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JIM VIBERT: Health minister needs to take charge

Nova Scotians now have some insight into a perplexing question about their health care system.

Provided various opportunities to set things straight in the legislature, Health Minister Randy Delorey deferred to the Nova Scotia Health Authority.

That helps clarify confusion over “who is in charge?” It seems the government itself is a tad muddled as to the answer.

This may be understandable, if inexcusable. The Nova Scotia Health Authorities Act is an excruciating legal text, written by lawyers who ensure everything’s covered in language they alone easily comprehend.

The minister, who is a well-intentioned and astute fellow – that needs saying in case anything here is interpreted otherwise – like any other normal person cannot be expected to read and decipher all 155 clauses.

Nor does he need to. The Act says he’s in charge, which is all he, and we, need to know. Question answered.

The Nova Scotia Health Authority must heed the instructions of the minister. He doesn’t need to seek their direction on anything, although that may be the polite thing to do, so long as he recognizes such direction is merely advice.

So, when questions come up about stuff the NSHA is doing or not doing, the minister needs a different answer than “I’ll ask them.”

For example, when queried as to why the NSHA Board meets in secret, the minister’s answer really should not be that he’ll have a chat with them about that.

He has talked to the board about taking its mystery tour around the province and the board seemed amenable. But without some additional changes in protocol, a road trip won’t help.

The time, place, and agenda of NSHA Board meetings, like the minutes that would shed light on its decisions, are “private” – the term health bureaucrats prefer to “secret.” You can imagine why.

Under the board’s current by-laws, Nova Scotians have a better chance of discovering the CIA is in town than finding out the NSHA Board is meeting locally.

The minister can fix that. He can make new by-laws respecting the conduct and management of the affairs of a health authority including, calling of meetings of the board and the rules of procedure at such meetings.

That’s directly out of the Act.

The NSHA Board is a group of highly-regarded Nova Scotians. Granted doctors and others in the field wouldn’t object to a health professional or two on there, but the government decides its membership. If someone were to ask, the government could explain, or not, why no health professionals are on the board.

Membership is of less importance than the circumstances under which members serve. It must be, because with enviable regularity we’re told the board is “voluntary,” by which the informant means members are unpaid.

Another matter broached in the House last week, by Queen Shelburne Tory Kim Masland, concerned a constituent who is waiting a long time for cancer tests.

Problems at the regional hospital have interrupted such testing.

The patient in question is willing to travel to another hospital, but has been told that’s not possible, a situation the minister found puzzling and requiring of a discussion with the NSHA.

This would seem, on the face of it, to be another of those cases in which the minister could step up and tell the authority to fix it, rather than deferentially asking what the obvious problem might be.

Surely, one logical purpose of a single, province-wide health authority is to coordinate services province-wide. Indeed, the authority frequently makes the claim that it does just that. Yet, examples keep cropping up to indicate the reality is otherwise.

One could speculate that the appearance of ambiguity in the structure of the health bureaucracy is purposeful and intended to provide political cover. When things go bad, the government can shift blame to the authority. Such a suggestion is cynical and does not reflect the apolitical nature of public services in Nova Scotia. Okay, that might be a tad sarcastic.

Let’s just recognize that the government, in the person of the Minister of Health, oversees the health care system. He can let Nova Scotians in on what ever is really happening.

And if we already know, stop complaining and start worrying.

Jim Vibert, a journalist and writer for longer than he cares to admit, consulted or worked for five Nova Scotia governments. He now keeps a close and critical eye on provincial and regional powers.

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