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.

Canadian journalist Libby Znaimer beats breast and pancreatic cancers!

TORONTO — Canadian journalist Libby Znaimer knows what it takes to survive against all odds and how to overcome the challenges of rehabilitation.

Znaimer has successfully battled not one, but two cancers: breast cancer in 2006, and pancreatic cancer – the most lethal kind of all – in 2008.

On October. 8, Zoomer Media’s vice-president of news and information for Classical 96.3FM and AM740, will share her story as the honoree at Beit Halochem Canada’s Woman of Distinction Award luncheon.

The event, to be held at the Oakdale Golf and Country Club, will raise funds for Beit Halochem, an Israeli organization that helps 51,000 wounded veterans and victims of terror to recover from their injuries and psychological trauma.     

Znaimer said her personal experience with recovery and rehabilitation has made her connection to Israeli victims of war and terror even stronger.

“It’s hard enough when there are no visible signs [of injury] on you. When it comes to cancer, some people have different lasting problems and some people don’t. I’m very lucky that I don’t. To have to recover with a disability, I mean, I can’t even wrap my head around it.”

After her diagnosis in 2006, she tested positive for BRCA2, a genetic mutation more prevalent in Ashkenazi Jews that increases the likelihood of developing breast, ovarian and pancreatic cancer.

In 2008, a year after she endured months of surgery, chemo and radiation, Znaimer learned that she had pancreatic cancer, a disease that has a five-year survival rate of about six per cent.

She was lucky that her pancreatic cancer was detected before it spread. But it was wrapped around a main artery and vein and couldn’t be operated on unless her doctors succeeded in shrinking the tumour.

Znaimer and her doctors decided to try an experimental treatment to shrink the pancreatic tumour by targeting the BRCA2 mutation.

Today, the growing number of pancreatic cancer survivors can credit Znaimer, the national spokesperson for the Pancreatic Cancer Canada – a foundation that raises awareness and funds for the fourth biggest cancer killer in North America – for being the first patient at Toronto's University Health Network to test out a treatment plan that has had some success in treating a cancer that is largely considered incurable.

“No one was more surprised than my doctors when it worked,” Znaimer said.

“They started treating people with the BRCA mutation that way and they respond better to treatment… I think I probably responded way better than the average, but what they started to do is they test every case for BRCA now at Princess Margaret [Cancer Centre in Toronto] and some other places,” she explained.

“It’s a big advancement for a small subset of patients. Literally, I was just about the first case. I’m lucky that it wasn’t the next person.”

Beit Halochem luncheon chair Susan Flam said she is thrilled to be able to recognize Znaimer as a woman of distinction.

“Not only is she professionally accomplished as a journalist, broadcaster, and radio executive, but she has braved and won her battle with cancer and she supports many cancer-related causes. She gives back,” Flam said.

“Both the veterans and the honoree have a kinship with each other, because all of them have faced major roadblocks in their lives. They have had really arduous journeys to regain control of their lives.”

For more information, call 905-695-0611, or visit www.beithalochem.ca.

Reprinted from the article Cancer survivor can relate to disabled Israeli vets, by Sheri Shefa, Staff Reporter, with permission from the Canadian Jewish News, Monday, September 16, 2013.

Nova Scotia Election Campaign: New Democratic Party 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:

In the 2009 election campaign, the NDP committed to the creation of a Drug Management Policy Unit. As a result of the work of that group, the Fair Drug Pricing Act was introduced and passed in the Legislature, and went into effect on July 1, 2011.  Seniors and other Nova Scotians enrolled in the province’s Pharmacare programs now pay less for each prescription of most generic drugs at the pharmacy counter. Prices went down on July 1, 2011 and again on January 1, 2012, and again on July 1, 2012. Through the Fair Drug Pricing Act, the NDP is making sure that Nova Scotians covered by Pharmacare are getting better prices for generic drugs – prices in line with those paid in other parts of Canada. The Data in the 2012 CMAJ article you cite would not capture the advances the NDP government has made on drug prices during this mandate. And, using overall data for the Atlantic provinces may mask the effects as well. That being said, there is more to do, and the NDP will continue to take action in government to drive down the cost of drugs.

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:

As you may be aware, the NDP recently announced a new program to cover some of the costs of hearing aids for seniors in Nova Scotia. In reviewing options, the Ontario program provided some very useful insights. The Ontario Assistive Devices Program provides coverage for compression garments and is a potential model for Nova Scotia, should funding become available in the health spending envelope.

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 Cancer Systemic Therapy Policy Committee provides the Nova Scotia Department of Health and Wellness with advice on what cancer drugs should qualify for public funding. The Committee is made up of 23 people, including cancer specialists, a cancer survivor, a pharmacist, ethicist, other health care providers and Department representatives. The Committee reviews cancer drugs using a values and evidence based on a decision making framework. The framework is used to guide discussions around the economics, ethics, and evidence to make recommendations to the Deputy Minister of Health about additions, changes and deletions to the cancer drug formulary. Decisions about specific drugs should not be made by political parties – they are medical decisions and the NDP relies on the advice and experience of the people on the Committee to that end.

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: 

When elected, the NDP government hired Dr. John Ross to help develop a new approach to pervasive ER closures across the province. As a result, CECs – now regarded as a model across the country – were developed. In communities with a CEC, ER closures have decreased by as much as 93%. But there is still work to do. The NDP will open more CECs in consultation with communities and working with DHAs to meet local health needs. In addition, during this campaign, the NDP committed to a network of nurse managed clinics – Better Care Clinics – to provide better care to those suffering with chronic diseases or conditions. Cancer survivors will get better care with these clinics too, since nurses are often able to spend more time with their patients and can take a more holistic approach to their care plans.

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:

Dr. John Ross hit the nail on the head when he said that the push to amalgamate the DHAs in to centralized superboards will waste money on “administrative busywork.” Under the NDP government, health administration spending was reduced by 23.3%, the best record in Canada over the same time period. Mary Jane Hampton, a well-respected health consultant said, “To suggest that the solution to saving health care is to yank millions of dollars out of administration and put those dollars into patient care is a dangerously simplistic argument.” Losing local control in decision making is simply wrong. The NDP has committed to reducing administrative spending in health further, but without throwing the system into chaos.

Participants Needed: UBC Research Study - Lung Cancer Booklet

Are you related to a person with lung cancer? Do you smoke or have you recently quit?

Researchers at the University of British Columbia are looking for family members of lung cancer patients to participate in a research study.

Tell researchers what you think about a new booklet for family members about reducing and stopping smoking. Up to 2 hours of your time - $50.00 honorarium.

The feedback from the booklets will be summarized and the findings will be used to refine and improve the new booklet resources. Interested individuals will be asked to read the booklet and complete two telephone interviews (the total time to participate is less than 2 hours).

Your personal experience and feedback will make a big difference on the effectiveness of this resource.

For more information, please contact raquel.graham@ubc.ca or (250) 807-8054.

Canadian Cancer Survivor Network calls for increased training and closer oversight and supervision of radiologists

The approximately 3,500 patients who relied on results of CT scans and mammograms conducted by Trillium Health now called into question have every right to be both worried and outraged.  Canadians trust that mammography and CT scans will help them learn whether they are in good health or whether an abnormal scan requires further investigation, leading to an early diagnosis and treatment of cancer with better outcomes.

“When I have a mammogram and then get that letter saying everything is fine and I don’t need to come back for two years,  I believe that everything is okay and that I don’t have cancer,” said Jackie Manthorne, president and CEO of the Canadian Cancer Survivor Network. “It would be devastating to be told that my mammogram was not read correctly and to lose that sense of assurance and trust in mammography, which is our only mass breast cancer screening program in every province in Canada.”

This is not the first time that the results of mammography screenings or pathology tests have had to be reviewed:

In 2010, the College of Physicians of Quebec ordered an investigation of 15,000 mammograms performed in Montreal and Laval, which showed that thousands of Quebec women might have been given inaccurate results.

In 2005, Eastern Health Pathology Lab in Newfoundland and Labrador, faulty pathology tests over an eight-year period resulted in 400 breast cancer breast cancer patients receiving the wrong treatment; over 100 of these women died.  The resulting judicial inquiry by Justice Margaret Cameron and her subsequent report stated that Eastern Health failed patients with shoddy lab work and nearly non-existent quality controls.

In 2009, hundreds of Quebec women diagnosed with breast cancer may have received the wrong treatment because of inaccurate pathology tests.

Faulty diagnosis or incorrect pathology tests can lead to onerous consequences, from the diagnosis of cancer at a more advanced stage, resulting in increased level of treatment, to an increased risk of recurrence, or the development of metastases, where the cancer has spread to other parts of the body, which often results in a reduced quality of life and treatment which last a lifetime.

Canadians deserve better. The Canadian Cancer Survivor Network calls on provincial and territorial screening programs and hospital and cancer centres to ensure supervision and oversight of cancer screening program staff and that Canadian and provincial/territorial associations of radiologists and pathologists ensure that their members receive regular professional evaluations development opportunities.

To arrange interviews or for additional information:  Jackie Manthorne, President & CEO, Canadian Cancer Survivor Network. 613-898-1871 or 613-710-3636 or jmanthorne@survivornet.ca.

Albertan men and women with advanced prostate and breast cancer deserve access to bone-targeted therapies

The Canadian Cancer Survivor Network is deeply concerned that men and women living in Alberta who have advanced prostate and breast cancer that has spread to their bones do not have public access to treatments that can reduce the risk of serious bone complications.  

Men and women whose cancer has spread, or metastasised, to their bones are at risk of developing serious, debilitating complications such as fractures, spinal cord compression or the need for surgery or radiation. These complications can cause mobility issues, disability, hospitalization and even death.

To reduce the risk of developing bone complications, men and women with advanced prostate and breast cancer need a bone-targeting treatment at the earliest confirmation of metastases. Currently, the government does not pay for these treatments for patients in Alberta. However, the Government of Alberta’s introduction of Changing Our Future: Alberta’s Cancer Plan To 2030 in February 2013 means that now is the time to have a serious discussion about the importance of ensuring cancer patients in Alberta receive the same standard of care available to patients in other provinces.

Alberta is one of only two provinces, along with PEI, that does not currently provide public access to bone-targeting treatment. We believe that all patients with advanced prostate and breast cancer in Alberta deserve the same access to treatment and standard of care as patients in other provinces. The launch of the new PharmaCare program in January 2014 makes the consideration and correction of coverage issues in Alberta a timely issue right now.  Alberta Healthcare Insurance Plan must provide access to bone-targeted therapies to prevent complications that may be debilitating.

If you would like to assist us in our efforts to help men and women with advanced prostate and breast cancer receive the same evidence-based care as patients in other provinces, please contact me at Jmanthorne@survivornet.ca.

Together we can make a difference.

Precautions to Take After Being Exposed to Asbestos

If you've been following CCSN for any amount of time, you've probably amassed a considerable amount of knowledge about the health complications that can develop after asbestos exposure. However, you may also have spent a considerable amount of time racking your brain for times when you could possibly have been exposed to asbestos.

If you've identified any potential exposures, you may now be dealing with intense feelings of anxiety. You’re not alone! This is a reaction we hear often at The Mesothelioma Center.

You’ll be relieved to know that many people who are exposed to asbestos never become ill. Those who do develop asbestos-related diseases were often exposed to high quantities of the fibers for prolonged periods of time. Most people – including those who inhale one or two fibers in the home or environment – won’t have to worry about mesothelioma.

That said, certain precautions can give you peace of mind. It’s important to monitor your health so that in the rare event that a tumor does develop, your medical team will be able to make a quick diagnosis.

If you've been exposed to asbestos, we suggest that you:

• Ask your primary doctor to make a note of your exposure in your medical history. If, in the future, you note any abnormal symptoms, your medical team will know that you have a history of asbestos exposure. This insider knowledge will help them narrow down the causes of your symptoms – and hopefully catch any malignancies in their earliest stages.
• Register for respiratory screenings and other routine imaging scans. These tests can provide easy tracking of your health over time. If your doctors note a decline in lung function (or any suspicious spots inside your body), they’ll be able to immediately pursue further testing.
• Schedule a home inspection to prevent future exposure. Knowing that your home is free from asbestos hazards offers you – and your family – added peace of mind.

Faith Franz is a writer for The Mesothelioma Center. She likes to spread the word about the benefits of alternative medicine.