New Brunswick seniors are vowing to fight the Gallant government's recent decision to privatize the management of extramural and Tele-Care services, citing concerns about a loss of accountability.
Representatives of L'association francophone des aînés du Nouveau-Brunswick and the Coalition for Seniors and Nursing Home Residents' Rights met with Health Department officials for two hours in Fredericton on Tuesday to express their concerns about the new deal with Medavie Health Services New Brunswick.
They contend the Canada Health Act stipulates, as one of the five national principles of the health system, that health care be managed under "public administration."
'Once you move it into the private sector, it is not accountable to the public.' - Cecile Cassista, seniors advocate
Privatization of the management of extramural services "goes directly against the concept of 'public administration,' and represents a "dismantling" of the provincial health system, the groups said in a statement.
"Health care belongs in the public administration," said Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights. "It needs to be accountable to the public, and once you move it into the private sector, it is not accountable to the public.
"Basically, who will we question? We'll have to question Medavie, and that is certainly not the road we want to go."
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Medavie, a company that runs Ambulance New Brunswick, will be looking for "efficiencies" and will have performance targets to meet in order to get paid, government officials have said.
Cassista said the seniors advocates were told one of the plans to reduce the number of emergency room visits by people being cared for by extramural is to use paramedics who are on stand-by in idle ambulances to check in on people.
Paramedic house calls 'unacceptable'
"The message I got from that is that extramural [nurses are still] going to come in and do the surgical needs, the bandage, whatever," while paramedics would go in and "check to see how Mrs. Jones is," she said.
"But you know what? We can't predict when the ambulance is going to be [needed], so we're going to tie a paramedic up basically doing house calls? I think that really is unacceptable."
The seniors presented the government officials with a resolution that the province "should be solely responsible and accountable for publicly administering and expanding the efficiency of the extramural and Tele-Care programs."
Cassista said public opposition to the switch is growing and the coalition plans to hold a news conference on Friday in Moncton.
'How do we know if it's going to work?'
For years, extramural has been sending nurses, physiotherapists and other health-care workers to people's homes to care for patients so they don't have to be in hospitals or nursing homes.
This month, the province announced that starting on Jan. 1, the service will be managed by Medavie.
The company will also take over management of Tele-Care, the 811 line patients can call to get health advice from a nurse.
"They didn't do a pilot project with any of this," said Debbie Ellison, who also sits on the coalition's executive.
"So how do we know if it's going to work? We're just going to say, 'OK, Medavie, just go ahead and do this.'"
Awarded without tender
The 10-year contract for the home health-care program was awarded without a tendering process or call for proposals.
Although Victor Boudreau, the health minister at the time, could not explain how exactly Medavie would improve extramural, he suggested the co-ordination and collaboration among health professionals that exists now will continue.
Nurses will be covered by their union contract, keeping their seniority, benefits and pension plans, whether they leave or join the Medavie-run service, Boudreau said, since they'll still be public-sector workers paid by the province, not by Medavie.
Boudreau also said the move to privatization wasn't being made to cut costs. The contract provides incentives up to $4.4 million from New Brunswick taxpayers the first year if the company meets key performance targets stipulated in the contract, he said.
Medavie Health Services, a Dartmouth, N.S.-based company, runs paramedic services in a few other provinces as well.