A member of the Horizon Health board fired in a shakeup of health-system leadership is pushing back against Premier Blaine Higgs's argument that the board was creating bureaucratic barriers to reform.
Linda Forestell, who had been an elected member of the Horizon Health Network board of directors for 10 years.says the premier's removal of all voting members last Friday came as a total surprise.
"We collaborated in as many ways as we possibly could," said Forestell.
"We tried over and over again to respond with lightning speed to requests from the Department of Health, only to have them stall at that level or be delayed, deferred or refused."
On Friday, after a man died in a Fredericton emergency room while waiting for care, Higgs replaced the minister of health, fired the Horizon CEO, and replaced the 15 voting members of the Horizon and Vitalité boards with a single trustee each.
Higgs said the dissolution of the boards would remove a "bureaucratic stalemate" and make the system more efficient, but he did not explain how.
"I completely disagree with that," Forestell said Wednesday.
"Our people, at Horizon, participated in the development of the provincial health plan, we helped craft it, we worked together with the task force, we were implementing it. … We incorporated the recommendations of the provincial health plan into Horizon's strategic plan.
"So no, I don't support that at all."
A public firing
Forestell said she got the news she was being removed from the board through a colleague, who was watching the news conference Higgs called to announce the move.
The colleague's text said: "I really enjoyed working with you."
"My phone started to ring from fellow board members," Forestell said. "So I called [chair] Jeff McAloon and said, 'What's going on?' He said, 'We've been ... revoked.'
"I don't know why. I really and truly don't ... other than there was that unfortunate death in the ER. at the Chalmers Hospital."
John McGarry, a former board member and Horizon CEO who was fired by Shephard last year, agreed that HIggs's decision does not make sense.
McGarry said he doesn't know "whether it was just a knee-jerk reaction to somebody screaming 'Do something, do anything,' and this was the first thing that came to mind."
He wondered why, when other players involved in running the health system are appointed by government, Higgs focused on getting rid of people at the regional health networks.
The switch in cabinet ministers, shuffling cabinet minister Bruce Fitch into Health and Dorothy Shephard into Social Development, was a "lateral move," and the bureaucrats at the top are "being protected," McGarry said.
"It's kind of the easy way out," he said.
And making the changes out of the blue, without warning to those affected, is "not a sign of good management."
McGarry also said that when he was fired by Shephard, it happened the same way.
"I consider that a drive-by shooting, that's not fair to say those things in a press conference or in public without giving the organization an opportunity to address it," he said.
Forestell said that over the years, the Horizon board made recommendations that were rejected. One was to centralize certain procedures at certain regional hospitals, which, before Friday, seemed to finally be on the way to being implemented for hip and knee surgeries.
Another recommendation the province wouldn't take up called for a greater focus on building nursing homes to free up acute-care beds in hospitals.
During her 10-year term, Forestell saw three governments, four chairs of the boards, and five CEOs.
"You can see that changes at the top are predictably not necessarily the best result for the delivery of the health-care system or health services in the province," she said.
One person voting more 'nimble' than 15
On Wednesday, the new health minister, Fitch, repeated Higgs's notion that the boards posed bureaucratic barriers to getting things done.
"There seems to be an ability — with less bureaucracy, without big boards — to drill down and make some changes that need to be changed without getting caught up in the bureaucracy," he told Information Morning in the Summer.
Fitch had no specific examples of the bureaucratic tangles he was blaming the boards for.
The board of directors has three non-voting members and 15 voting members. In making this decision, Fitch effectively replaced all 15 people with one trustee, said constitutional lawyer Lyle Skinner.
This means only one person would be voting about how to advise the health network, what recommendations to make and who the next CEO would be.
"It's always been reported that the board has been dissolved and that's technically incorrect," Skinner said. "It's just that the board, the voting members have ceased to hold office. A board exists that just has a voting member of one person."
The people chosen as trustees for the two health authorities are Gérald Richard for Vitalité and Suzanne Johnston for Horizon. They are also co-chairs of the health plan implementation task force, in charge of figuring out how to implement the province's a health-system overhaul in a timely manner.
Fitch said this change would mean the province can "be nimble, be quick to react using the best practices."
Board acted with caution, former director says
McGarry said change can happen faster when people are taken out of the system, leaving "a direct line to the premier or the minister."
But he said not having diverse opinions can lead to bad decisions.
Forestell said the Horizon board did not stop trying to make quick decisions, but the directors tried to be cautious too.
"You don't just measure once or measure twice before you cut," she said. "You measure 15 times before you cut."
Skinner said the trustees do have one single vote in deciding what advice and recommendations to give the health authority, but they would still be making decisions with the help of the three non-voting board members who remain.
"There's still the CEO … and the two chairs of the professional and medical advisory committees," he said. "It's not that the trustee is just having a meeting by themselves."