Consulted to death? More talk? Where’s the action from the last round of consultations? The public can be forgiven for feeling skeptical because the health field has been the most “consulted” field in our society. In this province, consultant reports were presented in the 1960’s and finally acted upon in the 1990’s-but then, only in part.
Why the timidity on the part of governments? Why does common sense need more consultation? This round of consultations is taking place because government tried to implement what they thought were logical steps in healthcare reform in February 2019. The logic was clear: acute care beds occupied largely by frail elders in small hospitals should be re-classified as long-term care beds. Because small, rural emergency departments only see 2-3 patient’s over-night, why would you keep a doctor and nurse on staff to cover? Tim Hortons would not do that? Economically it does not make sense. I would guess that the cost per visit would be exorbitant relative to the cost per visit in a high-volume centre.
It is hard to focus on the important when pre-occupied by the urgent. Covid-19 is the urgent and has our collective attention: the public, our institutions, our public servants, elected officials. And while we all just want to get out of this mess, it will be over in a few months and we will be in a new normal, whatever that looks like.
But please do not forget how angry so many in the population have been prior to the pandemic about the state of our health system. Rural people were traumatized in February with talk of eliminating what they believed to be an essential service. Urban people have been very angry about access to efficient primary care services, long waits for service, over-crowded emergency departments.
As promised, Health Minister Dorothy Shepherd released her Discussion Paper on Thursday, January 21, 2021. The paper raised issues of Primary Care, System Efficiency and Safety, Access to essential surgical treatment, Mental Health and Addictions, Senior Care, and use of current technologies. The last thing in the world New Brunswick needs is more public consultation, summaries, and reports. All of these themes have been beaten to death for 20 years. What has held us back from progress is having a government with the political courage to face reality in the eye and move forward on a plan to fix what so many know is broken!
The results of this Discussion Paper consultation will inform the development of the new 5-year health plan. Apparently, New Brunswick currently has a 5-year health plan about to expire. Surprisingly front-line staff and consumers of care seem unaware of such a plan. Health care is such a politically sensitive issue that governments have to avoid issues and deal only with cosmetics or wade in without fear of losing legislative seats.
The issues that plague the system stem from lack of consistent focus and informed, consistent leadership at various levels in the health system. Here are the issues that simply require courage to do the right thing:
In all the noise made in public about health care issues, the pleas from interest groups, unions, associations, societies, almost without exception, are for “Government to do more; we need more…..”
Seldom does one hear any discussion about issues of efficiency and effectiveness of the current services and systems. Why is that? It goes against the grain of interest groups to acknowledge that there may be other ways of achieving better service. And because health care is a highly-charged political system, majority governments have only 2-3 years at most in order to make a dent in improving one of the most complex and convoluted sectors of our society. We, the people, have a love affair with our health care system and heaven forbid that any politician should do anything to offend my doctor or my daughter, the nurse, or all those other people who the public believe to be working very hard to keep services going.
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.