WINNIPEG -- The Manitoba government announced plans Wednesday to centralize management of ambulances, emergency rooms, labs and other health-care services, and said an unknown number of job cuts is to be expected as it makes the health-care system more sustainable.

"We want to ensure that where we can share services -- whether that's clinical or other services -- that they should be shared," Health Minister Kelvin Goertzen said.

"There are both places where there will be reductions as a result of duplication, because I don't think people expect us to do services twice. But there will also be new opportunities within an organization."

Details will be worked out by a transition team, Goertzen said, but the plan is to centralize many functions carried out by the province's five regional health authorities into a new entity to be called Shared Health Services Manitoba.

Decisions about how and where to provide diagnostic tests, laboratory services, ambulances and more will be made by the centralized group instead of by regional authorities acting on their own. Procurement, legal and communication services will also be brought in under one roof.

"There are examples that sometimes cross my desk that mystify me about why rural (health authorities) are hiring lawyers on health-related or human resource issues when the Winnipeg Regional Health Authority has those lawyers but they can't be shared," Goertzen said.

Another change will see the province's biggest hospital -- the Health Sciences Centre, which includes the provincial Children's Hospital -- controlled by the new central agency instead of the Winnipeg Regional Health Authority.

The changes do not go as far as those announced earlier this year by the Saskatchewan government, which opted to merge its regional health authorities into a single entity. Manitoba regional authorities will continue to exist, but will focus more on front-line services while administrative and other decision-making duties are centralized, Goertzen said.

Some of the province's biggest health-care unions said the changes are confusing and will hurt front-line care.

"The provincial government has already imposed system-wide cuts," the Canadian Union of Public Employees said in a written statement.

"The new (central agency) will supposedly find even more 'savings', but the government is unclear where those savings will come from or what front-line positions will be affected."

The Manitoba Government and General Employees Union said health-care workers are worried about what might lie ahead.

"We don't have much detail. This is very stressful for patients and their families and for the hardworking staff who provide the services," union president Michelle Gawronsky said in a written statement.

Goertzen said the detailed changes will be worked out in the coming months by a team that includes doctors and nurses.

"In 2003-2004, the health-care budget was just over $3 billion. Today it is just over $6 billion," Goertzen said.

"It has nearly doubled during that time frame. We know, and Manitobans know, that the health-care system as it stands isn't sustainable with that level of spending."