New president and CEO of health authority has ties to Dalhousie University

The next president and CEO of the Nova Scotia Health Authority is a Dalhousie University-educated doctor who grew up in Sydney River, N.S., and has spent the last seven years running health authorities in British Columbia and Ontario.

The health authority announced Friday that Dr. Brendan Carr will assume the organization's top role. The first day of his five-year contract is Dec. 16.

In a telephone interview, Carr said he's excited to come back to the province he calls home.

"I see a lot of positives in the system in Nova Scotia," he said.

"There's a lot of ingenuity, a lot of passion and compassion and I'm just very excited to be part of the team again."

'It takes a lot of work'

Carr's family moved from Ontario to Sydney River when he was 12. They moved to Dartmouth when he was in high school.

He graduated from Dalhousie's medical school and also received his MBA from the Halifax-based university.

After his residency he worked as an emergency room doctor in Halifax, served as vice-president of medicine at the former Capital District Health Authority and as an assistant professor in emergency medicine at Dal from 2007-12.

He then moved to B.C., where he was the CEO of the Vancouver Island Health Authority from 2013-17 and has since held the top job at William Osler Health System in Ontario, which serves Brampton, Etobicoke and the surrounding areas.

Carr said the challenges facing the system in Nova Scotia are similar to the challenges he's seen in B.C. and Ontario.

"The health system in Nova Scotia has been under a huge change in the last few years and a lot of what is playing out in Nova Scotia has played out in other provinces that have undertaken this kind of change," he said.

"That's not to say it's not real, but it's also not unexpected. It takes time for these systems to mature and it takes a lot of work from the many stakeholders in the system to get together and work it through."

Common challenges and bright spots

Long waits getting patients from emergency departments into the hospital, ambulance offload delays and challenges accessing primary care areproblems throughout the country, said Carr.

But despite the challenges in Nova Scotia, he also sees bright spots.

Nova Scotia is viewed as a leader in terms of the creation of collaborative family practice teams and the Inspire Program, which originated in Cape Breton and is now being expanded across the country to help treat chronic obstructive pulmonary disease, he said.

Ontario is just now starting to establish health teams, while Nova Scotia already has 70 in place.

Frank van Schaayk, the health authority board chair, said Carr stood out in the interview process because of his experience and his "pragmatic, practical view" on health care in this province.

"He had done his homework," van Schaayk said in an interview.

"He knows the issues in Nova Scotia, he knows the challenges and he knows the advantages of Nova Scotia."

Tapping into local knowledge

"What you look for is someone who has experience in the areas that are relevant to the challenges in Nova Scotia and he had those and he was managing a health authority in British Columbia, which looks a lot like Nova Scotia, quite frankly a large urban centre and then lots of rural," said van Schaayk.

One of the challenges he confronted in B.C. was concerns about too many decisions being centralized, and as he did there, Carr said he has views on how to address those concerns here in Nova Scotia.

A system that's organized to meet the needs of people needs to be organized in a way that meets people's needs where they live, said Carr.

"That means taking advantage of whatever local services and assets and relationships exist. You can't be effective at trying to make that work from a meeting room in Halifax," he said.

Plans and priorities

In a system the size of Nova Scotia's, there is a balance that can be achieved so that everyone is working toward the same priorities while also allowing things "to be driven by a lot of local conditions and local understanding," said Carr.

Van Schaayk said it wasn't the top priority to find a candidate with ties to Nova Scotia, but he said Carr's familiarity with the province and the challenges it faces is an asset. Being a doctor should also help build relationships, said van Schaayk.

While priorities will be set after Carr starts work, van Schaayk said the focus will continue to be on lowering wait times in emergency departments and operating rooms and expanding access to primary care and long-term care. Carr said he also hopes to see improvements in how patient information is shared among providers so patients aren't constantly having to repeat their histories.

Carr becomes the organization's second full-time president and CEO, following Janet Knox, who retired at the end of August. Health-care consultant Janet Davidson is serving as interim CEO until Carr steps in.

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