Monday, April 02, 2018

Health care in Nova Scotia

Things are not looking so good lately in Nova Scotia health care.

Nurse fired at Cape Breton hospital after patient death. A patient who had dementia "was found dead in the early morning hours of Feb. 23 outside on the grounds of the Cape Breton Regional Hospital." yikes. Well apparently and a bit to my surprise, it is possible in government health care in Nova Scotia for an employee to get fired.

In Halifax a man called 911 when he was already at QE2 emergency. The guy had been down to ER 4 times and couldn't get any traction. Turns out he had stage 4 lymphoma. Although David Doucette himself got service after taking drastic measure, what he did establishes a bad precedent.

The ambulance/emergency system in its current form will collapse if this becomes the norm, people stepping out of the ER if they feel they are unsatisfied with the level of service in triage/ER, then pulling out their call phones and calling 911 to come back into ER this time from an ambulance, effectively in a sense bypassing triage and jumping the line. Obviously once someone is at ER, they don't need an ambulance to take them to ER. The media should have spoken out more strongly against what Doucette and his girlfriend did.

And now these same employees who deliver these health care outcomes, are themselves seriously considering an illegal wildcat strike. Which I find ironic in light of these recent stories of the service they have been delivering to the patients whose taxes pay their salaries, benefits and pensions already. sheesh.

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Together it seems that health care is seizing up in Nova Scotia. Which is remarkable as it has been under government central planning now for 50 years, two generations and counting. Medicare is not a new thing, there are now decades of experience planning and administering government health care. And amazingly it is still a train wreck. And getting worse, while spending grows every year.

The think with ER, to fix ER you need to fix the family doctor issue, the overcrowded inpatient wards issue, the nursing home issue. These things are all related, the visible symptoms of a failing system. ER on its own cannot be fixed, not with the $600 million "one time" Don Downe money bomb just a few years ago which we were assured would fix everything, not Jamie Baillie's $2 billion "one time" money bomb for health care from the election campaign just this year.

The thing is, from primary care through to nursing homes, how can you have all this administration, all this central planning, and yet appear to be completely unprepared for these developments, years behind in addressing anything, always caught off guard, seemingly lurching from crisis to crisis.

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So where is it going to go? There is strong evidence that, two generations in, the original medicare dream is failing. The objective evidence and data is it just can't be fixed or saved in its traditional form. So what will emerge? Which way will it break? Will it end up like Venezuela health care, or perhaps a US-style system, or perhaps a European or NHS outcome.

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