Horizon Health CEO Warns of Surgery Delays Amid Bed Crisis

The CEO of Horizon Health has issued a stark warning about the escalating crisis involving patients requiring alternative levels of care (ALC) in New Brunswick. According to Margaret Melanson, ALC patients currently occupy 40 percent of Horizon’s hospital beds, significantly impacting the ability to schedule surgeries. This situation, she stated, poses the greatest challenge to emergency departments across the province.

During a meeting with the legislature’s public accounts committee, Melanson emphasized the urgent need for systemic change, stating, “Without urgent systemic change, these challenges will only continue, and possibly worsen.” ALC patients are those who do not require hospital care but remain admitted due to the unavailability of nursing home spaces.

The crisis is not new; Melanson previously raised concerns to the committee in October 2023. At that time, she proposed reallocating part of her budget to create more long-term care spaces, but no actions have been taken since. The Holt government, which took office in 2022, has yet to announce any new nursing home developments.

As of last month, Premier Susan Holt reported that 1,076 individuals are waiting for nursing home placements, with about half of them classified as ALC patients. The absence of new nursing home plans exacerbates the issue, leading to overcrowded emergency departments. Currently, the average wait time for a patient with urgent needs to be seen in emergency is 231 minutes, far exceeding the recommended 30 minutes. Furthermore, patients in emergency departments are waiting an average of 18 hours for an inpatient bed.

The situation has led to significant delays in patient care. Melanson warned that if the crisis continues, it may soon start to affect surgical schedules. “We have tried our best, and our teams work tirelessly daily to see surgical care proceed, despite these bed challenges,” she explained. “That is not indefinite. We will have surgical interruptions because we will not have any other places to put patients.”

In response to the crisis, Holt stated last year that her government is implementing measures to improve the situation, including expanding home care services and the Nursing Home Without Walls initiative. However, there has been no mention of building additional nursing home beds to alleviate the waiting list.

Melanson expressed cautious optimism regarding an upcoming long-term care plan from the government. A recent document from the Liberals suggests the potential for “shifting beds from hospitals to long-term care facilities to provide the required care in a more appropriate setting, at a lower cost.”

In a bid to address the immediate crisis, Horizon is expanding an initiative launched at Moncton Hospital. This program aims to transfer ALC patients to the first available nursing home bed within a 100-kilometer radius, regardless of patient preferences. While the province has agreed to coordinate this effort at other Horizon facilities, the lack of available beds has hindered progress.

During the committee meeting, MLAs focused on various issues beyond ALC patients, including the rollout of collaborative care clinics. Sam Johnston, a Liberal MLA from Miramichi Bay-Neguac, acknowledged the challenges within New Brunswick’s health care system, stating, “There most definitely is.” He commended the government for developing innovative approaches to tackle these complex issues.

The ongoing crisis in New Brunswick’s health care system raises critical questions about the future of patient care and the government’s commitment to addressing the needs of its most vulnerable citizens. As hospital capacity reaches a tipping point, the urgency for effective solutions has never been more apparent.