The Case for Civil Service Reform: Part 2

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.  

But they come to their positions of MLA and some to cabinet positions lacking the level of knowledge that is required to ensure that responsible public policy is made and executed.  As they do that, they have every right to believe that staff in the respective departments have subject matter expertise at the level of development that should be strong resources for advising on policy relevant to the issues of the day.

In health, it could reasonably be expected that there would be a rich mix of people with advanced training and much experience in health care service delivery. It is not really possible to understand health services unless you have “paid your dues” in the trenches.  Working with Boards, Unions, families and sick people, physicians, nurses, and the entire array of great professional and vocational groups that make up health care…. that is an education in itself whether for a couple of years or for decades.

When the minister needs expert advice for dealing with the variety and complexity of issues that they face daily, he/she should be able to assume that there are those in the department with that rich mix of experience, education, and practical experience the various levels of health care that the department regulates.

In the hospital field in which I invested decades in my career, the rule of thumb was that new board members need multiple years of experience on the board before they finally feel comfortable with their understanding of the issues.  Hospitals are known in the literature as one of the most complex organization types in our society.

Persons who excel in one branch of public service, if moved to a senior administrative position in the health or social development department will normally struggle for a year or two until they get to understand the sector in which they are now playing a role in regulating.  

Norbert Cunningham, in his column on September 16, said it well:  the result of all this is the perpetuation of the merry go round:  same issues, different government, and if we don’t like what this minister is trying to do, we can wait him out…. he will be gone in a few months!
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In my career, I have always been engaged in working as the CEO of some hospital or long-term care facility in which I was accountable to a board of directors.  In every case, these were people who had great experience in their own careers whether as lawyer, banker, accountant, physician, priest, local business person, often a mayor or councillor.  There was a board orientation program in which they were quickly schooled in the basics:  legislation, labor regulations, governmental regulations, financing and governmental policies, governance and the legal duties and demands on trustees.

In every case they took their jobs very seriously and ensured that as CEO I not only had a contract that spelled out accountabilities, limitations, performance requirements, and compensation.  I was not allowed to “do what I wish” but had great accountability to the board which led to very meaningful relationships.   Those relationships and accountabilities enabled us to move organizations to new levels of performance.

So, in New Brunswick we now have some of our most treasured programs that seem to be “in the ditch”.  Do we need to hear more about the embarrassingly long waits for emergency and urgent care?  The health care issues with public under-servicing in primary care, human resources development, urgent care and, for sure, emergency department waits.  Long-term care gets equal billing on the public policy scale.  ALCs are a serious measure and symptom of system effectiveness, or not, but as documented in the last commentary, there are so many other issues in that file that have had scant attention. 

In my consulting assignments I witnessed many situations that honestly do not measure up to quality and great service.  But those issues, like Norbert’s merry-go-round, go round and round.

Then in the news today was the release of Lamrock’s report of how the education system is failing our children.  While sobering, it comes as no surprise to observers of the public policy scene.  Each government that has gotten elected in the years I have been in this province (since 1990), has appeared to “have the fix” for the education system and, surprise, they seldom work well.  But the Advocate, who is closer than most of us by far, has seen enough to warrant him using his good office to heighten awareness for the need to overhaul.

The common denominator in those three illustrations is the public service, in my view.  Most civil servants, and all that I have known personally, were great people who wanted to do good work.  But the collective best efforts have resulted in these three vital public services being in need of new directions.  In any organization that I have led, when faced with similar situations, albeit on a much smaller scale, it always resulted in serious course change.  That is how excellence happens.  Not simple, risky, difficult…. all of that.  But essential.
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Government has announced the development of new plans associated with some level of consultations for Education and Long-Term Care.  I expect that many feel as I have come to feel:  been there, done that!  I have attended many consultations in the years that I have been here.  I can’t, for the life of me, imagine anything of substance coming from any that I attended.  I always had the feeling of “they know what they want to do and just need to be able to say they consulted with the public.”

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