It was 6 years ago that a newly elected premier and his colleagues called for reforms in the health sector, amongst many other things they had on their agenda. For two decades prior to that, a number of serious health and long-term care issues had been accumulating:
As Lamrock’s report (“What We All Want”) so eloquently noted, the issues in long-term care are way more numerous and complicated than simply adding a few beds or recruiting a few staff. The central issue is that there is not now, nor has there ever been, a plan for long-term care. A plan for nursing homes that does not include home care and special care homes along with many other long-term care issues is planning for one segment only. Plans presented in the last 20 years have not been long-term care plans at all.
Nor, for that matter, has there been a plan for the orderly development of health care. One of my mentors often said: “If you have no plan, any old road will do.” Health and Long-term care suffer, as do those who staff those services. Working in an environment that lacks clear vision and direction must be a struggle. What would a plan for Health and Long-Term Care look like? What would be the essential ingredients?
Apparently, there has been improvement in access to hip and knee surgery; wait times for other surgery seem to be unchanged. The issues that are in need of urgent focus and direction did not happen overnight nor will they be corrected overnight. Measurable progress can be made soon but not without courageous strength and determination. The steps required will not make everyone happy any more than regionalizing the hospitals made people happy in 1992. But it was the right thing to do and every province in Canada followed with their own versions. People wiser than I have noted that all politicians start out with a certain level of political capital and start investing it with the decisions they make. Such is the case in fixing health and long-term care. Reform requires a level of courage, commitment and vision that goes far beyond change. A good deal of political capital will be required if efforts to fix the issues described above are to be successful. Some elements of essential change will include:
What the public often does not understand is the complexity of getting change make in such a complex environment. I would hope that the public would resist the temptation to simply insist that government just pour in more money. We need to insist that the government take the time to create viable plans so that resources are invested in a responsible manner. It has taken primary care 30 years to get to its current state; it needs more than patchwork. Similarly with Long-Term care…. engaging nursing homes, special care homes, home care to their maximum and challenging their leaders to be creative….so much potential to be harnessed. Government cannot do it all alone. Emergency and Urgent Care also need systematic and well-considered planning, perhaps some external resources to advise. New Brunswick still has the opportunity and potential to become a model for the country. Small enough to be manageable; great cohort of professional staff Ken McGeorge,BS,DHA,CHE is a retired career health care CEO, part time consultant, and columnist with Brunswick News; he is the author of Health Care Reform in New Brunswick and may be reached at [email protected] or www.kenmcgeorge.com
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AuthorKen McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada. Archives
May 2023
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