The former chair of the Horizon Health board and a longtime board member are speaking out about a dysfunctional relationship with Health Minister Dorothy Shephard that is "filled with tension" and is "maligning" the professionals who manage health care in the province.
At 69, John McGarry said he is fine with being fired by the health minister from his position as chair last month.
He is not fine, he said, with Shephard criticizing the health authority for failing to recruit doctors, and with her telling the media her department would now lead recruitment rather than Horizon and Vitalité.
In April, Shephard told CBC News there are "family physicians who want to come home" to practise in New Brunswick but "can't even get a call back" from the regional health authorities.
"That's why we've taken recruitment into the Department of Health to lead it," the minister said. "I have not been satisfied with our recruitment process."
McGarry took exception to that statement, in part because neither Shephard nor anyone from her department called Horizon first to raise those concerns.
"That's just a cheap shot to say those things without really coming to the [regional health authorities] themselves and say, 'Tell me the story here. Why are people saying this?'" McGarry said. "That's what upset me — I find that it's maligning our recruitment people, who are doing a good job."
Minister has never met with board
Longtime board member André Veniot decided to speak out after McGarry was fired April 23.
Veniot believes the minister is unnecessarily undercutting and "throwing shade" on Horizon staff.
"I think it's been for some time that the Department of Health, and this minister in particular, has been almost throwing Horizon … and this board under the bus — and the decisions we make under the bus," he said.
"And that, I think, caused a lot of friction."
Since she was appointed health minister at the end of September 2020, Shephard has not met with the Horizon board, said Veniot and McGarry.
"Your board … represents the people of New Brunswick. We have a ton of experience and it would be nice to be appreciated for the work we do," Veniot said.
McGarry, who has worked with other health ministers in his time as board chair, said he expected to have a good working relationship with Shephard where they could challenge one another, but he hasn't met with her or her deputy since last fall.
"There's usually more regular board chair-minister meetings. I had a lot of them with minister [Ted] Fleming," he said, referring to Shephard's predecessor in the Progressive Conservative government.
"I think I've only met once with the minister and the deputy probably in October or November."
Health-care 'vision' questioned
McGarry was fired after he publicly criticized the health minister at a Horizon board meeting on April 16, saying he was "perturbed" by Shephard's assertion that her department would be taking over doctor recruitment. He questioned whether the Department of Health could do a better job.
McGarry understands why the minister dismissed him, but he said Shephard's comments during a legislative committee hearing April 29, one week later, left him scratching his head.
At that meeting Shephard responded to questions from Liberal MLA Jean-Claude D'Amours about McGarry's firing saying, "I'm not going to explain myself to the member opposite with regards to a position that is held at the pleasure of the minister."
She went on to say that her objective was to "begin putting in place people who share my vision, our vision, government's vision, for the direction we need to take the Department of Health."
Shephard never explained how that vision differed from McGarry's.
McGarry said when he heard Shephard's comments he thought, "What is she talking about?"
"Is there something that I'm missing here? No. You're upset that I criticized you for taking broadsides at the recruitment process. And then you decided that I should go — which is fine I have no problem with that — but own up to it."
CBC requested an interview with Shephard but she refused. Instead her spokesperson sent a statement that reads in part, "the minister of health would like to thank Mr. McGarry for his hard work and dedication to the people of New Brunswick."
During the legislative committee meeting, Shephard was asked about her vision for health care in New Brunswick.
"We have to have vision," she replied. "I see a health-care network, networks, in this province where patients are as equally satisfied as the medical professionals who serve them. What a goal. There's my vision."
Health Department not equipped to recruit doctors
McGarry continued to cast doubt on the idea of the Department of Health leading doctor recruitment, saying it is a "delicate" process.
"It shouldn't be led by the government — the government should be creating an environment in the province that is open to physicians and welcoming to physicians."
You don't have some assistant deputy minister start calling people and saying, 'Hey, would you like to have a job in Fredericton?' - John McGarry
McGarry explained that physicians have an important role when it comes to recruiting doctors who will be a good fit for the province and their existing teams.
"They do the calling in most cases and say, 'Listen, Dr. X, we'd like you to come here and come on up for the weekend and … talk to us and come out to dinner with us and see if you like Saint John or Fredericton or Moncton … see if you're compatible with us because we're really interested in talking to you," he said.
"You don't have some assistant deputy minister start calling people and saying, 'Hey, would you like to have a job in Fredericton?'"
Adding insult to the injury of Shephard's initial comments, McGarry said, was that nothing actually changed at Horizon after Shephard said her department was taking the lead on recruiting doctors.
"Did she send a letter afterwards saying, here's what I mean — here's what we're going to do, and here's what you're going to do? No. So it was just a throwaway in a media scrum that slammed the [regional health authorities] without any basis."
Veniot said it feels to him that Minister Shephard is making up policy as she goes, pointing again to a CBC interview where she promised to eliminate the wait list for primary care in New Brunswick within six months.
"Good luck. I wish you well. I'd love to see it," he said. "It's just I don't think it's going to happen."
Future of health boards questioned
Veniot, who is an appointed member of the board, expects he may also be fired for criticizing the minister but said the board's job of charting a course for health care in the long term is not easy, and government should expect to be challenged.
Seriously, I mean if all the board is going to be doing is tinkering at the edges, that to me is not the proper functioning and good use of the board. - Andre Veniot, Horizon Health board member
He said if the minister isn't prepared for the board chair and the board members to "speak truth to power," then perhaps there isn't any point of having health boards.
"You're not dealing with the problem. You're not dealing with the issues."
In his six years on the board, Veniot said, successive governments have directed members to leave rural hospitals out of any reform plans, and that is hamstringing any real reform.
"Seriously, I mean if all the board is going to be doing is tinkering at the edges, that to me is not the proper functioning and good use of the board."
Veniot still believes the health reforms introduced last year that would have seen emergency rooms in six rural hospitals closed overnight is the right way forward.
"I still stand by that. But the government chose otherwise. And that's their role, but at some point down the road, and in a not too distant future, it's going to come back."
Veniot said working with Horizon has been a privilege and given him "a real insight" into the $1.2 billion health corporation with 13,000 "dedicated, professional, highly trained" employees.
Shephard recently finished 46 community engagement sessions across the province talking about the future of health care in New Brunswick as her department works on a health care plan that she has said will not include the closure or reduction in hours of any emergency rooms.
McGarry believes Shephard needs to listen to, not ignore, members of the Horizon board.
"Board people, they don't do this because they want to get bashed around, they do it because they love their communities, and they want to do the best job they can and they want to build a good health system."
There are seven appointed members of the Horizon board, and eight elected. In the upcoming election, 26 candidates are running for those eight positions, including six incumbents.