‘Critical narrative' in health system is news
It should go without saying, but apparently it doesn’t so here goes.
In the vast majority of cases, Nova Scotia’s health system works, and usually quite admirably. It should go without saying because that’s what it’s supposed to do. Nova Scotians collectively spend more than $4.7 billion a year to make it so.
When it fails to perform as advertised by the provincial government or the Nova Scotia Health Authority (NSHA), it’s news.
Last week, the new CEO of the authority, Dr. Brendan Carr, held a news conference where he said the “critical narrative” about the provincial health system is one of the biggest challenges facing that system. Is it? Or is that narrative symptomatic of a system beset with unmet challenges and intractable problems?
To his credit, less than a month into the job, Carr opened the doors into the NSHA executive suite wider than we’re accustomed to. He also promised to listen to front-line health workers and to patients, learn from their experiences and make corrections as needed.
When he follows through on that pledge, and if health-care providers feel it’s safe to give him the straight goods, he’ll discover that the wellspring of the critical narrative is within the system itself. Front-line health care providers flag problems for the news media, often because they don’t feel like their issues are heard, or don’t feel safe taking those issues to the authority’s senior management.
Carr acknowledged that the health system has “deep problems,” and he’s spent the past eight years leading large health organizations, first in British Columbia and then in Ontario, so he knows those problems are not unique to Nova Scotia.
A good deal of the pressure on the health system, in Nova Scotia and elsewhere, is a result of changing demographics. The Canadian population is aging, and no where in the nation is that trend more pronounced than on the East Coast. Older populations naturally place more demand on health services, and the system is struggling to keep up with that demand.
Most of us recognize that changes are needed to address those and other pressures on the system.
The Nova Scotia Health Authority won’t be five years old until April 1, and those five years have brought a “tremendous amount of change” that Carr says put in place the building blocks to set the system in the right direction. Mixed metaphors notwithstanding, let’s hope that proves true.
“(T)here's been a lot of good work done and we've made significant progress in a lot of areas, and despite that ... the prevailing narrative here tends to be a very critical narrative of the health-care system.”
Carr acknowledges that the issues raised are real, but they should be balanced by acknowledging the progress that’s been made.
He’s right about that. Where there is demonstrably improvement in the delivery of health services, it should be acknowledged, even celebrated.
For example, the province is making huge investments in hospital infrastructure, most notably in the Halifax region and in Cape Breton. That’s good news, despite the controversy in Cape Breton where local hospitals in North Sydney and New Waterford will close as part of the redevelopment and consolidation of acute care facilities.
He also pointed to collaborative family practices as an example of changes to the way primary heath care is delivered and he said those collaborative practices are working well. We’ll have to take his word for that because thus far the authority hasn’t been able to produce much, if any, empirical evidence to show the collaborative model is superior to other practice models.
Carr himself seemed to be signalling a more open and accessible style of leadership at the authority, which could go a long way toward creating the more balanced narrative he’s seeking, provided he remains accessible, and is accountable, both publicly and to NSHA staff through thick and thin.
More than a few health-care providers in Nova Scotia have called for a reset at the Nova Scotia Health Authority. It seems like opening unthreatening lines of communication across the outfit is a good place to start. If that’s what Dr. Carr is doing, he deserves our support.