Holt's health-care promises shot in the arm system needs, stakeholders say
Medical society and nurses union say human resources, pay among biggest challenges
Premier-designate Susan Holt and her Liberal Party made a lot of health-care promises during the election campaign, and while some timelines are tight and some estimates are lacking, front-line health-care professionals say they're optimistic about healing the ailing system with the new government.
Dr. Lise Babin, the new president of the New Brunswick Medical Society, which represents more than 2,000 physicians in the province, said she believes Holt's pledge to open "at least" 30 collaborative health-care clinics is "going to go a long way toward improving access" to primary care for the thousands of people without a doctor, as well as those who have a doctor but have difficulty getting a timely appointment.
The proposed clinics will bring together doctors, nurses, nurse practitioners, psychologists, physiotherapists, pharmacists and others "to provide a health-care home for patients."
At least 10 of those clinics will be in place in 2025, Holt told CBC News on Thursday.
That's up from the four she previously committed to open next year, in Fredericton, St. Stephen, Sussex and Campbellton, at an estimated $3.8 million in capital and operating costs, according to information filed with Elections New Brunswick.
The remainder will open before 2028, the party has said, with Year 2 capital and operating costs of $7.7 million, then $11.5 million annually in subsequent years.
Babin, a family doctor who works in a collaborative practice in Dieppe, contends the model serves patients better and makes practising medicine easier. Doctors are able to take on more patients because other members of the team can handle some of their visits, and they don't have to worry about going on vacation or being at a conference because someone else is always there to care for their patients, she said.
"We believe that younger generation physicians, they're looking for this type of practice and they will be interested in moving toward this," said Babin.
Human resources biggest challenge
One of the biggest challenges the Liberals will face with the new clinics is staffing them, said Babin. The province will need to attract more doctors and other health-care professionals.
Holt has said she wants to create additional seats for medical students, in Saint John and Moncton, through Dalhousie Medicine New Brunswick, along with residency positions for graduates completing their specialized training. The goal of 10 new seats would cost $430,000 a year, Holt has said.
This will help, said Babin, but will take years to bear fruit.
According
to the New Brunswick Health Council, only 79 per cent of New
Brunswickers have access to a permanent primary-care provider, down from
93 per cent in 2017, and only 31 per cent can get an appointment within
five days. (Shutterstock)
The medical society is seeking a commitment to improve remuneration for physicians, she said. She declined to discuss specifics, citing pending negotiations, but did say when compared to the other Maritime provinces, "we are lagging a little bit behind."
The current fee-for-service payment model is also overly complicated, according to Babin.
In an emailed statement Holt acknowledged, "To begin establishing community care clinics we need to make changes to the compensation models."
ER is expensive place for primary care
Earlier this week, Holt told CBC investing in primary health care, ensuring people have access to a family doctor, nurse or nurse practitioner, will save money.
"Right now, everyone is going to the ER because they don't have a family doctor. But that's a really expensive place to get health care."
About 180,000 New Brunswickers are on the wait list for a primary health care provider, Holt said, noting some have been waiting for years. But "early in 2025," when the first collaborative-care clinics start to open, that number will drop, she said.
The Liberals pledged during the election to open at least 30 collaborative health-care clinics before 2028. (Shutterstock)
Similarly, 550 seniors are currently living in hospitals, when they could be getting care at home or in long-term care for much less, said Holt. "So if we make the investment in health care, in community and a proper dignified care for seniors, we will save money on the other side of the health-care system. I'm really confident that we can achieve that balance."
Doctors want to see "a commitment to get going on these promises," as well as a willingness to consult with the people on the front lines and include them in any decision making, said Babin.
"I think [the Liberals have] shown an interest in doing that, and I think people will have confidence that the plans are going to move forward," she said. "I think it's going to go well."
Nurses sense 'different temperature' with new government
The province's nurses also sense "a bit of a different temperature" dealing with Holt's Liberals than the outgoing Higgs government, said Paula Doucet, president of the New Brunswick Nurses Union.
She noted the premier-designate met with the nurses Tuesday afternoon, following her win Monday night.
More than 200 nurses from across the province were gathered in Fredericton to celebrate the union's 50th anniversary and to attend the annual general meeting.
"Our government is committed to showing nurses and other health-care professionals the respect they deserve and earning their trust," Holt said in a statement.
This will start by "bargaining in good faith and getting the first round of retention payments out the door as soon as possible," she said.
The Liberals have pledged nurse retention payments of $10,000 this fiscal year, at an estimated cost of $74.3 million, plus an additional $5,000 for every nurse, nurse practitioner and licensed practical nurse next fiscal, raising the total cost to nearly $111.5 million.
Holt aims to increase the province's five-year-retention rate for nurses to 80 per cent, from 74 per cent, with the bonuses, and contends the strategy costs less than the travel nurse contracts under the Higgs government during COVID.
"Nurses and other health-care professionals are going to staff our new community care clinics and they will be the greatest recruitment tool for attracting more health-care workers to New Brunswick while also giving those who have left the profession a good reason to return," she said.
Working conditions are key
The retention payments, which are expected before the new year, said Doucet, are a long-overdue recognition of the work nurses do in the face of ongoing staffing shortages, and all they went through during the COVID-19 pandemic, when other jurisdictions compensated their nurses.
But money alone won't be enough to stem the nurses burning out, retiring early and leaving the profession, she said.
Doucet
says nurses are 'continuing to work short in many areas and they're
just looking for some hope' and a reprieve from the shortages. (nathaphat/iStock)
Working conditions must to be addressed "right away," she said, adding she expects they will play a key role in upcoming contract negotiations, based on a recent survey of members.
Nurses are "continuing to work short in many areas and they're just looking for some hope and some reprieve, actually, to that dire shortage that they're facing."
Last month, Part 3 nurses, who make up about 90 per cent of the membership, rejected a tentative agreement with the outgoing Higgs government by a margin of 59 per cent.
Doucet declined to discuss any details, saying the union had agreed to a media blackout.
But she did say she doesn't believe they will start over "from scratch. I'm hoping to build on what we had previously."
With files from CBC News New Brunswick
David Amos
I wonder if the Premier-designate has asked anyone why I have not been refunded my Health Care expenses yet
Daniel Franklin
Reply to David Amos
I bet that's top of mind for her.
David Amos
Reply to Daniel Franklin
How much do you want to bet and is that your real name?
Reply to David Amos
Of course it is!
David Amos
Reply to Daniel Franklin
Are you one of her minions???
I wish Holt nothing but success on most of her healthcare promises, and especially so with the 30 collaborative healthcare clinics.
The nurse bonuses are not “retention” unless tied to an agreement that accepting the bonus is conditional on continuing to work in NB for a fixed period of time. Otherwise there will still be no incentive to stay.
David Amos
Reply to Don Corey
Welcome back to the place I can't mention
Reply to Don Corey
They are retention if more bonuses are likely in the future.
Lou Bell
And I've been a part of one in NB for almost 5 years . 4 Doctors who cover for each other when on leave or working at ER . There are several in the Fredericton area . The media really doesn't care to get out and actually see what's happening , just towing the left wing line of " nothing happening here .
John Montgomery
Reply to Lou Bell
Well people can call Maple too, but for a lot of things you need a dedicated doctor. Such as for ADHD meds or major heart pills. You need to be monitored.
Lou Bell
Reply to Lou Bell
They all have access to the others' patients , same office , same files . Even a Doctor on call for all patients , and no ER visits needed .
Lou Bell
Reply to John Montgomery
What is " Maple " ?
Peter Hill
Reply to Lou Bell
So there is no healthcare crisis.
John Montgomery
Reply to Lou Bell
Online clinic. I guess in NB it is called 'eHealth NB'
Dave Sellers
Reply to Peter Hill
Just a federal debt crisis..?
David Amos
Reply to Lou Bell
Is that a revelation?
Eric Hamilton
Reply to Peter Hill
Why do you think there is healthcare crisis. If this is an emergency please hang up and dial 911.
Hugh MacDonald
"Holt's health-care promises shot in the arm"
And a "shock to many NBers" if she keeps the promises.
David Amos
Reply to Hugh MacDonald
Yup
Lou Bell
Reply to Hugh MacDonald
More like shot in the dark ! Sure misses and everyone duck !
Lou Bell
The reason for the delay ? The liberals hired no Doctors when last in power . It takes 7 years to train Doctors . Those that Higgs put in training won't start graduating until next year ! Holt's promises based on the Higgs work !
David Amos
I am bored with you already
Lou Bell
" remainder to be open before 2028 " . That wasn't the promise , it was 2 years once elected . And the " immediate " cut to hST on power bills is now at least March , and probably much longer . Much like DJT , lotsa promises , no followthrough on those promises !
David Amos
Reply to Lou Bell
Surprise Surprise Surprise
Bob Smith
Reply to Lou Bell
How's the search for the new leader of the provincial Conservatives going? They should have one to replace Higgs by now.
Reply to Bob Smith
Even a spare mop would do.
Whoever the new Minister of Health is, he or she has a lot work ahead.
David Amos
Reply to Marcel Marcotte
I can't wait to stress test his or her ethics
Lou Bell
Reply to Marcel Marcotte
Most likely the one elected who got fired for not doing his job under Higgs .
Bob Smith
Reply to Lou Bell
Well, he has a job after this election. Higgs got fired by the voters.
Reply to Lou Bell
Not doing his job...lol. He was fired 6 months in because Higgs needed a scapegoat. What did that get us? A 2 million dollar payment to the guy that is most likely going to be the new Minister of Health.
Keep trying Lou.
"pay" is a big issue for everyone. I think nurses do quite well. A good base salary, flexible hours if you work casual, huge overtime pay.
SarahRose Werner
Reply to John Lewis
Hugh mandatory overtime.
John Montgomery
Reply to John Lewis
Patients that spit at you and throw feces.
David Amos
Reply to John Lewis
"pay" is a big issue for me in particular
Lou Bell
Reply to SarahRose Werner
Overtime is not mandatory . Never was .
John Montgomery
Reply to Lou Bell
It absolutely is for nurses. They need a full complement of staff, it doesn't matter who is sick or on vacation.
Reply to Lou Bell
There are many types of nurses; not a job anyone could do. Takes a special person to do their job, saving lives, improving people's health.
MR Cain
Reply to SarahRose Werner
Due to understaffing; not pensionable time and the extra taxes end up being paid less than the normal hours.
Marcel Marcotte
Working with Premier Designate Holt should be easier than working with out going Premier Higgs.
David Amos
Reply to Marcel Marcotte
I doubt it
Lou Bell
Reply to Marcel Marcotte
Not sure how , unless she completely washes her hands of it , which would be best as she's shown she has little idea of what she's doing .
Cory Crete
It would be nice to see it transform into literal action instead of just lip service. Promises have been made by everyone, so let the progress speak for itself. Praising someone for stating a promise that's so bold she forgot the "I'll do my best to" part of it all seems like high risk odds to put faith in. I hope she succeeds.
David Amos
Reply to Cory Crete
Time will tell the tale