Too much smoke and mirrors concerning health care
Decisions being made purely to curtail expenditures for the citizens of Nova Scotia, particularly those who reside outside HRM
As a physician with 35-plus years experience, I am greatly concerned about the continuous, relentless and intentional disassembly of our health-care system.
This has been done in the guise of “improvement,” but from my standpoint, as a doctor who sees patients from the eastern end of the province and from all walks of life, we are clearly very quickly moving backwards. This results from the intentional politicization of the health-care system where all decisions pass under the gaze of politicians in Halifax. The changes are made purely to curtail healthcare expenditures for the citizens of Nova Scotia, particularly those who reside outside HRM.
It seems all decisions in our provincial system are currently made in Halifax. Politicians and Department of Health and Wellness officials seem to lack insight with regards to the outcome of these decisions. In discussion with senior colleagues, the politicization is pervasive and intentional, and the fact that the two elected Liberal ministers in Cape Breton are mute on the issue does indicate that the changes, which result in the eradication of consistency and quality in health-care delivery, are coming from the very top.
A case in point is the lack of psychiatrists in Cape Breton. A year-and-a-half ago a letter was written by the psychiatric service predicting this situation, but the letter was “shelved” for what can only be described as political reasons, and the rest is history.
Personally, I have recruited two family physicians in my short tenure as a family physician and six anesthesiologists in my career as an anesthesiologist. It is more like trout fishing than rocket science. You go where the doctors are, your offer them good jobs and good pay, good working conditions and then you follow up to make sure that they are happy.
What we see instead is a parade and charade of ineptitude from people responsible for this activity. It clearly is not being addressed in a cohesive manner by people who know what they are doing. Trips to England are just expensive smoke and mirrors such that it looks like people are actually doing something when, in fact, it is the opposite that has taken place.
Recently, we have heard much about the closure of the pain clinic in Dartmouth. The response from the Department of Health and Wellness was an offer of help to the pain clinic in Halifax such that they could implement changes to address the patients’ needs and the cost would be covered by the province. What is even more illuminating is the fact that when approached about a similar group of patients in Cape Breton, no help was forthcoming. A treatment plan was put on the table and passed up the food chain to Halifax where, after a delay of about 16 months, it was declined.
What is particularly damming about the whole issue is the fact that in a discussion of this matter with two vice presidents from Halifax, I was assured that the patients could be looked after by nurse practitioners. Neither of these vice presidents, to my knowledge, have any training or history of clinical acumen in pain management programming. They are merely mouthing the buzz words that have become so common in the smoke and mirrors show that we clinicians currently have to deal with.
In essence, the changes that have been brought in by the current government and Department of Health and Wellness constitute a move away from universal health-care coverage. As doctors, we recognize this and it is especially offensive when our entire industry is evidenced based. These seem like hard words, but I would suggest that cancer, heart disease, uncontrolled diabetes, congestive heart failure, psychosis and so forth are also hard words. The current course of health-care delivery in Cape Breton and other areas outside of HRM makes it necessary that we, as Nova Scotians, stand up to the intentional erosion of our ability to provide for our patients.
What is necessary is that responsibility for these types of decisions be returned to the people in the health districts involved who actually care about getting something done. We had this previously but it was removed in all areas of the province. Its removal was done under a plan that has never been publicized for Nova Scotians to see. Where are the consultants’ reports that suggest these changes would be a good idea? I do not believe they exist.
“Doctors are a conservative group and the change in morale amongst my colleagues is distressing to me.”
Doctors are a conservative group and the change in morale amongst my colleagues is distressing to me. The changes noted above have removed universal health care coverage from many Nova Scotians. The smoke and mirrors covering that fact makes it very unpalatable to doctors in the province.
I would suggest that people concerned should make it a point to email the Department of Health and Wellness with their questions about gaps in health-care coverage that affect them. I have been a Liberal for a long time but being a good doctor is more important than that.