by Kathy Hamer (Edwards)
Probably everyone in rural New Brunswick knows that our access to health care is likely to require some travel, even for routine appointments with a family doctor. We are not so naive as to think the full range of medical care will be available in every community of any size. We’re nothing if not fairly realistic. Living here has made us that way.
But there are limits to what we are prepared to accept. The premier urges us to examine the details of proposed changes to hospital services. We would if we could: however, at this point, we have more questions than answers, especially given Horizon Health CEO Karen McGrath’s preference for avoiding a main-door exit from the Sackville hospital where she would have faced an anxious public on Thursday.
We are told that acute-care beds in Sackville will be converted to beds for the long-term care patients now accommodated in the larger hospitals. Can anyone at Horizon Health explain the logic of moving these patients to Sackville or Sussex, further away from family and friends, while moving acute-care patients to Moncton, and thus also further away from familial and social “safety nets”? Will the shuffle of patients meet the needs of those in long-term care? Will it release enough beds to accommodate all acute-care patients in the regional hospitals? We know that currently at least the three largest hospitals are operating at or well beyond capacity much of the time.
We are concerned about added travel time, especially in emergencies. Ms. McGrath has cited St. Joe’s (Saint John) and Oromocto hospitals as evidence that the proposed changes work. She neglects to add that each of these facilities is within little more than 10 or 15 minutes’ drive from full-service hospitals – the Regional in Saint John and the Chalmers in Fredericton. How do these distances compare with travel from Cape Tormentine to Moncton?
Both the NB Medical Society and the paramedics have expressed concerns about the fragility of existing ambulance services and the risk of adding new demands to an already stretched system. When and how will ambulance services be adjusted to ensure adequate service delivery? Will rural patients be forced to shoulder the additional financial burden of ambulance or taxi costs to receive ER service?
Ms. McGrath has claimed that doctors will now be able to see many more patients during the day, since ER services will be closed at night. Can she explain just how they will accomplish this in the face of already full-to-bursting patient loads? How exactly are nurse practitioners to be integrated into the current system?
Has Ms. McGrath considered the potential impact of the proposed changes on the Amherst hospital, which provides service to many residents of the Sackville area? That facility was blindsided by Tuesday’s announcement, just as were our own municipal councils and medical community. How will Amherst accommodate any increase in demand for services in its already overcrowded hospital?
What of the more than 2,000 university students in Sackville who rely on hospital access as much as our full-time citizens, and who, moreover, are unlikely to have spare funds to pay for ambulance or taxi travel to Moncton or Amherst? What timely access to needed services can they expect? After all, as one student commented on Thursday, “we die too.”
What about recruitment and retention of medical professionals? The medical programs training doctors in New Brunswick were created with two objectives in mind: to offset the likely rate of retirements among doctors, and to ensure better access to physician care in rural areas. How likely will new doctors be to come to communities where, among other potential limitations, they can’t even admit their own patients to a local hospital and oversee their ongoing care? How easily will nurses be able to move to positions elsewhere, especially if a move means uprooting a whole family?
Has anyone considered potential “downstream” effects of the changes? Sackville has welcomed a number of newcomers from more urban areas of the country; one factor in their decision to move here has been the presence of a hospital providing a good range of basic services and care. The attractiveness of this community and many others in New Brunswick risks being seriously undermined if access to health care is perceived as insufficient.
The communications fiasco that has accompanied the roll-out of these changes provides an excellent case study in how not to develop and announce challenging new directions. The word was out informally by Monday, February 10, and Sackville town council discussed it that evening; the formal announcement was made on Tuesday; a full-page ad appeared in local papers only on Wednesday; and not until Thursday was Ms. McGrath available to meet our local hospital administration and staff, the medical community and our municipal and university representatives — though remaining invisible otherwise. Her defense of the changes, published only yesterday in the Telegraph-Journal, is as detail-free as the ads featured earlier in the week.
Rural New Brunswickers understand that our fiscal ship has been listing badly for some time, and that changes to high-cost services may well be inevitable to ensure continued access to quality health care. We know finding effective long-term solutions is a challenge. Yet we now face what has been presented as a done deal, out of public view, with less than a month to prepare for and implement what clearly will be a major shift in service provision. Were no alternatives considered?
There is now so little time to put the required supports in place that patient care and public certainty are both likely to be the victims of a poorly-communicated, top-down, unconvincingly presented fait accompli, developed and announced without consultation and seemingly without consideration of alternatives or likely or unintended consequences. Ms. McGrath, Minister Flemming, and Premier Higgs, can expect much more blowback from skeptical voters.
Kathy Hamer (Edwards) came to New Brunswick in 1971 and worked as a Professor of French at Mount Allison University. She held various administrative posts at Mt. A before spending five years as Vice-President at the University of New Brunswick in Saint John. With the exception of those five years, she has called Sackville home. She and her husband Peter Edwards are now retired here. She is a member of the boards of the NB Youth Orchestra, Symphony NB, the NB Museum, and Sackville’s Festival of Early Music, and is a past president of ArtsLink NB.
Very well written survey of this blow to our small community. Will young families or retirees want to live in Sackville when they realize how bare our medical cupboard will become after these changes? Just to add to those affected would be all those who drive by Sackville on the major highway…if an accident occurs how much longer will they wait for the stabilizing treatment, oxygen, controlled bleeding and pain control if all are transported to Moncton? I have heard that the Day Surgery program will also close. I hope this is not the case. One of the reasons given for setting up Day Surgery in our hospital was that it allowed for Doctors to schedule Day Surgeries without blocking time in the larger hospitals’ surgery rooms.
Thank you Ms Hamer for your insightful commentary on the current hot-potato issue of impending overnight closures of ER departments at 6 of New Brunswick’s smaller rural hospitals.
Your words echo what a lot of us have been thinking lately, as we struggle to make sense of the partial bits of information being fed to us by the Provincial Government and the CEO of Horizon, which fail to adequately explain how these changes will help the overall health-care system in New Brunswick.
These are some of the questions that need to be raised again and again, until we get some concrete answers.
Our provincial government is supposed to be ‘representative of the people’ – but the question which comes to mind now is – which people are they representing?
Horizon Health has confirmed to me that within 90 days all beds at Sackville Memorial Hospital will be converted to long term chronic-care beds, leaving us with no(0) acute care beds and no(0) intensive care beds.
The building will remain and it may still have a sign which says Hospital, but they will have effectively closed Sackville Memorial Hospital. It will have been replaced by a holding facility for people waiting for placement in a nursing home, with a corner for a clinic/emergency room.
How can we prevent this from happening without waiting for a change in government? By the time we can have a election these changes will long since have been implemented.
Well said. I would also point out that, in addition to attracting retirees and young families to choose to live here, a hospital is crucial in attracting economic development of our town — i.e. attracting businesses to set up here.
very well written and great points – all the talk about an election – really just give the money wasted on another election to the health care – the surgeries are so important here – freeing up wait times for many doctors – if all the teams ie Dr’s – nurses – CEO’s and community members could work together and come up with something better than this. Lives are going to be lost – think of the many accidents – ie in the woods – snowmobile – car and farming accidents and just a plain bad fall
Excellent comments. Thank you, Kathy Hamer ( Edwards)
With considerable knowledge and verve, shown especially well through a series of telling questions, Kathy Hamer (Edwards) has laid bare the insensitive actions of New Brunswick’s Conservative government towards retrenchment in the delivery of health care to many of the province’s rural citizens. As she clearly demonstrates, what is particularly galling is the failure to consult. Reasonable, risk-free access to essential medical services is the right of every Canadian, not just those residing in the heavily populated regions. Hospitals stimulate the growth of healthy communities; by removing essential services, a community’s social and economic well-being is thwarted.
This is outstanding coverage, and I thank you, Bruce Wark, for your excellent coverage of the hospital/health care crisis, both in your written articles, and today with your edited recording of the recent meeting in Sackville. We were away for ten days right in the midst of this, so to be able to catch up now we are home has been made much easier because of your columns.