Health Reform in Early 1990s - Nurses' Perspective

Many nurses found themselves out of work after a large scale restructuring of the health care system in Saskatchewan in the 1990s. Health Districts were created in an attempt to integrate and coordinate care. The Saskatchewan Drug Plan, one of the most generous in the country at that time, had been incrementally scaled back until it basically no longer existed except for those on low incomes Health system funding was changed to place greater emphasis on population demographics of each of the health districts. Furthermore, government announced there would be greater emphasis on primary health care and health promotion and disease prevention; a concept that government termed "wellness."

The Saskatchewan Union of Nurses (SUN) has always advocated for this type of health reform. Nurses are front-line health care workers and as such recognize the importance of emphasizing health promotion and disease prevention. This reform was clearly within the realm of SUN advocacy. In September of 1988, SUN made recommendations to the Commission on Future Directions in Health Care. Clearly their recommendations reflect wellness reforms:

Nurses and other health-care professionals are currently experiencing extreme frustration because of their inability to provide quality care in current circumstances. They are, however, a tremendous reservoir of necessary energy and creativity to provide the quality care that Saskatchewan citizens expect and deserve. We believe Saskatchewan citizens want and need a health-care system that is universal, accessible, comprehensive, portable, and publicly administered. We believe Saskatchewan citizens want and need a health-care system primarily based on preventative, community-based public health programs. We do not believe Saskatchewan citizens can afford the tremendous waste and cost of continuing a "sick-care system." Nor do we believe Saskatchewan citizens can afford privatization or profit-making in our health-care system (Presentation to the Saskatchewan Commission on Directions in Health Care - Summary).

However, health reform became tainted by the conversion of 52 hospitals to wellness centres that offered sharply reduced services and hours of operation. Countless nurses lost their jobs. The facilities that were converted were small hospitals in small communities. Many of the nurses who lost jobs were those whose income propped up that of the family farm. At first SUN was open to genuine reform, but it soon became apparent that the government's "wellness" initiative seemed to really mean facility closures, health care cuts and massive layoffs of nurses.