Ross Thomas is a retired family doctor who’s been involved with Sackville’s steering committee on healthcare reform since it was formed in response to proposed cuts to rural hospitals back in February.
Thomas worked in Sackville for about 30 years, in both the emergency room and in family practice. Now, he says, he’s just a citizen of the town who has concerns about the future of healthcare here and how it’s delivered.
The cuts announced on February 11th and scrapped five days later, would have meant serious changes for the Sackville Memorial Hospital, including the shutting down of the emergency room overnight, the elimination of all acute-care beds, and the closing of the operating room where day surgeries are performed.
In light of an upcoming election, and recent meetings attended by Sackville Deputy Mayor Ron Aiken, I called up Ross Thomas to talk health reform.
ERICA BUTLER:
Before the election was called, Deputy Mayor Aiken had reported back from a meeting with department officials saying that previous proposals were off the table. Were you hopeful about that? About what he had to say when he came back from that meeting?ROSS THOMAS:
Yeah, I think we have to take the premier at his word. And we have to believe that he has enough power to make those kinds of decisions. The initial proposals were put forth by the CEOs of the health authorities, Horizon and Vitalité. And you know, there were claims at the time that they had the power to make those decisions. But obviously, it appears that the politicians can override them, as they are employees of the provincial government.So I am hopeful. I certainly believe that he felt that was a mistake. I think he’s admitted that. He hasn’t taken the action that we asked for, that they fire the CEOs. And the CEOs have continued to agitate to make the same cut as recently as, I think, June. And so there’s certainly a conflict within, between the department of health and the health authorities about whether these changes need to be made. We’re just hoping that the premier is true to his word. And I think he is. I think he has shown the ability to correct course when he feels errors have been made, and I think this is a prime case of that.
EB:
Now when the election was called, there were murmurs on social media of people with renewed concern that this meant that the hospital was in danger again. How do you see that? How do you see the election affecting the situation with the hospital?RT:
Well, I mean, I think he’s gone on record in the last few days as saying that was a mistake, that’s off the table, we’re not going to do that. Now, I think, what we would be looking for from our group… You know, the problems we had, not only were these changes being made appearing to be attacking rural communities only, but there was no consultation about the changes. There was consultation that took place, but there was no mention of these changes until they were rolled out. And secondly, there was no transparency about how the decisions were arrived that.We recognize that, or I recognize at any rate, that changes need to be made. We can’t keep everything the same forever, that’s just the nature of life. But we would ask that if there are changes being made that we are part of that process, and that we have access, if we wish, to the same information that the government is using to make those decisions.
Those are the big things that have come out of this, for me.
EB:
The mayor has referred to a health summit, and that certainly seemed to be something that Deputy Mayor Aiken’s meeting that was mentioned. Is that something that you can see being useful, some sort of massive province-wide health reform discussion?RT:
Well I guess it speaks to the need to seek feedback from communities and user groups about what they feel is needed in health care, rather than for it to be totally dictated by administrators, without any rational basis, and seeming to penalize, in this case, rural communities.
As you know, over the last two or three decades, healthcare has become increasingly concentrated in the urban areas. And most of the specialty services and many of, virtually all of the major investigation modalities and imaging modalities have to be done in urban centres, which has increased the discord between availability of equitable services between rural and urban residents. And that’s happened nationwide as well. We just see this as yet another attack on rural health care. And one would hope that that would be addressed in some kind of future summit.EB:
In your experience is rural healthcare too expensive for us to deliver properly? Or do you see that there’s changes that can be made that can actually make it more efficient?RT:
I think, unfortunately in this process, and this is one of our huge criticisms, there is a no data released on what the decision is based on.I would think that rural health care is in general less expensive than urban health care. There are going to be certain things, like for example, keeping the emergency room open at night. There’s not as much usage overnight but it also doesn’t cost as much money as it does to keep an urban emergency room open. We don’t have all the allied health professionals working 24-7 in our hospital. There’s nurses and there’s doctors… And there’s lab technicians and there’s radiology technicians. But there’s no physio, there’s no respiratory therapists. We don’t have specialists in the building. So there’s a lot of things that are way less expensive in delivering rural health care, including rural emergency health care.
I don’t know, I don’t have the numbers to tell you, but my sense would be that if you looked at where healthcare dollars are spent in this province, 90% of them are spent in those three urban areas, Fredericton, Saint John, and Moncton. And that reflects about, maybe, 40% or 50% of the population.
Granted, some of those dollars are being sent on rural citizens who have to travel to urban areas to get that care, often with caregivers who have to get the time off work. So it’s a huge disadvantage for people, even if they can access the care, it costs them more in time and money and gas to get that kind of care done.
EB:
Now, when when candidates For Memramcook tantramar come knocking at your door. If and when they do…RT: I would be shocked if they do.
EB:
Oh, that’s true. I’m dating myself here. That’s pre-COVID. No one’s going to be knocking at your door. But let’s say they were, what would you ask them?RT:
What I would look for is a commitment to equitability in health care, first of all between rural and urban areas. You know, it should be equitably available for all New Brunswickers. I would look for consultation and transparency to be involved in decision making. And that is consultation with stakeholders, not being driven by urban CEOs and the like.I think we have a right and are very capable in rural New Brunswick of making decisions about what we need. And I think we should have a voice.
And part of that problem is the system has been structured over the last 20 years with increasing centralization of the decision making process into the urban areas. And less and less input at the local level, or power to make decisions at the local level. I don’t think that is going to be on the table, the structure of the healthcare corporations. But ultimately, that’s part of the problem here. The loss of control, the loss of autonomy, decision making.
And it’s not all bad. There have been good things about that. The standardization of service provided. But there has been certainly a loss of autonomy.
But those would be the three things, the equitability, the transparency, and the willingness to consult stakeholders.
EB:
What’s next for the Sackville Steering Committee on Health Reform?RT:
Well, my sense is that there will be reactivation hopefully of the mayors’ group. So the mayors of the communities that were going to be affected by these cuts, hopefully will have something to say about what they expect members of legislature who are going to represent those communities to do and to behave with respect to healthcare. And I think if they do, that voice will have a lot more clout in formulating policy.I think that certainly from the statements made by the person running for the Conservative Party, they are very cognizant… They are trying to backpedal. Unfortunately, you know, they are responsible for initiating it in the first place so they’re wearing a little bit of mud right now. But the lady that’s running is certainly advocating to retain services at the Sackville hospital which is good to see.
