https://www.cbc.ca/news/canada/new-brunswick/higgs-health-minister-1.6522029
Impatient Blaine Higgs drops health minister, Horizon CEO
Bruce Fitch becomes health minister, Dorothy Shephard moves to Social Development
Death in N.B ER waiting room highlights health-care crisis, premier says
Premier Blaine Higgs dropped his health minister Friday and fired the CEO of one of two New Brunswick health networks after worsening news on the health-care front that included a "traumatizing" death in an emergency department's waiting room.
Bruce Fitch is now health minister, switching places with Dorothy Shephard, who moves from Health to Social Development, Higgs announced, during a Friday afternoon news conference.
Higgs also announced Horizon Health Network CEO John Dornan was fired from his role, and replaced on an interim basis by Margaret Melanson, the network's vice-president clinical services.
In addition, Higgs said he revoked the boards of both Horizon and Vitalité health networks and installed in their place a trustee for each.
WATCH | 'It starts at the top:' Higgs details changes to health-care leadership
"We have a plan," Higgs said. "It needs to be implemented. The situation we're in today is the result of many, many years of successive governments refusing to deal with urgent situations."
The shakeup of New Brunswick's health-care leadership comes after a patient died in the waiting room of the Dr. Everett Chalmers Regional Hospital's emergency department early Tuesday morning while waiting for care.
Witness John Staples said the man, a senior, had been waiting alone in a wheelchair, in visible discomfort for hours when he appeared to fall asleep. It was only during a routine check of people in the waiting room that a hospital employee realized the man had stopped breathing, he said.
Investigation ordered into death
Higgs said he was "appalled" when he heard a patient died while waiting to be seen in an emergency department.
He said he's asked Horizon Health Network to undertake an investigation into what happened, and that if he's not satisfied with the results, will ask for an external review.
Premier Blaine Higgs said the death of a patient in a Fredericton waiting room this week was traumatizing for the ER, the family and people who witnessed it. (Pat Richard/CBC)
"I have no doubt that every New Brunswicker is saddened and concerned by this story. We all want to know that if we go to the hospital we will receive help we need."
Answering questions from reporters, Higgs said his hope is the investigation uncovers whether any standards for care at the hospital were not being met when the patient died in the waiting room.
However, he was quick to note he doesn't believe fault lies with frontline health-care workers.
"I don't believe this has anything to do with — and I'm just stating an opinion here — anything to do with the nurses on shift or the people on shift.
"I believe it's a management issue. I believe there's no co-ordination of activity and that's what I'm trying to drive home here. If we don't get better management results in our hospitals, we won't get better health care."
Switching ministers
Higgs praised Shephard's work during the pandemic, and for her role in putting forward a new health-care plan for the province.
However, he said, Fitch would take a "fresh look" at how the department measures performance and where the shortcomings lie in health care.
Dorothy Shephard was shuffled from being minister of health to minister of social development, while Bruce Fitch was moved from social development to the role of health minister. (CBC)
"In the case of Bruce joining, sometimes a change is, some may say, better than a rest," Higgs said.
"Bruce is a seasoned individual within the government … he'll work with people anywhere, as Dorothy was, but bringing in a fresh look at, OK, how do we measure performance? How do we deliver on results? Where have we not provided and followed through on commitments made and what were the root causes of that?"
Revoking health authority boards
In place of the boards of directors for the two health authorities, Higgs said his government has appointed trustees Suzanne Johnston and Gerald Richard for Horizon and Vitalité, respectively.
"We are fortunate to have two outstanding and experienced individuals to come out of retirement to help guide us through these challenging times.
The boards of the health networks include members elected by the public and members appointed by government.
Higgs said the two boards were revoked to make quicker changes at the two health authorities.
"We're taking a crisis management approach here to allow decisions to be made, to allow direct consultation with appropriate people and get on with it.
"So we're removing this situation of a bureaucratic stalemate … and this isn't intended to be permanent but this is intended to get results. And right now I need to see results, and I want to remove the barriers and roadblocks for our health professionals to achieve them."
Higgs said he didn't have a timeline for when he expects results from the two trustees and was vague on what their targets were.
"There's going to be some targets we'll be setting out there that we want to achieve first. So I can't put a timeline on it but I do want to be clear on what the outcomes need to be."
'Major step backwards,' says ousted Horizon chair
Higgs's announcement was met with swift criticism from Jeff McAloon, the Horizon board chair until Friday.
"I am disappointed and disheartened by Premier Higgs's unilateral decision to remove Dr. John Dornan as CEO of Horizon Health Network," McAloon said in an email statement.
"I believe in Dr. Dornan's experience and ability to affect real and positive change in the provincial health system."
During the news conference, Higgs sidestepped a question about what it was Dornan failed to do in his role as CEO.
"I think what I'm demonstrating here is a need to get a groundswell in relation to frontline workers in the case of Margaret Melanson and her role in clinical services and you know, how we can direct that in the hospitals," he said.
"I think in every hospital there needs to be a manager of clinical services that is really that gatekeeper of who is coming in? Who is going out? What's the time in? How quickly are we managing that? And we need to get on the ground with that.
Dr. John Dornan was fired as CEO of Horizon Health Network after being officially named to the position only four months ago. (Jacques Poitras/CBC)
McAloon characterized Higgs's move as a centralization of health-care control.
"To me, and to the partially elected, local board I led, today's announcement is a major step backward," he said.
"It represents the loss of community ownership and engagement and clinical, leadership expertise.
"Centralizing control within the Premier's Office is not the answer. Politics is what got us here and is not the solution."
McAloon said he had not heard from Higgs and only learned of his decision moments before the news conference began.
"I join with all New Brunswickers in their feelings of shock and want nothing more than to see our system stabilized."
Johanne Lise Landry, spokesperson for Vitalité Health Network, said in an email that the health network did not receive any correspondence about its board being revoked.
There was also reaction from the medical community itself.
"Firing Dr. John Dornan would have to rank as one of the ill-advised, mindless and ill-considered decisions I have ever heard," tweeted cardiologist Dr. Robert Teskey.
Opposition reaction
Interim Liberal Leader Roger Melanson wondered why it's taking so long for Higgs to do something about problems in the health–care system.
He said the premier has been in office for four years, and he needs to explain to New Brunswickers what his new plan is and why he thinks it will work.
But Melanson is concerned that attracting new doctors won't be high on the agenda for the province.
"We need health-care workers to be able to deliver these services, and they still have not even mentioned that today in this press conference," said Melanson.
Green Party health critic Megan Mitton said successive governments of Liberal and PC stripes have contributed to the state of the province's health-care system.
She's concerned about the abandonment of partially elected health boards, a move she said goes against democracy.
"We should not be seeing more centralization of our health-care system," said Mitton. "We should be going in the other direction and having more decision-making and power and resources at the local level."
Melanson said he would like to see the legislature recalled to deal with this issue, something Mitton said she would support.
ABOUT THE AUTHOR
-With files from Karissa Donkin, Shift and Jordan Gill
Horizon review underway after patient dies in Fredericton ER waiting room
Witness John Staples says the health-care system is 'broken,' Liberals call for health minister's resignation
John Staples says the experience was a "stark and sombre realization" that New Brunswick's health-care system is "so sadly broken."
"It was a surreal moment because, I mean, I think I realized that they had just passed away in an ER waiting room," he said. "You're at a place where you're supposed to get care and you wind up passing away while you're waiting for that care."
"You're basically at the front door of health care … You're on the threshold of getting the care you need and you don't get it in time."
Staples, a residential support worker at an Oromocto community residence, says he went to the emergency room with a client who needed emergency care around midnight Monday.
He noticed the patient in question, who was several feet in front of them.
"It was very evident that they were in a lot of discomfort, just the way that they were behaving," he said.
"There was moaning and groaning and just the grimace on the face. I mean, it's just, you know, natural signs of discomfort when somebody is ill."
Appeared to fall asleep
After at least an hour of waiting, Staples moved his client from sitting along the wall to sitting beside the patient, respecting COVID distancing, so the client could watch the television on the wall.
Staples and his client watched a couple of half-hour TV shows and the patient appeared to fall asleep, he said.
John Staples says he doesn't know the man whose death he witnessed in the ER, but that 'doesn't change the importance and the severity of the situation.' (Submitted by John Staples)
A hospital employee came out to check on people in the ER, which was fairly full, Staples said.
"And when they checked this one individual, very professionally rushed back [into the ER], so as not to cause any alarm, I assume."
Staples looked at the patient and noticed no rise and fall of the man's chest to indicate he was breathing. "And I thought, 'This person is gone.'"
That's when the hospital employee reappeared with three people and they wheeled the patient into the ER, he said.
"And as they were wheeling that person back, they called the 'code blue,'" which typically signals cardiac or respiratory arrest.
But they were too late.
"So that individual actually sat there in the waiting room and passed away."
No details released
Dr. John Dornan, president and CEO of the Horizon Health Network, confirmed that "an unexpected patient death took place" in the emergency department waiting room of the Dr. Everett Chalmers Regional Hospital on Tuesday,.
No details about the patient or the circumstances surrounding the death have been released.
"Horizon thoroughly reviews any unexpected deaths that occur in our facilities to determine what took place and whether further action is required," Dornan said in an emailed statement. "As it relates to this incident, we immediately started the review process.
"We would like to extend our deepest sympathies to this individual's family and loved ones."
'We all have somebody that it could have been'
Staples was so moved by the experience he posted about it on social media Tuesday night.
"I think bringing this to people's attention, I mean, it's not new information, the wait times and the strain on our health-care system. But the fact that somebody passed away while waiting in a waiting room is — if there's ever a straw that breaks the camel's back, I think this is definitely a good opportunity for change to come about because we can't have people dying in our waiting rooms."
The Facebook post appears to have struck a chord. By Wednesday afternoon, it had been shared more than 3,000 times and had received nearly 200 comments. Staples isn't surprised.
"Well, I know for me personally, I have elderly parents. My dad has health issues. It could have been my dad being there. Right? And we all have somebody that it could have been.
"I mean, the fact that I didn't know the name of the individual who passed away doesn't change the importance and the severity of the situation.
"They're somebody's loved one. … They're still somebody who deserves the dignity and respect of being seen by a health-care professional."
Staples couldn't say whether the patient was triaged properly but said he doesn't blame the ER staff who were working that busy overnight shift. He has great empathy for them, he said.
They had to field a lot of questions and complaints from patients, he said, including one man who rang the bell after waiting four hours and left without being treated, as did a few others while Staples was there.
"The attendant was very empathetic with [the man who complained], but [said], 'You know, we've had people that have been here for eight hours. We're doing everything that we can,' which I believe they were.
"But it's just, what do we do with these wait times? Like, where do we get the doctors to come in so that we don't have people dying in waiting rooms?"
Minister reacts
Health Minister Dorothy Shephard said she was "deeply saddened and concerned" to learn of the patient's death and offered sympathy to the individual's family and friends.
She has requested a review of "the incident" from Horizon "for a complete understanding," she said in an emailed statement.
"We know the health care system is facing challenges and that frontline staff are working hard," Shephard said. "I have no doubt that every New Brunswicker and all of our health care workers are affected by this story. We all want to know that when we go for help it will be there, and that it can be provided.
"I anticipate receiving more information from Horizon officials in the coming days as the review progresses and the Department of Health offers our support to help in any way we can."
Save system 'before it's too late'
The Official Opposition is calling for the minister's resignation.
Jean-Claude D'Amours, the health critic for the Liberals, issued a statement late Tuesday afternoon about the patient's "very tragic passing" and offering condolences to family and friends "involved in this sad situation."
Citizens are pleading for help and all we hear from this government are platitudes and excuses for missed deadlines.
- Jean-Claude D'Amours, Liberal health critic
"Unfortunately, given the incompetence of the Higgs government and in particular the minister of health in addressing the dire crisis in health care in this province, this terrible outcome was a very real possibility," D'Amours said.
The Liberals have repeatedly demanded to see Shephard's plan to recruit "desperately needed health care professionals," he said.
"And ours is not a unique voice: professional health care associations like the Medical Society and the Nurses Association have demanded action, citizens are pleading for help and all we hear from this government are platitudes and excuses for missed deadlines."
D'Amours called on the province to immediately free up enough of its "huge surpluses" to address hospital staffing issues.
Finance Minister Ernie Steeves initially budgeted a $244 million deficit for this year, but massive federal pandemic spending and a roaring economy turned it into a projected $487.8 million surplus.
But last month, Premier Blaine Higgs said it's too early to say if the province will be able to run a budget surplus as projected. The province is facing $100 million in higher costs because of inflation, and N.B. Power could take a similar hit, he said.
The premier "needs to stop whining to the federal government, demand that his minister of health resign and get on with saving our health care system before it's too late," said D'Amours.
With files from Hadeel Ibrahim