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Sometime ago I wrote that Saskatchewan Health was out of reality when it removed the universal accounting processes of budgeting/funding and implemented the so-called "needs-based funding allocation(1)." District boards and CEOs could not understand this new way of funding, and Saskatchewan Health made this allocation of funding more confusing when first they stated that the allocation of funding was based on 70% of the districts' needs(2) and later when they kept changing this percentage and methods(3).

The end result of this ever discretional way to fund health districts is that we have districts which are puppets of the government(4), we have districts which are operating in a deficit position(5), we have districts which don't report to the Health Minister the monthly accounting comparisons between actual and budgeted expenses(6), we have districts which are unable to identify the sources of financial difficulties and therefore we have districts which cannot provide health plans by leveraging and prioritizing their health services.

Our health care politicians and leaders have downgraded the universal budgetary accounting processes and have at the same time overemphasized the use of health indicators(7). In addition, we continue to experience different timing for the approval of health plans; last year, the districts' budgets were globally approved one year later(8), and today these same budgets are going to be globally approved as soon as possible within a new provincial context(9).

We require health districts to go back to their universal accounting budgetary processes and be away from their present secretive, confusing, inconsistent and ever changing global budgetary methodologies.

Endnotes

Quote by Donella Meadows "challenging a paradigm is not a part-time job. It is not sufficient to make your point once and then blame the world for not getting it. The world has a vested interest in, a commitment to, not getting it. The point has to be made patiently and repeatedly, day after day after day" ftp://sysdyn.mit.edu/ftp/sdep/Roadmaps/RM1/D-4143-1.pdf http://iisd1.iisd.ca/pcdf/meadows/default.htm

General reference: Articles by Mario deSantis published by Ensign

1. Immediate Need of New Budgeting Processes for Saskatchewan Health and District Health Boards, by Mario deSantis, March 9, 1995 http://www3.sk.sympatico.ca/desam/paper-NeedBudgProc-mar09-95.htm

2. Presentation of the healthcare system architecture to vendors and software developers. Presentation sponsored by SAHO, Sask Health, and Economic Development. Regina, January 12, 1995. A report by Mario deSantis http://www3.sk.sympatico.ca/desam/paper-presentArch-Jan12-95.htm

3. Hospital closure permanent, Carrot River 'betrayed', by Ernest Unrau, The Nipawin Journal, March 8, 2000. Margaret Anderson, Chair of North-East Health District, has stated "It has taken the board four years to make this decision... If your community can change the funding process in Regina, I wish you well -- we have tried and been told there is no more money."

4. The two primary needs of health reform: independence of the districts & the booting out of hoodlums, by Mario deSantis, April 5, 2000

5. The Big Question for Saskatchewan Health Care: Underfunding or Mismanagement? By Mario deSantis, March 5, 2000

6. The reporting of monthly comparisons between budgeted and actual expenses has been a recurrent concern expressed by Wayne Strelioff, Provincial Auditor of Saskatchewan

7. Minister of Health Pat Atkinson and Health Indicators: "There are lies, damned lies, and statistics" By Mario deSantis, March 24, 2000

8. Government News Release, Health - 86, March 3, 2000 http://www.gov.sk.ca/newsrel/2000/03/

9. Atkinson's won't rule out more hospital closures, by Murray Mandryk, The StarPhoenix, May 13, 2000, Saskatoon, Saskatchewan