CHRONICLE HERALD COLUMN: Nova Scotia Prime To Lead On Health Reform

There is perhaps no province in Canada that is better-suited to make the case for health reform than Nova Scotia.

Consider some data that SecondStreet.org obtained from the Nova Scotia Health Authority. Their records show 51 patients died in the province last year while waiting for surgeries which could have potentially saved their lives. The government noted that in “just over three quarters” of those cases, the patients waited longer than the recommended time frame.

Imagine being one of those patients.

You’re having heart problems, so you visit the doctor and you’re informed you need coronary artery bypass surgery. The government’s recommended time frame for providing the surgery is three weeks, but the system is pretty backed up so you’re told you’ll have to wait a while longer.

You ask about paying privately for surgery at a private or non-profit clinic, but you’re told the government does not allow alternatives. Your choice is simple: wait in line for who knows how long, or leave the country and pay for surgery elsewhere. Travelling abroad during the middle of a pandemic does not seem wise, especially with your weak heart, so you wait … and wait. Then you pass the recommended waiting period. A while after that, you’re gone.

If this scenario sounds implausible, note that the aforementioned government data shows a patient met with a surgeon on February 18, 2020 to discuss coronary artery bypass surgery. The patient agreed the same day to proceed with the surgery and was put on the government’s waiting list. While the recommended wait time for the procedure was no longer than “21 days”, the patient was removed from the system in March 2021 – more than a year later – with a note that read the “patient expired.”

Some have tried to chalk up Canada’s current health care system woes on the pandemic. It’s true the pandemic has added pressure to our health care system. No one would deny that. However, data shows that in 2019-20 there were 33 Nova Scotia patients who died while waiting for procedures that could have potentially saved their lives. The year before that, there were 25 such cases. Patient suffering is a serious issue; one that extends beyond patients dying while waiting for surgeries that could potentially save their lives. Over one thousand patients have died on waiting lists in Nova Scotia over the past three years while waiting for all kinds of surgeries – hip operations, knee operations, etc.

Data from the Fraser Institute shows Nova Scotians face the longest wait times in Canada. In fact, wait times the year before the pandemic were three times what they were back in 1993 when the Institute first started tracking this problem. This, despite the Nova Scotia government having more than tripled how much it spends per person on health care – from $1,418 to $5,000.

In terms of reform, there are several options to consider.

First, the Nova Scotia government could improve its data collection on patient suffering by tracking information on patients dying while waiting for diagnostic scans and appointments with specialists (not just data for surgeries). Further, it could track information on patients developing complications due to long waiting periods; mental health issues that arise and other problems. More data helps diagnose problem areas.

Second, the government could keep the public system but allow private and non-profit clinics to provide the same surgeries – just like Norway, Sweden, Australia and the rest of the developed world. As some patients decide to pay for surgery – instead of relying on the government – waiting list pressure would ease. This decision would also create jobs in the province as some patients decide to pay for treatment locally instead of travelling abroad for care.

To be sure, these are just a couple of options that could be implemented relatively quickly. More substantive changes – which maintain the universal aspect of health care that Canadians hold dear – could also improve care. Hopefully for Nova Scotia patients, change comes sooner rather than later.

Colin Craig is the President of SecondStreet.org, a new Canadian think tank. This column was published by the Chronicle Herald and Saltwire.com on February 7, 2022.