A Nova Scotia woman who has spent years trying to access health care outside of the province says a new report by the auditor general only scratches the surface of the number of people who actually need help.
Laura Johnston of Mount Uniacke has lymphedema, a condition that causes painful swelling in one of her arms, but there are no specialists who can treat it in Nova Scotia.
She’s in chronic pain and has to wear a compression sleeve around the clock. Johnston also gets her arm drained as often as she can afford it, but each treatment costs $136.80.
Johnston, 42, has a documented trail of emails sent to the Health Department and MSI, the administrator of Nova Scotia’s out-of-province health-care program.
In the emails, she begs to be sent to a specialist out of province who can treat her condition. But both MSI and the department repeatedly ask for a referral from a local specialist, despite none existing.
“Why does it have to be so hard? Why do I have to be my own researcher, my own case manager, my own advocate?” Johnston asked.
Johnston also connected with Jennifer Brady, an advocate with the same condition who took the province to court.
When Brady finally had her surgery in 2025, Johnston felt confident the path forward would be smooth. Instead, she was told again that she had to find a local specialist.
“It just hit a wall where I had to step back a bit and take care of myself and my sanity to begin the fight again,” she said.
This week, Auditor General Kim Adair released her investigation into the program, and flagged the loophole as a key issue that needs to be fixed.
Adair suggested the province create a special pathway for patients who need care for conditions that have no specialist in Nova Scotia. She specifically mentioned one anonymous patient who continued to struggle to get help because of the catch-22.
Johnston, who participated in the investigation, believes she is the patient referenced. She said it was validating that someone finally listened.
“I do need care and I do deserve care just like everybody else that has a condition or a disability,” she said, adding that she’s cautiously optimistic she’ll finally be sent to see a specialist.
“It gives me the a glimmer of light at the end of the tunnel. It doesn’t light the tunnel up.”
In a four-year period, Adair found 125 patients who applied for care out of the province but were denied. Some of them appealed. The number represented seven per cent of the total number of claims.
But Johnston said that doesn’t paint the full picture. She couldn’t even submit her application for out-of-province care because she was missing the referral.
She said she’s now part of an advocacy group where she has connected with dozens of other Nova Scotians who are in the same boat.
“I think there’s a lot of people … that just throw their hands up.”
Dr. Rod Wilson, the NDP health critic, agrees that there are many more people who have been blocked from accessing care out of province.
“I would suggest it is underreported because the burden is on the individual and that takes a lot of time and effort and if you’re sick and need care, you may just not have the time.”
Michelle Thompson, the health minister, said the department won’t be creating a specific pathway for these cases.
Instead, she said the program now has a general practitioner and a surgeon working as consultants to help with the referral piece.
“When we don’t have that expertise within the province, we’ll seek someone with that understanding, it could be virtual,” Thompson said of the changes underway.
The department has accepted all eight of the recommendations in the auditor general’s report.
While it said it will take two years to revamp the program, Thompson is confident they can get the work done in a year.
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