NSHA gets a failing grade in Cape Breton

System needs more transparency

Cape Breton’s health care crisis, with its shortage of doctors and psychiatrists, is worse than the public realizes. The recent report, from Nova Scotia’s auditor general, Michael Pickup, has revealed there are serious problems with the way the Nova Scotia Health Authority (NSHA) functions, one being the failure to communicate with the people of Nova Scotia.

Premier Stephen McNeil did not receive the auditor general’s criticism with the open-mindedness one would hope for in an elected official. He insisted the government has done an “outstanding job” of communicating with the public on health care issues, and he made it clear the auditor general was out of line in criticizing the government.

Auditor general’s report where governments go wrong. Thank goodness Pickup is the forthright watchdog he is. The government, he said, must address shortcomings in homecare and mental health. Cape Bretoners are very aware of these needs. With only six psychiatrists here and a parttime psychiatrist for adolescents, (the full complement being 16) the need for more psychiatrists is clearly a critical one. So is the need for doctors.

A recent, internal memo revealed the NSHA is considering sending teenagers, suffering from depression, to the IWK in Halifax. The memo also suggested video-conferencing consultations between mental health patients here and “health care professionals” in Halifax. Anyone who has worked with teenagers, or raised them as parents, could poke a lot of holes in this idea. Imagine a teenager, suffering from depression, cogently vocalizing to some unknown adult on the screen.

The auditor general’s report stated that public agencies have done a poor job communicating the government’s plan to address problems in primary care, including doctor shortages. Pickup recommended that the government execute a plan on doctor recruitment goals, and communicate that plan to the public. He also said people should know when they can expect service delivery.

MLA Alfie MacLeod voiced concern over Cape Breton’s health care crisis. What is worrisome is that he does not believe the NSHA has a plan. How, he asks, does the government expect to entice doctors to come to Cape Breton when Nova Scotia has the lowest salaries in the country?

Before he became premier, McNeil had already decided to scuttle the district health authorities and establish one central body to deliver health care to the province. In 2012, John Malcolm, former CEO of the now defunct Cape Breton District Health Authority, warned that this centralization structure would not serve the needs of Cape Breton. A concern he has regarding the current system is that it is “not being open and transparent in what their challenges are and what their plans are.” He said Cape Breton has lost a lot of good people in the last three years, but there are still good people trying to do the right things. Of the NSHA, he said that “after three years, if you haven’t got your game together, there’s something really wrong.”

This is not the first time a government has centralized power. In Ontario, Premier Mike Harris fractured the health care delivery system in Ontario, to the point where doctors and nurses left the province to work in the states. Evening news had scenes of ambulances, often with critical, heart attack patients, being turned away from hospital emergency centres because they were full. One day he closed 14 hospitals.

Premier Harris was intent on cutting health costs. He vilified doctors, nurses and then teachers because health and education were the two largest expenditures for the province, and he wanted some of that money for other things. It took 10 years to repair the damage he did to health care.

This kind of behavior might be expected of neo-conservative governments, but not Liberal governments, right? Wrong. Another Ontario premier, Kathleen Wynn, has taken a page from “Mike, the Knife’s” book, eroding the collective bargaining system for government employees and teachers. Her centralization efforts have left the education system with debilitating, bureaucratic structures, and soulless leadership that have had a negative impact in the classroom. McNeil has chosen to follow in Wynn’s footsteps.

Fiscal responsibility is important, but government is not all about bean counting. It’s about helping people. And in Cape Breton people are dying because of the government’s misplaced focus.

“Fiscal responsibility is important, but government is not all about bean counting. It’s about helping people.”