Nokomis’ appeal to the health minister for X-ray machine funding

Key points from this story:

• The Town of Nokomis has been fundraising to replace its outdated X-ray machine at the Nokomis Health Centre, with a goal of raising $690,000, but has received little support from provincial health authorities and must shoulder the majority of the cost itself.
• Despite similar facilities in neighbouring towns receiving new digital X-ray machines at no cost to local taxpayers, Nokomis has faced years of delays and has been largely ignored by health authorities, resulting in a prolonged effort since 2016 to secure a replacement.
• The Nokomis Health Centre serves over 2,000 patients through Dr. Lim’s practice, and lab services are accessed by rural residents who would otherwise need to travel to larger cities; anticipated regional growth due to projects like the BHP Jansen Mine could bring over 4,000 new residents to the area.
• The Saskatchewan Health Authority (SHA) has provided usage metrics that significantly underestimate the actual usage of the X-ray machine, reporting only 100 uses per year, while local data shows 45-50 patients per week require X-rays, equating to about 2,250 per year.
• The Town has proposed cost-saving measures for the renovation—such as keeping existing lead walls, using local electricians, and minimizing unnecessary construction—to reduce costs by over $350,000, and continues to request provincial funding and partnership to address rural healthcare needs and growing demand

Here is that letter and the subsequent letter responding to the Minister's decision following a meeting with Carr.

January 27, 2025

Hon. Lori Carr, Minister of Rural and Remote Health, ministerrrhe©gov.sk.ca
Hon. Jeremy Cockrill, Minister of Health he.minister@gov.sk.ca
Legislative Building- 2405 Legislative Drive- Regina, SK S4S OB3
Re: Fundraising for new Digital X-ray Machine for Nokomis Health Centre.

Greetings Honourable Ministers:

We address you as the Mayor of the Town of Nokomis and elected Council Members, to make you both aware of our concerns with the current fundraising efforts to replace the X-ray machine at the Nokomis Health Centre (NHC).

It is unfortunate to say that our rural community - and the region it serves - has a long list of challenges, delays, and fights from recent years with regional and provincial health representatives, in order to maintain the Healthcare Services we've had in our region for over 115 years. We hope this letter will provide both Honourable Ministers with some perspective of our circumstances.

The Nokomis and Area Community Health Council (NACHC) was formed in 2009 in response to the threat of having Lab Services closed at the NHC, by the Saskatoon Health Authority. And, since 2009 this council has been guided by a Terms of Reference that includes building stronger relationships with regional and provincial health representatives; and, our communities health and wellness. However, the majority of our work has been defending and protecting the NHC, Dr. Bee K Lim's practice, and Lab Services.

We started the process of replacing our X-ray machine in 2016, the same time other provincial health authorities were replacing diagnostic equipment. The neighbouring town of Imperial received a new digital X-ray at no cost to the local taxpayers. Over the past 9 years our continual requests have been ignored and now we face the sole responsibility of raising $690,000 to replace our X-ray machine. Since being granted permission to begin fundraising, we have received little support from SHA representatives and feel they don't believe we can reach our goal.

This small health facility was built by municipal partners in 1978/79, and over the past 30 years Dr. Lim has built a practice of over 2000 patients. The NHC Lab Services are also accessed by rural tax-. payers seeking the lab-work and imaging they require - without traveling to the city. The renewal of, equipment and the investment in the NHC is essential in our growing region! With the construction of the BHP Jansen Mine and the establishment of the Aspen Power Plant NNW of Nokomis, our region is anticipating the arrival of over 4000 people. Over the past 12 years the Town of Nokomis has invested 15 million dollars in renewing infrastructure and improving core services - in anticipation of this growth - and seek your support as a partner in health to invest alongside us.

After winning a 5" term as Government and as one of the rural constituencies that help deliver that mandate, we ask you to support those who supported your government. We have invested, fought and defended the Healthcare needs of our rural community and region for 16 years and ask for your financial support to help us reach our goal of $690,000, and make an investment for the future, one of growth and prosperity in rural Saskatchewan! We have adapted with the times and met new commitments to remain a viable and growing community in the region. We are prepared to work for and raise funds for the renewal of our X-ray machine, with nearly $70,000.00 raised already!

However, with the perspective this letter provides, we ask our Honourable Ministers to contribute $250,000 as a capital expenditure in the 2025-26 fiscal year to meet our fundraising goal and address the issues raised in this letter. The discrepancies between the priorities of different health authorities in the past, and the years of being ignored and underestimated, warrant your consideration to become a partner in our efforts to renew our X-ray machine and meet the needs of a growing region.

We also request a meeting with our Honourable Ministers early March 2025, it Nokomis. We will welcome you for an NHC visit and meeting with NACHC representatives to set common goals for the replacement of our X-ray machine by March 2026.

Growth takes resources and we are prepared to invest and work together in a municipal-provincial partnership to meet the needs of our shared residents.

We look forward to your response and working together,

Sincerely,
David Mark, Mayor
Town of Nokomis
Member of NACHC

A Virtual Meeting was held with Lori Carr and the Nokomis Council on March 10th, and on April 28th Council received a letter from Carr’s office outlining their review process in determining funding for the X-ray project.

May 27, 2025

Dear Honourable Minister Carr,

“...We are disappointed with your decision but also understand there is a current backlog of needed diagnostic equipment across the province. We would argue that SHA's ineffective management plays a large part in the reason there is a backlog. However, we continue in good faith with your support and leadership to "find efficiencies within the renovation portion" of our project.

Our numbers show that currently between 45-50 patients a week are being forced to travel into either Regina or Saskatoon for Xray imaging. With a new x-ray machine, our doctor would use the x-ray machine 45-50 times a week for a total of 2250 per year. A far more realistic usage volume than the 100/yr provided to you by the SHA. Current volume of usage metrics would only reflect the fact that our facility is utilizing other x-ray facilities while we wait to replace the one at the NHA. Between our doctors' practice and those in need of lab services in a growing region, we have the potential to serve over 3000 patients annually. Records reaching back into 2016-17 show viability and high-usage and justifiable replacement 9 years ago - and still today.

We can't help but feel your lack of financial support through a cost-sharing model is a missed opportunity to invest in rural health in a region undergoing unprecedented growth.

Your government needs to take the requests of rural health facilities seriously. There is a great need to invest in rural Saskatchewan - especially in communities like Nokomis where regional assessments show we need more houses, expanded health services and daycares as 3 key examples of how to serve the area.

Furthermore, we need to look at how we execute renovation projects that increase efficiencies and bring down costs so we can all afford to replace outdated equipment across the province.

With your leadership and involvement in adjusting the current workplan, we feel renovation costs can be reduced by over $350,000. We propose the following adjustments to the work-plan be taken:

• Keep the leaden wall in the X-ray area intact;
• Remove small interior wall to expand the width of the narrow passageway;
• Use local electricians to assist in the wiring of the new Xray machine; and
• Use available space and existing plumbing to install a sink in the examination area.

These 4 steps will greatly reduce the cost of the renovation project, saving vital time and effort in fundraising and save taxpayer dollars to proceed with additional replacement projects currently waiting on SHA's inefficient and high-cost methods.

Why is rural Saskatchewan in this position when past health authorities like the Regina Health Authority replaced this equipment at no cost to the taxpayer less than a decade ago?

Why do rural residents have to do without and travel farther for primary health care when rural constituencies delivered your current mandate as government?

Let's turn the page and make renovations that meet current building codes and infectious controls that don't needlessly drive-up costs. How can your government afford to meet our needs if we are conducting work that appears to be over-inflated, unduly obfuscated?

We request another meeting with yourself and SHA staff to review the work-plan to reach our goal of replacing the X-ray machine here to the NHA before the end of 2025. The good work we can do together will not only help us, but it will also contribute to helping every other rural health facility in need of improvements and investment.

Sincerely,
David Mark, Mayor
Town of Nokomis
Member of NACHC