Doctors, nurses aren't fans of primary health care plan

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Doctors and nurses are giving the government’s primary health care action plan a thumbs down, saying it “misses the mark on a number of issues” and doesn’t address the current crisis in the system, which includes a “record-high” 92,000 New Brunswickers waiting to get a family physician.

While both New Brunswick Nurses Union (NBNU) president Paula Doucet and New Brunswick Medical Society (NBMS) president Dr. Connie Keating were happy to see the plan publicly released, neither had much good to say about what it contained.

And neither did the Greens, who described it as “very odd” and “rushed out.”

The plan, released on Tuesday, focuses on incentivizing doctors to move to a collaborative, team-based family medicine model, a change the province has been struggling to get them to do. About half of New Brunswick’s family doctors currently operate solo practices, and some have said they want to keep working that way because they’ve invested large sums of money in their current operations.

On Tuesday, Health Minister Bruce Fitch said the plan contains a mix of new and existing moves to address problems in primary care.

The plan, Keating said in a statement to Brunswick News on Wednesday, “provides some important context, high-level system data and a retroactive overview of some of the initiatives that were launched by government in the last 18 months.”

“However, despite the strategies and accomplishments outlined in this document, during the same 18-month period we have seen the wait list for a primary care provider explode to record levels. As of April 2024, there were over 92,000 patients waiting for a physician, with over 30,000 of them having no access to services.

“The NBMS joins the Regional Health Authorities and other health-care organizations from across the province in their calls for adequate funding to appropriately tackle our primary care challenges. We all agree on direction, but we need to accelerate our implementation.

“We urgently need to invest in the stabilization of family medicine. Family physicians continue to leave their practices across the province, or simply choose not to take on patients, in response to rapidly rising costs due to inflation and the impact of current government policies.

“We also need to fully realize physician-led team-based primary care across this province. To accomplish this, we need a joint plan, agreed upon by stakeholders, with defined targets and associated resources to ensure accountability to patients across this province.”

In an interview, Doucet said she’s “disappointed” that the plan “misses the mark on a number of issues, including the retention piece.”

For the last few years, Doucet has led calls for the province to provide retention payments for nurses, a move that the other Atlantic provinces have all made. The government, meanwhile, has suggested that that issue should be discussed during contract negotiations, which began last month.

The plan, Doucet said, “looks great on paper” but doesn’t contain anything for other health care providers, including nurses.

“It doesn’t speak to the acute care sector of health care. This is very much about enabling doctors to work in a team-based model, which is great. I do think we have to move away from the solo practices.”

The province has to put more consideration into its human resources, Doucet said.

“We’ve been saying we’re on fire. We’ve been on fire, it’s been an inferno, for a number of years, and you need to concentrate on putting that fire out before putting more practices in place.”

Asked about the government’s position – that retention bonuses should be a part of contract negotiations – Doucet said she’s been pleading with the government for years to get something done, long before contract talks started.

“It really disappoints me that this government continues to push things down the road that they don’t want to deal with now, to put that inferno out.”

Green health critic Megan Mitton said she feels like the “very odd” plan, which contains several spelling mistakes, was “rushed out.”

“I want to know: who did they consult, and what kind of plans did they actually make?” she asked. “Retention bonuses has been something that nurses have been saying that they want, I’ve been calling on them to do that for a long time. All (the other) Atlantic provinces have done so.

“We really need to be listening to health care providers and experts, and for some reason the government continues to refuse to do so.”

Asked on Wednesday for reaction to Doucet’s comments, Fitch said he wasn’t surprised.

“That’s been their mantra all along,” he said, then referencing glowing comments he made about nurses in the legislature earlier on Wednesday.

– With files from John Chilibeck