Trust is the most important part of a relationship, closely followed by communication. If you have those two things, everything else falls into place.

Canadians and all people should be skeptical of government power and should ask hard questions: What is the authority? What is the oversight? That’s the way it ought to be.

Every leader has a right to implement his own policy. But when things that are done are not right – abuse of power, wrong approaches, wrong strategies, then it is incumbent upon people to say something.

Last week, the front page of Nova Scotia’s largest daily newspaper contained a very disturbing quote from an article speaking to the issues why Dr. Jeanne MacGillivray is no longer permitted to provide surgical services at both St. Martha’s and Inverness hospitals, attributed to an official of the Nova Scotia Health Authority. “In some cases, what is being claimed and shared is unfortunately, not accurate,” reads part of the statement.

In the same edition of the newspaper, framed as a counterpoint to recent articles on health care, is a plea for reprieve from negative criticism of health management. The author suggests that criticism of health management could impact on the good works of volunteers who raise much needed funds for health care services.

A year ago an official of the NSHA suggested that “negative articles about health management” negatively impacted recruitment and retention of physicians. Again no evidence was advanced.

It is unfortunate that leaders of health organizations and foundations would characterize informed opinion about what is not working well with health care in such a negative way. By questioning the motives of authors of critical opinion, the counterpoint’s author and the NSHA official have diminished and unwittingly impugned the motivation of the critics. Is this a strategy meant to silence critics?

Criticism is something we can avoid easily by saying nothing, doing nothing, and being nothing. But it is important to remember that in the absence of accountability, there is dysfunction that fosters mediocrity at best and abuse of power at its worst. Nothing strengthens authority more than silence. Without accountability, standards cannot be enforced, feet cannot be held to the fire.

As people become more senior in their career, it can be thin at the top. It is harder and harder to get unbiased and direct feedback when making decisions. A tired cliché, over used in this Trump era, is still important, and that is for people to speak truth to power.

Dr. Jeannie MacGillivray’s plea for understanding of her personal and professional challenges has reached the front pages of the media. As such, it is another example of how fractured the relationship is between physicians and the Nova Scotia Health Authority. Trust and respect have been causalities of the failure of leadership to appreciate the challenges of providing medical services in very challenging environments. To deny they exist is not a sustainable strategy, and to denigrate those one who are sounding the alarm is shameful.

Leadership contains certain elements of good management, but it requires that leaders inspire, that they build durable trust. For an organization to be not just good but to win, leadership means evoking participation larger than the job description, commitment deeper than any job contract’s wording.

Dr. MacGillivray feels wronged and threatened. It is not acceptable for the NSHA to simply state that she is wrong without evidence. This is a publicly funded health care system in need of qualified people. The health authority owes it to the people to be more transparent about issues that threaten the stability of a service as critical as general surgery in Eastern Nova Scotia.

Whether it is a surgeon in Antigonish, a psychiatrist in Sydney or an emergency room physician in Halifax, it demeans the relationship that should exist between the managers of the health system and its service providers when their integrity is questioned or their concerns are characterized as hysterical or inflammatory. It is bullies who use language of that nature, not bridge builders, and certainly not statesmen or inspired leaders.

By encouraging critical thinking and processing of knowledge we are creating full, well-rounded human beings who will strengthen society, not diminish it. You cannot build a healthy society without giving your citizens a sense of ownership. Otherwise, they will not share with you the responsibilities.

It is troubling that leaders within the health establishment are failing to ask the right questions of their superiors. The leader of the health foundation in the very area that Dr. McGillivray practiced, should ask why people are questioning the practices of health managers, rather than blaming them for trying to hold them accountable. Legislators have failed in their legislated role of holding government and health managers accountable, therefore it defaults to the free press to fill the void while it still can.

In order to improve healthcare, we will have to spend more on it, increase accountability and decentralize services, enforce standards, and reinstate people’s faith in it. These are self evident facts that few political leaders have been willing to admit as they continue to promote the false notion that they have everything other control.

Dr. Robert Martel

West Arichat