New Brunswick's new health plan includes no sweeping changes

The Higgs government's much-anticipated health plan is out, promising a range of new tools and targets to improve the system in New Brunswick but no sweeping changes to address some of the sector's most chronic problems.

The plan promises to reduce surgical wait times by half by the fall of 2023 thanks to electronic referrals to orthopedic surgeons and an "e-consultation" system for faster access to specialists.

People will also be able to schedule their own blood work or X-rays, and Ambulance New Brunswick will expand its staff and its fleet.

Those measures, included in the document released Wednesday morning, are on top of elements rolled out earlier in the week aimed at addressing primary care and long-term care.

"New Brunswickers deserve a more seamless experience," Health Minister Dorothy Shephard told reporters Wednesday.

According to her plan, a pilot of the e-consultation system that let doctors and nurses consult specialists about a patient via their electronic health record reduced the need for in-person consultations with specialists by two-thirds.

There are also promises of better mental health and addiction services, including new walk-in services at the 14 clinics around the province and an around-the-clock provincial phone-in service.

New Brunswick Medical Society president Dr. Mark MacMillan said the society was "strongly encouraged" by the plan.

"We believe this a transformative step forward for our health system and for the health and well-being of New Brunswickers."

New Brunswick Nurses' Union president Paula Doucet was more guarded, saying it was a positive step that the government had listened,and "implementing this is the start of building a foundation for sustainable health care."

But she said recruitment and retention would be instrumental in making the plan work.

There are few details on how the province will address a growing shortage of doctors, nurses and other health-care professionals, which has been identified as one of the biggest challenges in the system.

The plan says "communities and providers will become official partners" in recruitment efforts and will receive financial grants to help them develop "promotional materials" to attract workers.

It also promises new training models, shorter training programs and faster recognition of the credentials of health professionals trained outside Canada.

And it says it will lean on "non-traditional" providers such as reflexologists, chiropractors and life coaches, as well as volunteers, to fill gaps.

I am struggling to understand how these goals will become a reality when we are facing a severe shortage of primary health-care providers.- Kris Austin, People's Alliance

According to the plan, 35 per cent of family doctors will reach retirement age in the next five years, and almost one-third of nurses are 55 years old or older.

Shephard wouldn't say Wednesday whether the existing health workforce, or the one that's expected in five years, is large enough to make the plan work.

"We have vacancies. We have to fill them. The [regional health authorities] are managing with what we have," she said. "We know we need more."

She was also unable to put a dollar figure on how much the plan will cost.

"Those numbers are still being worked out."

She also said health officials believe the plan is"valid and attainable and workable within health-care budgets, or working with what we perceive to be our increases going forward."

Liberal health critic Jean-Claude d'Amours said the minister's lack of specifics on recruitment and costing was disappointing.

"The government's been in place for the last three years,and she worked on that document for a year and a half, and during that time, the quality of service to the population has not increased," he said.

In a statement, People's Alliance Leader Kris Austin questioned the plan's ambition, given the scant details on recruitment.

"I am struggling to understand how these goals will become a reality when we are facing a severe shortage of primary health-care providers such as doctors and nurses," he said.

Green health critic Megan Mittonalso said she's troubled by the lack of detail on recruitment and disappointed the province is relying on Medavie, a private company, to administer the new primary-care referral system announced Monday.

No closures

The plan also has no closures of small hospitals or reductions to emergency departments in those facilities tough decisions that health officials said in February 2020 were necessary and could not be put off for long.

"These are hard challenges that we have to address and we can't just lay off," the then-deputy minister of health Grald Richard told a committee of MLAs at the legislature at the time. "We have to do something."

Richard made the comment just days after the Progressive Conservativegovernment withdrew a plan to reduce hours at emergency departments in six small hospitals.

He and assistant deputy minister Ren Boudreau said at the time that the public's desire for emergency services near where they live was drawing strained resources away from other parts of the system that would benefit more patients.

But Shephard said Monday no hospitals or emergency departments will close, or see reduced hours under her plan.

The document says public health laboratory services will be centralized into a single lab. There's no mention of where it will be located.

Richard is now retired and was appointed this week as one of two co-chairs of a task force that will "help guide the objectives" of the health plan and make recommendations to the minister.

In 2014, the province's clinical services planning advisory committee, made up of officials from the Department of Health and the Horizon and Vitalit health authorities, said maintaining the existing number of emergency departments was "not clinically sustainable."

Shephard said the flaw with previous plans was health-care executives deciding what level of services worked for a community rather than listening to the community itself.

"We have got to decide what communities need and work from that point," she said.

Mitton, whose Memramcook-Tantramar riding includes the Sackville Memorial Hospital, said there's still anxiety locally, despite the nominal lack of hospital cuts and closures.

As of Friday, the Sackville hospital's ER will close every day at 4 p.m. because of a lack of staff.

"It's not written in the plan, but that's what's happening in Memramcook-Tantramar, and so people are still concerned," Mitton said.

The document says public health laboratory services will be centralized into a single lab. There's no mention of where it will be located.

"This will not change where New Brunswickers go to have their blood work done or where they drop off samples," she said, adding results will be available online.