The Progressive Conservative party says it has a proven track record of improving health care but the NDP rejects that, with its leader saying the province’s health system is a "mess" that requires an external review to get to the bottom of what ails it.

At an election forum in St. John's Tuesday, the Liberals came somewhere down the middle. They’re calling for a less comprehensive review and are accusing the PCs of acting too slowly.

Progressive Conservative candidate Jerome Kennedy, Liberal Leader Kevin Alyward and NDP Leader Lorraine Michael debated health care at meeting held by the Newfoundland and Labrador Nurses' Union.

Union president Debbie Forward said health care has not received the attention it deserves in the Oct. 11 election campaign.

"Health care is the No. 1 priority of the people of this province and registered nurses feel this way too," Forward said.

All three parties agreed the health care system must be improved but they didn’t agree on how to do it.

"We would do an complete, external review of our health care system because we really believe there are major problems in the system," said Michael.

Kennedy, who has been the province’s health minister since Oct. 2009, doesn’t buy it.

He said an external review would inevitably lead to recommendations that rural services should be cut.

"There was an external review done in 2004 and if we had followed the recommendations at that time then there would be no rural health care left," said Kennedy.

"I really don’t know why Ms. Michael believes a review today would be any different … They’ll try to streamline and create efficiencies," he said. "I can predict that that’s what will happen with a review and that’s not somewhere where we’re willing to go because we are not willing to downgrade services in the rural parts of the province."

Michael called on Kennedy to be more open-minded about an external review.

"I think the minister is not recognizing that we have many systemic problems. I think that he is second-guessing what a review would find," said Michael.

"I think the minister is denying the fact that we do have a mess and when I say that it’s not my word people inside the health care system are continually saying to me: our health care system is a mess," Michael said.

PCs call for piecemeal approach

Kennedy said the province is tackling problems as they arise. He said the province has had some success recruiting doctors and nurses since signing new contracts that left both groups with hefty pay raises.

"Nurses in this province are now the highest paid east of Ontario," said Kennedy, who also said the province’s doctor recruitment strategy is working too.

Like the NDP, Alyward is calling for a review but his party wants one with a narrower focus. The Liberals's platform promises the party will "review the governance" of regional health boards, and will "implement reforms to clarify and improve the roles of these boards."

Alyward is promising to the Liberals will work more quickly than the PCs.

"We’ll get at the issues instead of letting them fester," he said.

No support for privatization

The Progressive Conservatives and the NDP have very similar positions on publicly-funded health care.

"Our commitment is to the delivery of publicly funded, universally-available health care without user fees, as outlined in the Canada Health Act," said Kennedy.

The province spends more on health care than any other sector. It spent almost $2.9 billion or 38.5 per cent of all provincial spending on health care in 2010-2011.

Michael said maybe it’s time to consider spending an even larger part of all public dollars on health care.

"I know there are people concerned about how much money goes into health care but you know what? The slice of the pie doesn’t change – it hasn’t really changed – it might be that the slice of the pie has to change," said Michael.

The Liberals opened the door to privatization, if only a crack.

"Our party supports [a] publicly funded health care system. Yes, there are opportunities there for some private services but that would only be an adjunct to our public system," said Alyward.