Nova Scotia Had Plans Underway Before Ottawa’s Health Funding Announcement
Posted February 10, 2023
At a meeting with provincial premiers this week Prime Minster Trudeau promised almost $200 billion in increased funding for health care over ten years. As details emerged it became clear that less than a quarter of it was new money. The rest would have arrived anyway under existing agreements.
The premiers had been asking for much more. Having expressed their disappointment they agreed to take the money, and plan to start a new round of pressure on Ottawa. Ontario premier Doug Ford called it a down payment.
For Nova Scotia the ten year total of new money is about $1.2 billion, an average of $120 million per year in new money. Including previously agreed funding the annual average is $500 million per year.
Premier Houston has not been waiting till now to spend it. A series of recent announcements will consume much of the increase.
(1) On February 1st the province announced a $365 million ten-year contract with Oracle Cerner for a One Person One Record systems project, with first implementations scheduled for early 2025.
There have been a number of major failures in projects of this type over the years, but more recent implementations in Canada and elsewhere have largely met their targets.
That said, it will require strong oversight of the technical aspects and well planned change management to meet the timetable.
(2) On February 6th the province announced the $34 million purchase of an unfinished 110 suite hotel near Highway 102, one of two transitional care units envisaged to take pressure off hospital beds.
Michael Gorman of CBC unearthed a report that the facility would be unable to support patients with mobility or cognitive challenges who also require some level of daily care.
The Department of Health and Wellness is unable or unwilling at this time to identify the profile of the patients not able to stay at home for whom this would be an option. Nor have they disclosed an estimate of the cost to complete the building.
This feels like it comes from the ready, shoot, aim school of planning. The building may end up being a solution in search of a problem.
As it happens we have lots of other challenges. Perhaps it can provide relief for over-crowded student housing. Or some of the homeless can be accommodated.
(3) On January 27, 2023, Premier Tim Houston announced that Cape Breton University will be the site of a new state-of-the-art medical campus.
CBU’s website says the campus will:
“Increase the number of primary care physicians serving Cape Breton and rural Nova Scotia. Train physicians in culturally competent care … Create healthier communities … Educate nurse practitioners, social workers and other healthcare professionals … Focus on interdisciplinary research … Create a collaborative clinic that will serve up to 10,000 patients … Operate in partnership with Dalhousie School of Medicine … Offer 30 seats with a focus on rural medicine and will be established as its own medical school in 2034…”
That is a description of the intended outcomes, but tells us nothing about how it will happen, what it will cost, or when it will start. There is a successful model to follow at the outset, even if the intention is to ultimately establish an independent CBU medical school.
In 2007 the University of New Brunswick and the Government of New Brunswick agreed to fund a Dalhousie Medical Education Program. UNB Saint John is the host facility, providing infrastructure, student support services, and library facilities. The program admits 30 New Brunswick students each year, providing them with the opportunity to study medicine in their home province.
When asked if that model would be followed, the province replied “The partnership details between Cape Breton University and Dalhousie University are still being finalized by all parties…”
Perhaps those details will get sorted out in the next few weeks. If they drag on it will be because CBU wants a broader role than UNB, even at the outset, as it plans for its own faculty.
Significant staffing and infrastructure is necessary for medical school accreditation. It is hard to imagine that this can be cost effective for cohorts of only 30 seats, or that the medical community on Cape Breton (population 133,000) can support all of the necessary internships for more students than that.
This feels like it comes from the ready, aim, aim, aim… school of planning. Perhaps more knowledgeable minds will announce an agreement before the end of February, with everyone smiling. If not they should adopt the New Brunswick model for now and plan to postpone discussions on a possible independent school of medicine until the program is underway.
Houston has been right to advance initiatives without waiting for federal funding promises. Each of the recent Nova Scotia announcements responds to a real need. That does not guarantee that they will be well managed. Strong oversight and restraint on scope creep will be essential.
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