One of the new members of the
Nova Scotia Legislative Assembly is Dr. Ronald Stewart elected in the 1992
provincial election and named Minister of Health in the Government of John
Savage. In this interview he discusses his career before entering politics and
his impressions of legislative life after one year. He was interviewed in
January 1994 by Bart Armstrong
How long you have been a
practising doctor and in what field of medicine?
I graduated from Dalhousie
University (Halifax) in 1970 and had intended from early in my training to go
into a family practice in what I thought was a remote area of the province. I
came from Cape Breton and I was interested in going back home. I wanted
something where you got to do a lot of things and the most remote area of the
province at the time in terms of a full fledged practice is the area north of
Cape Smoky, Neil Harbour, Cape North, Meat Cove, St. Paul Island, (all in the
area of the province's most northerly tip). I went there with the intention of
starting a general practice but soon switched to emergency medicine.
Did something prompt you to
I was heavily influenced during my
training at the Victoria General Hospital by professor Bob Scharf who was the
head of emergency medicine from 1968 to 1974. He was a marvellous man, a great
physician with a holistic approach to care. He was a teacher, a pinnacle of
teaching. He was interested in students and was constantly teaching. There was
not a minute that went by that he was not teaching us something and I often
thought I would like to be like him.
I also wanted an academic career, a
teaching career. In 1971 the field of emergency medicine was just getting
established as a full fledged academic department. Only one university in the
world, the University of Southern California was offering training. USC was
quite a distance from Neil Harbour but I did not care. I applied and got the
position in August 1971.
Something else influenced me to
study emergency medicine. About 8 months earlier I was in a bad car accident. I
received a major head
injury and ended up in Victoria
General as a patient. I had lost my ability to speak. While it slowly came back
I came to respect the area of trauma medicine. I had seen it first hand from
the other side of the blanket. I thought I could make a contribution.
I understand at one time you served
as a health consultant to Bill Clinton.
That has been much overblown. In
fact I was chairman of a committee established as part of the overall study of
health reform in the United States. I was involved in only a very minor role,
and our report was submitted a few months before the Nova Scotia election in
We were asked to look at one phase
of ambulatory care, the measurement of training standards with regards to
emergency care. But with the exception of a few calls now and then to touch
base, my involvement is really over.
In Nova Scotia we have now taken a
much broader look at the issue. We have realised that only about 15 or 20 of
every 100 ambulance calls involve true emergencies where you have to get J . n
there and pump or whatever. But what happens to the other 80 percent of the
calls, the worried-well and the walking wounded? In the past we tended to think
of them as an inconvenience in terms of emergencies. We have now come to
realise that they are the majority of our calls and as such we need to look at
how to train to deal with these people as well.
What made you decide to enter
I did not one day suddenly see the
light from heaven but over time I developed a growing interest in health care
systems. As a "doc" I had been trained in the disease oriented
approach to health care issues. In the last several years however, I came to
the realisation there were areas in the system that we needed to change. W~
needed to look at our approach in terms of community ownership. I thought I had
really something to contribute. I had been away from the province for some time
and felt that I really had sort of abandoned it. I love Nova Scotia and Cape
Breton Island and so I began to look for a way to make a contribution. I was
willing to give five years of my life to public service and had to think of a
way to do this. But the question was how. To make changes in health care I
decided I would have to get personally involved. Then it hit me. I would have
to get involved in politics in order to make the changes I thought were needed.
But we have always been a private family, involved in a small way in our
community but never in a big way. But my private life soon changed in a big way
and that is one of the most difficult things to face.
I think a political life ought to end
in five years. This is a very seductive pursuit you know. You tend to believe
that only you can do it. But that is not true. I think I learned that within my
first 6 months. Politicians all have to learn this lesson in our own way.
During the election you were
made an Officer of the Order of Canada. That must have been a boost to your
Not really. The election to the
Order occurs some 6 to 12 months before you are notified. I learned that my
name was being considered around November of 1992 but did not learn of the
results until near the end of April 1993.
When I got a letter from Rideau
Hall I was surprised. I did not know anyone there so I did not immediately open
it up. I was so busy with the provincial election that it ended up just sitting
on the table for a few days. Then my mother reminded me it was there so I
finally opened it up about 11 o'clock one night. I was so tired at the time but
quickly realised what it was. My mother and sister started crying. I did not
cry but I was so thrilled it was indescribable. It was such a wonderful thing.
But the toughest thing was that I could not tell anyone. Politicians, while
serving are not suppose to receive the Order. I got it before the election and
it could have helped my campaign. It was so hard not to tell anyone but if I
did I knew I would risk losing it.
Not long ago, the people of Nova
Scotia broke new political ground in Canada. They used telephone voting to
select their new leader, a man who became Premier in the following provincial
election. What are your thoughts on this technology?
Oh, it was a disaster to begin
with. I stood in the phone lines to vote for about three hours. When it failed
we cancelled it but tried again three weeks later.
I was in Europe at the time so I
had to vote from there. We had this emergency medicine convention at a retreat
in Norway. People were there from all over the world and I was there advising
them on some emergency medical issues. We were in a 13th century Abby off the
coast. It was a wonderful place but there was only one phone on the whole
island. I used it to call home for the results after the first and second
ballots. By9 o'clock that night when the final ballot came in we were having
our banquet dinner. The people did not know anything about Nova Scotia politics
but they all knew my man was John Savage. When the results were announced they
all stood up to applaud and cheer.
It had not been announced by the
party yet but I think that we will see it used again at leadership elections
and maybe even at general elections. The British Columbia Liberals used a
similar approach to elect Gordon Campbell.
In December you finished your
first session in the Legislature. What is your impression of how it works?
It was rough. There is no school to
go to although we went to be ethically cleansed at St. Mary's University. We
had an ethical session and a couple of sessions on what to do and what not to
do in the House about how to bow to everything that did not move. But as for
the day to day operation of the Legislature we were told we had to learn on the
job. I had envisaged the House as the work place of the government where you
got all the work done. But of course it is not. It is theatre. It is the
ultimate protection for the people because you cannot hide too much from an
opposition that is going to dig up everything they can. That is good, they
should do it', even though they get it wrong. Wrong because of the slant or the
One of the difficulties I had was
in law amendments (a committee of the legislature) realising that the
suggestions from the opposition were often quite reasonable so we adopted them.
That apparently was a new tact. Not only do you get briefs submitted that have
some good points but the opposition comes in and tells us that some of the
stuff we do is ridiculous and sometimes they are right. Who cares who gets the
credit, we have got 41 seats in a majority government. The people will not
remember who said what, just what bills finally get passed.
When you sit in the Legislature you
think that it is reality but it is not. The reality is out there, it is out on
the street. A legislature is also terribly inefficient and it can be very
boring and painful, particularly for a rookie. But it is wonderfully protective
for the public. That is its reason for being.
Are there any reforms you would
like to see in the Nova Scotia Legislature?
I would take the estimates out of
the Legislature and put them into a committee where you can hack at them in a
reasoned way with some logic and stop the grandstanding we now see from all
sides of the House. (Annually the estimates are debated with the resulting
authorisation for department expenditures).
During this year's estimates I was
asked health care questions and took hours to speak about my favourite
subjects. When you get asked a question it is your ticket to go on at great
length. And if you so wish, it is also your ticket to waste time and prevent
others an opportunity, to be heard.
The opposition must have thought I
was boring, but it was my turn to talk. You do not really accomplish very much.
Better scrutiny could be obtained by having these debates moved elsewhere. All
parties should have more time to examine the estimates before they speak.
Currently, neither the opposition or even the ministers have the time to fully
get to know the material found in these documents even though they deal with
their own departments.
You get situations now where
someone asks a question- You have your staff up in the public gallery, and you
have to instantly remember those semaphore signals from your boyscout days.
That is ridiculous, it should be changed. The first thing I would do is get the
estimates out of there.
As a government minister I would
also love them to cancel question period once in a while too. It would be like
giving you a day off school. But I doubt that will ever happen.
How has being a doctor affected
your duties as Health Minister for Nova Scotia?
By being a doctor, I have a head
start. I understand the language. When someone says something I understand what
they are really saying, what is behind their words. I think that is a big plus.
I cannot imagine sitting as the Minister of Finance, for example, if I cannot
even balance my own cheque book, and understanding things like what capital is
and so on.
In this era we have so many health
issues and a lay person, not being a doctor would have just too many problems
understanding them. Not being able to speak the language would be a real
There are also drawbacks to being a
doctor. One of these is that physicians are not trained to manage. Many
ministers come to the job thinking that part of the role involves the
management of the department, Not so. My role is not to manage, but to
understand the issues, to represent the broad range of views on these issues,
to distil them into policy and then to make sure that the policy created is
carried out The methods by which that is done is best left to the managerial
staff, the deputies and their divisional chiefs.
How has the role of a politician
affected your personal life?
I sometimes think I no longer have
a personal life! I came into this open minded, but I am used to an environment
where students are always around. My speciality is emergency medicine, and this
is not planned. When it happens you have to be there. You do not have scheduled
hours. But medicine was nothing like this. This is constant. There are
compensations though. We have exciting talks and can see that as a result of
our actions things will be happening. You get the satisfaction of knowing you
have made a difference.
But as far as a personal life goes,
you lose a lot of that. It is not a great loss to me but you know I would like
to have the time when I can walkabout and do my private business without
everyone knowing who I am and stopping to talk to me. If I walk into Zellers
today five people will say I know you, you are that person I saw on TV last
night." It happens everywhere I go. It is very difficult. I have never
been in that situation before. Sometimes I would just like to go about my
business. You have to consider every thing you do and if there is any c6nce it
could be misinterpreted. But the real sacrifices you have to make are balanced
by, the fact that you made the decision, and you learn to adjust. You must
believe that what you are doing is valuable. You cannot whine about it when you
know you are getting good pay for what you do.
I have a great staff, people who
believe in me. They work hard. They have become my friends and I owe it to them
to get on with the job. You must believe in yourself. Politics is not dirty. It
is the interaction of people. It is the formation of policy that we all need to
govern ourselves. The alternatives are not very attractive.