The future of access to healthcare in Nova Scotia - Emergency Debate

CLAUDIA CHENDER « » : I'm pleased to rise and say a few words about the pressing issue of the state of our emergency departments. We just heard from the government that we should be here only discussing the matter of MLA pay raises. With respect, and as far as I can tell, contrary to the wishes of the government, the passage of this emergency debate shows that that is categorically false and that in fact the state of our emergency departments fit the definition of a matter of pressing public concern that needs to be debated by the House at the first available opportunity. We have been debating it the last few days, but we will continue to, and we should continue to.

Earlier my colleague for Northside-Westmount said we're all here for the right reasons. I agree with that statement, and I believe it. I think people put their names forward for public service because they want to serve, and they want to make a difference. I guarantee you, Madam Speaker, that every one of us in our office has more heartbreaking stories about what's happening in our health care system than we could possibly tell in this Chamber. It's a systemic problem. There's no question. I think we can say it's a systemic problem without immediately moving to cast blame.

Unlike any other election campaign that I have seen in my political life, this government ran a campaign on a single issue, one issue - that was to fix health care. They were clear, they were decisive, and they were repetitive, and they won a majority government. They were given a mandate to fix health care. Here we are a year later, and health care is worse.

As we have talked about, it's worse by every measure. More than 25,000 people added to the wait-list for a family doctor - not because they think now being added to the wait-list is useful because maybe they'll get one. That is one of the strangest arguments I have heard put forward in this Chamber. Why are they on the family wait-list registry? Because they need a doctor. They need access to primary care, and they don't have it. We know that there's a multiple of that number. For 100,000 people on the list, there's that many more, probably twice as many, who aren't on the list but don't have access to primary care. We know that the number of people leaving the emergency department without being seen is up 60 per cent.

The member for Halifax Atlantic, I think, mentioned earlier today that someone with a broken wrist was sent home and told to come back. My nine-year-old broke his wrist last Summer. We were just talking about it because he's going back to the camp where he broke his wrist last Summer. It shows you the kind of parent I am, I guess. (Laughter) We'll hope for better outcomes this year. I was talking to him, and he said, oh God, Mom, this year I promise I'm not going to break my wrist. I said okay, Sam, I believe you. I don't think you're going to break your wrist.

We were talking about it, and I was trying to remember what happened when he broke his wrist. I said, Sam, do you remember? Anyway, my mind is kind of like a sieve these days. I said, what happened? Do you remember? He said, yes, Mom, remember, you picked me up and you picked up the girls and you dropped them off and the babysitter came, and we went to the emergency room. I said, yes, we waited a long time, right? He said, we waited for a while, and then they put my cast on and we left.

From that perspective, it was kind of unremarkable. I don't really remember, which is kind of how it should be. If my child breaks his wrist, I need to know that I can take him to the emergency room and get the wrist set. I need to know that I can do that anywhere in this province. If the IWK has the waits that we've seen, what of the other emergency departments - if they're open?

Madam Speaker, this is an emergency. We know that people - our emergency care system is still functioning. Frontline workers are still working. If Sam breaks his wrist again this year, which I really hope he doesn't, we'll go back to the IWK and we'll wait as long as we can, and I have a good amount of faith that eventually his wrist will be set. But I shouldn't have to hope that that happens. I should be able to know that that happens.

As we spoke about in the Chamber the other day, Evelyn Hornbeck doesn't have a family doctor and can't get the medicine she needs, can't get to a walk-in clinic. Vickie Gray, waiting for carpal tunnel surgery, can't use a doorknob, can't lift anything, can't zip a zipper - and she's looking at a wait of two to three years.

Are things happening in the health care system? Sure. But that doesn't mean that we can ignore the fact that things are bad. I would like to hear from the government what is being done right now that is going to alleviate some of the deep fear that people are facing when they're trying to access basic health care.

One of the things I want to say is that I turned on CBC Radio the other day, and the health care hack was how to access private health care without breaking the law. That was a health care hack on the morning news - how to access private health care without breaking the law.

This is a well-documented process - things get so broken that it suddenly appears that only the private sector can fix it. Beware. You know, I hope I don't have to revisit the words I'm speaking right now, but we are at a dangerous crossroads in our health care system. People are losing trust in their ability to find health care.

We talked about Spencer Thomas, who tried to go to six walk-in clinics. He tried to go to a private clinic, and they wouldn't take him because his kid was too young. But he would have done it, and why? Not because he's a bad person, not because he doesn't believe in public health care, but because he was desperate. He had no other choice.

The idea that it's not appropriate for us to be discussing the state of our health care system right now, in this Chamber, is frankly offensive to all of the people that we represent. We know that it's getting worse and worse. So what do we do about it?

Well, we've heard that there's progress being made. We've certainly seen some announcements that we're happy about. New seats for nurses is great. Guaranteed employment is great. But the reality is we are in a global competition for health care talent. I thought we all knew, after Premier McNeil ran on a promise to deliver a doctor for every Nova Scotian and was unable to do that, that that wasn't actually going to happen. It's not going to happen. We're not going to have a doctor for every Nova Scotian. But Nova Scotians need to know, everyday people and families and seniors across this province need to know, that when they need access to care, they can get it.

How do we do that? Well, we haven't heard a plan. We know that the government tabled a plan, but it didn't talk about what the future of primary care was. It didn't talk about how we're going to do things differently in a time when our population is growing. When we know that, as a province, we are older and we tend to be sicker than much of the rest of the country. When our health care transfers remain frankly insufficient to cover the costs of what we need to do. So what are we going to do? Well, we have to do things differently.

One way that we could do things differently is to think about a different way to run our public health care system. The NDP embarked on this path when we were in government and that is collaborative care. That's finding a way that people can access primary care and emergency care without necessarily having to have fully-staffed facilities with physicians all the time. We can use paramedicine. We can use nurses. We can use nurse practitioners. We can use physician's assistants. We can use non-medical personnel to do certain tasks that may not require medical training. These are things that could happen now, but what we are hearing, in fact, is a move away from that model. So, what's the plan? We don't have enough doctors.

I think it is great that there is an emphasis on recruitment, although last I heard, the head of recruitment mysteriously disappeared, and we haven't heard why. Notwithstanding that, great - recruitment. It's not enough. It's not going to fix the problem. So what is going to fix the problem? We need a new approach. We need to know that it's happening. It's not enough for us to hear that seeds are being planted.

If I hired a gardener and asked how did things go out there today, and they said, seeds are being planted, my next question would be what seeds? What is going to come up? What is my garden going to look like? Are you planting swamp milkweed so I will have a bunch of butterflies? Are you planting goutweed so that I will be upset for the rest of my life every time I go outside my door?

I don't know what seeds are being planted. We are just being told that we should trust that seeds are being planted. Also, those seeds are being planted by four people, or maybe three - I don't know what's happened to Dr. Orrell. Frankly, without any transparency, without any clarity, without any conversation about what this innovation looks like, it's very difficult for us and for the Nova Scotians we represent to have faith in this.

Yesterday the minister, in response to a question about overcrowding at the IWK, seemed to suggest that parents might not be used to having sick children, or children might not have been used to going to the emergency room. I found that response really troubling. As a parent of three, my strong belief is that if you feel like there is something wrong with your kid, you go to the hospital and you get it checked out, because you never know. You never know. I'm not a doctor. If I think my child is sick, I take them to the hospital and I should be able to expect that they will get care there. I think that goes for all of us.

I think when we are sick, when we need medical attention, we should trust that we can get the help we need, and there are a lot of steps that could be taken to accomplish that. I think moving to a different model, as I have discussed, is one. I think actually looking at wages is another - not just of continuing care workers in long-term care, but of people throughout our medical system.

More generally, with the disposal of an entire government department, we are asking the question: What seeds are being planted? When are they going to grow? How long do Nova Scotians have to wait? I hope we get answers to that.

I am glad that we have the opportunity to talk about this in the Chamber tonight, although I know it wasn't on the government's agenda, and I look forward to hearing the comments of my colleagues.