Premier walks fine line on language as health authorities talk service mergers

Premier Blaine Higgs is walking a fine rhetorical line as he encourages the province's two regional health authorities to look at combining some services to alleviate the severe shortage of nurses at two Moncton hospitals.

Higgs says he's leaving it up to the RHAs to decide what merged services might look like — a change that would almost certainly reopen the always sensitive language debate.

"I don't know how it's going to be proposed at the end of the day, but I'm just excited they're working on solutions to provide the service," the premier said diplomatically Thursday morning.

Higgs has long been frustrated by what he sees as duplication between Horizon Health, which operates in English, and Vitalité, which functions in French. 

So the recent call by New Brunswick Nurses Union president Paula Doucet to merge some services at the Dr. Georges-L.-Dumont University Hospital and the Moncton Hospital dovetailed with his instincts.

"We're trying to run these two separate hospitals with skeleton crews in both," Doucet said last week. "Why wouldn't the RHAs have a conversation to say 'which services can we put together for a period of time?'"

Higgs used to speak favourably about the idea of merging the two health authorities, but since becoming premier, he's chosen his words carefully, instead calling for less overlap and more cooperation between the two. 

"We need to look at better ways for our two networks to complement each other," he said during one recent question period.

"Not duplicate each other, not argue about who gets where when, but provide complementary services and a balanced approach to our health care system."

He also said that would not mean "a threat to either health authority." 

Opposition denounces merger

The political sensitivity of the issue, and its potential to polarize New Brunswickers, has been clear in the legislature.

The Opposition Liberals, with their majority francophone caucus, has denounced any idea of merged services as a violation of the Official Languages Act and the Charter of Rights and Freedoms. 

"What we are telling the premier and the entire Conservative caucus is to protect the laws and the rights of all communities in this province," said Liberal Leader Roger Melanson.

He said previous Progressive Conservative leaders, who embraced language rights enthusiastically, would be "disturbed" by Higgs's comments.

"There have been so many strong leaders who have built this province. Let's not destroy it over one comment by the premier," he said.

But the People's Alliance, which says it opposes the way official bilingualism is applied, has applauded Higgs's stance. 

"I want to commend the premier for his willingness to look at this very concerning issue, Miramichi MLA Michelle Conroy said Thursday.

Doucet said last week that nurses have been working 24-hour shifts and are facing a summer with no vacation time, two potential triggers for mass burnout after 14 months of dealing with the COVID-19 pandemic.

She said combining some services such as obstetrics, palliative care and mental health would make it easier to schedule much-needed breaks for many nurses.

Higgs took up that call. "We're all focused on a normal summer and they shouldn't be different," he said.

But the premier has been careful to avoid being seen as imposing any of his ideas on the health authorities, saying he's leaving it to them to sort out what's feasible.

"I understand they're having multiple meetings so they'll continue on in that regard, and I'm obviously hoping to get reports on how well it's going, and what issues they're finding and what their proposals are to deal with it," he said.

"I'm not prescribing what that should look like." 

Higgs has also carefully skated around the suggestion of hiring unilingual nurses to fill vacant positions, which might jeopardize either authority's ability to provide bilingual service as required by law.

He says he's not suggesting that bilingual hiring requirements are driving nurses away — only that it's an issue worth examining. 

"Is it a significant barrier or not? I've asked a pretty basic question that I still don't have an answer to," he said. "If we don't understand why someone who lives here wants to leave, how do we ever attract someone who doesn't live here to come?" 

Changes won't be well received by francophone community

Despite the delicate phrasing, Higgs is risking a major legal and political battle, says Acadian Society president Alexandre Cédric Doucet. 

If any services at the Dumont hospital are merged, "that won't be very well received in the Acadian and francophone community," says Doucet, who launched an online petition against the idea that had 2,300 signatures by Thursday afternoon.

He would not rule out a constitutional challenge. "All options are on the table right now."

Higgs said this week he has not asked government lawyers for a legal opinion on whether services between the two health authorities can be merged.

There has never been a court ruling in New Brunswick that clearly says whether hospitals fall under Section 16.1 of the Charter.

It says the English and French communities in the province have "equality of status and equal rights and privileges, including the right to distinct educational institutions and such distinct cultural institutions as are necessary for the preservation and promotion of those communities."

While there's no explicit reference to health care, constitutional law expert Michel Doucet says there are three reasons why a challenge would likely succeed:

• A 2001 New Brunswick Court of Appeal precedent said courts should apply a "broad, generous and purposive" interpretation of the Charter in language decisions.
• A 2001 Ontario Court of Appeal ruling found that a francophone teaching hospital threatened with closure in the Ottawa area was protected because it was "essential to the Franco-Ontarian community."
• While Section 16.1 doesn't mention health services, it identifies rights "including" educational and cultural rights, implying other rights also exist.

In 2018 the Higgs government announced it would relax bilingual hiring requirements for ambulance paramedics to address a shortage there.

But within a month it conceded that it could not legally do that and had to come up with another way to address shortages, which is what the Liberals are calling for now.

Higgs however continues to call for change while avoiding being too explicit in what exactly that change should be.

"I'm very focused on our health care authorities working more closely together," he said. "I don't know what that looks like but I've never been supportive of us competing with each other. … I've said for a long time that I think we can manage our resources better."