Need a Family Practise Registry - Adjournment Debate

CLAUDIA CHENDER « » : I am pleased to rise after a heated few, very long days in this House and talk about something that I hear about from my constituents every day, and that is the number of people without attachment to primary care in this province.

Years ago, Premier McNeil promised a family doctor for every Nova Scotian. That didn't happen. Our Premier then ran a successful election campaign on fixing health care. That didn't happen.

AN HON. MEMBER: Yet.

CLAUDIA CHENDER « » : Okay, let's see if we all agree that you fixed health care in two years. My guess is no, but I hope so, for the sake of my constituents and for the people of this province. What I want to say is that the idea that there's a quick fix, that this is an easy situation, is fundamentally wrong.

That is why we talk about not a physician for every Nova Scotian, but how we can attach more Nova Scotians to continuous primary care. This is why we become very upset when we hear the government say things like, people are happy with virtual care, people can access care at a walk-in. They might be able to access some care, but make no mistake, that care is no substitution for attachment to a continuous primary care provider. We would suggest the best way to do that is collaborative health care.

We were pleased to see a small step in that direction from the government. We will continue to press for more and I hope that it comes. In the meantime, I think we have to be really clear that we're working with what we have and that what we have is wholly insufficient. It is against that backdrop of 116,000 people on the list who need a family doctor, and the 220,000-plus people who, according to Statistics Canada - and I tabled this earlier - are in need of a family doctor in this province.

If we split the difference and say maybe one in five Nova Scotians doesn't have a family doctor, then the fact that this government chose to remove the incentive for existing family doctors to take additional patients in the Central Zone, as one columnist put it, boggles the mind. It boggles the mind, Mx. Speaker, especially in an environment where one of the signature moves of this government is to say that they want to double our population, but they don't want to put in the infrastructure or the incentives or the systems or the policies where we can accommodate that kind of population growth.

This is a great example of a fundamental miss. The Central Zone of Nova Scotia has over half of its residents. When this government took office in 2021, there were 4,000 patients on the Need a Family Practice registry in the Central Zone. There are now 46,000 patients in the Central Zone. That is an astronomical increase. That is the context in which this government cancelled the incentive for doctors to take more patients. Mx. Speaker, it boggles the mind.

The idea that people are happy with virtual care or a walk-in - let's take that, because that is all we have. Before I move away from this truly incomprehensible decision of the government to cancel this incentive, let me also say that when I asked the Premier about this in this House, his response was telling. It was divisive. I said to the Premier « » : Do you agree that it was a mistake to cancel this incentive in the Central Zone? He said: We're improving health care in Parrsboro, we're improving health care in - and then he listed off a litany of Tory ridings across the province where he is improving health care.

I have no doubt that that's true. I believe that this government, that all of us, that all Nova Scotians want to improve health care, but that is divisive. That is fundamentally divisive, and it doesn't address the question. Yes, rural Nova Scotians need access to health care, and urban Nova Scotians need access to health care. We all need access to health care. The fact that that would become a binary, that that would become an either/or - it's like saying, why didn't you have any red candies? Don't you want blue candies? Like, what are you talking about? It doesn't make any sense.

I continue to be perplexed by that, and also the notion that virtual care or a walk-in clinic, number one, takes the place of that, but number two, is even available. The reality is - and, again, I think virtual care is better than nothing. I think it has to exist because of the number of people in Nova Scotia - and I'll remind people that the population of Nova Scotia is among the most complex medically, and the oldest in the country.

We need health care. Our constituents need health care. If virtual care or walk-in care is all that's there, well, it's better than nothing. But if you talk to people about trying to access virtual care or trying to go to a walk-in clinic, they will tell you it's almost impossible. I hear from constituents almost every day who say, "I've logged in every morning, right away, and the slots are full for the day. I can pay if I want to, but the slots are full," or "I go to a walk-in and, again, the options are full. It's not even that I have to wait a few hours. It's no, there is no care here."

Again, we're glad that this exists. If they're full, it means people are using them. That's great, but they are wholly insufficient. People want regular access to health care. They want to know that when they get sick, there is an avenue for them to get better, and in particular, to access specialists.

I have a friend who was recently diagnosed with Parkinson's. She doesn't have a family physician. Her journey has been excruciating - tests, specialists. She's now being followed by someone in neurology because they didn't have the heart to release her as a patient because she needed someone to follow her chart. Virtual care does not follow your chart.

There are so many people in this situation who have a diagnostic test that reveals an abnormality, they have a diagnosis of cancer or some other disease, but there is no one following their case and there's also no one advocating for them. We have many people who live alone, who don't have an advocate in the form of family. But in addition to family, in an overburdened health care system like ours, a family doctor is an important advocate. They will send a referral. When it comes back and says you can see the specialist in three years, if they're good, they will hopefully send again and they will get you on a wait-list and they will help to advocate for you in the health care system. Without an advocate, your chances are worse, your outcomes are worse, and it's scary, frankly.

The point that I want to make here - and I'm so glad we have the opportunity to talk to this issue - is to say, first, I know there's work being done. I'm not saying there's not work being done. But it's not working. What's happening right now in the health care system is not working. It's not working for families. It's not working for seniors. It's not working for my constituents. It's not working for anyone.

I would ask the government to look at how these systems are set up, because what we've seen, from what little window we have, is that the independent board was fired, the CEO was replaced, the physician lead is gone, the power is centralized - and presumably all of that was done so that decision-making could happen more quickly and more effectively. But I think Bob Martell, a retired physician, recently wrote a column - and I'll table this - entitled "Time for 'martial law' to end in health care." He made the argument that that might have been necessary at the beginning, but it's not necessary now.

We need a more robust system that can act on this very difficult and complex matter as soon as possible, and above all else, Mx. Speaker, people in Nova Scotia need family medicine. They need to know that when they are sick, they will have a health care professional who can see them, who can follow their chart and who can advocate on their behalf.