Health care is becoming a major battleground in this election campaign with both the Liberals and the Progressive Conservatives promising radical cuts by eliminating regional health authorities.
The New Democrats say that would create chaos and drive health-care workers out of the province. They've released an ad targeting the Liberal plan:
The ad claims, "The last Liberal government closed 1,600 hospital beds and drove 1,000 nurses out of nursing" and that a "giant centralized health bureaucracy that will cause chaos for patients, drive away nurses and close beds."
Health-care unions have echoed the New Democratic Party's claims, prompting the Liberals to take out large newspaper ads promising their plan will free up more money for frontline health-care workers.
So what's on the table?
The Liberals propose going from 10 to two boards: one provincial board with four management zones and one for the IWK Health Centre. They say they will cut 103 executives for a savings of about $13 million a year.
The Progressive Conservatives propose going down to three boards: one for Halifax, one for the rest of Nova Scotia and one for the IWK Health Centre. They say the mergers will cut $17 million and they promise another $43 million in savings by implementing recommendations from an independent audit done for the government by Ernst & Young.
It's hard to say if those will be real savings, but we can look at a couple of real life examples for some background — the most recent case was in Alberta, where nine regional health boards were replaced with one.
According to data gathered by the Canadian Institute for Health Information, when Alberta had nine boards it was spending between 3.6 per cent and 3.7 per cent of its health budget on administration costs.
In 2009 — when Alberta went to one "superboard" — those costs ballooned to 4.33 per cent, primarily due to severance packages and pension payouts to the executives who lost their jobs. In 2010, costs went down, but last year they rose again to 3.65 per cent — basically at the same level as when they had nine boards.
It hasn't been all smooth sailing in Alberta. The province fired the man they brought in to establish the superboard, unhappy with his handling of an ER crisis. Last summer, it fired the entire board in a dispute over bonuses paid to administrators.
We can also look to the experience in New Brunswick. In September 2008, New Brunswick cut the number of its health boards from eight to two. At first administrative costs declined, but again, now they're back to the levels of spending before it eliminated all but two of its boards.
Nova Scotia's situation
For its part, the New Democratic Party is promising to keep all 10 health authorities in Nova Scotia and said it has already cut administrative costs by centralizing some services. The numbers seem to support that.
Before the NDP took power, administrative costs were well over 6 per cent of the overall health budget. That's now down to 4.83 per cent but that's still above the national average of 4.7 per cent.
The party has promised it will cut administrative costs even further, getting it down to 4 per cent by 2017. But for now, that's just a promise.