This letter was sent to Liberal leader Stephen McNeil on Tuesday, March 26, in response to his recent comments regarding forming two provincial boards for the entire province:
Tuesday, March 26, 2013
Mr. Stephen McNeil
Leader of the Opposition and Liberal Party Leader
P.O. Box 741
Dear Mr. McNeil:
I am writing in response to media reports about your speech to the Sydney and Area Chamber of Commerce on Friday, March 22.Â In particular, I am writing to express our significant concerns with your proposal to replace district health authorities with two provincial boards: one apparently covering eight district health authorities and another for the IWK Health Centre.Â We understand this is the most recent version of your earlier proposal which was outlined on April 27, 2012.
As you may know, we are the largest union in the province with approximately 30,000 members, of which almost half work in health care. This proposal (if implemented) would have major impacts for our members as well as the patients and communities they service.Â I would like to know what assessment your Party has done of the impacts of your proposal.Â Is there a more detailed version and if so, could we receive a copy?Â I would also like to know how it was developed, and whom you consulted about it.
The main reason you seem to give for this proposal is that our health care system is over-administered, and you want to get rid of unnecessary administrative duplication.Â However, we want to know what could be lost if there is a move to two provincial health boards, and how will this transition be handled?Â How will front-line programs and services be maintained and even, strengthened?Â What assurances can you give that the â€œproverbial baby wonâ€™t be thrown out with the bathâ€ in a rush to achieve apparent lower administrative costs?
We already know what it was like to have the health care system administered by one provincial body prior to 1994, namely, the Department of Health, working with a large number of hospital and nursing home boards. It was found to be cumbersome, out of touch, ineffective, and even, costly.Â Following the extensive consultations conducted by the former Provincial Health Council leading to Nova Scotiaâ€™s Blueprint for Health System Reform, the former Liberal government under then Premier John Savage set up four Regional Health Boards and a network of Community Health Boards in 1994.
After its review and public consultations, The Ministerâ€™s Task Force on Regionalized Health Care in Nova Scotia recommended in 1999 that the process of regionalization be continued and that the present number and boundaries for the four regional health boards be retained. Instead, the Hamm government moved to set up the nine District Health Boards we have today with the introduction and passing of Bill 34 â€“ the Health Authorities Act.
While we and many others were not in favour of moving from four to nine DHAs in 1999, we also never called for a return to having one or two large provincial health boards.Â From all that we have seen and heard about the experiences in Alberta and New Brunswick moving to one or two boards, such a restructuring has not led to a major improvement in the quality of care and cost-efficiencies. In fact, cost overruns and long wait times seem to be worse than ever.
Still another significant issue for us is what will happen to the present legislated protections for health care workers.Â When Bill 34 was first introduced in 2000, it did not protect the rights and benefits of health care employees.Â It did not protect collective agreement and benefits for all groups.Â It did not guarantee that new employers would maintain employee benefits and entitlements. It did not protect any employees if their work were to be transferred elsewhere. It did not protect employee rights to pensions.Â It did not protect civil service employees and employees of the then Regional Health Boards moving to be employed by the DHAs.Â Only through determined and persistent efforts by our members, were we able to amend the Bill to provide these protections.Â What are you and your Party prepared to do to ensure these protections for all front-line health care workers will continue?
For all these reasons, I would urge you to re-think your proposal to set up two large provincial health boards, and instead work with front-line workers and their unions to develop positive and progressive changes to address long standing health care issues and needs.Â Adopting simplistic, short-term solutions will do little to change or resolve these issues and needs.
I look forward to hearing from you in the near future.
President,Â Nova Scotia Government and General Employees Union (NSGEU)