Monday, February 29, 2016

Improving a program requires cooperation

The provincial government is looking to place the management of two healthcare services - Extra-Mural Program (EMP) and 811 TeleCare - under Medavie EMS.
Government currently has a Memorandum of Understanding (MOU) with Medavie to examine these options. The New Brunswick Union (NBU) represents respiratory therapists, social workers, registered dieticians, occupational therapists, physiotherapists and speech-language pathologists working in the EMP.
This would privatize a portion of the services - management - but the employees of extra-mural and TeleCare would remain government workers and stay in the same unions, according to the discussions we've had with government officials.
The New Brunswick Union does not support the privatization of any public services. In this case, Health Minister Victor Boudreau has stated the potential change isn't a cost-cutting exercise, but rather a way to manage the programs in a more collaborative way. He's also stated this potential change may be able to better help the five per cent of the population that use the services most often. It's also been stated the changes could help keep seniors in their homes longer.
In a nutshell, government is looking to privatize at least a portion of a public service. This is problematic for many reasons. Medavie is a private company whose primary responsibility is not to the people of New Brunswick, but to its bottom line. The second is there's been a lack of consultation with those who work in the EMP to gain their perspective and insights.
Front-line workers have many ideas on how to improve services, but yet have not been asked for their opinion. This is made all the more discouraging when you look at another plan government is going to implement. Government has agreed to let the New Brunswick Medical Society - a professional association representing all physicians in New Brunswick - set up a non-profit company to administer a pool of family doctors.
The new system is designed to let doctors coordinate their vacations, after-hours shifts and administrative work, with the goal of giving them more time to see patients. This makes sense as doctors understand the challenges they face. A collaborative approach in this case seems to have produced a potential solution.
The members of the NBU in the EMP were given no such opportunity. This means years of experience was not considered and the collaborative approach Minister Boudreau referred to in justifying the MOU with Medavie was not extended to the government's own employees. The employees could have at least provided an education to government members about their work and the challenges they face, not to mention potential changes and improvements to the system. For instance, government's focus in its statements regarding the MOU talk about keeping seniors in their homes longer, but don't address the paediatric side of the EMP.
Working with young children with physical and intellectual disabilities is part of the program, but one rarely discussed or mentioned. However, it is just as vital as caring for the elderly.
The NBU believes an MOU between government and a private company does not constitute collaboration. True collaboration doesn't exclude perspectives and ideas from those working in the field, in fact, true collaboration welcomes it.