It’s clear that Cape Bretoners aren’t getting access to the health care they need. As the population ages, innovative solutions will be necessary to deliver health services. Replacing old hospitals with smaller clinics may help ensure that.

The Nova Scotia government’s decision to replace the Northside General Hospital and New Waterford Consolidated Hospital with clinics and long-term care facilities, and expanded emergency rooms in Sydney and Glace Bay, will not score easy political points. No one rejoices in closing hospitals.

But if it improves access to health services with a lower price tag, saving money and improving access to health care for years to come, then the premier should be commended.

The devil is in the details. Taxpayers will have to vigilantly watch to ensure that decisions are made transparently and money is actually saved. But there’s potential for significant cost savings.

There’s an old public policy rule: you can’t save the world if you can’t pay the rent.

As the number of seniors in Nova Scotia outpaces the number of children, the need for health services is increasing as the tax base shrinks.

The emergency rooms at the Northside and New Waterford hospitals are crowded, but for the wrong reasons. They’re understaffed and employ open-and-closing hours, though emergencies can happen at any time. Many hospitals in Nova Scotia are grappling with the same issue, and it’s a serious problem.

Wait times are painfully long, partially because emergency rooms are being used as walk-in clinics. The Nova Scotia Health Authority noted in 2016 that about half of all patients using emergency rooms didn’t actually have a medical emergency, and in Cape Breton it was particularly common.

Clinics for prescriptions and doctor visits would be more efficient and cheaper to run, while freeing up emergency room space for people who actually need it.

Four hospitals for Cape Breton County simply isn’t necessary.

The Regional hospital in Sydney is only 20 minutes away from both the Northside and New Waterford hospitals. Glace Bay Hospital is only 25 minutes away from Sydney, and even closer to New Waterford patients.

The population in all of Cape Breton County is only around 98,000. Since the Cape Breton Regional Hospital was opened in 1995, the population has declined by over 16 per cent.

Budgets are tight and choices have to be made. The government should explore repurposing the existing facilities. That’s just due diligence. But if the overall cost isn’t reduced, the government is setting future generations up for dramatic service cuts down the road.

Closing hospitals is not an unprecedented nor a party-specific decision. It’s been done in other provinces by NDP and PC governments as well. In the 1990s, Saskatchewan had a hefty debt load to tackle. Then-NDP Premier Roy Romanow closed 52 rural hospitals.

Saskatchewan taxpayers no doubt felt the impact in the short term, but over the longer term they reduced the debt and enjoy good health services today. They also enjoy the fact that their kids can find work in their home province.

A little pain can make for long term gain.

The major problem with Nova Scotia health care is that doctors are desperately needed. One of the obvious reasons why doctors (and other professionals) aren’t choosing to start their practices and raise their families in Nova Scotia is the high taxes. The top marginal income tax rate is the highest in the country.

Reducing unnecessary spending means the government can – and should – hire more doctors and more easily lower taxes to retain them.

And hopefully, this decision actually improves services in Cape Breton.

Taxpayers shouldn’t applaud the decision quite yet. The McNeil government has yet to release the cost details. But if costs are reduced in the long-term, and care is improved and made more efficient, then this is good news for Cape Bretoners.

Paige MacPherson is Atlantic Director of the Canadian Taxpayers Federation, a non-profit, non-partisan citizens advocacy group dedicated to lower taxes, less waste and accountable government.