Who to trust?

The Nova Scotia Health Authority has trouble communicating what they’re doing. Auditor General Michael Pickup made that point in the fall. It’s worth remembering that in 2011 former Auditor General Jacques Lapointe, having studied the problems with the cost overruns of the Truro hospital, recommended “The Department of Health and Wellness should put a process in place to ensure only complete and accurate information is presented to Cabinet.”

The former AG determined that inaccurate information was presented to justify the construction of a new hospital. And here we are almost a decade later and we’re still questioning the veracity of health executives.

It seems that after each appearance by an NSHA representative before the Legislature’s Public Accounts Committee their testimony is questioned.

For example, in April 2017 Dr. Bob Martel, a palliative care doctor from Richmond County, took issue with a statement from NSHA CEO Janet Knox that paramedics can offer in-home palliative care to 1,000 patients who have signed up for the service. Martel wrote, “On the surface, this statement is factually correct, but is misleading in that it leaves the impression with political officials interviewing Ms Knox that these paramedics are offering palliative care services to 1,000 patients. The number refers to the patient population registered as special palliative patients with Emergency Health Services over the last two years. What it really means is that EHS will respond to calls from these patients and their families in a different way: no lights and sirens, more sensitivity around issues of resuscitation and on occasion, administer bridging pain and symptom relief to patients who do not have access to their regular physician or palliative care practitioner. … This program is neither meant to provide primary palliative care nor is it qualified to assess or administer comprehensive palliative care. … It is too bad that Ms Knox was not challenged on this point as it appears that she successfully conveyed that all is well in palliative care …”


Now Herald columnist Jim Vibert questioned the information provided by – or left unsaid – by Rick Gibson, NSHA’s senior medical director, who appeared before the Public Accounts Committee in December. Vibert writes, “Gibson told MLAs the authority now has what it needs to plan for future doctor requirements across the province … But even as he was speaking, the NSHA was issuing a tender “for a more robust data system to better track and report on physician information, including credentialing, privileging and recruitment”.”

Vibert continues, “No mention was made of the tender at the committee, and members could be excused for coming away with a sense that at least the NSHA is working from good information, when it is in fact just going about the process of buying better data.”

It was, as Vibert says, not a complete picture. I am reminded of the line from A Few Good Men, where an angry Jack Nicholson screams, “You can’t handle the truth!” Is that what the NSHA executive feel about the right of the public and politicians to know about the state of our health care system?

Are Nova Scotia health executives too cute with details or uncomfortable with facts? As Vibert says, “Say what you will about the health authority – and I have – they are good at teaching us who to trust.”



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2 Responses to Who to trust?

  1. ausca says:

    It only gets worse.

    I doubt any second term government would allow the Auditor General to take a fine tooth comb to the financial and management practices of the NSHA. The chances are that their Department of Health and Welfare if not the Premier could be hugely embarrassed by what is discovered. I guess demands for this has to come from the opposition parties. Surely they can see that more than ever public health is the Achilles heel of the current government?

    If the NSHA can be cracked open and the problems turn out to be so immense, I wonder if some sort of cross-partisan health committee could oversee both temporary fixes to slow down the rate at which health care is sinking, then devise a way to manage health care that will eventually re-float it in times where the Canadian GDP is expected be around 1.7% p.a. (which means the rate of increase of Federal health transfers will always be on the floor at 3%). This has to be longer term vision, not constantly upended by changes of government.

    I’ve started nagging one of the party leaders again, but so far, no joy…

    • Thanks. Contact the party leaders, but also include your MLA. And do write the Health Minister and Premier. It’s only when the public expresses their concerns specifically to individual politicians can we expect action. It’s the squeaky wheel thing. Be polite, but be firm.

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