A retired doctor is welcoming the newly released provincial discussion paper on health care because he feels it touches on the main issues facing the system.
“I think those (main issues) are there and I think that’s a good starting point for sure,” says Ross Thomas who practised family medicine here for 31 years before he retired in 2019.
During a telephone interview, Thomas mentioned the discussion paper’s focus on a number of key issues such as:
- improving primary care and mental health services
- reducing wait times for surgeries
- moving long-term patients out of hospital beds into nursing and special care homes
Hospital cuts not the solution
Last year, Thomas opposed cuts to services in six rural hospitals, including at Sackville Memorial, that the government and the regional health authorities argued would help solve some of the problems in the system.
The province said closing overnight emergency rooms, for example, would allow family doctors to see more patients during the day and that converting short-term, acute-care beds into ones for patients awaiting placement in long-term facilities would free up beds in the bigger hospitals.
In addition, the province and the regional health authorities announced that a nurse practitioner would be hired in each of the six rural communities and that community clinics would improve mental health and addiction services.
“Part of my disdain about the proposed changes that were made last winter was that these things weren’t looked at closely,” Thomas says. “There were no clear plans made, it was very poorly thought out, it was cuts without any plan and without any consultation.”
Thomas adds that instead of converting rural hospitals into nursing homes, it makes more sense to create beds in facilities specifically designed for long-term care.
He says the additional nursing and special care homes could be paid for by reducing the overall number of hospital beds.
“Theoretically, if you take 30% of the patients out of the Moncton Hospital, that will free up huge numbers of beds that aren’t presently being used for acute care,” he adds.
Group-based physician care
Thomas welcomes the discussion paper’s focus on group-based family care with doctors working together instead of on their own.
The paper mentions Family Medicine New Brunswick which operates nine clinics as one example.
Thomas says the province began encouraging this model of care a number of years ago in response to public demand.
“People want better access to primary care and I agree with that,” he says. “If you look at other countries’ health-care systems, they’re far more responsive to clients’ needs than ours is.”
He says patients should be able to see their doctors more quickly.
“Only half of patients can see their doctor within five days, I don’t think that’s acceptable,” he adds.
“I think you have to be careful not to blame physicians for that because the way they practise is largely driven by the way governments want them to practise. So, if you have the fee-for-service system that we have, it doesn’t reward, in any way, people being seen promptly.”
Thomas says that since the province pays for health care, it has the right to implement gradual changes.
“They could say within five years, all physicians need to be in group practices and if they’re not, they’re not going to be paid as well.”
Thomas says he’s glad the province is not proposing its own solutions, but is seeking the public’s ideas on reforming health care.
In addition to the discussion paper, the provincial minister of health is planning a series of online community consultations including one in Sackville.
Meantime, people can respond with their own ideas for improving the health system by e-mailing: email@example.com.