I have received a good deal of feedback from physicians, patients and the public to my Aug. 12 opinion piece, Here’s what happens when you lose your family doctor. But no one was more pointed than a neighbour, who asked, “Who were you writing to and for, and what point(s) were you trying to make?
The article touched many because the plight of the young gentleman was a poignant first-person account.
It gave rise to the possibility “that could be me.” It gave voice to those with similar experiences who have not yet found their voice.
My neighbour asked more questions that speak to what he really wanted to say.
What are your colleagues saying? Has the Nova Scotia Health Authority responded to any of your articles? Has the Department of Health ever asked you or your group to sit down to discuss these issues? Has the new minister followed through on his public commitment to speak with your group on health governance?
The real question should perhaps be: What is the point of writing these articles if no one is listening?
Sometimes it takes someone like my neighbour, who has the wisdom of age, the opportunity to see things from outside the box, a broad view honed from a life lived away from rural Nova Scotia and a personal experience with rural health-care delivery in Nova Scotia, to point out that “there is a time to provide advice and offer an opinion, and there is a time not to. Unsolicited advice will not endear you to people.”
My medical and nursing colleagues have shrugged their shoulders and just carried on complaining about the health system. I am not certain I can conclude that the disinterest from colleagues is what is to be expected from burned-out, disenfranchised people focused on staying on the treadmill.
The health authority has ignored the op-ed articles.
The last minister of health and the current minister have not followed through on their promises to have a discussion.
The Department of Health and Wellness has been mum.
The public, for the most part, has been sympathetic. Is it because they do not have the time, language, knowledge or inclination to take on the juggernaut that health care has become?
Unfortunately, the latter group has the most to lose from disengagement.
The purpose of writing these articles was and is to provide information. Nothing more.
The target audience was the public and their political leaders.
Functioning democracies are built through open societies that share information. When there is information exchange, there is enlightenment. When there is informed, balanced debate, there are solutions.
When there is no sharing of power and no accountability, there is abuse and indignation.
The Nova Scotia Health Authority was created to rescue the health system from the burden of spiralling costs. In our writings, we have tried to point out that something was sacrificed in the zeal to achieve that outcome.
The problems are real and are manifested in real pain and suffering.
This is particularly true for rural Nova Scotians.
We have tried to position access to appropriate health services as a moral imperative for government. That has fallen on deaf ears.
We have pointed out that major change is never achieved unless credible change agents are able to communicate effectively. Government and the health authority have ignored lessons learned in other jurisdictions.
We have promoted the notion that accountability to, and collaboration with, health services users and providers should be part of the governance culture.
We have tried to use language that will enable the taxpayer to ask questions of the managers of the health system and of the politicians who created it.
It is evident to my neighbour that our message has failed to convince government that there is a problem with health-care governance in Nova Scotia.
This is a valid conclusion, given our lack of engagement with the powers that be.
The minister of health has a tough road ahead. Cutting health-care costs is the easy part, but it has limited impact if better health outcomes is his mission.
Moving forward will require human resources with a broad knowledge of what works and what does not, resources that are respected by the front-line worker and the user group and communication skills to build the relationships with users and governors of the system.
The minister is squandering an opportunity by refusing to engage with health-care providers in a meaningful, transparent manner. He is jaded and distrustful, especially of physicians and other health-care providers. Given the track record on health reform and the performance of the NSHA, it is completely understandable.
To my neighbour, I say: Keep asking questions. You are paying for a system that has to be there when you need it.
You have a right to hold people accountable for the decisions they make about your health system.