Examining the key health-care issues in Nova Scotia's election

As is often the case in Nova Scotia elections, health care is looming large in this campaign.

There are differences among the proposals from all parties, but there are also three common themes: access to primary care, how to improve long-term care, and putting a greater emphasis on supporting mental health and addiction services.

With that in mind, here's what some people connected to the sectors think of what they're hearing.

Primary care

The parties all agree the province needs more doctors, nurses and other primary care supports, but the differences emerge in what they each believe is required and how they intend to go about it.

Dr. Chadwick Williams, a gastroenterologist in Dartmouth, said the factors a doctor might consider as they determine where to go can include a variety of things, but they commonly include the quality of the work site, compensation and the level of communication among staff and people in decision-making positions.

"Sometimes the folks who are making the decisions and making policy aren't necessarily in touch with what's actually happening when it comes down to a level of providing patient care, and that can be a big problem when there's a lack of communication there," he said in an interview.

Nova Scotia Nurses' Union president Janet Hazelton is also pleased to see the three major parties talking about getting more nurses here and expanding training options, but she said those efforts need to go further.

• What the Greens say about health care
• What the Liberals say about health care
• What the NDP says about health care
• What the PCs say about health care

In particular, Hazelton wants to see more training seats for registered nurses to meet demand, and more nurse practitioners trained and integrated into the primary care system.

"It's not all about every Nova Scotian having a doctor," she said.

With the last 18 months being such a grind on health-care workers, Hazelton said it's vital that politicians hear the burnout concerns of nurses and othersand take steps to address them.

"They're on the front line, they're working hard and if they're telling us they're burning out because they're not getting time off, we need to find a solution for that or they're just going to leave," she said.

Williams, who isn't backing any particular party, said he's also pleased to see discussion about how tackling issues such as poverty, housing and food insecurity can affect health outcomes. Too often, he said, health care is treated as a separate issue as opposed to being interconnected with other challenges.

"I think that there's a lot to be said about those issues and how they are related to health care," said Williams.

"If we try to just address it by picking out little pieces here and there, like the little Jenga slide-out puzzle, I think we're going to fail by doing that. We have to kind of take a step back, look at bigger pieces that can be tackled and do it that way."

Long-term care

If there's a spot with the greatest distinction between plans for health care, this might be it.

The NDP is promising to build enough single beds by 2030 so that everyone who wants one would get it. The Progressive Conservatives are pledging 2,500 new beds and 2,000 new continuing care assistants and nurses to help staff them within three years. The Liberals, meanwhile, are focusing on promises to refurbish or replace existing facilities, while adding 500 new beds to the system.

Both the Tories and NDP are also on record as supporting an increase in the legislated number of hours of care per day residents receive.

Hazelton said that's a crucial changebecause people going into long-term care have higher needs than they did in the past.

Her concerns about staffing numbers for primary care extend to long-term care. It's another area she believes more nurse practitioners could be of use by providing primary care for residents who don't have a doctor.

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Gary MacLeod, president of Advocates for the Care of the Elderly (ACE), said he's pleased to hear the parties talking about opening more beds. But MacLeod alsosaid a looming increase in the number of seniors in the next 10 years means more needs to be done.

He's concerned the Liberal plan doesn't go nearly far enough and doesn't take into consideration the lack of investment in the sector in the eight years the party has been in power.

"The cuts that were experienced in the last eight years were the worst that I've seen since the ACE team has been doing advocacy for the elderly," he said.

MacLeod also wants better oversight for people in care and their protection. He'd like to see a third-party position created that would be arm's-length from the government and have the power to monitor resident treatment and take action when necessary.

Mental health

As with the other issues, the parties all agree on the need for greater mental health and addictions support, but they're approaching it in different ways.

Still, Marg Murray is just glad the issue is featuring so prominently in the campaign, with parties promising to add millions of dollars to the sector. Murray, co-manager of the Halifax-Dartmouth branch of the Canadian Mental Health Association, said it seems like after years of advocacy work trying to get more attention and funding, politicians are starting to listen.

Less than seven per cent of the province's total health budget is currently dedicated to mental health and addictions. The Tories and NDP have pledged to increase that to 10 per cent.

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Whatever party forms government, Murray said it will be important for them to engage with the sector before taking action to ensure the approach used is the best one possible. While she has hope for change, Murray said many people she's talked to are less confident.

"There's not a lot of faith that people will follow through on their promises," she said, adding that it's important for all parties to be aware of those doubts and find ways to address them.

Murray's organization and the Nova Scotia College of Social Workers will host a candidates' forum on mental health and substance use care on Monday.