Health Politics Rants

Yes we can: Revoke pols’ hospital privileges

drawing
Architectural drawing of an upgraded hospital building in HRM

For far too many Nova Scotia politicians, the interests of their party outweigh those of the people who vote for them. This is why citizens hold them in such low regard. So, if we want see the Halifax’s hospital and outpatient services upgraded to modern standards, we will have to wrestle the project away from our political class.

An independent authority would do, but not the NS Health Authority, which was born wearing the political stink of 2013 campaign politics. Problem is, the task of creating the authority would fall to partisan politicians, who hate to put distance between themselves large amounts of money or power.

A case in point is the Efficiency Nova Scotia Corporation, which lost its legislated independence and revenue stream shortly after the Liberals took over in 2013. The money was about $45 million a year tacked on to electricity bills, where government couldn’t get at it. The corporation’s short-lived independence was the result of consultations in which the public was clear that ENSC should be free of politics.

ENSC had its own Act because, the thinking was, it would be too embarrassing for a government to repeal it. Turns out it wasn’t a problem for Stephen McNeil’s Liberals, who killed the law six months after they were elected and seized control of ENSC.

ENSC’s other problem was that it was an NDP creation and thus inherently unacceptable to Liberals, just as the NDP loathed the Conservative-crafted Environmental Goals and Sustainable Prosperity Act. What saved that act from repeal was its unanimous passage by a House that wasn’t really paying attention. It’s harder to repeal an act you voted for.

The QEII redevelopment project involves hundreds of millions, which presents both an opportunity and a problem for Nova Scotia partisans. The opportunity is obvious: the  budget estimate starts at around $714 million, according to a 2009 Capital District Health Authority PowerPoint you can find here. The problem is, no sane politician campaigns on a promise to spend that kind of money in Halifax. You would win more votes by promising a mandatory puppy-cull.

Oh, and all the rooms would be private and have big windows, something proven to pay for itself in shorter recovery times, but nonetheless hard to explain to a certain class of voters.

Why am I so cynical about this? Because all three major parties have had a crack at the  project since 2009 and all three have dropped the ball after an election. And self-serving political parties are the reason. In a better world, new governments would pick up important projects where their predecessors left off. But not in NS.

To wit: the PCs got the 2009 plan just months before an election and turned a blind eye. The NDP appears to have ordered the project cut by half (see below) just before the 2013 election, although unlike the other parties, they did consult the public on the plan. The Liberals won’t even discuss the cost, preferring to add up all the bits sometime in the future and THEN tell us. Or they don’t want to be accountable for it. Or it wouldn’t fly in rural NS. Or they have no idea.

And don’t think the Liberals jumped on the job right after they were elected. They announced “their” plan in April 2016, borrowing heavily from earlier work, after wasting 2.5 years amalgamating nine health authorities.

Just for example, this is an excerpt from the “final report” the NDP had in front of them in May 2013. If you’re a lover of detail, here’s the full version, but prepare for a long download.  It’s worth your time, though, because it’s the standard we should be aspiring to. (I expect, as with the NDP, whoever is in power will prefer something much cheaper.)

For a quick fix, here is a single page from the report illustrating with a photo of the concept the planners had hoped to emulate, with some explanation.

Or, here’s a cropped version of the picture:

photo
Banner Page Hospital in Arizona, an example of what the defunct CDHA aspired to.

This could have been ours by 2015, if the NDP or Conservatives had been interested.

What happened, you ask? Here’s a clue — just a clue — from a subsequent draft report dated August 2013, two months before a general election, but likely never seen.

"To develop cost reduced scenarios within a fixed budget assumption, several major potential space/ bed capacities were explored ... Project budget is $360m."

In other words, Capital Health had been told to slash the project cost. To see the impact of that budget cut, you can look here. Of download the full document.

What to do? Well, the groundbreaking Environmental Goals and Sustainable Prosperity Act was passed by a Conservative minority government. The power dynamics of such governments often produce creative results. The job of citizens is to persuade the party holding the balance of power that it’s in their partisan interests to force the winners into de-politicizing the hospital project if they want to stay in power.

Yes we can.

 

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