Bud­get aimed at health but missed the tar­get

The Amherst News - - OPINION -

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.

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