John McGarry, Board Chair, Horizon Health Network

The health summit is on.  Thank you, Premier. That's one silver lining of the tumult heard after the health changes were announced, and were soon retracted.

Let's hope the summit doesn't become an opportunity for every stakeholder to simply proclaim that all would be well if only more money was committed.  Or, if only Ottawa would turn over more cash. Or, if every community were handed back local governance over their hospital. 

Changing a system - especially a health system - provokes angst among all those affected, no matter how it's brought forward. That's something we all must realize and accept in order for us to move forward - but it must not be something that stops us from moving forward.

I hope this summit deals not only with rural issues, but also the fact that the regional hospitals are facing 25 to 30 per cent reduction in their ability to serve every New Brunswicker - rural and urban.  Every single person in this province who is waiting for major surgery for months - sometimes years - is waiting for a bed to be free in a regional hospital. 

And those patients, mostly in our regional hospitals, are waiting to go to nursing homes, community or special care homes? The summit needs to hear we are providing them with inadequate care.  I use the word "inadequate" to avoid using a better descriptor.  Hard to hear, but must be said.  And, it seems to have been missed in the outrage, but the larger part of the proposed changes was to improve regional hospitals' ability to send patients awaiting long-term care to smaller "transition" facilities properly staffed by professionals who know better how to look after such patients, thereby freeing up beds for some surgeries. We need real changes that will better allow the sickest people in our province to be seen. Right now, it doesn't work this way.   

At the summit let's be sure to speak about what this regional hospital congestion means to health human resource planning, recruitment and retention.  Our struggle to recruit and retain health care professionals doesn't just exist in our rural facilities - it's an issue in our regional hospitals, too. That's because anywhere from 35 to 40 per cent of physicians, nurse and medical laboratory technicians in this province are eligible to retire in the next five years. And where do the majority of these professionals work? In our regional facilities. How many surgeons/anaesthesiologists/specialists will come to or stay in our province if they can only practice their craft at 60 per cent capacity? Do we not appreciate that regional hospitals need to be absolutely secured to ensure quality care for all of us?

The future of New Brunswick's health system is clearly dependent upon a broader discussion. The time dimension needs to change from the easy look to 2020 or 2021, to the more difficult, but far more relevant, 2050. Do we truly think physicians and other professionals will want to continue to provide care as we do today in facilities that were designed in the 1950s?  Will the patients in 2050 judge the care and how we deliver it today as quality health care.

As a regional health board it's our job to spend the majority of our time on foresight, on planning for things to come in 10, 20 and even 30 years. That is how a good board works. Who else is looking after the needs of New Brunswickers, 30 years out?

So, the summit must not become exclusively a rural health discussion.  Secondary and tertiary care, and long-avoided improvement to seniors care must be added to the discussion.  To listen to the narrative for the past five years one would think primary care is the only care that we need to improve.  If we maintain that posture, primary care will be the only care the NB health system will provide!

It sounds arrogant to many, but we need governments, health boards and professionals to bravely propose, publicly, how we must have our care system designed for the next 30 years. The public should be consulted but cannot be given veto to reject anything that threatens status quo.  The fact is status quo is threatening itself, as we speak.  June could be a defining moment for all of us.   

John McGarry joined Horizon Health Network as Board Chair in January 2019. Mr. McGarry brings a wealth of knowledge with more than 35 years of experience in health care. He previously served as President and CEO of Horizon Health Network from February 2013 to January 2017. Prior to this he was appointed Co-President of New Brunswick's Office of Health System Renewal in April 2012. With the provincial move to regional health authorities in 2002, Mr. McGarry was appointed CEO of River Valley Health in New Brunswick. In 1995, he assumed the responsibilities of President and CEO of Region 3 Hospital Corporation (Fredericton, New Brunswick); previous to that, he was the Corporation's Senior Vice-President and Chief Financial Officer. Mr. McGarry also has worked as a private health care consultant, undertaking major operational review assignments in Ontario and Nova Scotia. After obtaining his Bachelor of Commerce degree from Dalhousie University, Mr. McGarry began his career in public accounting where he obtained his CA designation in 1976. He worked at NB Tel before moving into the health care system where he held various positions in Saint John, Kitchener-Waterloo and Fredericton.