N.B. hasn't met any of its goals for access to primary health care, report shows

While some progress has been made on New Brunswick's Provincial Health Plan, there's a long way left to go, says a report from the New Brunswick Health Council on the first year of work to implement the plan.

The plan titled "Stabilizing Health Care: An Urgent Call to Action" laid out 35 goals the province wants to achieve in five areas of health care.

Unmet goals include all five in the area of access to primary care and the eight in creating a connected system, according to the council's report.

Only eight goals in the overall plan have been achieved, 23 are in progress and the implementation of four goals has not started yet.

The Department of Health released the long-awaited health plan in late 2021. It contained no sweeping changes but promised new tools and set targets. 

During the year since, many of the in-progress goals had to be delayed, some to as late as 2025.

While the progress report may look less than promising, Stéphane Robichaud, the CEO of the council, said it's important to put it into context.

The plan was released in November 2021, just before another difficult winter for a health system battered by the COVID-19 pandemic and a shortage of health-care workers.

Robichaud said the council, which was created by legislation in 2008 to report on the province's health system and make recommendations to government, understood the impact this would have on how well the plan progressed.

"In the first half of the year what we saw was a system that was really struggling with that last wave of the pandemic," said Robichaud. 

"What we saw was a transition that really only occurred mid to late summer in being able to mobilize key stakeholders from the system towards the deliverables of the health plan."

 Mental health goals

The areas the province has seen the most success are with are addiction and mental health services and supporting seniors to age in place.

Four of nine goals in addiction and mental health services have been met, including implementing an overdose prevention service and organizing walk-in services at the province's 14 addiction and mental health clinics.

In keeping seniors in their homes, three of seven goals have been met, including having 11 special care homes work with the Extra-Mural Program to offer clinical services in homes and providing special care homes with tablet computers.

In the area of access, the province promised to eliminate the Patient Connect list, which attempts to match New Brunswickers without a family doctor to a primary care provider. A target of Q2 2022-23 has been shifted to Q1 2023-24.

Only one of six goals in access to surgery have been met, while work on two, having to do with online consultations and referrals, hasn't started

Some goals have also been delayed by years, such as the plan to start a provincial public health laboratory, which has been delayed until 2025-26.

In an emailed statement, departmental spokesperson Adam Bowie said the "update shows we are making progress, with 31 of 35 deliverables either completed or in progress, and just four yet to start."

"Shortly after the plan was launched, the Omicron wave hit, and it slowed our progress," said Bowie.

"While some timelines have shifted as a result, we're committed to this plan, and to ensuring improvements are made."

ERs left out

One omission in the plan, and therefore not part of the report, is progress on fixing the province's overtaxed emergency room system.

Long wait times have become endemic in ERs and recently there have been several confirmed reports of patients dying in emergency rooms while waiting to be seen..

But when the province announced the provincial health plan in 2021, there were no specific mentions of ERs.

Robichaud said while there aren't any specific goals in the plan, there are several related to ERs.

"The focus on primary care in the provincial health plan is actually a key element in improving the reality in our emergency rooms," said Robichaud.

"Most people will go to the ER … not for emergency reasons … It's because they cannot get access in a timely way to a service that they need."

More frequent check-ins

Robichaud said the council will use quarterly reports in the future, something previous governments have not had to deal with in health plans.

Now, at the very least, New Brunswickers will know where these initiatives stand.

"I think what's important is a commitment to quarterly reporting," said Robichaud. 

"For someone who's worked in the system now for 14 years, we were used to hearing initiatives, but we never hear about, 'OK, were they completed? If they were, what results were obtained?'"

Robichaud said the province has always been "open and transparent" in giving the council information.

New survey

To get a better understanding of how progress on the plan is being felt by New Brunswickers, the council is implementing annual primary health surveys.

The surveys, which were previously done every three years, will seek input from residents about their interactions with the health care system.

"We're hoping to get a good participation rate in each of our zones between now and the end of January," said Robichaud. 

"This is going to be important information from a baseline perspective."

Robichaud said the annual surveys will be conducted by phone.