Liberals promise 30 collaborative health-care clinics before 2028
In first major commitment ahead of election, leader Susan Holt says clinics would improve primary-care access
Liberal Leader Susan Holt is promising to open "at least" 30 collaborative health-care clinics in her first three years of power in order to cut wait times for primary care.
Holt said the commitment — the party's first major promise ahead of the fall election campaign — would cost $115.2 million over four years.
"Your health care is our number one priority," she said. "We will cut your wait time for care."
Holt said if she's elected, the first four clinics, in Fredericton, St. Stephen, Sussex and Campbellton, would open in 2025, and the rest would be operating before 2028.
The first four locations are in areas that were promised "integrated community care" facilities in the Higgs government's 2022 throne speech. The other sites were based on data from the arm's-length New Brunswick Health Council, she said.
The centres would bring together doctors, nurses, nurse practitioners, psychologists, physiotherapists, pharmacists and others "to provide a health-care home for patients," the Liberals said.
Holt said that some of the 30 new clinics would be managed by the regional health authorities, some would be set up by groups of clinicians and still others might be through partnerships with municipalities.
Holt was joined by 16 Liberal candidates for her announcement in Fredericton, where the lack of access to primary care is acute.
According to the council, 79 per cent of New Brunswickers have access to primary care, down from 93 per cent in 2017.
Holt invited New Brunswickers to measure the success of her plan based on those numbers, saying she was aiming to increase that percentage above 80 per cent and was "shooting" to get it higher than 90 per cent.
She also said reducing the 180,000 people on the wait list for a doctor would be another measure.
"Our government is prepared to be held accountable to these commitments," she said.
Premier
Blaine Higgs said Monday he wouldn’t respond to the Liberal criticism
but pointed out his government is also working on rolling out
collaborative care clinics. (Jacques Poitras/CBC)
The Liberal leader said the $115.2 million cost included capital costs for clinic spaces and technology, and the hiring of non-clinical administrative staff for each centre.
Taking the paperwork burden off doctors and nurse practitioners would free up more of their time to see patients and would make it more attractive to recruit more professionals, she said.
Many family doctors "tell us they are drowning in a broken model of primary care that needs to be fixed," Holt said.
She said there are additional clinics ready to go in several communities, including in Sussex and Haut-Madawaska, but the province hasn't put enough supports in place, such as funding for administrative support.
In June, Health Minister Bruce Fitch announced several changes to reduce the administrative load on doctors and to encourage more of them to join collaborative care clinics.
Premier Blaine Higgs said Monday he wouldn't respond to the Liberal criticism but pointed out his government is also working on rolling out collaborative care clinics.
"We have to find different ways to deliver primary care," he said.
In July, Fitch said 26 of the 35 initiatives in the government's 2022 health plan have been completed.
That included connecting 59,000 people to New Brunswick Health Link, which allows people without a primary care provider to register to see someone in the interim.
The PC party's executive director Doug Williams said the previous Liberal government of Brian Gallant, which Holt worked for, had promised every New Brunswick a family doctor.
"Today's announcement by Susan Holt continues a Liberal tradition of making big healthcare promises before an election that are completely ignored as soon as the vote is over," Williams said in an email.
New
Brunswick Health Council CEO Stéphane Robichaud told CBC News recently
that New Brunswick has among the highest provincial rates of family
doctors in solo practices. (Submitted by Stéphane Robichaud)
New Brunswick Health Council CEO Stéphane Robichaud told CBC News recently that New Brunswick has among the highest provincial rates of family doctors in solo practices.
With many physicians retiring, that leaves patients susceptible to losing access to care, given no provincial co-ordination of primary care.
"That environment has not been managed at all," said Robichaud.
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With files from Nipun Tiwari
scary...... under Higgs............not a word from health minister
In 2018 Higgs touted himself as an experienced manager and legislator that would hit the ground running. Six years later NB healthcare is in way worse shape.
Crisis in the ER: Fredericton doctor asks if it’s time to call a state of emergency
Fredericton emergency room doctor Dr. Yogi Sehgal is asking whether it’s time for the provincial government to declare a state of emergency for what he calls a medical system in “crisis mode.”
He said Fredericton, N.B., is decades behind what it should be, with an aging population and too few physicians for a rising demand for health care.
Code Orange
On Aug. 24, Sehgal says, he was called into work after his shift to help with a Code Orange – the number of incoming patients exceeded the department’s normal capacity.
He said there were nine trauma patients in the ER in addition to expected patients. With a shortage of space, he had to assess some patients in what were “essentially hallways.”
He added that patients with less serious ailments weren’t seen for hours, which can be dangerous for people with conditions like appendicitis where delaying treatment can make the situation worse.
“The one that’s OK for a bit but does get into trouble,” he said.
He wants to know whether a state of emergency might temporarily reduce strain on the system as a band-aid solution while the medical system is revamped.
“Would it benefit us to be in a state of emergency, and if it is, then why wouldn’t a politician do it?” he asked in an interview with Global News.
Provincial state of emergency
According to the Government of New Brunswick’s website, provinces have to show they’ve either exhausted their resources or are without resources before they can get federal help. It also says a state of emergency “has nothing to do” with funding or federal assistance.
In a statement, provincial health minister Bruce Fitch did not say whether the province would consider a state of emergency, but said that dependable public health care is a priority for the department.
He listed a number of measures the department has taken, including recruitment efforts and implementing programs like NB Health Link.
Health care in crisis
Sehgal isn’t the only one speaking out about the challenges being faced within the medical system.
Dr. Paula Keating of the New Brunswick Medical Society also says the province’s health care is in crisis.
“People are feeling desperate at times to seek medical care. Health care providers, front-line workers are feeling over-worked, over-stressed,” she said.
She suggests that with more stabilization and support, it can get better.
“I see hope on the horizon,” she said.
Dr. Sehgal is not so optimistic, and points to recent tragedies as evidence of a broken system.
In 2022, 78-year-old Darrell Mesheau was found dead after staying in the Dr. Everette Chalmers Regional Hospital ER waiting room for nearly seven hours.
Sehgal predicts it will happen again.
“I’m surprised that’s the only one that made the media, because there have been plenty of near-misses or close calls, and not surprisingly. There’s no way we can keep up with absolutely everything,” he said.
As for long-term solutions, he wants more nursing homes, care for seniors and support for people experiencing poverty to reduce the strain on ERs.
“That’s something that needs to change today. That’s not something that can wait five years to change,” Sehgal said.
— With files from Global News’ Jake Webb'Scary' state of health-care system prompts Fredericton ER doc to compile rescue ideas
Dr. Yogi Sehgal says hospital closures possible if dire strain on staffing worsens
Doctors and nurses are having panic attacks on the job, and many who haven't already left because of stress are exploring ways to, according to an emergency room doctor in Fredericton.
New Brunswick's health-care system is in "crisis," and Dr. Yogi Sehgal says political and health-care leaders need to act immediately before the exodus of staff reaches a "critical mass" that leads to widespread hospital closures.
"You could see the system kind of steadily circling the drain over the last few years and in the … last year, a lot of people have been leaving on a daily basis, and they tell me the reasons for it and those reasons haven't changed at all.
"It's scary to go to work and see people having panic attacks at work and actively looking for other jobs on their breaks."
Sehgal said the problems facing the province's health-care system have become so dire that he was inspired to gather his own recommendations and those of his colleagues.
Sehgal says nurses and doctors are having panic attacks at work because of high stress caused by problems in the system. (Joe McDonald/CBC)
On Wednesday, he emailed copies of a 10-page report he wrote to Premier Blaine Higgs, Health Minister Bruce Fitch, Social Development Minister Dorothy Shephard, and leaders within the Horizon and Vitalité health networks.
The laundry list of recommendations covers how emergency departments could be better staffed and operated, better compensation and more protection for nurses, and boosting incentives to recruit physicians, nurse practitioners and physician assistants for improved access to primary care.
Speaking to CBC News on Thursday, Sehgal said the problems facing the province's health-care services are systemic, with problems in one area having knock-on effects in others.
However, he said one of the biggest problems is the lag in having eligible hospital patients transferred to nursing homes.
"If you just remove those patients out of hospital, you now have a whole bunch of space and potential staff that you can use in other ways, so that's a big one for me," he said.
"And of course, the nursing home patients will get better care in a nursing home than in the hospital."
Promised improvements falling flat
Last fall, the Department of Health released its plan for improving health-care, which is referred to as being in crisis.
The plan set timelines for providing primary care access to all New Brunswickers and offering more supports to help seniors remain in their own homes and out of hospital beds.
More recently, Higgs has promised improvements by way of removing the boards of directors for Horizon and Vitalite and replacing them with trustees tasked with making quick, decisive changes in light of the death of a man while waiting in the emergency department waiting of Fredericton's hospital.
Sehgal said he's aware of those commitments, but he hasn't seen any material difference.
"You can see things getting just a little bit worse all the time, and it just takes that critical mass [of staff] to be gone and then we're in real trouble," he said.
"Like you just won't be able to get the system back up, and then you'll be shutting down hospitals and you'll be, you know, you'll be making very difficult decisions of who gets care and who doesn't, which is, you know, that's unfortunately coming. That the outcome I think we're trying to avoid."
Sehgal's recommendations to officials are "bang-on," said Anthony Knight, CEO of the New Brunswick Medical Society.
"He understands from the front lines as an emergency room physician the challenges confronting our health system, the difficulties patients are facing, and the frustrations family physicians and other health care workers are experiencing on a daily basis," Knight said.
New
Brunswick Medical Society CEO Anthony Knight says Sehgal's
recommendations for improving the health-care system are 'bang on.' (Zoom/CBC)
Knight said the medical society have already advocated some of the recommendations, adding that he encourages Fitch and other leaders in his department to review the document and work on implementing them.
"There are health, human resource shortages throughout New Brunswick, and this places additional strain on those who are able to or continue to work in the province, and his recommendations really capture several of the new initiatives that need to be taken action on immediately by government."
Minister 'happy' to hear from doctor
In an email statement to CBC News, Health Minister Fitch said he was pleased to receive Sehgal's recommendations.
"I am happy that we are hearing from him and others who are offering solutions," Fitch said.
"It is important for us to hear about actions and improvements that people working in the system see as crucial to improving our health-care system and to build upon the incredible work and care being provided to New Brunswickers every day."
Health Minister Bruce Fitch says he's happy to have received the report from Sehgal. (Ed Hunter/CBC)
Fitch said he just began reviewing Sehgal's document, which he received late Wednesday night but noted that several items align with priorities in the provincial health plan, including allowing staff to work to their full scope of practice, improving access to primary health care and addiction and mental health services.
"I will be speaking to staff with the Department, the trustees from the regional health authorities (RHAs) and Extra-Mural/Ambulance NB (EMANB) about all the ideas we are receiving to see how we can take action that will lead to improvements in our health system that benefit New Brunswickers."
Health networks review recommendations
In an email statement to CBC News, Dr. France Desrosiers, president and CEO of Vitalité Health Network, thanked Sehgal for his report and said the network plans to follow up with him.
"At Vitalité Health Network, we have been working for several months on improvements in various sectors, including emergency services," she said.
"Our efforts continue and we look forward to share some of our early results in the weeks to come," she said, adding that health-care staffing challenges aren't unique to New Brunswick.
Horizon Health Network is focusing on the patient experience and patient flow within its emergency departments, as well as "creating the best possible work environment" for staff and physicians, and recruiting new team members, said interim president and CEO Margaret Melanson.
Melanson said Horizon recently consulted leaders at the Dr. Everett Chalmers Regional Hospital in Fredericton, and is now working on creating a "patient flow centre" at the hospital.
Also, to improve access to surgery across its hospitals, Horizon recently announced a new medical co-lead and a new administrative co-lead for surgical services.
"These leaders will engage with staff to hear their ideas on how to improve this crucial aspect of the health care system.
Melanson said Horizon leadership values the input of its physicians and staff as they work together to address health-care challenges, which are being seen across the country.
"We believe engagement and consultation with our staff is an essential means of generating important discourse and new ideas, as well as a way to receive feedback from those on the frontline. We have received Dr. Sehgal's correspondence, and it will be reviewed in accordance with our processes."
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