Dr Gabrielle Horne (CBC)

Elections offer opportunities. If you have a question, or concern, or if there is some specific issue bugging the hell out of you, the upcoming election gives you the chance to raise it, face-to-doorstep, so to speak, or email-to-email, with the candidate of your choice, and have a reasonable expectation the candidate will respond — perhaps even to the question you ask.

After the votes have been counted, you can then use that answer to hold the candidate-now-MLA to account for whatever he/she said/promised/solemnly swore to do, or not to do.

I know, I know. This is the abstract, Civics 101 version of how politics is supposed to work, and bears no relation whatsoever to Stephen McNeil’s 2013 cross-his-heart pledge to maintain the film tax credit for another five years, or Darrell Dexter’s 2009 read-his-lips commitment to no new taxes, no program cuts…

But let’s — for a brief, hopeful Monday morning moment — presume Pollyana is real.

What is the one, otherwise unlikely-to-be-the-subject-of-official-party-platforms-or-public-pronouncements issue you would like to ask your candidate to respond to?

I know what mine is.

It is the incredible ongoing, never-ending injustice one un-merged and one merged health authority — not to forget three governments of varying partisan stripes led by four different premiers — has perpetrated on one Dr. Gabrielle Horne. Horne is a Halifax cardiologist whose promising world-class research has now been derailed for nearly 15 years, thanks to a combination of professional jealousy and bureaucratic butt-covering, overlaid with a generous dollop of self-interested, expensive, billing-by-the-hour private lawyers.

I first wrote about what was the then-four-year-old Horne case in a 2006 feature for The Coast (here). In the decade since, I’ve written columns about it for the no-longer Halifax Daily News (here and here and here), for Metro (here and here), for Atlantic Business Magazine (here), and now, of course, for the Halifax Examiner.

If you’re interested in the story in all its full all-its-gory-un-glory, you can, read all those “here” and “here” links. But for now, let me give you the Cliff’s Notes version.

In 2002, Gabrielle Horne was a rising star cardiologist whose innovative, make-a-difference-to-patients research into heart failure was not only described by her employers at Dalhousie University and the Capital District Health Authority as “world class” but was also attracting millions of dollars in international research funding to Nova Scotia.

Perhaps as a result, Horne’s superior at the health authority asked her to add one of the cardiology department’s other senior male physicians “prominently” to her research team — even though he’d had nothing to do with her work.

Horne refused.

And that was how it began.

On October 17, 2002, the CDHA unilaterally suspended Horne’s hospital privileges, a draconian, emergency action usually only taken to protect the safety of patients and the public — certainly never the case here —  and which had the ultimate, unintended effect of shuttering Horne’s research lab and drying up its funding.

Let me now turn my megaphone over to four prominent Halifax physicians: Kenneth West, Michael Gross, Ross Leighton and John Sullivan. Each of them is a former president of the 700-strong Queen Elizabeth II Medical Staff Association. Late last month, they issued a rare joint open letter in which they noted clearly that no independent review of the case in the past 15 years had “found any wrongdoing on the part of Dr. Horne.” She had been — their words — “unjustly punished because she refused to be bullied by a male supervisor into crediting him as a research collaborator and co-author.”

Consider the number and range of specific independent reviews of the case over the past 13 years that they cite in their letter:

  • In 2003, an outside mediator recommended a settlement that was agreed to and signed by Dr. Horne and the CEO of the Capital Health Authority. The authority subsequently refused to honour the settlement agreement.
  • In 2005, the QEII’s Medical Staff Association appointed a four-member panel of senior physicians to review the allegations against Dr. Horne. The panel reported that the claims against her had no merit.
  • In 2006, the Capital Health board of directors reinstated Dr. Horne’s hospital privileges, as a result of a review process launched in 2002 that under hospital bylaws should have taken no longer than 30 days to conclude.
  • In February 2016, the Canadian Association of University Teachers released the results of an independent investigation into the handling of the Horne matter, and said that medical faculty at Dalhousie University did not enjoy adequate protections and rights.
  • In June 2016, a jury awarded a $1.4-million settlement for damages due to loss of reputation and career opportunities.

Incredibly, the Nova Scotia Health Authority announced last fall it plans to appeal the jury’s clear repudiation of its clearly wrong and wrong-headed initial 2002 decision, and not to mention its every vindictive, self-serving, butt-covering decision since.

The health authority has spent countless millions of dollars — it won’t tell us the actual count — on private lawyers to defend the indefensible. That’s money that could have been spent on underfunded patient care. Besides the money it’s spent, there’s the funding it’s lost — millions of dollars that didn’t come to Horne’s pioneering research lab because the authority effectively shut it down.

The only higher authority that can stop the health authority’s appeal madness is the provincial government to which it reports.

That’s why I emailed the three provincial parties last week. I wanted each party to state its position on whether it would order the authority to abandon the appeal and allow the jury’s justice to take its course.

I got responses from both the Liberals (sort of) and the NDP.

“Thank you for writing to us,” responded the auto-responder connected to the Liberal Party’s email address. “This note is confirmation that your email has been received. We will direct your message to the appropriate individual.” (One lives in hope, of course, but I should point out Stephen McNeil’s spokesperson told the CBC last October the premier “can’t intervene because of ‘the ongoing legal process.’”)

An NDP spokesperson meanwhile emailed to say that the party believes the “health authority should abandon its appeal. It’s time to move on and let Dr. Horne continue with her life.”

So far, I haven’t had a response from the Tories, but will certainly post their response here if there is one.

Have a question of your own? Now’s the time to ask. And to save the answer for later.

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. “… if there is some specific issue bugging the hell out of you, the upcoming election gives you the chance to raise it, face-to-doorstep, so to speak, or email-to-email, with the candidate of your choice, and have a reasonable expectation the candidate will respond — perhaps even to the question you ask.”

    Over here! Yes me! I have one. Or two. Or maybe a few…

    Why does no political party ever want to talk about the state on Nova Scotia’s public health system – and most emphatically never during an election? Do any of them see any value in it beyond being way to attack the current government? (Actually, that question is just the wrapper that holds others).

    Our health system is fiscally unsustainable on one hand (it consumes over 40% of all program spending, and rising) yet unresponsive to patient needs (e.g.we are ranked worst in the country for joint replacement wait times). Is there any credible way to explain why other than that we are managing it badly? Sure, it’s nice that the Premier proposes to (buy land in the middle of nowhere from a prominent Liberal donor at 10-12 times it’s likely value to) build a replacement for the VG outpatient clinic. But that just maintenance – like fitting new tires to your car. The VG wore out. This is not proof of any kind of health care vision. Announced days before the writ dropped, this is already being trotted out as proof of sage health care leadership.

    So if NS public health is not being optimally managed for today’s demographic, who do we blame for that? We could blame the Liberals, who in turn would blame the NDP, who might then blame the Tories. They’ve all formed government over the last 15 years. The one thing that apparently hasn’t changed is the bureaucracy that manages the system, including the District Health Authorities. These are the folks that hounded Dr Horne.

    Every time a new party wins office and some small town lawyer or inner-city teacher becomes Minister of Health and Wellness, they immediately become intellectual hostage of their Deputy – the apex of the pyramid of their Department, and the DHAs. That’s because they know little about the responsibilities they are about to assume, but the Deputy knows how they like the system to run, and how to steer new ministers. What if the thinking in these hallowed halls never changes? What if some folks therein have their own agendas and are not supportive of incoming governments with ‘new-fangled’ ideas? How would The Minister, much less the Premier, even know how to argue with the health bureaucracy? Huge amounts of money and lives are literally on the line. Best to accept their advice…

    Why don’t we have ‘central booking’ so that when your family doctor requires imaging, you are not just told it’s going to take 10 months to see their favourite radiologist, but you could have it in 4 weeks if you don’t mind overnighting in New Glasgow? The choice is yours.

    Why don’t we have publicly funded patient navigators? In Nova Scotia it seems nobody is going to advocate for you in the health system – you have to do it yourself. Yet the system is so Byzantine, so confusing and sometimes so hostile to outsiders that ordinary folks without the extreme moxy to fight it are easily repulsed. Corollary to this question of course is why are patient navigators even needed in the first place? They are IMHO.

    How is it that NS has more doctors per thousand people than the national average, yet there is a chronic shortage of doctors in rural areas and even in HRM for Heaven’s sake? The Liberals assure us they are actively recruiting more, while paying about the lowest rates in the country for family doctors. Tell me how this is great management.

    So which of the parties will seriously discuss any of this beyond the usual electoral partisan platitudes and snipes? I’ve not heard much said before the election, and wide-eyed promises made during feel, well a trifle insincere if not downright desperate.

    How successive health bureaucracies backed by governments of all parties successfully sandbagged Dr Horne from legitimate research for no good reason is symptomatic of a deeper malaise. That leaves one more question.

    Who is going to take leadership and fix NS public health, while we still have it?

  2. Very credible indeed here where authority is corrupt and violent by habit. BUT what hold has the small group making this evil happen got? and on whom? Why this submission to thugs by those whose job is to limit them? Please tell us.

  3. Unbelievable… these are the same folks continuing to talk about ” innovation” in the province. Thanks for this piece!