Keep it public was the warning from the Canadian Health Coalition at the recent Council of the Federation gathering in Charlottetown, and it must be heard in Nova Scotia. As premiers met in P.E.I., health-care advocates called on them to reject two-tier medicine and strengthen public care rather than cut it back or hand more of it to private interests.
That warning is especially urgent because Alberta is moving in the opposite direction. Alberta’s Bill 11, the *Health Statutes Amendment Act, 2025 (No. 2)*, establishes a “dual practice” model that allows physicians to work in the public system while also providing private-pay medically necessary care. It opens the door for patients with money or private insurance to buy faster access to services that should be available according to need.
The Alberta government claims this approach will provide choice and reduce waiting lists. But the concern, voiced by doctors, health advocates and legal experts, is straightforward: the same limited pool of surgeons, nurses, anesthesiologists and other professionals will be pulled toward private practice. That leaves fewer people available to treat patients in the public system, where everyone else must wait.
Nova Scotia must not follow Alberta’s lead. Our province is already moving down the road of privatization, not necessarily through direct patient fees in every case, but through an expanding reliance on private delivery, private financing and for-profit operators within services that should be publicly planned, delivered and accountable.
We all know the system needs improvement. That too many people lack a family doctor or nurse practitioner. That our emergency departments face closures and long waits. We know our health workers are exhausted. That seniors struggle to obtain home care, long-term care and timely treatment. These failures are real. They demand urgent action. We know that privatization is not the answer; it's more costly, non-accountable and generally not better.
More Nova Scotians need to understand that the current regime is already funding private facilities for some elective and outpatient procedures, including surgery at Dartmouth’s Scotia Surgery as well as dental and cataract care in private clinics. The provincial government has said it is considering a greater role for private clinics to address surgical backlogs. That approach risks shifting professionals and resources away from public hospitals and community-based care.
The QEII Halifax Infirmary expansion is also being delivered through a public-private partnership, a design-build-finance-maintain agreement valued at $7.4 billion over construction and a 30-year operating period. In Nova Scotia, our long-term care is a mix of providers, including private and chain-operated nursing homes.
These are not isolated choices. Together, they point toward a health system in which public money increasingly supports private operators while public capacity remains under pressure. Nova Scotia has faced this question before.
In October 2003, then-NDP Opposition Leader Darrell Dexter introduced Bill 36, the proposed *Medicare Protection Act*. It would have entrenched non-profit delivery, universal and accessible care, and public consultation before insured services could be removed from coverage. The Progressive Conservative government never called it for further debate, and it died on the order paper.
The Houston government should revive the spirit of Bill 36: invest in public hospitals, primary care, home care and long-term care; support and retain health workers; enforce protections against extra billing; and reject Alberta-style two-tier medicine.
Health care must be based on need, not wealth. Nova Scotia should challenge privatization and avoid the slippery slope of Alberta’s dangerous experiment.
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These are my opinions written to get you thinking about what actually matters in this province. Fairness. Accountability. Who gets helped and who gets left out. Agree with me or don’t. But let’s have a respectful conversation.