Adam Huras, in a very thoughtful piece in Monday’s Brunswick News, outlined the fact that Premier Higgs has backed off ER cuts and seems to have had second thoughts about the health care reforms announced in February 2020. It is absolutely true that both the Premier’s office, Departments of Health and Social Development and other departments have been pre-occupied by the pandemic.
The pandemic, vicious as it has been internationally, has created huge issues for policy makers trying to keep abreast of the latest changes in forecasts, etiology, transmission methods, mitigation methods and ever so much more. Had the measures announced in February gone forward as outlined, there is little doubt that a health system already beset by major issues would have been in a major state of confusion or pandemonium. That is not the voice of extremism speaking; it is the voice of experience, however!
Further in the article, the Premier, who was committed to major reforms in the health system long ago, acknowledges that the reforms as announced perhaps were not well conceived and raises the rhetorical question: “what was that going to accomplish anyway?”
“Mental illness is one of the leading the leading disabilities in the world with 4 of the 10 leading disabilities being mental disorders!” So says the Action Plan for Mental Health in New Brunswick published in 2011. The plan was a visionary document and has a wealth of statistical and historical information regarding Mental Health in New Brunswick.
Twenty percent of Canadians suffer with some mental disorder while 80 percent are said to have someone in their family or close circle of friends suffering from one of many mental disorders. Mental Illness is referenced in the report as “The Orphan of Health Care” which suggests that it does not receive the priority that it deserves.
Time was when the family doctor knew each patient, each family, their idiosyncracies, pressures, distress and pressure points. That was in the days when medicine was considerably less complex and doctors worked 70-80 hours per week. Office visits were not limited to 10-15 minutes and there was no such thing as “only two things per visit; if you have other issues to discuss with the doctor, you will need to book another appointment”.
That was also in the days when housecalls were common which served to render urgent in-home care but gave the doctor some insight into living conditions and family dynamics. The thousands of drugs that have an impact on the body and the moods just were not available so treatment of known mental challenges was pretty limited.
There has been a good deal of concern within the public, the media, and advocacy groups about the Covid-19 outbreak in Region 5. For the provincial leadership team, it was akin to the opposing team hitting a game winning home run in the bottom of the ninth after a stellar pitching duel. It was a big disappointment. And the doctor who was thought to have been the carrier and whose life has been badly scarred will deal with the aftermath for years to come, no doubt.
People had a right to be frightened; it is a wicked virus made even more wicked by the fear that the warnings starting with the WHO and many others in regulatory and advisory roles play. The fear of this awful virus has ensured that businesses closed, that commerce came to a halt, and that our lives have been put on hold as we “stay the blazes home”. And just when we see light at the end of the tunnel and we think we can get back to the golf courses and Tim Hortons, we get broad-sided.
The discussion at the Horizon Health Authority Virtual AGM this week suggested that even though the Premier has not been able to conclude the consultations with municipalities that he promised, thanks to the Pandemic issues and distress, the CEO remains convinced that the plan needs to go ahead as originally announced. This, now, has raised the hackles of persons in rural communities and has now created strong pushback from some.
Having now had 5 months to ruminate on what was announced and how it was announced, and having consulted with some knowledgeable people in the field, what appears obvious is the classic stalemate! Rural Health Care thinking versus Urban Health Care thinking. What appears obvious is that the rurals were handed a plan that took them by surprise and did what they should do…push back!
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.