Advocate says New Brunswick's social policy process is broken

New Brunswick's child, youth and seniors' advocate has issued a sweeping and scathing denunciation of how the provincial government runs social programs, saying the system is fixated on following rules rather than achieving results.

Kelly Lamrock traces the problem back three decades and blames it for what he calls the "breaking down" of a range of services in such areas as health care, social development and education.

He decided to write the 49-page report while working on a review of the long-term-care sector.

What he found during that work convinced him there was a bigger picture to examine beyond the normal scope of his mandate.

"The failings in long-term care are also the failings in how New Brunswick social programs have been governed," Lamrock writes.

"The programs can only be fixed by fixing flaws with general government. The centre of government cannot order a department to fix the problem when the centre is a large part of the problem."

He told CBC's Information Morning Fredericton he produced the report out of frustration.

"I'm frustrated because it doesn't have to be this way," he said.

"We've got to have an urgency about solving problems instead of an urgency about going through the motions."

The report lists several examples across a number of departments where program goals were not set out, from housing incentives and First Nations mental health programs to child protection services and school-based behaviour mentors.

The child protection service was one of the programs Lamrock called out in his report. (Shutterstock)

Meanwhile, front-line employees lack the flexibility to adapt to the needs of the people looking for help, because those employees are forced to stick to rigid rules.

Lamrock writes that when he asked the finance department how it came up with its budget for moving seniors stranded in hospitals to long-term care, and how many transfers it aimed to do with the money, officials "could not provide us with any of that."

"The department of finance did not even think to check if the waitlist numbers were getting better or worse, even though those numbers were knowable," says Lamrock, who eventually obtained the figures from the Department of Social Development.

"This is precisely what we mean by the disconnect between the budget process and the actual results that impact New Brunswickers."

Another example he points to is the lack of any forecast of how many children will need the services of school psychologists — a workforce plagued with shortages — in the coming years.

Lamrock's report said there is a disconnect between the budget process and what New Brunswickers see day to day. (Guy LeBlanc/Radio-Canada)

"You would think that, if you asked those questions, there would be an answer. And in New Brunswick, you would be wrong," he says.

The report urges the government to split the Executive Council Office and the Finance Department — which now share a deputy minister — into two distinct units, with a new social policy branch in the mix to promote a focus on needs and goals, not budget lines.

Lamrock's conclusions are so blunt that his report includes a short appendix addressing civil servants and underscoring that he is not attacking them.

"It's just my job to try to get your attention when the people who need all this to work can't," he says.

Lamrock, a Liberal cabinet minister from 2006 to 2010 who was appointed advocate by Premier Blaine Higgs in 2021, is careful in the report to not blame any single government for the problem.

He traces its origins back to the Frank McKenna Liberal government and its focus on reining in program spending in an effort to balance the budget.

The government took the credit for good fiscal results, and "the buck was passed on" to health authorities, hospitals, school districts and others to deal with the consequences.

That approach "infested" the civil service and has not changed, Lamrock says.

"We are trying to get a bureaucracy built for 1994 to solve the challenges of 2024," he writes.

Lamrock's report traces issued back to the Liberal government of Frank McKenna in the 1990s. (Chris Young/CP)

"If the effect seems about as effective as trying to pump up a high school dance today with the Macarena, that's because the time lag is every bit as dramatic."

While sound budgeting and fiscal management are important, Lamrock argues the flawed dynamic often cost taxpayers more in the long run, forcing governments to spend unplanned amounts of money to fix a problem they might have avoided in the first place.

"A failure to train enough nurses will eventually lead to overpaying for travel nurses in numbers suspiciously close to the original training shortfall," he says.

That is a reference to the controversy over the health-care system's use of contracts with private travel-nurse agencies.

New Brunswick's auditor general confirmed this week he plans to investigate what led to the contracts being signed and whether they represent good value for taxpayer dollars.

The decision followed reporting by the Globe and Mail that agencies such as Toronto-based Canadian Health Labs have charged rates of more than $300 an hour, roughly six times what a local staff nurse earns.

The Vitalité Health Network alone spent about $158 million to hire out-of-province nurses in 2022-23, contracts obtained by the newspaper revealed.

Lamrock linked previous failures from the provincial government as leading to the highly criticized move by Vitalité Health Network to hire travel nurses through agencies that sometimes charged more than $300 per hour. (CBC)

Lamrock's report also slams external consultants, including the Arthur Andersen company, the global accounting firm he blames for a policy that said two people on welfare could not live together to pool their money without having some of their benefits clawed back.

The rule, repealed in 2022, was "one of the stupidest, most self-defeating pieces of policy ever dreamed up by a consultant," he says.

Another system adopted by the province, Lean Six Sigma, promoted uniform, centralized approaches to programs at the expense of flexibility, Lamrock says.

That model is more appropriate for the manufacturing sector than social policy, he adds.

"We only hold people accountable for: did you follow the rules? And if people get hurt, that doesn't matter," he said in the interview.