Will firing the CEOs of our health authorities change anything to our healthcare sustainability/efficacy issue?

Bambi’s comment below is to this interesting article in the New Wark Times entitled “Sackville Town Council calls for heads to roll over plan to cut rural hospitals”. Thank you Mr. Wark for keeping us well informed!

Will firing the CEOs of our health authorities change anything to our healthcare sustainability/efficacy issue?

Likely not. So why are we throwing the baby out with the bathwater then? To score political points or because we are too angry at these two CEOs (hired before the current government came to power)?

It is understandable, and noble, to want to defend our hospital tooth and nail. Thank you to our MLA and everyone’s efforts in doing so! Bambi has always thought to herself: By moving to Sackville, she now understands, more than ever, all what she used to hear in the news when growing up in Beirut about citizens’ complaints in regions of how centralization in the capital does not serve them as optimally as possible.

With time, Lebanon got more populated and big healthcare centres, and other institutions (like universities, etc.) opened almost everywhere in the country.

Lebanon has economic sustainability issues. Did a sort of mismanagement of resources take place, in addition to corruption? Did the country live beyond its financial means whilst nor diversifying its economy enough?

Anyhow, from such questions about public funding in Lebanon, Bambi now wonders the same about NB, and more locally about our Dear Hospital in Sackville:

  • 1. What is the percentage of time the ER was closed nighttime in the past year (even if not on paper)?
  • 2. How much does it cost to have it open each night?
  • 3. What is the volume of patients seen during the day, the eve, in the summer versus the winter times?
  • 4. Could we afford to attract more physicians or nurses by offering them better packages (salaries, appealing family benefits, etc.)? Could this help save our hospital in its current format?
  • 4b. Could we perhaps consider in the future a two-tier system, mixed public and private? A bit like in some European countries or even in Lebanon? Will this help? Same healthcare providers for all. Same quality but the source of funding of services could differ, depending on the preference/financial capacity of the consumers of health services (the patients).
  • 5. Did we think of coordinating with the ambulances or with the nearby out-of-province hospital/ER (Amherst, NS) or the two hospitals in Moncton?
  • 6. Could we consider perhaps alternative solutions part of the time?
  • 7. If not, is the vocation of an “urgent” centre better than no centre with “an emergency room”?
  • 8. Perhaps this reform is even more damaging up North… and no it is not because these regions are francophone and it is a conspiracy against them by Mr./Dr. Lanteigne directly or by his colleague?

The above is just a sample of questions crossing her mind.

Other countries (France, Switzerland, Maine in the USA, etc.) or provinces (NS, ON, etc.) had to take tough decisions like that. Some even closed their emergencies over the summers. Can you imagine? What can we learn from their experience?

It would be financially and logistically impossible to have a hospital in each citizen’s backyard, so to speak. It is realistically (and sadly) sometimes not/no longer possible, for legitimate reasons. Could it be the case here?

This is problematic because money does not grow on trees to be used in a non-sustainable way. This has nothing to do with the language, colour, ethnic origins, seniority on the land, etc. This is a health economic/quality of care issue.

This being said, it is already geographically problematic to be far from a heart centre, if we have a heart event, even during the day (Saint John hospital is far) but, luckily, we have Moncton nearby and the Amherst hospital (at least until now), that has a helipad.

Even to have access to an endodontist (for a root canal treatment), one must travel to Moncton (1 specialist there) or to Halifax or Truro.

Part of the problem is due to our semi-rural areas, to the lack of professionals, to the low population density (in our whole province, we are not even 780,000 citizens). Another part may be due to mismanagement of funds or political choices.

Yes, our population is aging. Yes, winters can be tough. Yes, it is expensive, for students and other local citizens, to come back from Moncton or even Amherst, in a cab, after visiting a hospital. Could the government consider perhaps helping with costs in particular cases like that?

Yes, it would be ideal to keep our hospital existing (and hopefully thriving). However, it is challenging to do so. It is tough to take those unpopular political decisions… and it takes courage to back off when we should.

Some say no consultations happened in the community. Some things are clear to administrators, just from the data and/or from the clinical/operational observations. Sometimes, some consultations happen but in NB all is secretive.

Is it less hypocritical to pretend to consult and then take a decision or not to consult and take the decision?

Bambi hopes that if our hospital will stay, it will be for the good reasons. And if our hospital will change its vocation to be saved or to keep offering quality services, it would be for the good reasons too.

We deserve an explanation about the rationale behind the reform. Our government also deserves fruitful discussions with us to find reasonable solutions together.

Governments come and go… problems stay.

To come back to the CEOs of our two health authorities, and as a commentary to an earlier New Wark Times article, their individual salary is less than in NS [$250 000 $- 274 999 $ and $275 000-$299 999 respectively (public information) versus $372,031, plus benefits in NS, https://www.canhealth.com/2019/08/21/new-interim-leader-at-ns-health-authority/].

It may seem to be high. However, their job is not as easy as we think, as we can see with the current story. Plus, they spend much of their time travelling across our province. They may even feel at times that they live in hotels.  

A few years ago, Bambi and her spouse, learned (at a personal cost) that in NB we can be as corrupt as other places.

Tomorrow, Bambi hopes that NB will not become as indebted as Lebanon. We are sadly not immune to bankruptcy.    

Joseph Facal: «Contempt and machine guns» [‘Le mépris et les mitrailleuses’]:

First, here is the original French article by Mr. Facal, published in the Journal of Montreal yesterday:

https://www.journaldemontreal.com/2020/02/29/le-mepris-et-les-mitrailleuses

Second, before presenting a translation further below, Bambi cannot help not to think to herself: Canada seems a bit like Lebanon nowadays (not a good comparison for us), that is with its weak governance and lawless pockets; villages or suburbs where police or the Lebanese army may not dare to enter to intervene (although from time to time they do so, with casualties). Why is Bambi saying this? Because of Kahnawake both in 1990 and, more so, now in 2020. This is what happens when we postpone addressing problems or potential conflicts for decades.

Bambi is old enough as an immigrant to remember the Oka crisis, which began when a check point was erected by Mohawks in Kanesatake. When the Sûreté de Québec (provincial police) intervened, one of its officers got killed.

Lebanon too tried to ignore, pretended all was good, and somehow implicitly accepted the non-sovereignty of its rule of law to all. Some kept their weapons (at the end civil war) and became above the law. They somehow became the law itself, justifying this with the “holiness” of their resistance, especially after a history of being neglected and/or oppressed.   

Anyhow, that is Lebanon in a different continent miles away. What about us here in Québec or Canada? Mr. Joseph Facal’s article may help us understand… or recover our apparently lost 30-year-long memory:

When the hype overwhelms everything, you have to get back to the facts.

François Legault [Premier or “Prime Minister” of Québec] says there are heavy weapons in Kahnawake.

He says this to make it clear why the police is hesitant to intervene.

And there is an outcry! How does he dare? Can of oil on fire! Pyromaniac!

The next day, oops, we learn… that there are heavy weapons, including machine guns.

On January 7, we found these weapons during a vehicle search. Come on…

Law?

Only the idiots will be surprised.

There were already heavy weapons in 1990, and I do not know that a large operation to clean up the criminalized elements of these territories has taken place since that time.

Obviously, as soon as Prime Minister Legault mentioned these weapons, a Mohawk spokesperson asked for an apology.

Then, in a press release, the Mohawk Council of Kahnawake declared:

“The defenders of our territory are unarmed and are peaceful. There are no guns.”

So, it was false and untrue. Who should apologize? Surely not the one who told the truth.

Prime Minister Legault was all the more justified in telling the truth that he cannot count on the Mohawk police.

The chief said: “We have no interest in criminalizing people who defend our rights.”

This gentleman has chosen his side: his own clan before the law, and one wonders what rights he is talking about.

The “right” to machine guns? The “right” to tell the courts to get off? The “right” to paralyze everything? Show me that right.

But when it comes to Indigenous people, the prize for delirium goes to non-Indigenous people who want to be on the right side of morality.

They tolerate behaviours on the part of some Indigenous factions that they would not tolerate from any other group.

In this hesitation, even in this refusal to denounce what one would denounce in anyone else, there is an infantilizing condescension towards Indigenous people, posed as not being required or not capable of being compelled to the same moral behaviours as us.

This amounts to saying: “Them- one must-understand-one must-endure-what-do-you want-they-have-suffered-so-much-because of our-fault-that-we-are-going-to-look-elsewhere-that we will pretend-not-to-see-the-nose-in-the-middle-of-the-face ”.

When contempt is wrapped in good feelings, it remains contempt, but it is even more insidious because it belittles the other by pretending to raise or defend him/her.

A column in La Presse [a French-Canadian daily newspaper] argued that Prime Minister Legault’s statement amounted to saying: “The message is clear: it is war. Over there, on the other side of the barricades, is the enemy. “

At this level of stupidity, it gets dirty to answer.

Responsibility

See also all these people who suddenly become experts in crisis management. Hon, the Prime Minister shouldn’t have …

What, do they know? No, they don’t know.

Balzac described some journalists as “nothingologists”: they talk about everything. However, they are not experts in anything.

Legault was right, and the first person responsible for this mess is Justin Trudeau.”