Fighting to keep New Brunswick’s health care system public

A new report from the New Brunswick Health Coalition documents how the province’s public health care model is on a slippery slope towards privatization — and also that many advocacy groups are fighting to stop the slide.

The report, “The Creeping Privatization of Health Care in New Brunswick,” highlights Canadians’ belief that everyone should have equal access to high quality health care, with the costs paid by public funds. It points out that Canada’s universal health care system is the result of numerous hard-fought battles won by many groups and individuals in the not-too-distant past. Even with its few faults, Canada’s health care system remains a model for many countries around the world.

The New Brunswick Health Coalition report documents the trend in the province away from public health care and toward corporate provision of health services. Information in the report includes privatization examples occurring across New Brunswick in primary health care, senior care, extra-mural care, prescription drug coverage, blood plasma, and hospital laundry, cleaning and food services. The trend towards corporate health service provision has consequences for patients, health care workers, seniors, women, Francophones and residents of rural communities.

In addition to documenting these changes, the report includes recommendations to the government to keep health care as a public service.

Two key recommendations are to invest in a primary health care system based on prevention and to expand services in primary health clinics and ensure integrated services. Indeed the government’s NB Health Council’s 2014 Primary Health Survey found that prevention-based health care saves costs and is a more humane way to deliver health care. In contrast, the current trend to privatization by the New Brunswick government makes health care increasingly dependent on treatment — an illness-centred and profit-oriented approach to health services.

The government’s search for ways to cut the costs of health care will become more intense in the coming years. The Gallant government made New Brunswick the first among the provinces to sign a health transfer deal with the federal government that many critics have called inadequate. One of the recommendations of the NB Health Coalition report is adequate health transfers to the provinces.

Jean-Claude Basque, co-chair of the NB Health Coalition, says the current provincial government is moving more rapidly towards privatization than the previous government, and the province is experiencing “a real encroachment” of corporate health care. At the same time, he points out that advocacy groups are continuing their fight to ensure that people and not profits are the main focus of New Brunswick’s health system.

The report highlights many successes of non-profit advocacy groups in the province fighting the privatization of health care, including labour unions, the New Brunswick Midwives Association, TransAction NB and citizen groups including the Concerned Citizens of Charlotte County and residents in Caraquet to save their hospital services.

One example of the privatization trend highlighted in the report is the Gallant government’s decision to turn over management of provincial hospital food, cleaning and patient transportation services to an international corporation. That decision is being opposed by public health care advocates. As reported in an earlier NB Media Co-op story (Feb. 7), the NB Council of Hosptial Unions (CUPE local 1252) is leading the struggle to slow down or stop the privatization of these hospital services. CUPE is one of the many unions working together to keep corporations and profits out provincial hospitals.

Senior care facilities and home support services is another focus of the report. The group advocating for seniors in the province is the Coalition for Seniors and Nursing Home Residents’ Rights. Cecile Cassista, the executive director of the Coalition, believes that the fight to stop privatization of health services is critical in the province. “No question, if the government reduces the quality of services it will affect seniors,” she says. “When seniors are in the hospital they need good nutrition.” Cassista pointed to the example of Manitoba that had an unsuccessful experience with privatized hospital food services. “The experience proved that privatization at its best does not work.”

The Coalition for Seniors and Nursing Home Residents’ Rights has demonstrated what sustained advocacy can accomplish. The group formed in 2004 to begin a successful fight to change the formula for fees for nursing home residents. In the 13 years since then it has accomplished much more for seniors. “Look at the list of programs for seniors on the province’s website — they are there because we advocated for them,” said Cassista. She believes the big struggle now for seniors in the province is home care. “There is not an adequate home care system in New Brunswick,” she said.

The NB Health Coalition report’s recommendations for senior services and home support services include investing in public long-term care facilities and abandoning the public-private partnership model in long-term care facilities, supporting the different needs of seniors including dementia care, increasing funding for health food for seniors in nursing homes, better coordination of care for seniors, and investing in implementing the Home First strategy so that more seniors can stay in their homes. Each of these recommendations will save costs by supporting well-being as an alternative to treating ill health by profit-centred corporations.

Another current example of advocacy to fight privatization of health services is the collective response to the plan to operate corporate plasma collection clinics in this province. The NB Health Coalition is coordinating a letter opposing these plans to the media, members of the legislature and parliament, and the provincial political parties. At press time the letter has been signed by 25 New Brunswick organizations including the unions representing professors of three universities and other unions in NB, the Canadian Labour Congress, the Canadian Federation of Students and student groups, Acadian groups, religious groups, seniors groups and others. All these groups agree that a corporate blood and plasma service would directly compete with the non-profit Canadian Blood Services in New Brunswick and have a negative impact on the availability of blood and plasma in the public health system.

Jean-Claude Basque with the NB Health Coalition believes that public advocacy will continue to be necessary to stop the privatization trend. “If there is no public outcry to protect our health system, we will lose it,” he says. Basque encourages everyone interested in this issue to read their report and then talk to their MLA about it. People who are members of an organization can encourage their organization to take a position on the issue.

Susan O’Donnell is a researcher based in Fredericton and a bargaining group executive member of the Professional Institute of the Public Service of Canada (PIPSC) union.