Budget aimed at health but missed the target
Tuesday’s budget speech began with Finance Minister Karen Casey reminding Nova Scotians that the Liberal government was the first in 30 years elected to back-to-back majorities. When she ended, there were legitimate questions as to whether the Grits got the message voters tried to send.
The election was closer than expected, reduced the Liberals to a slim majority, and health care was the issue that usurped the campaign and eroded government support.
The budget acknowledged Nova Scotians’ concerns, and sprinkled money on health, but didn’t have much to say to the tens of thousands of Nova Scotians looking for a family doctor.
It did increase spending for mental health, which is both welcome and predictable in a province where mental health services have been barely more than a lick and a promise.
More money was allocated to reduce wait times for orthopedic surgery and bring the province closer to national standards. And, it provided some assistance for people who need at-home cancer drugs, a long overdue through still inadequate recognition of an inherent lack of fairness.
But the pickings were slim for those looking for help or hope finding a family doc.
This was the government’s second budget this year. Former finance minister Randy Delorey’s April effort died shortly after birth when the government called an election. The changes between the spring and fall budgets could have been achieved with a dollop of whiteout here and there and the added paragraph to note the Liberal’s electoral achievement.
The province seems to be pinning a lot of hope on more seats in Dalhousie Medical School’s family medicine residency. Health officials say something like 70 per cent of family physicians that do their residency in the province stay in the province.
There is more money, yearover-year, to support the collaborative primary care model that the province hopes will reduce demands on family doctors.
But, the numbers are not encouraging. The government’s efforts to recruit and retain doctors isn’t keeping pace with the number that are retiring or leaving. The Nova Scotia College of Family Physicians has reported a net decline of 40 family doctors in the first seven months the year.
The Health Department says Nova Scotians should be optimistic that access to primary care – which once meant a family doctor – is on the road to recovery, as collaborative practice teams develop across the province.
Health officials also admit they are worried that, if enacted, federal tax changes that hit doctors in the pocketbook could exacerbate the doctor shortage, although they add that doctors in every province face the same issue.
Doctors aren’t necessarily buying that pitch. Last weekend in Halifax, hundreds of them met and seemed unanimous in their opinion that other provinces offer greener pastures, so the nationwide tax increase doesn’t limit their options.
Indeed, many say a tax increase will be the final straw that forces them to look outside Nova Scotia to places where conditions are already more attractive for family practitioners.
While health made it to the top of the government’s “key priorities” there were five more items on the list. In addition to “healthy people and communities,” the government wants you to know it’s focus is broad enough to capture education “for a stronger Nova Scotia;” young people and jobs; support for an older population; infrastructure, and “new ideas for a better economy.”
The budget couldn’t have been the right place to identify new ideas, so it stuck to old ones. Its familiar economic themes included keeping young people in the province, promoting fishing and tourism, a small business tax cut and attracting immigrants to train and work in Nova Scotia.
Given that the budget is a near carbon copy of the spring edition, it may not be getting a fair shake here or elsewhere. It casts that eerie déjà vu feeling because we’ve seen it before, just five months ago.
Yet, after an election that become totally dominated by a single issue – access to health care – it is fair to expect more of a response from the government, even if it doesn’t share the opinion that Nova Scotia’s health system is in a crisis.
The budget hit the target the government set for itself before the election, but it seemed to miss the mark Nova Scotians expected after.