Province unmoved by Horizon's request to fund abortions outside of hospitals

The New Brunswick government says it won't start funding abortions at Clinic 554, even after Horizon Health's board of directors forwards a motion asking it to.

The health authority passed a motion this week after hearing from members of the advocacy group Save Clinic 554, which has been fighting to prevent the closure of the abortion clinic in Fredericton, the only one in the province.

"The goal of this motion is to improve access to any approved services that can safely be provided in the community," Horizon board chair John McGarry said in an email statement Friday.

But in an emailed statement to CBC News, Department of Health spokesperson Bruce MacFarlane said that while the department is aware of Horizon's request, its position remains the same.

Sticks to same position

"The Province of New Brunswick's position on abortions remains unchanged from that of the previous government," said MacFarlane.

"Abortions are available in publicly funded hospitals in New Brunswick."

The former government of Brian Gallant expanded the availability of abortions in New Brunswick, so that they're now performed at hospitals in Bathurst and Moncton, although nowhere else except at the Fredericton clinic. 

Clinic 554 says it's facing closure because the province has refused to cover out-of-hospital abortions. 

On Thursday, Horizon Health's board of directors passed a motion calling on the province to consider paying doctors to provide abortion services in safe environments outside hospitals.  

Save Clinic 554 group spokesperson Jessi Taylor wasn't able to attend the Horizon meeting but said members of the group were able to talk to board members about their concerns. 

"We were thrilled at the commitment that Horizon Health and the board of directors made to advocate for community-based abortion access with the government of New Brunswick," Taylor said.

She said the board made the group feel heard and that their concerns were being taken seriously.

"Horizon stepping up, it is a huge success for us because they have so much power, because they have so much authority in New Brunswick because they provide so much of the care," Taylor said.

"But at the end of the day a lot of the changes that need to be made are in the hands of the premier."

Ottawa may step in

In a campaign stop before the federal election, Prime Minister Justin Trudeau vowed to force the provincial government to provide "paid-for access to clinics that offer abortion services outside of hospitals."

Under the Canada Health Act, Ottawa can withhold funding from provinces that fail to comply with Health Act standards.

Kerri Froc, an assistant professor at the University of New Brunswick law school, said while the Canada Health Act doesn't talk about any specific procedures it does talk about medically necessary health services.

There are two provisions at issue regarding the situation surrounding Clinic 554, Froc said: the standard of accessibility for medically necessary service and ensuring that comprehensive health services are offered.

"With respect to accessibility what it says is that a province has to provide insured health services on the basis that doesn't impede directly or indirectly reasonable access to those services," she said.

The issue is defining what counts as reasonable access. Currently, New Brunswick will only cover abortions at the Moncton Hospital and the Dr. Georges-L.-Dumont University Hospital Centre in Moncton and the Chaleur Regional Hospital in Bathurst.

"This is a surgical procedure if you're asking women from Fredericton to travel to Moncton [or] Bathurst, that's a couple hours' drive," Froc said.

This would require most patients to take time off work and arrange transportation, which would be impediments especially for women who may struggle financially. 

In terms of comprehensiveness, Froc said the Canada Health Act says a province has to ensure all insured health services provided by a medical practitioner are medically necessary.

"New Brunswick has already said that abortions are medically necessary services because they fund them [in hospitals]."

Froc said the ball is in the federal government's court to force New Brunswick to fund abortion services outside of hospitals.

"The women of New Brunswick are counting on them to live up to that promise," Froc said.