The Nova Scotia Health Authority is disputing a claim that bureaucracy is slowing down plans to help with the physician shortage.
Mary Jane Hampton, a health consultant, made the allegations on the CBC's Information Morning.
"I think that the huge elephant in the room here is that the health authority, which is responsible for managing delivery of health care, doesn't seem, for whatever reason, to be able to make the decisions or implement the plans that everyone is crying for," said Hampton.
"It becomes really problematic when the people who have the least amount of content knowledge seem to have the most amount of decision-making power."
The Health Department holds the purse, so it must approve changes requested by the health authority.
For example, the health authority is waiting for a response on a recent pitch that could help people with chronic illnesses who have no family doctor.
Janet Knox, the head of the Nova Scotia Health Authority, says there is no reason for the public to be worried.
"We are working very hard together."
She says growing pains from the amalgamation of the province's health boards mean change is happening slower than some may wish.
"Are we doing things fast enough? I would say I would like the pace to be picked up," she said.
Knox says some important changes have been made since amalgamation, with full support from everyone involved.
"One example would be access to MRIs in this province. We had wait-lists that were where they shouldn't be. We were able to move resources around, move best practices around and reduce the wait time by 12 per cent."
She also points to the increased number of knee and hip surgeries as a success story.
Knox says over the years, there have been times when the department has asked for changes to the health authority's plans.
"Would I say that I always agreed with everything? Likely not. Have I ever been asked to do something I could not do? Not yet."
Health Department responds
No one from the Health Department was available for an interview on Friday, but a spokesperson sent a statement to CBC News.
"Everyone agrees that changes are required in the health-care system for the benefit of patients and providers, and that transition is taking place and continue over time," the statement said.
"The Department of Health and Wellness is responsible for setting health system policy direction and ensuring accountability for funding and system performance."
Hampton says it's time to shift the model.
"We need to get the decision-making as close to the front line as we possibly can."