Dr. Allison Dysart comments on need for more hospital autonomy

A well-known doctor in Sackville says he agrees with the Green Party that small, rural hospitals don’t have nearly enough say in the kinds of medical services they provide.

Allison Dysart was commenting on Green Party leader David Coon’s plan to give local hospital administrators and staff more power to ensure they can provide the health services people need in their communities.

Coon also advocates establishing community health boards to replace the members of the public who currently serve on the boards of the regional health authorities.

Dysart, who is a longtime Green Party supporter, spoke on Thursday after listening to Coon outline his proposals for decentralizing hospital decision-making during a Green Party campaign stop near Sackville Memorial Hospital.

“Centralization has progressed through successive provincial governments starting in the early to mid-1990s,” Dysart said.

“The priorities and the input of small, rural communities in this province has been steadily eroded to the point where now it’s very, very small,” he added.

“If you don’t have input from small communities, you’re less likely to get decisions made that are in the best interests of small, local communities.”

Dysart was referring to plans outlined by the Horizon Health Network and initially supported by Premier Higgs to close the emergency room overnight, cancel day surgeries and convert the hospital’s acute-care beds into beds for patients awaiting placements in long-term, nursing-care facilities.

He suggested those planned cuts were only the latest examples of substituting centralized services in city hospitals for ones that could be provided in Sackville.

“You could talk about access to a number of diagnostic tests that perhaps, do not always need to be centralized,” Dysart said.

“Why do rural people always have to travel to Moncton to see a specialist?” he asked.

“There are maybe two or three or four specialists who will see patients in Sackville, but to me, that number should be increased,” he said.

“There’s no reason why we can’t have clinics held at this hospital for specialists to see people like used to happen in much greater numbers back 15-20 years ago.”

Health services where people need them

Dysart says that, for him, it’s about giving people services where they need them.

“We have a Service New Brunswick office here in Sackville,” he says. “It would be cheaper not to. It would be cheaper just to make everybody drive to Moncton, but we don’t do that because we say ‘that wouldn’t be reasonable, we should be able to reach out to people where they are’ and I don’t see why that shouldn’t also be the principle in health care.”

Green Party leader David Coon with local candidate Megan Mitton near the Sackville Memorial Hospital

During the question period at Coon’s campaign stop, Dysart asked the Green Party leader how he would respond to critics who say that centralizing health services saves money.

“We’re not looking to save money at the expense of people’s health and that’s what’s been going on,” Coon answered.

“If the patients were at the centre of the decisions that are made in our health-care system, then we would have a way better health-care system,” he said.

“But when it is so centralized, it’s impossible to put patients at the centre of the health-care system because the decision-makers are so removed from patients entirely and from…the health professionals who care for them in their communities.”

Coon added, however, that he’s not arguing for getting rid of regional health authorities because some centralized planning is essential.

“If we’ve got a major trauma problem whether it’s a major car accident or airplane crash or  a bus crash or a mine disaster,” he said, “we’ve got one of the best trauma systems in Canada,” he said.

“The same with cardiac care or neurology or endocrinology, if you’ve got serious problems that need specialized care, specialized diagnosis, specialized intervention, we’ve got those folks, we’ve got them working in our regional centres of excellence,” he added.

“That’s where the centralized parts work to make sure all of that is functioning for New Brunswickers.”

Coon said centralized and local services should complement each other: “Where the centralized part of the system manages the things that necessarily must be managed from a centralized perspective and (where) the community-based medicine is managed at the community level,” he said.

“That’s the change I’m talking about here today.”