When people talk healthcare, they usually talk about waiting times, funding cuts, scarcities of doctor/nurse resources, staff overloads, and flirtations with public/private healthcare delivery systems, accessibility, bed closures, quality of service, etc.

This week, I had the privilege of spending time at the Albert County Health and Wellness Centre in Riverside-Albert, New Brunswick, not as a patient but as a visitor. The Centre is part of Regional Health Authority-B. It provides rural communities in Albert County with primary healthcare services (illness/injury-prevention services and wellness programs), chronic disease management and community development services. The Centre serves about 4,000 people and is closely linked to the Moncton Hospital and the Provincial Ambulance service.

People who complain about waiting times in Moncton should move to Riverside-Albert. Waiting times in that community, on a bad day might be fifteen or twenty minutes. In Shediac, it takes an hour or more just to get a blood test. The Riverside-Albert Centre has two doctors, a nurse practitioner, nurses, X-ray technicians, an extra-mural team, a nutritionist, a physiotherapist, a physiotherapy gym, a food bank, an education centre and a bunch of other professional services. It used to be a sixteen bed hospital.

When the community lost its hospital about ten years ago, people in the community were concerned and agitated. There was a lot of opposition to the change but people have gradually come to realize that the combination of easy access to primary (daily care) in their community combined with quick access to state-of-the-art, acute care services in Moncton and Saint John gives them the best of two worlds. As one person told me "I'd rather go to Moncton or Saint John if I had a life-threatening situation than rely on an old time country doctor in a village hospital".

The primary focus of the Albert County Health and Wellness Centre is health promotion. Sure, they receive patients every day for diagnosis and minor treatments but perhaps, more importantly, they operate a very aggressive wellness program that involves members of the community in walking programs, diet management, stop-smoking programs, healthier eating programs and educational programs that teach people how to prepare healthier foods.

In a small province like New Brunswick, it seems to me that Riverside-Albert has figured out the real world. The high cost of technology and specialists is not affordable for small communities. It's hard to attract skilled doctors and nurses to communities where the technology is limited or not supported by professional staff. Community health centres overcome many of these issues. They reduce wait times and make healthcare more accessible. Based on my observations in Riverside-Albert, I think we need to be investing more in community health centres, improved ambulance services and trained paramedics. With better communication and province-wide access to primary care, we can improve the overall healthcare system.

The emotion of healthcare is usually found in "acute care" i.e. the necessary or essential treatment of a disease or the care rendered in an emergency department for car accident victims, disaster victims, heart attacks or other situations.

When people complain about the healthcare system, they are usually complaining about wait times, not the quality of care. A significant part of the wait-time crunch is caused by patients who routinely show up at hospital emergency departments for less-than-acute care treatment, rather than going to family doctors, clinics or community health centres. In some cases, this is because they don't have a family doctor. Often, it is because the doctor's office is closed for the night but the fact remains that over-crowding and wait-times makes it difficult for hospital emergency departments to focus on patients who present with true emergencies.

Primary health care focuses on health promotion, illness/injury prevention and the diagnosis and treatment of minor illness and injuries. Primary healthcare includes everything that plays a part in good health from housing to nutrition, from exercise to good food, from education to the environment, from early diagnosis to proper treatment. Primary health care is offered by family physicians, nurse practitioners, dieticians, physical trainers, health information lines, local pharmacists and others.

New Brunswick is a small population province. We cannot afford to have state-of-the-art hospitals in every town and village in the Province. It makes sense to house acute care facilities and expertise in the larger centres where they can be staffed by the best in the medical profession and equipped with the latest technology and equipment.

High tech medical centres connected to a province-wide network of regional hospitals and community health centres by quick-response paramedic/ambulance services and a state-of-the-art communications system is clearly the way to go. If the Riverside-Albert Health and Wellness Centre is a model for the future, I say bring it on.

W.E. (Bill) Belliveau is a Shediac resident and Moncton business consultant. He can be contacted at bill.bellstrategic@nb.aibn.com