The Green Caucus’s vision for health care in New Brunswick is that New Brunswickers, in rural and urban areas of the province, get the health services they need, when they need them, and where they need them.
All New Brunswickers have a right to quality health care. The global pandemic has brought into sharper focus the improvements needed to bring New Brunswick’s health care system into the 21st century.
We must improve primary health care services in all communities by adopting an integrated health care team-based model of practice. This needs to be seamlessly interconnected with mental health care.
Transportation for health care appointments is also an issue that must be addressed. This is particularly a problem for seniors and others who either have a chronic disease that prevents them from driving or do not have the income to own a vehicle. Reliable, province-wide public transportation is needed to address this issue.
The management of our healthcare system has become so over centralized, it has lost touch with the needs and expectations of local communities. Decentralization will provide better decision-making that reflects local realities.
This will require the creation of local community health boards to decide the services to be offered based on the needs and expectations of the people they serve.
As part of the move to decentralization, the essential role of the hospital administrator to manage their hospital must be restored, in collaboration with the medical and non-medical staff who work there. This will create a true sense of belonging for the hospital staff, confident that they are part of a team focussed on servicing the best interests of their patients.
We must expand the gateway to health services by ending the physician role as the gatekeeper to the system. The era of solitary doctors being your only ticket into the healthcare system, without going to the ER must end.
We need a new deal with family doctors that would see them integrated with nurses, nurse practitioners, social workers, dieticians, mental health specialists, pharmacists and others into primary health care teams who would work together to provide the best health care services to their patients. This arrangement would be an incentive for many new doctors and nurse practitioners to locate in New Brunswick.
The government should establish community health centres throughout the province. These centres would offer the services of a variety of professionals, including family doctors, mental health care specialists, nurse practitioners, dietitians, respiratory technicians, and midwives. They would be designed to meet the health needs and expectations of their communities.
Bold action is needed to address the mental health care crisis in New Brunswick. Government must rapidly implement its campaign commitment to opening walk-in mental health clinics around the province. Medicare must cover the costs of psychotherapy to ensure universal access. An emergency mental health care needs to be provided by transforming our Mental Health Mobile Crisis Teams into 24/7 first responders.
The regional health authorities operate mental health mobile crisis teams in the province, but their hours of operation and geographic reach are limited by their funding, leaving police to respond to mental health calls, for which they have no training. The mental health mobile crisis teams must be funded to serve as a new class of first responders so that there will be trained mental health professionals responding to mental health or “wellness” calls, around the clock, rather than police.
Community-Based Health Care
In Fredericton we have excellent examples of community-based health care that should be commonplace around the province. Access to midwives is unavailable outside of Fredericton. Many more communities would benefit from the establishment of community health centres such as those in Fredericton and Minto. Affirming health care is not widely available to members of the LGBTQ community, and needs to be. Access to abortion services remains unreasonably restricted to hospitals, and at that, restricted to hospitals in Bathurst and Moncton. Harm reduction initiatives to addictions remain poorly developed, with the new Riverstone Recovery Centre being a notable exception. These shortcomings in the community delivery of healthcare must be addressed.
Emergency Health Care
The dynamic deployment model used for paramedic care has proved to be inadequate to the task, allowing urban areas to be under-supported, requiring paramedics to be drawn away from rural areas to provide support, leaving those communities exposed.
Preventative Health Care
Preventative health care often gets ignored in health care discussions, but if it isn’t addressed, it’ll continue to contribute to some of the problems we face. The government must give Public Health the resources to implement a larger, targeted preventative health initiative. This needs to be done on a regional basis using Public Health’s regional Medical Officers of Health and public health nurses. The NB Health Council’s Community Health Assessments provide great data for tailoring preventative health care measures to specific communities that could be used for this purpose.