Perspectives is the quarterly newsletter of the New Brunswick Health Council

In this issue...

Stéphane Robichaud
CEO of the NBHC

Message from the CEO

In our most recent brief, The Cost of Chronic Conditions to New Brunswick, we discuss the need for change in the New Brunswick health system. How did our health system develop its current form? Looking at the past 60 years of publicly financed health services, we can see a number of factors that have influenced the evolution of the New Brunswick health system.  Two important federal decisions about public funding greatly influenced how all provincial health systems prioritized expenditures and services.  The “Hospital Insurance and Diagnostic Services Act” in 1957 ensured that one-half of hospital costs would be covered federally.  In 1966, the “Medical Care Act” expanded public insurance to cover physician services outside the hospital setting. The emphasis of these acts was to ensure that individuals and families who were touched by illness would not be ruined by the financial obligations of medical care. This led to an emphasis on acute care and family physician services in provincial health systems.

Public debates marked the early years and debates about publicly funded health services continue today.  Provincially, it was reasonable to ensure that all regions were covered with hospitals and physician services.  As a result, many local, non-profit institutions were recognized as hospitals and became part of a provincial network.  These decisions and the decision to build in other parts of the province have led to a provincial health system that has evolved by default rather than by design.

In the early years, even before the term “sustainability” became popular, some were expressing concerns about the financial implications of this approach. There was, over time, a gradual recognition that the growth of services and related funding was happening without appropriate planning and controls.  The 1980s and 1990s included many initiatives aimed at improving how health services were prioritized.

In the late 90s, health systems and the related costs were perceived as unmanageable. Governments, believing that new structures would lead to new behaviours, acted, replaced hospital boards with regional health authorities. In New Brunswick these were further reduced from 8 to 2 in 2008 as part of additional reforms to the health system. Since then, other initiatives have sought to address health system costs.

Alan MacEachen was the federal Health and Welfare minister in 1966 when the medical care act was introduced and he said, “Canadians should be able to obtain health services of high quality according to their need for such services and irrespective of their ability to pay”.   Even though important issues remain, much has been accomplished in addressing financial barriers to health services.  Providing health services according to the needs of the population has received far less attention. Planning and performance management have not yet been fully implemented, leaving the system to operate on past default settings, rather than fully adapting to current needs.

This is particularly evident when one considers how health services needs in the population have evolved since the 1960s while planning and design of health services have lagged behind.  In the early years health service needs were mostly about injuries, surgeries, burns or infections.   For the patient, these needs represented very limited interactions with health services with a clear beginning and end to services.  Over the past few decades, chronic conditions have become a common and costly reality within the population.  These conditions can require several health service interactions over longer periods of time.  When properly managed, the need for the costliest health services can be significantly reduced, and quality of life improved. Currently, the management of these interactions in New Brunswick leaves significant room for improvement.

Improvements can be made with the reallocation of current resources.  There is also sufficient information available for setting priorities and performance targets. To encourage this system change, the NBHC is supporting public accountability and transparency by informing the public of the required changes and health system progress. We all have a role to play in bringing the type of change that improves how our health system meets the needs of our citizens.

Perspectives Reader Survey

In our continuing effort to improve the quality of the information we provide, the NBHC asks you to complete the following brief survey. The survey, which should take less than 5 minutes to complete, helps us to understand which parts of Perspectives are the most useful to you, how easily you can access Perspectives, and which frequency of Perspectives would be best for you. We will use this feedback to ensure that our communications tools best meet the needs of our stakeholder. Thank you for participating.

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Did you know?
62% of New Brunswickers have at least one chronic health condition, and 20% have three or more.

New Council members

The New Brunswick Health Council met on June 24th at the Delta Beauséjour in Moncton, NB. This was the first meeting of the NBHC since the appointment of 8 new members by the Lieutenant-Governor earlier this year. The new members are:
Peggy Doyle of Miramichi, Mike Doiron of Campbellton, Danny Jardine of Saint John, Heather Jensen of New Denmark, Dr. Meghan Richards of Fredericton, Kim Nash-McKinley of Richibucto Road, Paulette Richard of Dieppe, and Eva Sock of Elsipogtog. 

They join reappointed member Dr. Shawn Jennings and continuing members Nathalie Boivin, Rita Labrie, and Jean-Claude Pelletier, the Chair of the Council. The meeting was also the first for the NBHC’s new Executive Director, Citizen Engagement, Frank Vandenburg.

Short biographies of all Council members can be found here:
At the meeting, the Council members reviewed the audited financial statements, the latest report on sustainability and the NBHC’s new multi-year communications strategy in addition to regular business.
The NBHC would also like to thank its departing members for their dedication and service: Cindy Howe of Burton, Floyd R. Haley of St. Stephen, Frank B. Trevors of Miramichi, Harry Doyle of Lower Coverdale, Jeffrey J. Beairsto of Fredericton, Julie Robichaud of  Dieppe, Laurie Boucher of Bouctouche, and Sharon E. Eagan of Perth-Andover.
Did you know?
According to an analysis by the NBHC, the annual average cost of health services used by New Brunswickers with three or more chronic conditions is four times the cost of services used by individuals with none.

Employment opportunity

The NBHC is currently seeking an individual to work as a Research Coordinator. This is a one year contract with the possibility of renewal. To learn more about this opportunity, please visit:
Did you know?
Trends indicate the percentage of New Brunswickers with three or more chronic health conditions could increase from 20% to 25% within seven years

If this occured, associated health costs would increase by $100 million.

New Sustainability Brief: The Cost of Chronic Health Conditions to New Brunswick

The latest brief from the NBHC outlines how the sustainability of the provincial health system is impacted by chronic health conditions such as hypertension, gastric reflux or diabetes. The brief, The Cost of Chronic Health Conditions to New Brunswick, illustrates the current health system spending and resource reallocation in the province, while showing how the trend of increased chronic health conditions creates higher costs and more health system demand than can be effectively managed.

A new costing model developed by NBHC shows how costs increase at a faster rate with multiple chronic conditions, and a projection shows how the cost of care for chronic conditions could increase by $100 million or more within seven years.

To address this risk the brief identifies two priority areas for the health system:
  1. Reducing the incidence of new chronic health conditions in the population of New Brunswick through resource reallocation that improves illness prevention and health promotion
  2. Managing existing chronic health conditions by aligning health system resources to population needs with an emphasis on comprehensive primary health services and other community health services
The brief is available online at
Did you know?

Addressing the sustainability challenge posed by chronic health conditions to the province requires a long-term commitment to:

1. Reducing the incidence of new chronic health conditions in the population of New Brunswick through resource reallocation that improves illness prevention and health promotion

2. Managing existing chronic health conditions by aligning health system resources to population needs with an emphasis on comprehensive primary health services and other community health services

Media stories and announcements

The NBHC receives a weekly report of media stories and announcements related to its core activities Engagement, Population Health, Care Experience, Sustainability. The following stories are examples of the type of stories that are included. If this weekly report would be of benefit to you and you aren’t already a recipient, please contact us at for information on subscribing.
The NBHC has been established as an independent organization that measures, monitors and evaluates New Brunswick’s health care system performance and population health, and that engages citizens in the improvement of health service quality.
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