Hospital Closures on the Table

JOHN CHILIBECK Legislature Bureau
January 25, 2015

hospital closures
Victor Boudreau is the minister tasked with carrying out the review that the govvernment hopes will eliminate the provincial deficit. Photo: Adam Huras/Legislature Bureau

FREDERICTON • The Liberal government is floating the idea of closing rural hospitals and converting them to nursing homes to help save taxpayers’ money.

On the eve of a public consultation tour that kicks off Monday night, Victor Boudreau, the cabinet minister in charge of finding up to $600 million in savings by the spring of 2016, said it was an idea that couldn’t be overlooked.

“We have some small rural hospitals, and maybe we have to ask ourselves, ‘Do they best serve the community as a hospital with limited services, or maybe some of them can be converted into a nursing home, community health centre or both, so that you’re keeping jobs in the area while repurposing the building and repacking some of the services. So I do think those are ideas that have to be looked at.”

The province is trying to get rid of a more than $400-million shortfall, what officials say amounts to a structural, built-in budgetary deficit. The government has spent more money than it took in for six consecutive years.

Governments in the past have considered closing rural hospitals and in many cases have stripped their services, centralizing the most important functions at regional hospitals in bigger centres such as Saint John, Fredericton and Moncton.

But changes in services usually come with plenty of complaints from people in rural communities who have come to count on them and don’t want to travel upwards of two hours for proper care.

Former Liberal health minister Mike Murphy said in 2010 the provincial government already had detailed plans to close several rural hospitals.

“In the fall of 2008, then-premier Shawn Graham asked deputy ministers as quickly as they could to find efficiencies within their departments so we could trim the deficit that was beginning to loom because the recession at that time was coming on gangbusters,” Murphy said. “No one really knew where the bottom of this thing would be. I received these plans within 48 hours that were quite detailed on the closure of 12 hospitals.”

The Liberal said he was aghast at the plans to close the hospitals and they were rejected. Forty-eight hours later, he said, health department officials presented him with a scaled-down version of the plan, calling for the shuttering of eight of the province’s 24 hospitals. Most patients would be directed to one of the province’s larger regional hospitals. Again, the advice was nixed.

“In all due respect for the people who worked for me, I don’t think the plans were all put together by burning the midnight oil for 48 hours,” Murphy said. “They appeared to be quite detailed. The civil service sometimes has pressure brought to bear on it by way of timelines, and I have reason to believe this was something that had been developed for some time.”

His memory of the hospitals slated for closure is hazy. He remembered the report listing facilities in Perth-Andover, Saint-Quentin, Grand Falls, Blackville, St. Stephen and Bouctouche.

Murphy said he discarded both plans because he didn’t believe they would save money in the long run.

But New Brunswick’s hospitals and half-empty schools have been cited by many experts as being inefficient and a burden on taxpayers. More than half the province’s 300-odd schools, for instance, are well under capacity. The situation isn’t changing over time, with student enrolment declining steadily in most schools.

In her annual report last week, auditor general Kim MacPherson warned the province’s rate of debt growth is the worst in the country. In a province with only 750,000 people, the debt stands at about $12 billion and is quickly growing. That works out to $16,000 of provincial government debt for every New Brunswicker.

Premier Brian Gallant’s government is shooting to find $600 million by cutting or charging more taxes, fees, tolls and the like because it doesn’t want to spend too much on debt servicing each year. Boudreau uses the analogy of someone with a credit card – eventually they have to stop racking up charges and pay up.

“We don’t want to do this exercise every year or every other year,” he said. “We want to get these things off the books completely and then going forward, manage growth.”

The Liberal government is modelling its strategic program review on the successful deficit-slaying of Jean Chrétien’s Liberal government in Ottawa in the mid-1990s. Like that government, it plans on introducing its big changes for its second budget, in this case, the spring of 2016.

Over the next three weeks, Boudreau, along with Finance Minister Roger Melanson and Miramichi Bay-Neguac Liberal MLA Lisa Harris, will make stops in 14 communities to get public feedback.

At each location, people will be divided up and asked to join different tables, where they will brainstorm and come up with ideas on how to cut spending or generate more government revenues.

The Liberals have already done a test-run of the world café model of consultations and will use it to compile a report that will likely be published in March.

Boudreau has made it clear that every service the province provides is up for consideration with the exception of New Brunswick’s bilingual services. Bilingualism in New Brunswick is enshrined in the Canadian constitution and cannot be changed by the whim of the provincial government.

“This isn’t going to be pleasant,” he said. “Finding $500 million to $600 million in an $8-billion budget won’t be easy.”

He warned changes will have to be made in the government’s three biggest departments – health, education and social development.

“We are not going to be able to tiptoe around those departments even if people are very attached to them and the services they offer,” he said.

The first meeting takes place Monday at 6:30 p.m. on the Acadian Peninsula at Pont-Landry at École La Passerelle.

Stops will also be made over the next three weeks in Balmoral, Saint-Léonard, Miramichi, Moncton, Minto, Rexton, Bathurst, Fredericton, Saint John, Sackville, St. Andrews and Florenceville-Bristol before the tour finishes on Feb. 21 in Norton.

The government is also accepting the public’s ideas online, by email or regular mail.