More money not best cure for ailing hospitals
SYDNEY — A spokesman for the Cape Breton District Health Authority says providing more money to hospitals isn’t the perfect fix.
On Wednesday, Nova Scotia auditor general Jacques Lapointe sounded the alarm over the state of the province’s hospitals, warning that they will continue to deteriorate if capital funding is not increased.
Lapointe said the Department of Health and Wellness has estimated that more than $600 million will be needed in the next decade for basic infrastructure needs just to maintain the health system.
“There will always be a challenge in relation to maintaining and updating or upgrading equipment,” said Greg Boone, spokesman for the Cape Breton district. “Our capital spending is important, but the other piece is that health cannot always be about more money. We need to look at managing what we have to spend now and spending it appropriately because that’s the reality: there’s only so much money in a pot to go around.”
Lapointe concluded in his fall report that if funding is kept at current levels, the province will not be able to cover equipment and infrastructure repairs and replacements.
His report also said there is no provincial long-term capital planning for hospitals and the Department of Health and Wellness doesn’t track the extent to which equipment and buildings are used.
Boone said the CBDHA tracks the use of its equipment and, in some cases, has developed long- term strategies for replacement.
“We would welcome any discussion with the department about enhancing the process, but we also would expect that that type of discussion would take place with all districts and the IWK through the ongoing discussions with CEOs and senior management at that level.”
Lapointe said there are problems with the way the department prioritizes equipment replacement. He said scoring criteria is not shared with district health authorities and leads to variations in how the districts rank their own needs.
“As a result, districts might or might not receive funding for their top priorities. For example, one district this year received funding for its fourth and 10th ranked items, but for no others.”
The report says that in one instance a health authority requested replacement of equipment that had been removed from service because of concerns over increased radiation levels. The request was turned down because it didn’t score high enough in comparison to other requests.
But Health Minister David Wilson said safety is taken into account as the province evaluates requests from health authorities.
He said that with limited capital funds for health — about $80 million for 2011- 2012 — the department has to make decisions based on what’s best provincewide.
“If there’s a piece of equipment that’s failing or needs replacing, then it’s given a higher priority than something that is maybe just aging,” said Wilson.
He admitted that keeping up with infrastructure and equipment needs would be “a challenge.”
Meanwhile, Lapointe’s report said the Department of Health wasn’t capitalizing on upfront savings for operational costs such as energy efficiency.
He also raised concerns around controls to protect personal and health information contained in computers at the Capital Health District and the IWK Health Centre in Halifax.
Lapointe said system weaknesses unnecessarily increased the risk of inappropriate access by hospital employees and contract staff.
The report says there needs to be better monitoring of network activity and the encryption of sensitive data also needs to be addressed.
Progressive Conservative Leader Jamie Baillie said he was “very concerned” by what the auditor general found, saying there needs to be a reconsideration of provincial priorities.
“There is a lot of wasteful spending going on in our health system, but real cuts to important things like our IT privacy protections,” said Baillie.