Health Minister Michelle Thompson (middle) addresses residents of Queens Feb 17, 2023. Photo Ed Halverson

People from across Queens gathered at the Best Western in Liverpool Friday to share their concerns about the health care system and hear what the province is doing to fix it.

Minister of Health and Wellness Michelle Thompson and representatives from across the health authority spent just over an hour answering questions from the public.

People wanted to know what’s being done to recruit more primary caregivers, how to reduce wait times, and if there are enough paramedics to answer their call in an emergency.

Minister Thompson says she welcomes the opportunity to speak directly to Nova Scotians about steps government is taking to tackle the healthcare crisis.

“Sometimes it’s hard for us to get our message out,” said Thompson. “It’s hard to get all of this information out past media cycle, we often live in soundbites and so to sit in community and hear directly and speak directly for two hours, I think is really meaningful for people.”

The minister went into detail about plans to recruit doctors from abroad and entice retired physicians back to practice.

Residents pose questions to Nova Scotia Health officials at the Queens Community Health Conversation on Feb 17 2023. Photo Ed Halverson

But she made it clear that across North America, systems are moving away from patients having a single-family doctor and moving to a collaborative team approach.

Thompson says that care team could consist of a nurse practitioner, a physiotherapist, a dietician, a pharmacist, or any other combination of healthcare professionals.

The point would be for your file to be with a clinic and when you sought treatment you would be triaged and directed to the appropriate caregiver.

This method would also allow your health record to stay within a practice so even if one of the members left, your record would be accessible, and you could still receive care.

Throughout the question-and-answer period the health minister hinted at new legislation that would be introduced during the upcoming sitting of the Legislature to remove obstacles from healthcare workers.

“Everything is focused right now on healthcare,” said Thompson. “There are barriers that sometimes we don’t always see, and we want to remove those.”

When pressed on which barriers her department would like to remove Thompson said, “How do we use people to the fullness of their scope? How do we ensure that there’s mobility so people can move into the province easily and making sure that we’ve modernized those systems.”

Thompson says how government will meet those goals will be revealed when the Legislature reconvenes March 21.

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NDP Caucus in Mahone Bay. Leader Claudia Chender is fourth from the right. Photo Nova Scotia NDP

NDP Leader Claudia Chender says Nova Scotians want proof that improvements are being made to the healthcare system.

Chender made the comments at the party’s caucus meeting being held in Mahone Bay Monday.

She says every week Nova Scotians hear government is making healthcare better while the number of people without access to primary care keeps growing.

“We just get sort of assurances that things are getting better but no evidence that things are getting better,” said Chender. “If you talk to the average Nova Scotian, I have yet to have a conversation in the last six months with anybody about health care who would argue that anything has improved people are seeing a steady decline and it’s, it’s very concerning.”

Chender sees a need for more long-term care facilities to open more beds in hospitals.

“In Dartmouth for instance, at any given time around half of the inpatient beds at the Dartmouth General Hospital are patients who have been approved for long term care. They don’t need to be there. It is clear that we need more long-term care,” said Chender. “The Liberal government built almost no long-term care beds in over eight years, and we pushed for it that whole time and I think we’re seeing some of the results of that now in the challenges were having in our hospitals.”

Chender says a model based on the collaborative care centres which her party began to implement when they were in power would provide people with access to healthcare professionals.

She says combining multiple ways to access care under one roof would allow a person to come in, be triaged and then directed to the appropriate caregiver.

“We believe that we every Nova Scotia needs to be attached to a single practice. That may not mean that you get to see a doctor all the time. You might see a nurse practitioner, you might see a physician assistant, you might see a pharmacist or social worker depending on what you need, but your file lives in a certain place and your care is coordinated,” said Chender.

The NDP leader says considering the number of baby boomers heading into retirement and needing medical care, it’s widely recognized people will have to adjust to the reality of not having a family doctor, not just in this province but across the country.

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Queens General Hospital. Photo Ed Halverson

Residents of Queens will have the chance to bring their healthcare concerns to those directly responsible when the department of Health and Wellness listening tour stops at the Best Western in Liverpool this month.

Health and Wellness Minister Michelle Thompson, Deputy Minister Jeannine Lagassé and Nova Scotia Health interim CEO Karen Oldfield are holding conversations in communities across Nova Scotia about the work underway to improve the healthcare system.

In a release announcing the events the department of health and wellness says participants will be able to ask questions and hear directly from those responsible for making change happen.

The health department issued a release Tuesday announcing the Emergency Department at Queens General Hospital will be closed for most of the week leading up to the event.

The ED will close Tuesday and Wednesday night, February 7 and 8. It will close again for the weekend beginning Friday at 1:30pm reopening Sunday morning at 8am then closing again at 1:30pm Sunday until 8am Monday morning.

The department will close again Tuesday afternoon until the morning of Wednesday the 15^th.

Anyone wishing to attend the community engagement session will need to register in advance.

Those who can’t be there in person can forward questions that will be discussed at the event by submitting them through the online registration link.

The listening tour will be held at the Best Western in Liverpool on Friday February 17 from 1:00 until 3:00pm.

To register for the Community Health Conversations event follow this link.

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Queens General Hospital. Photo Ed Halverson

The Government of Nova Scotia announced several initiatives to reduce wait times and improve emergency care at hospitals across the province.

At a press conference Monday, Health and Wellness Minister Michelle Thompson said the initiative focuses on two areas: improving emergency room care and safety and moving lower acuity patients away from the emergency room to appropriate health providers.

Several actions announced to get patients in most urgent need faster care include:
— having teams led by doctors focus on getting patients out of ambulances and into the emergency department faster
— assigning physician assistants and nurse practitioners to provide care in emergency departments
— adding care providers and patient advocates to support patients in waiting rooms
— making virtual care available to more patients with less urgent needs
— providing healthcare teams with real-time data on where beds are available across the system and what tests or other actions are needed to get patients well and home more quickly; this will free up beds for others.

Health officials are aiming to redirect patients with less severe or immediate health concerns away from emergency departments.

The actions being taken to give people more places to receive care, reducing pressure on emergency care, include:
–support for new and existing collaborative family medicine practices so they can see more patients
— expanding services in more pharmacies
— adding hours for virtual care appointments and enabling out-of-province doctors who are licensed here to offer virtual care
— providing more mobile primary care, mobile respiratory care clinics and urgent treatment centres
— making available a new phone app, known as a digital front door, that will help people find the right services for their needs and where they’re offered.

Some of those actions such as adding care providers and patient advocates to patient waiting rooms will be implemented almost immediately while others will be phased in as resources and capacity become available.

While the new actions include many new supports for patients and caregivers there was little talk about how to keep healthcare workers from leaving those jobs.

Minister Thompson says the newly announced initiatives will make for a better work environment and her department is still listening to front-line workers.

“Nova Scotia Health has also started stay interviews about what are the things that support people in staying and we do hear suggestions directly from frontline workers about different initiatives that would help them stay,” said Thompson. “So those are the things that are undertaken, again, we know there’s more to do and we are committed to working with health care providers to support their environment.”

The Nova Scotia Government and General Employees Union (NSGEU) represents many of the people working in healthcare in the province.

In a statement issued after the announcement the union’ 1^st Vice President Hugh Gillis says one of the key issues members have outlined is the inability to retain skilled, experienced nursing staff in the ED.

“Today’s announcement does not address that concern,” said Gillis, “The employer must provide incentives that will allow them to effectively keep experienced health care professionals in areas of high turnover and specialized need, such as the emergency department.”

Gillis says his members are glad to see some of the 59 suggestions they provided to government were included in the announcement but there is still more to do.

Government officials say they are open to any good ideas that will improve healthcare for Nova Scotians and will continue to listen.

Despite the struggles facing emergency departments across the province, Minister Thompson says if people are in immediate need of medical attention they should go and get the treatment they need.

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Queens General Hospital. Photo Ed Halverson

The Nova Scotia government is takjng steps to address the shortage of housing for new healthcare workers.

The province will spend $8 million to provide affordable and temporary housing for workers who need it the most in communities that have very limited housing options.

Government will partner with the Housing Trust of Nova Scotia, who will work with health partners, municipalities, and other key stakeholders to set up temporary mobile modular homes in areas where there is an acute demand.

In an e-mail, a spokesperson for the Department of Municipal Affairs says, “This is meant to be a short-term solution for people as communities build more housing stock over the next several years.”

Opposition party leaders questioned where new recruits would live after government recently announced 65 Continuing Care Assistants from Kenya had received offers to come to Nova Scotia.

The housing initiative will require cooperation from several departments and agencies.

The Housing Trust will work with Nova Scotia Health and the Department of Health and Wellness to establish qualification criteria for who can access the modulars.

Then they will coordinate with Municipal Affairs and Housing and municipalities to identify available land and placement options within communities.

When asked how it will be determined which communities will receive these new housing units the Municipal Affairs Spokesperson went on to say, “This initiative is based on need, so the principal criteria will be a demonstrated demand for units, within a given community.”

The spokesperson indicated a supplier will be selected based on how quickly the housing can be delivered and until the supplier is selected the department can’t say how many units will be purchased.

She stressed both government and the housing trust are aware of the urgency, and will work quickly to move the process along so modulars can make it to the areas where they are most needed as quickly as possible.

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Queens General Hospital. Photo Ed Halverson

Nova Scotia Health is reminding people that COVID-19, influenza, and RSV are still active and must be considered when visiting loved ones this holiday season.

In a release, they say masks must be worn at all times in all provincial health facilities and the number of visitors patients can have will depend on where they are being treated and what they are being treated for.

Only people identified by a patient as an essential care partner (support person, caregiver) can visit a patient in hospital.

Only one Essential Care Partner/ Support Person at a time for:

• children and youth under 19 in outpatient settings
• hospital inpatients
• patients in emergency departments
• prenatal visits, including ultrasounds
• ambulatory care clinics, appointments, or procedures
• patients with COVID-19 infection (additional measures may be required)

Two Essential Care Partners/ Support Persons at a time for:

• children and youth under 19 admitted to hospital, or having day surgery
• patients in intensive care units and critically ill patients in emergency departments
• patients in labour and giving birth

Three Essential Care Partners/Support Persons at a time for: 

• palliative care and other patients nearing end of life
• patients receiving medical assistance in dying (MAiD)

In a release, Nova Scotia Health says people with compromised immune systems are relying on the facilities to ensure a safe and healthy place in which to receive treatment, rest and recover.

And that health care workers take precautions every day to prevent getting sick or passing illness onto patients.

Nova Scotia Health asks when visiting loved ones under provincial care this holiday season to bear in mind that general masking requirements create a healthier environment, reducing the strain on care teams, and the health care system as a whole.

More information can be found at https://www.nshealth.ca/VisitorsDuringCOVID.

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Queens General Hospital. Photo Ed Halverson

The provincial government is following through on a promise to make up-to-date healthcare data available to Nova Scotians.

Residents can now see the daily or most current information for hospitals across the province for a wide range of stats like hospital occupancy, emergency department visits and number of surgeries performed.

Information is presented on an interactive dashboard and gathered from several sources including hospital inpatient, surgical and emergency data bases, continuing care home support and long-term care reports and EHS.

The data contains no information which could identify individual patients.

Government announced the website would be coming as part of their Action for Health plan back in April.

In a release, Health and Wellness Minister Michelle Thompson said, “Change won’t happen overnight. But by sharing this information now, we are holding ourselves accountable to make sure change happens and the system improves in the areas most important to Nova Scotians.”

The website also tracks continuing care services such as the number of people waitlisted for home support and how many have been admitted to long-term care facilities.

EHS is providing weekly numbers of calls, response times and average time it takes to offload patients at each hospital.

The Action for Health website also shows the most current numbers on doctor and nurse recruitment and retention and the number of Nova Scotians without a primary care provider.

The website can be found at novascotia.ca/actionforhealth.

Reported by Ed Halverson 
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Tim Houston addresses reporters following cabinet meeting June 16 2022. Photo: screen grab from Zoom

Nova Scotia’s premier says timelines to address healthcare are coming soon.

The PC government released their Action for Health plan in April which identified core issues and offered six broad solutions for the provincial healthcare system.

Opposition members have been critical of the plan for not providing timelines to go along with the solutions.

Following a cabinet meeting Thursday, Tim Houston told reporters they’re still working on it.

“We did commit to add some dates and some benchmarks and that work is ongoing,” said Houston. “I think the commitment was Nova Scotians would start to see that heading into early summer, which we’re at now and I suspect that those things are coming soon.”

Tim Houston campaigned and won the August 2021 provincial election on a promise to fix healthcare.

His government inherited a system with tens of thousands of Nova Scotians on a family doctor waitlist, ambulances lined up and waiting hours to offload patients at hospitals, emergency rooms closed for staffing shortages, long backlogs of people waiting for surgeries and a laundry of other issues.

Houston admits there is a lot of work to do but some of the changes are already having a positive impact.

“There’s lots of anecdotal stories about how difficult things are in the healthcare system. There’s also lots of anecdotal stories about how things are improving. I’ve certainly heard from paramedics who will tell me, at the end of a day I was able to do this many more calls because I didn’t have to do these transfers,” said Houston. “Now they’ll be saying, I was able to do this many more calls because I was able to offload my patient. So, there’s a lot of positive anecdotal stories as well.”

The premier was referring to the new direct to triage policy that came into effect June 1 allowing paramedics to leave low risk patients in the care of waiting room staff instead of staying with them until they are seen by a doctor.

The PCs also made permanent a pilot project launched under the previous government which created a fleet of vehicles dedicated to patient transfers.

Houston says those are a couple of examples of changes that are improving healthcare for Nova Scotians and there are more to come.

“I would say to Nova Scotians that they should know, number one, that this is our number one focus as a government,” said Houston. “They should see that commitment from the amount of changes we’ve made which have come from healthcare workers. They should see that commitment in the plan that’s been put forward before them and look, they’ll start to see that in their communities, and some of that is happening already.”

Reported by Ed Halverson 
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Twitter: @edwardhalverson

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Finance Minister Allan MacMaster stands to present the 2022-23 budget in the Nova Scotia Legislature March 29, 2022. Photo Communications Nova Scotia

An additional $413 million in health care spending will help push the provincial deficit to $506 million this year.

The first full budget released by the PCs since winning government last August focused on delivering on some of the promises made during that campaign.

The top priority identified in Tuesday’s budget is addressing the province’s ailing healthcare system.

Nova Scotia will spend $5.7 billion on health care this year, which accounts for 43 percent of the total $13.2 billion budget

Some of that money will make virtual care available to people waiting for a family doctor, extend operating room times to help clear a backlog of surgeries, create 200 new nursing seats at NSCC, and help recruits new medical professionals to the province.

Nova Scotia is also spending to improve long-term care.

Government has allocated $66 million for continuing care assistants to ensure they are the highest paid in Atlantic Canada.

Money is also being spent to recruit train and keep CCAs and keep seniors in their own homes longer.

A lack of housing has been identified as a major issue in Nova Scotia.

Government is attempting to keep housing stock in the hands of Nova Scotians with the addition of a five percent deed transfer tax for non-residents and a property tax of $2 per $100 of assessed value on buildings with three or less units owned by non-residents.

Finance Minister Allan MacMaster says the new measures accomplish a couple of goals.

“It will be a significant revenue generator and it’s going to take us as a couple of years to build a proper database to determine who actually is non-resident. We certainly have sources of information, but a database will be built over a couple of years,” said MacMaster. “For some it may result in properties becoming available to Nova Scotians who are struggling to find them right now.”

MacMaster says government is investing in Nova Scotia now but don’t expect to see a pattern of unchecked spending.

“This first budget, our focus is on fixing healthcare and our focus is investment in a province that’s growing,” said MacMaster. “In the future, I think what I would say to people who might be concerned about the degree of spending in this budget is that we are showing a track back towards reduced deficits going forward.”

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Queens MLA Kim Masland. Photo Ed Halverson

The MLA for Queens sat down with reporter Ed Halverson just before Christmas to discuss a busy 2021.

Kim Masland was re-elected and moved to the government side of the legislature when the PC’s won a majority, was appointed Minister of Public Works and government house leader shortly afterwards and contracted COVID-19 .

The interview is broken into four parts.

In part one, Masland discusses the quick learning curve when forming government.

Another challenge for Masland was contracting COVID, discussed in the second part of the interview.

Healthcare and long term care were hot button topics on the doorstep during the election campaign. The PCs promised to fix the system and Masland describes how her party is working to do so.

The interview wraps up with issues Masland is working to address in Queens including resolving long-standing concerns at Carter’s Beach and the affordable housing crisis.

E-mail: edhalversonnews@gmail.com
Twitter: @edwardhalverson

Nova Scotia Legislature. Photo Communications Nova Scotia

The newly elected PC government laid out their priorities for Nova Scotia as the fall sitting of the legislature opened with the speech from the throne Tuesday.

Topping the list is improving the province’s ailing healthcare system.

Premier Tim Houston and his team will be working to fulfill the promises he made while campaigning to get more access to family doctors and reduce wait times to see health professionals.

In his speech, Lieutenant Governor Arthur J. LeBlanc says government will listen to the needs and advice from healthcare workers.

“Doctors, nurses, paramedics, CCAs and everyone delivering healthcare has an important voice that is respected and valued,” said LeBlanc. “They will help guide us forward.”

The speech from the throne identified several areas of improvement in the healthcare system including: attracting and retaining more healthcare professionals, improving access to primary and mental healthcare, supporting seniors in their homes and in long-term care and tackling wait times.

The new PC government promised more accountability and is starting down that road by establishing fixed election dates in the Nova Scotia.

The province is the last one in Canada to do so.

“Election dates will be set immediately so that every Nova Scotian knows the timeline upon which they will be able to exercise the ultimate right of holding this government and every subsequent government to account. This session will see the creation of fixed election dates in Nova Scotia,” said LeBlanc.

The speech also outlined plans for tax breaks to incentivize young trades people to remain in the province and giving employers the chance to increase workers wages instead of paying that money in tax to government.

The 64^th General Assembly will begin working on those priorities when session resumes Wednesday.

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Queens General Hospital. Photo Ed Halverson

Difficulty attracting new doctors is one of the factors that contributed to the closures experienced by the Queens General Hospital Emergency department over the past couple of weeks.

This was the first time since the hospital opened a doctor couldn’t be found to work the shift.

But chair of the Queens General Hospital Foundation Al Doucet says the issue extends beyond the emergency room.

“The problem is that there’s not enough supply of health professionals and that’s just not physicians. It’s nurses, it’s CNAs, it’s LPNs, it’s lab technologists, it’s across the board,” said Doucet. “To look after our population that is aging, we have not been able to keep up the supply of health professions that are needed.”

Doucet has been recruiting doctors to Queens for the better part of 40 years and says the pandemic has thrown a wet blanket on their efforts.

“One of the things you do with recruiting, you want to bring people into the communities so they get a feel of where they would want to move and work, and with COVID, we couldn’t do that,” said Doucet. “We couldn’t bring people in, so for almost two years, it’s really stymied our recruitment abilities.”

Doucet says overall, the provincial healthcare system is struggling to keep up with demand, and because so many Nova Scotians don’t have access to primary care, they are now turning to the emergency room for treatment. But many general practitioners who take shifts in the ER find it difficult to then spend the day seeing patients in the office.

“In the past the emergency departments used to be seen more for just emergencies, so the people manning it could at least get a rest while they were doing it then have an office the next day. That can’t happen anymore,” said Doucet. “Our emergency departments are pretty steady because people don’t have family doctors so they have no other option but to go to the emergency department.”

Doucet has also seen a shift in the way medical schools train doctors.

He would like to see those schools return to the methods he was taught, where doctors were trained as generalists before deciding to move into a specialty.

“One of the good things about that was, that the specialists that came from that kind of a training environment understood what it was like to work in family practice, understood what it was like to have people referred to them. They had a much broader understanding so they didn’t become very narrow in their scope of practice. They looked at the patient more as a whole,” said Doucet.

He says the problems with the healthcare system are complex and likens the situation to a pyramid, with primary care as the base and other specialized care piled on top.

“In the last eight years I don’t think the emphasis has been on the bottom of that pyramid. There’s been a lot of emphasis on other things and those other things are important, I don’t minimize that,” said Doucet. “But fixing the bottom of that pyramid in the last eight years has not been the primary focus and I think that’s why we’re in the situation we’re in now.”

Reported by Ed Halverson 
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Twitter: @edwardhalverson

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Longitudinal Integrated Clerkship students. Photo credit: NOW Lunenburg County

South Shore doctors are lining up to prepare the next generation of physicians.

The South Shore Longitudinal Integrated Clerkship program recently launched in Liverpool, Bridgewater and Lunenburg will see third year medical students from Dalhousie University spend the year in those communities.

The aim of the clerkship is to entice future doctors to spend time in rural settings by offering them more hands-on experience than they are likely to get in urban centers where they have to compete for clinical time with fourth year med students and residents.

Site director Greg Thibodeau says the program wouldn’t have happened without local doctors stepping forward to teach.

“We started with maybe 25 interested physicians two years ago and we’re well over 55 now, and that’s across disciplines,” said Thibodeau. “Even since the program launched three weeks ago, there’s still physicians who’ve said, I’d like to teach now.”

Those physicians, practicing different specialties across the three hospitals in the South Shore, have each committed to provide a set number of hours every week to instructing the students.

Thibodeau says that broad range of training will be beneficial to the students no matter where they focus their practice in the future.

“Physicians that are in the rural setting have a tendency of being very adept, flexible, they do more with less, and they’re versatile because they’re able to expand their skill sets over multiple settings and in multiple situations,” said Thidodeau.

He says it’s not just students who benefit from this arrangement. By adding teaching to their responsibilities physician instructors benefit as well.

“It makes us more pensive and reflective and deliberate as we engage in our practice because we want to teach the best of the best approaches to those that come after us,” said Thibodeau.

A total of five students were selected for the clerkship. Two are based in Liverpool, two in Bridgewater and one in Lunenburg. One of the requirements of the program is for the students to live in the communities.

“Because if they’re taking call or if they’re delivering a baby or if they’re working a night shift we want them to be accessible in the community,” said Thibodeau. “Part of the program is that they are indoctrinated, or at least part of the communities on other levels.”

Thibodeau welcomes LIC students for orientation. Photo credit: NOW Lunenburg County

The Health Services Foundation of the South Shore, South Shore Regional Hospital Auxiliary and Queens General Hospital Foundation helped to make the program possible by contributing $890,000 to create duty rooms, lounges, and learning space at South Shore Regional and Queens General Hospitals. Those new spaces will also support doctor recruitment and retention.

The South Shore is the second location in the province to offer the clerkship after Cape Breton piloted the program last year.

Dalhousie University’s goal is to have one third of its medical students take part in the clerkship program around the province over the next four years.

Reported by Ed Halverson 
E-mail: edhalversonnews@gmail.com
Twitter: @edwardhalverson