Questions raised about changes to N.B.'s health authorities

Health policy experts are raising questions about how New Brunswick's government is restructuring its health-care system.

Health Minister Mike Murphy announced on Tuesday the eight regional health authorities in the province will be eliminated in favour of two larger boards based out of Bathurst and Miramichi.

Daniel Bourgeois, executive director of the Canada Institute for Public Policy and Administration at the University of Moncton, said he is concerned about both regional health authorities now being based out of the northern part of the province.

"They are also located in cities where there are no tertiary care hospitals and no training so the chief executive officers of these two boards, if you wish, will travel a lot between Miramichi and Saint John and Bathurst and Moncton," Bourgeois said.

A provincial health council will also be established in Moncton to report on the performance of the system and to provide a forum for citizen engagement and a public sector company in Saint John will be in charge of all non-clinical services.

Headquarters moving away from population: critics

The movement of the health authorities has the potential to alienate the public, said Dr. Michael Rachlis, a Toronto-based health policy analyst.

"It seems to be counterintuitive that the government wants to work on citizen engagement to then move the senior managers and the governance of the system away from where most of the people live," Rachlis said.

Dr. Don Craig, president of a medical staff organization representing physicians in the southern part of the province, said he is concerned the change will also have implications for the autonomy of hospitals.

Local control is needed in the south where Saint John Regional Hospital has been designated to serve as the province's main trauma centre, Craig said.

"This is the area where if there's a problem anywhere in the province, it ends up here," Craig said. "We're open 24 hours, seven days a week. Other regions can't handle the tertiary care services that we have to offer.… If we're going to have control out of a different area, I just don't see how that's going to work."

The changes amount to stripping hospitals of the administrative control of their services, Craig said, and is a major step backwards for the province's health care.

End of duplication needed: minister

Murphy said the existing system was expensive and flawed because of duplication of services and administration.

"We have eight of almost everything whether this is needed or not," Murphy said.

The duplication in the system was a problem, said Marilyn Quinn, president of the New Brunswick Nurses Union. The nurses' union is still examining the new structure and waiting to see how it will work when it is fully implemented on Sept. 1.

"You know, we think it has merit. But is it the right answer? At this point, it's very hard to know that," Quinn said.

The Canadian Union of Public Employees, which representing other health-care workers in the system is also waiting to see how the new system will function.

None of the 8,000 employees represented by CUPE will be affected by the changes, said spokesman Gordon Black.

"They're asking the question of will there be layoffs and after they hear that there will be no layoffs, they breathe a sigh of relief for that," Black said. "But there are still a lot of questions."

Job losses are expected in connection with the changes, Murphy said, but most will be from administrative positions, including the elimination of about half of the 56 vice-presidents employed at the hospitals.