Doctors say privatizing management of extramural care 'worth a try'
Medical society says contract with Medavie Blue Cross might keep seniors out of hospital
As opposition to the New Brunswick government's decision to privatize the management of extramural and Tele-Care services continues to grow, doctors in the province spoke out Thursday in support of the plan.
In endorsing the move to privatization, the New Brunswick Medical Society CEO also questioned why seniors and critics of the plan are holding meetings to try to get more information.
Medavie Health Services New Brunswick will take over management of the home health-care program and 811 health advice line effective Jan. 1.
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On Wednesday, the francophone lobby group Égalité Santé en français, announced it is seeking an injunction to stop Medavie from taking over the services.
Égalité Santé en français argues the minister of health does not have the power to privatize management of the programs and that privatization goes against the interests of the francophone community.
However, the New Brunswick Medical Society said the current system isn't working so why not try something different, including having paramedics provide care to people in their homes.
We're not going into this with Pollyanna dreams — we understand that these are complex problems.- Anthony Knight, New Brunswick Medical Society
"When we look at the fact that a quarter of our hospital beds right now are being occupied by seniors who don't need to be there but are waiting for a nursing home care or other services, we need to start thinking about doing things differently," said medical society CEO Anthony Knight.
The group's board of directors, which is made up of 22 doctors from across the province, reached its position on extramural care at its last board meeting.
'Hopeful' Medavie will free up beds
Knight said doctors regularly see seniors and their families struggling to get the right care at the right time and are hopeful that Medavie, which already manages Ambulance New Brunswick, will be able to find new ways to serve an aging population.
"We believe that Medavie has a number of strengths … and that the potential benefits of collaboration between the ambulance service, 811 and extramural bring about some real positive efficiencies," he said.
Knight said paramedics in other provinces provide care to patients in their homes when they aren't busy responding to emergencies, and he believes that is a model that could work in New Brunswick.
"There is potential for a paramedic to maybe be at a seniors home to identify a slip and fall area, to assist with monitoring medications, to make sure that a senior is getting good nutrition and maybe alerting some of our extramural folks who could then be brought into action and maybe provide further care and assistance," he said.
"Right now that's not happening in a proactive sense, so that hand and glove collaboration could occur between Ambulance New Brunswick and our extramural team."
No 'Pollyanna dreams'
Knight said New Brunswick doctors believe the new plan is "worth a try" since the current system has too many hospital beds taken up by seniors who should be cared for elsewhere.
If we can have a group — an organization — that's responsible for on-the-ground care delivery in the community and be experts at that why wouldn't we want to try that at least?- Anthony Knight, N.B. Medical Society
"We're not going into this with Pollyanna dreams — we understand that these are complex problems," he said.
Knight hopes that privatizing the management of extramural care will push the province towards a community-based approach to care for seniors that is outside of the regional health authorities, which he says are focused on running hospitals.
"If we can have a group — an organization — that's responsible for on-the-ground care delivery in the community and be experts at that why wouldn't we want to try that at least?"
Knight said doctors want to be partners in the new approach and plan to hold Medavie "to account."
Opposition questioned
Seniors, politicians and others concerned about the plan have questioned the need for changing extramural, one of the few areas where New Brunswick has been considered a leader. Vitalité Health Network has asked the province to abandon the plan.
Knight questioned the value of public meetings being held across the province by seniors groups who oppose the change.
"I think there's a lot of groups that have some very questionable motivations at times that are holding these meetings," Knight said.
"We're too small to try and start dividing and conquering folks and questioning in a way that isn't based in good evidence. ... We need to work together and with the ageing population that we have in New Brunswick."
Knight said doctors in the province believe the new approach could help to free up hospital beds to allow them to treat patients who need acute care.
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"My members often express their frustration about their hospitals sometimes being beyond over-capacity and patients lined up in the hallways waiting to be seen," Knight said.
"Those are the real day-to-day challenges doctors talk to us about and so if some of these efforts can start to address that challenge … then we want to roll up our sleeves and at least try to make this work."