Houston, we have an ER crisis …

So, Liberal leader, Zach Churchill wants Premier Tim Houston to recall the legislature to deal with the suddenly front-and-centre issue of why people are dying while they wait for care in our provincial emergency departments.

And NDP leader Claudia Chender wants a public investigation into the increasing numbers of those deaths as part of “making sure the system gets better.”

In response, Houston accuses them both of playing politics.

Who’s playing politics here?

Let’s recap.

The immediate backdrop:

• Allison Holthoff, 37, a mother of three school-aged children, died on New Year’s Eve after a nearly seven-hour wait to be seen by a doctor at the Cumberland Regional Health Care Centre. She was “in excruciating pain,” she told her husband. “‘I think I’m dying. Don’t let me die here.’” She died there.
• The day before, on December 30, 67-year-old Charlene Snow died one hour after leaving the emergency department at the Cape Breton Regional Hospital. She’d waited in the ER for seven hours without being treated and, when told she wouldn’t likely be seen until the next morning, decided to go home and “try the urgent care clinic on the Northside the next morning. Tragically,” her daughter-in-law wrote, “she didn’t make it to the next morning. Her husband Freddie picked her up and took her home. Her heart stopped within the hour. The idea that perhaps her life could have been saved,” she noted in her public statement, “adds an excruciating layer to the grief of a sudden death.”
• Last Wednesday, the NDP released the results from a freedom of information request that showed close to 3,000 Nova Scotians have died in emergency rooms in the past six years. There’s been a 10% increase in deaths — from 505 in 2021 to 558 in 2022 — during the Houston government’s first full year in office.” Perhaps as striking, the numbers also showed 43,000 people simply left emergency rooms in 2022 without ever having been seen.
• Alexandra Rose, the provincial coordinator for the Nova Scotia Health Coalition, told Global News the entire system is in a “dire situation” and wondered aloud: “When is the breaking point?”
• Dr. Kirk Magee, the chief of the provincial central zone’s network of emergency departments, suggested we may have already passed it. He said the system is in “crisis,” with “a shortage of nurses, physicians and hospital beds, and with a rise in patients with complex needs.” Reached on the phone after a 12-hour shift at Halifax’s QEII Health Sciences Centre emergency department, Magee told Canadian Press reporter Lyndsay Armstrong: “We all went into emergency medicine because we love to do it and we love a challenge, but we used to have the resources to meet that challenge. Now [ER staff] are extremely worried they’re going to be put in a position where they’re not able to manage the expectations or even the needs of patients and their families… This is not the care that we wish to provide; it’s the best we can do. But we know that in a well-resourced system we would be able to do much better, and that’s really tough.”

This brings us to all those other worse-and-surpassing-worst context numbers that continue to crash like a succession of tidal waves into the escalating crisis at ERs:

• The province’s Need a Family Practice Registry shows 129,321 Nova Scotians reported they need a family doctor as of January 1, 2023. That’s one in eight of us. Overall, it’s also a startling 56% increase over the number who were seeking a family doctor at the beginning of 2022. Where will many of those people end up when they’re in a healthcare crisis? Emergency rooms.
• “Virtual Care,” which Houston touted in September as playing an “important role” in providing online care for the-then 75,000(!) “unattached” Nova Scotians, has been a bottleneck failure, with just 150-200 virtual appointments available on any given weekday. Where will many of those who can’t get through to Virtual Care end up when they’re in a healthcare crisis?  Emergency rooms.
• There are currently more than 1,500 nursing vacancies in Nova Scotia, including in emergency rooms, “as officials struggle to recruit and retain staff, a crisis made worse by the Covid pandemic and, more recently, by the winter flu season…” Hugh Gillis, vice-president of the Nova Scotia Government and General Employees Union, which represents health care workers and nurses at the Halifax Infirmary emergency department, noted that the current situation has been years in the making: 10 years ago, in fact, he said, nurses went on strike to draw attention to the crisis they were already facing but were ordered back to work instead. The issues they raised, he argues, have never been adequately addressed.
• Two thousand Nova Scotians are now waiting for a place in a nursing home, with 280 of them currently occupying beds in hospitals because there is nowhere else to house them. Last week, Seniors Minister Barbara Adams announced plans to build 600 new beds, doubling the number under development. Good news, but… Is it playing politics to note that most of those beds will not open until 2025, the year the Houston government is scheduled to seek a new mandate? Or that the Houston platform in the last campaign promised the PCs would “open an additional 2,500 single long-term care beds within three years.” Or unfair to note that, even with those new beds — imagined or actual — the problem with the lack of long-term care beds won’t magically disappear, especially given our aging population. Today, there are 225,000 seniors in Nova Scotia. By 2033, the prediction is that there will be 300,000. How many of those whose care should be managed in a long-term care facility will end up occupying space in ERs, or beds in hospitals?

Back to the question. Are the opposition leaders simply playing politics with the emergencies in our emergency rooms?

For better — but mostly for worse — Houston owns the health care file. In the last election, he campaigned almost exclusively on the issue. On the day after he was sworn in as premier, he fired the CEO of the provincial health authority and its entire board, replacing them with a smart Tory insider with no experience in health care.

“I think sometimes it’s just you have to hit reset,” he told reporters at the time. “It’s time to hit reset at the Nova Scotia Health Authority. It’s time to refocus the efforts.”

How’s that working out for you, Mr. Premier? And for the rest of us?

Perhaps it is time for Tim Houston to press reset on his own reset.

It’s fair to say that fixing health care was never as simple or straightforward as Houston, the campaigner wanted to make it sound. It has taken many decades and many more short-sighted decisions by many different governments at all levels to get us into the fine mess we are in today.

Who knows? Maybe Houston’s expanded, speeded-up, costs-un-costed — “If that’s the first question somebody asks, they’re missing the point” — new age version of Stephen McNeil’s 2018 faux-costed $2.3-billion expansion of the Halifax Infirmary will begin to ease some of the worst of the many crises… After the first new tower with inpatient beds, 16 operating rooms and a new emergency department opens in five years. After the cancer centre comes along after that. After… after.

The reality is that the system is in such a mess right now that we can’t just focus on solutions that will improve the situation down the road. We also need to walk and chew gum, deal with the here and now here and now too.

Are there short-term patchwork band-aid fixes for the crisis in our ERs? How soon? How much will they cost?

Chender believes a public inquiry is the beginning of understanding — and finding solutions to — the immediate crisis in ERs. “An inquiry into emergency room deaths would help Nova Scotians understand what’s going on in our hospitals and what needs to be done to ensure no other family faces the same tragic situation as the Holthoffs,” she said.

The government’s response? No public inquiry, just bland reassurance from the Health minister. “I also want to reassure people that our health care workers in emergency rooms are skilled and dedicated and, when people need that care, they should seek it,” Michelle Thompson said.

Churchill, for his part, is calling for an emergency session of the House of Assembly. “What we can do by being in the legislature is ask questions of the premier about what is happening despite the fact that he is spending more money on health care, to get answers for Nova Scotians and also to talk about potential solutions and improvements that we can make together as legislators.”

Neither opposition leader is offering specific solutions, but they are both suggesting we need to discuss and debate public policy in public, and those charged with making and implementing public policy need to be publicly accountable for their decisions — and their mistakes.

Houston countered in his own statement that Churchill was “just grandstanding,” and then, of course, proceeded to grandstand himself.

“Our complete focus is on delivering improvements to the health care system and providing assurances to all Nova Scotians that they can count on a health care system when and where they need it,” he declared, then added a dig. “Given that Zach Churchill is a former Health minister who played a key role in creating the health care status quo” — take that, Zach — “we would welcome his ideas from that experience. He has our number.”

Let’s unpack that. The reality is that, although Churchill was first elected in 2010 and served in various cabinet positions during the Stephen McNeil era, he was only appointed Health minister on February 23, 2021, the day Iain Rankin’s now-you-see-it-now-it’s-gone Liberal government assumed office. Six months and one election later Churchill was no longer Health minister. Played a key role in creating the health care status quo?

During his own first days as premier, Tim Houston displayed an admirable willingness to admit mistakes, to acknowledge others, to even change course when necessary But those days are long gone now. The new Tim Houston has morphed into the old Stephen McNeil: arrogant, angry, self-righteous.

Pity.

Definitely past time to press reset, Mr. Premier.