DECH control threatens rural care, hospital’s future – Dr. Bill Goodine
Dr. Bill Goodine has worked behind the scenes for nearly two years, trying to help ‘fix’ problems with surgical scheduling and staffing at the Upper River Valley Hospital (URVH) in Waterville.
The respected ophthalmologist has served patients in the region for 37 years and is set to retire in June 2026.
“When the issues with our surgical department were first brought to my attention, I was suspicious,” Goodine told the River Valley Sun.
He said the hospital’s problems began when orthopedic surgeries started being performed in Waterville’s OR.
“It was a good thing,” admitted Goodine. “We were getting rid of a (provincial) backlog, our staff welcomed them with open arms, and the surgical theatre was busy and productive. But within six months, more extensive changes were planned for the OR schedule and our two local surgeons advised against those. They felt those changes would prevent them from fulfilling the mission of their department, which is to provide quality, general surgical services in a timely manner to the Upper River Valley.”
Dr. Gurpreet Singh Ranger then resigned as Chief of Staff, and Horizon later removed him from the position of head of surgery. Someone from Fredericton replaced him.
“Over time, our local OR head nurse position as well as our booking clerk positions were eliminated,” said Goodine. “This means someone in Fredericton really makes all decisions regarding the day-to-day operations of the OR. The problem is overzealous administrator physicians from Fredericton,” he said. “They believe they have not only the right, but the moral obligation to impose changes on our Department of Surgery that THEY think are necessary.”
When his internal inquiries didn’t yield meaningful results, Goodine took his concerns to Woodstock-Hartland MLA and provincial health critic Bill Hogan, who has since been working with local mayors to pressure Horizon Health.
“They’ve lost most of their experienced surgical nurses because of the state of affairs there,” said Hogan. “Everything is being run out of Fredericton. We are losing local control. I don’t think this is the best model.”
The MLA fears that if the URVH doesn’t maintain control and loses any medical services, recruitment will face even greater challenges.
“We have issues now. We lost a surgeon a year ago, and there have been no advertisements for that position. It feels like they are actively trying to reduce surgical capacity,” said Hogan. “Why else would you not advertise for a surgeon when we are missing one?”
Goodine sees this as an issue of urban doctors trying to run a rural facility without understanding how their rural team operates.
“They insist that any department as small as ours is, by its very nature, inefficient and, more importantly, unsustainable. We’ve done this for years. We know how things work best, but they don’t think we do.”
Goodine and other medical staff are worried that Horizon Health will eventually turn the URVH into a glorified clinic, with day surgeries that don’t require overnight stays, and no surgeons on call, which threatens the ER and obstetrics.
Other doctors, who don’t want to be named for fear of repercussions, say morale is at an all-time low, while frustration levels are at an all-time high.
“Accordingly, our nurses and doctors who know what it takes to run a rural surgical service were ignored while urban administrators were given free rein to ‘improve the system,'” said Goodine.
He added that the administrator’s efforts did little to improve anything.
“These ‘so-called’ improvements have had a major destabilizing effect on our department of surgery. They basically pushed out a surgeon more than a year ago, and since then, there have been no recruitment efforts. Nothing has been posted to fill that position by Horizon. Dr. Singh Ranger is working alone, again, which is problematic,” said Goodine.
After nearly two years of diplomacy with no results, Goodine said it was time to reach out to the media. At a recent staff meeting, he asked if anyone had any objections to his speaking to reporters.
“Radio silence. No one objected. It’s safe to say I have the backing of our medical staff,” said Goodine.
Dr. Lyndsay Lovely has been an anesthetist at the URVH since July 2021 and is currently the Chief of the Anesthesia Department. She turned down our request for an interview but sent a written statement.
“The Operating Room at URVH has faced a multitude of challenges over the past two years. What concerns me most is the unprecedented number of long-term, highly skilled nursing staff leaving the OR. The uncertainties surrounding the future of surgical services at URVH have created significant instability within our department, adversely affecting morale and confidence in leadership. The increased pressures on the remaining nursing staff, coupled with the elimination of many essential nursing, nursing leadership and clerical positions at URVH, have contributed to excessive workload and stress for our nurses. This is not sustainable.”
Lovely went on to praise the staff she works with.
“Nurses are the foundation of our OR. The viability of surgical, obstetric and anesthesia services at URVH are largely dependent on the immediate action to provide our remaining nurses the resources and support they need and deserve.”
The River Valley Sun requested an interview with Horizon Health CEO Margaret Melanson. She was not made available, but we received a written response from Dr. Susan Brien, Senior Vice President, Medical, Academic, and Research Affairs.
“Horizon remains committed to providing safe, high-quality care to patients in the Upper River Valley area. Like many other health care organizations across Canada, we continually evaluate our service delivery models to ensure we’re providing the best possible care with available resources while adapting to advances in medical practice.”
She went on to explain that Horizon is examining ways to expand outpatient day-surgery models, and that any changes will be made “thoughtfully, with patient care and safety as our primary consideration.”
On Dec. 5, physicians who work out of Fredericton and Upper River Valley facilities received an email from Dr. Ash McLellan, Horizon’s Senior Medical Executive Director. The River Valley Sun obtained a copy.
In his correspondence, Dr. McLellan said he wanted to provide “clarity on the status of surgical services at Upper River Valley Hospital (URVH),” noting staff may see the issue in the local media in the coming days, and he wanted to ensure his staff had “accurate information.”
“Like all services across Horizon, we have a responsibility to continuously examine options that ensure safe, high-quality care for patients in the Upper River Valley area and reflect our staffing realities,” wrote McLellan. “Any potential changes regarding surgical services in the future would be made thoughtfully, with patient safety as our primary consideration, and in consultation with our clinical teams.”
When asked about McLellan’s letter, Goodine let out a big sigh.
“It’s corporate double-speak to hide the truth,” he said, adding that breaking his silence is a last-ditch effort to save the services at the Upper River Valley Hospital.
“I want to educate the public, not so they forget about it, but so they make a choice and organize an effective opposition to these changes. I am asking the public to become engaged on this issue and do it now. Don’t wait for your neighbour to do it. Write letters to the premier, talk to your MLA, reach out to the (Horizon) board of directors, hold public rallies,” said Goodine. “Without that, it seems likely we’ll lose our hospital as an acute care facility. Our medical staff believe if these changes go through, this is what’s going to happen.”
