Morgan Peters: Needed: Timely actions for improving health care

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Last month, the Fredericton Chamber of Commerce, in partnership with the Greater Fredericton Area Physicians Staff Organization, hosted our first Physicians Round Table.

Health care is an essential component of a livable city and a primary concern of the business community – in fact, it has been the No. 1 member-identified issue in our annual survey for the previous two years. With an issue as fundamental as health care, we have to go to the source of those foundations – the professionals with experience in our local hospitals, our clinics and lives. Our recent work understanding the concerns of many physicians and other health care workers has led to the conclusion that recruitment and retention efforts now must also include supplying those who are here, who are dedicated, and who want to serve their patients, with the tools they need to do their job.

By bringing together physicians from our community to discuss the current state of our health care system, we not only wanted to better inform our research based on the personal experiences and expertise of those working within it daily, but also to better communicate the needed actions within our system to the community.

Health care professionals of the Greater Fredericton Region are dealing with more professional, physical, emotional, and social stresses than could ever have been expected. Physicians working within an ill-equipped system yet pressed further with exponential population growth, patient care is now only one of the many expectations placed on their overloaded “plates.”

Within our provincial health care system, increasing strain has caused many to ask what is the role of physicians in achieving a stable and acceptable system? More physicians are forced to become systemic advocates when faced with deteriorating conditions that have put their patients’ care at risk. They have always been advocates for their patients on an individual level, but this is something larger beyond this direct patient care role. This is a professional and dedicated group, who have stepped forward to express there is an immediate need for our health professionals to receive the industry standard resources they require to serve their patients.

Health care professionals working with patients across numerous fields and specialities possess both the training and practical experience to recognize areas of immediate concern and understand the realities of our growing community. Despite stepping forward with concerns, there is an increasing disconnect between provincial policy and local, first-hand, evidence-based recommendations.

In the very short course of our discussion, immediate and obvious needs in our province and specifically our local community emerged. To summarize broadly, our discussion touched on numerous topics including access to longitudinal primary care for all New Brunswickers. Among the long list of obstacles and areas of potential reform to help improve access, tangible issues affect progress every day. Within such a large and complicated area such as health care, we may fail to realize the everyday logistical barriers in setting up a mixed-use clinic or family practice. Something as tangible as the identification and access to office space, for example, is a real impediment in our community.

Staffing and recruitment also emerged as an urgent need and our system requires innovative changes made to recruiting and retaining physicians, nurses, and technicians to incorporate everything from industry-expected resources, practical supports and livability issues which encompass the modern concerns of professionals.

The example of removing logistical barriers through red-tape reduction was highlighted and the chamber once again points to the industry leading progress exhibited in Nova Scotia by the Office of Regulatory Affairs and Services and their effectiveness in directly “Reducing Red Tape for Physicians”.

A new vision for shared practices and clinics must also be embraced by the government and our communities, as only once these services are made available, meaning adequately staffed and supplied with resources, will the public alter its utilization of health services. The delivery of these practices and clinics must also include the essential role played by Licensed Practical Nurses, Personal Support Workers and others.

Timely access to diagnostics is key to a successful system but can only be achieved by adequately staffing and suppling these departments the necessary resources. An effective and complete innovation strategy concerning technology and supports can only work if everyone within the system has access to the same equipment and programs. This would represent a streamlining of time-consuming functions, increased access to records and simplified filing, all in efforts of increasing time for patient care.

Any reforms and improvements to these areas, whether large or small, represents the act of taking time-consuming elements off the plates of our physicians and allowing more time to be devoted to their primary focus, patient care. Only through effective engagement and communication can we apply the modern multidisciplinary approach to medicine needed in our province.

This brief overview of our discussion is an example of the ideas that can be identified and the changes that can occur as a result of open and constructive communication. Perhaps the most concerning issue negatively impacting health care reforms is the prevalent conclusion health care professionals do not feel they are part of the process in policy decisions. Repeatedly, examples exist in which their first-hand, expert and evidence-based knowledge has not been consulted during the decision-making process. As a result, decisions in health care have been increasingly removed from our community perspective. Local advocates and community supports are required to ensure resources meet the demands of the growing Fredericton region. This recognition entails coordinating proactive supports offered to the health care community by municipal representatives, businesses, community service groups, and ultimately individual community members. Fredericton is an engaged community and must make clear to health care workers and the provincial government we are committed to the improvement and growth of our health care system.

A timely plan of action? Standards and deliverables

On March 26 the federal government and the province of New Brunswick announced two bilateral agreements to invest a total amount of more than $430 million to improve health care access and services in New Brunswick. Through the Working Together Agreement, the Government of Canada will provide more than $313 million to support New Brunswick’s three-year action plan to deliver improvements to its health care system.

The new bilateral funding agreement with the federal government will be incrementally tied to progress against targets which New Brunswick will publicly report on annually. The targeted improvements have been identified in the November 2021, New Brunswick health plan, Stabilizing Health Care: An Urgent Call to Action. This five-year “evergreen” road map for evolving health care in New Brunswick outlined a path intended to stabilize and rebuild New Brunswick’s health-care system to be more citizen-focused, accessible, accountable, inclusive, and service-oriented.

This new progress-based bilateral agreement is the latest in a long series of opportunities to update this “evergreen” road map and affect positive change. The current health care plan has very noticeably languished in pursuit of the stated and basic goal of stabilization. While the needs that were certainly urgent in 2021 remain today, it is more obvious than ever the approaches to achieving this goal must change. The provincial government and our health authorities must genuinely engage with health professionals, to include them as part of the process in implementing reforms and improving services. These reforms must be based on available evidence and immediately accept a standard of providing our services the resources based on established industry norms and expectations.

We repeat our previous call that rather than simply striving to stabilize a previous standard which our system is not living up to, the province must modernize to provide truly world-class health care. To do this, we must utilize all available resources, by responding to the needs of professionals working within the system daily, maximize existing and potential partnerships, and seeking new solutions to long-standing problems.

A renewed community focus

Our physician round table has further impressed upon us the urgency for proactive reforms and timely targeted action. Affecting this change within the Greater Fredericton Region will require the necessary resources be provided by the provincial and federal governments, but it will also require effective implementation of evidence-based policies. This is only achievable through consistent communication between the local health authorities and health care professionals. Another immediate requirement is the support and engagement of our local community, referring to the municipal government, the business community, service groups and the efforts of private citizens.

The Fredericton Chamber of Commerce recognizes the daunting challenge the topic of health care imparts in the public today. It is important to say, however, that despite current negativity, the physician round table has served to energize our resolve to be a supportive partner within positive action. We salute the City of Fredericton and other regional service representatives currently coordinating efforts to attract and support health care workers and we emphasize the need to expand these efforts and align community actions in recruitment, retention and all steps advancing the livable healthy community we all desire.

It should also not be lost one of the biggest takeaways from the round table was physicians are dedicated and here to serve their patients. They are part of the Fredericton community and want our city to grow and be as healthy a place to live as possible. They are only one part of the process, however, and require the resources to perform their jobs. Health care and the future of our livable community is a collective effort, and we all have a part to play.

Morgan Peters is CEO of the Fredericton Chamber of Commerce