Premier Stephen McNeil unveiled a new plan for the delivery of health care in Cape Breton involving the closure of emergency departments in North Sydney and New Waterford and expansions of other facilities Monday, eliciting a raucous and negative reaction from members of the public.

McNeil and two Cape Breton Liberal cabinet ministers, Geoff MacLellan and Derek Mombourquette, were roundly booed and jeered during the announcement at the Joan Harriss Cruise Pavilion in Sydney.

While the new blueprint for health-care delivery was unveiled, there were no details provided about how much the overall plan will cost and when it will be put in place.

The redevelopment plan includes an expansion by 40 per cent of the emergency department at the Cape Breton Regional Hospital in Sydney?and a doubling in size of the cancer centre, as well as renovations at the Glace Bay Hospital emergency department — including a 30 per cent increase in space.

The New Waterford Consolidated and Northside General hospitals?are to close, replaced by community health centres and new long-term care facilities, resulting in the loss of the communities’ emergency departments. Those existing buildings are deemed too old and unsuitable for renovation by the province.

Concerned local residents — more than 200 turned up to hear the news — shouted in anger, worry and disgust as the closures were announced. People were also upset they weren’t given a chance to ask questions at the end of the presentation.

Lila Briggs from Sydney left during McNeil’s speech, which was last, because she was too distraught.

“We’re done here. We’re done. We’re losing our hospitals. They can sugar-coat it all they want, we know what’s going on,” she said, fighting back tears.

“I’m very upset. They come in here, they take everything and then they go back to Halifax.”

Stuart MacDonald was very vocal during the presentations, booing the Liberal MLAs and calling the premier a “murderer.” During McNeil’s speech, security asked the Sydney Mines resident to leave.

The province won’t release anticipated costs before going to tender. The province has also said it will consider public-private partnerships in building the new facilities.

When asked if he would commit to maintaining the number of acute care beds currently located in the CBRM once the dust settles — there are 45 at the Northside General and 22 in New Waterford — McNeil said “that’s the goal.”

The new facilities will be built before any services are transferred, reporters were told.

Janet Knox, CEO of the Nova Scotia Health Authority, said the plan is intended to ensure a strong and reliable health-care system.

“Our goal with this project is for the people of Cape Breton to receive the right care at the right time in the right place,” she said, adding it is also intended to assist with recruitment problems and aging infrastructure.

She said the current chronic emergency department closures are “confusing and frustrating.”

McNeil said he understands the anxiety expressed by the members of the public who attended the announcement.

“We can’t walk away from problems, we need to make sure we have an integrated health-care system that responds to the needs and desires of this community and making sure that they get world-class health care and we can attract world-class physicians,” McNeil said.

The premier said people need to know what health-care facilities are open and when.

“We have four emergency rooms, two have been closed substantial numbers of times,” McNeil said.

The new community health centres will house collaborative family practice teams for delivering primary care and are to also host some services offered now, including day clinics, blood collection and X-rays, and provide space for services including mental health and addictions.?The new long-term care facilities will have an estimated 48 beds each, a net increase of about 50 new beds to the system.

The functional planning process is expected to begin immediately and take nine to 12 months at a cost of $500,000. Timelines for construction and changes in services are to be determined through that process.

There would also be a new community-based paramedic program which would see paramedics do home visits and follow-up visits after hospitalizations which could begin within the next six months and is estimated to cost about $900,000 annually.

Dr. Paul MacDonald, department head for internal medicine and who works as a cardiologist in Cape Breton, said that even the regional hospital, which is relatively new, is outdated for some services. He said he and some colleagues about four years ago looked at improvements needed to the critical care units.

“We drew up a plan four years ago and I did not think this plan was going to come, this day that we were going to actually look at implementing major changes for the sickest people in our community to allow us to do a better job,” MacDonald said.

Surgeries and emergency services are to move from New Waterford Consolidated and Northside General to Glace Bay and the Cape Breton Regional Hospital with hospital beds also transferred to the Glace Bay Hospital, Cape Breton Regional Hospital or Harbourview, a long-term care and rehabilitation facility in Sydney Mines. A new laundry centre would also be constructed in North Sydney.

The Cape Breton Cancer Centre was built to serve 16,000 people annually but currently sees 40,000.

When asked about the fact that the two communities losing their emergency departments are in opposition-held ridings, McNeil reiterated it was the right thing for the communities and the regional hospital is the right place to make investments.

While there were doctors on hand supporting the changes, some medical staff have indicated they had no idea the announcement was coming and hadn’t been consulted.

Director of emergency medicine Dr. Chris Milburn, who is also an emergency room and family doctor, said having people present at emergency departments with non-emergency health issues is an expensive way to provide care.

“I think there’s an opportunity if we have collaborative centre or a better family practice centre in New Waterford, in Northside, I think people will actually get better care for the type of problems they have,” he said.

He noted there is currently a system in place where people requiring critical care are not taken to the Northside General ER, they are taken directly to Sydney, although people are not aware of that.

“In a way it’s a loss but in a way it’s a big opportunity to give better care and what people really need, which is primary care,” Milburn said.

MLAs Tammy Martin and Eddie Orrell were left “disgusted” by the Liberal government’s planned closures of the two hospitals in their ridings and how they heard about it.

An email invitation was sent to all MLA’s Sunday evening for the new health care plan announcement taking place Monday at 11:45 a.m. There was a technical briefing for media and government officials at 10:30 a.m., however, Martin, the NDP health critic wasn’t told about it but still showed up.

Martin, MLA for Cape Breton Centre, and Orrell, MLA for Northside-Westmount, both said they repeatedly asked the health minister if there were plans to close any hospitals during the last legislature sitting and were told no.

Both health critics are concerned about the loss of the emergency rooms at the hospitals and concerned there wasn’t enough consultation done with community members or stakeholders.

Martin said she is sure no one from her community was consulted. Orrell said there was a consultation in his constituency, but it was more of a presentation about community health care centres than an investigation into what the community needs.