Premier-designate Susan Holt and her Liberal Party made a lot of health-care promises during the election campaign, and while some timelines are tight and some estimates are lacking, front-line health-care professionals say they’re optimistic about healing the ailing system with the new government.
Dr. Lise Babin, the new president of the New Brunswick Medical Society, which represents more than 2,000 physicians in the province, said she believes Holt’s pledge to open “at least” 30 collaborative health-care clinics is “going to go a long way toward improving access” to primary care for the thousands of people without a doctor, as well as those who have a doctor but have difficulty getting a timely appointment.
The proposed clinics will bring together doctors, nurses, nurse practitioners, psychologists, physiotherapists, pharmacists and others “to provide a health-care home for patients.”
At least 10 of those clinics will be in place in 2025, Holt told CBC News on Thursday.
That’s up from the four she previously committed to open next year, in Fredericton, St. Stephen, Sussex and Campbellton, at an estimated $3.8 million in capital and operating costs, according to information filed with Elections New Brunswick.
The remainder will open before 2028, the party has said, with Year 2 capital and operating costs of $7.7 million, then $11.5 million annually in subsequent years.
Babin, a family doctor who works in a collaborative practice in Dieppe, contends the model serves patients better and makes practising medicine easier. Doctors are able to take on more patients because other members of the team can handle some of their visits, and they don’t have to worry about going on vacation or being at a conference because someone else is always there to care for their patients, she said.
From retention bonuses to improved working conditions, Liberal Leader Susan Holt made many promises to nurses en route to her victory in Monday’s New Brunswick election. Nurses’ union president Paula Doucet spoke with CBC’s Rachel Cave about what nurses are expecting now that Holt is to be premier.
“We believe that younger generation physicians, they’re looking for this type of practice and they will be interested in moving toward this,” said Babin.
Human resources biggest challenge
One of the biggest challenges the Liberals will face with the new clinics is staffing them, said Babin. The province will need to attract more doctors and other health-care professionals.
Holt has said she wants to create additional seats for medical students, in Saint John and Moncton, through Dalhousie Medicine New Brunswick, along with residency positions for graduates completing their specialized training. The goal of 10 new seats would cost $430,000 a year, Holt has said.
This will help, said Babin, but will take years to bear fruit.
The medical society is seeking a commitment to improve remuneration for physicians, she said. She declined to discuss specifics, citing pending negotiations, but did say when compared to the other Maritime provinces, “we are lagging a little bit behind.”
The current fee-for-service payment model is also overly complicated, according to Babin.
In an emailed statement Holt acknowledged, “To begin establishing community care clinics we need to make changes to the compensation models.”
ER is expensive place for primary care
Earlier this week, Holt told CBC investing in primary health care, ensuring people have access to a family doctor, nurse or nurse practitioner, will save money.
“Right now, everyone is going to the ER because they don’t have a family doctor. But that’s a really expensive place to get health care.”
About 180,000 New Brunswickers are on the wait list for a primary health care provider, Holt said, noting some have been waiting for years. But “early in 2025,” when the first collaborative-care clinics start to open, that number will drop, she said.
Similarly, 550 seniors are currently living in hospitals, when they could be getting care at home or in long-term care for much less, said Holt. “So if we make the investment in health care, in community and a proper dignified care for seniors, we will save money on the other side of the health-care system. I’m really confident that we can achieve that balance.”
Doctors want to see “a commitment to get going on these promises,” as well as a willingness to consult with the people on the front lines and include them in any decision making, said Babin.
“I think [the Liberals have] shown an interest in doing that, and I think people will have confidence that the plans are going to move forward,” she said. “I think it’s going to go well.”
Nurses sense ‘different temperature’ with new government
The province’s nurses also sense “a bit of a different temperature” dealing with Holt’s Liberals than the outgoing Higgs government, said Paula Doucet, president of the New Brunswick Nurses Union.
She noted the premier-designate met with the nurses Tuesday afternoon, following her win Monday night.
More than 200 nurses from across the province were gathered in Fredericton to celebrate the union’s 50th anniversary and to attend the annual general meeting.
“Our government is committed to showing nurses and other health-care professionals the respect they deserve and earning their trust,” Holt said in a statement.
This will start by “bargaining in good faith and getting the first round of retention payments out the door as soon as possible,” she said.
The Liberals have pledged nurse retention payments of $10,000 this fiscal year, at an estimated cost of $74.3 million, plus an additional $5,000 for every nurse, nurse practitioner and licensed practical nurse next fiscal, raising the total cost to nearly $111.5 million.
Holt aims to increase the province’s five-year-retention rate for nurses to 80 per cent, from 74 per cent, with the bonuses, and contends the strategy costs less than the travel nurse contracts under the Higgs government during COVID.
“Nurses and other health-care professionals are going to staff our new community care clinics and they will be the greatest recruitment tool for attracting more health-care workers to New Brunswick while also giving those who have left the profession a good reason to return,” she said.
Working conditions are key
The retention payments, which are expected before the new year, said Doucet, are a long-overdue recognition of the work nurses do in the face of ongoing staffing shortages, and all they went through during the COVID-19 pandemic, when other jurisdictions compensated their nurses.
But money alone won’t be enough to stem the nurses burning out, retiring early and leaving the profession, she said.
Working conditions must to be addressed “right away,” she said, adding she expects they will play a key role in upcoming contract negotiations, based on a recent survey of members.
Nurses are “continuing to work short in many areas and they’re just looking for some hope and some reprieve, actually, to that dire shortage that they’re facing.”
Last month, Part 3 nurses, who make up about 90 per cent of the membership, rejected a tentative agreement with the outgoing Higgs government by a margin of 59 per cent.
Doucet declined to discuss any details, saying the union had agreed to a media blackout.
But she did say she doesn’t believe they will start over “from scratch. I’m hoping to build on what we had previously.”
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