Fact checking – or “reality checks”- once features of election coverage by mainstream media, seem absent in the Nova Scotia campaign. So far, the only fact checking I’ve seen has been coming from the well-oiled Conservative campaign machine – including one on Monday challenging NDP claims about the scale of rent increases, another last week alleging a billion dollar hole in Liberal platform costing. 

I may get around to fact checking the fact checks, adding to those areas – for example immigration or carbon pricing – where I’ve already shown how PC political rhetoric and the facts diverge significantly. Now, as the campaign enters its final week, there is one other claim crying out for a reality check – Conservative assertions about the physician workforce.

The question of doctor numbers is important because the lack of primary care is a central issue of the campaign. The opposition parties have focused their criticism on the doubling of numbers on the Need A Family Practice Registry. And as reported here recent estimates from the Canadian institute for Health Information (CIHI) indicate that the number of Nova Scotians without a primary care attachment is likely even higher than the 145,000 on the Registry.

The PC leader has tried to counter criticism by pointing to a number of initiatives planned or underway while claiming that since 2021 his government has added 265 net new doctors, a figure that also appears in the party’s short 12-page platform and is the basis of the “More doctors” billboard pledge. 

A slightly different calculation appears in another document recently issued by the government. More Care Faster, controversially mailed to all households at public expense a few days before the writ was dropped, makes a different claim – “nearly 300 more doctors (71 family doctors and 209 specialists).” The word net is absent, indicating that perhaps some departures were factored in to produce the 265 net new doctors since 2021 claimed in the the platform. 

To put that 265 number in perspective, it would represent an increase of 9.7 percent since 2021, according to data released last month by CIHI. So the question is, if Nova Scotia has all these new doctors (nurse practitioners are mentioned only in passing in “More Care Faster”) why are there still so many people without access to primary care? 

The first point that should be made is that when physician numbers are being used as a measure of access, population numbers also need to be taken into account. Between the end of September 2021 and now the population of Nova Scotia has increased by almost 80,000, an increase of about eight percent. But with the number of physicians increasing by 9.7 percent, we are at least keeping ahead of the increase in demand that could result from the larger population. So maybe we can look forward to those wait lists continuing to decline?  

Perhaps, but there are flies in the ointment. According to the More Care Faster booklet, only one-quarter of the “nearly 300” (actually 280 if you add 71 and 209) doctors added since September 2021 are family doctors, an increase of only 5.2 percent based on CIHI figures, well below the eight percent increase in population. So the government’s own statistics provide further evidence for assertions about how population growth is leading to deterioration of primary care access under the PCs. And the picture could be even worse. 

The government has provided no evidence to support the claim that the province has added 265 net new physicians since September 2021. CIHI data covering 2021 to 2023 casts some doubt on those PC assertions.

  • In 2021 there was an increase of 17 physicians from the year previous. Prorating for the four-plus months the PCs were in power would credit them with five net new physicians;
  • In 2022 there was an increase of 22 physicians, according to CIHI;
  • In 2023 there was an increase  of one (1), bringing the overall total increase to the end of 2023 to only 28.

With only 28 added to the end of 2023, getting to 265 net new doctors since September, 2021, means that in the first ten months of 2024, there has been a net gain of 237 doctors. Such an increase would be unprecedented. The closest Nova Scotia has come to that rate of increase in the recent past was a net gain of 161physicians for all of 2018. One would think that in an election year the addition of a record-breaking number of doctors would be trumpeted loudly as evidence of the PC’s health care fix. That hasn’t happened.

CIHI receives its data from provincial health authorities, but the apparent discrepancy between its reporting and the Houston government’s claims suggests that something may have been lost in the transmission. That’s one possibility, among others, leaving Nova Scotians to chose from three big doors, like In the TV show The Price is Right.

  • Door #1- CIHI data for 2021- 2023 is inaccurate; 
  • Door #2 -there has been an unprecedented increase in net physician numbers in Nova Scotia in 2024; 
  • Door #3 -the government is fixing the numbers to hide its failure to fix health care.

Given Houston’s casual approach to the facts on issues like carbon pricing, asylum seekers and fixed election dates I’m inclined to choose Door #3.

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