Curious cuts to care

There are curious choices made in our health care system. In September of 2011, Annapolis Valley Health reduced clinic hours in Berwick and Wolfville as a way to save money.

In the spring of 2012 the health authority made $100,000 in cuts to their food services in Valley Regional Hospital, Kentville. In May they further reduced clinic services by cutting access to X-rays 30 percent in Wolfville and 40 percent in Berwick.

These clinic reductions force more patients to travel to Valley Regional Hospital in Kentville. Whether patients are seen by appointment or at an ER visit it puts more strain on front-line medical staff in Kentville. Yet this week AVH announced it’s cutting 2.5 nurse positions from the VRH ER and that another two nursing positions will be cut in other departments!

Have they forgotten their mandate or are they trying to coerce the government into giving them more money?

What are their priorities? Their first choice is always to cut front-line care, but there is no evidence that executives bear any fiscal pain. AVH traditionally has administrative costs well above the national average (as much as 60 percent higher), yet manages to find the funds five days a week to drive food for a subsidized lunch program for 160 executives and white-collar workers in their corporate bunker on the other side of town. What does this perk cost? And could it pay to preserve the nursing positions being cut?

How do you send more people to hospital to be attended to by fewer staff and claim not to impact patient care and overall performance? How do AVH president Janet Knox, the Health Minister and Premier justify this?

This is how one health authority acts, what are the province’s other nine up to?

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4 Responses to Curious cuts to care

  1. ausca says:

    “This is how one health authority acts, what are the province’s other nine up to?”

    One can only wonder. In fact I really wonder why less than one million people need all these district health authorities and whether there is not a more efficient way to deliver public health services.

    I must say I was disappointed with previous Health and Wellness minister MacDonald. It seemed that she seemed to side with the administrators – more or less preserving the multitude of DHAs – and appeared to do little more than offer relatively minor tweaks to the existing system. I don’t know if our health administrators, medical and nursing practitioners and support organizations are so powerful and entrenched that they successfully fended off any genuine efforts by her and her department to reform management of Nova Scotia’s public health system to reconcile the looming demand in age-related services with the anticipated decline in transfer payments which Harper will tie to GDP after 2017, or whether no such efforts were ever made. In either event it’s ground for serious concern. I had so much hope for the Dexter government, but at least as regards health care they have so far been disappointing, and that is our single biggest public program – crucial to both the health and economic sustainability of this province. It’s hard to imagine that with an election approaching in a year they will suddenly take this seriously. If they suddenly produce a genuine health care reform plan, will they be believed after breaking unrealistic promises to keep all ERs open 24/7 and to not raise taxes?

    Now NS has a new Minister of Health and Wellness, Dave Wilson a paramedic. (It doesn’t impress me that after her performance in this portfolio, Ms MacDonald was ‘kicked upstairs’ to bring her demonstrable expertise to the crucial Finance ministry). Anyone know if Wilson would be more likely to succeed at genuine reform than his predecessor? I expect his assigned goal for the next 12 months would be to avoid scandal and to present our health care system in as rosy a light as possible for electoral purposes.

    We cannot go on like this.

    We really must address CORE issues that unsustainably accelerate the costs of health care delivery while holding it less ‘patient-centric’ than it should be. Nothing should be off the table and all principal stakeholders should be represented, but they need leadership on behalf of the principal stakeholders – the citizens of NS. If that leader is not the NS Minister of Health and Wellness, then who could it be?

    I had high hopes for this government. Of course almost any alternative would have looked better than the Rodney MacDonald PC government, and the NDP – an experienced Opposition had to learn how to govern – something they had never done before. It’s been a long tutorial. The time for cautious baby steps has long since passed. I contributed and worked to get them elected, but if this looks like the best they can offer, next time they go to the polls I may have to reconsider. This is not a sport. It’s not a matter of supporting your favorite team no matter how poorly they perform. Whoever wins, no matter what partisan nonsense they indulge to get there, in the end it’s all about governing. If they can’t govern then they should get out of the way and let somebody else try.

    Unfortunately we’ve not seen inspiring examples for their alternatives in a long time either.

    I wonder if we can just suspend the NS government and all elect a private consortium to govern in our best interests for 4 years? How is Ken Rowe these days? IMP Aerospace seem to have a good management track record. Maybe they and even Irvings should offer in 2013? At times lately it has felt like government of NS is actually being run by Joan Jessome. The current system seems clubby and backward – bereft of both lateral thinking to determine what best to do and the determination to do it, no matter who complains.

    At what point do we finally admit that 164 years of elected government has failed Nova Scotia?

  2. Obviously it is silly to have so many DHAs. But the inefficiency of these little fiefdoms is is not the core problem. I don’t think that it is realistic to expect that a modification in the system will solve the problem. I’ve experienced many different types of healthcare systems (in different countries and different times) and they all have their pluses and minuses.

    I suggest to you that the CORE problem is an unhealthy population that does not have the wealth to purchase health or the gumption to look real problems square in the face… It’s been more than 100 years since there was a politician that had a spine that could support an independent thought, so expect them to be the last ones to see sense.

    The CORE problem is FAT. It’s implicated as a factor in every health problem from bad knees to diabetes to strokes to … to dementia. I am of the opinion that our ignorance about the human endocrine system is the main reason for much bad public policy that has created this nightmare. To give one example: Are your Food and Water Containers Forcing your Stem Cells to Turn to Fat? Other examples are the obsessive campaign against fats which caused our society to load up on carbohydrates and sugars which really mess you up. We’d do better to invest in gymnasiums and scrap half of healthcare — it just doesn’t work!

    • It is unfortunate that so many people need help in managing their weight. For some it’s a matter of food education. Some it may be related to emotional issues. We can’t blame it wholly on educational levels because one of the perks given to an Ontario health care executive was a $5,000-a-year allowance for cosmetic surgery and weight-loss programs.

      Obviously we can’t leave obesity to our health care system to address. I have temporarily mislaid the op ed piece the head of the IWK wrote in the Halifax Herald a few months ago, but she referred to a major obesity study conducted in Canada in 1951.

      The findings of study she said still held true today. She didn’t take the position that this ongoing study was their failure, she took the touchy-feely position that weight is a struggle. So here we have a health care system that has had 61 years to address the issues presented in a definitive obesity study and they haven’t. That’s beyond ridiculous. (I will keep sorting through my files to get her op ed piece.)

      And what is the latest we learn about food in the health care system? Well, other than how much money health authorities are losing by operating fast-food franchises, we now have definitive proof of how unhealthy hospital food is.

      Read this:

      Our family’s experience with unhealthy hospital food comes from first-hand experience. We had an elderly family member who was a patient in a hospital in the Annapolis Valley. She was transferred to the VG in Halifax. When her daughter, who followed the ambulance in her car, arrived at the hospital, hospital staff had security ready to arrest the daughter for elder abuse. Why? Because her mother arrived with a broken hip, broken collar bone and was severely malnourished. The problem for the health authorities was this elderly woman had been a hospitalized for the previous three months. Her neglect was at their hands. That was 20 years ago.

      Fast forward to two years ago. A young bank manager knowing my experiences with the health system told me about her grandmother who was a patient in this same Valley hospital and failing quickly. She told me how her grandmother had lost her zest and how her skin had even lost its elasticity. I suggested she and her family not only bring in food, that they be there to feed their grandmother personally to ensure she was properly fed. They did and this woman returned home within weeks.

      I have no faith in our health care system to cope with obesity or other nutritional issues. In fact, I have little faith in them to do anything.

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