Tuesday 1 October 2013

Nova Scotia Election Campaign: Liberal Party's Responses to CCSN's Questions

Question 1:

The Canadian Medical Association Journal published research in 2012 that showed one in ten Canadians report they skip doses or decide not to fill prescriptions because of cost, with the second highest incidence of cost nonadherence happening in the Atlantic provinces. If elected to government, what will your party do to make prescription medications more affordable?
Response:
There are several challenges facing the health care system over the next few years. The Harper Conservatives will reduce Canada Health Transfer funding to our province - some $900 million over the next ten years. Coupled with this challenge is the fact our drug supply, both nationally and provincially, has been facing severe shortages over the past two to three years. Further government mandated price reduction prices will worsen this situation. Governments at all levels have to weigh the benefit of price reduction with the availability of prescription medications. A decreased price benefits no one if the patient is unable to access the drug in the first place. A Liberal government will work with pharmacists to ensure we save money in our pharmacare budgets which in turn can be reinvested back into services and funding of new drugs. It is important to acknowledge that drug costs, while always challenging for some, represent a portion of the monthly costs in a household which includes such necessities as power. If elected, we have also made a commitment to reducing the cost burden associated with the price of electricity. 
Question 2:
If elected to government, will your party change MSI regulations to cover the cost of treatment and pressure garments necessary to treat lymphedema?
​Response:
The Liberal Party understands the importance of covering costs associated with the treatment and management of lymphedema. In 2008, the current Health and Wellness Minister, Dave Wilson, brought representatives of BCANS to the legislature to impress upon the former Conservative government the importance of funding pressure garments necessary to treat lymphedema. Five years later, there is still no coverage. Currently there is a comprehensive review ongoing around changes to MSI regulations and we trust the costs of compression sleeves and treatment costs are being considered in this review. 
Question 3:
A key element of ensuring timely treatment for a Canadian cancer patient is ensuring they have access to the medications they need at the time they need them. Unfortunately, this is not always the case in Nova Scotia. If elected to government, will you commit to ensuring that all cancer patients in Nova Scotia receive timely access to medications at the time they need it?
​Response:
The Department of Health and Wellness relies on the expert opinion of the Cancer Systemic Therapy Policy Committee to make decisions on the types of cancer drugs that should qualify for funding. This group relies on clinical evidence when it comes to making decisions around coverage. The challenge oftentimes remains that once certain drugs are approved, coverage does not occur until such time as the Department of Health and Wellness approves funding. For some patients, drug budgets within the Districts will provide coverage if the drug is approved by the Cancer Systemic Therapy Committee however these budgets can only sustain these types of extra pressures for so long. As indicated in previous questions, there are unprecedented challenges coming in our health care budget. We will continue to rely on the advice of the Cancer Systemic Therapy Committee and attempt to do our best in light of significant fiscal challenges to ensure cancer patients receive timely access to medications. 
Question 4:
If elected to government, how will your party ensure that all hospital emergency rooms remain open 24 hours a day, seven days a week?
​Response:
This NDP government, after four years, has ignored the root cause of emergency room closures across the province. Emergency rooms remain closed because of a lack of physicians available to provide coverage. According to the Nova Scotia Physician Resource Plan this situation is about to become worse as 31% of doctors in Nova Scotia are due to retire over the next eight years. This is why a Liberal government will provide up to $120,000 in tuition relief to 25 new doctors per year for the next four years in exchange for a return of service agreement to serve in under-serviced communities throughout Nova Scotia. We have also committed to the appointment of an expert physician recruitment and retention team to ensure we are best positioned to recruit new doctors and retain the ones we have. Cancer patients rely on the care of physicians. There is no question, CEC’s are fulfilling a valuable health care need and the professionals in the system are providing the best possible care they can within their scope of practice. However patients need to be cautioned that some of the CEC’s have changed their protocols on the types of patients that can be accepted. In certain instances, there may be situations that even if a CEC is open, care for a cancer patient can no longer be provided because there is no longer a physician providing care on site. The NDP have ignored the root cause of emergency room closures – the lack of physicians – a key health care provider in the ongoing care of cancer patients. 
Question 5: 
Is your party in favour of maintaining the same number of health districts in the province? If not, please explain how you would modify the number of health districts and what is the rationale for this policy?

​Response:
A Liberal Government would reduce the number of CEO’s and VP’s by reducing the number of DHA’s from 10 to 2. The Liberal Party is proposing fewer CEO’s, fewer VP’s and fewer Directors in our health care system so a reinvestment can be made back into front-line health care. There will be one CEO and a lean executive leadership team. Health care will be delivered through four regional zones. Site based management and site based decision making will be strengthened and implemented providing health care workers with the ability to make a difference for the patients they provide care for. Community Health Boards will remain in place and their role and linkages with the health care system will be strengthened. The delivery through four zones coupled with site based management and decision making, and a strengthened role for Community Health Boards will strengthen community decision making. There will be one volunteer provincial board that will work with the executive leadership team to plan and manage health care for the province. Membership of this board will consist of one member from each of the current DHA’s. The cost savings from this restructuring - $13 million annually - will be re-invested into front-line health care. The IWK will remain as its own entity due to its Regional status and funding extends beyond Nova Scotia. Currently, the NDP would like nothing more than have this discussion focus on the costs of administration in a sorry attempt to cover up the significant challenges that exist within our health care system today. Our plan is much more than an attempt to save administrative costs, It’s a plan that will enable patients to travel more readily to facilities if they so choose for the purpose of accessing treatment and surgeries faster. Right now, this does not happen as frequently as it should because each DHA must protect its own budget envelope. As a result, we have OR’s sitting idle in some parts of the province while wait lists for procedures are bursting at the seams at others. The Liberal Party is equally concerned about the fragmentation that has developed around certain public health programs in our province. Your civic address oftentimes dictates the type of public health program support you can receive in your District and we in the Liberal party believe this is wrong. We need a system which will allow planning to occur utilizing all of our health care assets, not just those that are located within artificial budget boundaries. We need a system that enables patients to travel to other sites, if they so choose, to access their surgery faster. We need a system that, irrespective of where a patient lives, they are able to access the same level of public health programming. Nova Scotia has a population of less than a million people, why is it acceptable that we have 10 CEO’s and 10 executive leadership teams managing our health care system while wait lists continue to grow and inequitable public health programming continues to be delivered in this province? The Liberal Party does not believe this is acceptable and is proposing a structure to address these ongoing pressures and inequities.

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