Health-care green shoots

Two developments this week poked a ray of sunshine through the gloom surrounding the province’s health-care system.

First was the revelation that the Nova Scotia Health Authority is trimming its bureaucracy, eliminating three vice-president positions and talking about moving some decision-making power closer to the regions where health care is actually delivered.

The authority is between CEOs: Janet Knox left in August and new boss Dr. Brendan Carr arrives in December.

Interim CEO Janet Davidson, in an email to staff reported on in Monday’s paper, said the reorganization is needed to reform a structure “that does not allow us to easily address challenges that may be unique to individual zones, teams or hospitals.

“With this in mind, I have restructured the executive level of the organization to move executive level operational and medical leadership, including budget, to each zone.”

This is as close to an admission that things were not working as we’ve ever heard from the authority. It’s a statement by an organization that is too centralized finally realizing that if it wants to get something done, it has to empower the people closer to the action.

It’s unclear how that power will be transferred. Davidson’s email said an advisory group would be set up to recommend “necessary realignment of roles, responsibilities and reporting relationships under the new executive-level structure.”

Translation: They’re working on it.

The authority has been criticized for years for being too topheavy, too slow to implement change and too secretive. One of those critics, Dr. Bob Martel, told The Chronicle Herald’s Andrew Rankin that he wonders how much true power will eventually devolve to the regions.

But the authority must be given a chance to actually carry out this reform before anyone can conclude it won’t work. We certainly hope it does.

The second development is the ratification by the province’s doctors of a new funding agreement that gives all physicians a raise (two per cent a year over four years) and includes $55.5 million in new funding for five specialties: family doctors, anesthetologists, emergency doctors, psychiatrists and obstetricians.

Those specialties will be either the top, or close to the top, paid doctors in their field in Atlantic Canada by the end of the deal.

The province found $135 million to do this deal and it’s money well-spent. Other jurisdictions also feeling the pinch of doctor shortages offer more and Nova Scotia needs to be competitive.

But just as important as the raise was the health authority’s signal on restructuring earlier in the week, according to the president of Doctors Nova Scotia.

Dr. Gary Ernest said the deal could help retain and recruit doctors, especially now that both issues they were concerned about have been addressed. The first was money “and the other is work environment.”

These developments don’t fix every problem. For instance, too many patients in rural areas are without a family doctor and too many people waiting for nursing home spots occupy expensive hospital beds instead.

But it’s a good start.