SYDNEY, N.S. -- Nova Scotia's premier was met by raucous heckling as he announced major changes Monday to health care delivery in Cape Breton, including the closure of two hospitals.
Stephen McNeil announced that Northside General Hospital in North Sydney, N.S., and New Waterford Consolidated Hospital will be closing, and two new community health centres and long-term care facilities will be built in their place.
McNeil was booed as he delivered his remarks over shouting audience members during a press conference in Sydney, N.S., but he defended his Liberal government's decision.
"I understand the anxiety for those of you in Northside and New Waterford. There's no question there's anxiety in those communities," said McNeil as someone could be heard yelling "shame."
"This is not about job loss. This is not about doing anything else than ensuring that we provide a modern health care system, where we can have access into that system."
The government said New Waterford Consolidated and Northside General have exceeded their lifespan and cannot be renovated. As well, the emergency departments at Cape Breton Regional Hospital in Sydney, N.S., and Glace Bay Hospital are currently seeing more patients than they were designed for.
The province said the emergency departments at Cape Breton Regional and Glace Bay hospitals will be expanded by about 40 per cent and 30 per cent respectively.
Surgeries and emergency services will gradually move from New Waterford Consolidated and Northside General to the Glace Bay and Cape Breton Regional hospitals.
"This is Black Monday for health care in Cape Breton," said NDP Leader Gary Burrill.
Eddie Orrell, a Cape Breton MLA and the Tories' health critic, said the changes will bring chaos.
"Today's announcement does nothing to address thousands of men, women and children who still don't have a family doctor or access to the care they deserve," Orrell said in a statement.
"Premier McNeil will have to explain how shutting down two hospitals fixes the problems we're facing. Instead of tackling the healthcare crisis, this government has spun it into full blown chaos."
But the premier said the changes will reshape Cape Breton's health system and help attract health care professionals to the region.
"We have heard from health care providers, not just in our province, but across this country -- they want to move to communities and work in an integrated health care team. They want to work in new, modern facilities, and they want to work in collaboration," said McNeil.
"That's what these announcements are about today is how do we best ensure that when an emergency happens in your community, that you have certainty on which emergency rooms are open and to ensure those emergency rooms are equipped and staffed with what they should be."
Dr. Paul MacDonald, a cardiologist who has worked in Cape Breton for more than 20 years, told the news conference health care is complicated and dynamic, and even the region's newer facilities require improvements to "provide the best care to our patients."
"I have a number of new specialists coming to our community who are going to practice critical care and pulmonary medicine, and if I bring them into a facility that's out-of-date, that doesn't have the equipment and resources that they need, they're not going to stay," said MacDonald.
"I think this is very exciting for my department, for critical care, that we're going to improve the way we manage patients in Cape Breton."
The Nova Scotia Nurses Union said Monday it was "cautiously optimistic" about the government's plan.
"At a glance, the nurses' union sees the plan as a positive in a community that has struggled to maintain or attract physicians and specialists," union president Janet Hazelton said in a release.
"Enhanced services in critical and cancer care, and state of the art facilities, are welcomed as long as the positions to deliver these services are protected and intact."
A 2016 report from Nova Scotia Auditor General Michael Pickup noted that some hospitals in need of major repairs were located close to other hospitals, and recommended that the province "review hospitals located close to each other to assess whether this is the most efficient and effective approach to providing health care for Nova Scotians."
That report also noted that Northside General did not have an adequate heating and ventilation system, and that New Waterford Consolidated required electrical upgrades, a sprinkler system and the conversion of its 40-year-old boiler plant.
Both communities are a roughly 20-minute drive from the hospitals in Sydney and Glace Bay.
The province is also launching a program in which Cape Breton paramedics will do home visits with patients after they leave the hospital, in an effort to reduce trips to the emergency room -- a project estimated to cost about $900,000 annually.
It said the cancer centre at Cape Breton Regional will double in size, and a new laundry centre in North Sydney will replace aging equipment and serve health care facilities throughout the Cape Breton Regional Municipality.
The government said hospital beds will be moved to the hospitals in Glace Bay and Sydney and to the Harbourview Hospital, a long-term care and rehabilitation facility in Sydney Mines.
The new community health centres in North Sydney and New Waterford will create space for collaborative family practices and also offer services including blood collection and X-rays.
The new long-term care facilities will have an estimated 48 beds each, the province said.
Planning will take up to a year, and timelines for construction and changes in services will be determined through the planning process.
Costs will also be determined during the planning as tenders are awarded, and the planning itself comes with a roughly $500,000 price tag.