“But oh, we suffer, right? Yes, right!” So said Yente in the classic, Fiddler on the Roof! Families dealing with the Dementia journey suffer, often desperate for support. For years the challenges of getting a correct diagnosis followed by proper and helpful mechanisms and
supports for the patient, caregivers, and families has been the huge “elephant in the room” in
discussions of health care for the aging population.
With the greatest proportion of elders amongst provinces in the country and a population that has forecast its aging issues for decades, it should come as no surprise that emergency departments and hospital beds are distressed with elders in crisis.
Professor Richard Saillant, the noted Moncton-based economist and author of Over the Cliff, wrote a sobering article in the Brunswick News on March 4 in which he detailed the difficulty that the NB government seems to have with its fiscal projections. The current government was elected on a platform of fiscal responsibility, attacking the provincial debt and reforming health and long term care, municipal government, education and other services. Somewhat accurate fiscal projections are needed but are always elusive in the public sector.
At last count, according to Saillant’s summary, government was projecting a surplus in the current year of nearly $1 Billion. And to staunch fiscal conservatives, that is incredibly great news. This could not only stop the bleeding of expenditures but could also provide some capacity to actually reduce the public debt.
But not so fast. Are you heeding what is really still happening in health and long term care? Wait times for essential diagnostics are such that private clinics have been developed with the Federal government now “clawing back” over $1 million in health transfer payments. Worse still are the continuing stories of people either not getting essential diagnostics and care on a timely basis, but still a disturbing number without access to primary care or on long wait lists for long term care.
In July 2022, Premier Higgs, having promised reform of the health system prior to election, fired the newly appointed Horizon CEO and disbanded the boards of the two health authorities. Two trustees have served as surrogate governing boards and an interim CEO was appointed to replaced Dr. Dornan.
So now what? Health and long-term care cannot be run from the Premier’s office forever. Informed observers have been calling for a more relevant governance model for the health authorities for years.
By all accounts, the Health and Long-Term Care System in New Brunswick appears to be in the state that was forecast many years ago when Llewellyn Davies Weeks was commissioned to create a plan. The regional plan for hospitals, created by the Department of Health and introduced in 1992, was intended to be the first phase of a systematic development of the health care system. The plan had not spelled out, in finite detail, what it would look like but the regional hospital structure then paved the way for merging difficult files such as long-term care, mental health, even public health into a vibrant system that had 7 functioning regions, fairly close to the people.
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.