LETTERS — Well being care at a crossroads; Nova Scotians weigh in


A story of two potential surgical procedures

Moderately than merely throwing extra money at our Canadian system, extra efficiencies within the group of supply might go a good distance in direction of lowering wait instances and affected person nervousness. 

Permit me to provide a private instance that compares the Nova Scotian and French techniques.

A number of years in the past, an irregularity appeared on my mammogram. As a result of I, cavalierly, had not had common mammograms for a few years, the potential for a later-stage most cancers was higher than normal. I used to be booked for an echography three weeks later. Subsequent, a biopsy was required, six weeks later. A gathering with the interpretative surgeon two extra weeks later. Up to now, 4 journeys to Dartmouth and 11 weeks of ready. 

I used to be knowledgeable that had the biopsy confirmed malignancy, surgical procedure can be scheduled inside two to a few months. To not point out the nervousness precipitated to my household and me by this uncertainty, so many alternative, particular person, interactions with medical professionals was certainly not essentially the most cost-effective approach to diagnose and deal with breast sickness.

Earlier than I had the biopsy, a involved good friend in Paris, who occurred to be a medical physician, sought out a therapy plan in her metropolis: I might fly there, enter the clinic the following morning, the place they might instantly perform the biopsy of each breast and lymph nodes, then (with the affected person nonetheless on the desk) analyze the pathology, and instantly perform the required surgical procedures primarily based on the outcomes. The size of keep on the clinic would rely upon the severity of the process. One-stop procuring! 

This was a personal clinic, however French medicare would cowl the associated fee for its residents. For me, a Canadian, the worst-case state of affairs, involving a couple of days of hospitalization, was quoted at round 5,000 euros, which a number of years in the past, would have transformed to $7,000. It’s certainly larger at this time, however not astronomically.

Thankfully, my biopsy end in Nova Scotia was unfavourable. I didn’t require any additional therapy. Once I requested my French good friend how they may run a clinic not understanding simply how a lot therapy every affected person would require, the reply lay in calculating a statistic of chance. Workers and amenities can be out there primarily based on mathematical probability.

I have no idea how a lot an equal therapy would have value the Nova Scotian system, had it been mandatory. 

I’m not advocating for private-pay well being care. Nevertheless, this publicly paid, personal clinic in France had streamlined the forms, restricted the variety of encounters for a number of medical procedures, and vastly compressed the timeline, thereby obviating stress, detrimental outcomes, and higher expense. 

Maybe massive bureaucracies have higher problem turning on a dime? We do want to analyze finest practices in comparable nations.

Marike Finlay-de Monchy, West Quoddy, Japanese Shore

No to non-public route

When Tim Houston was elected with a majority in 2021, his principal marketing campaign promise was to “repair” well being care. I didn’t count on, nor do I would like, that repair to incorporate extra privatized well being care — which is among the many choices he says he’s contemplating.

Realizing that this was primarily a wildly optimistic marketing campaign promise, designed to hit a sizzling button for almost all Nova Scotians, we went forward and put him within the job anyway, within the hope and desperation that he truly meant a few of it, and can be able to delivering. 

Up to now, not a lot progress.

For instance, the already ridiculous household physician waitlist numbering over 95,000 folks, has elevated 15 per cent within the time he has been in workplace.

A privatized health-care scheme would divert desperately wanted sources of docs, nurses and allied health-care professionals away from an already almost damaged system.

Regardless of assurances that this is not going to end in a two-tiered system, I don’t consider that’s true, nor do most Nova Scotians.

As vehemently as I can say it, I don’t wish to see privatized well being care turn out to be a part of our provincial well being care system. I name on Houston and his ministers and departments to stop and desist going on this course instantly.

Karen Reinhardt, Pleasantville

Centralize Medicare 

Re: “Uneven Care,” Dr. William P. MacKay’s July 20 Reader’s Nook.

Certainly, our extremely touted medicare system is failing to serve residents of our nation in each province, in a number of methods, each day! Chaos is reported throughout your entire continuum, from major care to long-term and hospice/palliative care.

How can the system of free hospital and doctor providers legislated and ensconced within the Canada Well being Act (1966), later re-legislated in 1984, be thought of “common” when left to every province and territory to manage?  

Our health-care system has turn out to be nothing greater than a political soccer serving neither politicians nor the folks! 

How can there be constant software of providers when provincial governments typically change each 4 years? When politicians put in cost as well being  ministers haven’t any specific experience or data about well being techniques, how can efficient and accountable outcomes be achieved?

Every province appears to be in competitors with the others for sources — docs and nurses, in addition to for funds to perpetuate inequalities in providers.  

For example, a specific drug is roofed in a single province, not in one other, and sure surgical specialties are acknowledged and offered in a single province however not in an adjoining one. There are quite a few accounts of those and different inequities reported frequently via first-person tales.

Sadly, Canada’s health-care system ranks low amongst developed nations. Greater than “uneven,” as Dr. MacKay suggests; it appears extra like “derailed“ fully, today.

It’s time for all Canadians in each province to name our governments, federal and provincial, to account for the failed state of the nationwide Medicare program and revise the Canada Well being Act to switch oversight, along with funding, to our federal authorities. Then, as Canadians, we might be comforted to know we now have an equitable well being system throughout each province and territory.

Sandra Bauld, HRM

Give social work its due

As a social employee, I used to be happy to see Mary Jane Hampton checklist social work as one of many professions that might assist us break the “doctor-centric mould” (Aug. 20 visitor column). 

However to be a significant addition, social work must have a spot within the evaluation, therapy planning and supply of health-care providers. 

Social work is aware of that people are finest understood throughout the context of their households and broader social lives, that these relationships are intently associated to bodily and psychological well being and key to creating sense of the signs that push people to emergency rooms and docs’ places of work. 

We’d like a system of major health-care practices that enable physicians, nurses, social employees and others to collaboratively assess and arrange therapy plans that put the wants and considerations of sufferers and their households on the centre of service plans.

 After all, severe investments in inexpensive housing, earnings and meals safety, and in a public health-care service that has enough workers and different sources, are additionally urgently required. 

The cuts, neglect and avoidance of those investments through the previous 40 years have contributed to the health-care disaster and eroded our capability to creatively reply to new and altering wants.

Jim Morton, Kentville

Exhausting selections forward

We’re all conscious of the speedy improve within the worth of meals and gasoline. There could also be brief intervals of aid, however there’s little motive to consider this can be a momentary pattern. People and governments will face rising stress on budgets. 

For governments, these stresses would require a reconsideration of spending priorities. It should turn out to be essential to restrict some program spending as a way to stretch budgets to cowl as a lot as doable of requirements.  

Regardless of a real want to enhance health-care circumstances in Nova Scotia, situations don’t favour success. Though well being care is high-priority, it’s going to turn out to be mandatory to cut back spending in some areas in order that core providers might be retained.  

There are present shortages in docs, nurses, help workers and housing for the aged and infirm. There will probably be progress in these stresses, and addressing them will put monumental stress on the funds of the province. 

Among the many laborious selections that have to be thought of is the discontinuation of the air ambulance service. Whereas this service is crucial to saving some lives, it comes with an enormous value. Every flight is mostly for only one affected person. Factoring the price of the helicopter, crews, in-flight medical help, and gasoline, the entire prices of this service should run into many tens of millions of {dollars} annually.  

Sure, I perceive that every life is essential. Redirecting air ambulance monies to allow higher broad-based outcomes would, in the long run, supply far higher advantages. 

Including providers within the good instances is a straightforward political resolution. It turns into very troublesome to discontinue providers even once they turn out to be financially unsupportable.  

Excessive federal and provincial debt is the true expression of how a lot we now have exceeded our means. Including extra debt now will solely improve the difficulties to come back. 

Eliminating some providers doesn’t rule out the potential for passable residing situations. In my youth, most individuals couldn’t afford southern holidays or motorized leisure autos. Consuming in eating places was restricted to particular events. Clothes was extra sturdy and handed all the way down to youthful kids when outgrown. There was little or no waste, however numerous time for enjoyable. 

Governments will probably be pressured to make laborious choices. Delaying these laborious selections will solely make them harder. 

Orland Kennedy, Nice Valley

Failed experiment

The 25-year experiment of graduating no basic practitioners in North America is plainly not working. And the experiment has by no means been evaluated. 

Did we acquire something by insisting that every one medical college students graduate in specialties together with household apply, which, consider it or not, is a specialty? The remainder of the world graduates GPs; the place do you suppose we’re poaching them from? 

If Nova Scotia universities, authorities, and medical society might agree on graduating and credentialing basic practitioners once more, the next would occur:

1. GPs would graduate with the previously customary two-year residency, serve in any space of the province, repay their medical payments and, down the road, might select to specialize. A lot of the retiring MDs had been skilled in simply that approach. Approach much less commitments required of younger graduates.

2. The Nova Scotia GP might solely practise in Nova Scotia, thereby bettering retention of MDs within the province.

3. International-trained GPs might practise within the province  as GPs with much less punitive and dear recredentialing to turn out to be household practitioners.

4. GPs and FPs will proceed their similar yearly upgrading programs required to keep up their licences; the data and expertise of FPs and GPs will stay the identical.

5. The top of the stranglehold of the Faculty of Household Physicians on Nova Scotia physician recruitment.

Do you know that no GPs have graduated in 25 years?  Thought not.

Victoria Jenssen, Whiteside

Bitter on sugar tax

Re: your Aug. 16 opinion piece a few “sugar tax” being applied in Newfoundland and Labrador, beginning Sept. 1.

That is nothing greater than a further authorities money seize and if the “rank and file” public thinks for one minute that this received’t traverse the nation, their head is caught within the sand.  

The Newfoundland and Labrador authorities has promised to spend the proceeds on well being. I don’t consider this — if well being care sees 10 per cent of the proceeds, I will probably be stunned. 

If and when this “money seize” turns into efficient in Nova Scotia, I’ll cease consuming no matter beverage is focused.

Ivan J. Saulnier, Dartmouth





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