December 19, 2024
Hon. Dr. John Dornan,
Minister of Health
P.O. Box 6000
Fredericton, NB
E3B 5H1
Dear Minister Dornan:
Re: Fredericton Health Care Summit Follow-up & Next Steps
The Fredericton Chamber of Commerce writes to you today to thank you for taking part in Fredericton’s Health Care Summit, “Clear and Present Needs of a Growing Capital City”, on November 12, 2024. We would also like to follow-up on next steps to address the urgent primary healthcare crisis within the Fredericton Region.
As you know, this summit was the result of collaboration between the Fredericton Chamber of Commerce and the City of Fredericton, in partnership with St. Thomas University, and the New Brunswick Medical Education Foundation. This event aspired to convene a direct discussion about the current state of Fredericton’s health care and the needs of our community, now and in the foreseeable future.
Along with the 108 attendees, we were so pleased by your participation as the first guest speaker of the summit. Your engagement, and openness to dialogue with the many stakeholders of our community, including medical professionals, businesses and municipalities present, encouraged a collegial tone for the discussions to follow.
If we may, we would like to provide a presentation of themes which emerged from the summit, which will hopefully help identify the obvious steps forward in our shared goals:
Health Care Infrastructure and Future Collaborative Care Centres in Fredericton to Attract and Retain Medical Professionals
We feel the most urgent attention must be committed to addressing the deficit our medical professionals are experiencing through the establishment of health care infrastructure / new collaborative care centres to meet the critical needs of our community. The situation is dangerous given the current data on physician demographics and Fredericton’s increasing population growth.
- 62,000 people in the Fredericton health zone do not have a family or primary doctor representing one third of the province’s 180,000 New Brunswickers without a physician (source: New Brunswick Health Council 2023; CTV, CBC).
- New Brunswick cities comparatively with a primary health care provider – Fredericton 68%, Saint John 86% and Miramichi 95% (source: New Brunswick Health Council 2023)
- 45% or 48 of the 106 active family physicians in the Fredericton area are 50 years plus (source: New Brunswick Medical Society August 2024)
- Fredericton is among Canada’s top-10 fastest growing CMAs between 2022 and 2023 (source: Statistics Canada May 2024)
- Fredericton Census Metropolitan area’s population increased to 119,059 in 2023, up 4,543, compared to 2022 — capturing 63%+ of metro growth over 12 months.
- Fredericton City’s population within the pre-annexation boundaries on July 1, 2023 increased to 69,406, up 2,878 residents (+4.3%) from 12 months previous. This is triple the annual population growth forecasted in the City’s Imagine Fredericton Growth Strategy.
When asked the question – “Does Fredericton have the appropriate health care infrastructure of a modern and growing city?” – you refreshingly and directly answered, “No”. The Fredericton Chamber of Commerce resoundingly agrees with your answer. As you continued to explain “access is the number one issue”, we fully support meaningful access for both health care workers and Fredericton residents as a starting point. This access was further clarified through discussions to address the glaring needs via potential system reforms, increased communication, and infrastructure renewal, meaning tools, technology and adequate spaces, to assure our medical professionals have access to the industry standards they require to care for their patients.
Dr. Hauman provided insight, on behalf of her many collages, to explain that physicians of Fredericton do not have the tools to provide the care that they know people need. There is also a long standing, and glaring, need our medical professionals to have an avenue for direct input into clinical policy decisions.
We respectfully ask that you meet with relevant stakeholders to identify and prioritize Fredericton’s healthcare infrastructure needs and create an action plan to fill those needs as quickly as possible.
We ask that a needs assessment be conducted for the City of Fredericton to determine current requirements for access to primary and urgent care (drop-in clinics, Collaborative Care clinics, etc.) to ensure we are reducing the number of Fredericton residents on the Patient Connect list.
Collaborative, Community Effort in Partnership with Educational Institutions
Identification of our unique strengths and resources was another key takeaway, as we in Fredericton can utilize our academic institutions, where research and data, new methods and social information can be applied to health issues and policies. Professor Edelman (School of Social Work) highlighted the long history of research supporting collaboration and interdisciplinary methods. The panel represented a subjective agreement, propelled by the existing objective research and data, that collaborative interdisciplinary clinics is an immediate step forward to address the modern needs of our city. This commitment to embrace current evidence driven norms, and industry standards, in our medical services should be the standard of service expected by our citizens, and our medical professionals.
As Mayor Rogers noted, “our systems have not adapted as we’ve grown”, but growth remains the answer as with “growth comes opportunity”. Fredericton is the knowledge capital of New Brunswick and in fact has the highest concentration of knowledge workers and companies in Atlantic Canada. We can be part of the solution, by supporting medical professionals, medical education programming, academic research and future collaborations like the ones started at Fredericton’s Health Care Summit.
This is an opportunity to bolster New Brunswick’s network of university-affiliated hospitals to attract and retain medical professionals to the Capital Region. We would like to see the Dr. Everett Chalmers Hospital designated as a university affiliated hospital through its Family Medicine Resident program with Dalhousie and Memorial – like the other provincial cities of Moncton, Saint John and Miramichi.
Given the criticality of access to primary healthcare, we ask you to further consider investing in medical education infrastructure here in Fredericton – like Nova Scotia has, specifically Cape Breton – to address root causes and expand medical education programming seats.
Jurisdictional Scan & DOH Strategic Alignment
In addition to the needs assessment previously proposed, we urge that the Department of Health’s Strategy and health networks’ work plans reflect the competitive landscape of physician recruitment with other provinces (i.e. Nova Scotia and Ontario) and jurisdictions that are aggressively recruiting our family medicine residents before their program completion.
We need to remain competitive in terms of salaries and signing bonuses, and specifically flexible contracting to meet the current needs of young family medicine residents (FMR). We are aware of losing a FMR earlier this year, because a flexible contract could not be curated and negotiated with the physician. This should never happen again.
Moving Forward
We write to you today to convey the message of Fredericton’s Health Care Summit, and express that Fredericton has and will continue to present a clear commitment to the rapid improvement of our health care services. We seek to work in collaboration and cooperation with your department and the province on the establishment of new integrated community health centres, and how they will be prioritized, located and measures of decision-making.
Our aligned health care advocacy fully supports the implementation of evidence-based policy decisions and incorporating the needs and first-hand knowledge of the dedicated medical professional from our community within clinical policy. We hope to meet again with your office as we move forward with action and impact and formally ask if you might present a time in the near future when we can meet with you to discuss proposed actions.
Together, a growing and healthy Fredericton, one which offers worldclass health care services to its residents, can grow its knowledge industry to further elevate the city, its business community and the region. The resulting growth of a healthy and livable Fredericton will benefit all New Brunswick.
Sincerely,
Morgan Peters, CEO, Fredericton Chamber of Commerce