Hospital services

Centralize certain hospital services in the North, says the mayor of Caraquet

The mayor of Caraquet advocates a radical change in health care in northern New Brunswick to deal with chronic staff shortages: fewer hospitals offering specialized services.

Bernard Thériault says pediatric and obstetrical services in Miramichi, Bathurst and Campbellton should be centralized in one location at the Chaleur Regional Hospital in Bathurst.

Thériault, a former provincial cabinet minister and former chief of staff to a Liberal premier, says it’s impossible to have three teams of specialists in three hospitals serving a steadily shrinking population.

“We’ve seen in recent years that it’s a constant battle to keep staff there,” he said. “But by keeping just one, you don’t need to have three obstetricians at the same time”

Bathurst would be a “super-regional” center

In his model, Campbellton and Miramichi would continue to offer other services, but those most often affected by shortages would only exist in a “super-regional” hospital in Bathurst.

“It’s a question of volume, and the population is no longer there. These three regions combined are barely over 100,000, which is not even considered the number of a regional hospital. And we dealing with three here.”

The summer of 2022 has seen a wave of temporary ward closures at various hospitals across the province.

In Bathurst, what was supposed to be a four-and-a-half-day shutdown of pediatric wards starting in late July is now in its third week.

“The shortage of nursing resources is currently exacerbated by the summer period, the pandemic and the exhaustion of staff,” said Vitalité Health Network in press releases announcing the initial closure and extension.

Thériault likened the sporadic stoppages to a game of musical chairs.

“Right now you’ve got three systems that aren’t working. Every day one of them is down. … Let’s make sure we’re dancing on chairs that are firmly in place, in a regional service.”

Vitalité’s vice president of medical affairs, Dr. Natalie Banville, told CBC New Brunswick Turn that the challenge with pediatrics is that it requires specialist nurses who cannot easily be replaced by other staff if someone is sick or on vacation.

She said the decision to merge the services of several hospitals would not be made by the health authorities alone.

“It’s not our responsibility. It has to come from the government, through consultation with the public, with everyone. … It’s out of my domain.”

In a statement to CBC, Vitalité CEO Dr. France Desrosiers said staffing issues are happening across the country and the network “must work collaboratively with all communities” to find solutions.

“To that end, we look forward to engaging Mayor Thériault on the subject,” she said.

Thériault said he pitched his idea a few months ago to Dorothy Shephard, then health minister, and Gérald Richard, who co-chaired a provincial task force on the province’s health plan.

Richard was appointed director of Vitalité last month, replacing its board of directors.

Dr. Natalie Banville, Vice President of Medical Affairs at Vitalité, says decisions about merging services could not be made by the health networks alone. (Government of New Brunswick)

Thériault said Richard was “very supportive of this centralization approach”.

The Department of Health did not respond to a request for comment on the mayor’s suggestion.

In July, Premier Blaine Higgs suggested that a “bureaucratic stalemate” and that management procedures, not staffing shortages, were responsible for long emergency room wait times and service disruptions.

He said he wanted to see hospitals work together more closely to coordinate services.

“I don’t believe it has anything to do — and I’m just expressing an opinion here — anything to do with the nurses on duty or the people on duty,” Higgs said July 15. . I believe that there is no coordination of activities.

Hospitals are sacred cows, says mayor

Thériault said he expects a negative reaction to his idea because hospitals are sacred cows in their communities.

He pointed out that the Higgs government was almost overthrown in early 2020 by a lack of confidence in its plan to close emergency services at night in six small hospitals in the province, including that of Caraquet.

“‘Hands off my hospital’ is still very, very pronounced,” he said.

But he added: “Even though people in my area might not be happy about it, I say it’s not just the best way to do it, it’s the only way to make it work. “

Campbellton Mayor Ian Comeau said Thériault’s suggestion is unacceptable and based on a subjective look at health care in northern New Brunswick.

Bathurst may be the center of an area that stretches from Campbellton to Miramichi, but Comeau said residents of Saint-Quentin and Kedgwick also use his city’s hospital. Leave out Miramichi, and the “central” location is Campbellton, he said.

The Campbellton Hospital serves 25,000 people in Health Zone 5 and another 15,000 across the river in Quebec, with the government of that province paying New Brunswick for the service.

Comeau said rotating some services in the North might work, but he would resist anything.

“Even if you have to consider having services one week here, one week there, that would be good, but I’m certainly not in favor of completely centralizing things in the Bathurst area.”

Comeau added that Thériault was among two Liberal governments that either cut health services or did not do enough to avert foreseeable staffing shortages.

“He should look in the mirror and say, ‘What happened?’ and ‘Why did we do such things?’ I think it’s going to haunt him now.”