Health Care

Marked improvements to health care coming within a year, Houston says

Premier Tim Houston says the deaths of two women who waited hours for help in rural emergency rooms weighed heavily on him as the person responsible for health care in Nova Scotia.

This week, his government announced a number of changes to the health-care system, which have met with mixed reactions from providers.

“The tragedies that were in the news, they’re the depths of sadness,” Houston told CBC Radio’s Mainstreet on Thursday. “I mean, I feel that very personally”

Houston spoke with host Jeff Douglas about the progress his government has made on his campaign promise to fix health care.

Their conversations have been condensed and edited for clarity and length.

Listen to their full conversation here:

Mainstreet NS19:34Premier Team Houston promised to fix health care. He says progress takes time

Premier Tim Houston spoke with host Jeff Douglas about this week’s changes to the health-care system and what’s next for his government as it tries to tackle the crisis.

In what Health Minister Michelle Thompson announced, are there initiatives in there that you would see as transformative and are there some that are reactive?

I wouldn’t use the word reactive. Certainly, we’ve been focused on health care … but we took over a health-care system that was crumbling and we told Nova Scotians we would fix it and we’re just as committed to that now. We’re more committed to that now than we were in the past.

There’s a number of things that were in the works. Some of these things — like we talked about [Wednesday] about this float program — it’s just a way to put additional resources into an emergency room. Well, that was already being tested out and tried out in emergency rooms in the province, and now we’ve just said, ‘Let’s go, let’s go with that, let’s roll that out everywhere,’ so that’s not a direct reaction — it is a speeding up. It’s just a sense of urgency to get things done.

The tragedies that were in the news, they’re the depths of sadness, I mean, I feel that very personally. I take it very personally as the person responsible ultimately for health care in this province, so I carry that heavy. My team carries that heavy. The people working in health care carry that heavy. So anything that happens like that, we assess the time that we’re moving on these projects and say, ‘What can we go faster [on], what can we do more?’ So in that sense it kind of spurs action, but the action was already in the works.

There was an open letter from a group of ER doctors here in the Halifax Regional Municipality. They’re worried that the initiatives are not going to address core issues, which is the inability to admit patients to hospital, to get them moved on from the ER. What do you see as solutions for that ultimately?

Bed availability, that is a long-standing issue, and it’s certainly been exacerbated by the fact that for probably 10 years, there was no investment in long-term care beds, certainly not during the prior governments.

This was one of our campaign promises, investing in long-term care beds and there’s 3,500 in the works, and right now, today, there’s hundreds of people in our hospitals that, you know, could be living in a long-term care facility . I agree with the ER docs that that is a real issue today, for sure.

The investment in beds will take time, but in the meantime as well, we’ve got a number of initiatives around bed utilization where we set up a command center to make sure beds are being properly utilized, and the other side of that too is there are some people who are medically discharged from the hospital, and don’t need to go to a long-term care facility, but just haven’t been physically discharged because it’s later in the day and a family member can only pick them up later.

There’s all kinds of issues like that. That’s an issue, I think, we can deal with in a slightly shorter time frame than building long-term care beds, but absolutely the availability of beds is an issue.

A year and a half in the chair now, what is a realistic expectation for Nova Scotians out there — just to manage the expectations? When does this start to turn around?

During the campaign, I was very clear and I’m always very clear with people on these three points: one is fixing health care will take an investment, and there’s a lot of money being invested in health care. Two was that it would take time and it’s taking time, and three was that it could get worse before it got better. All of those things have been true.

When do things start to turn around? I’m hopeful that in the next six months, in the next year for sure, we start to see marked differences and we’ll come out with a suite of indicators that people can really get a sense of as to what’s happening in the health- care system. So we launched Action for Health, the first plan for health care that this province has seen, I think, in 15 years. That’s available online. People can follow along, check the progress against that.

But really, most people are familiar with one number: [the] Need a Family Practice Registry, and that’s the only thing they’re using to assess if things are getting worse or better, and that list is growing.

Why is that list growing?

One, our population is growing. And I said before — and people had a bit of reaction to — but people who came here generally don’t bring a doctor, so the more people who come to the province, they don’t have a doctor when they land so they immediately go on the list.

It’s also difficult to get people off the list, even if they now have primary care, whether it’s a doctor or nurse practitioner. They’re not generally phoning up and saying, ‘I’m good now. Take me off the list.’ They’ve kind of moved on, but the reality is … we do have an issue with people, doctors, with doctor recruitment and primary caregiver recruitment. There’s three things at play there, so I’m not happy with the way the list is going.

We know we have a lot of work to do, but we also know there’s other indicators to the health of the health-care system too, and we just need to get those out there for people so they can judge. That would be EHS ambulance wait times. That would be the number of people who have actually seen a doctor. People are seeing a doctor every day in this province, and they’re seeing a nurse practitioner, and there’s a lot of life-saving work that’s happening in emergency rooms.

Just giving a good picture of how the system is actually operating, that will be the baseline that people can make their own assessments as to whether it’s getting better or worse, but as long as they only have one indicator — and that’s the Need a Family Practice Registry — they’re going to reach the conclusion that it’s not getting better.