Newfoundland and Labrador's health minister is distancing himself from provocative comments by his deputy, saying John Abbott is "one voice of many" in the debate over health care.
"At the end of the day it is the elected officials, myself, cabinet, premier and caucus who will make government policy," John Haggie told Crosstalk host Cecil Haire during an appearance on the show Monday.
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But Haggie acknowledged "we need to change the way we're doing business" in a system that is costing the already strained provincial treasury just under $3 billion a year.
'At the end of the day it is the elected officials, myself, cabinet, premier and caucus who will make government policy.' - John Haggie
He then listed some of the same statistics highlighted by Abbott that sets this province's health system apart from the rest of the country.
"We have in this province 46 per cent more RNs [registered nurses] per capita than the Canadian national average. We also actually are the second-highest in terms of physicians, for example, per capita. Similarly LPNs [licensed practical nurses] — we're around 50 per cent more than the national average," he said.
Trying to lower the temperature
But, unlike Abbott, Haggie was vague on what needs to be done.
"The challenge there is what does that mean? And how does that tie in to getting the best quality health care we can have?" he added.
Haggie is trying to lower the temperature in a province divided over how best to heal an expensive — 25 per cent higher than the Canadian average — and some would argue ineffectual health-care system.
The deputy minister of health, John Abbott, added fuel to the fire last week after granting a rare interview and offering his views on the issue.
Abbott suggested, among other things. that the province has too many nurses and doctors, and is financing some services and facilities that are no longer affordable.
Abbott added that there may be opportunities to replace some RNs with LPNs, which have less training and are paid less.
They were some eye-opening comments from the top health bureaucrat in the province, and they unsurprisingly drew a strong reaction from Debbie Forward, president of the union representing RNs, which has been campaigning for more nurses.
"Our members today are feeling like they've been slapped in the face by this government," Forward said in response to Abbott's comments.
Making changes in a 'sustainable' way
Abbott issued a statement Friday, apologizing for "any heightened concern" his comments may have caused.
Haggie said the intention is to change the health-care system in a "sustainable way" in order to achieve the goal of having a healthier population, providing better care for people, and getting the best value out of every tax dollar spent.
It's a monumental challenge, but Haggie said the political will is there to tackle the challenges.
'There is a desire around the table in cabinet and within caucus to figure out how we get from where we are now to where we want to go.' - John Haggie
"There is a desire around the table in cabinet and within caucus to figure out how we get from where we are now to where we want to go," he said.
"And the description of where we want to go is actually quite simply summed up, but very difficult to sometimes implement, which is the right care in the right place at the right time from the right people."
There's no magic solution, he said, adding that looking at recent history shows that throwing more money at health is not the answer.
Haggie said the health budget more than doubled over a 10-year timeframe, and the number of physicians also soared from fewer than 800 to nearly 1,200. He said similar increases were seen in the ranks of registered and licensed practical nurses.
Despite this, "we have not seen improvements in health-care outcomes," said Haggie.
He said the department has held the line on costs over the past three years, and he's encouraged by that.
"That fact alone speaks to a change in the machine," he said.