일부의 매니토바 지방자치단체들은 의료 서비스가 자신들의 책임이 아님에도 불구하고 스스로 문제를 해결하려는 노력을 벌이고 있다.
Association of Manitoba Municipalities (AMM) 회장 겸 CEO Kam Blight는 농촌의 의사 부족이 지방자치단체에 부정적인 영향을 미치고 있다고 했다. CEO Blight는 의사 부족은 지자체 인구를 유지하는 것뿐만이 아니라, 지역사회로 이주하려는 사람들을 방해하는 기능도 한다고 했다.
매니토바 시골지역의 인구 100,000명당 의사 숫자는 캐나다 대도시 중에서 의사 숫자가 네번째로 낮은 위니펙보다 훨씬 적다.
시골지역에 있는 병원에서 의사를 구하는데 어려움을 겪으면서 지역 병원의 응급실이 폐쇄되고 있다. 예를 들면, 2022년 Leaf Rapids ER이 폐쇄하였고, 지난해에는 Arborg, Morris, Melita 그리고 Carberry의 응급실이 문을 닫았다. 매니토바 지역 헬스 당국들이 게시한 응급실 일정에 따르면, 이번주 또는 주말에 더 많은 응급실이 문을 닫을 예정이다.
| ■ 매니토바 헬스 지역별 인구 100,000명당 의사 수: ㆍ Interlake-Eastern Regional Health Authority: 92명. ㆍ Northern Regional Health Authority: 115명. ㆍ Prairie Mountain Health (예전 Western Regional Health Authority): 149명. ㆍ Southern Regional Health Authority (Southern Health-Santé Sud): 99명. ㆍ Winnipeg Regional Health Authority: 293명. |
CEO Blight는 인구가 줄어드는 것을 막기위해 지자체에서 병원과 의료시설을 계속적으로 운영하기 위해 최선을 다하고 있다고 했다.
Association of Manitoba Municipalities에 따르면, 일부의 지자체에서 의사를 채용하고 유지하기 위해 자금을 할당하고 있다. 현재 지자체에서 의료 종사자들을 채용하고 유지하는데 1 밀리언 달러 이상을 할당하고 있는 것으로 협회는 분석하고 있다. 앞으로, 이런 일들이 계속적으로 늘어날 것으로 예상된다는 것 또한 협회의 설명이다. 그러나 AMM은 의사 모집을 위해 한 지자체가 다른 지자체와 경쟁을 벌일 가능성에 대해서도 우려하고 있다.
위니펙에서 남서쪽으로 240 킬로미터 떨어진 Municipality of Killarney Turtle-Mountain에 있는 Tri-Lake Health Centre의 경우, 현재 2명의 의사가 있는데 응급실에서 교대로 근무를 하려면 5명의 의사가 필요하다. 그래서 Municipality of Killarney Turtle-Mountain는 2016년에 영국 의사 2명을 성공적으로 채용하기 위해 민간기업에 240,00 달러를 지불하였다.
지자체는 의사를 모집하기 위해 2023년 영국에서 3명의 의사를 초대하여 2명의 의사를 채용하는데 성공하였다. 한 명은 올해 8월 도착할 예정이고, 다른 한 명은 현재 이민 절차를 밟고 있는 중인 것으로 알려지고 있다. 다른 한 명은 풀-타임 근무를 피하고 있어서 새로운 사람을 찾고 있다는 것이 지자체의 설명이다.
영국에서 공부한 의사들이 매니토바를 선택한 주요한 이유는 영국에 비해 좋은 급여 (payscale.com에 따르면, 캐나다에서 일반의의 평균급여는 187,500 달러이지만, 영국에서는 105,459 달러) 그리고 일과 삶의 균형 (work-life balance)인 것으로 파악되고 있다.
매니토바 지자체를 대표하는 단체인 AMM은 지자체가 의료인을 모집하는데 비용을 지출할 필요가 없다는 주장을 하고 있다. 이유는 의료 서비스는 주정부와 연방정부의 책임이며, 매니토바 주정부는 연방정부로부터 헬스와 관련하여 기록적인 지원금을 받았기 때문이라는 주장을 펼치고 있다
매니토바는 올해 Canada Health Transfer를 통해 연방정부로부터 1.8 빌리언 달러를 지원받는다. 매니토밴 1인당 4,557 달러에 해당하는 금액인데, 2015-16 회계연도에는 2,655 달러를 지원받았었다. 매니토바 주정부 예산은 헬스 인력 부족을 해결하기 위한 유지, 채용 그리고 교육에 310 밀리언 달러를 배정하고 있다.
ㆍ 관련기사: 연방정부 이퀄라이제이션 교부금이 842 밀리언 달러 늘어나는 매니토바
ㆍ 관련기사: 1.2 빌리언 달러 헬스-케어 지원금에 서명한 Trudeau와 Kinew
매니토바 주정부의 Uzoma Asagwara (Health 담당) 장관은 보도자료에서 “지자체 자체적으로 채용을 하는 것을 방해하지는 않겠지만, 지자체는 주정부와 협력할 필요가 있다.”고 했다.
Asagwara 장관은 또한 이전 Progressive Conservative 정부가 시골지역 의사 채용과 유지에 관련한 기금을 2017년부터 31.5 밀리언 달러에서 25.6밀리언 달러로 줄였기 때문에 이를 복원하는 과정에 있다고 했다. 매니토바 주정부는 헬스 인력 유지, 채용 그리고 교육에 할당된 310 밀리언 달러의 예산 중에서 얼마가 매니토바 시골지역에 할당되었는지에 대해서는 밝히지 않고 있다.
ㆍ 관련기사: 막대한 적자와 싸우면서 헬스와 범죄를 해결하는데 중점을 둔 예산
한편, Prairie Mountain Health와 같은 지역 당국에서는 시골지역에서 일할 의사를 모집하기 위해 의과대학 학생들을 대상으로 “Rural Week”와 같은 행사를 벌이고 있다.
Southern Health는 농촌지역 순환 실무 간호 프로그램, 학생 인센티브 보조금과 이주 지원, “Home for the Summer” 프로그램 확대 그리고 취업 박람회에 적극적으로 참여하고 있다.
Interlake-Eastern 지역에서는 University of Manitoba 의대 레지던트를 대상으로 적극적인 홍보 활동을 벌이고 있으며, 올해말까지 해외에서 교육을 받은 의사 6명이 도착하기로 되어 있다.
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