When it comes to health care none of the mainstream parties is doing a stellar job.

This is the conclusion of the Nova Scotia Citizens' Health Care Network, a coalition of groups and individuals who want to protect and strengthen public health care.

Based on the responses to questions submitted by the coalition the NDP received an overall grade of C+, and the Liberals a C-. The Progressive Conservatives received a D-.

The Green Party received a B.

"All [mainstream] parties tinkered around the edges and missed ways to not only increase the delivery of health care but also to increase access," said James Hutt, spokesperson for the coalition.

"Especially given the looming cuts to federal funding and the high rate of chronic disease in the province, we find it troubling that these opportunities are being missed."

Community health care centres in the province are one such missed opportunity, the coalition believes.

"We face lots of problems, but let's take chronic disease, because this has been talked about by the various parties," said Dr. Margaret Casey, the newly appointed Board Chair of the North End Community Health Centre.

"Chronic disease is very prevalent. If it is not addressed early it can go on to not only severe disability but also to huge expense. People are admitted to hospital for long periods. If chronic disease can be managed and diagnosed, and treated at an early stage, not only do we improve the life of the affected person, but expenses are reduced."

"And this is what we do here, and we hope to increase our capacity to do that," said Casey.

On privatization the Green Party scored and A, but Liberals and PC's received a big fat F. The NDP received a D-, for opposing future privatization but not offering to reverse existing cases of privatization.

The coalition believes that the focus on administrative costs during this election campaign may be a bit of a distraction.

"We have been hearing a lot about administrative costs," said Christine Saulnier, who worked on the report card. "I am not saying adminstrative cost is something we shouldn't look at, but we really need to look at what patient-centered health care means."

Where do patients have a voice in our health care system, and how can we improve that? How do we help people stay in their homes, how do we help these caregivers who are really struggling to provide care to parents, siblings," said Saulnier.

The coalition believes that provincial health care issues take on an increased urgency because of the expiration of the current health care accord in 2014. The accord, an agreement between federal and provincial governments, defines health care funding levels and services. The federal government is ignoring calls to renegiate and announced $36 billion worth of health care cuts.

The coalition fears that without a new accord in 2014 Nova Scotia will lose more than $900 million in funding over the next decade.