REPLY TO DAVID:
If the small centers don’t save money they should be closed. If they do then the experiment should be expanded. Either way it is the government that will deal with the finances. There is no suggestion in the article that patients would be charged.
There is no doubt Mr. Black that this kind of healthcare delivery would help make those services more accessible but what you are failing to point out is that these services would come at a premium cost to the users of such services and that these costs will not be cheap! Isn’t it true that this kind of capitalistic healthcare structure is tailored toward the wealthy and does nothing for the poor!? Or will you deny that!?
Another point you made in your article regarding “less expensive real estate” also makes perfect sense. I am sure there are buildings in Bayers Lake Park that could be set up as auxiliary pods for certain Specialities. The convenience to patients and their families getting there would be a plus. There is no real reason why hospitals must stay in the south end of Halifax. The hospitals in Saint John and in Fredericton are not sitting in residential areas, nor do they need to be there. Every month, it seems, there are more leaks and flooded floors in the former Nurses’ Residence, part of the VG complex in the City–with staff again unable to work there and in many cases, again, sent home. The buildings that make up the old V.G. site are crumbling dumps (missing ceiling tiles, mould, leaking pipes, drafty windows, water often unfit even for bathing, dirty surroundings) all appear less than conducive to patients’ wellbeing and recovery prospects. These unhealthy places are less than ideal, as well, for all staff who work there.
One person who left a comment described a Capital Health ‘Mis’management Team. It does appear that we have a Provincial Government suffering from inertia–while the waitlists grow longer and longer.
________________________________
Please show first name only.
Off government expense. More productivity. “energetic and more flexible staff”. Who’d object? Maybe the ‘shrill resistants’ should be more closely reviewed by those who represent us.
Shortly after I arrived in Digby as a young lawyer in 1962 I was recruited to canvas selected people for Money for the new hospital which was then planned. It wasn’t because of my contribution to the effort that the goal was achieved and the NEW 90 bed hospital was built, with two fully equiped operating rooms. To the best of my knowledge they still exist. At that time I think we had about 5 GPs some of whom had some training in surgery, and in the years that followed with changing standards surgery was handed over to one “surgeon” , and an expert “anesthesiologist”. The latter found there was not enough busines for a satisfactory income…about that time we had that “task force” and soon, with no anesthesia our surgeon moved on to Antigonish.
I think it was as a result of the task force that we were placed under the management of Yarmouth…and much of the equipment from the operating rooms was removed to go?
One operating room I believe continues in use for visiting experts to do minor procedures. I have one myself in a few days.
To come to the point..Why would our Gov’t spend millions of $’s to build new space in HRM when the facilities here, and probably other places already exist within the system. I have been saying to my friends, and anyone else who would listen, that we should have Digby as a center of excellence for hip and knee surgery. ( Our Digby Pines could cater to an international clientele as a locale for pre-op preparation, and post-op recovery.) We already…to give credit…have an excellent rehabilitative program occupying one of the wings of the hospital for post-op hip and knee patients.
The need for this kind of program, in the province, if not in Digby was driven home to me several years ago when I was hearing a case where the issue of wait time arose. There must have been an issue of the delay in treatment. One of the leading Orthopedic guys of the time..Yabsly perhaps…testified that he could do 4 or 6 ? operations in a day if he had access to an operating room. I now forget what it was he said he was allowed, but I think it was something like one day every two weeks. I remember thinking at that time that there was no reason why he could not be persuaded to travel down to Digby and do two or three days in a week, ..and it would have provided the environment to keep the anesthetist gainfully employed.
What you did not say in your column is that there is expense to the public in having these conditions go untreated. Sadly an old friend of mine who was in excellent health developed a knee problem at age 88. She was told that no operation would be performed because of her age….she had planned, with reasonable expectation to hang on for 100…at 88 she was living in her own home, self sufficient, wit a reasonable income, getting out to Bingo twice a week….but by 90 she was restricted to a chair, and unable to stay in her own home and now becoming a burden to others. A couple of years later, she died from deconditioning, brought on by her inactivity. How much more the cost of a plumber or other tradesman who can’t comfortably go about his/her daily work…perhaps as a result of injury from a car accident or fall.
In your column you refer to the price of real estate…it is cheap here, and getting cheaper all the time. A specialists center in Digby, using visiting specialists could be a profit center in my (skewed?) view.
Excellent column regarding Scotia Surgery as well as your common-sense ideas, which our government seems to be devoid of. As Nova Scotians, we are unable to be referred for medical intervention in another Province unless that service is not provided here, as I understand it. With a 2-3 year wait to see a Neurosurgeon or Orthopedic Surgeon for a person needing Spinal Surgery, could it be said that this service is available here? Not to my way of thinking.
The Canada Health Act most certainly provides for two-tier medicine. Should politicians, RCMP and military members, and prisoners be permitted to jump the queue ahead of other Canadians? Because they are paid by the Federal Government? And where does the Federal Government get the money to make this possible? Are these groups somehow better than the taxpayers who pay their salaries? Do they hurt more? In the case of prisoners, I have lost track of the annual cost of keeping just one in a federal prison for a year–perhaps $100,00 or so–the cost, of course, paid by the taxpayer?
I just love that comment regarding 78% of our management term being women with nursing degrees. It just goes to show that the best interest of the patients is not the high priority that we are lead to believe.The truth is that the health industry is being handicapped by the employment of these narrow focused persons and it shows. I would venture that more thought is applied to choices for wardrobe than is given at any one time as to the care and comfort of the patients, and that my friends is no exaggeration.
Just let god forbid Joan Jessome or any of the other public service honcho’s suffer a knee or hip injury .we will soon see that these private facilities are not the devil in disguise after all disgusting
I have been reading the articles you have submitted to the Chronicle Herald over the past several months, and have found myself in very broad agreement with the positions you have put forward. Today’s article, relating to the potential value of specialized medical clinics, continues the pattern.
Some of the points you made, including your reference to the Shouldice Hospital, and your business background, cause me to conclude that you must be familiar with the work of Dr. Clayton Christensen of the Harvard Business
School. I hope I’m correct, but I have been dismayed by how many prominent
business people and politicians have never heard of him.
If you are not familiar with Christensen’s work, then I concur with Mayor Michael Bloomberg’s assessment that Christensen’s “The Innovator’s Prescription” is a book that “might just mark the beginning of a new era in health care”, and I recommend it to you. (I just checked, and there are several references to the Shouldice Hospital).
When will Canadians get over the “Canada Health Act” mentality?
There are many ways to improve services and why aren’t we willing to accept changes in the system to improve wait lists and costs?
Last year I had an application for physio, delivered by me by my Doctor’s request to Valley Regional on April 4, 2012. I received a letter in Oct, 2012 for an appointment Nov 20. When I went to the Physio Dept, it was completely empty except for a room filled with equipment and two therapists passing through.
Looking forward to more articles relating to the same,
I just read your piece on specialty clinics and I couldn’t agree more. Many savings can be had by contracting out services such as radiology (as is done in Alberta) to private clinics. The major saving is by using dedicated, non-union services, but there are many initially unseen, seemingly minor benefits like staff dedication and morale; and the fact that the clients even have a place to park!
The Cambie Clinic in Vancouver BC, which is mainly ortho-centred doing outpatient stuff started doing contract work for WBC and has mushroomed from there. They now do a huge business embracing much if the surgical spectrum. The head of the clinic, Brian Day was elected Head of the Canadian Medical Association in 2007 in a landslide, so you know where the doctors sit. Check out their website http://www.csc-surgery.com/
This is a great opportunity for governments to wean themselves away from the unions, and to embrace a new model which could include PPP’s for example.
Patients (excuse me, clients) stand to gain the most. Government finances (meaning you and me) next. Unions, and the status quo, last.
I disagree that the problem is the government restraint. The problem is mismanagement. The bulk of the costs are fixed and what we see constantly from our embarrassment of a management team at Capital Health is “slow downs” followed by “blitzes” which drive additional expense.
Firstly lets get a qualified management team that is NOT 78% middle aged women with nursing degrees. Secondly let’s put in place proper and accountable governance and Thirdly lets add some “smaller is better”. Well done, Bill. Keep this work up. It IS appreciated.
REPLY TO DAVID:
If the small centers don’t save money they should be closed. If they do then the experiment should be expanded. Either way it is the government that will deal with the finances. There is no suggestion in the article that patients would be charged.
Bill Black
Bill | July 2, 2013 |
There is no doubt Mr. Black that this kind of healthcare delivery would help make those services more accessible but what you are failing to point out is that these services would come at a premium cost to the users of such services and that these costs will not be cheap! Isn’t it true that this kind of capitalistic healthcare structure is tailored toward the wealthy and does nothing for the poor!? Or will you deny that!?
David | July 2, 2013 |
Another point you made in your article regarding “less expensive real estate” also makes perfect sense. I am sure there are buildings in Bayers Lake Park that could be set up as auxiliary pods for certain Specialities. The convenience to patients and their families getting there would be a plus. There is no real reason why hospitals must stay in the south end of Halifax. The hospitals in Saint John and in Fredericton are not sitting in residential areas, nor do they need to be there. Every month, it seems, there are more leaks and flooded floors in the former Nurses’ Residence, part of the VG complex in the City–with staff again unable to work there and in many cases, again, sent home. The buildings that make up the old V.G. site are crumbling dumps (missing ceiling tiles, mould, leaking pipes, drafty windows, water often unfit even for bathing, dirty surroundings) all appear less than conducive to patients’ wellbeing and recovery prospects. These unhealthy places are less than ideal, as well, for all staff who work there.
One person who left a comment described a Capital Health ‘Mis’management Team. It does appear that we have a Provincial Government suffering from inertia–while the waitlists grow longer and longer.
________________________________
Please show first name only.
Carol | March 11, 2013 |
Off government expense. More productivity. “energetic and more flexible staff”. Who’d object? Maybe the ‘shrill resistants’ should be more closely reviewed by those who represent us.
gordon a.... | February 25, 2013 |
Shortly after I arrived in Digby as a young lawyer in 1962 I was recruited to canvas selected people for Money for the new hospital which was then planned. It wasn’t because of my contribution to the effort that the goal was achieved and the NEW 90 bed hospital was built, with two fully equiped operating rooms. To the best of my knowledge they still exist. At that time I think we had about 5 GPs some of whom had some training in surgery, and in the years that followed with changing standards surgery was handed over to one “surgeon” , and an expert “anesthesiologist”. The latter found there was not enough busines for a satisfactory income…about that time we had that “task force” and soon, with no anesthesia our surgeon moved on to Antigonish.
I think it was as a result of the task force that we were placed under the management of Yarmouth…and much of the equipment from the operating rooms was removed to go?
One operating room I believe continues in use for visiting experts to do minor procedures. I have one myself in a few days.
To come to the point..Why would our Gov’t spend millions of $’s to build new space in HRM when the facilities here, and probably other places already exist within the system. I have been saying to my friends, and anyone else who would listen, that we should have Digby as a center of excellence for hip and knee surgery. ( Our Digby Pines could cater to an international clientele as a locale for pre-op preparation, and post-op recovery.) We already…to give credit…have an excellent rehabilitative program occupying one of the wings of the hospital for post-op hip and knee patients.
The need for this kind of program, in the province, if not in Digby was driven home to me several years ago when I was hearing a case where the issue of wait time arose. There must have been an issue of the delay in treatment. One of the leading Orthopedic guys of the time..Yabsly perhaps…testified that he could do 4 or 6 ? operations in a day if he had access to an operating room. I now forget what it was he said he was allowed, but I think it was something like one day every two weeks. I remember thinking at that time that there was no reason why he could not be persuaded to travel down to Digby and do two or three days in a week, ..and it would have provided the environment to keep the anesthetist gainfully employed.
What you did not say in your column is that there is expense to the public in having these conditions go untreated. Sadly an old friend of mine who was in excellent health developed a knee problem at age 88. She was told that no operation would be performed because of her age….she had planned, with reasonable expectation to hang on for 100…at 88 she was living in her own home, self sufficient, wit a reasonable income, getting out to Bingo twice a week….but by 90 she was restricted to a chair, and unable to stay in her own home and now becoming a burden to others. A couple of years later, she died from deconditioning, brought on by her inactivity. How much more the cost of a plumber or other tradesman who can’t comfortably go about his/her daily work…perhaps as a result of injury from a car accident or fall.
In your column you refer to the price of real estate…it is cheap here, and getting cheaper all the time. A specialists center in Digby, using visiting specialists could be a profit center in my (skewed?) view.
C Haliburton | February 25, 2013 |
Excellent column regarding Scotia Surgery as well as your common-sense ideas, which our government seems to be devoid of. As Nova Scotians, we are unable to be referred for medical intervention in another Province unless that service is not provided here, as I understand it. With a 2-3 year wait to see a Neurosurgeon or Orthopedic Surgeon for a person needing Spinal Surgery, could it be said that this service is available here? Not to my way of thinking.
The Canada Health Act most certainly provides for two-tier medicine. Should politicians, RCMP and military members, and prisoners be permitted to jump the queue ahead of other Canadians? Because they are paid by the Federal Government? And where does the Federal Government get the money to make this possible? Are these groups somehow better than the taxpayers who pay their salaries? Do they hurt more? In the case of prisoners, I have lost track of the annual cost of keeping just one in a federal prison for a year–perhaps $100,00 or so–the cost, of course, paid by the taxpayer?
The Canada Health Act is in dire need of surgery.
Carol | February 25, 2013 |
I just love that comment regarding 78% of our management term being women with nursing degrees. It just goes to show that the best interest of the patients is not the high priority that we are lead to believe.The truth is that the health industry is being handicapped by the employment of these narrow focused persons and it shows. I would venture that more thought is applied to choices for wardrobe than is given at any one time as to the care and comfort of the patients, and that my friends is no exaggeration.
johnny smoke | February 24, 2013 |
Just let god forbid Joan Jessome or any of the other public service honcho’s suffer a knee or hip injury .we will soon see that these private facilities are not the devil in disguise after all disgusting
johnny smoke | February 24, 2013 |
I have been reading the articles you have submitted to the Chronicle Herald over the past several months, and have found myself in very broad agreement with the positions you have put forward. Today’s article, relating to the potential value of specialized medical clinics, continues the pattern.
Some of the points you made, including your reference to the Shouldice Hospital, and your business background, cause me to conclude that you must be familiar with the work of Dr. Clayton Christensen of the Harvard Business
School. I hope I’m correct, but I have been dismayed by how many prominent
business people and politicians have never heard of him.
If you are not familiar with Christensen’s work, then I concur with Mayor Michael Bloomberg’s assessment that Christensen’s “The Innovator’s Prescription” is a book that “might just mark the beginning of a new era in health care”, and I recommend it to you. (I just checked, and there are several references to the Shouldice Hospital).
Greg Ross | February 23, 2013 |
Thank you for your article in today’s Chronicle.
When will Canadians get over the “Canada Health Act” mentality?
There are many ways to improve services and why aren’t we willing to accept changes in the system to improve wait lists and costs?
Last year I had an application for physio, delivered by me by my Doctor’s request to Valley Regional on April 4, 2012. I received a letter in Oct, 2012 for an appointment Nov 20. When I went to the Physio Dept, it was completely empty except for a room filled with equipment and two therapists passing through.
Looking forward to more articles relating to the same,
Ellie Kennie | February 23, 2013 |
I just read your piece on specialty clinics and I couldn’t agree more. Many savings can be had by contracting out services such as radiology (as is done in Alberta) to private clinics. The major saving is by using dedicated, non-union services, but there are many initially unseen, seemingly minor benefits like staff dedication and morale; and the fact that the clients even have a place to park!
The Cambie Clinic in Vancouver BC, which is mainly ortho-centred doing outpatient stuff started doing contract work for WBC and has mushroomed from there. They now do a huge business embracing much if the surgical spectrum. The head of the clinic, Brian Day was elected Head of the Canadian Medical Association in 2007 in a landslide, so you know where the doctors sit. Check out their website http://www.csc-surgery.com/
This is a great opportunity for governments to wean themselves away from the unions, and to embrace a new model which could include PPP’s for example.
Patients (excuse me, clients) stand to gain the most. Government finances (meaning you and me) next. Unions, and the status quo, last.
Peter Roy | February 23, 2013 |
I disagree that the problem is the government restraint. The problem is mismanagement. The bulk of the costs are fixed and what we see constantly from our embarrassment of a management team at Capital Health is “slow downs” followed by “blitzes” which drive additional expense.
Firstly lets get a qualified management team that is NOT 78% middle aged women with nursing degrees. Secondly let’s put in place proper and accountable governance and Thirdly lets add some “smaller is better”. Well done, Bill. Keep this work up. It IS appreciated.
Paula Minnikin | February 22, 2013 |