I was supposed to interview Auditor General Michael Pickup yesterday for this week’s Examineradio podcast, but Pickup cancelled for personal reasons. Shit happens, so it goes. We’ll get back to him in the new year.
But in preparation for the interview, I read Pickup’s audit of Family Doctor Resourcing, and I came back from it thinking, What’s the big deal?
The short of it is that Pickup and his team took a look at how the province is planning to address the shortage of family doctors.
Part of this dates back to the NDP government’s decision to establish collaborative care teams with the aim of reducing the need for single-doctor family practices. The idea was that a group of allied health specialists — doctors, nurse practitioners, family practice nurses, and mental health workers, among others — could provide health care for more people more efficiently than the old single-doctor practices. The Liberal government has embraced that strategy, and Pickup seems supportive of it, noting:
The health authority indicated that as of November 2017 there are 50 teams in varying stages of implementation. They ultimately plan to have a total of 70-78 full teams in place within the next six years.
That’s a good news story. But still, even with the collaborative health care teams, the Department of Health found that in the next 10 years, 512 family doctors will be needed. So the department created a list of people without family doctors — something like 42,000 people are on the list today.
Pickup’s audit got into the weeds of the strategy for addressing that doctor shortage, noting a few shortcomings, such as:
• a lack of communication to the public. There were a bunch of draft communication plans created but none of those were implemented. This is a problem because health care is so important and so potentially stressful to people that they make life plans around access to doctors. Keeping the public fully aware of where the doctor shortage stands, what’s being done to address it, and progress along the way will restore faith in the system.
• a failure to fully reach out to potential doctor recruits. “Information aimed at attracting potential doctors to the province, apart from a list of vacant positions, was also lacking,” noted Pickup. “Staff at the health authority told us they are working with a marketing firm to improve this part of their website.”
• relatedly, the government has two parallel doctor recruitment processes, one run by the health authority and a second run by the Department of Health. This is confusing and inefficient, said Pickup, so the two processes should be merged into one, with one set of inducements, etc.
• the website the province uses to track people without doctors is confusing to users and requires a lot of information to be entered manually by bureaucrats — work that could be done with better software more efficiently.
• perhaps Pickup’s most controversial suggestion was that the government should consider the health status of people without family doctors, and then prioritize access to new doctors for those in the most immediate need.
• Pickup also said the government should figure out how to measure the success of its doctor recruitment process.
The thing is, Pickup had 21 specific recommendations — all of which were accepted by both the Health Authority and the Department of Health.
I can’t see this as anything other than an auditor looking at a government process, finding shortcomings and inefficiencies, recommending some improvements, and having those recommendations accepted by the agencies that were audited. Isn’t this how it’s supposed to work?
That’s not to say there couldn’t be policy criticisms of the doctor recruitment process. We in the public could say that the government isn’t spending enough or is spending too much, there aren’t enough collaborative care teams or there shouldn’t be any, and so forth. But Pickup wasn’t making policy judgments; he was just analyzing the effectiveness of the policy decisions already made.
The proper response would have been for Premier Stephen McNeil to read the audit and say, “thanks very much for pointing out the minor problems in our doctor recruitment process. You’ve made good recommendations, and our government has accepted them and will implement them. You’ve helped make our policy an even stronger one, and Nova Scotians can rest assured that we are adequately addressing the doctor shortage.”
Instead, McNeil went off like some crazed lunatic, threatening to sic his underlings on Pickup at a Public Accounts session of the legislature. (The Liberal backbenchers didn’t criticize Pickup at all at the meeting.)
What the heck set McNeil off?
I have two guesses. The first is he simply didn’t read the audit. If he had, he would have found that it was broadly supportive of his government’s processes, and that the criticism Pickup did lay on the government was accepted as productive by the agencies that were audited.
But because he didn’t read the audit, McNeil came away only with the understanding that Pickup criticized him for “not communicating” with the public. “Do you think the auditor needed to tell me that we had a shortage of family doctors? …do you think the issue hasn’t been raised by Nova Scotians?” McNeil told Marieke Walsh. But that’s not the “not communicating” Pickup was talking about.
My second guess is that McNeil is simply of the old school paternalistic government mindset. That is, he thinks that as premier he decides on government action and takes it, and it’s not up to we lowly citizens to peek behind the curtains or ask how things are going.
McNeil demands deference, to the point of considering himself to be beyond even constructive criticism that will help him implement his own policies.
2. The spaceport will make us rich! And then kill us.
A bird being hit by this rocket has very little chance of survival.
There’s a short he-said, that-other-guy-said Canadian Press article making the rounds this morning:
A researcher says Canada’s first proposed spaceport in Canso, N.S., is a potential threat to migratory birds.
John Kearney, an adjunct professor at Dalhousie University, says he’s concerned that lighting at the $200-million site could confuse birds and delay their migration.
In a blog post this month, Kearney says he also thinks there could be a loss of stop-over and breeding habitat for a number of bird species.
[…]
Stephen Matier, president of Maritime Launch, says Kearney has never contacted his company to express any of his concerns or to learn details of what the company is planning.
Matier says one of the reasons the site was chosen was because previous environmental assessments done for a neighbouring Canso wind farm showed no issues for migratory birds.
CP didn’t provide a link to the blog post, but you can find it here. Kearney begins:
This note presents my concerns about the possible impact on migratory and breeding birds of the proposed Canso Spaceport (Maritime Launch Services Ltd. 2017) in Guysborough County, Nova Scotia. The above photo is a view of some of the coastal habitat to be affected by the proposed project.
These concerns arise from three years of pre- and post-construction avian studies I conducted in that area as part of the environment assessment of Sable Wind. These studies included research on breeding, migration stop-over, diurnal passage, nocturnal passage, and morning flight. An especially extensive database was collected on nocturnal passage based on nightly acoustic recordings throughout the spring and fall migrations at 3 sites in 2013, 2015, and 2016 and on morning flight on an hourly basis in 2016. These studies are summarized in Kearney (2017).
In particular, I wish to discuss the possible negative impacts on birds related to the effects of 1) lighting from the project on migrating birds, 2) loss and disruption of stop-over habitat of Whimbrels, 3) loss and disruption of breeding habit of Willets, and 4) the effects of a rocket fuel component, hydrazine, on coastal bird populations.
Kearney then details each of his four concerns, concluding:
The environmental assessment of the Canso Spaceport needs to include a detailed analysis of the four concerns raised in this memo to demonstrate that the project will not have significant negative impacts on migratory and breeding birds in their aerial, terrestrial, and aquatic habitats. If the project proceeds, it is imperative that the proponents conduct “Controlled Before-After” studies which are designed to provide statistically significant results in measuring the impacts on birds from the project. All project approvals should be dependent on the development of mitigation strategies that would be effective in reversing or greatly reducing any significant negative impacts as determined by the controlled before-after studies.
I only briefly discuss the environmental effects of the rocket fuel unsymmetrical dimethylhydrazine (UDMH). However, I believe it is a human health and safety hazard that has been greatly underplayed in the enthusiasm for the project. UDMH which powered the early years of the US space program is no longer produced in that country because it is so dangerous and toxic. UDMH is now powering the nuclear missiles of North Korea. The fuel is believed to be coming from production facilities in Russia or China. Here is an interesting article from the New York times about UDMH.
That New York Times article took me down a rabbit hole, and I found myself in bed this morning reading about North Korean science journals, a secret North Korean chemical plant, and a synthetic fiber called vinalon.
I can’t assess the science behind the threats to birds, so… well, I dunno.
But what bothers me even more than the threat to birds is that this whole rocket business seems to be caught up with a bunch of shady characters who are at least tangentially involved with villainous acts by nefarious rogue states and their non-state co-conspirators. Ukrainian rockets powered by secret North Korean fuel and marketed (I’m guessing) by Kremlin agents to sketchy U.S. start-ups with the hope of undermining the American space program, or at least of having a conduit to the technology…
It kind of feels like the FIFA of space travel: you know it’s corrupt, but you just don’t how corrupt it really is, and when you find out you’ll discover it was even more corrupt than you could have possibly imagined.
All of this will undoubtedly unfold whether we in Nova Scotia get to be rich by killing birds with rockets in Canso or if the people in Camden, Georgia undercut the Canso bid by promising to kill more birds with fewer rockets for a greater bird-killing efficiency. Either way, the North Koreans and the Ukrainians and the Kremlin agents will get what they want.
It just feels icky.
3. Liane Tessier
Liane Tessier
“Halifax’s fire chief apologized to all female firefighters who suffered systemic gender discrimination in the city, during a formal, negotiated apology to one former firefighter who won a settlement after a 12-year battle,” reports Keith Doucette for the Canadian Press:
Fire Chief Ken Stuebing said he wanted to acknowledge a part of the service’s history that “we are not proud of,” noting that firefighting has historically been a male-dominated profession.
“In Halifax and in fact in many other fire services across our nation this has led to systemic discrimination based on gender. For this I extend an apology to Liane Tessier and any other female firefighter who has experienced discrimination within this organization,” he said.
Two other women appeared at the event with their own stories of discrimination. Continues Doucette:
[Kathy] Symington, who worked with the service from 1997 to 2014, said she was harassed on the job, and like Tessier was attacked by management when she spoke out about it and sought help.
She said no one was ever held accountable and she felt isolated until she finally heard about Tessier’s case via news reports. Symington she had thought “it was just me.”
“That’s how quiet things get kept. That’s how they keep it (discrimination) going,” said Symington.
[Barbara] Sawatsky, an 18-year volunteer who was also a volunteer chief for eight years, said she was witness to what management did to Tessier.
“I was told to stay away from Liane, she was trouble … she was a trouble maker and a few more choice words,” she said.
Sawatsky said she was also the subject of a staff complaint that ended up before the Nova Scotia Human Rights Commission — a process that didn’t go well. She said she was eventually terminated by the fire service.
4. Civil service pay
Last week, I cited a Canadian Press article that reported that arbitrators decided on “a seven per cent wage hike to Nova Scotia civil servants over six years,” and commented:
The three per cent increase over four years (from 2015-16 to 2018-19) was an effective pay cut of around five per cent, because inflation runs at about two per cent annually. So in effect, what’s happened is the McNeil government has reset salaries at a lower rate, and thanks to the arbitration decision, that lower rate is the new normal, moving forward at about the rate of inflation for the next two years. Workers won’t see any further decrease in the purchasing power of their paycheques.
Today, Larry Haiven puts more concrete numbers to my estimates:
Let’s look in more detail at the arbitration award. The first column shows relative dates; the second group of columns shows the cumulative increase awarded by the arbitrators; the third group of columns shows the cumulative increases necessary to maintain the employees purchasing power assuming inflation of 1.5% per year after 2017; and the fourth group of columns shows the cumulative increases necessary to maintain purchasing power under an alternative scenario of inflation. The 13th row shows the loss in real pay under the two inflation scenarios.
[…]
There are several reasons to choose the second inflation scenario. For the past several years, the government and the Bank of Canada have deliberately tried to keep interest rates and inflation low in order to stimulate economic growth during the recession that began in 2008. But now that Canada’s economy is showing signs of health, inflation will surely be allowed to and will likely rise. One reason for low inflation in recent years has been the crisis in the petroleum sector. But, as the sector recovers, the cost of petroleum will also rise. Recent reports also predict that the cost of food is set to rise. These and other factors will likely boost the cost-of-living higher than 1.5% per year.
Even the second scenario makes modest predictions about inflation. But the message of both scenarios is clear: Barring a full-scale revolt, the real pay of public sector workers in Nova Scotia will continue to drop.
Government
No public meetings for the rest of this week.
On campus
Dalhousie
Tuesday
Annual Dalhousie Carol Sing (Tuesday, 12pm, Sculpture Court, Dalhousie Arts Centre) — Jacqueline Warwick will lead Christmas carols and Hanukkah songs .
Wednesday
No public events.
In the harbour
5:30am: Tomar, car carrier, arrives at Autoport from Southampton, England
6am: Spica, container ship, arrives at Pier 42 from St. Thomas, Virgin Islands
11am: Oceanex Sanderling, ro-ro container, arrives at Pier 41 from St. John’s
11:30am: Tomar, car carrier, sails from Autoport for sea
2pm: British Sailor, oil tanker, arrives at Irving Oil from IJmuiden, Netherlands
Footnotes
My biggest fear is dying in a plane crash. My second biggest fear is surviving a plane crash. From there, I have all sorts of other fears, from forgetting my wallet on the way to the tavern to having toilet paper stuck to my shoe when I leave the washroom to getting attacked by hungry racoons. Way down on the list, like fear #4,028, is becoming the caricature of an old man yelling at clouds. But even after that, fear #4,029 is becoming the caricature of an old man reliving past glory by baselessly yelling at those young whippersnappers just so people will still pay attention to me.
Tim Bousquet is the editor and publisher of the Halifax Examiner. Twitter @Tim_Bousquet Mastodon
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Said it before and I’ll say it again
1. Embrace the Legal Pot issue as a money cow, encourage NS production with licensed selling boutiques and bars. There’s a big potential shortage apparently so why not help create jobs in our province, get the farmers on board.
2. No tire burning for heat. None it’s just stupid.
3. No Northern Pulp affluent going into the Atlantic – clean up Boat Harbour and either come up with a viable solution or the plant has to go.
Pretty straight forward. Time for political change thinking is now.
I doubt Premier McNeil read the audit in question, he doesn’t need to, that is what staff is for. I assume his reaction is that even if the audit is generally supportive of the governments policies, any criticism related to the delivery of medicine in the province is politically damaging and needs to be countered. I’d say the media coverage of the audit bears that out. I don’t recall much of the coverage of the audit indicating that it was generally favourable.
1. thank you for changing the picture you use of Tessier.
2. at the very least Premier M should have had staff give him a synopsis of the AG report so he wouldn’t go off like our future space port. We, the public, should be getting hourly reports on the progress of the collaborative health care teams so we can continue clinging to hope.
Tim B: It’s been great spending part of the year with you and your staff. Also all the best to the many commenters. Isn’t it great when, every now and then, we can turn some troubling things into humour?
Why is UDMH toxicity an issue if UDMH isn’t used for rockets outside of North Korea? The hydrazine used for maneuvering jets in modern spacecraft is still quite toxic, so I guess there’s that.
If you want to go down a real rabbit hole, the history of rocket propellants is fascinating:
A UK registered BP tanker is a rarity.
In other news, I expect an Indigenous person to be appointed to the HRM Board of Police Commissioners to replace Mr Graham who resigned yesterday – 103 days before his term expired.
Said it before and I’ll say it again
1. Embrace the Legal Pot issue as a money cow, encourage NS production with licensed selling boutiques and bars. There’s a big potential shortage apparently so why not help create jobs in our province, get the farmers on board.
2. No tire burning for heat. None it’s just stupid.
3. No Northern Pulp affluent going into the Atlantic – clean up Boat Harbour and either come up with a viable solution or the plant has to go.
Pretty straight forward. Time for political change thinking is now.
I doubt Premier McNeil read the audit in question, he doesn’t need to, that is what staff is for. I assume his reaction is that even if the audit is generally supportive of the governments policies, any criticism related to the delivery of medicine in the province is politically damaging and needs to be countered. I’d say the media coverage of the audit bears that out. I don’t recall much of the coverage of the audit indicating that it was generally favourable.
1. thank you for changing the picture you use of Tessier.
2. at the very least Premier M should have had staff give him a synopsis of the AG report so he wouldn’t go off like our future space port. We, the public, should be getting hourly reports on the progress of the collaborative health care teams so we can continue clinging to hope.
Tim B: It’s been great spending part of the year with you and your staff. Also all the best to the many commenters. Isn’t it great when, every now and then, we can turn some troubling things into humour?
Why is UDMH toxicity an issue if UDMH isn’t used for rockets outside of North Korea? The hydrazine used for maneuvering jets in modern spacecraft is still quite toxic, so I guess there’s that.
If you want to go down a real rabbit hole, the history of rocket propellants is fascinating:
https://archive.org/details/ignition_201612
Get off my lawn!
A UK registered BP tanker is a rarity.
In other news, I expect an Indigenous person to be appointed to the HRM Board of Police Commissioners to replace Mr Graham who resigned yesterday – 103 days before his term expired.