Data shows wide disparity in hospital occupancy rates
A shortage of anesthesiologists is causing repeated delays for people needing routine surgery in Cumberland County.
A shortage of psychiatrists in Cape Breton has resulted in the Port Hawkesbury RCMP’s mental health calls jumping 80 per cent between 2016-17 and 2017-18.
Meanwhile doctor shortages are causing temporary emergency room closures at rural hospitals around the province.
“The historical approach to health care delivery, with a heavy focus on hospital-based care, is not sustainable given the province’s fiscal situation,” warned the auditor general in his 2016 report.
“Costs and demand for services continue to increase. Some changes have already occurred, including the use of collaborative emergency centres and programs such as Home First, but more work is required to create a system that can continue to provide health care to Nova Scotians into the future.”
That report warned that as Nova Scotia’s population gets older and needs more medical care, the province cannot afford to maintain 41 hospitals while also paying for the people and equipment to provide the care.
“Historically, and we’re talking in the ’70s and earlier, hospitals have been built not just on the basis of what would provide the most efficient delivery of health care,” said David Kogan, a retired doctor and mayor of Amherst.
The shortage of anesthesiologists at the Cumberland Regional Health Care Centre is symptomatic, he said, of the struggle to recruit specialists and family physicians.
The Nova Scotia Federation of Municipalities recently held a training session for councillors who will be joining recruiters at job fairs with the idea of selling communities as a place to both work and live. But those recruiters have to be able to offer competitive pay scales.
In data released earlier this year, the Canadian Institute for Health Information put Nova Scotia at the bottom for family physician pay in Canada.
The group pegged average full-time pay for a doctor in Nova Scotia at $259,368 — well below the top province of Ontario ($363,879) and the neighbouring provinces of Prince Edward Island ($305,091) and New Brunswick ($293,636).
Meanwhile data provided by the Nova Scotia Health Authority shows a wide disparity in hospital occupancy rates.
The Fishermen’s Memorial Hospital in Lunenburg and the Dartmouth General Hospital had occupancy rates of 103 and 104 per cent respectively in 2017-18.
At the low end were Canso’s Eastern Memorial Hospital and the Buchanan Memorial Community Health Care Centre in Neils Harbour, which both had 34 per cent occupancy rate.
But both the latter hospitals are in very isolated communities — the nearest hospital to Neils Harbour is an hour and a half away in Cheticamp around some of the province’s most treacherous roads in the winter.
Madonna MacDonald cautioned against reading too much into bed occupancy rates.
The senior director of acute medicine for the Nova Scotia Health Authority said that rural hospitals often have lower average occupancy rates due to the need to maintain certain services within a reasonable drive and the fact that many patients end up at the larger regional hospitals that offer more services to patients with greater needs.
The province has nine of those large regional hospitals.
MacDonald said seasonal changes mean that though the authority aims for an average occupancy rate of 85 per cent to allow for flexibility, at times of high demand like flu season even hospitals with healthy averages can get pushed beyond capacity.
The discussion around brick and mortar capacity versus human capacity is complex — involving service availability and patient flow in and out. It’s also an emotional one. Premier Stephen McNeil was booed and heckled last month when he announced a reorganization of health care in the Cape Breton Regional Municipality that was in keeping with the recommendations of the 2016 auditor general’s report.
He announced the closure of the Northside General Hospital in North Sydney and the New Waterford Consolidated Hospital along with the expansion of the Glace Bay Hospital and the Cape Breton Regional Hospital.
The plan also includes building two new long-term care facilities and the addition of a community paramedic program that will make house calls.