New Brunswick has released a health-care discussion paper outlining the challenges the system is facing as the health minister prepares to embark on a consultation tour with stakeholders and professionals.
The paper presents a grim picture of the health-care system, marked by lack of access to primary care and a coming labour crunch.
“We cannot continue to ignore these problems. It is time for the people using our system, the people working in our system, community leaders and all levels of government in every corner of the province to come together in a united approach to improve health care,” Health Minister Dorothy Shephard writes in the paper’s introductory letter.
Consultations with communities and health-care professionals were promised after a slate of proposed reforms were abandoned in the wake of large protests last year.
Among the proposed reforms was the overnight closures of six emergency rooms in smaller communities across the province in order to free up more physicians for primary care appointments.
According to the report, 90 per cent of New Brunswickers have a family doctor, but just 55 per cent are able to get an appointment within five days.
In 2018, 58 per cent of ER visits were deemed less urgent or non-urgent and the year prior one out of 10 New Brunswickers used the ER as their primary care provider.
Figuring out how to increase access to primary care is one of the stated goals of a five-year health plan to be spawned by the consultation efforts.
In all, the report lists seven areas that will form the backbone of a five-year health plan.
First up is optimizing the health and well-being of the entire population, which is listed as a priority and will be measured by hospitalization rates. The report notes that New Brunswick sees a rate of avoidable deaths higher than the national average.
Another is quality patient-centred care, which will be measure by wait times, the number of people with primary care providers, and how quickly patients are able to get appointments with care providers.
Addiction and mental health is another priority area, with success rates to be measured by hospitalizations for substance abuse, self-harm and repeat hospital stays for mental illness or drug use.
Next is how to improve senior care. According to the discussion paper, there are 660 people on the wait-list for nursing home beds.
That number is expected to grow to 2,500 in five years and 4,100 in 10. It also notes that 30 per cent of hospital beds are occupied by the alternative level of care patients who are waiting for beds in another facility.
The province is hoping to increase the time seniors remain in their own homes, with home care and support.
Increasing the number of New Brunswickers who can access health information digitally is another area of focus.
How the province will maintain existing infrastructure is also an open question.
The report says there are 53 health-care buildings that are at least 25 years old.
The estimated cost of maintaining health-care infrastructure in the province is $110 million, but right now only $35 million is set aside for that purpose each year.
The report highlights that many of the province’s aging IT systems will need to be replaced or updated in the coming years.
Finally, the report lists workforce recruitment as one of the most pressing issues facing the health-care system.
In the next five years, 35 per cent of family doctors and lab technicians are eligible to retire, along with 40 per cent of registered nurses. Recruitment is particularly difficult in rural and northern areas, and developing a strategy to address that is a top priority.
In measuring the success of recruitment goals, the province will look at the retention of New Brunswick medical grads, the use of sick leave and workplace injuries.
To put together the five-year plan, the department of health will be holding about a dozen engagement sessions, including with the six communities that would have been impacted by the abandoned health-care reforms last year, First Nations communities and health-care workers.
But the leader of the official Opposition is calling on the government to put consultations on hold.
“The minister has announced a public consultation on health at a time when the province and its health-care workers are trying to deal with the COVID-19 pandemic,” said Liberal interim leader Roger Melanson.
“Reducing the spread of the virus and keeping New Brunswickers safe should be our first priority at this time. There should also be a focus on a detailed vaccine distribution plan and communicating that plan to the public.”
Melanson also questioned the amount of time set aside for consultation. The province says it hopes to wrap things up by the end of March.