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Houston takes credible stab at solving health-care crisis

PAUL SCHNEIDEREIT pauls@herald.ca @schneidereitp Paul Schneidereit is an editorial writer and columnist.

Happy about the state of Nova Scotia health care?

You know what I mean. Lack of family doctors. Nursing shortages. Frequent ER closures due to lack of healthcare personnel. Wait lists for specialists stretching into years. Nursing home staff run off their feet, unable to properly care for our aged loved-ones. People with mental health issues with nowhere to turn.

There’s an election going on. So it’s a good time, if concerned about the above, to see what’s on offer.

Today, let’s look at Progressive Conservative Leader Tim Houston’s vision for healthcare reform.

The poor state of health care in Nova Scotia has been a major theme for Houston in recent years. It’s highlighted in his party’s just-released, 12page platform, Solutions for Nova Scotians — the first three sections focus on the healthcare system, mental health services and long-term care.

Quick take: The proposals are solid, comprehensive and, at times, potentially transformational. They show Houston’s been listening to what frontline health-care providers — and affected families — have been saying needs to be fixed.

As always, there are questions about costs and staffing. When I put them to Houston on Thursday, his answers were reasonable, if sometimes aspirational.

I can’t hit everything in his plan, but here are some highlights: First, the family doctor shortage.

To address today’s needs, Houston wants everyone on the I-need-a-doctor provincial registry — as of July 1, close to 70,000 Nova Scotians — to have immediate access to primary care.

The Liberal government rolled out pilot programs this spring making some on that list in northern and western zones — areas with the highest percentages of population without a physician — eligible for virtual care, i.e., telemedicine. The goal is to eventually offer at least virtual care to up to 30,000 on the registry in those areas.

Houston would open up virtual care to everyone on the list.

Sounds great, but do we have enough health-care providers to do all that? If not, where will we get them, considering doctor shortages worldwide? (I have similar questions later regarding the PCS’ plans to increase staffing in long-term care).

As a stopgap — since we don’t have enough family doctors — the PCS promise the government would pay for private virtual care (already in use in northern and western zones) whenever necessary.

In the longer term, Houston says it’s all about successfully recruiting and — crucially — retaining valuable, in-demand health-care staff. To do that, you must: a) Pay them well; b) Treat them well; c) Allow them to do their jobs without bureaucratic, centralized interference.

Despite some positive moves by the Liberal government in recent years, pay inequities that de-incentivize physicians — many carrying huge student debt loads — to work in family medicine still exist. Surveys have identified that many family physicians here say they feel disrespected by provincial authorities.

If working conditions were to improve dramatically for doctors (and other health-care workers), Houston predicts Nova Scotia’s exceptional quality of life would make recruitment and retainment far more successful.

While we’re talking about virtual care, it’s worth noting Houston also wants to expand the types of health-care services that would be available remotely, so that, for example, consults with specialists, occupational therapists and other health-care providers could be provided virtually when appropriate.

What about wait times? Houston’s solution is to extend OR (operating room) hours beyond normal weekdays, so willing specialists could perform more procedures.

Lack of OR time has been a longtime, major complaint of surgeons, pushing some to even leave the province.

Of course, you must also be able to properly staff those extra OR hours — and the system is already hobbled by shortages of nurses and other, key health-care expertise. How would the PCS do that?

Short answer: See Houston’s earlier comment on successful recruitment and retainment. Let’s jump to mental health. As was the case with former PC leader Jamie Baillie in the 2017 election campaign, improving mental health services to Nova Scotians is a cornerstone of Houston’s platform. But the current leader’s proposals, first unveiled last fall, are even more ambitious.

Houston wants the province to be the first in Canada to offer universal access to mental health services, regardless of income. That means those without private insurance to cover the cost of psychologists, etc., would have such services publicly funded.

He’d emphasize the issue’s importance by creating a new department, Addictions and Mental Health, as well as launching a 24 / 7 telephone counselling service and 9-8-8 mental health crisis line. Finally, long-term care. One big commitment by the Progressive Conservatives is to commit to adding 2,525 new single-room beds within three years, at a capital cost of $297 million.

Another is to improve staffto-resident ratios by hiring 2,000 nurses (RNS and LPNS) and continuing care assistants (CCAS), so that Nova Scotia could provide the nationally recommended standard of 4.1 hours of care per resident.

Again, easy to say, but given staffing shortfalls plaguing the LTC sector, how would they accomplish that?

Cue Houston’s earlier comments on successfully recruiting and retaining health-care workers (i.e., pay people well, treat them with respect, empower them). The PCS also say they’d reinstate the CCA training grant (50 per cent of roughly $9,000 tuition) and resume accredited training at long-term care facilities. Now, the price tag. Apart from capital spending, the estimated operational costs of Houston’s health-care proposals total $429 million annually.

How do we pay for that? Houston says improving the health-care system would definitely also bring substantial savings, but they’re hard to quantify.

If, for example, people get primary care when they need it, if people waiting for surgeries get them sooner, etc., they’ll likely cost the health-care system less and contribute more as more productive members of society.

Houston also says a healthy health-care system would itself make Nova Scotia a more attractive place to invest and do business.

Hard to argue with that.

In a future column, I’ll look at the NDP and Liberal healthcare platforms.

OPINION

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2021-07-24T07:00:00.0000000Z

2021-07-24T07:00:00.0000000Z

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