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Jim Vibert: Resolved - Change the program at Nova Scotia Health Authority

Nova Scotia Health Authority
Nova Scotia Health Authority

New Year’s resolutions are a mug's game. There’s no reason why a promise made by you to you on Dec. 31 should hold a greater likelihood of fulfillment than one made on, say April 1.
Nevertheless, they are made, and generally in the spirit of self-improvement.
In that spirit, Nova Scotia’s government and the board of directors at the Nova Scotia Health Authority need to have a hard look at their ongoing, shared failure and do what it takes to make a big change in 2018.
Call it a resolution if you want, but it must be real, not symbolic, and it will almost certainly require some tough decisions.
Medical professionals, starting with doctors, need to be invited in and made a part of whatever it is the NSHA and the province think they are doing to fix what we call health care. Because, as the docs will tell you, thus far in the NSHA’s brief history there has been no fix and a lot more stuff got broken in 2017.
Nova Scotians are asked to take it on faith that the NSHA board holds meetings. There is no discernable proof of these events available to the people who foot the bills for everything, including phantom gatherings of the well-heeled and well-meaning. If indeed the board does meet, it’s only agenda item until it has an answer should be: “Do the NSHA’s past failures need to be its future?”
If they manage to get to “no,” the next question is: “What needs to be done to turn this thing around?”
That may be where the hard decisions come in. If you’re going to change the program, you need to change the players.
The great incongruity, bordering on hypocrisy, at the NSHA is its reverent use of the adjective “collaborative,” even as it practices an unwritten policy of authoritarian mismanagement of the Nova Scotia miscellaneous care system.
Call it health care if you must, but it is much more about medical treatment than the promotion of good health. It can’t reasonably be called a health system when primary care is unavailable to as many as one in 10 Nova Scotians, a deficiency if not created, certainly exacerbated by the NSHA.
So now, the health authority is out in the world recruiting doctors with promises not kept to those who are already here.
“Hike soaring seaside cliffs, experience fine dining and culture on bustling city streets, and be the type of physician you truly want to be. Nova Scotia is big enough to provide endless opportunities, but small enough to make those opportunities your own. Become a key part of the community – both professionally and personally – wherever you decide to live,” says the authority’s come-on to doctors not here.
Two years ago, the NSHA was holding meetings with Nova Scotian family doctors where the message was very different. If there was a hint of soaring cliffs, it was because docs felt they were standing on the edge of one.
“Don’t get too comfortable and don’t put down deep roots,” is how family docs interpreted the NSHA edict of that day.
And while it now claims no knowledge of the events, the NSHA turned away dozens of family doctors because wherever they decided to live wasn’t somewhere the authority considered big or small enough for another doctor.
So, if the directors are not asking the authority’s leadership to explain this complete about-face in just 24 months, they should check their corporate director credentials at the door on the way out.
Next, those who are left should ask to see the plan to engage Nova Scotian physicians, not in a show consultation, but in the decisions which effect the way the docs practice medicine.
That is, after all, the promise made in the lure that’s out there for new doctors – “be the type of physician you truly want to be.”  It’s also what Nova Scotian doctors have been asking for these past three years.
The provincial government’s role is not passive in any of this. The government is ultimately accountable, and if Premier Stephen McNeil truly wants that third term he said he is already eyeing, he needs to change the program in health care, now.

Jim Vibert, a journalist and writer for longer than he cares to admit, consulted or worked for five Nova Scotia governments. He now keeps a close and critical eye on provincial and regional powers.

 

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