New Legislation Gives Communities Stronger Voice

New legislation introduced today by Health Minister Jamie Muir will give communities a stronger voice to improve local health care balanced with the accountability to support effective decisions and management throughout the system.

The Health Authorities Act will recognize, for the first time, the role of community health boards in legislation. The act will also legislate nine district health authorities with clear accountability both to their communities and to the Department of Health for the decisions they make and the money they spend.

"In a nutshell, the regional health board system had no clear connections linked to communities -- no clear accountabilities linked to the Department of Health," said the minister. "This legislation creates and cements these links."

Mr. Muir acknowledged existing community health boards have waited many years to receive the recognition they deserve.

"They are the ones who ensure that people of all ages, both young and old, have a say in their health care needs. This legislation will give community health boards the opportunity to make a significant contribution in promoting healthy communities."

Eight of the new district health authorities will be primarily responsible for smaller regions than the former regional health boards, with closer connections to the communities they serve, bringing decision-making closer to home. The smaller regions, coupled with mandated accountabilities, will help to keep costs under control. The ninth district health authority -- the Capital Health District Authority -- is based on the boundaries of the former Central Regional Health Board.

The district health authorities will be responsible for overseeing the delivery of health services. They will be required, unlike the former regional health boards, to include community health plans from community health boards as part of regional business planning. The district health authorities will be fully accountable for explaining their decisions on the community health plans through their business plan submissions to the Department of Health.

District health authorities will be governed by a volunteer board of directors. Under the proposed legislation, the Minister of Health will appoint two-thirds of the membership from nominees put forward by community health boards. The remaining one-third will be appointed by the Minister of Health.

"The community must be involved in the selection process to make district health authorities truly responsive and representative of the community's needs," said Mr. Muir.

The act increases emphasis on financial management and accountability, which responds to the auditor general's criticisms of the former system. The district health authorities must provide to the Minister of Health monthly and quarterly financial statements, and audited year-end financial statements. Deficit planning is not allowed, strict borrowing controls are in place, and mandatory recovery of deficits in one year is required.

District health authorities must also submit annual reports which will include progress on their business plans, to be tabled by the Health Minister in the legislature annually.

"Quite frankly, the fact that no clear accountability existed for business planning in the past was a major problem -- both in terms of health care results achieved and fiscal responsibility," Mr. Muir said. "This act fixes the problem."

A Capital Health District will be established that covers the same area as the former Central Regional Health Board. The same people will sit on the boards for the Nova Scotia Hospital, QEII Health Sciences Centre and the Capital District Board. However, they will remain separate entities with their own legislation.

The new approach to shared governance will facilitate the development of a joint health services business plan for the Capital Health District. The IWK Grace Health Centre, while retaining its current board, will be expected to participate in partnerships and joint business planning.

"The goal is simple," said Mr. Muir. "We want these hospitals to continue to deliver their specialized health services but there are clearly areas of administration where we can find savings, dollars that are better spent on patients."

The Cape Breton Regional Hospital, Glace Bay Healthcare System Corp., the New Waterford Consolidated Hospital Commission and the Northside Harbor View Hospital, which currently makes up the Cape Breton Health Care Complex, will become part of the district health authority for industrial Cape Breton and the surrounding area.

The Minister of Health's primary role is to provide leadership and strategic direction. For the first time, the minister will be required to review and approve health service business and other management plans by March 31 of each year.

The legislation introduced today is based in large part from feedback from the community health boards through a survey and a conference held in February of 2000.