard the mission, values and ethics of Catholic health care facilities in Saskatchewan.

“Mission control is the bottom line,” Bishop Blaise Morand, of Prince Albert, told The Interim.

The provincial government has proposed the establishment of 20 to 30 health districts to replace the 500 boards that now control facilities and programs. The districts will integrate, coordinate and manage all health services and determine the allocation of resources.

Sister Anne Collins, president of the Catholic Health Association of Saskatchewan (CHAS), said arrangements to protect the mission could vary from one district to another.

“We will need to be vigilant. We have a role to play and an opportunity to design what we want. The government has said it has a blueprint, not a plan.”

New districts

The new districts are part of the province’s wellness model for health care. Among other things, it aims to eliminate “unnecessary” and costly duplication of services. The document that outlines the model says the districts will be expected to establish arrangements to safeguard the rights and missions of privately owned health facilities. It also says the reform process respects religious values.

Bishop Morand said he wishes the wording had been stronger. But he added that both the minister and deputy minister of health have given assurances that denominational health care is secure.

In Prince Albert, the five major health-care institutions, two of them Catholic, have already signed an agreement that brings them under the authority of a single board.

“We’re now working on an arrangement to ensure that the owners of the Catholic facilities retain control of their mission. The central board can manage in other areas, but we’re going for an agreement with legislative backing that protects our philosophy by enabling the owners to govern in areas of specifically Catholic concern. Otherwise, they’re not Catholic facilities, and we may as well take down the signs.”

What appears to be developing is some form of council appointed by the owners and approved by the bishop to protect the Catholic mission. A person responsible to this council would monitor the mission on a day-to-day basis.

Hospitals may close

Saskatchewan has 21 Catholic health care facilities, including 13 hospitals and eight nursing homes. Sister Collins says some could close or change their mandate as a result of the effort to eliminate duplication and rationalize services. She and Bishop Morand are both convinced that services in the province must be rationalized to save Saskatchewan health care.

The key word would seem to be vigilance, not only in developing suitable arrangements but also in seeing that they endure. The bishops and Catholic people of Saskatchewan will need to be ever watchful in defending their mission through inevitable shifts in government policies and public preferences.

Prince Albert, in particular, bears watching. By surrendering managerial authority to a since board before completing an agreement on mission control, the Catholic institutions in Prince Albert would seem to have weakened their bargaining position. Pressure is already mounting on Holy Family Hospital to remove all restrictions on tubal ligations, which the Catholic institutions allow in certain circumstances. One option open to the new unified health board in Prince Albert is to remove obstetrics from Holy Family’s schedule of services. This is not a solution that Catholics should welcome.

Other Catholic facilities in Saskatchewan would be well advised to secure written agreement on mission control before making any concessions on rationalization. Some hard bargaining lies ahead. The Interim has learned that a number of Catholic hospital administrators are not interested in the Prince Albert model. They appear to want an affiliation agreement similar to the one St. Paul’s hospital in Saskatoon negotiated.

As reported previously (September 1992), St. Paul’s has retained its Catholic identity as an autonomous partner with the Saskatoon Health Board. Unlike the other Saskatoon hospitals, it does not operate under the board, and has a defined base of services including obstetrics, pediatrics and emergency procedures.