Nova Scotia: Health minister's optimism put to the test

Please chip in to support rabble's election 2019 coverage. Support rabble.ca today for as little as $1 per month!

It's been a year and a half since I left off writing about the crucial, politically charged and bureaucratically overwrought subject of health care, awaiting developments with the new government. Recently, I've been looking for signs of where we're at.

The news has been mainly about Dr. John Ross's task force as it tackles the troubled issue of emergency rooms. Beyond that, a $6.4-million community living initiative and the elaboration of a longer-term strategy for mental illness have been announced, as has an expanded role for pharmacists. More nursing homes have opened. There has been pressure to fund the eye drug Avastin, a bust-up over a fired nurse practitioner on Digby Neck, and a bureaucratic glitch that led the Dal Med School to have its funding partially cut (since restored).

Meanwhile, the ERs remain stressed, doctors are hard to come by, Nova Scotian waiting lists are the longest in the country for some procedures and the money crunch doesn't abate. There's little so far to give a larger sense of direction, which raises the same question as is aimed at the NDP government in general: Are we going anywhere and, if so, where?

I got Health Minister Maureen MacDonald on the phone for a brief chat. She said if it seems slow, there's a reason. As soon as she took office, her department was mostly bogged down for six months with the H1N1 crisis. Indeed, her rough inauguration was "seeing a young 20s mom on a ventilator at the Grace ... pretty sobering stuff."

Now, she says, things are moving and she declares herself optimistic. The plan is for more primary and collaborative care involving nurses, pharmacists and others; better management of chronic diseases; attempts to improve Nova Scotia's spectacularly unhealthy lifestyles, and others -- all aimed at reducing the load at ERs and doctors' offices.

None of this is new. It's the standard scenario now across the country, and was mainly outlined for Nova Scotia in the Rodney MacDonald government's Corpus Sanchez study of two and a half years ago. The difficulty is in getting it done -- to design the programs, clean out the inefficiencies in a stressed and sometimes obtuse health bureaucracy, motivate the ground-level workers and educate the public.

I asked MacDonald if there were, then, announcements imminent. "Developments," she corrected, indicating that the pace will be firm and methodical, without spectacular declarations.

Meanwhile, the larger context of health care has shifted somewhat and may boost MacDonald's optimism. For one thing, the distracting pressure for privatization has abated, as some of the measures indicated above start to take effect across Canada. The argument is actually being won by public medicine. Canadians appear to want nothing to do with privatized medicine. Medicare got a nearly 90 per cent endorsement in a recent Nanos Research poll.

The figures also speak loudly. Recently, Dr. Robert G. Evans, a specialist in comparative health systems, told parliamentarians in Ottawa that the medicare part of health costs -- doctors and hospitals -- has remained stable for 20 years. It's the non-medicare part that's skyrocketing -- dentistry (have you been to the dentist lately?) and eye care, for example, or, notably, drug prices.

Indeed, I had called MacDonald primarily to ask about a recent one-year agreement whereby the province will pay pharmacies more for dispensing drugs under the Pharmacare program. It's only for one year in order to do two things, she said: work out the future role of pharmacists in the system, and give time to see what the big provinces will do with regard to drug costs before making the next move.

One small province can't do much alone, she says, although there have been talks with other Atlantic provinces. Ontario and Quebec have moved to save hundreds of millions of dollars by changing the arrangements the large pharmaceutical chains have with generic drug manufacturers. Bringing down the cost of drugs -- and reducing their arguably excessive use -- is one of the keys to sustainable medicine.

On the less optimistic side, a resumption of recession, and therefore of governments' capacity to pay, will increase the pressure on what is the largest budget item for governments everywhere. Nevertheless, the endless studies and efforts to restore health care in Nova Scotia after the low points of the 1990s may be slowly bearing fruit. But MacDonald's optimism will be put to the test.

 

No corporate owner. No government money. No endowment. No cost to visit and use rabble.ca. Please become a member of the community that makes rabble happen today (www.rabble.ca/membership).

Related Items

Thank you for reading this story…

More people are reading rabble.ca than ever and unlike many news organizations, we have never put up a paywall – at rabble we’ve always believed in making our reporting and analysis free to all, while striving to make it sustainable as well. Media isn’t free to produce. rabble’s total budget is likely less than what big corporate media spend on photocopying (we kid you not!) and we do not have any major foundation, sponsor or angel investor. Our main supporters are people and organizations -- like you. This is why we need your help. You are what keep us sustainable.

rabble.ca has staked its existence on you. We live or die on community support -- your support! We get hundreds of thousands of visitors and we believe in them. We believe in you. We believe people will put in what they can for the greater good. We call that sustainable.

So what is the easy answer for us? Depend on a community of visitors who care passionately about media that amplifies the voices of people struggling for change and justice. It really is that simple. When the people who visit rabble care enough to contribute a bit then it works for everyone.

And so we’re asking you if you could make a donation, right now, to help us carry forward on our mission. Make a donation today.

Comments

We welcome your comments! rabble.ca embraces a pro-human rights, pro-feminist, anti-racist, queer-positive, anti-imperialist and pro-labour stance, and encourages discussions which develop progressive thought. Our full comment policy can be found here. Learn more about Disqus on rabble.ca and your privacy here. Please keep in mind:

Do

  • Tell the truth and avoid rumours.
  • Add context and background.
  • Report typos and logical fallacies.
  • Be respectful.
  • Respect copyright - link to articles.
  • Stay focused. Bring in-depth commentary to our discussion forum, babble.

Don't

  • Use oppressive/offensive language.
  • Libel or defame.
  • Bully or troll.
  • Post spam.
  • Engage trolls. Flag suspect activity instead.