The long-awaited blueprint for implementation of changes to the health care system has been released, but the Health Accord is not recommending the closure of any of the province’s 23 health centres.

The Health Accord says the health centres now in operation are geographically well-positioned across the province, but it is making some recommendations in hours of operation and scope of services depending on where those centres are located.

The Health Accord says health centres within 60-90 minutes of a hospital and serving a catchment population of fewer than 5000-6000 people, should provide a mix of services including urgent care and response to minor emergencies on a 12-hour a day basis.

Health centres which are more than 90 minutes from a hospital, and which provide a mix of services including urgent care, should be open 24 hours a day because they have the added responsibility of stabilizing and transferring emergency patients to the nearest hospital.

Meanwhile, the Health Accord says occupancy of acute care beds in some health centres is less than the optimal rate of 85 per cent while the rate of alternate level of care is greater than the provincial rate of 20 per cent. The Health Accord says alignment of the number of beds will be necessary over time. It says acute care beds should only exist in health centres with 24-hour urgent care.

The Health Accord emphasised once again that the number one social determinant of health is poverty and it recommends a guaranteed basic income with the help of the federal government to bridge the gap and improve life expectancy in NL, which is more than two years shorter than the Canadian average.

According to the Health Accord, lower life expectancy is driven by the highest provincial rates of death caused by cancer and cardiovascular disease. The province also has the highest rates of chronic disease in seniors and medical complexity in children with the highest per capita spending and worst health system performance in the country.