It appears the provincial government has rolled up its sleeves at seeking remedies to re-balancing a provincial health care system that even the Premier has recognized is broken. Following in the wake of the report and recommendations put forward by the Heath Accord on Feb. 17, the provincial minister of health has stated moves to repair a health care system will not involve job losses. Since then, the government has announced two major incentives. First, in collaboration with the nurses Union, will be the creation of a $420,000 bursary fund to attract international nurses to address 600 vacant nursing positions in the province. Second, for the first time in our short history as a province, government moved to set up an office in the Confederation Building dedicated to the recruitment and retention of health care professionals.
Premier Dr. Andrew Furey's government does feel the pain of a health care system in turmoil and appears willing to begin addressing issues. "I (premier) understand that the system was broken before the pandemic. There has been a huge exposure of gaps because of the pandemic, and I want to make sure that we're working collaboratively to ensure that we're closing those gaps."(Eaton, CBC, 03/02/22)
The recently released Health Accord report commissioned by the province has made some 57 recommendations for change. The intent was to chart the course for health care for the next decade. One major recommendation is that of a universal basic income. In order for this recommendation to become reality it will require a sizable federal input in terms of dollars. However a call for a universal basic income is not new in the province. A motion was proposed by the NDP and passed with full party support in the House of Assembly in 2020. Since then a proposed all party house committee to look into a basic income project has gone nowhere.
Another recommendation, which certainly will provide some interesting debate within the walls of Confederation Building, communities and open line dialogue, will be reducing the number of emergency care facilities within the province. Any talk of closing access to emergency services will be seen as a further loss of health care access, most notably in rural areas.
No doubt there is a need for a new direction. The present health care system is no longer meeting needs and no longer sustainable. Dr. Pat Parfrey, co-author of the report along with one time CEO of Eastern Health Sister Elizabeth Davis, estimated that in 2021 about $600 million was being spent by the provincial health care inappropriately or at least inefficiently (CBC April 20/21). That is a lot of money considering the annual budget for health care in the province comes in the $3 billion. That's $1 for every $5 spent on health care.
It will be interesting to see how the fiscal matters will be dealt with in a second report by the Health Accord due later in the year. Such wastage, if it exists, has to be identified and the political will has to be found to correct it.
No doubt the province has some difficult challenges ahead if a new direction in health care over the next decade is to evolve. Resource rich Newfoundland and Labrador is one of Canada's poorest provinces.
Comparatively, Newfoundland and Labrador has some very troubling health outcomes. Dr. Parfrey paints a dark picture by stating "NL's life expectancy is 2.4 years lower in men and 2.3 years lower in women than the Canadian average — a statistic that's steadily worsened since 1980." (CBC News Feb 22)
Any meaningful change will be a challenging road as the province comes to grips with a health care system characterized by general slowness to change. Health care operating in a climate of what appears to be knee jerk decisions exposed to the public domain, including a highly combative unionized professional sector chewing at the bit, has to change. As well, a mindset geared towards treating the problems in health care as an unavoidable consequence of circumstance must change.
We must throw away a crutch that the root of the problem is our declining and aging population spread over a vast geographic area. The focus for change must start with the overall design, management and a greater investment in rural communities. The constellation of health care services within the Avalon has not worked. There is nothing bright for those outside of the Avalon, having to travel to St. John's to get into a queue for a health care system struggling to meet demand.
Any change can be a tough political sell. Although straw polls (far from scientific) provide limited indication on just how people feel, a VOCM poll conducted on the day of the release of the Health Accord report does provide some food for thought of where people are in relation to seeing meaning reform come out of the accord.
When questioned on the possibility of success in delivery and outcomes within the health care system the results were: "Yes, if there is the political will to do so– 50 per cent; No, there is to much push back and inaction – 33 per cent; Yes, if the public is on board – 17 per cent." It's a simple gage but one that sends a ominous message to Premier Furey.
However, it seems to be a message that government has heard and appears, given its actions over the last week, willing to take. Let's hope those sleeves remained rolled up.
Port aux Basques, NL