ALGORITHMS ARE THE BEST MEDICINE. The government of Newfoundland and Labrador has bet millions on it. Health-care workers say it is a bad bet for them and all the people they work hard to care for.

Cut more, pocket more is a key element in a contract signed in secret last June between Change Healthcare Canada and the four Newfoundland and Labrador health authorities. The firm will get 50% of the value of the all the cuts it recommends. This could amount to $35 million, if the firm meets the $70 million target in cuts the province wants.

The government paid the company $3 million up front last June to begin months of preparation prior to the five-year operational side of the deal kicking in.

Strange way to cure burnout

“The government says they hired these guys to help us cope on the job,” says one frontline health-care worker. “I don’t get how looking for ways to cut my job helps me do that.”

Change Healthcare Canada sold the government on its claim it has software that can ferret out “improved operational efficiency” and cost savings that humans can’t. Computer algorithms will supposedly work like magic to allow for hyper-matching of staff supply to patient demand; and so reveal ways to reduce staffing costs, overtime, sick time, payroll errors and time-keeping labour.

The provincial government says the goal of the project is not to cut spending but to avoid staff burnout.

CUPE challenges government claims

Contracting with Change Healthcare Canada is no way to do that says Sherry Hillier, CUPE (Canadian Union of Public Employees) NL president.

To her, the contract has just one goal—job cuts. She questions whether an algorithm can match up to the reality of people’s day-to-day duties.

“My biggest fear is for our 3000 members out there. Our members are overworked right now. There’s just not enough people to do all the work. The Change Healthcare approach is only going to make the healthcare system that much worse,” says Hillier.

“This corporation isn’t in it for Newfoundland and Labrador. They’re just in it for the money,” she says. She asks why the health authorities could potentially give millions of dollars to an American company when the province is teetering on the brink of bankruptcy.

A CUPE NL media release points to what bringing in the Change Healthcare system did in Manitoba: “... the system transformation team made ‘title changes’ to hundreds of full-time jobs, converting the hours of work to part-time. At least 500 nurses received ‘job deletion notices’ that fall, along with more than 700 hospital support staff.”

The CUPE NL statement goes on to say: “The current staffing model for nursing is not meeting the needs of patients and results in chronic understaffing, excessive overtime and burnout among registered nurses.”

More workers only real cure

Hillier says the heart of the burnout problem is not having enough staff in the first place, particularly in long-term care. Workers are forced to rack up overtime to get the job done.

Hiller says if the province wants to drive overtime costs down it needs to do the obvious: train and hire more health-care workers to deliver the care people need and deserve.

To make a bad deal even worse, there are penalties in the contract for failing to adopt standards set by the consultants: the four healthcare authorities will have to pay up to $5 million in penalties it they do not achieve 95% adoption of the Change Healthcare program within their organizations.

CUPE Newfoundland and Labrador is calling on regional health authorities to cancel the deal with Change Healthcare.

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