How Susan Holt counts 'new' collaborative care clinics
Liberal premier says two existing centres are among 30 she promised — but that’s not the metric that matters
The rollout of the Holt government's primary care plan last week raised an important question: what exactly counts as a new collaborative care clinic?
Premier Susan Holt announced what she called the first two of 30 such clinics she promised in last year's election campaign.
Both, however, were existing community care clinics that she said were now adopting a "family health team" model that allowed them to be considered among the 30.
"We changed the definition," Holt explained last week.
"The words may be the same — a clinic, a family team, a collaborative care clinic, a community clinic — but what we want is for more New Brunswickers to be attached to a clinic," she said.
"That's the objective. Whatever we call it, a team or clinic, whether it has 10 people [working there] or 12, the question for me is whether New Brunswickers have better access."
Holt made improving primary care the top commitment in her campaign last year, and it helped propel her to a decisive win in the Oct. 21 provincial election.
She frequently cited an estimate of 180,000 New Brunswickers — about 21 per cent — who did not have a family doctor, which often required them to go to hospital emergency departments for primary care.
And just slightly more than 30 per cent of people with access to a doctor or nurse practitioner could get in to see them within five days.
"We are going to cut your wait time for care by supporting the creation of 30 collaborative care clinics across the province," Holt declared at an Aug. 26, 2024, news conference, almost a month before the start of the campaign.
During that news conference, she frequently said a Liberal government would "open" 30 such clinics.
Last week, though, she said the existing Fredericton Northside Community Health Centre would count as one of the 30.
The clinic is getting two new part-time doctors and two new nurses this summer, allowing it to take on 1,600 new patients living on the north side of the city.
The Lamèque Community Health Centre has also existed for years. The addition of two new nurses and a social worker will allow it to eventually add 3,500 patients — but only by 2028, the government said.
"We've had some of these clinics but we're augmenting them," Health Minister John Dornan explained.
Progressive Conservative health critic Bill Hogan said that expanding existing clinics "isn't a new clinic.… People aren't going to believe that."
The key change in Lamèque, Holt said, was the shift to a collaborative "family health team" model, where doctors, nurse practitioners and other health professionals work together, sharing a common list of patients.
The model allows a patient to see whoever can best address their needs at a given time.
"If there is a patient in the practice who needs care, it doesn't have to be me that they see. They see somebody in my team," said Dr. Ravneet Comstock, a doctor working on Horizon Health's rollout.
Holt said that model "will help us serve people faster … and they can take more patients."
But the family health team model isn't new, either.
Both Horizon Health and Vitalité described it in March 2024, when the Progressive Conservatives were still in power and Holt had not made her campaign promise.
Vitalité said back then it already had six family health teams in place and had 22 others "under development," including one in Lamèque.
"It's something our government started, and they're taking credit for it," Hogan said.
Dornan said Friday the difference is the Liberals are providing the funding necessary so the health authorities can implement the model more widely and more quickly.
"I would say that there has been a start of collaboration for decades. What's happening now is that we're growing this at a much faster pace," he said.
A review of last year's campaign promise shows that Holt attached a couple of caveats to the 30-clinic promise — including an acknowledgment that not all the clinics would be new.
"In some places this is going to be connecting into the health network's infrastructure," she said.
"In some places it will be connected into teams of health professionals that are already starting to get grouped together, that are looking for support from the government."
And, Holt said, the number of clinics wasn't her measure of success anyway.
The key, she said, was increasing the number of people with access to primary care — 79 per cent at the time — "into the 80s, and we're shooting for the 90s."
She later refined the target to 85 per cent.
"It's not measuring how much money we've spent," Holt said. "It's not measuring how many clinics we've opened.
"It's measuring whether fewer New Brunswickers are waiting for primary care."
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With files from Alix Villeneuve, Radio-Canada