VIBERT: FOUR YEARS OLD AND PROMISES UNMET

As it sneaks up on its fourth birthday, the Nova Scotia Health Authority should be hitting its stride.

Remember the promises made at the conception? Nine district health authorities would be replaced by one, more efficient and effective outfit, responsible for delivering health care services right across the province. The savings in administrative costs – something the province has not quantified – would be redirected to “front-line” services and care providers, resulting in better-quality care for all.

Words like “streamlined” and “equitable” peppered provincial government pronouncements about changes the NSHA would make to improve access to all manner of medical attention and intervention.

“This new provincial approach will better co-ordinate health resources and expertise in a way that helps us turn the tide toward better health,” the Health Department crowed back then.

Four years later – April 1 marks the NSHA’S fourth anniversary – and it would appear the tide has indeed turned, but it doesn’t seem to be toward better health.

Last week brought another crisis in a major emergency department – the Cape Breton regional – and the alarm was sounded by more “front-line” care providers, this time from paramedics.

Paramedics are frustrated by all the time spent waiting to offload patients at hospitals. In the past few weeks, their union tweeted about dangerous shortages of ambulance coverage – at various times – in northern Nova Scotia, Cape Breton and the Halifax Regional Municipality.

When there were no ambulances available to respond to emergencies in Halifax, 19 were tied up waiting to offload patients at three area hospitals.

Not coincidentally, last week a number of correspondents passed on information about the consequences of tied-up ambulances.

“Today I met an elderly lady in distress after falling on the ice. I stopped to lend a hand to get her up off the ground but failed as she yowled when we tried to move her. A gentleman stopped, seeing we needed assistance, but we still could not get her up off the ground because it was too painful for her. She said she heard something crack when she fell.”

Obviously, 911 had been called immediately, but it was 45 minutes before an ambulance arrived and took the injured woman from alongside a busy Halifax street to the hospital.

Another physician correspondent relayed another story.

“I just had a heart-breaking conversation with a volunteer firefighter (who) tells me that with the ambulances increasingly tied up at the hospital waiting to offload, the firefighters are being called to cardiac arrests to do the CPR.

“They can’t transport or give drugs, so they do CPR knowing that the person might well die because they are the wrong firstresponders for the job.”

Anecdotes are not evidence, but the paramedics union reports that “it’s pretty well a daily occurrence” for some part of the province to be either under or unserved – with too few, or no ambulances available.

After almost four years of the NSHA delivering health care to the province, emergency departments are busting at the seams. Ambulances are slow getting to emergencies because they’re backed up at hospitals. At least 55,000 people are trying to find a family doctor, but doctors are leaving – for retirement or greener pastures – faster than they can be replaced.

And those are just a few of the highlights. NDP leader Gary Burrill estimates that one-fifth of the hospital beds in the province are tied up by people who should be in nursing homes.

Blocked inpatient beds create a backup. In emergency, patients are admitted but stay there until an in-patient bed comes available. ERS, in turn, are so backed up patients have to wait in ambulances.

Meanwhile, at its November meeting the board of directors of the NSHA decided that “greater proactive communication and public education is required” to support the authority’s work to transform and improve the health system.

There are more than a few Nova Scotians – health care providers and patients, alike – who, after four years, have had enough transition, and are ready for the NSHA to start in on the improvements. Jim Vibert grew up in Truro and is a Nova Scotian journalist, writer and former political and communications consultant to governments of all stripes. He now keeps a close and critical eye on provincial and regional powers.