An external review into Central Health has found that the major hospitals in Gander and Grand Falls-Windsor need to find a way to get along for better health care in Central Newfoundland.
Dr. Peter Vaughn, a former health executive from Nova Scotia, released his findings on Thursday, May 17, showing a "rivalry" between the towns has been interfering with the performance of the larger health authority.
"Rivalry among communities is a fact of life in Canada. Such rivalry, however, can impair the success of regional boards to achieve their policy objectives and better health outcomes for their populations," Vaughn wrote in his report. "If the current model is maintained, incentives to encourage municipal collaboration could facilitate a more regional approach."
The corporate offices of the authority are located at the Central Newfoundland Regional Health Centre in Grand Falls-Windsor, while the bulk of senior staff work out of Gander at the James Paton Memorial Regional Health Centre.
The report recommends a redistribution of executive around the region, to help with both the rivalry and the delivery of health care.
"Silos and rivalries between the two referral facilities have perpetuated an 'us against them' mentality the board and senior management have been unable to resolve," Vaughn wrote. "In some ways, the current governance structure only serves to perpetuate and exacerbate an unhealthy long-standing rivalry."
Health Minister and Gander MHA John Haggie says there is lots of work to do to act on the report's findings.
"I think those are challenges that the community writ large and represented by the municipal government are going to have to address," said Haggie.
"Really, honestly, as minister, I can do so much in the department. As a CEO or a board chair, you can do so much through the board system and management staff, but in terms of difficulties between communities that live near each other, it's a wiser man than I that can come up with a recommendation."
A committee will be struck in the government and with the board of directors in Central Health to determine how to best implement the report's 32 recommendations.
Haggie says there's no timeline in place for the implementation of all the changes, but it's a priority for everyone involved.
Central Health is also looking to hire a new CEO after the sudden resignation of Rosemarie Goodyear in February. Louise Jones has been serving as interim CEO until a permanent replacement is found.
The new CEO will be appointed through the Independent Appointments Commission.
Haggie says while there's change in the organization, that could prove advantageous to a new CEO, who will be able to guide the authority through it all.
"I would say it's a good reason to bring a new CEO in at this point. The new CEO, with a skillset that matches the requirements of a CEO and a change manager, can be able to help steer the board, advise the board, and steer management in the direction that he or she decides," said Haggie.
Central Health’s Board of Trustees and Senior Leadership have received the external review report and recommendations.
In an issued statement by Central Health suggests, members of the board “look forward to working with the implementation committee to address the report’s recommendations.”
Local reaction
Vaughn founded his recommendations on meeting with 115 individuals and groups, and receiving 178 confidential emails over the course of two months – March and April.
The Gander and Area Chamber of Commerce was one of the groups to meet with him. President and CEO Hazel Bishop is pleased with the outcome.
She called it strong start to bringing about change.
The Chamber had brought forward concerns about senior management, the board of directors, the atmosphere at James Paton, obstetrical shortages and a loss of doctors.
“We feel it has been addressed in this report, and we are looking forward to working in collaboration with Central Health as they move to implement the recommendations,” she said.
Bishop has noticed the division between two health centres, as well.
She said Vaughn’s recommendation for management positions to be split between the two heath centres can help bring about balance.
Gander Mayor Percy Farwell too sees the benefits of having a senior management presence at both locations as well.
“The concerns staff and physicians have about being disengaged from management is perpetuated by never seeing someone from senior management outside of a prearranged tour once in a blue moon,” he said. “The relationship between physicians and management is probably closer in Grand Falls-Windsor because they are there, creating more opportunity for interaction.
“That’s a good thing, that’s what should happen, but it’s just not happening in Gander.”
He’s also pleased with the recommendation for more community engagement, as it could create an opportunity for local input, something Farwell said wasn’t an option in the past.
“When you have no input, no familiarity, no feeling of influence of how things are done, even though you represent a large portion of the authority’s population, you certainly feel one has an advantage over you,” he said.
The recommendations, he said, pointed to a broken system.
“The objective now is to get it fixed, to offer the best service to the people of the central region,” he said. “I’m happy to see a number of recommendations, if implemented, I think it will improve things.
Both Farwell and Bishop say they will play their part in keeping provincial government accountable in seeing the recommendations implement.
- With files from Adam Randell
Five recommendations highlighted by Gander groups
• Locate senior management offices equally between Central Newfoundland Regional Health Centre and James Paton Memorial Regional Health Centre.
• Medical bylaw changes are required to remove CEO as final authority for approval of credentialing and privileging of physicians. It should be the board's responsibility.
• Amend board bylaw to open meetings to be public beyond the annual meeting.
• There should be a full-time vice-president of Medicine for the Regional Health Authority.
• The Board develop a communication strategy a) internally for staff, and b) externally with communities to increase transparency of the board decision making process.
Source: Central Regional Integrated Health Authority External Review
