Today I think of the late Newfoundland industrialist Craig Dobbin. Dobbin founded a number of construction and real estate companies, as well as Canadian Helicopters Company, which was second only to the US military in terms of helicopter ownership, as well as Air Atlantic. In an interview he laughingly told me his father wasn’t necessarily a good businessman, but he was a happy one. Dobbin said, “He’d calculate the profit on the order (of lumber), and he’d calculate the profit again when he delivered it, and he’d calculate the profit when he sold it and then he’d add up all three profits. He enjoyed it three times.”
So it is with political announcements. Today, it was announced that construction for a 12-chair dialysis unit at the Valley Regional Hospital in Kentville would start in 2017. According to today’s announcement, the unit will be operational in 2019.
This is the latest in a series of announcements about a new dialysis unit. The first was $1 million pledge by the previous NDP government on November 28, 2012. In January 2016 it was referenced in the province’s 2016-17 Capital Plan.
Back in 2012, after the health executives finished applauding themselves and photographs were taken, it gradually dripped out that the new dialysis unit would take two years to open. The delay was because the health authority had to determine where to position the unit, commission designs, issue a construction tender and then have it built.
Two years might seem a reasonable time line if you don’t think about it. But given the behind-the-scene work that goes in to public funding announcements, why wasn’t that planning done first? Are we to believe that cabinet ministers jump out of bed and decide to give away millions of dollars without any background planning?
Assuming the initial announcement was pure political opportunity, the health authority committed themselves to a two-year timeline to build and open the dialysis unit. It didn’t. This is not the first dialysis unit ever built, so it doesn’t take forever to design or build it. There was a need in 2012 that hasn’t, isn’t and won’t be satisfied until 2019. Health care decided that seven years of patient suffering, sacrifice and travel expense was an acceptable time line.
The health executives also decided the cost increase is acceptable. In 2012, then Health Minister Dave Wilson told CBC radio host Don Connelly dialysis units cost $3 million to build and $500,000 to operate. Today’s announcement (January 13, 2017) is for $9.1 million. So, the inflationary increase for this seven-year delay is $6 million. Since we’re paying top dollar, why will it take 1.5 – 2 years to build? Cruise ships, which are fully functioning floating cities, are built in less time. Why can’t this be done faster? They’ve already had five years to plan.
One thing is sure: we’ll have a photo opportunity of over-dressed executives turning over a shovel of soil, another for a hard hat tour given to media and VIPs near project completion, and then the prerequisite ribbon-cutting photo. While I began this with the three ways the Dobbin patriarch enjoyed business, this dialysis unit will give health executives seven opportunities to celebrate without once having to actually help a patient.
helphealthcare 
Privatize the buildings. The government is only good at cost overruns. The company I work is a sub for renovations on Aberdeen in New Glasgow. Another boondoogle but when it comes to budgets nobody gets fired and even less care.
You say the government is only good at cost overruns. Let us exempt the health executives employed by the Nova Scotia Health Authority. Too often we speak of the government and by omission exempt those who are in direct, daily charge. Janet Knox, for example, heads the NSHA. Prior to that she headed the Annapolis Valley District Health Authority. She was there in 2012 when this dialysis unit was first promised. Knox was at that health authority since 2004 – all those years they spoke of and fundraised for a palliative care/hospice for Valley Regional Hospital. It wasn’t built during her decade in charge. So let’s not only speak of “government” when we complain about boondoggles…
The ones responsible for boondoogles in private sector get fired. The ones in public get promoted. I find it laughable that you have all this faith that somehow the system can be reformed when there are no consequences for bad decisions. The health care system is going to fail because those in charge have no reason to hold back increases in expenditures. I read your posts quite often. I suspect you either worked in or know many who work in health care field. You talk about this and that thing but only cut at edges. Why not talk about how much more money we are spending this year compared to last. Why not tell me and everyone what you think is appropriate percentage of budget should be for HC. I get the impression that budget has no limits. Sure you sometimes say ns.gov is spending enough. But last time I commented I suggested a 10 year freeze on dollars spent an you rejected it out of hand as ridiculous. Maybe it was a bit seeing as I was calling for a absolute freeze not tied to inflation but I am fucking tired of turning on TV and hearing all the experts blathering on about cuts to this and cuts to that.
And what is your point about Mrs. Knox. Did she work Private sector? Sounds to me like she didn’t. Anyways keep on keeping on. The system is going to fail. Sucks because I am getting to age when I really am going to need it.
Yes. The private sector replaces those who underperform. Sobey’s recent management shakeup is a prime local example. I wrote about this ages ago when the former Capital Health CEO told CBC that she felt their compensation should be comparable to the private sector for the level of responsibility. I wrote then that in the private sector executives are held accountable for their performance. Accountable to shareholders and bankers and customers. No such responsibility or accountably is required of health care executives. They get a free ride.
I don’t believe that more money should be funnelled in to health care. That said, I don’t believe in blanket freezes. Two reasons, one, stuff happens and things come up which require flexibility to deal with. Most people don’t realize it, but governments have special reserves for paying for war, should we find ourselves in one. My second reason for not supporting blanket freezes is that it makes people lazy. Politicians can step back and say the freeze is in place. They wash their hands. Health executives can claim that their hands are tied. A blanket freeze is too easy a ride for people at the top. Everyone below suffers.
To my knowledge Ms Knox has no private sector experience.
I believe that those in charge of the system may think they understand how to respond swiftly, but are so caught up in process that years seem a reasonable time for them and their ilk to act. Someone made the point this week that health care only has to think in four-year increments because that’s a government’s term in office. If you are a patient in a hospital in the care of a doctor on rotation – and 86% of patients in Kentville are – your care plan is never more than seven days. Rotation doctors work a week and then are off. In my experience most doctors try not to prescribe treatment that overlaps into the next doctor’s time.
My bottom line is always that the amount of money that goes in to health care is almost inconsequential if it is badly managed. If you have weak or ineffective or under-performing or unaccountable executives then it doesn’t matter how much they have to work with, a significant amount will be wasted. Only accountability will truly improve the system.
As for my experience, I do not, nor have I ever worked in health care or the public service. I was a caregiver. I have been a patient. I have a lot of patients and other caregivers, health care workers and medical professionals contact me with issues and ideas. I write about the things I do because a) I have specific knowledge of the situation and/or b) someone has approached me about it and c) it is on a scale that is understandable. Talk billions of dollars and a lot of people step back. They can’t get their heads around such a number. But they can understand or relate to delays in care or leaving someone laying in a hallway for hours or days.
I admire your passion. I just don’t see how things will change. Doing the same thing and expecting a differnet result is the definition of insanity.
We are working right now on an addition to Aberdeen Hospital. It has been a fustecluck from the get go. A lot of it cause by bad drawings, plans and bad execution. They had finished roughing in of the new area. Started with gyproc and wiring. Had one room completely done. And had to tear the whole room down to the studs because the room wasn’t configured correctly. No doubt an expensive mistake. Nothing written in paper, nothing done and no consequences.
Only one room? Read my piece Our Hellish History of Hospital Construction.
Three things are at play: first, poor management. What do health care executives know of building maintenance or construction? Secondly, who awards the work? Do they get the best companies or the best at filing paperwork? Thirdly, what are the consequences for failure and waste? Nada. So what the hell.
I like this post. In thinking about all that is said, while we are waiting and waiting and waiting for a new hospital to be built to replace the old V.G. hospital at the present cost of close to a billion dollars, the health department is in the throes of finishing two empty floors at the Dartmouth General Hospital that has been going on for the past couple of years and the renovation of several floors of the V.G. Hospital is still in the planning stages. It is my understanding, after the new hospital is built, somewhere yet to be determined, the old V.G. Hospital along with the Centennial Building will be torn down. If there is money to be wasted, the government will find a way.
The new Convention Centre being built in downtown Halifax, even after all of the delays and on site planning and changes, will be completed in its third year of construction. They can build arenas and ten thousand seat stadiums in a 1-2 year span. It is baffling to think that the construction of a new hospital has to be a ten to twenty year plan and is going to be a P3 project, meaning that there will be a greater cost burden placed on the the already overtaxed people of this province.
Trudeau, with all of his talk of a revenue neutral carbon tax and infrastructure bank will, exponentially, add to the cost of this present day billion dollar project. On top of that, the provincial government continues to dole out millions to corporate welfare, to a sinking Bluenose lll project and the Yarmouth Ferry. The hospital situation in Halifax has been known for over three decades and it had to deteriorate into third world conditions before something was finally done and is going to be another agonizing decade, at minimum, to come to fruition. The people are always last on the minds of government when it comes to meeting their needs.
Government’s sole function can’t be as the bank for health care. No matter what is done and given to health care, it is never enough. At least not if you listen to the executives. Former New Brunswick Premier Frank McKenna once told me that whatever you do in government the complaint is that that money should have gone to health care. McKenna said that in government you have to invest and support other things because those other things – whether it’s tourism promotion or entrepreneurship – are done with the goal of generating revenue. Revenues are taxed. Taxes provide the money for health care, social services, roads, education, etc.
I believe that if we continue to shovel endless amounts of money at health care we will only feed the problems we have now. That’s because we don’t have innovative leaders in health care. They’re old school and mired in the past. And, we give them areas of responsibility that are outside their specialties. Why do we expect nurses and doctors to grasp human resource management, catering, laundry, purchasing, building maintenance or oversight of a capital project? Other than perhaps hiring a contractor to remodel a house or condo, what do they know about these things? Look across Canada and see how every medical project is behind schedule, over budget, involved in dubious business practices and finished to a sub-par standard. The new McGill medical centre was $170 million over budget and handed over with 400 deficiencies! Some minor and some quite dangerous like fawlty wiring in ORs and plumbing that backed up into patient and treatment rooms.
The definition of crazy is doing the same thing over and over again and expecting different results. Health care is the prime example of that definition.
I believe I have stated this before. Dr. Michael Rachlis of the University of Toronto, insists the health care system does not need more money thrown at it, the system needs to stop wasting the money it already has. I contend that corporate welfare never produces the economic wealth, prosperity or jobs, jobs, jobs it intends to create and instead creates increased debt which leads to cuts in social programs of which health care seems to be taking the largest hit.
I’m not suggesting corporate welfare, just that all things be treated equally. For example, the Yarmouth ferry. It is a transportation service that has always received a subsidy just as the Digby, Sydney, Wood Islands, Tancook, Brier and Pictou Islands services as well as river services elsewhere in the province.
In NB, they spent $7 million a year buying sand and trucking it to several beaches. That seemed like an outrageously frivolous expenditure, but it, married with a campaign selling experiences in the province increased the average visitor stay from one night to 3.8 nights. It was an extraordinary success. The tax revenue generated by this was many times the investment.
Comparing the Yarmouth Ferry that runs to Portland for three months of the year to the other ferry services that run within Canadian waters that run twelve months of the year and are true extensions of highway service infrastructure is like comparing apples and oranges. They are totally covered by the Canadian provincial taxpayers on both ends of the service. The Nova Scotian taxpayer is totally subsidizing the Yarmouth Ferry and Maine contributes nothing at a cost that far outstrips the other ferry services. Why the Nova Scotia Government even paid $200,000 to the state of Maine to pave a parking lot. Some of the revenue for this ferry goes to the American military.
Why shouldn’t the Yarmouth ferry receive the same federal support every other ferry service in Canada receives? Prior to the cancellation of the service by the NDP government, that service received federal assistance. Perhaps you don’t realize that we also pay to attract air service to the region?
As for some of the money going to the US Military, yes, it’s the lease payment. Who owns the ferries plying the other routes? Few companies operating such services own their ships, just as most hotels don’t own the buildings in which they do business.
There is a Halifax hatred for this service, but it does make a difference to Southwest Nova. From her December 14, 2016 appearance at the Public Accounts Committee: “Tourism Nova Scotia CEO Michele Saran said that tourists arriving on the ferry spend an average of $2,100 per visitor party, compared to $1,000 dropped by others. Hotel bookings in the Yarmouth area were up by 34 per cent as of the end of September this year, compared to 2013 when there was no ferry.
“In the Yarmouth and Acadian Shores region, the international ferry link has been a catalyst for economic development and tourism, creating business and job opportunities for residents in the region,” said Saran at the Public Accounts standing committee.
A few years ago there was a massive fundraiser for a dialysis machine for the Hants Community Hospital. I participated in a walk in Windsors with many other people.
No machine ever arrived.
I’d like to know what happened – how much money was collected? and where is it now?
Capital Health was offended by the local fundraising. I recall an executive from the authority telling media that no one had permission to raise money for a dialysis unit, no one had spoken to the health authority about it and it was not in their plans. I recall the community raised around $360,000. It was an impressive sum for a short campaign. I suspect that money is held by the Capital Health foundation.
Kentville and Digby have both finally had dialysis units announced this week. Maybe some of the locals could contact your MLA and nudge them to asking the health authority to reconsider their stance. There at least are new executives at the top now, so room for face saving.
My concern is the money – where is it?
I’ll contact the Hants Journal/The Advertiser to ask them to follow this up.
It was a significant sum. Someone should have to account for it.