Amid political and pandemic uncertainty, health care must move forward
A possible political shakeup and second wave of COVID-19 have the potential to greatly impact the future of health care in New Brunswick.
As of this writing, it’s unclear whether a more formal collaboration of political parties will lead the way in New Brunswick or whether we are heading to a provincial election in the near future. What is clear and what cannot be lost in these uncertain times is the need for dramatic health system improvements in our province.
Physicians and others have noted the many critical issues facing our health system: the shortage of health-care professionals and available hospital beds; wait times for surgeries and emergency care among the highest in Canada; the largest proportion of seniors and the highest rates of chronic health problems such as diabetes, heart disease, and cancer in the country; and a shortage of mental health and addictions resources. These are just a few of the challenges.
We refer to the health “system” when discussing these challenges, but what we are ultimately concerned with is the health of the citizens of New Brunswick. Any efforts to change or enhance our health system must be based on solid evidence and have a goal of improving access to care for all New Brunswickers.
Thanks to the leadership of Public Health officials and local health-care providers as well as Premier Higgs and the COVID-19 cabinet committee, New Brunswick has weathered the first wave of COVID-19 better than most jurisdictions. But it wasn’t without sacrifice: the wait list for surgeries grew significantly when non-urgent procedures were put on hold during the first months of the pandemic. The challenges outlined above are just a few of the many that remained as we focused our attention on the immediate concern of the pandemic.
As we move forward, I believe New Brunswick is well prepared to manage an expected second wave of COVID-19. We have learned many lessons in recent months that will inform how government, health officials, and the public respond to the next phase of the pandemic.
With the school year beginning next month, it is critical that we balance societal, educational, and economic needs with the safety of New Brunswickers. Robust COVID-19 testing across all communities must continue and an adequate supply of personal protective equipment for health-care providers must be maintained. We have all seen the benefit of virtual care during the pandemic; clearly, we need a long-term, sustainable plan for virtual care through and post COVID-19. I would also encourage greater local physician involvement in clinical planning to support the government’s pandemic task force through future phases of COVID-19.
We cannot take our eyes off the pandemic, but like our economy we must also enable our health system to move forward. We must make changes. The status quo was unsustainable and unacceptable prior to the pandemic and that has not changed. Whatever the result of the political discussions happening in Fredericton, health care must be recognized as a key issue for all political parties.
New Brunswick’s health system needs a renewed provincial health plan built in collaboration with government and health-care leaders. The last plan, put in place by the Alward government, expired in 2018. A provincial health plan should take a holistic view of the health system with tangible objectives to align the services that are provided around the province with the needs of our population
Health budgets should be focused on meeting the immediate needs of the population while adequately building for the future of health care in New Brunswick: ensuring appropriate resources are available to accommodate each community’s basic needs; integrating services for improved senior and community-based care; creating a robust primary-care system that contributes to exceptional care; and enabling virtual solutions where and when suitable, especially for rural and remote communities.
In its 2020-2021 budget, the Higgs government announced a 3.9 per cent increase in health spending, a move in the right direction. Late last year, the federal government announced an additional $219 million in unconditional payments to New Brunswick in 2020-2021, far more than what was expected by provincial officials. Going forward, a significant portion of these annual federal payments should be allocated to the provincial health budget to cover inflation, increased cost of senior care, and overall system growth.
The province also needs a robust health human resource strategy to improve recruitment and retention of physicians, nurses, and other allied health professionals, who all play an integral role in optimal patient care.
New Brunswick needs a renewed focus on health human resource management and a holistic plan for current and future needs for all regulated health-care professionals. We are in competition with all other jurisdictions for these much-needed individuals. A provincial recruitment framework is required with collaboration from regional health authorities, government, and health-care professionals. Funding for additional seats for medical programs and schools should be considered.
Existing shortages have caused numerous challenges in recent years. Approximately 30,000 to 35,000 New Brunswickers do not have a primary-care provider. That number fluctuates but remains far too high. We have also seen a shortage of health-care professionals leading to numerous service interruptions in northern regions. As our population ages and existing health professionals look to retirement, the challenges will only grow. This cannot continue.
In addition to simply hiring more health professionals, we need to strengthen our primary care system and increase access to services. With strong primary health services, patients can avoid emergency room and walk in-clinic visits, focus on preventative care, and remain within their community. Investments in primary health care could include integrating allied health professionals within physician practices; growing Family Medicine New Brunswick, the province’s collaborative family practice model; creating a new provincial eHealth strategy; enhancing walk-in clinic practices; and improving access to reproductive services and health care for LGBTQ+ patients.
These are just some of the many issues that the New Brunswick Medical Society believes must be considered — now.
Whether we find ourselves with a more collaborative government or we head to the polls in the coming weeks or months, these issues will not go away. Health-care improvement is a long game. It has taken us many years to get to this point and it will take concerted, focused effort from governments and health-care leaders of today and tomorrow to improve the system and ultimately provide better care to all New Brunswickers.
Dr. Chris Goodyear, FRCSC, is a general surgeon in Fredericton and the president of the New Brunswick Medical Society.