A recent feature by Advocate Media showed that the Nova Scotia Health Authority (NSHA) is rightfully concerned with the almost 150 vacancies for family physicians and specialists in the province.
In the Eastern Zone, which covers all of Cape Breton, as well as Antigonish and Guysborough counties, the percentage of patients without a family doctor has gone from 6.4 per cent in 2015-2016 to 7.52 per cent in 2018-2019.
As of September, 2018, 4,260 patients in the Eastern Zone were not placed with a family doctor, but 6,171 patients found a primary provider.
Between April 1 and August 31, four family doctors and five specialists were recruited in the Eastern Zone.
The Eastern Zone is currently recruiting: 4 full-time psychiatrists; 3 full-time ophthalmologists; 15 full-time family physicians; 2 full-time emergency physicians; 1 full-time pathologist; 1 full-time oncologist; 1 full-time dermatologist; 1 full-time gastroenterologist; 1 full-time head and neck surgeon; 2 full-time pediatricians; 1 full-time obstetrician/gynaecologist; 1 full-time anaestheliogist; 2 full-time respirologists; 1 full-time radiologist; 1 full-time child and adolescent psychiatrist; and 1 full-time geriatrician.
Although concerned, the NSHA is optimistic their recruitment efforts are coming together and they are currently working with other agencies – such as the Department of Health and Wellness, Doctors Nova Scotia, the College of Physicians and Surgeons of Nova Scotia, and the Office of Immigration – to fill these gaps.
The health authority has been taking a number of different approaches when it comes to recruitment. Fifty collaborative practice teams have been added recently, increasing access to primary care. Since April 2017, 68 new family physicians have come on board.
Working with Dalhousie University’s Family Medicine Residency Training Program, 10 new residency spots were created throughout the province. One position will be used for family medicine residents to gain additional clinical experience in an area that would enhance services in the community, such as mental health and addictions, or oncology.
The health authority is attending job fairs and conferences, and reaching out to medical schools across Canada. There’s also a recruitment team working now in the United Kingdom.
As well, a new recruitment Web site: https://recruitment.nshealth.ca was recently launched, which provides on-line visitors to check out what’s available in terms of positions, and gives them a chance to find out more about the province. The NSHA confirmed they’ve already received 35 applicants or inquiries through the site.
The NSHA is also in contact with residency programs across Canada, and working on a delegation to go to Alberta after making contact at a conference in Toronto. Targeted advertising in academic journals is also being done.
To help the recruitment effort, some communities have created local recruitment groups, which feature local physicians, community and business leaders, and the health authority.
Despite the best efforts of the health authority, service gaps remain in the system, to such an extent that the political opposition is making noise and gaining traction.
After the end of the fall sitting of the Nova Scotia Legislature and a pair of health care rallies in the Cape Breton Regional Municipality (CBRM), NDP Leader Gary Burrill told The Reporter he is worried about the fates of health care facilities across the province given the sudden closures of hospitals in North Sydney and New Waterford.
Like the hospitals that were closed, other facilities across the province have dealt with staffing shortages, emergency department closures, and aging infrastructure, Burrill noted. Closing the CBRM hospitals with no consultation has many people on edge, he said.
Another issue that arose this fall in the legislature surrounded what Burrill termed a “crisis” in nursing home funding. Burrill said the main culprit lies in the governing Liberal’s decision to take $5 million out of the budgets of nursing homes over the last two years. As an example of the effects of these cuts, Burrill pointed to the reductions in hours for Continuing Care Assistants at the R.K. MacDonald Nursing Home in Antigonish last year due to budget restrictions.
Burrill said over 20 per cent of all hospital beds in Nova Scotia are currently being occupied by people who are not hospital patients, cannot continue to live alone, and are in a nursing home category, but there are no spaces in nursing homes for them. Unfortunately for Nova Scotians, the NDP leader said the Liberals have not added one single bed to nursing homes since assuming power.
The NDP leader said another important trend which is having a negative impact on nursing homes is that long-term care patients today are older, more frail and need more support. He said Nova Scotia’s formula for calculating the appropriate number of care workers for the number of patients is decades old and inadequate.
Burrill added problems run so deep and are so inter-connected that every aspect of the health care system has been compromised.
Not just the NDP, but the official opposition Progressive Conservatives are also making hay out of health care shortcomings.
On October 30, after Cape Breton-Richmond MLA Alana Paon had the topic of recruiting strategies within the NSHA rejected before the legislature’s human resources committee, she claimed the government is hiding information from Nova Scotians because they have failed to recruit doctors and refuse to answer for it.
The PC MLA explained that doctor recruitment is directly linked to the regular closure of emergency rooms, like that at the Strait-Richmond Hospital where there is no physician available to cover shifts.
She added it is ridiculous that so many people do not have access to Primary Health Providers and that emergency department closures have become acceptable to the government.
While it is unfair to place all the blame on the current government since PC and NDP regimes before them did little to stop or even reverse these trends, the Liberals have been in power long enough to accept responsibility for the thousands of Nova Scotians who have fallen through the cracks on their watch.
It is encouraging that the Department of Health and Wellness, Doctors Nova Scotia, the College of Physicians and Surgeons of Nova Scotia, and the Office of Immigration are all working together to identify, recruit and bring physicians and specialists to all regions of this province, and their efforts could very well bear fruit, but when, and will it be enough for a system that is bursting at the seams.
The problems in health care are systemic because they were left to fester over decades; without targeted investments, consistent planning, comprehensive maintenance, and long term funding commitments.
It is also hard to ignore the data and the personal stories of those who have encountered problems in the health care sector. And while the good work of many people and agencies pulling in the same direction can plug some of these holes, the only true solution is long-term and strategic financial investments in facilities, employees and programs.
Hospitals are crumbling, dying patients cannot get rooms, emergency departments are closed, facilities have been shut down entirely, budget cuts have reduced staff, nursing home patients are in hospitals, and on it goes. All these questions have one obvious answer, and while more money might seem the easiest and most obvious option, it is exactly what is needed for health care in Nova Scotia right now, and in years to comes.