In the last twenty years, the stories from good New Brunswickers have been heartbreaking. In the old days, a family doctor, facing slow-down leading to retirement, took responsibility for the transition of persons in his practice roster either to someone taking over the practice (a son, daughter, or new business partner) or to a new physician or physician group that would buy the practice and take over the care of the persons on the care roster.
That started to change 25 years ago for many reasons and it has become very difficult for doctors with “a practice” and case roster to “sell the practice” when a new practitioner can simply open up an office and be flooded with people desperate to “have a family doctor”, the euphemism for access to primary health care services. Volumes can be written on what all the changes have been that have created this situation but in the last 20 years we have heard horror stories almost daily of persons, often families or elderly couples, whose physician has decided to either move away, retire, or otherwise “give up the practice”.
For well over a decade in New Brunswick, many informed professionals, some former senior civil servants, others former politicians, others informed nursing persons, have been sounding the alarm about the state of Health and Long-Term Care Services in New Brunswick. Disgruntled nurses and an impending nursing crisis was foreseen two decades ago, for instance. The overcrowded emergency departments have been a serious issue since the early 1990’s. Primary Health Care Services and the issue of “getting a family doctor” has been an issue for nearly two decades.
Some of these bright people offered their help to the Gallant government but that was not acknowledged. Then some of these folks, all feeling a sense of desperation, offered to support the current government, taking heart in the Premier’s commitment, nearly 3 years ago, to health care reform.
The early attempt by the government to initiate reform in February 2020 was ill-conceived and ill-informed and it did backfire in a big way. Then after a cabinet shuffle, a new commitment to reform was made with virtual public consultations as a major element. What was reported from the consultations seemed strangely similar to many of the messages that have been discussed by informed people for nearly two decades; that is, there was nothing new.
Here We Go Again: Federal-Provincial negotiations on Transfers for Health Expenses
Some things never change! In 1965, when Judy LaMarsh was Federal Health Minister, the provinces were already sounding warnings of the rapid increase in health care costs, even though the Canadian Federal/Provincial Health System, had only been in place for six years! Years later, when Paul Martin was Finance Minister there was lots of federal/provincial debate about the costs as the federal government sought to slow down the growth by capping transfer payments. And so, it has gone with every government federally and provincially since the inception of the system in 1959 then Medicare in 1969.
So now they are at it again: the provinces, with legitimacy, arguing that the system that was supposed to be a 50/50 cost sharing has drifted a long way from that with the provinces left holding the bag for way more than was intended in 1959. The Hon. Dominic LeBlanc expresses the intent to have a resolution this fall while Mr. Higgs keeps pushing, as he should, for a larger fiscal presence by the Feds.
But it won’t stop there!
Tommy Douglas would be most disturbed at what he reads in the press this week! Two headline stories on July 4 in Brunswick News: Sinking Faster than the Titanic (Dr. Mark Waite) and Moncton Orthopedic Surgeons stop accepting referrals for elective surgery. That was not the vision that Mr. Douglas had nor any of those political leaders who went to the wall at a time of intense national debate in the 1950’s. Ours was to be a system that provided for essential medically-necessary care of all Canadians.
Fast forward to 2022 and the water gets really murky. Those who have been carefully tracking the trends for decades have seen this day coming for years; those with their focus strictly on budgets perhaps not so much. Much has already been written and said about how we have arrived at this place and this is no time to point fingers and ascribe blame. It is a set of health and long-term care circumstances that simply do not respond effectively to the demographic of 2022.
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.