I'm an emergency physician who works at to EDs in the city. Most of us support these changes. I've provided a summary of what's happening, rationale, and concerns I personally have below:
Winnipeg has an absurd number of hospitals for it's size. As a result, resources are spread thin, and a lot of money is wasted trying to provide duplicate coverage of every single hospital. An implication of this is also that you have shoddy care at some of the sites because there are not enough gold-standard resources to share across the entire city. As an example, there are still a number of physicians in Winnipeg EDs who have no training in emergency medicine whatsoever. Compare this to the national standard where urban emergency physicians are generally emergency medicine specialists.
Winnipeg also suffers from a huge lack of rehab/long term care beds. This plugs up the whole system and is the largest contributing factor to ED wait times in the city. Up to 90% of ED treatment spaces and nurses are taken up looking after admitted patients... who are placed in the ED because there are no ward beds... because 40% of ward beds are taken up by patients who don't need to be in hospital but are waiting rehab or long-term care...
The changes that are being implemented are:
1. Concordia - no ED or urgent care. Ortho surgery and rehab/long-term care. No more ICU or acute medicine.
2. MUCC - no more urgent care. outpatient IV clinic.
3. SOH - ED is now urgent care. increased elective endoscopy, more rehab and long-term care. No more ICU or acute medicine.
4. VH - ED now urgent care. more day surgery, mental health, and geriatrics. No more ICU or acute medicine.
5. Grace - now a tertiary care centre. Increased services to support this (diagnostic imaging, etc.). Increased ICU beds, increased surgery, increased acute medicine.
6. StB - ED is unchanged in short term. Increased ICU beds, increased surgery, increased acute medicine, increased family medicine.
7. HSC - ED is unchanged. Increased ICU, increased surgery, increased acute medicine.
This should allow more efficient use of resources due to centralization and specialization, and gets people who need rehab and whatnot out of acute beds into the peripheral rehab hospitals.
This is essentially the system that happens everywhere else in the world.
I have a few concerns. The choice of the Grace as the new tertiary care site, and complete closure of the Conc ED means that there are large areas of the city that are much farther from an emergency room.
There is no announced plan for increased funding for infrastructure at the 3 tertiary care sites. StB ED and HSC ED are anticipated to see a 50-100% increase in patient visits. Both EDs are already operating 50-80% over-capacity.
In general though, this is a step in the right direction and I am pleasantly surprised that goverment is finally doing something useful to fix the healthcare system (as opposed to opening quick care clinics).