by Alexander (Sandy) Burnett
Horizon Health CEO Karen McGrath seemed perplexed last week.
Faced with questions from the public and the press about planned reductions in service at six small-town hospitals across New Brunswick, her standard answer suggested a serious lack of understanding of the sense of community ownership that has fostered the development of healthcare in this province for over a century.
“This is not a consultative process,” she declared. “This is me… coming up with a plan.”
In fairness, Ms. McGrath, who has degrees in Business Administration and Social Work, speaks from the perspective of a seasoned administrator. Before her arrival in New Brunswick three years ago, she had more than 10 years of experience as a CEO, at the Georgian Bay General Hospital in Midland, Ontario, the Central Health Authority in Newfoundland and Labrador, and the Ontario Division of the Canadian Mental Health Association. Sad to say, such employment does not seem to have prepared her very well for public engagement and accountability.
That is unfortunate, as she now finds herself face to face with the passionate belief of local citizens in Sackville, Sussex, Perth-Andover, Grand Falls, Caraquet, and Richibucto that they have the right to participate in decisions affecting the healthcare facilities of their communities. And as of the weekend, even Premier Higgs reluctantly conceded the point.
Before getting embroiled further in head-to-head debate with a significant percentage of the population, Ms. McGrath might do well to inform herself about the history of community engagement that underlies such fierce opposition to her seemingly inflexible position.
I drew that title from a letter to the editor of the Sackville Tribune, written by William B. Fawcett and published on March 10, 1919. In it, he applauded the idea of establishing a community hospital as a memorial to soldiers lost in the First World War, and backed it with a pledge of $10,000 (about $144,000 in today’s currency) to start the ball rolling.
Explaining his gift, he stated, “Outside of all the sentiment surrounding the idea of a monument to the dead…I believe Eastern Westmorland is in even greater need of such a Public Hospital as a duty toward the living.”
It would be another 25 years before the Sackville Memorial Hospital finally opened its doors, but the concept that the community at large had “a duty to the living,” has remained central to Sackville’s view of healthcare from that day to this.
Throughout that century, the people of Sackville and eastern Westmorland County have consistently embraced that sense of duty by way of selfless volunteer service on boards, committees, the Auxiliary, and the Hospital Foundation, and through generous support of fundraising. Their goal? To build, maintain, and enhance a place where the health and wellness needs of the community could be met or, if need be, effectively referred to other centres for more advanced care.
Some of those efforts were as down-to-earth as donating locally made jams and jellies to the hospital kitchen to sweeten the breakfast toast served to patients. Others were as complex as the raising of millions of dollars over the years to purchase life-saving equipment for local use. Small wonder that members of the Tantramar community, from Dorchester to Cape Tormentine and beyond, have a proprietary sense of “their” hospital.
The editor of the Tribune-Post summed up that attitude in an editorial published on September 29, 1960: “We must remember that the Sackville Memorial Hospital is our hospital, built by the community and controlled by a Board of Trustees made up of local people who give of their time and energy without any remuneration. It is an institution in which the people of the community take justifiable pride. We want to continue to control its administration and operation. Our only means of keeping it that way is to maintain and strengthen local interest.”
In the years that followed, with the introduction of Medicare and a steadily expanding role for federal and provincial governments in providing state-of-the-art healthcare across Canada, that dedicated local commitment was enhanced by massive support from the higher levels. But the sense of local ownership and accountability never diminished.
In May 1986, the Board of the Sackville hospital adopted a new mission statement in which that determination was clearly evident: “The hospital provides primary medical, emergency, obstetrical, surgical, and ambulatory care, supported by diagnostic and consultative services; enhances access to secondary and tertiary care through integration with the larger health system; and maintains contact with discharged patients to ensure continuity of care.”
A year later, hospital administrator Neil Ritchie put it this way: “Family medicine is still our focus. Your family doctor is still in the best position to decide what health service you need. We [the hospital] are here to support the community and to enhance the ability of the family doctor to deal with your problems.”
That sense of mission saw a new hospital built and opened on its present site April 1, 1988, its operation supported and sustained locally by the Foundation, the Auxiliary, and local citizens and service clubs. And it guided responsible management into the bargain. At the 1990 annual general meeting of the Sackville Memorial Hospital, it was reported that the institution had ended the fiscal year in the black on an operating budget of over $5 million. In the course of that year it had supported 13,803 days of in-patient care, 32,000 outpatient visits, 2,986 clinic visits, and 1,022 day-surgery procedures.
It came as a shock, then, in March 1992, when provincial health minister Russ King announced the dissolution of the hospital’s Board of Trustees and a reduction in local services, amalgamating all independent hospitals within new regional authorities.
Board chairman David Jones reported it this way to a sombre meeting in Sackville: “Effective April 1, this board has no more power and no more purpose. I attended a meeting in Fredericton today. I was there to represent not only this board but all previous boards that helped build Sackville Memorial Hospital and make it what it is. And there was not one word of acknowledgment of those volunteers.”
It is significant that, despite that takeover 28 years ago, despite the consolidation of eight regional authorities into two province-wide networks (Horizon and Vitalité) and despite the transfer or reduction of some services, community loyalty has remained strong. The people of Tantramar have sustained a healthy desire to influence, support, and enhance “their” system, raising millions of dollars to keep the Sackville Memorial Hospital at the forefront of community medical care.
In view of this vital record of involvement, it should have come as no surprise to Ms. McGrath, her associates, and her political masters in Fredericton, that this community and others expect and demand open and constructive consultation on how best to achieve needed adjustments to the healthcare system.
She herself, on taking up her duties as CEO of Horizon, stated: “Engagement is the key to success — with patients, staff, physicians, and our communities.”
At the time, that sounded like a commitment to a consultative process. The supporters of small community hospitals across New Brunswick expect no less.
Alexander (Sandy) Burnett has lived in Sackville since 1978. Formerly employed as a teacher and with the National Film Board of Canada, he has been a freelance writer and communications consultant since 1984, working for a wide range of clients, among them the Canadian Wildlife Service, the Nature Conservancy of Canada, Ducks Unlimited Canada, and the World Wildlife Fund. His articles have appeared in a variety of publications including Canadian Geographic, Equinox, Harrowsmith and Nature Canada. He is the author of a number of books, among them: On the Brink: Endangered Species in Canada; A Passion for Wildlife: The History of the Canadian Wildlife Service; and A Duty Toward the Living: A History of Healthcare in Tantramar.