The New Brunswick budget announcement of job cuts to middle management positions in the civil service has drawn fire from opposition leaders.
Healthcare advocate Marilyn Merritt-Gray as well as Fredericton South MLA and NB Green Party leader David Coon, and NB NDP leader Dominic Cardy say there is a good chance the province will be forced to hire middle managers back at a higher cost.
The Budget, which was announced February 2nd outlined how the newly elected liberal government planned to put the province’s finances on the right track. The budget signaled the end of the governments Strategic Program Review process which resulted in a plan to merge government departments and eliminate waste in government.
Merritt-Gray, a nurse practitioner and the Green Party’s health critic, specified that “several areas of health programming need urgent clinical attention and reorganization, particularly health services for rural and small town residents; seniors; families struggling to manage with chronic illnesses; people of all ages with a mental illness, addiction and or past trauma.”
“At a quick glance it looks like NB health services have dodged a bullet with this budget… but when you look closely I believe there is a big reason for concern,” Merritt-Gray said.
Merritt-Gray stressed the need for “new ideas and fresh energy” in health services but concluded that “no hint of this is visible in the budget announcement or the Main Estimates document.”
New Brunswick citizens made it clear that they did not want budget cuts in healthcare. Finance Minister Roger Melanson claimed that the government did choose to protect healthcare. However, Merritt-Gray maintains her skepticism of this.
“The Budget announcement reads like a ‘bean counter’s’ tally of way to administratively streamline government services,” Merritt-Gray said. She worries that with the cuts in senior government and middle managers over the next two years that this will further worsen a deteriorating situation in health expertise.
She added that losing this expertise may cause the government to have to hire back these managers as consultants at a higher cost.
Coon said that this cutback on public servants is a “very worrisome thing” and that we would be “losing the capacity to essentially run our public service well.”
Cardy said that instead of “cutting arbitrary numbers and people out of the system, we should be looking at broader perspectives.” He added that telling departments to cut back the number of jobs and reducing the budget is essentially pulling pieces of departments down that are “necessary for that department to function.”
There is also the risk of the loss of expertise leading to larger management of NB health services by private offshore health corporations such as large home care management companies, Merritt-Gray warned.
She stated that this “clear-cut of NB government health program managers may be a decision we could regret for a long time.”
On the closing of rural hospitals, Cardy mentioned that “we’ve got a very large number of hospitals for such a small province” and “in many cases, those hospitals were built more as political monuments rather than ways to deliver good healthcare.” He mentioned that this was a common issue across Canada in the 1960s and 1970s.
Cardy’s view is that “the needs of the citizens have to come before the needs of having pieces of infrastructure” and that the only thing lacking is “political will.”
“Folks from small communities will be upset about the changes, but that is part of the nature of politics.”
Coon argued that rural hospitals meet a real need, especially if there is poor access to public transportation for long distance medical appointments. He included that the savings from removing hospitals are not as great as one may think, “because you maintain the same number of patients” and spend more in over occupied hospitals by hiring more staff.
Coon added that health care is “fundamentally about healthier people” and prevention, “which we are not doing” to help avoid diseases and injury, and manage chronic diseases.
In New Brunswick, because of the scarcity of family physicians, nurse practitioners have been acting in place of family doctors for families that are on the wait list.
Coon, whose family was on the wait list for a family physician in Fredericton for over two years, said he was relieved when he learned this family would be taken on as patients of a nurse practitioner. He stated that this “provides a gateway to the health system for people.”
Cardy stated that he is “all in favour for expanding the powers of the medical profession so that it is not so completely dependent on the doctors to provide care.”
The provincial government has decided to run a $347 million dollar deficit this year, and projects that the Strategic Program Review will yield $296 million in expenditure reductions and $293 million in revenue measures.
Christopher Pearson is a fourth year psychology and philosophy at the University of New Brunswick doing an Arts 3000 placement with the NB Media Co-op.