The waiting list for primary care in Nova Scotia exceeds 148,000

FFifteen percent of Nova Scotia residents are officially waiting for a primary care physician or nurse specialist — the highest number the province has seen since Nova Scotia Health opened its doors. Need a GP register in 2018. As of June 1, 2023, there are 148,431 people on the county primary care waiting list. That’s an increase of more than 3,400 since last month, and a jump of 53,500 from this time a year ago.

“We know there’s a lot more to do,” said Michelle Thompson, Nova Scotia’s Secretary of Health and Welfare said in a statement earlier in June, adding that the province has “a plan” to solve Nova Scotia’s primary care shortage and is “implementing it.”

And while the Nova Scotia government says its physician recruiting efforts are “starts to see results,” the new head of the association representing Nova Scotia’s approximately 3,500 doctors, residents and medical students says burnout remains a concern for those working across the healthcare system — and that resolving work-balance issues and personal life in a new collective agreement will be key in sustaining the province’s talent gap.

Waiting list according to the numbers

From the start of his premiership campaign, Tim Houston vowed to fix a county health care system he described as suffering “years of neglect.” At the time of his election in August 2021, Nova Scotia’s primary care waiting list was just over 75,000 – or about 7.5% of the province’s then 992,000 residents. Emergency services were available throughout the province seeing a wave of patients amid a third wave of COVID-19. Houston pledged $430 million in his party’s first year in power to give the county’s health care system a chance. It propelled his Nova Scotia PC Party to majority rule.

However, change is coming slowly. Nova Scotia’s primary care waiting list has nearly doubled since August 2021. As of June 13, 2023, Nova Scotia’s acute care units had a capacity of 96.3% – with some units work with a capacity of no less than 130% to 140%. A February review of wait times for walk-in clinics across the country found Nova Scotians waited 39 minutes longer to see a doctor in 2022 than the year before.

In response, Houston presented the latest facet of its health care plans in April. The prime minister introduced a period of four years Action for health plan to “transform” the county’s tottering health care system, promising better public reporting, faster emergency care, progress on waiting lists, and “accountability at every level.” (To date, the county’s public reporting has failed to deliver on its promises.)

“The message we’ve heard time and time again is clear,” Houston said in a press release at the time. “Change is needed to provide Nova Scotians with better health and better healthcare and to support and respect the people who work in the system.”

About one in seven people living in HRM is on the provincial waiting list for a general practitioner or practice nurse.

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As of June, waiting lists in Nova Scotia have increased across the board. Each of the 14 so-called regional “networks” that track county health authorities saw an increase in primary care waiting lists compared to a month ago. Nowhere was that more important than in HRM, where a net of 1,951 Haligonians joined the list of those awaiting a GP or nurse specialist. Today, that list has grown to more than 66,300 Haligonians, or about one in seven people living in the HRM.

Across the province, the story looks much the same: From May 1 to June 1, 2023, Nova Scotia Health says it matched 1,795 people with a primary care provider, but another 5,222 people joined the Need a Family Practice Registry of the province. In short, for every patient that the province managed to match with a clinic, almost three people were added.

“Lots to do,” says Health Minister

The county is hiring more doctors – the problem is it just hasn’t happened fast enough. From April 2022 to March 2023, Nova Scotia Health and IWK Health collectively hired 168 physicians. During the same period, 82 doctors left the province, retired or closed their practices.

“We know there’s still a lot to do, but our hard work is starting to pay off,” said Health Secretary Thompson, himself a former nurse. said in May.

The province has last year reduce red tape for U.S. licensed physicians to practice in Nova Scotia and made it easier for physicians from other maritime provinces to practice without further licensing issues. The province has also recruited medical students in Ireland and the Caribbean who may have ties to Nova Scotia or an interest in practicing in the province.

Doctors, province is working on a new contract

If there is any change in Nova Scotia’s primary care system, it could very well start with a new contract between Nova Scotia Health and the province’s physicians. Doctors all over Nova Scotia have been work without a contract since April. The last collective agreement between the province and Doctors Nova Scotia – the bargaining unit representing Nova Scotia’s approximately 3,500 doctors, residents and medical students – expired on March 31, 2023.

Although talks about a new deal have been “very positive”, according to Dr. Colin Audain, the new president of Doctors Nova Scotia, still worries. Burnout remains a problem.

Speaking to The Coast on the phone, Audain says the county’s healthcare system was “stretched to its limits” before COVID-19 — and the pandemic led to the early retirement of some nurses and doctors who might otherwise have continued to work.

“We don’t really have the same pool of nurses or doctors or other health professionals in general that we’re used to,” Audain tells The Coast. “So it means everyone is working a little bit harder — and that doesn’t help the burnout.”

Work-life balance is a central part of negotiations with the province, Audain says, along with bringing compensation in line with the rest of Canada. a 2019 Canadian Institute for Health Information report found that Nova Scotia’s family physicians earned one of the lowest gross earnings of any province or territory — and $55,000 less than the national average.

“That doesn’t necessarily mean it has to be competitive with Alberta or Ontario,” Audain says, “but if you fall too far behind, it becomes difficult to keep people in the province.”