Nova Scotia 2021 Election Campaign

The general approach of Greens to the health care system is to trust the professionals and leave politics out of it whenever possible. We have a big-picture approach to health and medicine. Our platform shows our plans and priorities: Three Pillars of Health Care First Pillar: Competence The first pillar of the delivery of services is the expertise and commitment of the physicians, professional staff, maintenance, and clerical staff. The top-down approach of the Nova Scotia Health Authority (NSHA) and the Department of Health have undermined the autonomy of essential workers and have had a negative impact on morale. In past years, reforms and changes have been made without true consultation. The Green Party of Nova Scotia rejects this type of top-down approach and will sit down with professionals, staff, and patients (first person) when planning services. Staff and physicians need to be supported in their work as opposed to being under constant pressure. The leaders need to promote a truly collaborative philosophy of care so that staff can have the time and energy to serve their patients. Second Pillar: First-Person Voice The patients need to be offered a place to voice their concerns and suggestions on how services are delivered. The staff holds the scientific knowledge, the patient holds the knowledge of their experience. There is growing evidence that when patients feel they can collaborate in their care, healing and recovery can be enhanced. Third Pillar: Interactions Between Services The interactions between services need to permeate all aspects of services. The Green Party supports navigator services to help patients transition from one service into another. Public Health Public Health in Nova Scotia has done a remarkable job in its response to the pandemic. However, the federal public health agency and all provincial public health agencies did not at first fully evaluate the impact of the pandemic and did not respond with the right approach. This slow reaction is mostly due to budget cuts. It is obvious that more investment in Public Health is necessary so that it can properly fulfill its role. Family Physicians One of the most pressing problems our Healthcare system is facing is the chronic lack of access to a family doctor. There are more people on the waitlist for a family physician in Nova Scotia than when the pandemic began in March 2020. This is simply not acceptable and may be a detriment in attracting interprovincial migration just at the moment when Nova Scotia’s population is growing. This demands strong, bold, coordinated, and collaborative efforts, exactly the type of approach the health care staff can do. It is the role of the Department of Health and of NSHA to promote and sustain these efforts in a practical way. Recently, family physicians have been trained to work in interdisciplinary teams. The Clinic of the future, and the present, is an interdisciplinary team: two or more physicians, a nurse or nurse practitioner, physiotherapist, occupational therapist, mental health and addiction clinician, and others. This Clinic provides services in the evenings and, by partnering with other clinics in the same area, on weekends. This ensures a continuity of care and prevents unnecessary visits to the Emergency Room. The ER does then what it is best at doing: emergent and urgent care and screening for admission. Dalhousie University has recently increased the number of admissions into medicine. We should explore the possibilities of further increasing admission into medicine. Many Nova Scotian students who are not admitted to Dalhousie choose to study abroad and then continue their careers elsewhere. Nova Scotia should be able to attract and retain local and international medical students. Equity in Access to Appropriate Healthcare Many people living in Nova Scotia do not have access to culturally or identity-relevant healthcare. Access to appropriate healthcare is only available to some, and this must change. Creating a resilient and just healthcare system that looks at comprehensive and preventative well-being requires that we are providing appropriate healthcare for all. Indigenous peoples, Black Nova Scotians, French speakers, newcomers, migrant workers, 2SLGBTQQIA+ peoples, women, people with disabilities, and those living in poverty are only some of the people experiencing unequal access to quality healthcare. The Green Party of Nova Scotia will: - Engage in consultations with staff, physicians, and citizens when planning new services or modifying existing based on respect and participatory democracy; - Increase collaboration and transition between health services by promoting the training and hiring of navigators - Make the recruitment of physicians a priority by promoting collaboration between local hospitals, municipalities, not for profit agencies, and having a clear recruitment strategy - Increase the number of admissions into medicine at Dalhousie University - Increase the number of admissions in nurse practitioner programs - Promote interdisciplinary approaches by providing professional services like nursing, mental health and addictions services, physiotherapy, etc. to medical clinics - Improve access to health services in French - Improve access to health services in Mi’kmaq - Improve access to translators for health services for people who do not speak English - Provide incentives to medical clinics so they can open on evenings and weekends - Increase the budget of Public Health so it can fulfill its prevention mandate - Invest in well-coordinated mental health and addiction services and improve the transition between services including supportive housing services - Invest in regional mobile mental health crisis intervention services - Improve access to mental health services for people living with disabilities, 2SLGBTQQIA+, BIPOC (Black Indigenous People of Colour), newcomers, migrants, and other marginalized peoples - Increase access to appropriate reproductive healthcare throughout the province, particularly for survivors of sexual assault and gender diverse peoples - Develop comprehensive strategies to provide relevant and appropriate mental health care and treatment for survivors of sexual and domestic assault - Eliminate the cost of birth control for anyone seeking it - Mandate ongoing cultural sensitivity and anti-oppression training for all healthcare professionals, ensuring that they are well educated on treating 2SLGBTQQIA+ patients - Increase availability and accessibility of gender-affirming care - Require that mental health professionals are trained in climate grief and ecological anxiety - Immediately implement a universal dental care and pharmacare program - Maintain telehealth and online access to health services after the pandemic - Drastically reduce ambulance fees, and work towards eliminating them with systems in place that will dissuade people from taking advantage of emergency services - Provide universal access to fertility services for any who need them regardless of gender identity or sexual orientation and work with healthcare practitioners and 2SLGBTQQIA+ and women’s organizations to create the policy framework for universal access - Work with Public Health, Healthcare practitioners, and Lyme Disease advocates to create a collaborative care plan to ensure adequate care for people at all stages of Lyme disease and proper prevention through instating tick testing and upholding standards of practice for diagnosing and treating Lyme Disease and other tick-borne diseases We realize that this doesn’t perfectly answer your question, and covers a lot of other ground, but we wanted to share with you how Greens approach health and medicine. It’s best to trust the professionals. Thanks for reaching out to the Green Party of NS, be well. Nova Scotia Green Party

If elected, I plan to do everything I can to safely increase staffing in health care centres, including facilitating the recognition of equivalent qualifications of professionals from other countries and overhauling the unhealthy work ethic and high costs of medical schooling. I have received inspiration from the stories of hospitals designed with patients in mind, so they aren’t sent shuffling back and forth throughout floors and sections of the building during an already difficult enough time in their lives. I care about improving health care for all Nova Scotia residents, reducing wait times, eliminating superfluous spending, and extending appointment hours of availability to a 24-hour cycle for ease of use by patients and healthcare workers’ ability to set their preferred schedules and avoid burnout. This would likely also involve changes to how physician licensing is distributed to allow for such flexibility. The Green Party of Nova Scotia also plans to fund family member caregiver salaries and implement more preventative measures overall to help keep people comfortable at home and out of the healthcare system when possible. Thank you for your time, Jenn Kang Green Party Candidate for Hants West

Hello, Ms. Manthorne: Cancer survivors are admirable and inspirational.  For me, the joy of lives recovered is best, but not only, exemplified by the phenomenal energy displayed by all the Dragon Boat races we see all around the world. Cancer has touched far too many people from many walks of life, crossing gender, age, race, and socio-economic boundaries. Improving the health care system’s ability to deliver timely support must consider three levers:

1. In the shorter term, increase the capacity to reduce the current backlog of initiatives such as screenings and surgeries, as well as ensuring access to family physicians
2. In the longer term, reduce the demands on the health care system through the promotion of active living and good dietary choices in order to reduce the current capacity imbalance to address, for instance, the demand for safe and timely access to cancer care when it is needed most
3. Structurally, ensure inter-department transitions are streamlined to prevent desperately needed care from falling between budgetary silos

Specific strategies endorsed by the Green Party that target all those who require care are detailed on pages 21 and 22 of the Green Party’s “Because There is No Plan B” – From Crisis to Resilience: Climate Justice and a Just Recovery from COVID-19 for Nova Scotia. While the other three parties are focused primarily on building health care capacity; the Green Party is uniquely positioned to focus also on reducing the demand.  Reducing demand not only leads to a smaller per-capita health care budget but also leads to enhanced quality of life.  As I am sure cancer survivors know, there is absolutely no substitute for the joy that comes from high quality of life. I thank you for reaching out and look forward to receiving Green votes from all of those in your network. All the best, Ian Dawson Green Party Candidate Sackville-Cobequid

Thank you so much for reaching out. This is a very important issue, as I don’t know anyone who hasn’t been touched personally or through a loved one by cancer. I lost my grandmother to cancer, and there are several cancer survivors in my family. I have spoken with some friends who have had difficulty receiving the life-saving care they need during this pandemic, as our healthcare system has been overtaxed, and it breaks my heart. I also know several colleagues who went into debt to pay for their cancer care, so I sympathize with your cause! If elected, I plan to do everything I can to alleviate the crisis in essential cancer care. In collaboration with advocacy groups such as yourselves and healthcare workers, I would seek to implement solutions such as extending the hours of treatment outside regular operating hours (by recruiting additional healthcare workers, rather than taxing the workers who are already working) — this was a great solution when imaging was backed up before the pandemic. This may mean increasing admissions to universities for healthcare programs, looking closely at licensure regulations, and promoting more interdisciplinary approaches, which are part of the Green Party platform. I am confident that with the right people at the table, we can develop a plan to improve healthcare for all Nova Scotians, including Cancer patients, and put an end to this crisis of care. Thank you, Sara Adams Green Party Candidate for Dartmouth East

Dear Ms. Manthorne, Thank you for writing to us to discuss the critical issue of health care for cancer patients and survivors. Health care providers are stressed and burned out, a situation that is no fault of their own. Frontline workers have placed themselves in harm’s way time and again during this pandemic to protect Nova Scotians and they have seen a  poor return for their selfless service. As you noted in your letter, our health care system as a whole is at a breaking point, and this was true even prior to the COVID-19 pandemic. Understaffing and overcrowding in emergency rooms have backed up the health care system,  and wait times for many non-emergency procedures have skyrocketed. Both of these issues have sent shockwaves across the health care system,  affecting thousands of people directly and indirectly. For example, hospital beds may be occupied by people who actually need long-term care, which results in less capacity for those awaiting vital procedures. Emergency rooms also currently work as a catch-all funnel for many patients who do not have family doctors or access to mental health services. These effects are felt even more acutely in rural areas, which have less capacity to start with. The NDP is committed to making the investments in health care that are necessary to ensure that cancer patients, as well as all other people in Nova  Scotia, can confidently rely on our health care system to take care of them.  That’s why an NDP government would ensure that our entire health care system is working as it should. We commit to: - Building a single long-term care room for every person who needs one so that our hospitals are not overcrowded by people who are better served in a different level of care, freeing up beds for other patients. - Improving access to emergency mental health services and establishing teams for an emergency response to mental health crises, so people have more options before resorting to the ER. - Publishing emergency department standards regularly, so that there can be transparency in emergency health care. - Keeping emergency services available at the New Waterford and  Northside General Hospitals, limiting the wait times for ambulances in  Cape Breton, and investing in Cape Breton health units to enable more local decision making. - Eliminating fees for ambulance services. No one should ever have to choose between their physical or mental health and the health of their finances. After eight years of Liberal government wait, times for surgery are among the worst in Canada. We need to focus on keeping the surgeons we have and the ones we recruit, to stop the revolving door of new recruits coming and just as quickly leaving. With regards to addressing the specific backlog of surgeries, an  NDP government will: - Develop an updated physician workforce plan that recognizes and enables the goal of shorter wait times. - Keep doctors here with high job satisfaction by listening to what doctors need and working with them at a community level to improve health care. - Provide alternative work models that doctors can choose freely, including collaborative emergency centres, community health centres,  collaborative practices, and same-day/next-day scheduling of patients. - Work with doctors to make sure they are better supported by allied professionals, such as physician assistants, nurse practitioners, and family practice nurses. - Negotiate payment levels and systems respectfully, to keep competitive with other jurisdictions. These are the kinds of creative solutions we should be looking for in our health care system. These commitments are among the many contained in our Vision  Document, Something Better for Nova Scotia. We would strongly encourage you and your members to read the original document to learn more about our plans to make life better for all people in this province. Thank you again for taking the time to write to us about this immensely important issue. It’s the care of Nova Scotians like you that keeps us working hard to make a difference. Sincerely, Nova Scotia New Democratic Party

The serious difficulties cancer patients face in getting timely treatment are generally caused by the same problems facing many Nova Scotians: the shortage of family doctors and specialists in this province and the extreme stress on the remaining providers leading to burnout and more retirements. An NDP government will take the following steps to work toward addressing your concerns: Retain doctors here with high job satisfaction by listening to what they need. Provide alternative work models that doctors can freely choose, including collaborative emergency centres, community health centres, and collaborative practices. We will ensure they are better supported by allied professionals –physician assistants, nurse practitioners, and family practice nurses.  Negotiate payment levels and systems respectfully to keep competitive with other jurisdictions. Make telehealth a permanent option for patients who wish to access care in this manner. Provide more support to community health centers to work with communities on primary care needs. Consult with groups such as yours to hear the suggestions you can offer from personal experience as to the kinds of changes that would improve the situations of cancer survivors, ensuring safe and timely access to diagnostics, testing, and treatment. In addition, the NSNDP is committed to improving access to same-day/next-day mental health care, which is crucial for cancer patients whose anxiety levels are particularly high in view of the delays currently being experienced. Thank you for reaching out, and we look forward to working with you in the near future to make these essential changes. Sean Foley New Democratic Party Candidate for Colchester North

Dear Ms. Manthorne, An Atlantica Party (AP) government would work diligently to ensure that the essential cancer care backlog would be cleared. If you view our platform you and your members will see that the Atlantica Party has no specific policy to address your concerns. However, unlike the other parties, we do not believe in making band-aid political promises during an election campaign. Instead, we take a more comprehensive view. Nova Scotia is a poor province. We have spoken to people on the doorstep who have concerns about our health infrastructure’s limitations. To be blunt, there are not enough resources in Nova Scotia to provide a substantive upgrade to the system that everyone would like to see. By “not enough resources”, we mean more debt cannot be incurred, taxes and costs cannot be raised, and other programs cannot be cut back in tangible ways to free up funding. Given that the national health care system is archaic when it comes to private-sector delivery, this leaves the one real option open to us – grow the economy and make Nova Scotians wealthier. This will ease childhood poverty, cancer backlogs, and food insecurity. This will also expand the tax base, and with increased revenues, a discussion can be had about health reforms and others. So how do we make Nova Scotia wealthier? By adopting AP’s economic measures outlined in our platform – harness the free market in addition. Thank you, Nova Scotia Atlantica Party

What is needed in the province is to open up the health care system to more privately operated medical facilities to help relieve the pressure on the public system.  Many tests and other diagnostic processes do not need to be performed in hospitals and can be undertaken by professionals with a private practice. The government’s terrible response to Covid made our already poorly running healthcare system even worse.  Longer wait times are the norm and not the exception.

Bureaucracy is grinding the very essence of health care, to assist people to regain their health, to a halt. This situation unfortunately is going to get worse over the next few years due to the incompetence and overreaction of the government when they put everyone at a greater health risk by shutting down the province and creating even larger backlogs.  There needs to be an honest discussion about the direction of healthcare in this province and the country as a whole, until that happens we will be stuck with ever-increasing wait times, which lead to more despair and worse health outcomes for everyone.  All of the mainstream parties make the same pie in the sky promises and none of them fulfill these promises, and we wonder why things are getting worse.

To be clear Canada already runs private medical along with the public option, but few parties/politicians have the courage to discuss this openly. Allowing private healthcare providers to ease the pressure on our current system is the best way out of this current mess.

Thank you,

Tyler Ducharme

Atlantica Party Candidate for Digby-Annapolis

The Canadian Cancer Survivor Network,

Thank you for your email and for the important work the Canadian Cancer Survivor Network does for cancer patients, survivors and their families. We know how important timely access to cancer care is and the Nova Scotia Liberal Party is dedicated to supporting patients, their families and the healthcare teams that provide care. Please see below for answers to your questions.

The Liberal government is committed to providing Nova Scotians with the cancer care and support they need closer to home, with investments totalling $18 million for ongoing supports in cancer care.

The Liberal Government has invested more than $4 billion in spending for new hospitals,  emergency care centres, and community health centres that will completely transform the way healthcare is delivered in Nova Scotia. These represent the largest healthcare redevelopment projects in the province’s history, which when completed will provide patients across the province with state-of-the-art facilities and the quality of care they need and deserve when and where they need it.

The Halifax Infirmary expansion includes a Cancer Care centre with radiation therapy and ambulatory cancer clinics, an inpatient centre with new operating rooms, critical care beds,  inpatient beds, diagnostic services and renal dialysis. It is expected to be completed by 2026.  We also intend to invest nearly $1 million annually to enhance cancer care in Southwestern  Nova Scotia. This will cover additional staff, medical supplies, and other supports for patients.  Investments span across Nova Scotia, also including a brand new and improved cancer centre in the CBRM Redevelopment Project. The CBRM cancer centre will provide a more comfortable,  supportive centre focused on patients and their families. Technology and additional supports under one roof will enhance the quality of care for patients, closer to home, and reduce the number of visits throughout treatment.

While there is still more work to do, these investments will make an impact on patients across Nova Scotia. We are committed to working through the backlog created by the Covid 19  pandemic to ensure timely access to cancer care.

Doctor recruitment and retention is a top priority for the Rankin government. In 2021, our government committed $12.2 million for physician training at Dalhousie Medical School,  including an additional $1.2 million to continue funding 16 new seats for a total of $2.7 million this year. We commit to establishing a Primary Care Council and will invest $1 million annually to establish a new community-based integration program with dedicated funding to support local groups, who have the proven expertise, networks, and resources to welcome and support new doctors and their families.

We will also launch the Office of Physician Recruitment and Retention with an initial $5 million budget, effectively doubling Nova Scotia’s investment in physician recruitment. Additionally,  we will invest an additional $6 million to support virtual care clinics for Nova Scotians currently on the waitlist by expanding the VirtualCare NS program to all four health zones in Nova Scotia.

The Liberal Party is committed to continuing to make strategic, targeted investments to increase access to health and cancer care and provide optimal patient care. We thank you for your continued dedication and the work you do to ensure the quality of life for patients, survivors, and their families.

Thank you,

Nova Scotia Liberal Party

Dear Ms. Manthorne,

The PC Party has put forward a fully costed, detailed plan to address this very issue. We are the only party to put forward thoughtful, realistic solutions for Nova Scotians to ensure people get the treatment they need when and where they need it.

We will do everything in our power to address the alarming backlog of cancer screenings and surgeries that are directly attributable to the neglect our healthcare system has witnessed over the last eight years.

The first critical step in addressing the backlog is opening our operating rooms past their standard hours of Monday through Friday, 9 AM-5 PM. With the money Nova Scotia spends on operating rooms and equipment, we should be maximizing their use to ensure Nova Scotians get the best care possible, in the shortest time possible. We have not witnessed any meaningful action to address our surgical shortfall over the last eight years.

Keeping our health system’s status quo is not good enough.

A PC government will also modernize our healthcare system by better leveraging digital technology to implement virtual care for Nova Scotians who want it. We will see quicker access to screening results, consultations, referrals, and follow-ups to patients in need of surgery, as well as more accessible, higher quality post-op care that doesn’t needlessly utilize hospital space,  if a patient would rather have a virtual appointment.

Remember, it was the PC Party that championed the permanent implementation of virtual care even before the COVID-19 pandemic while the Liberal government mocked the idea in the legislature. They have now shifted, and are begrudgingly accepting its implementation.

The PC Party also previously called for people receiving cancer treatments to be prioritized in procedures and vaccinations.

A PC government will immediately implement the actionable solutions needed to reduce wait times for cancer screenings and surgeries. Our detailed commitments, released well in advance of an election, demonstrate the PC Party is the only party that can enact the required change in our healthcare system that Nova Scotians deserve. Our party is fully confident our Hope for  Healthcare plan is the only plan that can successfully meet the needs of our citizens by attracting more family physicians and specialists while providing the hours of care needed to cut our surgery wait times to acceptable levels that do not leave Nova Scotians suffering for extended periods of time.

Sincerely,

Nova Scotia Progressive Conservative Party

Hi Jackie,

Thank you for your email. A Tim Houston government is focused on fixing healthcare. We have incredible opportunities to manage the backlog of screenings and surgeries and ensure safe and timely access to cancer patients so that patients across Nova Scotia know that they can trust and rely upon the healthcare system.

Another aspect of access to care that has been amplified in recent years is the waitlist for surgeries. Some individuals are living in pain, awaiting surgery to improve their joints, while others worry about the potential exacerbation of conditions as a result of extended delays. Presently, the hours that Operating Rooms (ORs) are open are generally limited to business hours, with the exception of emergent surgeries.

The only way to address the backlog is to open our ORs to allow surgeons to do their work outside of normal business hours. Once we are making the most efficient use of our ORs, we will start to see significant improvements on the waitlist.

I hope this answers your questions, Jackie. Please feel free to reach out should you have more queries.

Best regards,

Lisa Coates

Progressive Conservative Party Candidate for Dartmouth North