Taskforce lays out plans for Newfoundland and Labrador's hospitals

Build it and they will come. 

Members of the Newfoundland and Labrador Health Accord task force hope that principle works as well for health professional recruitment as it does for ball fields.

Co-chairs Dr. Pat Parfrey and Sister Elizabeth Davis were joined by sub-committee leaders this week for a series of four town halls on the future of health care in the province.

The task force, formed last fall, is charged with reimagining and reshaping the healthcare system to improve health-care equity and outcomes in the province, which consistently pays more than any other jurisdiction in the country and has among the least healthy population.

"We have an institution-based system that's over 50 years old, created for dealing with acute illness,'' Dr. Parfrey told more than 100 participants in the first virtual event Monday.

He said more attention needs to be paid to elder care and chronic care, and to elder care in the community and in the home.

"We would all have to acknowledge (home care) is the least respected and the least valued part of our health system,'' Davis added. "The Department of Health is taking some good steps to remedy this, but we still have some distance to go.''

After 21 town halls and dozens of meetings with stakeholders and special-interest groups, the task force finally started putting some meat on the bones of its impossibly broad mandate.

Specifically, Davis laid out a specific concept for how community-based teams and hospitals should work.

"We are envisioning that every single community, every single person in this province, be under the umbrella of a community team,'' she said.

The proposal is to have about 34 teams covering what's referred to as "catchment areas'' that can range from 6,000 people up to 50,000 people, depending on whether they are in remote or urban regions.

Those teams would consist of nurses, nurse practitioners, family physicians, social workers and physiotherapists, among others.

Davis said the province's 32 existing community health centres would continue to do what they currently do—provide primary and urgent care.

The 13 existing hospitals would also stay intact and would all provide emergency services and CT scan capability.

But 11 would be designated for broader services:

• Seven community hospitals would be located in Burin, Clarenville, Carbonear, St. Anthony, Stephenville, Happy Valley-Goose Bay and Labrador City. They would provide emergency services and a broad spectrum of general medicine, mental-health support, pharmacy services, laboratory services and diagnostic imaging. But they would not all have surgery, obstetrics or rehabilitation services.
• Three regional hospitals would be located in St. John's, Corner Brook and central Newfoundland. They would provide surgical, obstetric and rehabilitative services.
• One tertiary care hub in St. John's would provide the highest level of specialty care for adults and children.

"We would not have a regional hospital in Labrador. That would mean the two community hospitals there would have a slightly broader range of service than the five community hospitals on the island,'' Davis explained.

Task force members were asked by a participant how all these goals can be achieved without better recruitment of health-care professionals.

"Every part of this province has to have access to services in a timely fashion. So we need improved virtual care, we need a more integrated ambulance system,'' Davis replied. "When these things begin to happen, it is our belief that more people will be willing to work in different professions across the province because they have more support in their work, both in terms of colleagues and in terms of resources.''

"The establishment of community teams that function well will allow nurse practitioners and GPs to have the resources, the help, the depth and breadth at their fingertips as they deal with these patients,'' added Dr. Sean Connors, chair of the hospital services committee. "I think the cohesiveness will allow us to have the critical mass it takes for retention.''

The task force will have a draft final report ready by the end of September, with a full report due before the end of the year.