My Letter to Premier Brian Gallant

Below is a letter I sent to the Premier of New Brunswick via e-mail, earlier this week. Yes, it's a long read, but so is the economy plan (more to come on that).
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Dear Premier Brian Gallant:

My name is Adrienne Palmateer. I live in Athens, Georgia. However, I was born and raised in Charlotte County, New Brunswick.

I would not be here today if it were not for Charlotte County Hospital, its OR and staff.

Dec 31, 1992 a cantaloupe sized abscess on my appendix, tried to kill me. A few hours on the OR table, 22 staples, 6 days in the hospital hooked up to a drain, catheter and whatever IV meds they were pumping into me, to get me better…I survived. I was 13. I would not have made it to Saint John.

Earlier that year Jan 1992 our class watched as our classmate/friend, was being rushed out of our school in an ambulance to CCH. She did not make it. Her spleen ruptured. Her father was a local doctor in St. Andrews.  In the medical field, seconds and minutes count.

I was appalled, when I heard that Horizon Health Network was shutting down CCH’s OR. When your gut tells you something is not right, chances are—it’s not.

I began to research this. The more I research…the more I become disgusted with what the Government of New Brunswick has been doing for years when it comes to health care for New Brunswick Residents.

Reviewing Horizon Health Network’s Annual Reports from 2009 to 2016.  Did you know that all of the Statement of Operations show the previous year for comparison? Except the Annual Report for 2008-2009. Why is that? HHN first year’s deficit was approx. 9.5 million dollars. Then I noticed they haven’t been factoring in their surplus (deficit) of the previous year in their annual reports. Why is that?  There is absolutely nowhere in any of the annual reports, factoring in previous years surplus (deficit).  

2008	2009	2010	2011	2012	2013	2014	2015	2016
(9,580,751)	$2,713,050	(1,100,660)	(2,083,225)	6,100,462	(11,705,623)	(11,180,272)	(5,442,965)	($15,379,175)

Total Surplus (defict) ($47,659,159).

2011-2012 Statement of Operations discloses under “Amortizations of capital funding” 33,361,320. In the 2012-2013 Statement of Operations it shows nothing under that category and HHN with a surplus of 36,229,934. Why? The actual is 6,100,462. This sent up a red flag.

Here’s another thing that sent up a red flag. The Revenues, Expenses are all lumped together for HHN as a whole. However, when I hear HHN  is shutting down CCH OR, guess what I go looking for?  Charlotte County’s Hospital’s break-down of its numbers. It’s nowhere to be found. There is no break-down for every single facility under HHN. There is however, by the Province of New Brunswick an Annual Report of Hospital Services Ending FY 2015. http://en.horizonnb.ca/media/758110/annual_report_of_hospital_services__2014-2015.pdf (page 27). It provides a total operation cost for Charlotte County Hospital

RHA	Facilicorp	Total
15,823,446	1,037,518	16,860,964

I have worked in the business world since age 14. Since 2004 I have worked in the medical field (optometry) in the US. I have worked predominately in private practice, but I also worked for 4 years at a health center for the University of Georgia (state government)  – I know how it’s broken down.  Which is why I am asking these questions. The above numbers truly do not mean a hill of beans to me, because the questions I am now asking…. where are the break downs of expenses (salaries, admin, clinics, medical equipment, maintenance, security, ground up-keep, power), all of it for every single facility to include Charlotte County Hospital?

When numbers are grouped together in a big pot, it only means there is something to hide. HHN is hiding something; The Government of New Brunswick is hiding something. Which leads to more research, because that is unsatisfactory. I went back and reviewed the annual reports and what each category means in the reports.

Department of Health – payments for hospital services, mental health, public health and payment for physicians.

Government of Canada – mainly funded by Department of Veteran Affairs. “Government of Canada – Government of Canada revenue mainly relates to units funded by the Department of Veterans’ Affairs.” (HHN Annual Report 2015-2016)

Patient Recoveries – services not covered by Medicare; services provided to patients/client from other Provinces and countries.

Other Recoveries & Sales – recovery of cost providing services to outside agencies and other marketable agencies (paid parking services for patients and staff), retail food services, rentals and investment income.

Nursing Inpatient Services – inpatient units, operating/recovery rooms in hospitals. Wages, benefits for nurses. Development of workforce Optimization (Kronos), scheduling implementation, drug expenditures, medical, surgical supplies and “other expenses.”

Note I have put the Government of Canada in bold. On paper or just at a glance the Statements of Operation disclosed by HHN, it would appear that the Government of Canada has provided New Brunswick with funding for health care. However, when you read what HHN discloses as to what falls under the “Government of Canada” the funding is money from Department of Veterans Affairs. Which means only the hospitals, clinics in New Brunswick that service our veterans receive that money. Well that’s what “should” be happening, but I highly doubt it.

Which sends up yet another red flag and yes, more questions. “Why isn’t The Government of Canada helping Provinces with their health care?” Maybe I need to be writing a letter to Prime Minister Justin Trudeau, because this is not right. The grants New Brunswick has received over the years is very minimal. This doesn’t add up.

The next page you will see what I typed into a search engine to find out. 

Note 3 sites down “Federal Transfers to Provinces and Territories.”

The image is small, it is hard to read the numbers. I have provided them for you. 

Federal Transfers to the Province of New Brunswick since 2007-2008 for health care. It’s called the Canadian Health Transfer (CHT). Every Province gets CHT.

2007-2008	512,000,000
2008-2009	528,000,000
2009-2010	557,000,000
2010-2011	609,000,000
2011-2012	641,000,000
2013-2014	672,000,000
2014-2015	682,000,000
2015-2016	716,000,000
2016-2017	754,000,000
Total 2008-2016	5,671,000,000

Nowhere, except for this website through The Government of Canada is this shown or accounted for. I have looked through The Department of Health Annual Reports. I have looked through The Government of New Brunswick’s Financials, and these numbers are not in there. Of course how would anyone know? Even the Annual Reports for The Department of Health and the Government of New Brunswick are vague. Again more ways to hide money or ways to use fund inappropriately.

So I ask you Mr. Gallant since you are ultimately responsible, where is the money? I would also love to pose that question to CEO John McGarry and the Minister of Health Victor Boudreau.  Do not give me the lawyer, politician or any “line”. It does not work on me. I’ve heard it all. This “rural” woman who was born and raised in Charlotte County, NB, by a single mother ---has been around the world a couple times.

The findings of all the inaccuracies are a result of HHN deciding to shut down CCH OR. http://en.horizonnb.ca/home/media-centre/horizon-news.aspx?cat=stj McGarry said it was due to “low volume.” The statement goes on to say that the surgical volume at CCH has been low for numerous years despite HHN efforts to increase volume.  However there is more to the story. HHN’s statement in regards to the low volume of surgeries for the past few years is not accurate. I was married to a narcissist once. It was everyone else’s fault, never his. I can smell the load of manure you and your government are shoveling all the way down here in Georgia.

I am PROUD to have been born and raised in Charlotte County. My roots in Charlotte County go back about 200 years. We have a back bone.  I am PROUD that residents have stood up and are holding you and your government accountable and asking questions. “You can take the woman out of Charlotte County, but you can’t take Charlotte County out of the woman.” I am PROUD to stand next to Charlotte County residents, despite the distance that separates us. I chose to leave NB, 20 years ago, but it does not mean I am any less Charlotte County or any less of a New Brunswicker. This not only effects NB residents living in the Province, it effects every single New Brunswicker who has chosen to move away, and still has family and friends living in the Province.

When I was a child growing up in NB, wait times to see a doctor was about 2-4 wks. It didn’t matter how little or major the symptoms were, that my mother disclosed to the doctor’s office, the wait was just the same. Cold, flu, pneumonia, appendix, ear infections. My mother had no choice but to take me to the ER at CCH—there was no others options.  Here’s what I learned being a child growing up in New Brunswick. I’m either going to get better, worse or die. 8-10 hour wait in outpatients at CCH is nothing compared to the wait to see a doctor. The only time in my life I have never had to wait was back in 1992, it was pretty much head of the line when I arrived at CCH. I must be dying.

I have learned, experienced a lot of things since leaving New Brunswick at age 18/19. Granted my experience is mainly due to living in the states pretty much for the past 20 years. 3 of those 20 years, my family and I lived in Japan on a military base with just a little clinic. It was like getting out of a rain puddle and into an ocean when I moved here. In the past 20 years, my children and I have never had to wait to see a doctor.  99.9% of the time, we have been seen same day. Trust me, having two children we have been to the doctor A LOT in the past 20 years. No, the American health care is not without flaws. However, I can’t even compare New Brunswick health care to American health care because it’s not even in the same league.

10 years ago I had to deal with New Brunswick health care again (sans HHN), when my mother was sick and dying from 4th stage breast cancer, it was horrible and it was unacceptable. Not only did I know after moving away, that healthcare could be better, I was now also in healthcare myself. Trust me, I voiced my opinions. I have no doubt that the “professionals” did not like seeing me coming, or that I was yet again on the phone.

“You are elected to do the best you possibly can to make things better.” Those are your own words from 2014. You talk a good talk, Mr. Gallant. In the almost two years you have been in office, you have nothing to show for it. You have not made it better for residents. The healthcare is a disgrace, the economy is in the toilet. The only ones you have made it better for are the higher ups within your government.

In just writing this letter in regards to Charlotte County Hospital more and more residents of New Brunswick are complaining. It’s not just Charlotte County. This is NB wide and it’s in the Horizon Health Network.

Telegraph-Journal  (August 27, 2016) Dr. Everett Chalmers Hospital. You have residents waiting up to 14 hours in your ER’s to receive treatment. A patient interviewed said “One doctor all night isn’t enough.” Are you kidding me? The Horizon Health Network service area, is highly mismanaged. Again, this falls on Horizon Health Network, it falls on the Department of Health, and it falls on you.

The big idea is to shut down services in certain areas and move those services to another larger populated area. Yet, those hospitals are already over capacity and under staffed (obviously). That’s not a solution – that’s putting a Band-Aid over it.

September 1, 2016 Geri Geldart, VP of Clinical Services for HHN said that the health authority recognizes the long wait-times for patients and families are a problem in emergency departments across the province. If this “health authority” hasn’t been able to figure this out in 8 years, chances are they aren’t going to figure it out. She then blames patients. “there’s also a need to educate the public about the inappropriate use of the emergency room.” VP Clinical salary 2015-2016 (146,380-177,918). If patients are unable to get in to see a family doctor in a suitable amount of time, they are going to go to the hospital for non-urgent problems. This is not new and shouldn’t even be surprising. THIS was going on when I was growing up in NB. 

You have residents unable to get into see doctors, you have hospitals overcrowded and understaffed. HHN and the Government of New Brunswick have brought this on themselves. Actions, speak louder than words, in all aspects of life.

My Gallant you are almost 2 years (half way) into your term, and you have absolutely nothing to show for it. You have debt, that’s all you have to show for it. We can sit and theorize the view of the pessimist/optimist; half-empty or half-full. It truly depends on the situation. If we are talking about debt and the glass, you have set a glass in the sink with the water running. If we are talking about your term, 2 years in, what do you have to show for it in voter’s eyes? If we are talking about residents/voters are tired of the way the Province of New Brunswick is headed until they can vote someone else into office, they are almost there. It depends on the situation in how you look at the glass theory.

The results you implement now, even if they work, will NOT show a recovery, in time for the next election. If you had started at the beginning of your term, residents might have seen an improvement in year 3. The improvement of the Province will not be an overnight recovery. I’d rather be the turtle, than the hare. Quite frankly, anything you do now, is CYA because you are 2 years away from the next election year. In order to do damage control, in “hopes” you get reelected, you have to try and prove to the voters you have made an attempt to fix the problems in New Brunswick. You will tell  voters, you have implemented, x,y,z during your term, it will not be an overnight fix, elect me and you will see. You will have proof you have done this. The cold hard reality is NB residents are sick and tired of the empty promises and how their Province has been going on a downhill spiral. If I could vote in New Brunswick. I would take my chances with bringing in someone who has a solid plan. Because if New Brunswick is going to be turned around and made good again --- it starts with the voters and holding their elected officials accountable. If you can’t make good on the promises within your first term –you aren’t going to do any better if elected another term.

In Friday’s (August 26th,2016), Telegraph Journal. The headline on the front page was “More Family Doctor’s on the way, but Specialist on the Decline.” NB doctors are TELLING YOU, New Brunswick is being set up for a “perfect storm.” It’s pretty much common sense. Many of your specialists in New Brunswick are at the age of retirement. That should have been common sense about 10 years ago. Not now, when they are about to retire. The stock needs to keep being replenished otherwise eventually it all goes away. Welcome to life 101.

In that same article, Mr. Boudreau boasts about the fact that 16 new doctors have been brought on since the beginning….your election, in 2014. But a few paragraphs later he says 80% of the graduates in Moncton are staying in Province. If we train them, we gave a better chance of retaining them. More questions. How many are in the graduating classes for medicine? 80% of the Moncton graduates are staying in Province. Are we talking 10, 100, or 300 graduating students? Or is the minister of Health talking about 80% of Moncton graduates as a whole are staying in Province. He is not quoted in the article as to saying 80% of the Moncton graduates in Medicine are staying in Province.

I got to come home for 2 weeks this summer. Friends who have also moved away, came home during that time. We love and miss NB, we talked about how much we would love to come back to live. If I am thinking it, if my friends are thinking it, how many others from New Brunswick are thinking that as well? Why would we? It would be stepping backwards for us and our families.  It’s not personal, it’s just business. As long as New Brunswick keeps on this downward spiral, NB residents will leave, especially the younger generations. Previous NB residents will stay away.

In closing, there was a new article in the Telegraph Journal (September 3, 2016). You are promising that as long as you are Premier hospitals will not close. Residents don’t want promises, they want proof. What are you and your government going to do to make that happen, and not keep overspending?

Sincerely,

Adrienne Palmateer

Athens, Georgia