Ken McGeorge
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The Case for Civil Service Reform: Part 2

9/19/2025

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In my commentary on this topic published in June 2025, I touched on the role that the Civil Service should be playing in finding solutions to those difficult issues in health and long-term care that just keep getting worse.  As we seem to go from bad to worse on these issues that are of such importance to the public, politicians take all of the hits that result in interesting headlines and shots in the legislature as they try to explain issues.  They usually are crises, with each party attempting to pressure the party in power into announcing something.  Just announce something that sounds plausible so we can debate and criticize.

That is the typical process that so often results in disappointment for one side, frustration for the public, and a small victory for whoever won the skirmish.

I have watched this performance in our legislature for 25 years as the key issues of Human Resources, access to primary care, emergency department overflow with long waits, and the backlog for long-term care with all the issues in that sector that have remained fallow for decades.  I have watched as “debates” take place and all too often what I was seeing and hearing was not too impressive.  Often responses to opposition questions would represent, to my ears, information that I honestly knew to be lacking.  Sometimes I would leave wondering where that came from.

Minister Shepherd was a breath of fresh air when she dared to start her budget speech with the line that now resonates with many: “you cannot reform health care until you fix long-term care!”  Knowledgeable people in those sectors took note!

That politicians deserve heat goes without saying; they are the ones who get elected with promises to fix issues that they deem the public to be most concerned with.  And many of them become very skilled at responding to questions.  

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​ALC’s Again!  And Again!  And??

9/1/2025

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Despite any “emergency measures” put in place, the situation with elders occupying acute care beds in hospitals awaiting long term care continues to grow.  Government intervention is supposed to resolve problems!  Not so much on this file!

Ask any of the great physicians in practice for reasons and you will get different responses.  Ask civil servants and you will get some responses.  Friends in the political world will give some other responses depending on their exposure to this disaster and at what level and under what circumstances.  From Media friends, another assessment depending on who they have interviewed recently on the topic.

There are lots of opinions.  The advocacy associations will have yet another list of issues and they tend to be closer to the real issues because it is their lived experience every day and many have been advancing advice for decades.

The Lamrock Report had some nuggets of gold.  In 200 pages and 59 recommendations he covered the waterfront of long-term care, the best analysis done in NB in my lifetime.  It is an exhaustive report and the nuggets need to be taken seriously and dealt with strategically; otherwise, we will have this problem, only worse, in a year, two years and more.  When you need to build a system, you have to start somewhere; the system will not appear by itself.

In the last 20 years I have invested weeks and weeks, yea, months and months, reading, talking with serious experts in the field (nationally and internationally), discussing issues with politicians, civil servants, service providers and advocacy groups.  Some of those with whom I have interacted are legitimately “international thought leaders”.  These are not people who simply have an opinion based on a neighbor’s experience.
I have had great interactions with colleagues in Norway, Netherlands, Quebec, Ontario, BC, Alberta, Manitoba, Nova Scotia, PEI and more.


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    ​Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada. 

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