Regional Health Authorities - Frequently asked questions Q: Why is the number of RHAs being reduced to two from eight? A: With eight separate Regional Health Authorities, it has not been possible to achieve a single provincial approach to providing health services. As a result, health care is not standardized across the province and is not provided in the most efficient and effective manner possible. Rather, the New Brunswick health care system consists of eight separate health care systems operating independently of each other and competing for finite resources. Moving to two RHAs that will be mandated to work cooperatively will ensure patients receive a consistently high standard of care no matter where they live. We will also see more of our health budget going into patient care and less into administrative functions. Q: What is the timeframe for this to occur? A: The two-rha system will become fully operational on September 1, 2008. Until that time, the Minister of Health will assume the responsibilities and authority of the RHA boards. This time is needed to allow the new Chief Executive Officers of RHA A and RHA B to develop their organizational plans. Q: How can having two RHAs versus eight improve clinical care for patients? A: Each of the eight RHAs has operated under its own policies and practices related to patient care. This has resulted in inconsistencies in the care New Brunswickers receive from region to region. A publicly-funded drug in one Regional Health Authority may not be on the publicly-funded drug formulary of another. A health service available within a few weeks in one region can take a year to access in another. Transitioning to two, more closely integrated RHAs will result in better standardization of health care for all New Brunswickers. It will improve access for rural New Brunswickers to specialized services, as they will now be part of a larger RHA with more tertiary services. Implementation of new services or improved practices will be achieved more quickly than was the case with eight RHAs. It will also make better use of limited human and financial resources.
Q: What impact will this have on clinical care? A: The benefits of moving to two RHAs are explained in the preceding question. There will be no negative impact on clinical care as a result of moving to two RHAs. No hospitals will close or be downgraded; no beds or services will be reduced as a result of moving to two RHAs. Q: What will happen to the regional hospital in my area? A: New Brunswick currently has eight regional hospitals and this will not change as a result of moving to two RHAs. Each of these hospitals will retain its regional status. Q: What will happen to the hospital foundation in my area? A: There is no impact on the charitable foundations that exist in the province to support better health care. All of their assets will remain their property. Q: How does New Brunswick compare to other Canadian provinces in the number of health authorities it has? A: There is no set rule but one health authority per million of population is considered a good measure by the health industry. British Columbia has about 4.5 million people and six health authorities. Alberta has nine health authorities and five times as many people as New Brunswick. The trend is certainty towards fewer health authorities. Q: Will people lose their jobs because of this? A: There could be an impact on administrative and back-office positions as a result of moving from eight corporate headquarters and the related staff to two RHAs. The number of affected positions is not now known and will not be until the new Chief Executive Officers of the RHAs have developed their organizational plans, including human resources needs. Q: Will this save money? A: The major benefit of moving to two RHAs is that it will result in a more effective and efficient health care system. It will remove barriers to care that now exist between the eight health authorities. Whether there will be monetary savings will not be known until the organizational structure of the two RHAs is complete. It will depend on the impact on staffing. There could be savings related to a reduction in the need for corporate office space.
Q: Why should we expect two RHAs work better together than eight? A: The main goal of moving to two RHAs is to standardize and improve patient care around the province. This is a laudable goal that we believe will inspire RHAs to work cooperatively with each other and the Department of Health to achieve a common purpose. In addition, as part of their orientation, new RHA board members will be oriented on the importance of working for the betterment of one provincial system versus two separate and distinct health systems. The two RHAs are also going to part of a bigger system that now includes the New Brunswick Health Council and the new company that will manage non-clinical services. All four of these entities have to work together and cooperative with one another in order to fulfil their mandates. Q: Why didn t you go to one RHA? A: By having two RHAs we have been able to respect the working language of the majority of staff in the areas they serve. This means employees will continue to be able to work in the majority language of the hospital or other facility in which they work. Q: Why are board members being appointed rather than elected? A: Previously, boards were comprised of a mix of elected and appointed members. Due to a lack of candidate interest, there were actually more appointed than elected members. The move to competency-based boards recognizes the important role board members have in the public health system. The boards of directors of the two RHAs are responsible for overseeing health care services worth $1.2 billion annually. This is the largest single expenditure of the provincial government. We need people with the proven skill sets and experience to provide the necessary governance and oversight. This will be even more so with the larger RHAs. This is why we are moving to competency-based boards. Q: What is a competency-based board? A: A competency-based board of directors is made up of members who are chosen based on the particular skill set or expertise needed to support the organization. For Regional Health Authority governance, this will include people with demonstrable health/medical knowledge, financial expertise and human resource expertise. Competency-based boards are considered a best practice and are being utilized across the country by a growing number of not-for-profit and governmental organizations.
Q: Will RHA boards meet in public and can citizens present issues and concerns as they have in the past? A: The role of the boards has not changed, including the requirement under the Regional Health Authorities Act that boards meet in public. Boards will continue to provide opportunities for citizens to provide input into the services they provide. Citizens also have a new opportunity to be engaged in the health system through the newly created New Brunswick Health Council. Its role is to engage citizens in meaningful dialogue to bring the citizen/patient perspective back to health service providers and policy makers in an effective, timely and objective manner. Q: Will the board chairs and members be paid? A: The chairs and other members of the boards of the two Regional Health Authorities will be compensated. The level of compensation will be made public as soon as a decision is made. Q: Can I apply or nominate someone to be a board member? If so, how? A: A process is being established that will allow the public to nominate residents for various provincial agencies, boards and commissions. More information will be available once this process is complete. Q: Why were the first CEOs appointed rather than being hired by their board of directors? A: In future, the RHA boards will have the authority to both hire and terminate their Chief Executive Officer. Previously, the Deputy Minister of Health had authority to hire or fire the CEO. The first CEOs have been appointed because they need to be in place immediately in order to ensure a smooth transition between now and Sept. 1, 2008, when the two RHA system and the new boards become fully operational. Until then, the new CEOs will be carrying out strategic planning and working with the current management teams. Not having CEO in places would lead to a vacuum for staff. Q: What will happen to the current CEOs? A: The six permanent and two acting Chief Executive Officers are valued leaders in health care and will have the opportunity to remain in the system in prominent roles, if they wish to stay. One, in fact, is the new CEO of RHA B.
Q: Are the two RHAs divided along linguistic lines is this duality? A: No. We are not creating one health system for Francophone New Brunswickers and one health system for Anglophone New Brunswickers. This would be duality. Rather, each of the two RHAs will provide health services within their defined geographic areas in the official language of the patient s choice, as has been the case in the past. Q: Will people be able to receive service in either official language everywhere in the province? A: All New Brunswickers will continue to receive health services in the official language of their choice no matter where they live. Q: How will you ensure that facilities retain their cultural identity and language of work? A: The new governance structure preserves the cultural identity of facilities by grouping under each new RHA the existing health regions with regional facilities whose language of work is the same. Hospitals will be able to maintain their way of doing business, including language of work, as long as they do so within standards of care that will be established by the RHAs. Hospitals will also maintain their own charitable foundations.