New Brunswick plans major overhaul of health care over the next two years

FREDERICTON -

A much anticipated health reform plan by the New Brunswick government promises many changes to the system but lacks details on how it will get there.

The plan, which has been in the works for a year, outlines health care changes New Brunswickers will see over the next two years.

As promised, there are no cuts or closures to hospitals or emergency rooms across the province.

“If we’re going to truly embrace rural health care, we have to decide that we can work from a position, in a different direction. And every other government, any other reform or plan, has worked assuming that we have to go from one point. I’ve never believed that. And so if we truly want to create a network of excellence, we’ve got to decide what communities need and work from that point, and I am determined to do that,” Health Minister Dorothy Shephard said in a virtual interview with reporters Wednesday.

Some of the highlights in the 16-page report include a promise to eliminate the waitlist for hip and knee replacement surgery for more than a year. It also promises that by next winter, no one will have to wait over a year for the surgery.

The plan also adds new "multi-patient vehicles" to Ambulance New Brunswick’s fleet, "allowing them to increase service levels for non-emergency transfers for patients across the province."

Shephard said these vehicles are intended to address challenges in transportation across the province, which was one of the most common issues she heard during her consultations.

“This is a starting point. Ambulance New Brunswick is going to bring back a plan as to how we can implement them and utilize them to the best of our ability… and then we will see how it will evolve.”

The plan also includes the addition of emergency medical technicians (EMT).

When asked about that, Shephard said it’s to keep more ambulances on the road.

“Ambulances have two paramedics and when one of those paramedics calls in sick that, typically, that truck is off the road for that shift. And the other ambulance attendant spends their shift re-deployed if possible or they stay in-house. And so, if we have EMTs that we can partner with paramedics, we ensure that ambulances will remain on the road.”

Shephard has been releasing elements of the plan over the last two days, including an announcement that the waitlist for a primary care provider will be completely eliminated by next fall and replaced by an online registry where orphan patients can connect with a provider "in a timely manner."

Within the next couple months, New Brunswickers should see walk-in services available at 14 addiction and mental health sites and by next summer, a provincial phone line will be offered "to ensure addiction and mental health crisis response services are available."

“The first 24 months are the real focus of what we plan on doing to create the vision for our five year plan… and as we’re doing that, we’ll continue to progress with our other initiatives within our mandates,” said Shephard.

NURSES, DOCTORS HAVE SAID RECRUITMENT, RETENTION IS CRITICAL

The plan briefly outlines the province’s intentions to recruit more health-care professionals.

The president of the New Brunswick Nurses Union has been calling on the province to improve its recruitment efforts, saying there are almost 1,000 vacant nursing positions, which has led to 24-hour shifts, denied vacation and burnout.

"We know that we have less and less health human resources available to us, but yet our workloads have continuously increased," said Paula Doucet, president of the New Brunswick Nurses Union. "So, I look at this as potentially a way of doing something different, you know. We'll never know unless we try (to see if) there a better way of doing something."

Shephard’s plan says the province will work with the regulatory bodies, universities and colleges to develop shorter training programs "combined with experiential learning," as well as a speedier process for recognizing health-care professionals with foreign qualifications.

“We’re going to be working with a new program with NBMS (New Brunswick Medical Society) and our associations, making sure that they’re in the loop helping us to continue to go even further than where we’re at,” she said. “We know we need more, but the RHA’s are in constant contact now and I’m proud of the way they’re working together and so, we have what we have at this time and we’ll continue on.”

"Funding barriers will be assessed to identify opportunities to support more New Brunswick students seeking to enter into the health-care professions," the report says.

Shephard said they will be more “aggressive” recruiting students who are from – or want to work - in New Brunswick. She also mentioned she’s had meetings with post-secondary institutions this week on expanding programs.

PLAN RECEIVING MIXED REACTIONS

Nicki Lyons-MacFarlane, who is on the Patient Connect NB wait list, is looking for a family doctor.

"I lost my family doctor last summer, it's been difficult and it's only been a year-and-a-half for me," they said. "If they're adding us to the other primary family physicians in the province, what's the wait time going to look like? Are they bringing in more doctors and nurse practitioners, or are they just going to use an already overtaxed system?"

Liberal opposition health critic Jean-Claude D'Amours says he still has questions about how the plan will work – including how much it will cost.

“When there’s no costing, there’s a big risk that either they don’t want to spend money … or they really don’t have any idea of the cost of what they want to do and we may have a surprise in the future.”

He’s also concerned about depending too much on a virtual care model, and losing quality patient care.

People’s Alliance Leader Kris Austin says there is many positive points in the plan – but he’s concerned about the lack of details on recruiting.

Austin says the changes will depend too much on existing human resources already suffering from burnout.   

“I wonder how many physicians will be able to take on the additional workload to ensure that 40,000 New Brunswickers currently without access to primary care will be seen when they need help,” he said.

Dr. Mark MacMillan, president of the New Brunswick Medical Society, says the province is sending a good message to doctors.

"When a physician sees that the province is working with the other stakeholders, like the medical society, and working together with us, that's a big step forward and that's a really positive recruitment tool," said MacMillan.