New deputy health minister focused on 'setting the tone' to improve system

Dr. Tom Marrie was supposed to be easing into retirement when he recently received a phone call from Nova Scotia Premier Stephen McNeil.

McNeil wanted Marrie ⁠— who has served as dean of the medical schools at Dalhousie University and the University of Alberta ⁠— to take over as deputy minister of the Health Department.

In a recent interview, Marrie said the premier talked about the way people in the province are feeling about the health-care system, how it's functioning and what McNeil thought needed to be done to improve things.

"It was really something I felt I had to do," Marrie said in his downtown Halifax office.

Marrie takes on the interim position as the system faces regular capacity problems in emergency departments and inpatient wards, as front-line workers express concerns about burnout and as patients sometimes face long waits for service.

What Marrie will be doing

None of those things are unique to Nova Scotia, but they now fall on Marrie's plate as he attempts a system assessment.

Part of that work will include assessing the system five years into the merger of the district health authorities.

As the Nova Scotia Health Authority continues its search for a new CEO, McNeil recently told reporters he was bringing on Marrie in an effort to reset the relationship between the authority and Health Department.

Marrie said his main tasks will also include finding a way for people on the front lines to have control over what they do while working within a centralized system and identifying gaps in the system and within the department.

Building better relationships

He's pragmatic about how much he thinks he can get done in what is supposed to be a short-term appointment. McNeil has said the plan is to have a permanent deputy in place by early next year.

Marrie said he believes building better relationships is something that can be done fairly quickly, while other work, including his assessment of areas needing improvement, will ultimately fall to his successor to implement.

He said his intention is to be "very frank" in outlining what he thinks needs to change.

McNeil stressed the issue of building better relationships when he announced Marrie would replace Denise Perret, who'd only been on the job for a little more than two years.

Strained contract talks

One relationship in particular — between the government and doctors — is something the province likely hopes Marrie can help improve.

The two sides are engaged in strained contract talks and more recently, doctors have shown themselves to be more willing to speak out about working conditions.

While Marrie won't have a direct hand in contract talks, he said the two sides must do a better job working together.

"I don't think there's anybody who would dispute that relationships are not what they should be," said Marrie, who has also operated a family practice in Newfoundland and worked as a researcher.

"Doctors Nova Scotia has many of the same goals I have.… The only reason we're here is to provide the best possible health care for Nova Scotians."

'Setting the stage and setting the tone'

When Marrie took the job at the helm of Dalhousie's medical school in 2009, he did so at a time when the institution faced immense stress related to its accreditation.

He saw the need to rebuild the curriculum from the ground up. The situation meant five years of work needed to be completed in one year. The only way it was achieved was by everyone pitching in, he said.

"When we set up teams to do an environmental survey to see where we should be going, we had 30 teams of 20 each — 600 people working on this and everybody pulled together," he said.

He is expecting, out of necessity, something similar will happen now.

Finding a way to work together

Everyone within the system must find a way to work together, to serve patients' needs and allow workers to feel like they have a level of control over what happens where they work, said Marrie.

He sees his work in that effort as being about "setting the stage and setting the tone," and then others can carry on at the end of his tenure.

"In reality, it will remain to be seen, but I wouldn't have taken it on unless I had thought that we could make some progress," said Marrie.

"Otherwise, I should be planting my garden right now."