Nurse Practioner-Ralph Surette

The Chronicle Herald

OPINION


Saturday; Dec. 5, 2009

Blowup over a sacked nurse: the fallout

THE CASE of the terrni-
nated Digby Neck nurse
practitioner, Karen Snid-
er, and a popular near-
insurgency to have her rein-
stated is providing Health Min-
ister Maureen MacDonald with
her first real test out in the
open.
MacDonald has taken an
arm's-length approach - trying
to resolve the issue by bringing
the two sides together. So far it
has failed, and MacDonald is
loath to get more deeply in-
volved in what amounts to a
local "contract issue."
But it's more than a contract
issue. It's sending out cracks in
all directions. If there's no
adequate resolution to it, it's
primarily MacDonald whose
reputation will take tire hit and
at a very unfortunate time -
the beginning of the public part
of her ministry, so to speak, as
the honeymoon ends and ques-
tions arise as to where the
troubled vessel of health care is
heading. If she can't fix this, as
somebody said, the perception
will be: What can she fix?
And because the South West
district health authority


RALPH SURETTE

(SWDHA) has been overboard
on this - going as far as to
want Snider to sign a public
apology as a condition of nego-
tiations for her reinstatement
- the impression has been
reinforced, rightly or wrongly
and far beyond Digby Neck,
that the injured majesty of
bureaucrats is more important
than health care for the people.
It wouldn't be so bad if this
was an isolated episode. But it
evokes a broader medical-bu-
reaucratic culture that has
evolved as the health care cri-
sis worsened - uptight admin-
istrators, and overworked doc-
tors and nurses often in dread
of the system they work for,
sometimes with good reason.
You may remember, among
other episodes, the two QEII
doctors who had their medical


licences suspended for years
for what turned out to be frivo-
lous and arbitrary bureaucratic
reasons.
Digby Neck residents are
saying Snider was terminated
because she spoke out in a
community newsletter about
needing more clerical support.
The SWDHA says there are
other reasons that can't be
stated for legal and confiden-
tiality reasons. These other
reasons probably involve some
kind of implacable personality
clash. Nevertheless, even if
there really are reasons to sack
her, one thing must be under-
stood from the minister on
down: The health authorities
won't be believed by a suspi-
cious public as long as the
allegations remain secret.
Thus, here's my advice: If
she's not going to be reinstated
and the authorities stick to
their "other reasons," there
should be an investigation by
an independent third party to
tell the public that these "other
reasons" are substantial
enough to justify her dismissal.

In fact, says SWDHA spokes-
man Fraser Mooney, the auth-



ority itself has asked for such
an independent arbitrator. It
also has had its own third par-
ty, he says. A lawyer from
Boyne, Clark "reviewed all the
private and confidential facts
in the case and found South
West Health's decision was fair,
reasonable and unbiased."
Mooney also says the SWDHA
urged Snider to avail herself of
the union grievance process,
but she didn't.
But the issue is bigger. While
this arbitrator is at work, he or
she could also investigate the
functionality of the SWDHA, as
a starting point for a checkup
on all nine district health auth-
orities in the province. Wheth-
er they work well or not,
whether they should be re-
formed, whether their citizen
health boards help or hinder
are questions very much alive
in many expert minds.
Some provinces - notably
Alberta and New Brunswick -
have already moved to reduce
and re-jig their regional auth-
orities.
In Nova Scotia, they were set
up in the present configuration
during the John Savage govern-


ment in the mid-1990s with the
stated purpose of getting local
people involved in adminis-
tering health care, and in the
hope that this would ease the
gathering crisis. Instead, they
appear to have merely insulat-
ed the minister and head office
generally from local crises,
which can be blamed on local
managers - which some critics
have always said was their true
purpose.
This question is very much
in play in the Digby Neck case:
How much "arm's-length"
should a minister have in her
own department?
Meanwhile, the SWDHA has
a "robust campaign" going "to
recruit a full-time nurse practi-
tioner to serve the people of
Long and Brier Island," says
Mooney. And "we are working
to secure as much coverage as
possible at the health clinic,
and we hope to make an
announcement about this very
soon."
Good luck.

Ralph Surette is a veteran freelance
journalist living in Yarmouth County.
(rsurette@herald.caJ