(Originally published in "Outlook 2014" - January 2014 issue of the Nova Scotia Business Journal)

This new year may usher in major changes to Nova Scotia’s healthcare system, according to Leo Glavine, Nova Scotia minister of Health and Wellness.

“We are looking at going back to having one board and four zones instead of the current nine districts that are in place,” says Glavine. 

The proposed changes are said to resemble what was in place before premier John Hamm changed the system to consist of nine districts about 10 years ago. At the time, the changes were made with the hope of improving the healthcare system that was in place.

“We have been doing a lot of research and consultation in a wide range of health delivery areas over a long period of time,” says Glavine. “The standards and quality of care are much more efficient and effective with the proposed four zone approach.”

One of the groups being consulted is Capital Health. Chris Power, president and CEO of Capital Health, says there is a group of 10 people  which has been working on a similar concept for years.

“The minister has been very thoughtful in consulting us and all the boards for ways to move in the right direction.”

Under the current nine district approach if a patient is referred for a surgery or other medical procedure only the hospitals in his or her district are considered. This can result in long wait times in one district while others have openings. With the new system, patients will be offered other options throughout the province.

“It is definitely a positive move,” says Power. “However, a merger like this takes up to two years to take place. In that time there will be a lot of unsettling as the proposed changes will see the loss of about 133 administrative staff.”

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Although Power is thrilled to see the changes, she hopes that the government is not just looking at the financial aspect in considering the job cuts.

“We have a lot of talent in our administrative staff, I am worried that this could result in skilled workers leaving the province.”

The president of CUPE Nova Scotia, Danny Cavanagh, says he believes the McNeil government should move very cautiously with any kind of health care amalgamations.

“The downsizing of administration that was already taking place with the previous government was working. That was a good thing. It saved money and should continue,” says Cavanagh.

CUPE acute care coordinator Wayne Thomas, who bargains on behalf of more than 3,700 hospital workers in Nova Scotia, argues the health authority merger model hasn’t been shown to work in terms of cost savings.

“Data from the Canadian Institute of Health Information suggests that health authority mergers in other provinces did not result in administrative savings,” says Thomas. “In fact, in Alberta, after they moved to a superboard model their administrative costs actually went up.”

Thomas says Nova Scotia’s health care system, as it is now, shows potential. He believes the cuts in administration were a positive step in terms of savings and that certain initiatives that have been undertaken should carry on.

“We need to continue with the highly-successful Collaborative Emergency Centres model that's now being copied by other provinces, as well as bulk buying which has also lowered costs and increased services to the public.”