Our lives have been forever changed with Covid-19, so say just about every informed observer of human behavior and public institutions. Just imagine….90 days ago our lives were moving blissfully along, snowbirds enjoying the south, New Brunswick political people debating an attempt to reform health care, rural communities upset, unions also not so happy.
And south of the border the press was wondering why people were concerned about a virus in China. The virus had already established itself firmly in Wuhan but United States media downplayed it as did prominent health authorities.
Then all of a sudden, it is a crisis and our world is in turmoil, full panic mode. Suddenly we, as citizens, were in panic, stores were out of toilet paper, hand sanitizer, and disinfectant wipes; long term care facilities scrambled to find basics like masks, gloves, and protective outerwear……and the prices skyrocketed!
Drop everything, go home, and stay home! Put your life on hold; do not go to work unless we tell you to. And if you lose money, we, the government, will cover your losses. And suddenly doctors were doing virtual, electronic patient visits, emergency departments were cleared, seniors got to the care level they needed rather than languishing in hospitals for months. Huge sums of public funds were suddenly allocated for many purposes never ever contemplated in doing a budget just days before Covid!
How does that happen? New Brunswick experienced a transformation of public policy and discourse. The leaders of our four political parties in New Brunswick suddenly discovered that more is gained when they work together toward a common goal than when they snipe at each other. No more ridicule, no more personal attacks and questions of credibility and integrity. Frankly, my sense is the public is tired of that anyway.
The fact that we can actually see visually, on television, the four leaders sitting at the same table discussing strategies for dealing with this dreaded disease is remarkable. Actually, this achievement should be held out as a model for the rest of Canada. It takes me back to the early days of health reform in the early 1990’s when New Brunswick was doing some incredible things, things thought impossible in Ontario, Nova Scotia, and points west. Many thought that New Brunswick was just the right size that it could become a model for the rest of Canada.
Results were achieved then in record time because in the legislature there was no opposition so government could do what it wanted. So Health Care Reform was born. But the absence of opposition is dangerous and that is why the official term describing the opposition party with the largest seat count is Her Majesty’s Official Opposition. Any government legislative initiative needs healthy, informed debate and health reform of 1992 may have gone better had there been that level of debate.
Other serious contributing factors were a premier with vision and a Minister of Health with knowledge and determination, supported by a superb team of knowledgeable, experienced civil servants.
The cynic will say that the legislature has not been capable of healthy informed debate for years. Depending on its composition that might often appear to be the case. But always in public policy there are multiple sides to any argument and the purpose of democracy is to ensure a fair hearing for all sides. Without that, we have autocracy or worse.
And indeed that is so. With a small population spread over significant square miles and with the closeness of the people to government, this province could, very well, become the model of how a province should be run.
Modernizing the health system has been a priority since real change was abandoned in the mid -1990’s and the public has paid a high price with long delays for specialty care, inefficient primary care if they have access to primary care at all. And who will forget that prior to the pandemic, emergency departments were really the surrogate for the access to primary care services that thousands of New Brunswickers do not have.
Why has real modernization not happened? Resistance from the usual sources of push-back would be one major factor. In “normal times”, doctors, nurses, unions, and other professional groups tend to react against any change that does not suit the immediate needs and aspirations of their members. In putting resistance forward, and now with 4 political parties, these groups have an ample supply of potential allies to line up against whoever is in power. In recent years, some exchanges in the legislature have been quite laughable if not annoying.
And thus it has been for 30 years and that is largely why no real progress has been made in fixing the health system. Given a choice, opposition politicians and the public will take the side of health professionals long before they will accept the direction of political leaders in government. So in New Brunswick we have had stalemate since 1995 on the things that really matter.
So what is the way forward? How do we regain the momentum that was in place in the early 1990’s? These columns have outlined, in the past year, many of the things required to move the agenda of health reform. But the power of the 4 parties coming together for the purpose of designing and developing a truly world class system of health care services would be phenomenal. Indeed, the prospect is exciting for those passionate about health care reform.
Just imagine what would happen if the 4 parties could agree on the 4-5 top major strategies required to transform the New Brunswick Health System. And just imagine what could happen when public servants, doctors, nurses and all in the system knew that “this agenda is here to stay.”
In the past, on a number of progressive initiatives, there has been blockage even within the civil service; public servants have occasionally been known to engage in waiting it out with a particular government or political figure, knowing that there will either be cabinet change or government change soon!
The last I knew of the public positions of each parties was that they know the system is unsustainable, that it has long standing performance issues, that way too many citizens have no access to the care they need when they need it.
So just suppose those same party leaders could sit in a room with a half dozen knowledgeable people for a couple of days and really sort through the real issues as opposed to the political blather that too often gets in the way. So much of the public discourse, often inflamed, is based on little fact and evidence and much hearsay and perception.
So while there is a mood to work together, and the public has been impressed with what they see, could they together with a small field of knowledgeable people with expertise, sit in that same meeting room, roll up their sleeves and find plausible answers to: What really needs to be done to ensure that New Brunswick residents have access to the superb diagnosis and treatment when they need it, where they need it, and in an efficient manner. That would truly make history in New Brunswick!
Then New Brunswick could become the model of public policy excellence that many have dreamed of but few have seriously thought possible. Just do it!
Ken McGeorge is a retired CEO in major teaching hospitals and long-term-care facilities. He was co-chair of the New Brunswick Council on Aging and is a columnist with Brunswick News. His email address is firstname.lastname@example.org.
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Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada.