New Brunswick

Call from premier led Horizon CEO to push Ambulance N.B. to break the rules, leaked audio shows

Margaret Melanson heard asking a dispatcher to move a patientfrom his Fredericton home to Saint John hospital

Posted: December 21, 2022

Leaked audio from a dispatch call is offering new insight into how Premier Blaine Higgs pushed the head of Horizon Health Network to personally intervene in the medical treatment of a man who was in a motorcycle crash in Fredericton last summer.

In the audio file obtained by CBC News, Margaret Melanson, CEO of Horizon Health, can be heard asking an Ambulance New Brunswick dispatcher to break the service's own policy by transporting a patient from his home in Fredericton to the Saint John Regional Hospital.

The incident, which happened on a Saturday evening in July, raises new questions about Higgs who that summer had fired the chief executive of Horizon and his role in the health-care system. 

On the evening of July 30, Melanson called Ambulance N.B.'s dispatch service to say she had a "problem" she needed help solving.

A patient in Fredericton needed to get to the Saint John Regional Hospital, and Melanson said on the call she wanted him taken there by ambulance from his home.

"I know that's not your protocol to go straight there," said Melanson.

She added that Higgs was "upset."

WATCH | Leaked audio from Ambulance N.B. dispatch shows political interference:  

Ambulance N.B.'s policy, however, is that patients be transported to the nearest hospital, the dispatcher replied.

"Yeah and you see, this is the problem. This is a political issue," said Melanson in response.

"The patient won't go back to the [Dr. Everett Chalmers Regional Hospital]. I'll tell you I've got the premier calling me, I've gotta get this guy to Saint John."

John Barnet confirmed to CBC News that he was the patient Melanson described in the dispatch call.

In the days leading up to that call, his family was demanding answers after he was sent home from the Chalmers hospital after receiving six hours of care for a broken neck and sternum he sustained in a motorcycle crash on July 26. His family said Barnet should have been admitted.

Following those complaints, Nancy Barnet, Barnet's mother, received a call from Higgs and then a call from Melanson, who arranged to have a doctor examine him at home and to later have him taken by ambulance to a hospital in Saint John.

DOCUMENT | Read a transcript of Margaret Melanson calling an Ambulance N.B. dispatcher: 

However, until the audio of the dispatch call was leaked to CBC News, it wasn't known that Higgs had called Melanson personally about the case.

The leaked audio, along with a transcript of the call obtained through the province's Right to Information and Protection of Privacy Act, offer new insight into how Higgs personally intervened in the health-care system by asking the head of a health authority to take a closer look at the case.

In an interview with CBC News, Higgs admitted he called Melanson, but said he didn't give her specific orders around having him sent to Saint John by ambulance.

'I wanted to understand more': Higgs

Higgs said he spoke to Barnet's parents, and then decided to call Melanson to learn more about the case and whether anything more could be done.

"I wanted to understand more so then I did call Margaret Melanson, and and just said 'Do you know any details on this ... is there something more needed?" Higgs said.

"So for me, whether the individual was transferred or not transferred, or assessed, Margaret Melanson is in a much better position to do that than I.

"And so it would be her call where to go from there, and all I wanted was an explanation that I could share with the parents based on their, their real life concern."

Horizon Health didn't provide an interview with Melanson, but in a statement to CBC News, she confirmed she spoke to Higgs.

"And the Premier did ask me to look into the matter of a patient," Melanson said.

"I then spoke with the patient's partner on the night of July 30, 2022, as I was concerned about the patient's health."

• After more hospital complaints, Higgs gets involved in health-care system again

• Family demands answers after Fredericton ER sends man home hours after he broke neck

Melanson said based on those concerns, she consulted Horizon's vice president of medical, academic and research affairs, who recommended the patient be treated at the Saint John Regional Hospital, to which the patient's partner agreed.

CBC News also requested an interview with Ambulance N.B. CEO Richard Losier about the dispatch call from Melanson.

In an emailed statement, Ambulance N.B. spokesperson Christianna Williston said while it cannot comment on specific cases, the company is committed to providing the best possible patient care.

Action undermines health authority: expert

"There are many factors that go into care decisions, and we will continue to work with our partners to put the best interests of our patients at the heart of everything we do," Williston said.

It was the 1990s when Canadian provincial governments established separate health authorities tasked with directly managing the provision of health care, said Katherine Fierlbeck, chair of Dalhousie University's department of political science.

It created the separation between the provincial department "steering" the system, versus the health authorities doing the "rowing," she said.

With that, the health authorities were to enjoy a level of autonomy in their daily operations, she said.

"If the principle of having a health authority is that it does look after the day-to-day running of the health-care system, then what the heck is the premier doing shouldering his way into the discussion and micromanaging the situation, right?" she said.

"Either he has confidence in his appointees or he does not."

'My job to question' those in authority: Higgs

Last summer, Higgs made sweeping changes to the province's two health authorities by firing the CEO of Horizon Health Network and replacing the board of directors of both Horizon and Vitalit with a single trustee each.

He also replaced the minister of health, all in direct response to the death of a patient in the Chalmers hospital's ER waiting room.

At the time those changes were announced in July, Higgs noted it was up to him to ensure the right people were in the positions to run the health authorities, but that it wasn't up to him to run them.

However, speaking to CBC News, Higgs said as premier, the "buck stops" with him, and that it's up to him to question the decisions of the leaders of the health authorities.

"That is my job to question those that are are more, let's say, knowledgeable than I on specific issues and and say OK, well this doesn't necessarily make sense to, to the public or to me," he said.