A Horizon Health board member fired in a health system leadership shake-up is rejecting Prime Minister Blaine Higgs’ argument that the council was creating bureaucratic barriers to reform.
Linda Forestell, who had been an elected board member of the Horizon Health Network for 10 years, says the removal of all voting members by the prime minister last Friday was a total surprise.
“We collaborated in as many ways as we could,” Forestell said.
“We tried time and time again to respond quickly to requests from the Department of Health, only to stop at that level or be delayed, postponed or denied.”
On Friday, after a man died in a Fredericton emergency room while waiting for attention, Higgs replaced the health minister, fired Horizon CEO and replaced the 15 voting members of Horizon and Vitalité councils with a single trustee each.
Higgs said dissolving the boards would eliminate a “bureaucratic deadlock” and make the system more efficient, but 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 develop it, we worked together with the working group, we were implementing it … We incorporated the recommendations of the provincial health plan health to Horizon’s strategic plan.
“So no, I can’t stand it at all.”
A public dismissal
Forestell said he received the news that he was being removed from the board through a colleague, who was watching the press conference convened by Higgs to announce the move.
The companion text said, “I really enjoyed working with you.”
“My phone started ringing from board mates,” Forestell said. “So I called [chair] Jeff McAloon and said, “What’s going on?” He said, “They’ve … fired us.”
“I don’t know why. I really and really don’t know … other than that there was that unfortunate death in the emergency room. At Chalmers Hospital.”
John McGarry, a former board member and CEO of Horizon who was fired by Shephard last year, agreed that HIggs’ decision makes no sense.
McGarry said he doesn’t know “if it was just a knee reaction to someone yelling ‘Do something, do anything’, and that was the first thing that came to his mind.”
Former Horizon health network chairman John McGarry called the sudden, public dismissal of board members “mismanagement.” (CBC)
He wondered why, when the government appointed other actors involved in the implementation of the health system, Higgs focused on getting rid of people from regional health networks.
The change of cabinet ministers, which shook cabinet minister Bruce Fitch in Health and Dorothy Shephard in Social Development, was a “side fashion” and top bureaucrats “are protecting,” McGarry said.
“It’s kind of the easy way out,” he said.
And making changes unexpectedly, without notifying those affected, “is not a sign of good management.”
McGarry also said that when he was fired by Shephard, the same thing happened.
“I think it’s not fair to say these things at a press conference or in public without giving the organization a chance to address it,” he said.
Forestell said over the years, the Horizon board made recommendations that were rejected. One was to centralize certain procedures in certain regional hospitals, which by Friday seemed to be finally to be implemented for hip and knee surgeries.
Another recommendation that the province would not accept called for a greater focus on building residences to release acute care beds to hospitals.
During his 10-year term, Forestell saw three governments, four chairmen of the boards of directors and five CEOs.
“You can see that the changes at the top, predictably, are not necessarily the best outcome for the provision of the health system or health services in the province,” he said.
One person votes more “agile” than 15
On Wednesday, new Health Minister Fitch reiterated Higgs ’idea that boards posed bureaucratic barriers to getting things done.
“There seems to be a capacity, with less bureaucracy, without big boards, to deepen and make some changes that need to be changed without getting caught up in bureaucracy,” he told reporters in the summer.
Fitch had no concrete examples of the bureaucratic messes the boards blamed.
The board of directors has three non-voting members and 15 voting members. In making that decision, Fitch effectively replaced the 15 people with a trustee, said constitutional attorney Lyle Skinner.
Lawyer Lyle Skinner says Horizon and Vitalité’s boards of directors still exist, but now they only have one voting member. (Submitted by Lyle Skinner)
This means that only one person would vote on how to advise the healthcare network, what recommendations to make and who would be the next CEO.
“It has always been reported that the board has been dissolved and this is technically incorrect,” Skinner said. “It’s that the board, the voting members have stopped holding office. There is a board that only has one voting member of one person.”
The people chosen as trustees of the two health authorities are Gérald Richard for Vitalité and Suzanne Johnston for Horizon. They are also co-chairs of the health plan implementation working group, tasked with figuring out how to implement the province’s health care review in a timely manner.
Fitch said the change would mean the province can “be agile, react quickly using best practices.”
The board acted cautiously, the former director says
McGarry said change can happen faster when people leave the system, leaving “a direct line with the prime minister or minister.”
But he said not having different opinions can lead to wrong decisions.
Forestell said the Horizon board did not stop trying to make quick decisions, but the directors also tried to be prudent.
“Don’t just measure once or twice before cutting,” he said. “Measure 15 times before cutting”.
Skinner said administrators have a single vote to decide what advice and recommendations to give to the health authority, but that they would still make decisions with the help of the three remaining non-voting board members.
“There’s still the CEO … and the two chairs of the professional and medical advisory committees,” he said. “It’s not that the trustee just has a meeting on his own.”