Kyla sits down with Dr. Michelle Pavloff, a registered nurse and researcher at the University of Saskatchewan, to talk about how she built a mental health network for Saskatchewan farmers and ranchers almost entirely from the ground up. Michelle's path started in a rural emergency room, where she was often the only nurse in the building, and where she began to notice that farm culture — distinct from both rural and urban culture — wasn't being served by either. When she set out to research farmer and rancher mental health, her patient partners threw out her plan for a survey and insisted on something slower: showing up at the farm, fixing fence, and earning trust before ever asking a  question. That decision shaped everything that followed, from a heifer auction that raised over $20,000, to a therapy network staffed entirely by counsellors who are farmers themselves, to a recent provincial funding commitment putting the network on stable footing. It's a story about what patient-oriented research looks like when you actually hand it back to the people who built it.  

Resources

Sask AgMatters Mental Health Network

• Website: https://www.saskagmatters.ca/
• Donate: https://www.saskagmatters.ca/donate
• Free counselling services: https://www.saskagmatters.ca/freeservices
• Farm Stress Line: https://www.saskagmatters.ca/farm-stress-line
• Background/vision: https://www.saskagmatters.ca/vision

Saskatchewan Farm Stress Line — 1-800-667-4442,  

Canadian Centre for Agricultural Wellbeing

• : https://ccaw.ca/
• National Farmer Crisis Line: https://ccaw.ca/ 

Saskatchewan Centre for Patient-Oriented Research (SCPOR) — https://www.scpor.ca/

Saskatchewan Health Research Foundation (SHRF) — https://www.shrf.ca/

What happens when you stop managing nurses and start trusting them? In this episode, Kyla sits down with Jos de Blok — the Dutch nurse-turned-founder of Buurtzorg, the neighbourhood care organization that rebuilt home nursing in the Netherlands around self-managing teams instead of hierarchy. Jos started as a community nurse in the 1980s, watched that model get dismantled when the system shifted to task-based, regionalized care in the '90s, and spent the next two decades building something better.

In 2006, Jos and a colleague founded Buurtzorg (Dutch for “neighbourhood care”) on a simple idea: if you give nurses real autonomy, keep the back office as small as possible, and build trust instead of surveillance into the system, both quality and cost will take care of themselves. Ten teams became hundreds within a few years. Today Buurtzorg employs roughly 15,000 people across the Netherlands — and the country's total volume of home care delivered has dropped by half, even as outcomes improved.

Jos and Kyla talk about what nurses lose when hierarchy and task-based care takes over, why he believes multidisciplinary teams are often treated as a solution when they should be a last resort, and what it would actually take to bring a model like this to Canada. It's a conversation about trust, autonomy, and what becomes possible when a health system is built around relationships instead of routines.

• How Buurtzorg Works
•  Buurtzorg in action (video) - 

•     Buurtzorg International — official site

•     Jos de Blok's personal website

•     Buurtzorg Nederland — Wikipedia overview

•     World Economic Forum: “Buurtzorg — The Dutch word that could revolutionize healthcare”

•     Corporate Rebels: The 7 Self-Managing Team Roles of Buurtzorg

•     Academic case study: “Buurtzorg Nederland: A Global Model of Social Innovation, Change, and Whole-Systems Healing”

•     Euronews: “Buurtzorg — the Dutch proximity health care revolution”

•     The 90% Code

To open this new season, Kyla sits down with retired registered nurse and author Cathy MacNeil to talk about her book Dying to Be Seen: The Race to Save Medicare in Canada. Over fifty years in the system — bedside nursing, ICU, hospital administration, and long-term care management — Cathy watched Canadian Medicare go from a hard-won, world-admired achievement to a system she believes is being deliberately dismantled. They trace the story from Tommy Douglas and the birth of Medicare in Saskatchewan, through the devastating cuts of the 1990s, to today's privatization pressures in provinces like Alberta and Nova Scotia — and close with Cathy's concrete ideas for what governments and individuals can do about it.

Resources & links

-       Book: Dying to be Seen: The Race to Save Medicare in Canada by Cathy MacNeil, or through the FriesenPress bookstore

-       Film: Bitter Medicine, Part One: The Birth of Medicare — National Film Board of Canada documentary on the 1962 Saskatchewan doctors' strike and the founding of Medicare

-       Canadian Health Coalition

-       Canadian Doctors for Medicare

-       Friends of Medicare (Alberta)

-       BloodWatch.org 

-       Cathy MacNeil on LinkedIn

This is the episode where all five flaws converge. When you don't plan your workforce, don't budget for results, follow rules instead of outcomes, and never track data — you end up funding the emergency and starving the prevention, year after year, until the safety nets all break at once. 

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

This episode is about what happens when governments collect data but never act on it, measures inputs but never outcomes, and substitutes the phrase "we are committed to continuous improvement" for an actual plan.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

A domestic violence survivor loses her benefits if she stays with her parents for a tenth month. A person with a disability turns down a job offer because taking it means losing housing support. A senior is denied a taxi voucher to a clinic and ends up in a hospital bed at ten times the cost. This episode is about a system organized around rule-following rather than results — and what that looks like for the people on the other side of the desk.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

Human Learning Systems as a method for Reimagining Government

Every year, government sets a budget for social programs. But almost nobody asks what those numbers are supposed to produce — or checks whether they did. This episode follows Lamrock's team as they ask the Department of Finance some very basic questions about its 2023 budget: what will this money do, for how many people, and how will you know if it worked? The answers — or the absence of them — will make you shake your head.  

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

In the 1990s, as a response decades of overspending, governments facing fiscal pressure made a deliberate choice: cap enrolments in health professions, reduce training spaces, limit billing numbers. The long wait times that followed weren't an accident. They were the plan — a way to slow demand without raising prices.  Thirty years later, we're still living in the system. This episode is about how we stopped planning for the people we need, and what that costs us now.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

This is the episode that sets the stage. In 2024, Kelly Lamrock — New Brunswick's Child, Youth and Seniors' Advocate — released a report that asks a question most of us have been afraid to ask: what if the problem isn't the people in our systems, and it isn't the money, but the governance model itself? 

This series is built on that report, and this episode explains why it matters far beyond New Brunswick.

How it All Broke Report

Kelly Lamrock Interview

How It All Broke Videos

The Second Coming (Poem)

Meet the Advocate

In this episode, Kyla sits down with Dr. Brittany Ellis — an emergency physician with specialized training in geriatric emergency medicine — for a wide-ranging conversation about why Canada's emergency departments are in crisis, and why older adults are bearing the brunt of it.

Dr. Ellis walks us through the full patient journey: from an older adult struggling
to get home care in a timely way, to ending up in an ED hallway for days,
developing pressure ulcers within the first hour, experiencing delirium, and
leaving the hospital in worse shape than they arrived. It's a cascade of
failures across a fragmented system — and she breaks it down with clarity,
urgency, and a healthy dose of "delusional optimism."

Resources

• CIHI: Emergency Department Wait Times in Canada — Insights from a Health System Perspective
• CAEP Position Statement: Care of Older People in Canadian Emergency Departments
• What’s behind Canada’s Doctor Shortage?