Due to a lack of funding, Fredericton’s Clinic 554 is up for sale. If it sells, about 3,000 New Brunswickers will be out of a doctor within 90 days—which is a problem since they’ll have to join about 20,000 other people on a waitlist for a family doctor. Those not on a GP’s patient roster are forced to rely on the ER, which adds a layer of time and hassle for patients, not to mention the lack of personal connection with a physician. As well as being the only clinic in the province that provides surgical abortions, Clinic 554 provides general and sexual healthcare services, and about a third of the clinic’s patients are queer or trans since Dr. Adrian Edgar, the clinic’s doctor, specializes in providing medical care to this community.
Tadhg Saxa, of the advocacy campaign Save Clinic 554, asked Horizon Health (the provincial health authority) at a recent board meeting whether it would support the clinic through the crisis and how it would help the patients if the clinic ends up closing. Horizon Health CEO Karen McGrath told Saxa that the authority would work to support the clinic and its patients. “Certainly, we’re prepared to talk to Dr. Edgar and any other advocates in terms of collaboration,” said McGrath.
This came as welcome news for the Save Clinic 554 folks, who thanked Horizon after the meeting. But this kind of support is new for the clinic. New Brunswick Premier Blaine Higgs has avoided addressing this issue in the past, and he again refused to talk about changing the funding setup after Horizon’s board of directors forwarded a motion last week urging him to look at how these services can be better provided.
However, Higgs tells FLARE that while the government has not discussed funding abortions at the clinic or repealing the legal restrictions that prevent them from being funded, he is open to having discussions with the clinic’s doctor and advocates about the situation going forward.
“I’ll sit down with anyone,” he says. “I would also include the Minister of Health. I want the appropriate ministers and departments to be involved in these discussions so we’re not going around each other, but I wouldn’t treat Dr. Edgar any differently than I would anyone else.”
“Save the clinic” has long been a rallying cry in Fredericton: Clinic 554 has struggled with funding for many years. Formerly the Morgentaler Clinic, it closed down once before due to a lack of funds and was reopened with money raised by community activists—mostly women and trans folks.
The only other places to get a surgical abortion in New Brunswick are three hospitals: two in Moncton and one in Bathurst, municipalities located in the southeast and the northeast of the province, respectively. For many rural patients who live outside these areas, the service is difficult to access. And after a pregnancy has passed the 13 weeks and six days mark, the service can no longer be accessed in hospitals. Patients whose pregnancies are past this point, who cannot travel to these hospitals or who feel more comfortable with queer-informed clinic care have historically gone to Clinic 554, where surgical abortions are performed up until 15 weeks and six days gestation. Patients from PEI travel to N.B. to access these services too.
According to the National Abortion Federation, the state of abortion access in New Brunswick is in violation of the Canada Health Act, even with the clinic open, because patients (or caregivers) are forced to cover the cost. In its own 2017–2018 report, Health Canada called the situation “a concern under the accessibility and comprehensiveness criteria of the CHA.” In order for abortion to be funded, the province would need to repeal Schedule 2 of regulation 84-20, a pre-Morgentaler piece of the law preventing abortions from being covered outside of hospitals.
The government before Higgs’ took steps to address the limited access to abortion services by providing Medicare-funded Mifegymiso, pills that bring on what’s called a “medical abortion.” But even these are hard to access at times, according to advocates, because while the province covers the cost of the pills themselves, it does not cover the time for physicians who bill per service, meaning only people on salary, like nurse practitioners, are providing this type of abortion with any frequency.
[Beth Lyons, executive director of the New Brunswick Women’s Council, reached out to FLARE after this piece was posted. Physicians, Lyons says, who are not receiving a salary are in fact able to bill the province for the time they spend with patients having medical abortions. However, Clinic 554 has criticisms of both the structure and value of the fee they can bill.]
Reproductive Justice N.B., a Fredericton-based activist group that calls for fair and equitable access to reproductive healthcare in the province, has been tagging politicians in calls for attention to the issue, but, they say, both Premier Higgs and Health Minister Ted Flemming have been untagging themselves in the posts. (“What we have removed are spam,” said Nicolle Carlin, a spokesperson for the premier’s office.) Despite this, Higgs tells FLARE, “I’m not aware of a request for a meeting.” As for Schedule 2 of regulation 84-20, he says, “It hasn’t been presented to me at this point as something that we need to look at changing. I haven’t had any discussions in relation to this as a concern, as an issue.”
Jessi Taylor, a spokesperson with Reproductive Justice N.B., told FLARE that Save Clinic 554 still hasn’t heard anything from the government. “We’ve had an alarming and really deafening silence from the Department of Health on the issue of Clinic 554 closing, which should be considered a crisis issue and given an immediate response,” they said.
“I have tried to meet with our premier, our health minister, the board of directors for our health authority, Horizon, and the Department of Health to no avail,” said Edgar in a statement after it was announced that the clinic was for sale.
Higgs says that, for now, the government plans to keep operating the way others have in the past: Surgical abortions will continue to be available in Moncton and Bathurst, and the clinic will remain unfunded. The clinic, adds Higgs, is private, and the government doesn’t fund private clinics.
Taylor says this doesn’t make sense. “The government of New Brunswick—both this one and the last—keeps using this line about not funding private healthcare. This is bizarre because if you fund it, it stops being private,” says Taylor, pointing out that the practice is actually a family clinic—with the exception of abortions, its services are covered by Medicare, just as they are at other clinics. “It’s a line used to make it sound like they’re nobly resisting two-tier systems. So some have access through luck or privilege, and some don’t.”
So far, there hasn’t been any openness to discussion from the Department of Health. New Brunswick’s health minister Ted Flemming didn’t respond to FLARE’s requests for comment. Department spokesperson Alysha Elliott reiterated Higgs’ statement that the province does not fund private clinics.
Higgs provides some hope, though, when asked about whether the government would talk about repealing 84-20, saying “Maybe it will be something that will come in the future.” It’s a tone that, so far, has not existed in conversations with government about the clinic. Prime Minister Trudeau has promised that, if these conversations do not happen, he will sit down with Higgs and work on solving the problem.
If the government does decide to sit down with the community to talk about how the clinic can be saved, says Taylor, it’ll take a lot of public support. “Saving the clinic means we need political will, which means we need more people contacting government officials and we need more people showing their support for the clinic,” says Taylor. “We need to not buy into easy stories, like that this only affects a couple of people or that we need to substitute or choose certain kinds of services over others. We’re all suffering here and we need to be in it together.”