JANET KNOX: Health-care bureaucracy hardly bloated

Janet Knox, president and CEO of the Nova Scotia Health Authority. - Ryan Taplin

Re: Ralph Surette’s Aug. 24 column, “N.S. needs to upchuck health bureaucracy hairball.” We, like Mr. Surette, have seen the numbers recently circulated by Paula Minnikin and republished in media. Unfortunately, no journalists have contacted us to fact-check any of the figures. But we have looked at the numbers internally:

In terms of administrative expenses, the common measure is the Canadian Institute for Health Information indicator on administrative expenses (administrative expenses as a proportion of all expenses), which shows our ratio (4.8) as slightly higher than national average (4.3), but behind Ontario’s. None of our analysis has been able to reproduce data to support the claim that Nova Scotians “pay 35 per cent more than the Canadian average on health-care administration.”
Our organizational structure includes five levels of management on average, not “10 to 14.”
The average number of employees reporting to a direct supervisor is 29, not 3.25.
Two-thirds of those employees whose compensation is $100,000 or greater are in direct clinical roles.
The number of employees in that category is higher this year as a result of the one-time service awards granted to the public sector in lieu of retirement allowances at the time of retirement.
The salaries and other compensation including overtime for unionized employees are set out in collective agreements. For executive, management and other non-union employees, salary scales are approved by government and are primarily the same as those that existed prior to the NSHA coming into being.
The only changes to these scales have been the government-approved economic increases. Individual management roles are assessed using Hay evaluation and placed within those salary scales.
Nova Scotia’s auditor general has in fact audited NSHA’s books. Our most recent audited (by the OAG) financial statements are available here and were presented at a well-attended public meeting in Truro in July.

There remains much to do and we are committed to making improvements. There is also a lot of great work happening, and we are seeing progress. Our organizational mission is to achieve excellence in health, healing and learning through working together.

Part of working together includes ensuring Nova Scotians are well and accurately informed in order to help understand and influence the evolution of the health system. Circulation of inaccurate information is not helpful in improving dialogue and understanding around health care in Nova Scotia.

Janet Knox is president and CEO, Nova Scotia Health Authority.