New Brunswick needs a vision for health care

As we enter the next decade, it has never been more clear that New Brunswick needs a vision for health care.

Our province has budgeted $2.8 billion for health care in 2019-2020, roughly one-third of the province’s annual budget. Despite this, our health system struggles to provide timely access to primary and specialty care.

We routinely see hospital departments close due to lack of health-care professionals or available beds. Approximately one out of three New Brunswick hospital beds are occupied with alternative level of care patients, and our wait times for surgeries and emergency care are among the highest in Canada.

Our health system cannot keep up with the demand that exists today, and that demand is only going to grow. We have the largest proportion of seniors in the country and some of the highest rates of chronic health problems and obesity.

We must act now.

Over the past year, the New Brunswick Medical Society (NBMS) has worked with government to eliminate the physician billing number system which we believe will lead to more physicians choosing New Brunswick. We have also seen government announce a nursing resource strategy and plans to expedite the assessment process for long-term care patients to free up hospital beds and get seniors into special care or nursing homes more quickly.

We must build on these actions and make additional meaningful changes to the health system.

The Canadian Institute for Health Information forecasted that health spending per person in New Brunswick would hit $7,187 in 2019. That puts us at the bottom in Atlantic Canada and right in the middle of the pack among all provinces.

We recently learned that New Brunswick will receive an additional $219 million in equalization payments from the federal government next year. Imagine for a moment what that additional money could do to improve access to health care in our province.

What the New Brunswick health system needs is a strategic provincial health plan. The last plan, put in place by the Alward government, expired in 2018.

In our view, a provincial health plan should take a holistic view of the health system in New Brunswick with a goal of addressing the many health-care challenges.

The NBMS would like to see a provincial health plan with tangible objectives to align the health services that are provided around the province with the needs of our population. This health plan would address improving access to primary care, reducing surgical wait times, and improving access to special care and nursing home beds.

It would focus on reducing obesity rates by getting our population moving more and eating nutritious foods, starting in our schools, hospitals, and other public facilities. We need active communities where local, healthy food is available and promoted as a smart choice. By taking steps to reduce obesity rates, we can also start chipping away at the rate of chronic disease in our province.

Mental health must also be a key focus of a provincial health plan. Our mental health system is simply not built for the needs of 2020, especially among youth. We need to enhance access to mental health services. There are existing mental health programs and organizations across New Brunswick that provide valuable counselling services; they should be better supported.

Technology must be a key piece of a forward-thinking health plan. Virtual care — where physicians can see their patients remotely — is being used elsewhere across Canada to improve access to care. Wearable technology can also help patients better understand and manage their health, enabling them to make informed choices.

A provincial health plan must also consider the many determinants of health, including education, income, social supports, and affordable housing. They are key to an individual’s health.

Homelessness is a growing problem in New Brunswick and tackling it requires collaboration between government, communities, and perhaps even the private sector. For instance, Kaiser Permanente, one of the largest private health-care organizations in the U.S., partnered with a non-profit group to purchase and preserve affordable housing to help reduce health-care costs. This kind of innovative thinking could have a significant positive effect in New Brunswick.

The NBMS would also like to see government create a patient health record system that allows patients to access their records so they can better manage their health and their interactions with the health-care system.

These are just some of the ideas the NBMS would like to see government pursue in the coming months and years. We must be innovative, aggressive, and forward-thinking if we are to improve the health of our population.

We can not expect wholesale changes to the health system or the health of our population overnight. But hopefully a decade from now, we will be talking about the progress made toward a healthier New Brunswick.

Dr. Chris Goodyear, FRCSC, is a general surgeon in Fredericton and the president of the New Brunswick Medical Society.