Higgs may have jeopardized reputation for making politically risky decisions in health reform fallout

A week is a long time in politics, they say, and that was especially true during the last seven days in New Brunswick.

Last Tuesday, the Higgs government's reputation for making tough, politically risky decisions was at the forefront of the announcement of changes to small-town hospitals.

If there was political flak, "we're going to do it anyway," Health Minister Ted Flemming declared. 

"A government has to govern. There's been enough studies, enough consultations, enough reviews, enough, enough, enough."

The CEOs of the province's two health authorities were "fabulously qualified" to lead the reform along with their staffs and boards, he said, "to the point that New Brunswickers should be thankful and grateful that we have these people in New Brunswick." 

Fast forward to Premier Blaine Higgs's news conference on Monday, when he said that the plan was not as "ready to go" as the CEOs had said it was, and that its implementation was "not well-defined."

"I did expect that they would have a greater ability to roll out the plan," he said of the CEOs, Karen McGrath at Horizon and Gilles Lanteigne at Vitalité.

"I was disappointed that that was not the case. Anyone would be disappointed that we weren't able to roll this out seamlessly."

Too many questions, few answers

According to Higgs, too many questions came up in the intervening week that lacked answers.

With six small-town emergency departments shutting down between midnight and 8 a.m. starting next month, would there be more advanced-care paramedics to accommodate the increase in patients travelling greater distances to city hospitals?

Would there still be palliative care in those smaller hospitals? 

Were doctors spelled off from overnight shifts in the ER actually practising in those communities, allowing them to see more patients during the day, as the health authorities promised? 

"Those questions should have been clear, answered, without any concern," Higgs said. But, he said, they weren't. 

And apparently they had not been asked by anyone in his government  — a startling admission for a premier who emphasizes managerial competence and precise, measurable achievements.

"I'm an engineer," Higgs told a business audience in Saint John last year. "I love Gantt charts," a kind of bar graph showing timelines and targets.

"I love measurements. I love people to hold accountable: like 'Who owns this?' and 'When are you coming back with a report?' and 'what's that report going to look like?' and 'When are we going to see results,' so that we have a timeline."

How, then, did no one ask the right questions about the health plan before it was released — especially given that versions of the plan have been floating around for more than a decade?

Higgs acknowledged Monday he had not been shown a Gantt chart, "which I would normally see," for the health reforms.

"I was assured it was all done," he said, "because we've been trying to do it for so long."

He explained that as premier he wants to delegate decision-making to "people in their own divisions, to take responsibility for their everyday activities."

In this case, though, it took a week of protests for Higgs to discover there was a lack of forethought about the spinoff effects on other parts of the system.

Health reform plans aren't dead yet

The resulting fallout took his minority government to the brink of a snap election call. It also cost him the only francophone MLA and minister he had, Robert Gauvin. He'll now lack that perspective in future caucus and cabinet deliberations.

How, then, to go forward?

"Doing nothing is not an option," Higgs said. "It's never been an option for me. Taking a step back is necessary." 

The plan isn't dead. 

"I don't know of another plan," Higgs said.

It will be the basis for consultations the province will organize this spring — the consultations Flemming said a week ago were no longer necessary. That will include visits by Higgs himself to the six communities with affected hospitals.

But the premier added he'd be glad to hear alternatives that address the pressing issues that still need urgent solutions: not enough doctors and nurses to allow the system to care for an aging population.

And how should people respond the next time he says he's standing firm on an unpopular policy and is willing to go into an election to ensure it goes ahead? 

"If I'm in a position again, which I hope to be, to say 'I have this plan to roll out, I have assurances we can do this,' maybe I'll ask more questions. But I do ask a lot of questions in any case, so I'm not sure how many more I would ask.

"But I would expect for people to be accountable for delivering what they promise to deliver, and I have to rely on people to be able to do that." 

So, he said, he would stake his ground "on different issues going forward, on the basis that I believe in what the plan is, that it will be well executed," he said.

"The concern here is that the implementation plan was just not well thought-out." 

For many who believed in Higgs — who were confident he was a non-politician willing to make the hard choices — that distinction was lost, the reversal particularly disappointing.

"I truly thought he was stronger," Bob McVicar, a Saint John businessman and Conservative supporter, said in a social media post. "He just choked like the rest have in the past. I'm suddenly wondering what makes him different from Gallant."

At the end of a critical week for Higgs and his government, that comparison — to the former Liberal premier he often accused of avoiding difficult decisions — may be the cruellest critique of all.