Denise Perret

Last week, when Premier Stephen McNeil “mutually” agreed to fire Denise Perret — the deputy minister of health he’d hired just two-and-a-half years ago — he explained it was because “we’re now re-setting and moving in a new direction.”

He did not explain what he was re-setting from or to, or in what new yellow-brick-road direction our healthcare system is now moving.

“There was obviously some changes to the relationship between the department and the health authority,” the premier continued to explain without actually explaining anything. “And we just both agreed that it required a different skill set and we left it at that.”

Whether Ms. Perret agreed is a moot point since her government email was immediately shuttered and automatically re-directed, and she declined to respond to media requests for interviews sent to a non-government account.

Despite the supposed mutuality of their agreement, the province will pay Perret about $215,000, or one year’s salary — funds that, of course, could have been used to hire at least three front-line healthcare workers for a year — in severance just to walk away.

I won’t pretend to know what kind of job Perret did as deputy health minister or whether her mutual firing was justified.

What does trouble me is how vague the premier still is — after a full term-and-a-half as the man in charge — about the sorry state of our public healthcare system and what he intends to do to fix it.

He has done things. The question is: were they the right things? Or even helpful things.

He did — with a stroke of his premier’s pen and with no meaningful consultation — transform nine regional health care authorities into one, ostensibly to save money (it hasn’t) and to improve care (there is scant evidence of that either). In fact, many in the system will tell you the system is now managed more poorly than it was before. At even greater cost.

According to Richard Starr, a former journalist and public policy wonk who has crunched the numbers:

“The bad news is that at $58.27 per capita, Nova Scotia health administration costs are the highest of any province and about 35 per cent above the national average.”

In response to the reality healthcare does represent the biggest — by far — government expense, the premier early on declared never-ending war on those who provide it, demeaning and diminishing healthcare workers in the process, thus exacerbating the shortage of trained professionals eager to work here.

Shortage? Oh, yes, that shortage… The latest official numbers show 51,802 Nova Scotians are looking for a family doctor but designated “not yet placed” — as in they still don’t have one. Others peg the number of people still seeking even higher.

The Liberals’ 2013 campaign platform — the one on which Stephen McNeil first ran and won government, and which is, conveniently, no longer available on the Liberals’ website (but is archived, here) — solemnly promised to “ensure a doctor for every Nova Scotian.”

McNeil also — cross-my-heart-and-hope-not-to-get-sick tonight — pledged to “invest in direct services for families in need to eliminate the waitlists.”

We know how that went.

Beyond the lack of family doctors for those who want and need one, there are the wait times for surgeries of all sorts, the over-crowded Halifax emergency rooms and the too-often no-go rural emergency rooms, not to forget the lack of mental health services available to those who need them, not to mention a lack of options like nursing homes and long-term care beds for seniors who end up warehousing at ERs because they have no other place to go.

McNeil did promise to move forward with a much-needed hospital re-development for Halifax, and he has. But he is opting to do so using the discredited private-public-partnership model, which has come under fire from Canadian auditors general and others who know about such things for ultimately costing taxpayers more than they would have paid under a public funding approach.

In fact, the deputy minister who preceded Perret, Dr. Peter Vaughan, even wrote a report before he retired highlighting the “challenges” of P3 hospital projects.

Which brought us to January 2017 and the arrival of  Denise Perret, a lawyer and career Alberta civil servant who had been Alberta Health’s assistant deputy minister of strategic planning and policy development before being plucked for the top job here.

I don’t know what Perret — who was the frequent public face of the health department at legislative committee hearings during her brief tenure — did or didn’t do to earn the ire of her political masters.

I do know her mutual firing won’t solve the many, various, and often-intractable problems plaguing our healthcare system.

That’s because the biggest problem in our healthcare system remains the man at the top and his blind unwillingness to acknowledge, let alone deal with, the crisis we face.

Two years ago — after a day of distressingly depressing testimony by doctors at the Public Accounts Committee detailing the daily disasters happening inside the province’s crumbling health care system — Stephen McNeil stood up in the legislature and declared, yet again: “Health care is not in crisis.”

There may have been problems, he acknowledged to reporters later, but his government was dealing with them.

“People are starting to see the changes now,” he said.


That was two years ago.

Now the change we’re seeing is another shuffling of the deck chairs on the Titanic, another blandly un-reassuring reassurance.

Insists Captain McNeil: “We’re now re-setting and moving in a new direction.”

Be careful of that iceberg called reality.

Stephen Kimber is an award-winning writer, editor, broadcaster, and educator. A journalist for more than 50 years whose work has appeared in most Canadian newspapers and magazines, he is the author of...

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  1. I’m a bit off topic but Family Doctor needs to be qualified in today’s medical vocabulary. I guess there is a shortage of Family doctors but in my experience the Family adjective has changed from someone that is familiar with your history, provides general advice and takes an interest in your general health. A yearly checkup, a conversation and a few topics covered. My GP retired and I have had two Family Doctors, that ask What is the issue…..they respond to that and essentially walk out for the next appointment. Had one that would walk out if I asked about a different symptom. It seems to me that being a walk in clinic is long term commitment.. do your time and walk out…so 5hrsof dealing with sick people @$35/ a 10 minute visit is $1050 a day is $210,000 – say 40% overhead is $126000/year…why keep records, read medical histories, get to know the 2000 patients in your practice..seems like a good business model….

    1. I wonder if we must make our “medical home” with one individual doctor at one location.

      If we implemented secure province wide electronic patient records accessible to all doctors then we should be able to go to any available doctor from a visit to a drop in clinic right now to booking our family doctor next week when they are available. Nobody is stopping you consulting the same GP if you want. But those without one need not have to use the ER or face the chaos when test and imaging results cannot be sent to your “medical home” because you don’t have a family doctor. They become appended to your EPR and any doctor in NS could make sense of them. This could help with our perennial doctor shortage and keep non-emergencies out of the ER.

  2. Maybe Captain McNeil will find solutions to our health care issues in China and the Middle East?