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Digby health coalition co-ordinator says ongoing issues in system ‘predictable’

Digby General Hospital.
Digby General Hospital. - Mark Goudge

NOTE TO READERS: This is another story in a series of stories over people’s concerns and opinions over the health care system in the Digby region. Still to come will be a story with the Nova Scotia Health Authority and what it says about the concerns being expressed, and also it’s view of the health care picture and the work being done to continually improve it.

DIGBY, N.S. – The co-ordinator of the Digby Area Health Coalition says the frequent closing of the emergency department in Digby and chronic shortage of health-care professionals in the region are both connected to a system that’s been “set up to fail.”

“This situation is entirely predictable,” Tony Kelly said. “They’ve made no effort to fund the system properly, which would allow the staff to operate the system properly.”

Kelly said while the Nova Scotia Health Authority denies it is attempting to shut down services at the Digby hospital site, he believes they’re laying the groundwork for a new system.

“If you get it to be so dysfunctional that people can’t or won’t work there then you have laid the groundwork for a new system,” Kelly said. “Those new systems may look like spiriting people off by ambulance services or greater reliance on nurse practitioners in the ER to stabilize people before they move them off to larger centres – either to Yarmouth or Kentville.”

COMMUNICATION GAP

Kelly said a piece of the problem with the current system is the large gap in communication from the NSHA.

“It’s always presented as a work in progress, but never is the thing they’re working on fully articulated,” Kelly said. “The public is left baffled by what is actually going on and how are we to react to this stuff when mostly what people see is services being diminished?

“That’s what people see but what they hear from the department is that everything is getting rosier ... but who is making the decisions and how are those decisions being made – nobody knows.”

While Kelly admitted the problems are not nearly as black and white as they appear, he also slammed the government’s budget-cutting and austerity measures.

“If you take a billion dollars out of the system over time, then you can’t expect the system to operate as if it’s at full capacity,” Kelly said. “You can’t take out that kind of money unless you can actually claim the services are intact or better but that claim is not credible – nobody believes that.”

Kelly also pointed to the language around the emergency department closings in Digby.

“They say it’s because of physician unavailability, but why are the physicians unavailable?” Kelly asked. “Doctors Nova Scotia has their point of view, citizens have their point of view… but when we look at it we know the staffing is insufficient. There are simply not enough of those professionals to work in the system, and the province claims they won’t work in the system. It’s weird. Now apparently, they’ve gone hither and yon looking in Europe and beyond for doctors.”

Kelly said he remembers a very different story that was delivered to the public not too long ago.

“Who doesn’t have enough memory to note that just a few short months ago they were saying they don’t have to look outside for doctors because we have lots of doctors in Nova Scotia,” he said.

FEELINGS ABOUT GOVERNMENT

Kelly had harsh words for the government, saying they’re all about the bottom line.

“This government has a particular fondness for balancing the budget, but that budget is being balanced on the backs of sick Nova Scotians or people in need and that’s a real problem,” Kelly said. “The system is not being adequately funded.”

Kelly feels the agenda for Digby and other rural hospitals appears clear.

“They want to restructure ER services, likely away from hospital care, so they can set up these stations that are manned by nurse practitioners or someone who can triage people, put on a Band-aid and then move them along the route,” Kelly said. “I think they’ve come to a conclusion somewhere that this will somehow be more efficient – not for patient care – but always going back to the budget and balancing the budget.”

Kelly also pointed to the government’s quick health-care deal with the federal government that was touted as a success, but that his coalition and the Centre for Policy Alternatives have observed things differently.

“The poorest provinces lined up first, and the richest provinces held out until last,” Kelly said. “Our poor government did not get the funding they could have had. The fact that Nova Scotia had its hand out first – and the government said at the time, ‘what a wonderful thing, we’ve got this accord.’

“It’s not wonderful because look at what it looks like. It’s not enough money to bring the system back to what people need or expect.”

Kelly pointed to the generational poverty in Digby County as a problem the government also doesn’t seem prepared to tackle – and that poverty and health-care issues are tied.

“What do you do with a population that has been repeatedly ground down by poverty?” Kelly asked. “Is the government prepared to come in here and move the minimum wage up to $16, even on a trial basis, and see what happens for five years or so? These issues are all tied. It’s a frustration for medical people because they see the same preventable troubles over and over again, and sometimes that comes off as blaming the victims. People need to be supported where they are.”

Kelly said the way forward for the Digby hospital should be clear.

“If they would replace the bare minimum with proper funding and if the place were staffed according to Canadian Medical Association recommendations, you’d improve the work conditions and improve the work retention,” Kelly said. “But if you don’t do that, you haven’t got a prayer for retention.”

Kelly said the whole “regionalization” of services across the province does not serve local populations well.

“In a place like Nova Scotia where the population is so small, it’s easy to understand why they think they have to regionalize services,” Kelly said. “But it isn’t really the specialists that people regularly need, they need the up-close care – in emergency departments or in family doctors’ offices. Those should be available locally or at least in close proximity.”

EMERGENCY DEPARTMENT CLOSURES

Kelly, who lives down Digby Neck in Little River, said the Digby hospital emergency closures are quite concerning, especially in the context of someone on the Neck or on the Islands requiring emergency cardiac care.

“There is just no stability in the current system,” Kelly said. “If they’re going to push you along to Yarmouth or Kentville, those distances are great and always concerning. If someone were to die, and it’s not unrealistic to think that someone has died or will die, then who is to blame?

“That’s what’s been done to rural Nova Scotia. We’re all supposed to be grateful for what we have. It’s almost like it’s set up to be dysfunctional on purpose – set up to fail in order to downsize and downsize services – and nobody wants to tell that story because it’s politically unpalatable.”

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