Nova Scotia doctor shortage plan hampered by poor communications, says AG

Nova Scotia Auditor General Michael Pickup has recommended the Department of Health and the Nova Scotia Health Authority find a way to prioritize the thousands of families who are on the provincial wait-list for a family doctor.

The provincial family practice registry was created a year ago but according to auditors, "there is no priority based on health history or condition."

According to the AG's latest report, which was released Wednesday morning, management at the health authority said it was "not possible to properly and accurately assess health status over the phone and prioritizing everyone on the registry in person is not feasible." 

Prioritizing patients

Despite that, auditors stand by their recommendation that the Health Department and the authority find a way to ensure people with serious health conditions are given priority.

Tory Leader Jamie Baillie said the lack of priority listing makes the registry "a sham."

"[People] should also expect that there are rules around prioritizing people's needs based on their health. That doesn't actually happen."

The AG's office noted doctor recruitment efforts are shared between the department and the authority, something that might be hampering the work and which the authority itself suggested was a problem.

"The health authority indicated this shared responsibility creates challenges in recruiting doctors as it can add extra steps for candidates to discuss incentives."

'Poor job' communicating 

The AG's office also highlights a problem that has plagued health administrators for decades: A lack of adequate information coming from those managing the health system in Nova Scotia.

Pickup found the Nova Scotia government had a plan to transform primary care in the province but both it and the Nova Scotia Health Authority needed to share that information with the public.

"The department and the health authority are doing a poor job of communicating publicly about planned changes to the delivery of primary care and what is being done to address family doctor vacancies," says the report.

Pickup told reporters the poor level of communication "has the potential of creating a lot of the confusion or potential stress of people not knowing where things are heading." He added that officials with the department and health authority are "probably under-explaining and under-showing people what exactly they have done."

"That's information, probably, the auditor shouldn't be explaining to folks," he said.

Auditors found both the department and the authority had communications plans, but those efforts were hobbled because not every aspect of those plans have been approved and they are not being fully implemented.

Dozens of staff

There are currently five communications staffers specifically assigned to the Department of Health but it also has access to dozens more at Communications Nova Scotia. The health authority currently has a team of 23 people on its communications staff, including digital content producers, graphics designers and website design and maintenance staff.

The Health Department agreed with the recommendations outlined in the AG's report and said it's working on putting them in place.

The Nova Scotia Health Authority issued a similar response in a news release Wednesday and admitted there are challenges to accessing primary care, calling it "a complex problem with multi-faceted solutions — but for those without access to a family practice and who are worried about their health, the basic need is very clear."

Speaking with reporters while in Cape Breton for meetings, health authority CEO Janet Knox agreed they have to do a better job of letting people know what their options are while they wait for system changes.