N.S. Health Care: System Breakdown - Prioritize

 CLAUDIA CHENDER « » : I am glad to be having this conversation today. I'm going to mostly constrain my remarks to Dartmouth because I am pleased to have the opportunity to talk about some of the health care challenges we are facing in Dartmouth.

 I was interested that the member opposite ended his speech by inviting us to suggest some solutions and in a specific way I'm happy to do that.

 This resolution we're speaking to talks about the fear and frustration around the health care system. But I want to start on a positive note, and I want to start by saying that Dartmouth is served by an amazing hospital, the Dartmouth General Hospital Foundation. The Dartmouth General is a jewel. It's full of incredibly smart people with good, innovative ideas, and they make those ideas work.

Unfortunately, what I have seen in my time in this seat in Dartmouth is that the Nova Scotia Health Authority has happily taken a number of those good ideas, incubated in Dartmouth - like their innovative approach to improving ambulance offload times - but hasn't offered, on the other hand, support for them to continue to innovate in the ways they need to. This is because, as far as I can tell, most health care decisions these days are made in Halifax.

While this is frustrating for those of us in Dartmouth, which is by all account not that far away - I probably have one of the shortest commutes of anyone in this House, including a number of people who live on this side of the harbour - we are our own City of Lakes in Dartmouth. But I can only imagine, with the frustration we feel with the centralized decision-making in Halifax, how it must feel for folks in Cape Breton; how it must feel for folks on the South Shore, southwestern Nova Scotia. I can only imagine.

 The centralization of health care management - I mean we don't go back to the basics much any more in this conversation - this, as far as I can tell, is the root of what we're talking about here, this centralization into a single health authority and the management of the entire health care system from Halifax, with very little regard for local and regional realities.

 This centralization took away power from those local communities and now we're paying the price. In Dartmouth our hospital serves over 100,000 people. We're the third largest hospital in the province and that hospital essentially should be able to manage itself. But the way that our health care system is now organized means that the Dartmouth General, along with the QEII and the IWK, is part of the Central Zone.

 The challenge with that is that the Dartmouth General doesn't actually have a lot in common with the QEII, other than they have to transfer patients back and forth a lot. The Dartmouth General has a site chief. The Dartmouth General has its own management and yet it is managed through the Central Zone. Decisions about many of the things that take place in that hospital are not made at that hospital; they are made in a board room in Halifax. From what I can see where I sit, that's a big challenge.

 But to speak to a few of the specific issues: the Dartmouth General has faced the same ALC backups as the rest of the province; we have people who are in beds much longer than they should be. I would suggest that this is exacerbated by the fact that we have a very high number of seniors in Dartmouth, and we have a very high proportion of seniors who are living on very low incomes in Dartmouth.

 Surgeries at the Dartmouth General were cancelled several days last Winter because there were no beds available for patients to recover in. The waiting lists for long-term care beds in Dartmouth are extremely long, as in the rest of the province. So what happens is a senior will experience a health issue, perhaps a health emergency, and they will go to the Dartmouth General and they will receive excellent care, although they may have to wait a long time. Then when it comes time for them to leave, there is nowhere for them to go.

This situation is unfortunately often referred to, these seniors would be called "bed-blockers," but that's really an unfortunate symptom of the situation we find ourselves in because of course these bed-blockers are our elders, the senior citizens of this province who have spent their lives working and contributing and caring for people. Now unfortunately they are often referred to as bed-blockers because we can't find a place for them to go and live the rest of their life in dignity.

 Another big issue we face in Dartmouth is the recent move of the dialysis chairs from the Dartmouth General through the duration of the renovation. Dialysis patients have now subsequently been told that this move happened because it was necessary for the renovation. But, Mr. Speaker, I submit that they could have worked around that. Not only that, not only do I think they could have changed the renovation schedule so that the people who already often have to travel quite a distance to get to the Dartmouth General from further regions, not only could they have been able to do it in the hospital - but even let's say they couldn't have been able to do it in the hospital; these patients are ambulatory, there are other options for providing treatments, like dialysis in communities.

 We've heard this from other people in this Chamber but now we know that these patients have to travel to Halifax, and again not just from Dartmouth but from points much further out and that they aren't receiving any support in that regard.

 We have a lack of psychiatric care in Dartmouth. We have no emergency psychiatric care at the Dartmouth General emergency department. We have heard of the arrival of some nurses with psychiatric specialties. I am not aware of whether those nurses have, in fact, been hired yet but the reality remains that if you are in an acute mental health crisis and you present at the Dartmouth General, you cannot receive care there, so you have to be medically cleared and stabilized and transferred to Halifax - when Halifax has room. And when does Halifax have room? This is a conversation we talk about all the time. Halifax never has room. People are routinely in that ER, my family members included, for 10, 12, 24 hours and that's a big problem.

 The minister said in response to a question in this House the other day that when the ambulance picks someone up in metro, they would be taken to the facility that has the treatment they need. That is not accurate, Mr. Speaker. If a patient is presenting in an acute mental health crisis and they are picked up by EHS, they will be taken to the nearest facility because that's how the EHS works. So, if the nearest facility is the Dartmouth General, that means they are going to wait a few more days, if at all.

 Mr. Speaker, in the spirit of providing solutions and asking specific questions for the Dartmouth General, which serves over 100,000 people whose emergency visits have gone up over 20 per cent since 2011, which serves a large population with very complex needs, our ask, our need is that we need local access to dialysis. We need emergency mental health services. We need more long-term care beds. Please help us solve these problems. 

 The Dartmouth General Foundation, the doctors, nurses, staff, front line, are incredible in Dartmouth. Now we need the government to step up and organize our system in a way that it actually works for the citizens of Nova Scotia.