In Brief: New Brunswick has announced it is replacing its eight health care authorities with two. AIMS acting President Charles Cirtwill welcomes the move as the new structure provides better ccountability and transparency.
FREDERICTON – When introducing sweeping structural changes to the health care system — reducing the number of regional health authorities from eight to two — Health Minister Mike Murphy declared the changes would go far in ending unhealthy competition between the various regions.
He has also consistently referred to the eight regional health authorities as operating in “silos.”
Yet Murphy has said a number of executives will find a place within the new system.
But are officials, who have dedicated years of service to a particular facility or region, able to make those changes?
“They better be — if they can’t, fire them,” said Charles Cirtwill, acting president of the Atlantic Institute for Market Studies. “It’s pretty straightforward. Unfortunately it never really turns out that way, in the public service in particular, but the simple fact of the matter is that they are being kept on or hired to do a job and if they can’t do it, or won’t do it, they need to be replaced.”
All CEOs of the soon-to-be-dismantled eight regional health authorities have been offered jobs within the new structure.
Although half of the more than 50 vice-president positions will be eliminated, others will likely find positions within the two regional health authorities or newly created New Brunswick Health Council.
That means individuals who sometimes found themselves competing for scarce health care dollars and infrastructure will have to set aside loyalties to their former institutions and work cooperatively.
Murphy has said many of the members on the former health authority boards are prime candidates for the newly-created positions.
Meanwhile, former colleagues might find themselves reporting to one of their peers.
Mergers of private companies have proved that significant changes in leadership can cause some friction within a new organization.
“One of the biggest shortfalls of mergers is that they don’t take the time to figure out how they’re going to recalibrate the team and make sure that everybody is now sort of pulling in the right direction,” said Bill Robertson, president of the New Brunswick-based consulting company Rethink Inc. “If you don’t do that, you get these sort of empire-building events that occur and they can be very, very disruptive.”
For example, if two businesses merge, one of the executives will typically accept a retirement or lay-off package in order to avoid such scenarios, said Robertson.
As the changes to the health system unfold, a clear roadmap outlining the direction of the new structure will need to be developed, he said.
Although structural changes often look good in the planning stages, they often end up testing leadership skills, he added.
“This will be a real test of the leadership skills, there’s no question about that,” Robertson said. “The real test won’t come immediately”¦because it will still be new and exciting. The real test will be after that initial romancing phase is over.”
All CEOs at the eight health authorities have been instructed not to comment on the structural changes.
Two regional health authorities — located in Bathurst and Miramichi — will replace the eight authorities that were serving the province.
The two new health authorities are divided along linguistic lines.
Regional Health Authority A — which will serve the hospitals previously administered by the Beauséjour, Edmundston, Campbellton and Bathurst health authorities — will be based in Bathurst.
Regional Health Authority B — which will serve the hospitals previously administered by the South-East, Saint John, Fredericton and Miramichi health authorities — will be based in Miramichi.
Each health authority will be served by boards each consisting of 17 appointed members.
Donn Peters, former CEO of the South-East Regional Health Authority, is the new CEO for Regional Health Authority B.
Andrée Robichaud, a former assistant deputy minister of health, is the new CEO for Regional Health Authority A.
Murphy said he doesn’t think any of the employees will have difficulties adjusting to the new system as they have worked together on various committees.
“The former CEOs who are taking a place in the new health care system are extremely professional individuals and they’ll be working with their former colleagues as CEOs and they’ll be reporting to some,” he said.
The key to making the transition work is a common focus on the goal of improving patient services, said David Wheeler, dean of management at Dalhousie University.
“If these are people who are more driven and ambitious and see their personal purpose as heading an organization and not stepping back from heading an organization, then it will be very problematic for them,” he said.
However, if the individuals are likely to share the same social network, significant changes in leadership are easier to navigate, added Wheeler.
“If you’ve taken over a newly-amalgamated entity you don’t want any ambiguity over who’s in charge,” he said. “There are certain politics here that become important and need to be addressed.”
Andrew Gaudes, director of graduate studies at the faculty of business administration at the University of New Brunswick, said it’s not unusual for individuals to feel some resentment if they suddenly find themselves reporting to a former colleague.
But there are benefits to introducing structural changes in leadership, he added.
“If the intent is to serve the end-user better, that should, for some intensive purposes, soften the blow of seeing some move into higher areas of an organization,” said Gaudes.
“Any organizational change, especially structural change, takes time.” It’s unclear how many jobs will be lost when the new health authorities and the health council are in operation by Sept. 1.
The new CEOs will determine how many employees are needed for the two regional health authorities and council and present a plan to government.
It’s also unknown what impact the new public company to administer non-clinical services such as payroll and laundry will have on job losses.
That change is expected to save about $20 million annually within the next five years.
The health department has stated the salaries of the new employees have yet to be finalized, although the details are expected to be released in April, meaning it’s unknown whether any official will see their pay increase or decrease.