Nova Scotia Health Authority CEO Janet Knox announces retirement

Janet Knox says she knew exactly what she was getting into the day she agreed to take on the top job at the newly created Nova Scotia Health Authority in 2014.

"I remember talking with my family and saying, 'I'm going to work 10 years in the next five.'"

That time is about to come to an end. Knox, the health authority's president and CEO, has informed the board she will retire at the end of the August. While that's a few months earlier than her contract allows, Knox said she knew it was time to go.

"It's a personal issue in terms of thinking about when you retire and it just feels right now," she said in a phone interview.

When the Liberal government merged the district health authorities following their election win in 2013, Knox, the head of the Annapolis Valley district health authority at the time, was tapped to oversee the new organization.

While that process has not been without challenges, Knox said she believes the biggest argument in favour of the move is being able to offer uniform quality and standards for services across the province.

"We need to pay attention to how we resource that and how we help citizens, residents access it, and I would say we are starting to reap the benefits of that."

Successes and challenges

Early successes she points to include improved orthopedic surgery wait times and access, more resources at local levels for mental-health care, reduced waits and improved access to home care, and more interest from doctors in collaborative primary care.

But some challenges, such as doctor recruitment and communication, have been more stubborn.

Knox acknowledged there have been problems with some communities feeling they weren't included in decision-making processes or that their voices weren't being heard on certain issues.

There's been a concerted effort in the last year to improve engagement, an effort that needs to continue, said Knox, pointing to the recent review of cancer services in Yarmouth as an example of how to do things right.

The biggest challenge, said Knox, is simply making changes within the health system, something she said isn't unique to Nova Scotia.

"We worry about taking away and we stay very focused on a hospital-based system, where we need to say that change is our contribution to responding to how our population's needs are changing and we need to support people where they live, where they work, in their community," she said.

Search process for successor has started

Frank van Schaayk, chair of the health authority board, said Knox took on a difficult job and did it with commitment and "a whole lot of grace."

"It's a tough file," he said. "She brought 40 years of experience to it and I admire that."

A subcommittee of the board is already beginning steps to find Knox's successor, said van Schaayk. An executive search firm will be hired and van Schaayk said the effort will consider national and international candidates as well as people within the organization.

Whereas much of Knox's focus was on getting the health authority up and running, van Schaayk said the focus of the next CEO will be on health-care delivery at all levels.

"This next phase is about getting really good at what we do," he said. "There's been a lot accomplished and there is yet a lot to do. There is no finish line to health care."

'An ongoing effort'

Knox's departure aside, the health authority has eight out of 63 senior leadership positions it needs to fill on a permanent basis, with seven currently filled temporarily and one — a new vice-president and chief of zone operations — soon to be filled. Van Schaayk said he didn't anticipate Knox's departure having an effect on the ability to fill vacancies.

Leading the health authority might be the most political job that doesn't involve an elected official in the province. But Knox has resisted being pulled into the fray during her tenure.

"I will not say that it is not hard sometimes to have discourse going around you that you would like to add a different perspective," she said.

But Knox said it's government's job to set policy and the job of her and her team to focus on achieving the goals laid out by the premier, health minister and Health Department officials.

"I would say you work within the parameters that you are given and then you just take it and push it home," she said.

"Helping people come to a common interest and a common vision, that takes time to do and that's an ongoing effort."