Promises and performance: Health

The Department of Health is by far the biggest spender in the provincial government, so it should come as no surprise that health was a big issue in the 2007 P.E.I. election campaign.

At the top of the list was a simple, direct promise, and one that every Islander could easily grasp.

"We promise every Islander a family physician," said Liberal Leader Robert Ghiz.

In an interview with CBC News the day after his election victory, Ghiz downplayed the significance of that simple statement.

"We don't believe it's that big of a promise," he said.

"The Conservatives promised 25 new doctors over the campaign ... Four would do it, on top of what we have now. We have five to eight thousand Islanders without a family physician."

The math is fairly simple: each new doctor taking on 1,500 to 2,000 patients to provide a doctor for all.

But the reality has proven to be much more complicated. The patient registry at the end of July listed 6,000 Islanders waiting for a family doctor, and there was evidence the registry would quickly grow. It did not include the 4,300 patients of Dr. Robbie Coull, who was officially leaving the Island in October, or Dr. David Morgan, who left Souris following a contract dispute with the province.

Numbers of patients and doctors have proven to be volatile. Two new doctors are expected in September to take 2,000 to 3,000 patients off the registry. The Liberal government has noted that a record number of doctors are practising on the Island, but at the same time the Island's population has grown.

No new hospital

One of the most unusual promises of the campaign was one not to build a new hospital.

Defending premier Pat Binns had announced a plan to close two small hospitals in western P.E.I. and replace them with one larger facility in Bloomfield Corner. Ghiz chose not to follow that lead.

"We want to invest in people, not bricks and mortar, because we believe that health care services are more important than cornerstones and ribbon cutting," he said at a campaign event.

"Give the new Liberal team 30 months to fix the shortage of health care providers in West Prince. I sincerely believe that we will be better off if we invest in people than we will by spending 23 million [dollars] on a new building."

Not building a hospital was an easy enough promise to keep. More complicated was the promise to fix the shortage of health-care providers, one that was extended to rural areas in general.

The promise was broad enough that the Tories were able to point to it almost every time they talked about health care in the last four years.

Specifically, the emergency department in Montague, in the district of Progressive Conservative Jim Bagnall, had its hours reduced so that it wasn't around the clock. The Liberals first said it was a temporary measure. That was 2 ½ years ago, and the emergency department is still not back to 24-hour service.

So the Tories argue that's a decrease in the level of service, not an increase as promised.

The actions the government actually took in West Prince in lieu of a new hospital also generated some controversy. A group of concerned citizens in O'Leary complain service at Community Hospital has dropped dramatically since the election.

During the last session of the legislature, a bus load of people from the area came to Province House to protest. The Opposition spent most of one day of question period grilling Health Minister Carolyn Bertram on the reduction of services in rural hospitals.

The Liberals argue that while service has changed in some cases, overall there is an increase. Not only are there more doctors on P.E.I. than ever, there is also a new accelerated nursing program to put more nurses in jobs across P.E.I. faster.

Where there were two nurse practitioners on P.E.I. before the election, there are now five.

Catastrophic drug costs

P.E.I., along with New Brunswick, is one of only two provinces that does not offer a program to cover the costs of expensive drugs for people with debilitating or terminal diseases.

In 2007, the Liberals promised they would work with the federal government and other provincial governments to establish a catastrophic drug program. About one in four Islanders does not have drug coverage, and drug programs delivered at home can costs tens of thousands of dollars.

Programs across the country vary, but most come into play when drug costs exceed a certain percentage of family income. In Newfoundland and Labrador, residents can apply for help when costs exceed between five and 10 per cent of net family income.

As recently as April, Bertram has said the province is still pursuing a program, but requires the assistance of the federal government to afford it.

A new health administrator

One of the biggest changes in health care since 2007 was the creation of Health PEI.

Health PEI was established in 2010 to take over the administration of health care, while the government focused on strategy. It is meant to be an arm's-length organization with an unelected board that oversees the operational side of health care.

The idea was to take the politics out of health care management. The creation of a health administrator was not even hinted at during the election campaign.

While Health PEI may have been intended to remove politics from the process, the Progressive Conservatives have been making political hay of it. They are calling it a way for Health Minister Carolyn Bertram to hide, and deflect difficult decisions and public statements on health care to the Health PEI board.

In July, when a doctor in Souris quit following a letter from Health PEI cancelling doctor contracts, PC Leader Olive Crane wondered loudly where the premier and health minister were.

"You see Robert Ghiz and Carolyn Bertram when they're announcing residency programs or announcing investment in healthcare," said Crane.

"When there's an issue or a problem, instead it's pushed onto Health PEI."

On the new Tory election website, there's a mock poster with a photo of Bertram, saying "Lost, one PEI Health Minister. Last seen hiding behind Health PEI."