Lewis: Saskatchewan’s farcical rural hospital closure myth endures

Every person in Saskatchewan over 40 remembers that in 1993, Roy Romanow’s NDP government closed 52 rural hospitals. So do a lot of younger people, because the story is recycled and brandished like the Sword of Damocles to remind rural voters of who their enemies are should they forget.

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Since then, like a land acknowledgement, every political debate about rural health care begins with a reminder of the alleged cataclysm. It has become the Origin Story of contemporary Saskatchewan political geography, the NDP’s albatross and scarlet letter, its fatal misstep on the road to extinction outside the cities.

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History informs thoughtful citizens’ political choices, but selective memory is a temptress as seductive and brain-addling as a televangelist’s pitch. History is built on facts. The government closed only two facilities; the other 50 were converted into long-term care beds or community health centres.

Calling those facilities hospitals was farcical to begin with. None was fit to deliver modern acute care. Ambulances with patients in dire condition rightly drove right by them.

They had no specialists and no major equipment, and thankfully almost no patients — an average of four per facility, mostly older people getting care that could easily be provided by a nursing home or home care. Like urban dwellers, rural people who needed acute care went to city hospitals.

But reality is a weak buffer against political outrage. The towns where the deed was done were furious; public servants dispatched to deliver the news on occasion feared for their safety. It was the ugliest time in Saskatchewan health care since the battles fought over medicare in 1962.

Often we never learn the full consequences of government decisions. We did in this case. I led the agency that evaluated the impact of the conversions several years later.

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In addition to looking at health-care utilization data and health outcomes, we surveyed 200 people in each of 25 communities where the H sign was taken off the highway. (Email me if you want the peer-reviewed publication with the full results.)

Survey respondents said that when the changes were announced, they a) opposed them vehemently; b) feared that their health status would be at risk; and c) anticipated reduced access to health care.

Four years later, they reported that a) their health status was not compromised; b) their access to health care had not declined; and, interestingly, c) the economic future of their town in no way depended on the fate of their little hospital.

Nonetheless, they still resented the decision, which if nothing else explains why reminding these communities of three-decade old events remains an apparently effective political message.

Voters don’t have to justify their memories, grudges and allegiances. But democracy pays a price when voters remember selectively, and refuse to reconsider their views when their own experience refutes prior beliefs. Nor is it prudent to fixate on the decision while forgetting the context in which it was made.

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Grant Devine’s government nearly bankrupted the province, its credit rating gravely at risk under a mountain of debt. Romanow was a gifted politician fully aware of the perils of unpopular decisions. It is plain fact that his government saved Saskatchewan from fiscal calamity. Perhaps that is worth remembering too.

Political parties’ fortunes wax and wane. When their brand gets tainted, some, like serial grifters, acquire new aliases.

The remnants of Devine’s disgraced Progressive Conservatives (eight Cabinet ministers convicted of fraud) merged with the rump of the wounded Liberals to become the Saskatchewan Party, the historical baggage marooned on the carousel of wilful amnesia.

Rural Saskatchewan’s seems to have placed the NDP (aka the NDP) in permanent exile partly for making a gutsy decision it surely never wanted to make. On health care grounds it was the right call.

So why doesn’t it condemn the Saskatchewan Party (aka the Progressive Conservatives) for creating the near-death fiscal crisis that made the tough love necessary?

Because that would be unwise, unfair, and intellectually lazy — just like parroting the hospital closure folk tale. Rural health care deserves a thoughtful debate. It won’t happen without escaping the rabbit hole of misremembrances of things past.

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Steven Lewis spent 45 years as a health policy analyst and health researcher in Saskatchewan. He can be reached at sl*********@***il.com.

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