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I am writing to express my concerns with the government proposal to restructure health care regions. The timeframe for the Advisory Panel is extremely short which does not allow for comprehensive and thorough public consultation. The government has said that the status quo is not an option, but it has not provided any reason for reducing health regions in this province. Some points to consider: * Saskatchewan has gone through two major reorganizations of health care regions. After each reorganization, health services to residents were disrupted and it took years for the health regions to establish models for delivering care. * The current reorganization shows no commitment to protecting Medicare - free, fair access to public health care for all. A major focus of the Fyke commission was to ensure the sustainability of Medicare in urban and rural health services delivery. * Another real danger is the loss of connection to local communities. Larger health regions will diminish the interests of rural Saskatchewan and could lead to reduced services and a loss of decision making in communities. * There is no evidence that amalgamating health regions will reduce costs. In a report called Healthcare Restructuring in Nova Scotia, Dr. Barbara Clow from Dalhousie University asserted that neither research nor recent experience support claims that centralization will be more cost effective than regionalization has been. * This will have a negative impact on workers. The uncertainty during and after the last two mergers caused stress and confusion for frontline workers in Saskatchewan. Research suggests that there are also health impacts associated with a long period of uncertainty, including low morale, burnout, and decreased job satisfaction. All of these factors can have an impact on quality of care for patients and residents. * I am also concerned about reduced transparency and accountability.  Larger health regions can be less responsive and harder to navigate. Alberta has faced many challenges since merging all of its health regions into one. A report entitled Review of the Alberta Health Services Organization and Structure and Next steps, written for the government of Alberta by consultant Janet Davidson raised several concerns with the larger system, including that the structure is confusing to navigate for patients and the general public and it is not unknown for staff to not know who they report to or who they can go to for assistance and support.

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