by: Patricia Seaman
More, Faster.
More, Faster.
More, Faster.
It has been the healthcare chant in Nova Scotia. We see their physician recruitment efforts paying off with 338 more doctors added to their system over the past two years with claims that they are recruiting more doctors than those retiring. But physician recruitment is only one piece to the puzzle.
In New Brunswick, the numbers would suggest that we have enough doctors to meet the demand. But we have a management issue. There appears to be a surplus of doctors, including specialists, in northern New Brunswick, but a shortage in southern New Brunswick. We have reduced the number of people waiting for a family doctor, but we are not where we should be.
Over the years, we have used band-aid solutions to address the challenges like hiring travel nurses during the pandemic. Over the holidays it was once again clear that these band-aids no longer work with the capacity issues seen in the ERs throughout the province. We need a realistic long-term plan and action it immediately. The urgency rings loud: More, Faster.
Eleven months ago, I was fortunate enough to hear journalist André Picard speak at Saint Thomas University. With a passion, he said “We must fix the system. Roll up our sleeves and fix it.”
He focused his discussion on fixing the system by focusing on primary care, involving community in care, universal health coverage (Medicare), the socials determinants of health and human resources.
With respect to primary care, we can see pieces moving. In 2023, the government expanded NB Health Link to connect patients to doctors, the role for pharmacists expanded and the urgent treatment centre in Fredericton was launched. This is not enough. We must also address long-term care. Long-term care should be moved from the Department of Social Development to the Department of Health.
When it comes to involving community in care, the government recently announced the new youth hubs – an incredible opportunity to address youth mental health. These hubs sound very similar to a past project funded by Medavie, the Graham Boeckh Foundation and GNB — the same funders for the Youth Hubs. If this is a replication of past projects, why are the Youth Hubs being supported as a project and not being implemented permanently? Imagine if we only funded projects with a guarantee that if they worked, they would become permanent fixtures within the system. We could support system change based on evidence through research and validation.
Regarding extending universal health coverage, the federal government has created the Canada Dental Benefit. Whether this will have a positive impact on the health outcomes of our citizens is yet to be determined. Imagine if Medicare provided coverage for preventative services so patients could receive preventative care for diseases like dementia or diabetes. Many of these diseases have modifiable risk factors where if you focus on prevention, you can avoid developing the disease. And, for diabetes and dementia, these risk factors are often one and the same.
Social determinants of health, patients with access to secure housing, nutritious food and energy security have better health outcomes. We see phenomenal work being accomplished by social pediatric teams throughout the province where they address the needs of the child by addressing their social circumstances. With the new mandates of the Regional Service Commissions wouldn’t it make sense to amend the New Brunswick Health Zones so that they match the 12 Regional Service Commissions. This way communities could collectively voice their needs in a way that can address the social determinants of health. We could then have a new ability to access federal dollars by knitting together the cause of our challenges to results based on quantifiable numbers.
When it comes to human resources, we have seen the role of pharmacists expanding, the growth of nursing programs and physician assistants becoming permanent fixtures within our hospitals. There are great organizations like the New Brunswick Medical Education Foundation providing scholarships for return-to-work agreements. Imagine if we completed jurisdictional scans to see what’s working elsewhere in the world to address this crisis and adopt those best practices. In Scotland there is similar numbers of doctors to patients as in New Brunswick but there isn’t the same challenge with accessing primary care. What is their secret? We intend to find out.
Everyone in our province needs our health system to work. We must create a long-term pragmatic plan that can be achieved using evidence-based decision making to better support the health of our citizens.
We must break down the silos and work collaboratively to address our issues and challenges. We must roll up our sleeves and tackle this challenge. We must do More, Faster.