Fragility of Healthcare

As an aging consumer of health services, reliability and accessibility of care become more essential for me and paramount for anyone considering residence alternatives. Professionally, I have devoted energy examining the health field. For twenty-years I have recruited healthcare professionals in multiple provinces and worked in both the private and public sector to deploy solutions. From both perspectives – there is an unsettling fragility of systems across the globe.

Health is the cornerstone of every politician’s triumvirate of electoral issues, along with education and infrastructure. But only health approaches half of all public expenditures, at a growing rate.? It can be a politicians dream when successes avail to celebrate or exodus inducing when the complexity becomes overwhelming.

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We can celebrate recent successes, but the unintended consequences of even minor tinkering of a fragile system reverberates in magnitude. The merits of opening a medical school are bulletproof defensible; but stripping resources from a delicate system too rapidly does result in irreparable fissures. Shuffling leadership or boards, building infrastructure, or collapsing the population can appear progressive, but knowledge loss, financial cost or economic consequence is impairing.

Redistribution of key resources and raised remuneration is an attempted tactic, but the remnants post deployment tends to leave gaps in places that cannot sustain the deficiency.

?Poorly planned policy can stress longstanding crucial regional relationships and our small modestly resourced province requires regional expertise as supports for services that all Islanders appreciate as failsafe.?

Over the course of the coming weeks, the Business Edge will examine our delivery of care and comment on three key areas: present operations, resourcing and human capital, financing and affordability, and strategies for future consideration.

For context healthcare investment has historically been growing between five to eight per cent per annum; more recently growing at over fourteen per cent. In the 2024-2025 budget, it represented approximately 34 per cent of all spending on a deficit of $85 million. A very unsustainable trajectory!

I have questioned politicians over myopic strategies, when what the province needs is a multidecade sustainable vision. Unfortunately, voters are not tolerant beyond the immediate, and politicians demand instant gratification.? Based on regional and international experience we are absolutely creating long-term challenge for our province, when we don’t need to compromise our sustainability or reliability of care access.

In coming articles, we will explore affordability in a rising medical and medication cost environment, reallocation of people in a small system and the challenges of promotions absent experience, imbalance of administration versus frontline capacity, how medical consumerism permeates healthcare, unavoidable evolution of privatization and impacts, leveraging artificial ‘general’ intelligence, and a move to remote diagnostics.

Health delivery on our Island requires courageous decisions need to be implemented, and courage is not born of financially burdening future generations. Islanders need to reflect if we are standing on the cusp of health assentation, or starring bleakly on the edge of an abyss.

There is a fragility to institutions we have taken for granted. Mettle is required to make difficult decisions and ensure the sustainability and the system. There are solutions, and some difficult choices. The system needs to be triaged.