By David Zitner (AIMS Senior Health Care Policy Fellow)
The latest missive from the Nova Scotia Health Authority (NSHA), sent to some doctors but not to the community at large, acknowledges the responsibility of the Health Authority for the sad state of primary care. In an April Department of Family Practice Update we see a development that imposes a costly and inefficient administrative burden on all Nova Scotians.
An objective of the Department of Family Practice is to ensure access to primary care: The Health Authority writes, “The Department’s purpose is to understand and coordinate the activities of the more than 1,000 family physicians practicing within the health system, ensuring that Nova Scotians have access to the primary care”. One imagines that the coordination of its activity ought to be directed to maximizing access instead of curtailing it. Unfortunately, the Family Practice Department follows with proposals that will decrease the already limited access Nova Scotians have to primary care physicians.
The health authority’s proposal is consistent with previous harmful actions that continually make care and access to care worse for patients.
The NSHA seems to have the unwarranted belief that increasing the administrative burden on clinicians will not decrease the time available for clinical care.
The specific proposal from the Health Authority is to create “14 Network Councils” with representation from every community. The Authority notes that “serving as a council member is an excellent opportunity [for physicians] to connect with colleagues.” No loss of income is contemplated because “time and travel costs are reimbursed for participating.”
However, it is the already burdened system and the frustrated public who will pay the cost.
Added to the shortage of doctors to see Nova Scotia patients, the costly time doctors spend connecting with colleagues and travelling is time that is not available for patient contact or patient care. These meetings will further limit the time doctors have to see patients.
The health authority essentially places an additional burden on communities by proposing regular “Department of Family Practice” network meetings across the province.
The authority, with no seeming oversight from the N.S. Government Department of Health has already hired 12 physicians as “network leads” in paid positions, asking each lead to take half day per week of clinical time from communities that are suffering now. There is a search for two additional physicians to add to these 12.
The N.S. government, as regulator and evaluator of care, is silent. Government proclaimed they would reduce the administrative costs they identified as a burden on health care. Yet, the NSHA has been empowered to take valuable clinical time from communities and develop 14 physician networks. Did the Nova Scotia Health Authority and Provincial Government mean to develop 14 networks to replace or compensate for the nine districts in N.S. that no longer exist?
The public needs better solutions. Health care represents 45 per cent of the Provincial budget and education is 14 per cent. Government divides the remaining money between 19 other departments. Elections in Nova Scotia have recently become about health care and who will run health insurance for Nova Scotians.
Nova Scotians expect better solutions. We expect the Nova Scotia government to comment on the state of health services management, to indicate when government will accept its responsibility for health care governance and oversight, and to indicate government’s plan to reduce the continuing decline.
David Zitner is a retired family physician and is senior health policy fellow at the Atlantic Institute for Market Studies (AIMS.ca)