Two years afters cuts were announced due to nursing staff shortages, the Sackville Memorial Hospital emergency room is still on reduced hours, but Horizon Health Network CEO Margaret Melanson is continuing with her message that the network’s goal is to return to full 24/7 service.

Melanson had a chance to deliver that message in person last night at a 'Future of Our Healthcare' meeting organized by Memramcook-Tantramar MLA Megan Mitton.

About 120 people gathered at the Tantramar Civic Centre to ask questions of Melanson and members of her management team.

“I will say that tonight feels different than February 2020,” Mitton told the crowd, referencing a previous attempt by Horizon management to reduce services at the Sackville hospital. “I know a lot of you showed up in different ways and sometimes in the streets to push back on that,” said Mitton, ”and many people have been organizing ever since.”

Melanson shared some updates on the hospital front, including the recent hiring of an anesthesiologist to cater to surgeries happening in the one functioning Sackville operating room. She also told the crowd that a new emergency department physician would be starting soon. For awhile now, the original nursing shortage that caused the service reduction has been replaced by a doctor shortage. That means the imminent hiring of a new ER doc “is great progress,” said Melanson, “as we do have the plan to be restoring your emergency department services on a 24/7 basis.”

About 120 people filled the room at the Tantramar Civic Centre to hear from Horizon management about developments in local health care. Photo: Erica Butler

There was plenty of applause for Melanson’s hospital commitment, but also some emotional and challenging comments and questions from people sharing experiences of 14-hour offload delays at the Moncton hospital. People spoke about trying to access specialist services without an active primary care provider, and of losing access to family doctors and pediatricians.

Dr Richard Lemay, Director of Primary Care in Moncton and Mirimachi regions, talked a bit about the plans for a temporary primary care clinic in Sackville to help take on the highest need patients that will be losing their doctors this summer after two doctors close their practices.

“We have committed to offer at least three days a week to start with, but build to get to four or five days.” Lemay said Horizon has secured commitment from a physician work two days per week in the new clinic, which will be located in the Tantramar Community Health Centre, a privately owned building across from the hospital and currently home to many Sackville doctors.

Lemay described the long term vision of the clinic, which would serve as a patient home with a variety of staff available for help. “We’re talking about mental health, other kinds of clinics, but where you will be attached to a home and not necessarily to a provider,” said Lemay. “So if a provider— physician or [nurse practitioner]—leaves or is not there, that [patients are] at least attached to the patient medical home.”

“We have been working on that for a while,” said Lemay. “We hope within the next year to have it into place.”

Lemay is responsible for Horizon-owned community health centres like the Port Elgin Health Centre, which works with one full time nurse practitioner. Strait Shores Mayor Jason Stokes was on hand Tuesday to ask about the busy Port Elgin clinic. “Anybody that lives in our area knows,” said Stokes, “you can’t get in there.”

Lemay was happy to confirm that Horizon has started advertising for another full time nurse practitioner to join the centre.

Dr. Jody Enright, Medical Director for the Moncton area, explained some of the changes that have been made to how Sackville doctors operate, with the goal of making recruitment easier. “They used to work in Emerg. They used to do their hospital work. They used to work in their community. And it’s really hard to find that kind of candidate these days,” said Enright.

“That model, it’s not really seen anywhere else in Canada anymore,” says Enright. “And so while many family doctors, myself included, still offer hospitalist care, we’re starting to see that some folks just want to offer hospitalist care, or some folks just want to work in the community. And so it’s not a one size fits all anymore, where you expect somebody to come and do everything.”

In response to a question about the retention of physicians at Horizon, Melanson acknowledged it was an issue. “Over the years, we have had individuals leave because they have been burned out or perhaps feel disengaged, or, you’re right, worse. Perhaps that the organization did not appreciate them or respect the care that they were providing,” said Melanson. “And we are very much in the midst of changing that.”

Melanson and her staff answered a number of questions about Beal University Canada and its plans to locate classrooms inside the Sackville Memorial Hospital. Facility manager Sarah Brown described a number of services relocated within the hospital, and some to be moved out to leased spaces in the community. Public health and mental health are due to move in August, and the diabetic nurse educator and respiratory therapy have already relocated to the neighbouring Tantramar health center, just across the parking lot.

A number of local officials were in attendance on Tuesday including Mayor Andrew Black, CAO Jennifer Borne, and a number of town councillors. Councillor Michael Tower chimed in to ask Melanson a longstanding question about the ability for ambulances to cross the border into Nova Scotia, especially at times when offload delays in Moncton are high. The answer was not good news for Tantramar residents.

“We have had conversations about that,” said Melanson, noting that both ambulance systems in Nova Scotia and New Brunswick are run by the non-profit corporation Medavie, but are essentially separate entities. “That’s our desire as well, and we raised that several months ago, and we have not received approval,” said Melanson.

The last request of the evening came from a member of the public who invited Melanson and her colleagues back to Sackville in the fall, in order to be accountable for some of the commitments and timelines discussed on Tuesday. Melanson agreed, and Mitton promised to host a meeting in October, as well as a community meeting in advance for anyone interested in working on some of the issues raised.