Premier Blaine Higgs defends sweeping changes to health-care leadership

Premier Blaine Higgs is defending what he calls his "shock and awe" changes to New Brunswick's health-care system leadership last Friday.

He replaced the health minister, fired the head of the Horizon Health Network and replaced the boards of directors of both Horizon and Vitalité with a single trustee each.

Higgs says his actions demonstrate a suitable sense of urgency for a system in "crisis," which he contends wasn't coming across from those managing the system.

"We're going to always find people that resist change. But the time for changing our system and getting it on a road to improvement is now," he said Monday.

"And sometimes I know the shock and awe thing is difficult, but I think everyone realized that something has to be different."

The shakeup comes after a patient died in the waiting room of the Dr. Everett Chalmers Regional Hospital's emergency department in Fredericton early Tuesday morning while waiting for care.

Witness John Staples said the man, a senior, had been waiting alone in a wheelchair, in visible discomfort for hours when he appeared to fall asleep. It was only during a routine check of people in the waiting room that a hospital employee realized the man had stopped breathing, he said.

There were 17 ER patients waiting to be admitted that day and the hospital was full, according to Higgs.

"We know hospital occupancy has always been a problem. We've had that before COVID. But are people being released [in] an appropriate [amount of] time? Do we have a flow through the system as needed, so we keep people moving because new people are coming in? All of these things are a process improvement, a flow, a management issue, and that's why I focus so much on that."

Higgs confirmed the results of the ongoing Horizon review of the patient's death will be made public. If he's not satisfied with the results, he will ask for an external review, he has said.

During Friday's news conference, Higgs announced Bruce Fitch replaces Dorothy Shephard as Health minister, while she takes over Social Development; Margaret Melanson replaces Dr. John Dornan as interim president and CEO of Horizon; and the government has appointed Suzanne Johnston and Gerald Richard as trustees for Horizon and Vitalité, respectively, replacing the boards, which included members elected by the public and appointed by government.

He was removing a "bureaucratic stalemate," he had said.

I guess I'm not the first to watch it deteriorate, but I might be the first to act like this in the sense of urgency to make something change.- Blaine Higgs, premier

Asked Monday about his own role and the role of his office in watching the health-care system deteriorate, Higgs replied: "Well, I guess I'm not the first to watch it deteriorate, but I might be the first to act like this in the sense of urgency to make something change."

Higgs has been in office for four years. He won re-election with a majority government in September 2020 after calling a snap election following two years of leading the province's first minority government since 1920.

His government put more money into the health-care system, "but that wasn't working," he said between frequent sips of water, apologizing for having what he described as "a problem with [a] cold in [his] throat."

"I think I've demonstrated the responsibility to act and make something happen in a timely fashion and taken that accountability."

'Not afraid to try' new way

What if the sweeping leadership changes don't work?

"Well, there's a lot of what-ifs in the world, and I guess we'll cross that bridge when we come to it. Right now, I'm not afraid to act and to carry on to act because our people deserve better. Our employees deserve better. And we all need to ensure that that better happens," Higgs said.

"And I'm not afraid to be measured along the way to see that better is indeed happening. So I guess, you know, you can make that judgment in a few years and decide whether we got traction or whether we didn't. But right now, I'm not afraid to try and try in a new and in a different way."

Call for more resources

The Canadian Union of Public Employees (CUPE) in New Brunswick agrees changes are necessary, but contends more workers and better funding are among the things needed.

"We can change whoever we want at the head. If they don't have the resources to do their job and they are told all the time 'do more with less,' our members will continue to be frustrated with their managers and the managers will be frustrated with the government, which don't give them the tools to do their job," said spokesperson Simon Ouellette.

New Brunswick should pull out all the stops to recruit health-care workers, according to CUPE, including offering free education in the field.

"Instead of doing that, we come to do an administrative shuffle and we have just removed a layer of transparency that we had with our health authorities which are now under supervision," said Ouellette.

Higgs said "money isn't going to fix all this."

Health plan will still be implemented this mandate

The leadership changes will allow for swifter changes to a strained system. Having a small, focused group emulates what the government did in the early days of the pandemic, he said. "We had a small group that made decisions … based on facts, and then moved that out across the system."

He still wants his government's health reform plan, announced last November, implemented during the current mandate, he said.

"We've fallen behind on the schedule, but we're going to get caught up because our health plan that we put forward is solid. There will always be tweaks and improvements as we go with any improved process, but we committed to doing it during this mandate."

The need for targets and speed of implementation were part of the health plan, which promised that by the second quarter of 2022-23, the list of New Brunswickers waiting for a doctor would be eliminated and replaced by the New Brunswick Primary Care Network.

An update provided last month showed about 63,000 people are now on the Patient Connect New Brunswick list — 23,000 more than when the plan as announced.

Higgs wants to see more sharing of best practices between the two health networks. He notes Vitalité, for example, just hired about 275 students to help allow staff nurses to take vacation this summer.

He also wants to see better communication and collaboration between individual hospitals. One area he points to is sharing information about ER capacity each day so people can travel to another hospital where waits may be shorter.

In addition, nurses should have the flexibility to trade shifts with each other, family doctors need to work in teams more, and surgeries and emergency care should be offered where waits are shorter, he said.