Systemic change, support required to revive N.B. health-care system, says medical community

Sarah Ecker, a Fredericton registered nurse, listened in to Premier Blaine Higgs's press conference on Friday. She had mixed feelings, but grew increasingly disappointed as it went on. 

Following a death in a New Brunswick emergency room, Higgs announced he had dissolved the boards of Vitalité Health Network and Horizon Health Network, the health minister would swap positions with the social development minister and the Horizon Health CEO had been fired.

Ecker was happy to see Dorothy Shephard removed as health minister, but was surprised to hear that Dr. John Dornan, CEO of Horizon, was fired. 

Higgs bypassed any sort of accountability, said Ecker. She said there's a personnel crisis in New Brunswick and the short-staffing problem won't be solved by shuffling management.

"[Higgs] mentioned people getting their vitals done in the ER while they're waiting, yes, that is an awesome intervention that should be done, but if you've got four nurses working in ER and people come in with a big emergency, like, something has to give," she said.

"There's only so many people. You can only do so much."

She said adding new policies and procedures will just add more stress to the front line. 

Nurses' voices are not being heard, said Ecker. She hopes front-line staff are given opportunities to share their opinions and that the government recognizes the need for more staff. 

"I really think they need to work on the morale," said Ecker. "It's like one of those cyclical problems where you need more staff to bring up morale, but you need better morale to encourage more staff."

COVID-19 reveals system flaws

Higgs said during the press conference that he was "appalled" by the death in an ER waiting room. Ecker said it's not a new problem and there was some accountability attached because this situation made the news.

Ecker said the health-care system is on "thin ice."

"COVID just shone a flashlight on an issue that was in the dark and it's just bringing all of those cracks to light now," she said. "It might be the straw that breaks the camel's back."

Ecker said Horizon staff received a notice earlier in the week asking staff to wear masks in public and lead by example. She thinks Dornan saw that having a healthy staff would make an immediate impact for the good of the health-care system. 

Dissolving of boards

Ecker called dissolving the health authority boards a "unilateral power grab." 

She said she thinks any voice that represented a larger group of people is gone. 

Norma McGraw, a former Vitalité Health Network board member, said she wasn't overly surprised with the decision.

"It was expected that something [would] happen and Higgs [would] eventually act on those pressures coming to him to improve the health-care system," she said. 

She said she didn't hear about the decision to dissolve the boards until the announcement was already made.

Johanne Lise Landry, spokesperson for Vitalité Health Network, confirmed in an email Friday that the health network did not receive any correspondence about its board being revoked.

McGraw said she would like to know what the board did that didn't meet the premier's standard. 

She said Vitalité should have self-governance of its health network. She said removing the board to replace it with a single appointed trustee will diminish the influence the community has on Vitalité Health Network.

But she said she hopes that the appointed trustee will be able to make change. 

"Everybody wants the system to improve and if that is what it takes to get the result, well, I wish Mr. Higgs the best," said McGraw. 

What's next?

Paula Doucet, president of the New Brunswick Nurses Union, said she was called to a brief meeting at 2:15 p.m. on Friday where she learned of the announcement. 

She was surprised that the health authority boards were going to be put in a trusteeship and was disappointed by Dornan's removal. 

"I felt that he really understood the issues on the front line and the issues that nurses were raising," she said. 

But she said systemic changes need to happen so front-line staff can feel supported.

"We were in a shortage pre-pandemic and then, you know, two and a half years, almost three years into this pandemic, the staff, retired nurses, health-care providers, you know, all our allied health-care workers, they're exhausted."

She said the decisions announced Friday are a start. But she plans to reach out to the new minister of health, Bruce Fitch, the premier and others to figure out where to go next.

The New Brunswick Medical Society released a statement yesterday supporting the government's change in leadership. The statement said the society looks forward to meeting with the minister of health to discuss how the government will address the priorities laid out in the provincial health plan.

The statement also thanks Dornan for his service as Horizon CEO, stating "he did an admirable job guiding Horizon under incredibly challenging circumstances."

Ecker said it feels like Higgs isn't looking at the root cause.

"It's not going to be fixed by just shuffling the deck. We really need purposeful, intentional, meaningful change, not just more bureaucracy," she said.

"I know [Higgs] spoke a lot about removing barriers and bureaucracy yesterday. But I have a feeling that the emperor just has a new pair of clothes."