Crucial transformation coming to Halifax Infirmary site

Updated March 9, 2020

The  $2-billion cost of revitalizing Nova Scotia’s most important medical centre, and the debate over the public-private-partnership (P3) approach to building it, have obscured a much more interesting feature of the project.

Far from the decentralization discussed just two years ago, it will create a health care powerhouse at the Halifax Infirmary site.

According to the Nova Scotia Health Authority, when the dust has settled in the middle of the next decade, the HI site will comprise 625 inpatient beds, 28 operating rooms, 33 intensive care beds and 15 intermediate care beds.

expansion of inpatient care at HI
Increases are net, reflecting new facilities and transfers from the VG site. (Courtesy NSHA)

I know I should lower my expectations here. After all, the effort to bring the so-called Victoria General campus up to standard has been driven solely by hot air for at least 20 years. But the politically risky decision to make it a P3 build tells me Stephen McNeil’s government means business.

The VG campus, notwithstanding its disgraceful buildings, is supposed to be the centre of excellence for medicine in the Maritimes. We need to take note of what’s going to replace it.

For starters, the Infirmary parkade will be demolished and rebuilt underground, with a new inpatient building sitting on top.

The existing emergency department will remain where it is, but will be flanked by three new buildings dedicated to a research and learning centre, cancer care, and ambulatory care.

As late as April of this year, the plan was to retain cancer care at the Victoria General site, but planners decided patient health would be better served if the centre was part of the HI site. In part, it will permit views of the outdoors, communal space, gardens and natural materials designed to make cancer patients more at ease. It will also promote team care.

Whatever the decision, it will gobble up the communal vegetable garden occupying the site of the former QEII High School. But we don’t yet know whether the cancer care centre will occupy the garden site or the former CBC building on Bell Road. Planners will complete a study of patient flow before making that call. (See illustrations.)

beacon streetscape crop 2 w arrows
This  concept illustration shows an area bounded by Robie St. at the bottom, then, moving clockwise, Bell Road, Summer Street and Veterans’ Memorial Lane. Arrows point to numbers on key buildings: 1-new inpatient building; 2-outpatient building; 3-learning and research centre; 4-cancer care building.

In sum, the site will have four new buildings: cancer care, ambulatory (outpatient), a research and learning centre, and an additional inpatient building. Dartmouth General is already undergoing an extensive remake that includes

GP street scapes cropped arrows
In this concept, the locations of cancer care (4) and outpatient (2) have been swapped. Patient flow will be the key to the decision. In either case, the community garden will have to go. (Courtesy NSHA)

a new tower, and the rural-friendly community outpatient centre at Bayers Lake is going ahead.

So that’s a total of six new buildings.

A team approach to care is seen as one of the benefits of the new campus. For example, people with cancer often have other illnesses and will benefit when specialists can work along-side cancer-care providers.

The focus on patient comfort will extend to the 180 new inpatient units, 80 per cent of which will be single occupancy. This, as well as good views of the outdoors wherever possible, has been found to pay for itself in shorter stays and fewer returns to care. The remaining rooms will be similar but with a maximum of two patients and no sharing of bathrooms.

Victoria van Hemert, who heads the project, told your incredulous correspondent (who prefers to lick his wounds in remote caves) that some people actually heal better in a social setting.

As noted, the parkade on Robie will go underground with the additional inpatient building on top. Underground parking lots will also be constructed beneath the cancer care and outpatient buildings.

Interestingly, the net increase in “regular” inpatient beds on the Peninsula is just 36. But van Hemert, who has a number of successful hospital projects on her CV, says it’s the right number:

“This outcome was objectively derived based on programs and services, demographics (including age), technological changes, and more day surgeries. Epidemiologists were a part of the calculation. And then we looked ahead 20 years.”

Intensive care beds will go up by nine to 33; intermediate care will rise by three to 15.

There is some capacity to scale up the emergency department, but planners are counting on three things to ease the current overcrowding:

  • Expanded outpatient services (mastectomies, for example, can now be done on an outpatient basis);
  • Faster transfers of emergency patients to continuing care (home care);
  • Faster access to long-term care (e.g. nursing homes).

“More timely discharge of inpatients to Continuing Care and long-term care services will assist with improving flow of patients from the Emergency Department to inpatient units,” Nicole Brooks de Gier, community relations advisor for the project, said in an email.

That’s an understatement. Your correspondent has spent the night with family members in an emergency room on three occasions, once for 36 hours. The beds are actually gurneys, which are narrow and uncomfortable, and it can he hard to get help from staff because they are busy with, well, other emergencies.

In each case, the explanation was the lack of a hospital bed for my family member. Too many were already occupied by patients who belonged in a home or continuing care.

This is surely expensive, but it’s also hard on staff morale. “We’re trained and equipped for emergency medicine,” an exhausted emergency nurse told me one night. “Our job is to treat patients and send them home, or get them ready for admission to inpatient care. (Your relative) is not getting the right care here.”

Given the net increase in regular inpatient beds, it seems this $2-billion project has a lot riding on care given outside a hospital.

NOTES:

  • Part of the project is a new operating room at Hants Community Hospital. It’s completed and expected to handle 800 surgeries per year;
  • NSHA will own the buildings and deliver services

To come:

  • Dartmouth General expansion (ghost floor comes back to life)
  • Continuing care and long-term care
  • Bayers Lake outpatient centre
  • Short rant in favour of P3 model

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Doctor-shortage: Eastern Zone feeling better

As of the first of this month 58,046 (6.3%) Nova Scotians were in search of doctor. That’s an increase of about one-tenth of a percentage point, or 1,416 people.

On the upside, it’s far better than the increase recorded on July 1 which, as they say on TV, was a “whopping” 2,483. Since then, the monthly increase has been declining steadily, so maybe that’s good news (hard to say, as I have never been “whopped”.)

The data come from the Nova Scotia Health Authority, which has been notably open about the doctor shortage. Further, the October report contains new details offering a pretty good idea of the situation where you live, based on the percentage of people there without doctors.

In the first table below, I’ve highlighted the four best performers in green, and the worst in red. The Eastern Zone has all the best — four areas where there is effectively no doctor shortage, in my view.

Liverpool is in dire straits, with 16.3% of the population (1,781 people) needing but unable to find a doctor.

As usual, about half the people without doctors (29,469) live in Metro Halifax. That’s 7.7% of the city vs. 6.3% for the province. At the bottom of this post is a Halifax-centric table sorted from the highest percentage of people without doctors to the lowest. I’ve used a seasonal orange colour to illustrate the local problem, about which our councillors and MLAs don’t seem to care.

Highlighted table from NSHA

Oct.1 2018

Halifax-centric table

Halifax-centric October 4
This table is sorted from the highest percentage of people without doctors to the lowest. I’ve used a seasonal orange colour to illustrate the local problem, about which our councillors and MLAs don’t seem to care.

The easy, low-cost way to catch stoned drivers

Driving_Simulator_2_8.7.2014_300px

It’s amazing to see how much effort and money is going into preparation for next Wednesday, when pot becomes legal in Canada. You’d think government would have less to do when something becomes legal but, no, all the levels of government have been bulking up for a year now. It’s the way we do things here.

Still, amazingly, it’s not going well.

For example, CBC reports that police departments are still ill-equipped to detect and deal with suspected stoned drivers.  “Only” 833 of Canada’s finest have been trained as a Drug Recognition Expert (DRE) versus the 2,000 sought by the Canadian Association of Chiefs of Police.

But their methods, which can involve detention with scant cause and be highly intrusive, are in for a rough ride in court.

Here, thanks to Robichaud Law, are some of the hoops traffic officers will go through to get a conviction.

First, the police officer must determine whether there is a “reasonable suspicion” the driver is impaired by drugs. Here’s a list of suspicious signs:

  • smelling marijuana emanating from the person,
  • observing erratic driving behaviour,
  • obtaining an admission of the suspect of recent drug consumption
  • observing strange behaviour
  • observing bloodshot eyes, slurred speech, etc.

Hell, spending an hour in the visitors’ gallery at Doug Ford’s Ontario legislature could produce four of those symptoms. More if you visited the press gallery.

And what if your doctor has prescribed you tranquillizers? What’s your answer when you’re asked if you’ve recently consumed drugs?

So, let’s say the cop determines you could be stoned or drunk. You’re off to see a DRE, if there’s one to be found. Here’s what happens.

  • a preliminary examination involving pupil measurement and comparison, pulse, eye tracking of an object;
  • a horizontal and vertical “gaze nystagmus test” (i.e. jerky eye movement);
  • a “lack-of-convergence” test (i.e. can’t cross your eyes);
  • divided-attention tests, which consist of balancing, walking and turning, one-legged standing, finger-to-nose test;
  • blood pressure, temperature and pulse;
  •  an examination of pupil sizes under (different) levels of ambient light, near-total darkness and direct light and an examination of the nasal and oral cavities;
  • an examination which consists of checking muscle tone and pulse; and,
  • a visual examination of the arms, neck and, if exposed, the legs for evidence of injection sites.

After checking off that intrusive list, the DRE may decide the driver is impaired and demand samples of saliva, urine and/or blood. But fluid tests are unreliable indicators of weed impairment and, in any case, CBC says there isn’t a single cop in the country qualified to take a blood sample.

This is tough enough on police trying to do their jobs, but what if you’re the driver and you’re innocent? To paraphrase comedian Russell Peters, somebody gonna get real mad.

And one way or another, it’s going to be a licence to print money for criminal lawyers.

What to do? The answer is as obvious as your bloodshot eyes: ask suspect drivers to take a test in a driving simulator. You could even fit a simulator in one those over-sized police vans for roadside testing. The officer would simply ask the suspect to take the wheel of a simulator and start “driving”. The machine could measure all the key aspects: reaction-time, hazard recognition, speed, ability to stay inside the lines, etc.

Best of all, the machine would produce the results in a cold, objective printout. It wouldn’t matter whether the suspect had alcohol or other drugs in her system, or how much of it, because we would know whether or not she can drive safely. From a public safety perspective nothing else really matters, right?

Do driving simulators exist? Of course. Are they expensive? Alibaba has a wide variety of them at reasonable prices. Even after being tricked out for law enforcement purposes, I doubt one would cost more than a single police patrol car. And, assuming I passed, I wouldn’t feel inconvenienced because the simulator experience looks kinda fun. (There’s a demo video here, for a model starting at US $10,000. NB: Download takes patience.)

Some will say the system might unfairly catch sober but bad drivers. Well, what’s unfair about getting dangerous drivers off the road? That’s why we require driving tests in the first place.

To summarize. Smoked weed? Don’t care. Drank alcohol? Don’t care. Dangerous driver? We care. Then, and only then, we’ll investigate whether substance abuse is the cause.

So, problem solved. Or, as we say at Turpin Labs: ipso facto duodenum.

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Don’t go down that rabbit hole

 

Mehta fiasco common but avoidable

Conversations between fair-minded people about Rick Mehta tend to begin with something like: “I don’t know who’s right, but I do know … “

Unfortunately, even what we “do know” is wrong or not enough. All I’m certain of is that he was fired by Acadia University Aug. 31 amid a firestorm of accusation and counter-accusation.

The dispute, as others have noted, is a “rabbit hole.” We’ll never know who’s right or wrong. For sure, Mehta’s detractors and advocates (yes, he has some) will never persuade each other of anything.

But there is a way to avoid more rabbit holes: invite Kenneth Westhues, professor emeritus at the University of Waterloo, to lecture on “mobbing” or, in this case, “mobbing in academe.” And while we’re at it, have him speak to non-academic employers as well. Westhues is a leading scholar on mobbing, a phenomenon first identified in the late 1980s by Dr. Heinz Leymann, of the University of Stockholm.

And let me assure you: if Mehta is a victim of the academic form of mobbing, he has plenty of company.

I contacted Westhues because the Mehta controversy was reminding me of two incidents in my own own worklife. Some time ago, a large, somewhat plump and naive young woman walked into a office of twenty-somethings next to the room where I worked. For reasons still lost on me, a single loudmouth in the group began attacking her at every opportunity. He publicly mocked her hair, her intelligence, her body, her words and, unbelievably, her name. Others joined in and soon her work-life was hell. I didn’t participate, but I didn’t intervene either. The pressure grew daily until she left. It was the cruellest psychological attack I’ve seen.

Much later, I saw a gang of office-workers attack someone whose only crime was a lack of support. A single person launched a whispering campaign and it spread like a brushfire. This time I was sure I had the authority to intervene, but I was wrong. There was blood in the water and dismissal quickly became the inevitable outcome. (Concerted, unrelenting attacks on someone’s competence tend to be self-validating.) The instigator, who should have been fired, was triumphant. 

Here’s how Westhues describes the phenomenon: “Mobbing can be understood as the stressor to beat all stressors. It is an impassioned, collective campaign by co-workers to exclude, punish, and humiliate a targeted worker. Initiated most often by a person in a position of power or influence, mobbing is a desperate urge to crush and eliminate the target. The urge travels through the workplace like a virus, infecting one person after another. The target comes to be viewed as absolutely abhorrent, with no redeeming qualities, outside the circle of acceptance and respectability, deserving only of contempt. As the campaign proceeds, a steadily larger range of hostile ploys and communications comes to be seen as legitimate.”

Mehta’s dismissal letter, especially the last two sentences, is an unwitting illustration of Westhues’s definition. Its intensity, inflammatory language and length are unlike anything I’ve seen in a firing. Perhaps it’s the way academe does these things.

I asked Westhues if he thought Mehta was a victim of mobbing. He was aware of the dispute, but he takes on only three or four cases a year and wouldn’t offer an opinion without first studying every scrap of relevant information.

He did, however, direct me to the many resources on his website.

One is a list of 10 conditions that increase a professor’s vulnerability to mobbing in academe. I’ve highlighted the five that apply to Mehta:

• Foreign birth and upbringing, especially as signalled by a foreign accent;

Being different from most colleagues in an elemental way (by sex, for instance, sexual orientation, skin color, ethnicity, class origin, or credentials);

Belonging to a discipline with ambiguous standards and objectives, especially those (like music or literature) most affected by postmodern scholarship; Based on a Google search, Mehta’s discipline, psychology, is at least affected by postmodern scholarship.

• Working under a dean or other administrator in whom, as Nietzsche put it, “the impulse to punish is powerful”;

An actual or contrived financial crunch in one’s academic unit (according to an African proverb, when the watering hole gets smaller, the animals get meaner). I can’t find any indication that Mehta’s department is having financial problems, but the university is. See CBC, $10.5M bailout for Acadia helps avoid ‘more difficult decisions’.

Having opposed the candidate who ends up winning appointment as one’s dean or chair (thereby looking stupid, wicked, or crazy in the latter’s eyes); From Mehta’s  Facebook Page: “In the early part of 2017, Acadia University was searching for its next President. On March 27, I submitted the concerns that I had with Dr. Ricketts being the next President of Acadia University in a letter that I submitted to the Presidential Search Committee.  … Dr. Ricketts became the President of Acadia University.”

• Being a ratebuster, achieving so much success in teaching or research that colleagues’ envy is aroused;

Publicly dissenting from politically correct ideas (meaning those held sacred by campus elites); Here’s some media boilerplate, courtesy of The Canadian Press: “The associate professor of psychology has been outspoken on a range of contentious issues. He has come under fire for saying multiculturalism is a scam, there’s no wage gap between men and women, and the Truth and Reconciliation Commission has created a victim narrative.”

• Defending a pariah in campus politics or the larger cultural arena;

• Blowing the whistle on or even having knowledge of serious wrongdoing by locally powerful workmates.

I told Westhues that Mehta seemed to be digging in his heels, or “doubling down,” on the issues that were causing him so much trouble. I asked if his seemingly irrational reaction could be the result of stress. His response surprised me: “Generally, a mobbing target is best advised to dig in heels and go for broke.”

Westhues said that once a mob has formed against a target, any sort of apology he or she may offer is likely to be misconstrued as an admission of serious wrongdoing or dismissed as insincere.

Mobbing can extend outside an academic institution (which is self-evident to people who’ve been following the Mehta story) and become “virtual mobbing.” Westhues cites a “very hostile” petition aginst Mehta as an example of that.

I’ve not studied the petition in detail,” he writes, “but I have done so in the case of similar petitions and learned that many, even most of the signers know little or nothing about the facts of the case, just add their names as a means of what’s called now ‘virtue signalling,’ the conspicuous declaration of values they hold dear.”

Indeed, the very first signatory has no apparent association with Mehta: “… I honestly would boycott any classes with him if I still went there … ” (Emphasis added.)

If you read on you’ll find plenty more signatories who demonstrate no association with Mehta, but say some nasty things.

So, should we be pro- or anti-Mehta?

The answer is: we should be anti-mobbing.

Managers of all kinds looking for help with that could start with the Waterloo Anti-mobbing Instruments. And then look around Westhues’s website.

It might just keep you from falling down a rabbit hole.

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Bad environment = bad economy

Intern proves planet always survives,

economy not so much

Surrounded by fire, wind and floods, world leaders are stepping up talk of balancing the economy and the environment. Ordinary people talk about “saving the planet.”

To learn more about the science behind these ideas, Turpin Labs has honoured another intern — Bob — with an opportunity to take the controls of our Time Machine Mark II XL. While we regret the difficulties experienced by our first pilot-intern, whose name I forget, she will always be in our hearts. That said, we have high hopes of recovering Bob because he is protected by a new safety device unique to the Mark II.

We will never rest until Bob and his predecessor are returned safe and sound, while pointing out that both interns did say they had “better things to than fetch coffee”.

Below is Bob’s report. Please note he found spokespeople for both the environment and the planet, something rarely accomplished by today’s lazy reporters. — Bill Turpin, CEO


439 million years ago

Environmental conditions: crazy low sea-levels, humongous sheets of ice destroying  everything in their paths, making it almost impossible for anything to grow.
Economy: down by 100% as 86% of species have been wiped out. Although trilobites are among the survivors, Beloved CEO, they lack the innovation and drive the economy’s needs.
Environmental spokesperson: “It’s all good. We’re working with the Planet to press the reset button and see what happens next. Should be interesting.”
Planet: “I’ve been a planet for four billion years or so. I’m not going anywhere.”
Trilobites: “We don’t see a problem.”

364 million years ago

Environmental conditions: There’s almost no oxygen in oceans and volcanic ash on land is causing outrageous cooling.
Economy: With 74% of species wiped out, the economy has shrunk by 99%. Reefs are taking a beating, completely destroying sales of handmade jewelry on beaches. On the bright side, the slaughter appears to be opening an evolutionary door for human existence.
Environmental spokesperson: “We’re low on oxygen, but so what? We’ll just press the reset button again.”
Planetary spokesman: “I agree completely with the environment. Whatever it does is fine with me. Can’t say I’m sorry to see the trilobites go — not much of a contribution there, really.”
Trilobites: Did not return calls.

251 million years ago

Environmental conditions: Unbelievable global warming, apparently set off by a huge volcano. This is no place to be unless you’re in a time machine.
Economy: Well, 96% of all species have been wiped out, what do YOU think, Bill, er, Beloved CEO?
… [Static. Loss of signal …]
Planetary spokesperson: “I feel good, always do. I see humans are still on timeline. They should more interesting than trilobites. Anyway, time to press the ol’ reset button.”

Between 199 and 214 million years ago

Environmental conditions: Bill, there’s been a helluva an asteroid collision, but not enough to blow up the planet. It’s clear things are looking up for the arrival of dinosaurs, but mammals are losing ground … [Static. Loss of signal.]

65 million years ago

Environmental conditions: This is the big one, Beloved CEO, the one everybody loves to read about. Volcanoes, asteroids, climate change. It’s obvious that after a 135 million year reign, dinosaurs are on the way out, along with 76% of all life on Earth.
Economy: Prospects are not as bad as you might think. With dinosaurs off the board, this is a big, big break for humans and sharks. If humans step up like we know they can, we should be rocking the economy in 65 million years or so.
Environmental spokesperson: “Whoa! Did you SEE the explosion when that asteroid hit? Hoo-WEE! … What? No .. no worries .. we’re good here, man.”
Planetary spokesperson: “I gotta admit, we felt that one. Still, we held together and we’re in top shape again. Just orbiting and spinning. Love it.”
Dinosaur spokesperson: “We’ve banned marijuana-smoking in public places, so we don’t expect any further problems.”

Now

Environmental conditions: So-called scientists think we have climate change again, that humans are causing it and that it’s too late to stop it. However, we don’t have consensus. Also, some believe non-human species are becoming extinct at 100 to 1,000 times the normal rate. But really, Bill, can you really take a number like that seriously? And humans are doing great!
Economy: Fantastic! Just fantastic! We haven’t seen an economy like this for 65 million years. Coral reefs are under pressure again, but beach sales of jewelry are through the roof!
Environmental spokesperson: “No question we’re running hot. How are YOU doing, that’s the real question. I mean, your kind are done like dinner. You can’t SEE that?”
Planetary spokesperson: “We see another big-time extinction coming on, but we’re optimistic that intelligent life will finally emerge in the next 50 million years or so.”
Human spokesperson: “Halifax has banned public smoking of tobacco and marijuana. That should tale care of any problems.”

… [Static. Loss of signal …  ]

Anyway, Beloved Leader, this much is clear: you can do anything you want to the environment and it will always be there. But you can’t say the same for the economy. You mess with the environment, you mess with the economy.

Gotta go. Two big destroyer-class time machines have shown up. The “Exxon Memory Hole” and the “Trump Narcissistic Liar.” They’re turning my way. Infallible Leader, did you ever install those shields you talked about? I mean, because if you forgot …

[Loss of signal.]

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Call 1-800-LIBEL

Legal advice for ex-prof Rick Mehta


Two scary libel lawyers recommended


Acadia should put up or pay up

 

I’M GLAD I’M NOT A LAWYER because, if I were, I could not write this: Rick Mehta should sue Acadia University for defamation, big-time.

Acadia says it based its decision to fire Mehta on a report it commissioned from Wayne MacKay, professor emeritus at Dalhousie University’s Schulich School of Law and a hardy  media favourite.

Rick Mehta
Rick Mehta: Looks like a nice guy

But they won’t release his report and won’t even let Mehta have a copy unless (according to him) he agrees to keep it to himself. To me, this lowers Mehta’s reputation in the mind of a reasonable citizen, which is a good place to start a defamation suit. Put another way, in the absence of more information, we have no choice but to conclude that he’s a bad guy, which I don’t think is true.

A. WAYNE MACKAY, CM, QC
Wayne MacKay, investigator

One way to settle matters is a defamation trial.

I recommend lawyers Dale Dunlop (902-423-8121) or Nancy Rubin (902-420-3337). The mention of either name in this context will stop a boardroom conversation cold and liquify the bowels of the directors.

I believed academic freedom and tenure were meant to make universities a safe haven for unorthodox thought. But a tenured associate professor has been fired by his university. What has this man done? How can we decide who’s right?

Here’s the media boilerplate, courtesy of The Canadian Press: “The associate professor of psychology has been outspoken on a range of contentious issues. He has come under fire for saying multiculturalism is a scam, there’s no wage gap between men and women, and the Truth and Reconciliation Commission has created a victim narrative.”

Dr. Peter J. Ricketts, President, Vice Chancellor
Dr. Peter J. Ricketts, President, Vice Chancellor, Acadia, did the firing

To my point about safe havens: try posting those ideas on Facebook or Twitter and see how long you keep your job. Ideally, none of us should face that dilemma, but we do. And now even academics are learning not to speak freely, so who do we turn to–unemployed bloggers and Russian fake news sites? (In some cases they’re probably one and the same. Ahem.)

CBC quotes a letter from Heather Hemming, Acadia’s vice-president academic, sent to Mehta by way of explaining the decision to hire MacKay, the investigator:

Dr. Heather Hemming Vice-President, Academic
Heather Hemming, Acadia’s vice-president academic

“These concerns relate to the manner in which you are expressing views that you are alleged to be advancing or supporting and, in some instances, time that you are spending on these issues in the classroom,” she said in a letter on Feb. 13. “The university has a legal responsibility to provide an environment free from discrimination, sexual harassment and personal harassment.”

The university has an obligation to explain in detail what it means by that last sentence not only to Mehta, but also to the mere citizens who pay a substantial portion of Acadia’s bills.

But the university has locked MacKay’s report in a vault somewhere, which makes Mehta’s life even harder because it forces us to speculate on what he’s done. Nothing good will come of that. It certainly will not help his employment prospects.

Acadia has to back up its allegations or compensate Mehta for egregious  defamation.

Ipso facto duodenum, your honour.

Postscript: Mehta has a long FaceBook post on his problems here. Look for a post dated September 9.

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Doc shortage September update

September chart
The past nine months show an almost linear growth of Nova Scotians wanting, but unable to find, a family physician. The current rate is 6.2 per cent of the population, up from 4.6 per cent in January. It represents another 14,753 people looking for a doctor for a total of 56,630. On the other hand, NSHA does its calculation based on the number of people who have registered with its Need a Family Practice Registry. It’s possible greater awareness of the registry is driving the numbers up. As usual, metro Halifax represents about half the problem.
Source: Need a Family Practice Registry Monthly Report – September 2018

Steady increase since January


56,630 now seeking doctors


Two key players depart


Is good policy to blame?

TWO OF THE key players in the Nova Scotia Health Authority’s physician recruitment efforts have left the building in the past few days.

No doubt the alarming record of the past nine months is part of the reason (see chart above).

The health authority bases its numbers of the count of doctor-less people signed on to its Need a Family Practice Registry, something it strongly encourages. This makes sense because it’s realistic — you can be sure someone who’s taken the trouble to register truly needs a doctor. By contrast, surveys will count people who shouldn’t be counted: those who don’t want a family doctor but still, truthfully, say “no” when asked if they have one. That could be why Statistics Canada always reports a higher number than NSHA.

Put another way, the steady increase in the number of people needing doctors may be a reflection of a steady increase in awareness of the registration service. Can this be an example of sound  policy being bad office politics?

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Massive scoop!

Electoral boundaries commission proposes four restored seats


Three Acadian ridings back on the map


One for Preston


Two more for HRM


I know — it’s complicated

Electoral boundaries map
Proposed riding map. Right-click for higher-res download.

 

We don’t get many “scoops” at Turpin Labs. In fact, some of our detractors insist we’ve never had a single one, apparently forgetting the time we sent an unpaid intern into the future to see how weed laws will affect Haligonians.

And so I was asleep at the switch Tuesday evening during a consultation held at Acadia Hall in Lower Sackville by the Electoral Boundaries Commission. (Note to peninsular Haligonians: Sackville, aka Bagtown, is a thriving settlement that, remarkably, is part of neither Bedford nor Dartmouth and YOU CAN GET THERE BY BUS!)

I attended because I knew the committee was required by law to disclose its draft boundaries in advance of its first consultation, if only by five minutes.  There were no apparent news-hacks in the room (two of the six attendees were MLAs of some kind), but I assumed some hack somewhere would telephone commission chair Colin Dodds later to “catch up on the story”.

But as of 10:00 p.m. Wednesday there was nothing, so Turpin Labs is THE FIRST TO TELL YOU the commission’s draft proposal is to restore four new seats to the Legislative Assembly.

Three “Acadian” seats would be resurrected: Clare, Argyle and Richmond. All were vaporized by the NDP in 2012. Preston, too, would return. These changes are in response to complaints from Acadians and African Nova Scotians.

HRM could get two more seats, but your correspondent dropped the ball on the explanation, figuring the so-called mainstream media would have filled in the blanks by Wednesday morning. Moreover, my days of calling sources late at night are long gone. My bad.

Unbelievers, I can feel you out there. So you can find the commission’s handout here.

And that, lamestream media, is how Turpin Labs handles a “scoop”. Failing New York Times: I write this more in sorrow than in glee.

-30-

August no-doctor stats

Patients needing doctors since Jan1
Chart shows a steadily growing number of Nova Scotians who want but can’t find a family doctor. Halifax continues to represent about half the problem. See http://www.nshealth.ca/files/need-family-practice-registry-monthly-report-august-2018

We’re still losing ground to the physician shortage,

HRM still watching from the sidelines

On the one hand, the Nova Scotia Health Authority’s latest stats on patients without doctors are nothing new — just another increase of a few per cent from the previous month.

On the other hand, it’s like compound interest on credit card debt. Everything seems OK until one day you’re in too deep. And so we’ve gone from 41,877 people needing a family doctor in January to 54,915 today. That’s six per cent of the population. By way of perspective, most of us would be thrilled with a six per cent return on our savings. In pre-election polls, six per cent can mean a lock on victory.

But the bad news doesn’t seem to be for lack of effort from government, which has brought in two new programs since January and made an important improvement to a third.

On the face of it, we seem to have our act together.

  • Since February, NS Immigration has operated a “physician stream” under the provincial immigrant nominee program.
  • In April, the Department of Health and Wellness launched the Patient Attachment Incentive Trust. It offers physicians a one-time incentive of $150 per head to take on additional patients. The trust brought 7,536 people in from the cold since it began in April. That’s a clear success. (But, alas, during that same period the net tally of people seeking doctors grew by 9,360.)
  • DHW continues to offer tuition relief, bursaries, debt assistance and a site-visit program. And these incentives now put Halifax on an equal footing with the rest of the province.
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  • Area in red is “Metro Halifax”

All this makes it easier for recruiters working for the health authority and the IWK Health Centre. Let’s hope the effort starts paying off.

While we’re discussing effort, I note Metro Halifax (see map) consistently represents half of the provincial shortage, so it would be nice to see HRM contribute. Queens has an attractive website aimed at physician recruitment. Why not Halifax?

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Just do it!

Behave like Dave

Halifax Council, Annapolis Group directors:

will you leave a legacy behind or just empty chairs?

A long time ago I accompanied some staff from Nova Scotia Environment on a two-day trip in the Tobeatic Wilderness Area in southwesternNova Scotia. Our job was to check out a derelict cabin before demolition in the winter. We canoed, portaged, camped, and visited an island covered with lush old-growth forest. suit imageA satellite phone was our only link with civilization. “Dave”, one of our guides, cooked gourmet meals in a single frying pan (everything tastes great when you’re camping).

Dave’s job sometimes required him to spend weeks at a time alone in the forest and he loved it. I asked if he was concerned that someday he might be too infirm to go into protected areas, where ATV and wheelchair access is banned.

“No. I’ll be happy knowing that partly because of the work I’m doing, wild places will always be available to people’s children and grandchildren,” he said.

I trained my bullshit meter on him but there was no reading. Dave meant what he said. He could think beyond his own self-interest.

In late 2007, ’round about the same time Dave and I had our conversation, NSE announced it would convert more than 3,000 acres of Crown land between Highway 103 and the Bicentennial Highway, adjacent to the Bayers Lake Business Park, into a protected wilderness area like the Tobeatic.

There would be places there where you could neither see nor hear the city. And you and your backpack could reach the trail heads by public transit.

Even better, as the new release somewhat naively put it:

Blue Mountain-Birch Cove Lakes Wilderness Area will complement Halifax Regional Municipality’s regional planning strategy, which includes creating a large park in that region.

“I’m very pleased with the province’s collaborative approach and support for HRM’s regional plan,” said Mayor Peter Kelly. “This will help us move forward with HRM’s plans for a regional park in the area.”

This was genius. The city would create a municipal park of about 1,350 acres that would be the necessary protective buffer around the wilderness area. But, being a municipal park, it would also provide a near-wilderness experience for people who don’t or can’t hike into the back country. In other words if  —  perish the thought — Dave found himself in a wheelchair someday, he and others could still enjoy a semi-wild area.

Many believe the project, if completed, would be the largest urban wilderness area in North America. Perhaps, but the real value is that this patch of paradise would be available to Haligonians and their neighbours no matter how big the city grows. Think of Calgary’s (smaller) Nose Hill park, which is 11 square kilometres of high plains, replete with wildlife and cheek by jowl with 12 communities.

Blue Mountain-Birch Coves Lakes Wilderness Area is a legacy project. If our descendants are going to have it, then key people have to raise their gaze and think bigger. Like Dave.

Sadly, 11 years later, park proponents have learned just how slowly municipal government can move. The province fulfilled its promise but successive city councils, apparently dazzled by the power and glory of the developers who own much of the needed parkland, couldn’t come to grips with their task.

By way of background, ownership is not the last word on what happens to a piece of land. For example, the city can “buy” your land at fair market value to widen a road. Usually, the landowner and city are able to negotiate a deal, which is what Halifax has been trying to do with landowners around the wilderness area. The last resort is expropriation, which forces a sale at the fair market value.  It’s based on the idea of the greater good, which is why the province expropriated land for the Maritime Link power line.

So far, city staff have made one purchase — 80 hectares by Hobsons lake in January — from West Bedford Holdings.

That might have inspired other owners to sell but for one thing: a $120 million lawsuit by Annapolis Group, a private company with long history in Nova Scotia. It owns critical portions of the land the city needs and, ironically, claims the land is being effectively expropriated by the delaying in negotiating purchases.

The city says Annapolis “… acquired the majority of its lands in the area prior to 2006 in speculation of potential future serviced urban development. The Plaintiff acquired additional lands in 2014 from Armco Capital and the Sisters of Charity with the same intention.” (Emphasis added.)

Speculation is a common practice: you buy land at a low price and wait for the day it’s worth a lot more, e.g., when cities like Halifax expand.

The land in question is currently assessed at under $2 million, one-sixtieth of what Annapolis is suing for.

In response, the city says it is acting well within its rights. (And it still has the right to expropriate.)

Of course, both parties to this suit have to prove their cases in court, but that’s a problem. City staff have to round up at least 8,000 pages of documents demanded by Annapolis. At the last appearance in Supreme Court, the city was represented by outside counsel, which is expensive. This puts enormous pressure on city hall’s officials and councillors to give up or pay an outrageous price.

But why are we going through this? Do company directors cease being citizens once they’re behind boardroom doors? Maybe you can’t be a board member and my friend Dave at the same time.

Or, maybe you can accept the fact you speculated on some land and lost, which is part of being a developer. Then you can be a citizen for a moment and realize you are standing in the way of an historic project that will improve the lives of everybody in your community and their descendants — forever.

You can sit down with the city and negotiate a fair deal.

For the same reasons, if you’re a councillor, you can stop being afraid and direct staff to begin expropriation. The Utility and Review Board might have to adjudicate, but it’s a lot faster and cheaper than the court system. My guess is the two sides will quickly come to an agreement because, as the saying goes, nothing concentrates the mind like the prospect of a hanging.

Other landowners will follow suit and all concerned will be celebrated as legacy-builders.

Annapolis directors*: do the right thing and take your place in history.

Councillors**: grow a pair of ovaries and start the expropriation process. Leave a legacy when your council days are over instead of an empty chair.

*Annapolis directors: C. Robert Gillis, Director; David J. Hennigar, Director; Archibald Colin Hattie, Director; Jason A.O. Weston, Asst. Secretary; Murugesu Sooriyakumaran, VP-Planning & Engineering; April Greencorn, CFO & Corp. Secretary; Archibald Colin Hattie, President; David J. Hennigar, Chairman; Michael Laycock, VP – Development.

**Councillors: Steve Streatch, District 1; David Hendsbee, District 2; Bill Karsten, District 3; Lorelei Nicoll, District 4; Sam Austin, District 5; Tony Mancini, District 6; Waye Mason, District 7; Lindell Smith, District 8; Shawn Cleary, District 9; Russell Walker, District 10; Steve Adams, District 11; Richard Zurawski,  District 12; Matt Whitman, District 13; Lisa Blackburn, District 14; Steve Craig, District 15; Tim Outhit, District 16, Bedford; Mike Savage, Mayor.

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Downloads:

Amended Notice of Defence of HRM filed Apr 5, 2017 re Annapolis

ANNAPOLIS V HRM Amended Notice of Action filed March 22, 2017 re Annapolis

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