New Brunswick’s healthcare system already has above-average numbers of doctors and nurses per capita compared to other provinces in Canada. We aren’t underfunded on a per capita basis compared to other provinces. Yet we have some of the worst access and longest wait times in Canada.
It’s time to stop promising more and start treating the underlying problems that prevent us from a having the quality system we deserve.
Demand changes to healthcare governance
New Brunswick’s healthcare system defies accepted principles of good governance adopted by other healthcare organizations. We have no knowledgeable body in charge. Boards are advisory only, with no authority, power or accountability. Healthcare CEOs report to the Premier, albeit technically through a cabinet minister. CEOs aren’t subject to any relevant, identifiable performance review or performance management system. And the entire system is vulnerable to political interference.
Require properly qualified healthcare managers
Health and long term care management is a specialized area of practice, much like nuclear energy. While there are certain generic, transferable skills from other disciplines, nothing takes the place of specialized training and certification in healthcare management. Those who lead, oversee or regulate at any level in the system must have then requisite training and experience. Clinical training does not qualify someone to oversee the system. Nor does management experience in another industry. The best healthcare organizations demand leaders and planners with the proper qualifications. We should too.
Require a provincial plan
Since 1956, we’ve been cobbling together the various pieces of our existing healthcare infrastructure and calling it a system. We’ve never had a comprehensive top-down plan (architecture drawings, if you will) for our healthcare service delivery across the province. We need a plan for the orderly long term development and evolution of health care services to ensure best use of all resources and optimal service efficiency and delivery. Secondary and tertiary care service must be integrated provincially so that service complement each other, eliminating competition between professionals and communities.
Merge acute and long term care
Years ago, government decided to separate acute and long term care into two separate departments, ostensibly so that one minister did not control more than 50% of the provincial budget. But it doesn’t work. Those two areas of healthcare must be planned, executed and delivered together.
Push for full adoption of the electronic information network
New Brunswick invested in a province-wide Electronic Health Record to keep accurate records of your interactions in any acute care facility in the province. However, the EHR is only as good as the people who use it. Many New Brunswick clinicians simply refuse to chart using the electronic systems, resulting in a hodge podge of handwritten notes and electronic charts of any single patient. This delays care and creates a patient safety minefield.
Many New Brunswick doctors don’t use electronic systems in their own offices. They keep paper charts and rely on fax machines to communicate with hospitals and other providers. Patients can’t communicate via email or book appointments online. Their files aren’t automatically flagged to ensure they get guideline-based preventative screenings or receive critical test results. Our healthcare system operates in the technological dark ages and there is no reason for it.
This isn’t just an efficiency issue— this is about patient safety. Electronic health records are the standard of care.
These aren’t simple fixes— they are complex ones that require strong leadership and vision. It’s easy to throw more money at the system. But it won’t solve your wait time for a specialist or surgical cancellations.
To fix the symptoms, you have to address the disease.