How did we get into this mess?

Spurred by what seems like the disaster-du-jour with the VG, a letter writer to Saturday’s Chronicle Herald asked, “The more I hear about the deterioration of the Victoria General Hospital, I have to wonder how we got into this mess.”

No doubt a lot of Nova Scotians wonder the same thing. The health care establishment would have us believe it is down to shoddy 1960s construction. But is it that simple? If the hospital was poorly built, what have hospital executives and successive governments done to mitigate it? Politicians and health executives seem to have engaged in decades of negligence under the heading of “deferred maintenance”. At some point in 40 years someone should have stood up, admitted that “deferred” can’t be an open-ended option and acted.

For over 40 years the VG’s water has been too toxic for anything more than flushing toilets. I’ve asked before why that was not fixed? Year-after-year, decade-after-decade, government-after-government the VG’s water and other problems haven’t been addressed. It’s as if everyone were waiting for a plumbing/electrical/construction miracle to fix the accumulated problems. Previous governments haven’t pushed executives and executives haven’t pushed governments to solve the issues, instead they have been content to leave it for someone else to deal with. We are that someone else and this is the time.

Given their history, I’m not certain the new health executives can do any better when it comes to building care and maintenance. As I wrote in November 2010 ( when mystery spots appeared on ceilings in patient rooms at Valley Regional Hospital staff were told by management – many of whom now head the new provincial health authority – not to say this was mold because the authority had no funds to deal with mold. That’s a patient-be-damned position.

That sums up the maintenance focus in this province: ignore the problem, don’t give it a name, hope no one notices and leave it for someone else to deal with.

I have long wondered what in the training of health executives prepared them for the non-medical aspects of running a hospital: building maintenance, human resources management, catering, laundry, transportation and so forth. The VG seems to be the embodiment of the collective failure of health executives to deal with physical plant problems. The VG has the headlines now, but what is happening across the province with other hospitals? If they don’t have problems now, can we trust that they’re being well maintained or are their problems simply flying under the radar?

After the Truro hospital ran 84 percent over budget and was two years late opening the Auditor General said this was an example of management by people with no experience overseeing a capital project. Perhaps the Auditor General should do a wider study into the maintenance issues at all hospitals and clinics in Nova Scotia to warn us about the next problem. If one set of executives lacked the experience with capital projects how do we know other executives are any better at building maintenance? Or managing a fix for the situation in Halifax now?

As I have said before, other places, like England, manage to maintain buildings so that hospitals built 150 years ago are still able to be used as hospitals. Why are ours considered obsolete in less than a generation? Is it lack of experience in running a physical plant – which no one will admit – or a belief that if left to deteriorate the government will cough up the money for a new building?

I still believe we should expand management ranks to include hoteliers because they are people who know how to manage high-volume buildings.

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1 Response to How did we get into this mess?

  1. one of the biggest problems is that there is no accountability for bad decisions by management. The front line grunts have to wear it, no matter what

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