Horizon Health's John McGarry says dramatic change needed now

Horizon Health Network CEOJohn McGarrysays it is time to move away from the concept that all care must occur in hospitals.

"We have seen a shift in demography coming for some time an aging population, southern migration within the province, and the shift from rural to urban living," McGarry writes in a commentary.

The health of ourpopulationis not getting better for the dollars that we're spending. It's like banging your head against the wall.- John McGarry, Horizon Health CEO

"There are negative health impacts associated with our climbing poverty rate; the incidence of chronic diseases in our province is at an all-time high. Clearly, we need better preventive, primary, long-term and palliative care."

McGarry says it is time to embrace a new way of thinking about health care in our province,which he believes should include fewer emergency rooms and improvedcare in communities.

"I think we need to start looking at our infrastructure and say,'If we came from Mars to New Brunswick and we looked at this province and the way it's laid out, is this the way we would design a system?Would we put hospitals where they are now?Would they be the same size?Would they have the same programs?'"

The constant challenge of seniors who are in hospital beds because there are no long-term care beds available is a real and immediate problem, but McGarry says changes must go beyond that.

"We will always be here to look after the seniors, but the fact is that we have a bigger mission and it is not just to provide hospital services or residential care for seniors, it is much beyond that."

More than half of ER visits unnecessary

McGarry understands the angst that communities feel when he suggests cuts to local hospitals, but says primary care has changed and it should be offered outside of hospitals.

He says about 60 per cent of visits to New Brunswick's more than 20emergency rooms aren't from people experiencing a healthemergency but rather from people who have no where else to go.

"One ...night shift in [all 22 New Brunswick emergency rooms]just for doctors is $550,000 that's not talking about the nurses and all the other services that go with that," McGarrysaid.

"Sixty per cent of the visitsreally don't have to be there if you would serve them someplaceelse in a better environment."

He says the amount the province spends will likely neverdecrease, but the way the money is spent should change.

"The health of ourpopulationis not getting better for the dollars that we're spending. It's like banging your head against the wall. You're always going to feel the same at the end. If you just keep doing the same thing you're always going to get the same results so we do need to spend our money differently."

McGarry cautions premier

The Gallant government will release its budget on Feb. 2, and PremierBrian Gallant has said New Brunswickers are asking him to protect health care and education from cuts as the province struggles to reduce its deficit.

• Premier Brian Gallant vows to 'protect' health care, education in budget

I think we have some big changes that need to be made.- John McGarry, Horizon Health CEO

"I hear the premier talking about health care is going to be protected I hope he's talking about funding issues and not there will be no changes in health care because I think we have some big changes that need to be made,"McGarry said.

By closing some hospitals and freeing up money, he argues more could be invested in community health care.

"And prove to people that this is a better way of providing health to a population so I think we will be seeing hopefully some changes inour hospital infrastructure ... let's face it health care just can't bedesignedthe way it was in the 60s and 70s and 80s and still be effective."

McGarry says the province must take a long-term view and begin measuring the health of the population over ten years and then making investments that will improve it.