Because of fundamental flaws in the way Canadian health care is delivered across the board, the province’s recent shakeup of its system is just “rearranging the chairs on the Titanic,” a leading public policy expert says. Charles Cirtwill, the acting president and chief executive officer of the Atlantic Institute for Market Studies, said Thursday that New Brunswick Health Minister Mike Murphy’s structural revamp is a quick win politically, but he was skeptical that it would pave the way for any real progress. “It’s an easy win to demonstrate you’re serious about making change,” Cirtwill said. He noted, however, that if the province really wants to move health care forward, it must look to the fundamental building blocks of other systems that have succeeded around the world. He lauded the parallel public-private model that has been implemented in European countries, saying it allows for the delivery of a broader range of services at a lower cost. “The key thing is to stop trying to reinvent the wheel ourselves and try to recognize that there are models out there to use, and pick the ones that have worked in the long term,” Cirtwill said. Earlier this month, Murphy unveiled sweeping changes to health-care governance, reducing the number of regional health authorities from eight to two. Authority A will be based in Bathurst and Authority B in Miramichi. Under the new plan, a health council will be established in Moncton and non-clinical services, such as laundry and payroll, will be centralized in Saint John. The changes have been blasted as undemocratic by the Opposition and have fuelled concerns among doctors about the erosion of local leadership. According to Cirtwill, it will be hard to judge whether the shakeup has any impact until benchmarks are established and annual reports drawn up. But he stressed that the problems with health care in the province and the country as a whole are broader in scope, pointing to the lack of division between health-care funding and delivery. The existence of regional authorities creates the illusion of separation but ultimately, the province pulls the strings as to how funds are used, Cirtwill said. This leads to conflicts of interest and ultimately has a negative effect on patients, who can be looked upon as costs, he added. “If we create a system where we’re treating people as a threat to the system as opposed to a resource to make it better, we’re always going to have problems.” New Brunswick has invested resources in probing how health care is delivered in other regions, department officials noted. Last October, the province hosted a summit in Saint John that looked at health innovations around the globe, including different methods of service delivery. The stated goal was to open a dialogue on how to make the province’s health system more sustainable. The Health Department has also sent delegates, including Andrée Robichaud, the new CEO of Health Authority A, overseas to study health practices in the United Kingdom and Australia. Don Juzwishin, CEO of the Health Council of Canada, said there is value to investigating health structures in other countries. “There are lessons that can be learned from offshore and those certainly should be taken account of,” Juzwishin said. But he added the council is clear on its support for universally accessible, publicly funded health care. The Canadian system is sustainable, but it’s all about making choices, he said. Rather than looking to the private sector, he added, we need to find ways to maximize value for the dollar through innovations, such as electronic record-keeping, that will reduce duplication and help to better co-ordinate care. “The public-private debate adds little to advancing the agenda there,” Juzwishin said.
