Higgs set to take on, trim down duplication across province

Hospitals, municipal arenas and even airports: these vastly different examples of public infrastructure are linked by a common thread that ran through the Higgs government's throne speech this week.

They are all examples of what Premier Blaine Higgs sees as overlap and duplication, a theme that has irked him for years. 

"When one city has one, another city gets it, another city gets it, and so on, and so on, and so on, and we go around the province," he grumbled last year.

He was defending his decision to cancel plans for a new courthouse in Fredericton — after Saint John and Moncton each got one.

Now Higgs is applying that lens to a range of government spending and even to the structure of local government itself.

He says one possible reform to the many complex challenges facing municipalities would be to beef up the powers of regional service commissions. 

The 12 commissions are supposed to co-ordinate shared services in their respective regions, ensuring cities, towns, villages and rural areas shoulder the costs fairly and avoid having to administer their own individual services.

According to Higgs, it can also mean not spending millions of dollars on one municipal arena that's a short drive from another municipal arena.

"What does a region look like?" Higgs said this week. "Let's start defining that, so we're not trying to duplicate efforts every 20 miles or 40 kilometres."

During the 2018 election campaign, Higgs complained that federal and provincial governments fund municipal structures such as sports arenas not far away from each other.

"But then when you look out over 20 or 30 years, it's practically bankrupting a municipality trying to keep it going," he said.

He suggested there was little the province could do to stop municipalities from building duplicate facilities — except to choose to not contribute any money to them.

That was all Higgs could do when he only had a minority government: cancel what he considered "duplicate" projects like the Fredericton courthouse.

Now that he has a majority, it's a concept the premier seems prepared to apply more broadly to reforms to hospitals and other services.

Goal of efficiency could bump up against public preference

"The economics of this are pretty simple," says Herb Emery, the Vaughan chair in regional economics at the University of New Brunswick.

"If you're trying to make your dollars go further and look like an efficient government, your preference is to have larger centralized services with scale economies," he said, referring to the lower cost of having more staff and equipment in a single place.

"But what the public tends to like, particularly rural, is not having to travel and having better access to their own local amenities and services."

In the throne speech, the government called for more "co-operation" between hospitals, an idea Higgs spelled out in detail in several scrums with reporters over the last three days.

He said he would like to see some hospitals become "very focused" on key provincial roles, such as hip and knee replacements happening at St. Joseph's in Saint John and high-volume COVID-19 testing at the Dr. Georges-L. Dumont Hospital in Moncton.

"It's not 'I got an MRI so you need one,' " he said, sketching an imaginary conversation between two hospitals. "It's OK, you got an MRI, I need something else.'

"So if I need an MRI, I'll go to this hospital, and if I need something else I'll go to your hospital. It's that sort of co-operation and complement services that I'm talking about. We're too small a province to think any other way." 

The premier said he knows someone who couldn't get a test scheduled in Saint John and travelled to Bathurst to get it done.

"They were happy to get it and not wait six months or a year," he said.

"We have a tremendous highway network throughout our province, and let's utilize that, so the services can be provided anywhere."

He's going to have to overcome the local politics of people wanting to see their local bricks and mortar and see the jobs in the community.- Herb Emery, Vaughan chair in regional economics at UNB

It sounds like a logical idea, and it already exists at the Saint John Heart Centre, a facility that serves patients from around the province.

But it's also one fraught with political risk, Emery says.

Opposition Liberal Leader Roger Melanson says it's true Higgs has articulated these ideas for years, but he argues the PC leader did not talk about them when it mattered most: when he was seeking a majority government during the recent election.

"People pay attention during election campaigns," he said. "They vote for what is being proposed by different political parties. Nothing was mentioned in the [PC] platform. He didn't even mention it in his speeches, from what I recall."

Asked Thursday for any calculations of how much money would be saved or how much the economy would grow with less duplication, Higgs did not answer directly but said that would be the test applied to any changes his government makes during this mandate. 

Emery says the province or the regional health authorities probably do have an estimate of cost savings from centralization of some hospital services.

He says that would have been part of the decision in February, later reversed, to close some emergency departments at night to shift those resources to more primary care services for patients during the day.

But in other areas Higgs is looking at, the math is not as clear-cut, Emery says.

The throne speech said this week the government would ask the "fundamental question" about having three airports in Moncton, Saint John and Fredericton that see fewer total passengers per year than the single, centralized Halifax Stanfield International Airport. 

"Every year there are tens of millions of dollars spent, one airport after another, and there's provincial money as well," Higgs said. "It moves from one airport to another. We extend a runway here, we build a building, we put new pavement, new parking lots, new flower pots."

Not clear one airport would have more access

Airports fall under federal jurisdiction, and Higgs said repeatedly this week he has no preconceived notion about shifting to one airport. He just wants to pose the question.

Emery says the competition between airlines isn't really for passengers but for airline routes, and it's not clear whether a single airport would have more access. 

"It's a bit more speculative because it's all based on a hope and prayer that if you were to crater two airports and go to one, the airlines would respond giving you the routes you expect." 

Emery says the researchers he works with at UNB have compared New Brunswick and  Nova Scotia and have found there's no difference in rates of economic growth, despite one province having three rival cities and the other having a single metropolitan area. 

The possible changes to the property tax system could also affect the "duplication" debate, he adds. 

If the PCs allow municipalities to collect a larger share of property tax revenue, they may also decide to reduce the number of grants they hand out.

That in turn could mean the only cities and towns building infrastructure will be the ones that can afford it without provincial help. 

"This whole idea that because two other cities got one, we get one, wouldn't be the case if we had to pay for it."