Disclaimer: I am not affiliated with any political party; in my career I have tried to stay in my lane of administering hospitals and long-term care facilities. It has always been wise to maintain great working relationships with persons in all major parties, sharing with them all that I know which is health and long-term care excellence. Beyond that, who gets elected is up to the public as far as my involvement is considered.
With that in mind, and since I have been so visibly passionate about health and long-term care reform in the past several years, it goes without saying that anything that slows down what should have been a clear reform process is irritating to me. In my commentaries, in the past 4 years, I have outlined issues around long waits in Emergency, Primary Care Access (or not), workplace culture and health manpower issues and ever so much more.
In 2021, following false starts, a new approach to reform was announced based on consultations undertaken by the Department of Health and its Minister, Dorothy Shephard. My adrenaline picked up when priorities were outlined; then when the health authority boards were replaced by two Trustees to guide “reform”, I confess to having some optimism.
For the 15 months that the Trustees served, apparently some initiatives were taken. Lots of things including e-visit and others that would be described, in reform terms, as incremental initiatives.
I would be remiss if I did not acknowledge the efforts of those who have been trying to get things moving. There have been positive improvements, some regulations that impede the engagement of foreign-trained health professionals are getting dealt with finally. There are pockets of good things happening.
But the call has been for reform and that was the language a few years back. Reform is different from incremental change. Reform engages leaders and informed public policy persons in moving the agenda with focus and decisiveness. This is what happened in the reforms of 1992: very public, very tough, very focused, the right people at the table.
To get serious traction on the primary care issue, the overcrowding in emergency departments, the large numbers of hospital beds occupied by persons waiting for long term care, the human resources issues…. these require a reform mentality with reform thinking. That is where the rubber hits the road.
Getting to real reform, policy makers need to understand that neither the civil service nor the elected government can get the job done in real time with business as usual. It requires a level of thinking and approach not yet seen that can only be initiated by senior government while engaging key leaders outside government.
Then, while health and long-term care reform is so vital to thousands of families and seniors in the province, governments’ agenda went in a different direction; that is not my issue. So now we seem to be faced with an election with the distraction and delay that election campaigns and political instability engender.
Whatever is the outcome of this period of delay, I would plead with whoever forms the government following this period that they make health and long-term care a priority and assign it Reform Status. The issues that are so troublesome to the public are not new but have been brewing for over 20 years and certainly visible for well over a decade. And the results of not responding in fairly short order are not good. Just speak with the people who have struggled with these issues. It is not a matter of numbers but of policy.
The stories that I hear unsolicited from readers and other contacts do not represent what the public should expect in a country whose health system, per capita, ranks amongst the highest in the world after the US.
To get the policy right, you need a reform mentality with the right people with the right motivation at the table. Quality health and long-term care is not created nor maintained with sound-bites, technology, quick fixes. The only thing that should be quick is getting at the issues with the right people.
Serious reform takes place when the language changes. The language has to start with government who need, then, to assemble the right people with the right facts and insight as to how to drive essential change. Frankly, much of the change that needs to take place will be difficult for elected officials and public servants, but reform must happen.
In a previous position that I held, we began to seriously turn the tide when we declared “this organization will be a Centre of Excellence.” That sent the right messages to the public, employees, unions, potential partners, and so much more. Similarly, government needs simply to state emphatically that Reform will happen and here is the team to drive it, here are their priorities and here is the timeline. Approaching these difficult challenges with incremental, tentative language simply keeps the status quo in place or worse.
It is hard to imagine that if elected officials and senior public servants seriously knew the gravity of the situation, mountains would be moved in order to get to an acceptable level of public service. Hopefully the political waters will settle and true reform can proceed.
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@example.com or www.kenmcgeorge.com
Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.