HANSARD

 

NOVA SCOTIA HOUSE OF ASSEMBLY

 

 

STANDING COMMITTEE

 

ON

 

HEALTH

 

 

Tuesday, April 14, 2026

 

 

COMMITTEE ROOM

 

 

Improving the Health of Women and

Gender-Diverse Nova Scotians

 

 

 

 

 

 

 

 

 

 

 

Printed and Published by Nova Scotia Hansard Reporting Services

 

 

HEALTH COMMITTEE

Danny MacGillivray (Chair)

Adegoke Fadare (Vice-Chair)

Hon. Susan Corkum-Greek

Ryan Robicheau

Nick Hilton

Lisa Lachance

Rod Wilson

Hon. Iain Rankin

Hon. Derek Mombourquette

 

[Lisa Lachance was replaced by Claudia Chender.]

 

 

 

In Attendance:

 

Gordon Hebb

Chief Legislative Counsel

 

Judy Kavanagh

Legislative Committee Clerk

 

 

 

WITNESSES

 

Nova Scotia Health Authority

Dr. Annette Elliott Rose, Chief Nurse Executive and VP Clinical Performance and Professional Practice

Dr. Cheryl Pugh, Western Zone Medical Executive Director 

 

IWK Health Centre

LeeAnn Larocque, Vice-President Clinical Care, Learning, and Chief Nurse Executive 

Stacy Burgess, Vice-President, Clinical Support and System Integration 

Dr. James Bentley, Head, Department of Obstetrics and Gynaecology 

 

IWK Foundation

Jennifer Gillivan, President and CEO

Heather Creighton, Vice-President, Women’s Strategy and Partnerships 

Nicole Slysz, Women’s Strategy and Projects Lead 

 

Kim White, breast cancer survivor

 

 

 

 

HALIFAX, TUESDAY, APRIL 14, 2026

 

STANDING COMMITTEE ON HEALTH

 

1:00 P.M.

 

CHAIR

Danny MacGillivray

 

VICE-CHAIR

Adegoke Fadare

 

 

            THE CHAIR: Order. I call this meeting to order. This is the Standing Committee on Health. I am Danny MacGillivray, the MLA for Pictou Centre and the Chair of this committee. Today, we’ll hear from the Nova Scotia Health Authority, IWK Health Centre, the IWK Foundation, and Kim White regarding Improving the Health of Women and Gender-Diverse Nova Scotians.

 

            I ask you to please set your phones to silent.

 

            Now I ask the committee members to please introduce themselves for the record by stating their name and constituency, and we’ll start to my left.

 

            [The committee members introduced themselves.]

 

            THE CHAIR: For the purposes of Hansard, I recognize the presence of Chief Legislative Counsel Gordon Hebb on my left and Legislative Committee Clerk Judy Kavanagh on my right.

 

            Welcome to the witnesses. Thank you for taking time out of your day to join us. We appreciate it. I think we’ll start with opening remarks.

 

            Ms. White.

 

            KIM WHITE: Good afternoon, everybody. My name is Kim White. I am currently going through breast cancer - survival, I guess, would be the word.

 

This has been a tough road for me. I’m not going to make my opening statement which I submitted to everyone in this caucus today. I’ve decided to leave the opportunity to the current majority government to ask me questions based on the statement and the timeline of events that I have submitted to you all. I’m not going to tell my story from my words; I want you to tell my story through your questions. I’m hoping and anticipating that a government that is claiming to have transparency and that has all this power has responsibility with this power.

 

            I am, right now - I do not classify myself as a survivor because I haven’t survived yet. I need you to take the power you have, be responsible with that power, and ask me questions based on my opening statement and based on the timeline of failures that I have pointed out. To make sure that you’re held to account for your questions to me directly, I have submitted the same documents to a lovely reporter who told my story back in October.

 

With that, I say thank you and you can move on.

 

THE CHAIR: Thank you, Ms. White.

 

From the IWK Health Centre, Ms. Larocque.

 

LEEANN LAROCQUE: Hi. Good afternoon. Thank you, Chair, fellow witnesses, and members of the committee.

 

Before I begin, I’d like to acknowledge and sincerely thank Ms. White for sharing her personal journey here today with us. We recognize that it takes a lot of courage to speak openly about your journey and your experiences, and we’re grateful for her willingness to do so. Stories like hers are powerful for us in the health care system. They deepen our understanding, and they continue to inform our work and help us drive meaningful improvements in care.

 

My name is LeeAnn Larocque. As stated before, I’m the vice-president of Clinical Care, Learning and chief nurse executive at the IWK Health Centre, and I am joined here today by my colleagues: Stacy Burgess, who is the vice-president of Clinical Support and System Integration, and Dr. Jim Bentley, who is the head of Obstetrics and Gynaecology.

 

Thank you for the opportunity to speak to you today about improving the health of women and gender-diverse individuals in Nova Scotia, work that is central to the IWK Health Centre mandate and our Nova Scotia Health Authority’s mission, essential not only to individuals and well-being but also to the strengthening of families and the long-term sustainability of our health care system.

 

At the IWK Health Centre, we provide specialized and tertiary care level services across the lifespan. This includes reproductive and sexual health, maternity and newborn services, gynecology, breast health, mental health, and gender-affirming care. For many Nova Scotians, IWK serves as the access point for complex women’s health services and services for Nova Scotia.

 

Many investments have occurred, which we will speak to throughout our time here with you today. However, it’s important for us to recognize that demand for these services continues to grow. Population increases, rising clinical complexities, and greater awareness of conditions such as fibroids, menopause, and breast health have contributed to higher referral volumes than we’ve ever experienced. As a result, wait times in some areas, particularly gynecology, remain longer than what we would like. We are acutely aware that behind every referral is an individual awaiting access to care. At the same time, we are also making measurable progress to expand capacity and modernize our care delivery.

 

Through targeted investments from approved business cases from the Department of Health and Wellness, we have increased clinical capacity, upgraded diagnostic imaging equipment, strengthened referral triage processes, and strengthened system navigation. These are important structural changes that are enabling more timely and appropriate access to care.

 

Support from our IWK Foundation has also accelerated research and innovation. The introduction of Acessa as a minimally invasive fibroid treatment system is but one example. This approach offers patients an alternative to more invasive surgery, reduces recovery time, and helps minimize and optimize the use of operating room capacity. We have also hired our first women’s health accelerated research chair, which has been vastly supported by our IWK Foundation. We are also working with the Breast Health Research Unit, which also has been supported by the foundation.

 

Recently we have been looking at advancing menopause care with a new announcement. With new provincial investments, we are working in partnership with the Nova Scotia Health Authority and the Menopause Society of Nova Scotia in establishing a dedicated menopause clinic, in addition to our current complex menopause clinic that we currently have at the IWK. This will address long-standing gaps in care and provide specialized assessment and treatment during a stage of life that has significant impacts on physical health, mental well-being, and workforce participation.

 

Across all of this work, equity remains a central focus. We recognize that women and gender-diverse individuals experience barriers related to geography, income, race, and gender diversity. Our approach to service redesign is grounded in culturally responsive, trauma-informed, and inclusive care.

 

Improving the health of women and gender-diverse Nova Scotians is foundational to a high-performing, sustainable health care system. When we support patients earlier, provide timely treatment, and address life-stage health needs, we reduce downstream pressures across the continuum of care.

 

The IWK remains committed to continued progress, evidence-based and informed care, and strong partnerships. My colleagues and I look forward to your questions that you have today.

 

            THE CHAIR: Dr. Elliott Rose from the Nova Scotia Health Authority.

 

            DR. ANNETTE ELLIOTT ROSE: Thank you for the opportunity to meet with you today to discuss women and gender-diverse care.

 

I’d like to echo LeeAnn’s words to you, Ms. White. Thank you for being here. Thank you for your courage. The only way that we make changes and differences in your care and the care of others is to hear from you and to hear the voices of women and gender-diverse people, so thank you so much.

 

At the Nova Scotia Health Authority, we are focused on advancing women’s health and ensuring care is equitable, inclusive, and accessible for all. Every day, I see the commitment of our teams across the province working to improve care and outcomes. This is work I care deeply about, both as a woman personally and as a leader. We are proud of the work that people do, and we are aware that there is more to do. Being here is about having that conversation about what’s working well and the more that we need to do. We remain committed to listening, learning, and continuously improving.

 

We are seeing some progress - meaningful progress. Care is becoming more accessible in both urban areas and rural communities through our health homes and primary health care. It’s becoming more culturally responsive through various services. We’d like to share some of that information with you today. We’re expanding education and support for patients and providers to make sure they have the knowledge and skills to provide care for Nova Scotians.

 

Access to primary care remains a priority, as it is often the first point of contact for women and gender-diverse people in the health care system. We also have Well Woman Clinics across the province to provide accessible services and education. These clinics are delivered by physicians and nurse practitioners working in interprofessional teams. They require no referral and are available to individuals, whether or not they have a primary care provider. Please check out that information on the YourHealthNS app or through 811.

 

            The Nova Scotia Health Authority delivers approximately half of the babies in the province at the regional facilities, and we are proud of the care our teams provide throughout the pregnancy and childbirth journey.

 

Services that women and families rely on to expand include things like sexual health services, pregnancy and parenting supports, and midwifery care across the province. Public Health and Early Years programs play a vital role by supporting families with infant feeding, sleep, mental health, growth and development, immunizations, and more. These supports make a meaningful difference in the early stages of life, and we know it is so important for people to have a good start.

 

            Partnerships with communities continue to strengthen care. Initiatives like the Nova Scotia Sisterhood clinics - and you will learn more about that today, hopefully - ensure African and Black Nova Scotians receive culturally appropriate and responsive care. Investment in innovation is improving outcomes.

 

This work requires collaboration, and there are strong examples of progress across the province. Work is under way in partnership with others, and many others here at this table, on the first-of-its-kind-in-Canada Menopause Centre of Excellence. We want excellence to strengthen care in all life stages for all people, including women and gender-diverse people. We have investments, such as the Deanne Reeve Pelvic Health Suite at the Dartmouth General Hospital and the Dr. Maria Angwin Memorial Wyse Road Health Clinic, which is a partnership with the IWK Health Centre. This is all improving access and specialized in-community-based care.

 

            At the QEII, the da Vinci surgical system is expanding access to minimally invasive procedures, including gynecologic oncology surgeries. These approaches result in smaller incisions, less pain, faster recovery, and greater precision. With support from the QEII Health Sciences Centre Foundation and The Orchid Women’s Health Initiative, we have a second system that was introduced earlier this year, helping to expand access and attract new specialists, and we have a state-of-the-art robotics training system at the QEII, where people come to train from the region and across the country.

 

            Important progress has been made in gender-affirming care. Nova Scotia has the highest proportion of transgender and non-binary individuals aged 15 to 34 in Canada, and we are working to meet those needs. The Nova Scotia Health Authority now offers a dedicated program for gender-affirming chest surgery, improving access and reducing the need for out-of-province care. We are seeing good outcomes and positive feedback from patients.

 

            We recognize that the system has not always met expectations, and we hear that clearly by working alongside health care providers, partners, and most importantly, patients and families. We are focused on continuous improvement so that every Nova Scotian, including women and gender-diverse people, accesses timely, respectful, and high-quality care.

 

            Thank you. We look forward to your questions.

 

            THE CHAIR: Thank you, Dr. Rose.

 

            Ms. Gillivan from the IWK Foundation.

 

            JENNIFER GILLIVAN: Kim, I feel your pain. I see you, and I’m so sorry you’re on this journey. Let’s try to turn it into something positive.

 

            The IWK Foundation has always fundraised and supported women’s health care at the IWK Health Centre.

 

We’ve been successful in raising hundreds of millions of dollars toward the IWK Health Centre over the years. Predominantly, those funds have supported pediatrics, mental health, research, and women’s health.

 

One of our goals was to expand our support of women’s health care and research. Through this work, we’ve learned about the systemic bias in health systems locally, nationally, and globally.

 

It was this understanding of the health care and research gap in women’s health that led to our strategic approach to be a catalyst for change. Our motto is we have to educate, advocate, and mobilize to equalize.

 

[1:15 p.m.]

 

            In January 2024 and 2025, McKinsey Health Institute, in partnership with the World Economic Forum, published a report released at Davos called Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economies. Drawing on extensive global and national data, the report shows how poor health among women translates into lost productivity, shorter working lives, and wider inequities, offering one of the clearest pictures yet of how this gap affects women and it affects Canada’s future.

 

            We are working to promote transformational changes at a regional, national, and even international level to reimagine women’s health, but it’s going to take all of us. One year ago, we set out these goals: to continue to support fundraising efforts to improve and change equipment, programs, and facilities at the IWK Health Centre; to explore the opportunity to develop an accelerated research institute solely to study women’s health; to establish stakeholder alignments to support our organization’s goals to act as a transformational leader; to give women a voice and advocate for changes that will change the future of women’s health in the Maritimes; and to push for a commitment from the federal government to create a Canadian national women’s health strategy. Currently, Canada is the only G7 nation without such a strategy.

 

            What did we do? The Voice of Maritime Women: The Unspoken Burden of Women’s Health garnered 27,317 responses from the Maritimes and has become, to date, the largest open survey on women’s health in Canada. Some of the key stats: over 75 percent of women admitted to delaying or avoiding care altogether; 56 percent report health issues that actively disrupt their day-to-day life; 70 percent of women feel the current system does not meet their needs; 86 percent of women agree significant changes are needed to improve women’s health care. Top issues women want to prioritize: menopause; hormonal health; stress, anxiety and depression; obesity; weight management; sleep disorders; heart disease; and cancer.

 

            We believe in educating ourselves and each other, so we launched the podcast The Fifth Wave: Curing the Healthcare Bias against Women, which is now currently sitting in the top 25 percent globally.

 

We’ve established relationships with:

 

·       Women’s Health Collective Canada, a partnership between five health foundations across Canada. Each partner organization is partnered with their research arms and, in turn, we are connected to over 1,000 researchers in Canada;

 

·       European Institute of Women’s Health. We actually contributed to their manifesto and their plan which ultimately became the draft strategy presented to the European Union. We were the only Canadians to do so;

 

·       Deloitte: We partnered on a pan-Canadian paper called “The Case for Advancing Women’s Health in Canada,” advocating for a national women’s health strategy and, as a member of WHCC, developed a Blueprint for Action on Women’s Health with McKinsey & Company in Canada, an evidence-based road map to close the women’s health gap;

 

·       Steering committee for the National Framework for Women’s Health. We’re very involved in this. This is the work led by Senator Henkel to pass Bill S-243. The IWK Foundation has been at the table pushing for this bill.

 

We launched, in February, a movement called WHEN - Women’s Health Equity Now - and we’re focused on fundraising, supporting, and advocating in the following areas: education, research, innovation, leadership, and care.

 

The 27,371 women who responded to our survey and the rest of the women who have come forward to help are our North Star, and they guide us as we build support locally, regionally, and participate in a national and global movement.

 

THE CHAIR: Thank you very much, Ms. Gillivan. I skipped a step here. Maybe I’ll introduce a name, and you can say who you’re with.

 

[The witnesses introduced themselves.]

 

THE CHAIR: The opening remarks now concluded, we begin the question-and-answer period. Please, everyone, wait for the microphone to turn on. Wait for your name to be called and the microphone will turn on automatically. You don’t have to press any buttons. Each caucus will get 20 minutes with a second round of 10 minutes as time allows, and questioning will wrap at 2:40 p.m.

 

We’ll start with the NDP caucus. MLA Chender.

 

            CLAUDIA CHENDER: Thank you all for being here today. Thank you, Kim, for being here today. You’ve asked for the government to ask you questions, so I’m going to leave them that opportunity right off the top.

 

            I also want to acknowledge that in the audience we have Rafah DiCostanzo. She is a former MLA who has been pioneering in her work on making sure that we don’t ignore women’s health in this arena, and also my colleague Elizabeth Smith-McCrossin, who is unable to join us at the table but is paying attention keenly.

 

            I want to start with some questions for the foundation. I have been very persuaded by the work that you’ve all done on a national strategy. You spoke about this a bit, Ms. Gillivan, in your opening comments. I think what your survey shows is how behind we are in our region, frankly. We know this through your work, but we also, as MLAs, know this anecdotally, because of course we have hundreds of women and gender-diverse people sharing their stories - stories like those of Ms. White. Just recently, a woman joined us at the Legislature to talk about how she had lost an ovary due to delayed diagnosis of endometriosis and insufficient care; people whose diagnoses for breast cancer are missed; et cetera, et cetera.

 

            I wonder if we could imagine a situation - and I should say that this is against the backdrop of a situation where often when we ask questions about this, what we are told is “We are fixing health care for everyone.” I think what your study shows is that we, in your words, have some built-in systemic biases and we have to make a defined and strategic approach to fix health care for women and gender-diverse people for that to actually become a reality.

 

            I wonder if I could ask you: How might things, in your estimation - sitting where you do at the foundation - look differently in our health care settings if we had this women’s health strategy at a national level? What kind of different investments might we see? What kind of different outcomes and different patient experience might we be able to see?

 

            THE CHAIR: Ms. Gillivan.

 

            JENNIFER GILLIVAN: Giving an Irish woman a mic - okay. I think what you have to look at is - in general first. That’s why I purposefully started my opening remarks bigger.

 

When you’re in a system where less than 7 percent of our taxpayers’ money is going to research our actual bodies, when women weren’t even included until the 1990s in clinical trials, when only 9 percent of the curriculum is on women’s bodies that’s taught in med schools in general, when most doctors I’ve talked to weren’t trained on menopause - and menopause is a lightning rod, because it’s at that point - we have no choice, as women. We’re going to go through this.

 

When you see all of that, that is why we have focused on research. The research is going to change and inform the care. That’s number one for us. Educating ourselves, educating our doctors, educating ourselves on the new technology that’s coming and making sure we have the teams that can do this - making women a priority and helping them advocate for themselves. That’s part of why we’re doing the podcast. It’s to help women advocate for themselves. Then looking at what the facilities are - what is the equipment, and how can we partner together to reimagine a health care system?

 

This is only my opinion, but I feel women’s health is precision medicine. It’s never actually properly been done before. We’ve been sort of squeezed in, but really to actually focus truly on women’s health, we need a national strategy. If you look at the other G7 nations and the countries like Australia, they all have a women’s health strategy, and from that strategy, as provinces and regions, we can then use that as a guidepost to start working together.

 

There needs to be investment in women’s health. We need to make women’s health a priority across the board in society. I think we have actually - we can look at all the problems, or - I’m coming in, maybe the only one on this panel - but I’m coming in saying, listen we have opportunity here. We really do. We’re in a moment in time that, as we have this discussion today, it’s happening all across this country and around the globe. We’ve met these leaders. We’ve met these people. We know what’s happening.

 

            I think women are done. When you saw our results - and this is women’s voices. This isn’t my voice or anyone else’s at this table, with the exception maybe of Kim. They’re done. They’re tired of being dismissed. They’re tired of not being listened to. They know that the system needs to change, and they want that to change. Otherwise, we’re going around in circles.

 

            I don’t know if that’s answered your question. I could literally go for hours here, but this thing is freaking me out a bit. Anyway, I’ll stop there.

 

            CLAUDIA CHENDER: That’s okay. I’ll give you a bit more to work with here.

 

We have been advocating for a provincial health strategy. Of course, we believe that that should be happening concurrently with what’s happening federally. We know that an enormous amount of any government spending is in health and that this government in particular came to office promising to fix health care, so it is our opinion that we ought to have a road map for that, particularly in an environment where we are dealing with those systemic inequalities. If we don’t have a road map that guides investment, we not only risk but almost ensure that we will continue to perpetuate those systemic barriers.

 

            I wonder if you could speak to what you might see as the value of having a strategy that guides that kind of investment.

 

            JENNIFER GILLIVAN: A strategy that is in partnership - it’s not any one government, any one opposition, or any one health authority that is going to make this happen. We have to decide and put women as a priority in our society, in our province, and in our country. Then we have to work together to create that strategy.

 

            A strategy is like a map. You’re in a car. You need a map - or GPS nowadays - to know where you’re going from A to B. I feel like there’s a real value.

 

            I also would say that the voice of women has to be at that table. What we learned from the survey we did was that there wasn’t much of a difference in the answers from three provinces. Rural or urban, it didn’t matter. This is the women’s experience - the women’s voice. They have a lot to say, and they know what they’re talking about, so they need to be at any table designing a strategy.

 

            A dream of mine is to see a strategy nationally and a strategy provincially or regionally. To start, you would see a reduction in spending in health care. Women would suffer less and would go earlier and be diagnosed earlier and preventive health - all of that would help.

 

            We’re at an inflection point in this country. If we’re going to build it strong, and we’re going to build our provinces strong, we’ve got to include the other 50 percent of the population.

 

            CLAUDIA CHENDER: That’s helpful. I do think, as women, we have a different lived experience of this - like the number of times in my pregnancies when I would go to the pharmacist, and they would say, “Well, this hasn’t been tested on pregnant women. We don’t know if it’s safe.” Why not? Why don’t you know that? - or different barriers, so that’s so helpful.

 

            I want to jump off on this investment piece and the fiscal piece because this is important. One of our arguments, of course, is that a strategy doesn’t have to cost a great deal of money - in the doing, in the creation. We also know that, based on the McKinsey report that you cited. I think the stat that was quoted there was that investment in women would unlock $700 million in GDP or something like that.

 

I wonder if you could speak a bit about what the economic - not just the potential savings, because I agree with you. This is a theme. We’ve been clear, and the Auditor General has been clear - many people - that if we are more targeted, if we are clearer in what we are trying to achieve, in fact, that will be a more efficient use of funds. I’m interested also in asking: What would the economic benefits of investing in women’s health care be for the province? I know you guys have done some thinking about that.

 

[1:30 p.m.]

 

            JENNIFER GILLIVAN: Based on not my opinion but on the McKinsey report that I cited out of - internationally - they just finished the blueprint in Canada. The femtech industry, which is basically predominantly female-led companies - entrepreneurial companies - which are creating medical devices and all kinds of interesting advances, are almost the long tail of research. If you think about research as the - and that’s why we’re looking at applied research at the IWK Health Centre - it’s to the bedside research. The long tail of that could be the femtech industry, and we have many entrepreneurs right now in our province doing this kind of work.

 

Unfortunately, like most venture capital, they’re getting less than 2 percent currently, but here’s the interesting thing. If we were to close the health gap in this country in the next - you know, by 2040, which is not that far off - we would contribute $37 billion to our economy.

 

Currently, today, we are losing $3.5 billion every year in Canada to menopause alone. McKinsey is telling you that there is a trillion-dollar minimum - trillion-dollar opportunity with little competition right now because of the bias sitting out there, and all of these countries are in a race now to go there. Yet, when we’re talking to people outside of our country, they’re saying how amazing our researchers are in Canada. They have a huge reputation - and they are. If you think about marrying the researchers and the innovators as part of the strategy going forward, we could create all kinds of economic benefits and opportunities. You’re going to save, and women are going to suffer less, but you’re also in the driver’s seat to take advantage of what’s happening.

 

Everywhere you go now, there’s this conversation starting to happen about women’s health care, about new devices, new technology, and new procedures, and this is what McKinsey’s talking about. We have a Blueprint for Action on Women’s Health, and they’re going to be breaking it down regionally. We don’t have the regional version yet, but we will as part of our partnership with Women’s Health Collective Canada. We’re happy to showcase that once it comes our way. It’s safe to say this is an emerging economy that would absolutely be - we could be a gamechanger and a leader out of this province or region.

 

CLAUDIA CHENDER: That’s helpful. It’s helpful, also, to think about how provincially - not just how we are supporting individual women on their health care journey but also how we are supporting the ecosystem. I wonder because I know that the foundation has been engaged, as you said, in the Chair and in applied research. Do you see that same systemic bias here in Nova Scotia? We do have that innovation ecosystem, but we are concerned about it. Do you see that same bias against funding for that kind of VC in particular here? What could be done to unlock opportunities in that sector?

 

JENNIFER GILLIVAN: You just have to look at the stats. The stats are - it’s around 2 percent of available capital for women, full stop, and then it gets even tougher if it’s in the medical field.

 

I will tell you that there’s some amazing innovation happening right now at the IWK Health Centre. That’s my experience. I’m sure it’s also happening - and you see some of it in NSHA, as well. You can see how some of the breakthroughs that they’re having could then be turned into opportunities economically.

 

I’ve met with innovators from Nova Scotia, and some of the work they’re doing is breathtaking it’s so good, but they can’t get the venture capital to get it to market. We’re in an interesting time in this country. This is the time, this is the moment, to step into that ring and say, “Okay, how do we invest? How do we do that?”

 

It’s all back to the same - it’s the same bias. If you’re walking - it is what it is. You’ve got to call it out. Look, I’m not blaming anybody who got this far, but when you know what you know, now what are you going to do about it? That’s my motto. I’m not going backward. As far as I’m concerned, we’re going forward, so how do we help?

 

We’ve taken on what we can do as a foundation in support mainly of the IWK Health Centre but also our country and our community, but others have to also do the same, and they are. Some volunteers and stuff are stepping up. We need all of us working together to make this change. It’s a systemic change.

 

CLAUDIA CHENDER: Maybe this is my last question for you guys. One of the things that I’ve noticed is that, often when there are technological advances, it feels like, in this province - and this is my only unit of measure - we’re very slow at doctors when they benefit women and gender-diverse people specifically.

 

            I’m thinking of take-home HPV tests. I’m thinking of increased and better screening for breast cancers. All of these things - I’m thinking of even HRT therapy and what we understand about treating menopause, birth control - things that have been adopted in public health care systems in our country but not here.

 

            I wonder if you could speak to whether - back to my initial question - having a strategy or a road map: Do you think that would lead to an earlier adoption of those technologies and medical advances that we know would be of so much benefit to women and gender-diverse people?

 

            JENNIFER GILLIVAN: You look at HPV testing, and B.C. and P.E.I. are the two that are in the lead, but I think this province is looking at it. It’s not just the testing. Then you have to have the staff behind it.

 

That’s why I feel strongly that a national strategy - because it’s not equal all across the country. We might have something we’re advanced in, and then you can’t get it in B.C. or vice versa. It’s not like a woman has the same level or standard across the country. It’s varying. A national strategy would help move the dial and create an equal playing field across the country.

 

I was in Toronto at an event, and somebody said, “Well, how could we possibly break it down province by province?” I said, “Well, the borders are coming down. If we can sell beer across the provinces, we can sure start to figure this one out.” It’s possible. It’s not impossible. That’s what I feel.

 

            CLAUDIA CHENDER: I appreciate that, and I think it’s so important - in particular, the survey you did - to have those voices at the table. So often, even as women and gender-diverse legislators, when we talk about breast cancer, when we talk about what a PAP smear means, when we talk about all those things, we have a different understanding of those things - even midwifery care and things like that - so it is so helpful in guiding us. I want to thank the foundation, again, for that pioneering work.

 

            In my last couple minutes, I want to ask a question to the IWK Health Centre. Maybe it’s Dr. Bentley, but you guys can figure it out amongst you.

 

            We know that we wait nearly three times longer than other Canadians for gynecological care. You mentioned that in the opening remarks. Our understanding is that we are nearly staffed up, so there is some - often, when we ask this question, we are met with, “Well, we have team-based care; we’re expanding primary care,” but that’s not the question I’m asking. I’m asking about people who need to be referred to specialty gynecological care and who are waiting years. Can you speak to that wait-list?

 

            THE CHAIR: Dr. Bentley, with 1 minute, 40 seconds remaining.

 

            DR. JAMES BENTLEY: It’s a big topic in one minute and 40 seconds.

 

Gynecological wait times are a huge problem. They weren’t on the radar, particularly before COVID-19, and they ended up with a lot of changes after that, with the changes in provincial demographics and the changes in availability in primary care.

 

            It seems to us, when we look at the data, that we’ve gradually had more than 500 referrals at the IWK Health Centre. I know it’s the same around the province for the other 40 or so gynecologists around the province - 500 referrals we get a month - and it is a challenge to see those patients in a timely fashion.

 

            We’ve had additional resources put at us. We’ve had additional innovations with nurse-led triage pathways and introducing NPs into the mix, but we still have a huge increase in demand - a change in demographics with a lot of newcomers to Nova Scotia who are between the ages of 25 and 50, who are all in that prime gynecological period of life - so we have increasing difficulties just to see those patients, and that is despite having extra gynecologists. We probably have about five extra gynecologists to help us with general gynecology, extra endometriosis surgeons, generalists, and menopause specialists.

 

            We are doing what we can with the resources we have, and I fully appreciate the waits are way longer than they should be for what is felt to be, when we triage patients, elective or non-urgent procedures. We get the patients with cancer in quickly.

 

            THE CHAIR: Order. Thank you, Dr. Bentley. Sorry to cut you off there. We’ll move onto the Liberal caucus.

 

MLA Rankin.

 

            HON. IAIN RANKIN: Thank you, Chair, and thank all of you for being here on an important topic. We put this topic forward back after - last year after the survey came out. It was important for us to shine a light on the work that you’re doing.

 

            I want to talk about the work and the follow-up in February with the WHEN - the Women’s Health Equity Now - launch. I was happy to be there in support. I want to get to that, but for the flow of the meeting, the issue around wait times for gynecology is alarming and disastrous, and we need to figure it out.

 

            The question I want to ask is: When the minister says that they have a full complement, I gather from your answer, Dr. Bentley, when you’re saying that you’re doing what you can with the resources that you have, that that doesn’t really line up. Maybe the complement has to grow. Maybe you need more resources. The efficiency of the system is what I’m most curious about because I happen to know someone in my community who has been trying to access care being told that it’s going to be upwards of three years with severe quality of life impact - that individual barely able to leave her house with the uterine prolapse.

 

            When we know there are other regions in the province that have shorter wait-lists - the idea about having one health authority was to be able to efficiently use the resources that we have. When we know there’s a shorter wait-list in the Eastern Zone - and maybe this is a question better asked to the Nova Scotia Health Authority because there is obviously demand in the Central Zone - why can we not have that person looked at? Why do they have to use their own private money to find care from a nurse practitioner?

 

            THE CHAIR: Dr. Bentley.

 

            JAMES BENTLEY: Specific diagnoses go to specific specialties and subspecialties. Over my career - 30 years in gynecology - there has been more subspecialization and prolapse is one of those things that is best dealt with by the subspecialist who deals with that. That, for us, is a urogynecologist or pelvic medicine specialist. We have four people who do that. They are all in Central Zone at the IWK Health Centre, and yes, we have horrendous wait times for those.

 

            Could we deal with more of those people? Yes, we could. Do we have all the resources we need? We have some of the resources, but we have challenges there, and we have a program to expand our surgical services at some stage or another. Some of that care can be done around the province and can be gone through the systems to look at everything else, but I do know that, around the province, they are up to quota in the regional areas, for the most part. I think there’s one 0.8 vacancy for obstetric gynecology in the province at this point in time.

 

            I fully accept that is not satisfactory, and the surgeons will be the first to tell you that they are operating on people with the worst prolapse because the waits are long. That is a real, significant issue. The patient demographics are against us as we - the baby boomers are getting older, and a lot more people are getting to that age where prolapse is a big issue.

 

            IAIN RANKIN: I’m happy to hear from others. I think what I’m hearing is it’s specialized in Central Zone, but to get an assessment - just to have an assessment from a specialist - when receptionists are telling people in Eastern Zone that they have a lot less time to wait, this is something that’s debilitating.

 

I wanted to ask: What’s the process to use the resources we have to have people looked at?

 

            THE CHAIR: Dr. Rose.

 

            ANNETTE ELLIOTT ROSE: It may be easier for all of our shared understanding to describe the system a bit first.

 

We work in a tiered model, and we work in a distributed model for some services. I know there were comments earlier around primary health care, and we know primary health care is foundational to our system.

 

If we build the primary health care system in a good way - and now, 94 percent of Nova Scotians have a primary care provider, primary care team - we increase the services available in primary health care, and we increase the skills and competencies of people in primary health care, then some of those needs for women and gender-diverse people can be met at the level of primary health care. Then that changes the demand coming to specialists in regional centres or into the tertiary centres.

 

[1:45 p.m.]

 

We are in a distributed model when it comes to what we call Wait 1, and I say this because all waiting is waiting for women and gender-diverse people. In the system we tend to think about Wait 1 being the time to see a specialist, so the time it goes from a referral from primary health care to see a specialist.

 

Wait 2 is the time from seeing the specialist to the time you have surgery, if surgery is indicated as a - we have better data in Wait 2 around surgery. There’s been a lot of work in the last couple years around centralizing the Wait 2 data around surgical services.

 

More work needs to happen in Wait 1 because, right now, for instance, the gynecologists around the province would have their own wait-lists and sometimes their own offices in communities. We need to combine some of that, and work is under way to do that so that women and gender-diverse people - so Nova Scotians - have line of sight around what the resources around the province are, and if they choose to go outside of the place where they’re living to another community, to another zone, for care then they have the ability to do that.

 

I should mention, too, that my colleague, Dr. Cheryl Pugh, is here today. She’s an obstetrician, she’s the medical lead in Western Zone, and she has some additional information around wait time, if that would be helpful.

 

THE CHAIR: Okay, Dr. Elliott Rose. My apologies for not saying the full name before.

 

IAIN RANKIN: I’ll get back to wait times later, but I do want to make sure I hear from the foundation on the work that’s happening. We all take the note that primary care is important, but when you learn that 75 percent of women don’t feel like they’re being adequately addressed by that system - like we need systems change - I think that’s what the crux of the report is advocating for.

 

My colleague kind of asked this in a different way, but what are some real examples that the provincial government can be doing to implement that systems change to try to lead a type of strategy - we tabled a bill, as well, that looked at a strategy, but the report and the WHEN are looking for partnerships between federal, provincial researchers, hospitals, foundations, and others. What’s something that the committee can be helpful with in advocating alongside all of you to push the provincial government to act?

 

THE CHAIR: Ms. Gillivan.

 

JENNIFER GILLIVAN: I’m not an expert in systems. My colleagues here would be more of an expert in that, but I’m probably someone who may be - I believe in common sense. We could all come together and look at the system as it is and - including women at the table - we could all decide if women are the priority, a priority, or one of the top priorities of this Province, and then let’s work together because it’s not one over the other that’s going to create this. It’s going to be a combined effort.

 

We’re supported through the generosity of donors, so the public and people with resources are stepping into the fray. There are some amazing projects happening right now at the IWK Health Centre that will alleviate or help in some of these key areas, but it’s not an answer on its own. I feel for a lot of these - like Jim and his colleagues - because they’re working night and day, and they’re doing the best they can, but it’s upon all of us as a community and as a society. If we decide this is important, then let’s all come together, and let’s bring the best of our talents, our know-how, and the women’s voices. The women’s voices have got to be there. Let’s create a strategy that will address this.

 

It’s all of those prongs. It’s research, it’s the system, it’s the equipment, it’s the talent, and it’s the new technology that’s coming on stream that we’re not even - we don’t even know what to do with it yet it’s coming so fast.

 

What are all those pieces? Take the best of everything that we have to offer as a society in our region and create it ourselves and create it with industry, create with those innovators, and create with the philanthropists. They’re there. They’re putting their money where their mouth is. Those donors are stepping up.

 

What we did differently was - I mean, honest to God, it was organic - we went out and asked women. That is something that doesn’t happen a lot, and that’s the response we got. They’re telling you. They’re giving you the road map, so it’s all of us working together.

 

I don’t know if you guys want to - I don’t know how to do health systems. Don’t even put me there. I know you guys have a better shot at that than me. I don’t know if that answered you.

 

            IAIN RANKIN: I was going to go through each one of your areas of focus, but maybe because we have limited time, I’ll just package it. What can we do in those five areas and in education and in research? We have more universities per capita than anywhere else. We have the med school and another med school coming in. As you said, 9 percent of the med school curriculum is focused on women. The third area was innovation. We talked a little bit about the economic impact. The fourth being advocacy and partnerships, which really should be the strategy. Should there be a provincial minister of women’s health? Should there be specific policy tools? The fifth, of course, is equipment and patient spaces.

 

I was going to ask one on each, but I’ll just ask it all together. Maybe Heather and Nicole want in on this. What kinds of investments should the provincial government be making? What kinds of collaboration do you see? What is possible to help that work?

 

            JENNIFER GILLIVAN: Those are the key areas that are listed in there. Underneath them is subsets, obviously. How much it costs, I have no idea. I think it’s not just cost. You asked me the question about investing. It’s also an economic engine. You have to look at this as an opportunity. If women are heard and felt and they’re believed, and they are coming to a system that’s really starting to design itself for them, they’re going to come earlier and sooner, if we have the access for that that we just talked about. I think it’s all of that together. I don’t know if you want to step in. It’s hard to put a number and say here’s what it is. I just think it’s the will to prioritize women and their health care and then work together.

 

            THE CHAIR: Ms. Creighton.

 

            HEATHER CREIGHTON: Yes is the answer to some of the things you suggested. A provincial women’s health strategy: yes, government can announce that. A women’s health minister: yes, great; let’s start. All of those things are yes. We can’t give you specifics under each of those because we haven’t had even a wish list to think that that’s possible. If you start with a women’s health strategy in Nova Scotia and you start with a women’s health minister, let’s get started. Let’s talk.

 

It’s going to happen federally; it’s coming. I think you’re going to see every province respond accordingly, but Nova Scotia can lead, so let’s start that now. That announcement sends a huge message. Then let’s look at the specifics. I mean, we could probably all list five things right now that could be done - HPV testing at home, universal contraception. All of those pieces, we see other countries and other provinces doing them. Let’s just make the first step and say we’re going to have a provincial women’s health strategy and start.

 

            IAIN RANKIN: I agree. I think those are great suggestions. I do want to get back to the discussion around wait times for women. I happened to spend significant time over the last four years at the IWK Health Centre in my personal life and have had conversations with folks. Now we’re running through watching the OPOR be implemented at the IWK. We hear about the administrative burden that is putting on doctors. In neurology, before that was in place, there was very much an effort to reduce burden on doctors and have less time on paperwork. I’m hearing that wait times are actually being impacted - that we’re adding to wait times. I know for a fact that there are missed appointments, and I know that people aren’t getting notified of appointments in time.

 

I just want to ask how we’re evaluating this - as succinctly as you can tell us - how we’re looking at the whole exercise of implementation of OPOR and how that’s specifically impacting wait times and missed appointments for women.

 

            THE CHAIR: Ms. Larocque.

 

            LEEANN LAROCQUE: I am actually the lead for implementing OPOR at the IWK Health Centre, as the executive sponsor for that. You’re absolutely correct in terms of adding some wait times to our current patient wait-list. It differs depending on which service you’re looking at. We have had some great successes with OPOR implementation in our periop environment. They have actually regained their pre-OPOR numbers, which is fantastic.

 

            Where we’re struggling is in the ambulatory care space. We’re working very closely with the OPOR team in terms of what that is about - why we’re struggling, and what we can do for enhancements in the system so that people can actually use the system in a much more comprehensive way than they currently are. We know that when we bought the system, it was a standardized system. Sometimes when you’re working in an ambulatory care area, you need a little bit more customization in order for you to be able to function.

 

It’s been a long time since we’ve introduced a new technology to our workforce. They’re used to using MEDITECH for the last 30 years, so any new system, we knew that we were going to have to decrease some of the patient visits until people get used to the system and try to navigate their way through that. When we’re looking at the evaluation pieces, we’re looking at our no-show rates, we’re looking at how many patients we’re serving and comparing it to pre-go-live, and then we’re having those conversations with NSHA as they prepare for go-live. Our lessons learned are shared with them so that they can prepare as well.

 

IAIN RANKIN: How is the public going to see the impacts of the rollout? Will that be disclosed? The impacts to wait times, will that evaluation be made public so we can have a look? Some doctors have told me that the system that was chosen was like buying a brand-new car with a CD player in it - that we went for the bare-bones kind of system and the add-ons aren’t there to help scribe and things like that that would help doctors. My main question to end this round is: What will that evaluation look like, and how will that be shared with the public?

 

LEEANN LAROCQUE: We publicly report our wait times to government on a regular basis, so anybody can look at what our wait-lists are on the government website in terms of how we’re serving patients. We talk to our patients and family advocates all the time in terms of when they come in from a service delivery perspective, talking to the health care professionals they’re seeing.

 

We have not decided that we would do a big public forum in terms of what this looks like, but we’re hearing from our patients and families all the time. We’re following up with them on any challenges or any struggles that they are having with the new system and what they’re experiencing. Then we’re working very closely with OPOR in terms of how we make those enhancements to this particular system for the CIS - the clinical information system - so that we can get better at what we’re doing and be more efficient in terms of the implementation.

 

I’m not sure if Annette is also involved in OPOR and leading it as well. I’m not sure if she also wants to add to that question.

 

ANNETTE ELLIOTT ROSE: As LeeAnn mentioned, this is a significant new technology after 30 years of MEDITECH. MEDITECH was no longer able to be upgraded - no longer able to move forward with that system - and we had different systems across the province. If you look at other jurisdictions across the country and beyond, having a clinical information system is important, not only to make sure we’re connected and we have the right information - clinicians have information at hand and patients are not telling their stories multiple times to multiple people - the transfers and information-sharing across the province is much more efficient. But it’s also good for system planning. Then you have real-time information in order to make good decisions like the ones that we’re talking about today.

 

We’ll be looking at all of that, but it would be premature to start to look at all of the different indicators of success right now because it takes three to six months, really, to get going with a new system like this.

 

As LeeAnn said, there are areas that have already knocked it out of the park. They are doing well with the system and seeing that their services are 100 percent as they were before the launch. We’ll likely see improvements as we move along in those systems. My hope is that we’ll see efficiencies in this system even before it was introduced. It will take time.

 

I’ll make a comment because I have the opportunity from a workforce perspective, because we’ve done a lot of work in provincial workforce planning. Having a clinical information system is a key recruitment tool and retention tool. We’ve had people say, “Oh, you’re still doing paper charting? No thanks, we’re not coming to Nova Scotia.” It is a significant lift, a significant change for teams, and there are lots of supports. We’re learning more and more as we go, but it’s an important change.

 

[2:00 p.m.]

 

            THE CHAIR: There are six seconds remaining, so we’ll move on to the PC Party.

 

MLA Hilton.

 

            NICK HILTON: Thank you all for being here today.

 

            The health committee - any committee - this is the most valuable time I spend as an MLA, number one, hearing from the people doing the work in Nova Scotia and hearing from the residents on the issues that they encounter within the system. I truly want to say thank you to all for coming in and sharing your experiences.

 

Specifically, you can - I am the first member of the government caucus to speak today, so I want you to know that I am listening. I am hearing you. When we sit around this table, we don’t just represent ourselves. We represent the million Nova Scotians across the province and, specifically today, talking about women’s health, 500,000 - at least 500,000 - of our population.

 

Last session, we sat here, and we talked about Early Years, where we’re going, and the effect that has over the next few decades, the money that we can save, and the way we can improve health for all Nova Scotians.

 

            I feel like every time I come to health committee, we’re having conversations that matter. I have your opening remarks in front of me, and although you didn’t share them, I hope you do share a bit of that in some answers throughout today, and if not today, in further conversations when we leave here. Use that experience, hopefully to improve health care for others.

 

I truly value the women in my life. They are the most important relationships that I have, so hearing from you does make a difference. In my role as a nurse, I’ve spent many nights listening to my colleagues, predominantly women, share how their health has been affected over the years and quietly listened, to be honest, because it’s important that I sit back and reflect because I am not the one who is experiencing those things. That’s what I’m doing here today.

 

When I go back to the Department of Health and Wellness, in my other role, I take all of this with me. I also know that there is a significant amount of work happening within the health department. We’re focused on the idea of a women’s health strategy, but I guarantee you this; we are doing the legwork to get there. That’s when I say that strategy is no small feat. It’s for half of the population of Nova Scotia. I truly hope we get there at some point, and I hope that the work we’re doing now - the positive work that we’re doing now - is building on that.

 

Thank you, again. I know we’ve talked a bit about what hasn’t been working, but let’s talk about what has been working and maybe some of the good things that have happened that maybe, through that work, will lead to more positive places.

 

I wanted to ask: Where has there been progress, and where will that progress lead us?

 

            THE CHAIR: Ms. Larocque.

 

            LEEANN LAROCQUE: There has been a lot of positive work and progress that has been made in the last number of years, especially at the IWK Health Centre. I’ll pass it over to Annette to comment on the Nova Scotia Health Authority.

 

            In terms of the IWK Health Centre, through business case submissions and approval through the Department of Health and Wellness, we’ve been able to get some additional resources in our perioperative environment. With the additional gynecologists, we were able to also open access to our ORs and have more throughput through our ORs. In our operating room, we were able to do an extensive number of more cases - surgical cases.

 

Also through that business case, we were able to develop what we call a procedure room, where we can take some cases out of the OR. They’ve been done safely in a procedure room, so we are making more room in the periop environment for more complex cases. When we looked at our stats, we were able to do an additional 600 cases in the procedure room compared to the previous year, which is a substantial number of women and gender-diverse individuals coming off our wait-list from a periop environment.

 

            The other initiative that we have been able to move forward progressively is our Endometriosis and Chronic Pelvic Pain Clinic. With the resources from our business case, we were able to implement a nurse-led clinic and also NP-led care mapping for those patients who are coming through that clinic. They can actually be assigned a nurse practitioner while they are waiting for the subspecialist gynecologist in order for them to be seen. They’re giving options of care treatments while they wait.

 

What we have found is that sometimes those options they’re provided from a treatment basis actually negate them even having to see the surgeon. They’re actually moving along and coming off the wait-list before because they don’t actually need to see the surgeon. The nurse practitioner is able to give them some care modalities that are successful, and they’re able to go on their way and increase their quality of life.

 

            The other one that we have that I’ll just note today is our Maritime Centre for Pelvic Floor Health. In terms of that, we have also implemented a nurse-led clinic there and have a nurse practitioner who sees patients as well. The same sort of progress from a care-mapping perspective is seeing those patients without having to see the surgeon, giving them options for what they do while they wait. We have seen a 40 percent reduction in the number of women who were on that wait-list because they were able to be cared for by the nurse practitioner and then do not actually have to see the subspecialist for that.

 

            In terms of other support that we are seeing, obviously our foundation is a huge supporter of the IWK Health Centre. Just having the inaugural women’s health research position is going to transform in terms of how we are spending our time and what we’re looking for in terms of the research pieces so that we can actually put evidence into practice. We don’t want a research person who is coming to do evidence that sits on the shelf for 25 years before practice changes are implemented. We’re actually looking at the research and putting practice and piloting things that we’re learning immediately, which is foundational to how we want to advance care going forward.

 

            The last thing that I’ll add is the menopause clinic - the recent announcement of the menopause clinic. The IWK Health Centre, the Nova Scotia Health Authority, the Menopause Society and our partners with primary care will look at the Menopause Centre of Excellence and create that moving forward in the next fiscal year. Right now, there’s an RFP out there to look for a clinic location. We will be starting to hire in the very near future - of what that menopause clinic will look like.

 

            I’ll pass it over to Annette because I know that she also has some significant progress that she can speak to.

 

            THE CHAIR: Dr. Elliott Rose.

 

            ANNETTE ELLIOTT ROSE: I think it’s important since we’re having this really good conversation about the importance of women and gender-diverse health to add - I’m going to add to Ms. Gillivan’s comments earlier and others. Women are the backbone of global health. They make up 67 percent of the world’s paid health and care workforce and only have 25 percent of the leadership positions. I think also having women at decision‑making tables is important. They deliver the equivalent of over $4 trillion in health care annually, and half of that is unpaid. They influence 70 percent to 80 percent of all household health decisions. We know this work is important and we’re so happy to share some of the really good stuff that’s happening, and more to do.

 

            Awareness and advocacy: women’s health and gender-diverse health has been top of mind for us all here and globally, nationally, for quite some time. We’re so fortunate to have a person, a member, a woman’s voice and a member of the public here to share experiences. We have very established patient and family feedback mechanisms at the Nova Scotia Health Authority and at the IWK Health Centre where we gather the voices of patients and families. We gather the voices and experiences of women and gender-diverse people. That informs the work that we do. We have great partnerships - as LeeAnn mentioned - across the system with the foundations, with advocacy organizations to advance this work and to contribute financially and otherwise to this work in really good ways.

 

            At the Nova Scotia Health Authority, I mentioned primary health care is the foundation and the successes there. There are also 26 well woman and sexual health clinics across the province that can be accessed through YourHealthNS or 811 for information. Women do not need a primary care provider; they can self refer. There are lots of different services provided there: prevention, screening, information on other aspects of women’s health like menopause - and referrals to specialized areas as well.

 

It’s always important to think about women’s health in a whole-of-woman approach. At the Nova Scotia Health Authority, we provide specialized women’s health care in cardiac, geriatric, mental health, perinatal, gender-affirming gynecology, pelvic health, and breast health care. We want to think about women and work with women in a whole-of-health kind of way.

 

We have equity-focused resources, as well, so we’re fortunate to stand up a nice prideHealth program, a small but mighty team of navigators who help women and gender-diverse people navigate the system in a good way, and we have the gender-affirming care that I mentioned earlier. The Nova Scotia Sisterhood initiative is an example of an interprofessional team of providers. They are all Black African Nova Scotian providers, and they go to communities in Nova Scotia and provide services and are partners in services, as well. There are great things happening there.

 

            I will mention, from a research perspective, that - some interesting stats and some good work that’s happening with Nova Scotia health researchers. Critical diseases affecting women are severely underfunded. Under 5 percent of all the CIHR-funded grants over the 15 years studied were about women. The top 11 global causes of disease or death for women are cardiovascular disease, diabetes, dementia, depression, and musculoskeletal disorders. Less than 1 percent - 0.7 percent - of CIHR funding examined cardiovascular disease for women, and that’s the number one reason for women’s mortality, so it’s important to think about that.

 

            At the Nova Scotia Health Authority, the researchers are focusing on many areas of women’s and gender-diverse health, including: postoperative pain; women’s cardiovascular health; sex and gender differences related to kidney transplantation; prevention, causes, and negative health outcomes related to violence against women and gender-based violence; differences in risks for women experiencing mental health challenges; women’s health, nutrition, and food security; and gynecological, breast cancer, and endometriosis.

 

I’ll give you a couple examples of quality improvement, which is also a way that we take information and make improvements in our system. As a learning health organization, we’re very much committed to that at the Nova Scotia Health Authority: increasing the percentage of patients aged 25 to 70; increasing pap screening by 50 percent or more; collaboratives on menopause care; and information for women in the health workforce. As I mentioned, there are a lot of women in the health workforce, and now we have menopause education for women working in health. In perinatal care, the eat-sleep-console method is family-centred care looking at neonatal opioid withdrawals. That’s important to support - obviously, neonates - women and gender-diverse people as new parents, and we’re improving patient discharge information post-surgically and post-medical care.

 

Those are some examples of some great work that’s happening from a quality improvement perspective but also from a research and service perspective.

 

            NICK HILTON: In follow-up to that, we know we truly do need to sustain focus and investment to improve the entire system, but we all acknowledge that there have been some systemic barriers that have influenced the evolution, access, and investment in women’s health. Can we speak to what those barriers are? Maybe, Kim, you can weigh in on this, what you’ve encountered throughout your journey through the system, and where we can improve. Maybe I’ll hear from you and the government, as well, on what barriers exist and where we can improve.

 

            THE CHAIR: Ms. White.

 

            KIM WHITE: We’re done at when - at 2:40 p.m.? I don’t think we have enough time.

 

            THE CHAIR: We have six more minutes in this session.

 

            KIM WHITE: Unfortunately.

 

THE CHAIR: Ms. White.

 

            KIM WHITE: Barriers are multi-faceted. In my case, I had a hospital that had a policy. I am a very large woman - obese, morbidly obese, fat, blubbery, whatever you want to call it - and I was told by my hospital that they couldn’t provide my surgery for my invasive mammary breast cancer. It’s not like I stubbed my toe.

 

[2:15 p.m.]

 

            The health care system has been about as useful as the boob on my head, which I wore today, because that’s exactly how I feel. This particular government right now is not listening. Health care has been a problem for decades. It’s not a right-now problem. Things have gone this way for years, for decades, and I’m pretty sure every woman in this room has been a woman all of their life. Maybe some haven’t - which we talk about gender diversity and transgender - but BMI should never, ever be a decision to prevent someone from life-saving surgery. I’m not talking about going into the hospital and having heart surgery or open-heart surgery or lung surgery or kidney surgery or anything like that.

 

            The anaesthesiologist and my hospital in Amherst had a policy in place that the Northern Zone chief anaesthesiologist said was archaic. He called me directly but the other barriers that I have encountered are not just those. When I made my story aware to the Health Committee last year, I believe it was MLA - sorry, I can’t see. Yes. You stated that you were not going to move forward after MLA Wilson brought my story forward. I believe I can quote you by saying that we are going to let the nurse navigator policy program and the research do its work before we bring this forward. Well, I’ve never heard from a nurse navigator. I have no doctor. So who am I supposed to hear from?

 

            Those are the other barriers that we face when we have no family doctors. I’ve been without a doctor for two years. My MLA, who is sitting directly behind me, has been a huge support. Now, unfortunately, some of you in this room will think that I am a political pawn - that I’m put here politically by the other side. But I’ll let you know that I am not a Liberal nor a PC nor an NDPer nor Green Party or whatever party you want to talk about. I’m a very independent person. I believe in pro-life. I believe in pro-choice. I don’t believe in abortions myself, but I believe every woman should have the right to choose. No man should choose that, but I’m quite sure, based on the makeup of this committee - 75 percent men, 25 percent women - that 75 percent of you do not have a clue what a woman goes through and the barriers that she faces.

 

I am so sick and tired of everyone blaming me because I’m fat - that I should have died, that I should have taken pills to lose weight. Yes, it’s my fault I’m fat. Yes, it’s my fault that - yes, it is. It’s my fault that I’m fat because I chose to be fat. I’ve lost almost 100 pounds in the last two years, but that didn’t stop the people in this province blaming me willy-nilly for what a policy did - not my health. I’ve got a heart specialist. I had all the testing done and I was cleared for surgery.

 

Sorry, help me with that. Dr. Faryniuk in Amherst was willing to do my surgery, but I had to wait two more months because I was dismissed by the IWK Health Centre because I obviously wasn’t fat enough - according to them - that my hospital should be able to do my surgery. I want to ask a question of the two particular gentlemen on either end of that table. Now, I see that there’s an elevation of weight on you and I’m going to be polite because I’m a polite person most times. Have you ever had surgery? Have you ever been denied surgery? Because I’m pretty sure that you would tip the scales beyond the BMI and, according to the province, that BMI, alone - and I’m quoting our Minister of Health and Wellness by the way - BMI alone should not be the contributing factor for clearing a patient for medical procedures in this province. I was - alone - that was the only reason. My health was fine. I came through the surgery fine.

 

            THE CHAIR: I have to call order, Ms. White. The 20 minutes are up.

 

            KIM WHITE: My time is up. I apologize for not allowing the other people at the table to speak.

 

            THE CHAIR: We’ll start the second round of questioning with the NDP caucus. I’m going to set for seven minutes each.

 

            MLA Wilson.

 

            ROD WILSON: Thank you, Ms. White, for speaking today again and again. I’m sorry that you have to - it must feel like the burden is yours to change health care, but I suggest the burden is not yours. Thank you for speaking out.

 

            If there was one thing this government could do, based on your experience - one thing that could change or even two things - that would make your access to care and your experience better, what could they do?

 

            THE CHAIR: Ms. White.

 

            KIM WHITE: That’s a fully loaded question. There are a lot of things that the province could do - the majority government and the MLAs who work hard to try to help - but the eyes of our government need to be opened to the fact that, while it’s important to have all of these tools that we have currently focused in HRM, we in the rural communities are suffering. We are suffering.

 

I haven’t had a doctor for two years. I have no idea where I am on the list. I’ve called to find out. I’ve stopped in at clinics, asking if I can get a doctor. “Oh, you have to find out where you are on the list.” I have no idea. My MLA requested that I get a doctor when she referred my case to this provincial government. I have yet to hear from anybody to take my case.

 

I’m here - we need more focus. While we need focus on women’s health overall, we need focus on family doctors and for technicians, for radiologists - for them to be paid well. The same equipment that’s in IWK Health Centre women’s clinics needs to be in our rural communities. I shouldn’t have to travel two hours for a follow-up mammogram. I should be able to do that in my own community. It shouldn’t cost me, especially at today’s gas prices, $200 to come to the city just because there’s no money and no focus put on our rural community. That needs to be a focus, as well. It’s great that we’re focusing on women’s health, but we need to focus on the other things that are causing problems.

 

Women are suffering. Women are - quite frankly, we’re messed up. Even with getting mental health care, I have to wait two months. I called on March 30^th. I have to wait two months to get my first appointment. During my time with my intake application, I told her that I have had thoughts of hurting myself because I didn’t want to go on because it was so stressful. Dealing with cancer is hard enough. I’ve dealt with it before. I came through it before, but the mental stress of what this - I don’t even want to call it a journey because “journey” sounds pleasant - this lost ship without a sail on the ocean, the stress of that was debilitating.

 

I’m a strong woman. I think you can all gather that. I’m mentally strong and physically strong. I’ve been the cornerstone of my family: both my siblings, my parents, my husband, and my children. I have contributed for women to this Nova Scotia project on women’s health.

 

One of my daughters was denied breast reduction surgery in the last four years because she was - quoting the doctor, “You need to lose a few pounds.” She was slightly overweight, but she was denied this surgery, with a neck issue that was causing her debilitating pain. She was missing jobs, going to work, and interacting with her children.

 

There are a lot of things. I’m sorry I took up so much time, but there are a lot of things that need to be fixed. In my particular case, the whole province needs to be looked at because BMI is still being used. I know we need to fix our own personal health, but when you’re denied life-saving surgery - because my cancer had already spread to two lymph nodes. I don’t even know if my breast cancer journey is over because I couldn’t take radiation because of an infection.

 

Let’s be clear: Next year, I might not be here. I don’t know, and I won’t know that until June 18^th, when I have my next mammogram. I asked for one on my other breast six months ago, and I don’t have one until June.

 

That’s all I have to say right now.

 

ROD WILSON: You mentioned access to care. One of the things that women in Nova Scotia don’t have access to is HPV - doing your own swab at home. Five other provinces can do it.

 

The pap smear is 100 years old today this year. It was invented in 1926, so 100 years later, Nova Scotia women are still using 100-year-old technology.

 

We know that HPV technology screening is available. It’s done by an analyzer, like RSV. I asked the minister a year ago, “When are we going to switch to HPV detection?” She said, “We’re waiting on equipment.” The analyzer is there, the same one that does screening for RSV. My understanding - the equipment that’s not available is a labeller.

 

I’ve spoken to many people at the IWK Health Centre and through the province. We’re the fifth - there are five other provinces - the minister has told us it will be another two years, which could make us the last province in the country to switch to HPV screening, which again, could be available across the province.

 

What I’m trying to ask, for the frontline people, Dr. Bentley: Can you think of any reason, other than a labeller, that we could not have HPV screening done in Nova Scotia in the next year?

 

THE CHAIR: Dr. Bentley, with 30 seconds remaining.

 

JAMES BENTLEY: No. What I’ve done my research on over the years is the best test. It needs to be implemented.

 

THE CHAIR: There are 18 seconds left on that side until the next party.

 

MLA Wilson.

 

ROD WILSON: Thank you for being that candid. One of your colleagues told me you could roll it out in six months, and the cost for that, to start up, would be about $600,000 - less than what would - endorsement for SailGP.

 

THE CHAIR: We’ll now move on to the Liberals.

 

MLA Rankin.

 

IAIN RANKIN: I want to pick up on Kim’s point around breast cancer screening diagnostics and the issue that was raised - that we do hear from physicians - around the shortage of radiologists and technologists. That is driving up wait times for diagnostic imaging, and that can run routinely into hundreds of days for women looking for mammograms.

 

I want to ask: What is the current vacancy for imaging technologist positions in Nova Scotia?

 

We did look at a FOIPOP that shows the Nova Scotia Health Authority spends about $7 million per year on travel technologists - last year.

 

Two questions: How is the vacancy, and how is NSHA going to invest in training and deal with attracting more technologists in the long term so we don’t need to spend so much each year on the travel technologists?

 

THE CHAIR: Dr. Elliott Rose.

 

ANNETTE ELLIOTT ROSE: I don’t have all the data at hand, but I’m happy to loop back with you and give you specific vacancy information.

 

I can talk about the strategies around recruitment for technologists specifically; obviously, doubling the schools and the seats that we have, and there is a program through the School of Health Sciences at Dalhousie University. Most of our recruitment for newly graduated technologists comes from there. The international recruitment is variable because the role of the technologist varies around the world, but we have had some success with international recruitment, as well.

 

If we think of the health workforce in a couple different buckets, recruitment being one of them that I just spoke about, the next being retention, and think about workload: Are technologists doing the work that they should be doing? Are they working to their full scope? There’s active work there. Process improvements in the actual clinics so that people are freed up to do that work: that improves some of the services and wait times. The introduction of assistant roles: again, making sure people are doing the work that they’re doing - that they’re educated to do, so that Nova Scotians have that good care. A successful project that we’ve had in the nursing world, and the IWK Health Centre has had a similar success, is with the introduction of student nurses. We’re planning for the same with technologists, so when they’re partway through their program, they can come and work in defined-scope roles in the clinics. That’s been helpful.

 

[2:30 p.m.]

 

There’s a lot under way, and I’m happy to loop back with you with the specifics around vacancies.

 

IAIN RANKIN: That would be helpful for the committee. As well, relative to the retention we just spoke about, how does the salary for radiation technologists and imaging technologists compare with other provinces? I have to get a couple in at a time because we’re running out of time, but have you looked at immigration policies to try to do what is happening with nurses for technologists?

 

ANNETTE ELLIOTT ROSE: I can speak about the second question first, if you want, and then Stacy has information around compensation. Yes, we have a federally funded program. We call it NICHE 2. It’s around supporting newcomers to the province. We look at five priority professions, and all of the roles in diagnostic imaging are part of that project. It’s a provincial project, so again, it includes the IWK Health Centre, the regulators, government, the Department of Labour, Skills and Immigration, and then federally we’re connected with in with ESDC.

 

Part of that work is mapping out the immigration pathways and relationship pathways for technologists. We can streamline that a bit better, and we have had some success, although as I mentioned, the pools of recruitment for technologists are limited around the world, simply because the role is quite different.

 

THE CHAIR: Thank you, Dr. Elliott Rose. Ms. Burgess.

 

STACY BURGESS: One of my areas is human resources, so I do have our vacancy rates for the IWK Health Centre. We have a 43 percent vacancy rate as of April 2026 in ultrasound technologists, and for mammography, which is diagnostic and screening, we have a 26 percent vacancy rate. As you can imagine, that’s quite concerning as the VP of people services.

 

The things that we are doing are around recruitment and retention. We’re starting to see the effects of the bargaining increase for radiology technicians that put them in line - highest in the Atlantic. We’re starting to see that, so it’ll take time to get to the level that we want to see for vacancies. We were higher than that about a year ago.

 

The other thing that I don’t think Dr. Elliott Rose spoke about is increasing our seats with Dalhousie University. We have increased our class size for radiology technologists from 13 to 26 and diagnostic medical ultrasounds from 8 to 16, with the first graduates expanding programs in 2026-27. We’re looking at return-of-service agreements for all of those individuals.

 

IAIN RANKIN: I’ll just do the final question on the issue around dense breasts that was talked about in the Legislature multiple times. Specifically, we know that there’s better detection with contrast-enhanced mammography technology. Does Nova Scotia currently have this technology, and if not, when will we be receiving it?

 

STACY BURGESS: Yes. I’m pleased to say that we are enhancing our mammography units across the province: IWK Health Centre, VG, Bridgewater, Kentville. I think it’s important for us, especially when I just talked about the vacancy rates, to really understand what that might mean for appointments and for radiologists. These technologies do need people to be skilled up and advanced in that area. I think it’s important for us to understand as well that having a day dedicated for just those for CEM - a mammography - if we were able to do 20 a day of regular screening, we can only do five of the other.

 

I think as we work through this enhancement and start to roll it out across the province, we have to ensure that we’re looking at it from a population basis and that we’re using the resources for the most symptomatic as we expand in our technology. It’s hard when you have a 43 percent vacancy rate, or a 26 percent vacancy rate, to ensure that you’re able to meet the wait times that we want to, and to ensure that we’re screening everybody that we would like to.

 

THE CHAIR: Order. Good timing. We’ll move on to the PC Party. MLA Hilton.

 

            NICK HILTON: Before I pass it to my colleague, I wanted to respond to the question that you put out.

 

Personally, from me to you, I think people want to see themselves in their government, and that’s why it’s important that I answer this question and for the people who are in here today. Every time I put on a suit jacket, every time I sit in this chair that reminds me of a porch swing, every time I go anywhere, and every time I travel, I am constantly reminded that, according to the BMI scale, I am morbidly obese, so your comments today are heard and respected. I wanted you to know that.

 

            THE CHAIR: MLA Corkum-Greek.

 

            HON. SUSAN CORKUM-GREEK: As we find ourselves in the final minutes of today’s meeting, I also want to thank everyone who is appearing here today, those offering a valuable first voice perspective, and those of you on the front lines and in upper management regarding this issue.

 

Again, I would like to acknowledge the presence of Dr. Cheryl Pugh, back there in the second row - she heard it was sinners to the front, and she chose the second row - an obstetrician whom I first met when I was pregnant with my eldest. She saw me through in a rotation at an obstetrical clinic that I now realize was maybe ahead of its time in terms of the way it worked. She did not deliver my babies - got to be safe from seeing me in that state - but I received excellent care.

 

Of course, now I turn to Dr. Pugh, as the medical executive director for Western Zone, to keep me apprised and when I have questions or concerns - but I had excellent care. For colleagues who have known me for a shorter period of time, I took - talked to the doctor and double-checked later - I took excellent care of myself when I was pregnant. I could do for those babies what, before and frankly after, I have not been as faithful to.

 

            I wanted to reflect on something that was also gathered with the survey, which is - this is not about blaming women, but it is a fact that women tend to forgo their own health advocacy, whether it’s making time for an annual checkup, for breast examinations, for pap smears, or for follow-ups of any manner. They tend to - as caregivers, they put other people first, they’re nervous - whatever their reasons. I wanted, before we ended today, to go to that.

 

We’ve seen - it’s not simply breast cancer care. We have a great mammography program here, but we need people to make appointments. We need them to be able to access services.

 

We have seen national attention on colon cancer screening. I wanted to ask, particularly those from the IWK Health Centre, if you could do a thumbnail PSA right now to women and gender-diverse individuals in Nova Scotia on that issue, realizing, as we have heard here today, and we knew coming in, that we have more work to do. Making progress - I think that’s what I have importantly heard. There’s interest in being part of a larger national strategy, absolutely, but getting to the doctor, the NP, or the clinic - if we could hear from you on that, I would be most appreciative.

 

            THE CHAIR: Ms. Burgess.

 

            STACY BURGESS: The number one thing that I would say is - maybe not perfect - but we have population health screening in the province. I encourage everybody to do those tests. Don’t let the colorectal cancer package sit and expire. Book your mammography. Our rates right now are 43 percent for the province.

 

In order to see real change - and we know that breast cancer diagnosis rates have stayed the same. The cancer stats came out yesterday. In order to see real difference, we want that at 70 percent. Recognizing that we need to enhance our screening times and things like that, but we also have a fair amount of the population who’s not taking those tests and doing them. Go to your family doctor or nurse practitioner and get your screening.

 

            As a woman with two children, I often put myself last. With a busy work life, I say: Don’t put yourself last. Go and do that. It’s important for now, and it’s important for the future.

 

            THE CHAIR: Would anyone else like to speak to that? MLA Corkum-Greek with one minute, 20 seconds.

 

            SUSAN CORKUM-GREEK: I’ll try to get through the question as quickly as possible to get to answers. I know during Estimates, there was a lot of focus on the Endometriosis and Chronic Pelvic Pain Clinic. I wonder if we can again speak to - because I think even myself as a woman, I’m not fully aware of the scope of services or scope of conditions that may identified and treated through those clinics. If we could . . .

 

            THE CHAIR: Ms. Larocque with 45 seconds. Dr. Bentley, sorry.

 

            JAMES BENTLEY: The Endometriosis and Chronic Pelvic Pain Clinic deals with those people who have significant pain problems. The idea is that everybody else would be triaged through primary care, the gynecologist, and/or the (inaudible) providers, then get to that setting, so that the people who need to be in the clinic - which is a multidisciplinary clinic with anaesthesiologists, nurses, physio support, et cetera - can actually be seen there to have the specialist care. Not everybody needs that. A lot of things can be done every step of the way to deal with that problem, which is a very frequent problem. Yes, we need to do more about it, but across the country, it’s the same issue everywhere.

 

            THE CHAIR: Order. Thank you, Dr. Bentley. The time for questioning is now closed. I’d ask if the witnesses have any closing remarks. We’ll start from the left with Dr. Elliott Rose, perhaps.

 

            ANNETTE ELLIOTT ROSE: I had a few notes, but I’ll do it on the fly. I think we today heard the importance of women and gender-diverse health. We’ve shared some really good successes in, I would say, foundational services across our province in primary health care. They’re very targeted services to support women and gender-diverse populations. I think we’ve heard from our foundation colleagues and others that this is about collective action that also includes, and must include - be central - the voices of women and gender-diverse people.

 

            Thank you for the opportunity today. There’s a lot of important work that is happening and much more to do. The Nova Scotia Health Authority looks forward to working in partnership across the system.

 

            THE CHAIR: Thank you, Dr. Elliott Rose. Once again, my apologies for not pronouncing your name fully the first time. Ms. Larocque.

 

            LEEANN LAROCQUE: I just want to echo Dr. Elliott Rose’s comments and thank you today for the opportunity to be here to talk about this important issue. As all of us up here are women - except for one - we actually can resonate with all of the issues and things that we’ve talked about today. This is a very important topic for us. We look forward to partnerships and developing that strategy for women, both provincially and on a national basis. We have a lot of great things that we have success rates with, and we have more to do. I think collectively, we’ll get there if we all plan together.

 

            THE CHAIR: Ms. Burgess.

 

            STACY BURGESS: I want to take the time to thank you for having us here. I thank Mrs. White for her story. It takes a lot of courage to be able to sit here and tell those stories. Those are the stories that we listen to to make meaningful difference.

 

I know we spend a lot of time about whether it’s a provincial health strategy or a national health strategy, and I just want to let everyone know that this topic is near and dear to our hearts. We have strategies that we’re working on to improve the care for women and gender-diverse people in our province, and we’re using the resources that we’re given from government to do just that. Please know that despite a strategy, the work is happening, the investments are coming, and we’re putting them to good use.

 

            THE CHAIR: Thank you, Ms. Burgess. Dr. Bentley.

 

            JAMES BENTLEY: Thank you for allowing me to be here as a thorn between lots of roses. (Laughter) My department, the people in Central Zone, I think the gynecologists in the province, do what we can to improve the care of women and gender-diverse populations. We’ve done a lot of work. There is still an enormous amount to do. We’ll try to work with everybody to get there, to improve access, and get to a better place.

 

[2:45 p.m.]

 

            THE CHAIR: Thank you, Dr. Bentley. Ms. Gillivan.

 

            JENNIFER GILLIVAN: Thank you, everyone. Thank you, Kim. It’s not your fault. Don’t - it breaks my heart when I hear women say that.

 

            It has been, personally, one of the biggest privileges of my life to support the IWK Health Centre, and this particular work with women’s health and equity for women’s health is going to be something I do until I draw my last breath.

 

            We’ve got to get our heads around the fact that there is a systemic bias. The system was not designed for women. It was designed as the male is the standard norm. That’s why women have so many adverse drug reactions, et cetera. You’ve seen all the stats.

 

            Let’s take this moment now, and let’s lead this country. It’s going to happen. It has to happen. Women are done. They’re done being blamed for stuff, and they’re done being not listened to and dismissed. You can see all the stats that are in our survey. Now is the time to step up. Now is the time to take all the great people and all the great work that they’re doing. You guys - everybody - come together. Let’s make women a priority.

 

            We are the shock absorbers of the world, we are backbone of the world, and we are growing. We’re over 50 percent, and if we’re going to have a future - a strong future for my grandchildren - it starts with supporting and prioritizing women, so let’s make it that way.

 

            THE CHAIR: Ms. Creighton.

 

            HEATHER CREIGHTON: Now I have to follow Jennifer.

 

What I would say to Nova Scotian women and Maritime women: Continue to use your voice. Don’t carry the burden that keeps you from getting health care. Fight through the bias. It’s going to take all of us to make this change, so keep fighting for it.

 

            THE CHAIR: Ms. Slysz.

 

            NICOLE SLYSZ: Thank you for having me here today, and thank you again, Kim, for using your voice.

 

We can’t do what we’re doing without these women’s voices, and I want to take the time to say that our province can be a leader in this country. We need to get there and continue doing the incredible things the IWK Health Centre is doing and our province is doing. We can do it together if we all work together and make those changes.

 

            THE CHAIR: The last word goes to Ms. White.

 

            KIM WHITE: Oh my - let’s see if I can step up to the plate and say a few words.

 

I am almost 60 years old, and I can honestly say, in my 60 years of life, I have never been so disappointed and belittled by this health care system and by the lack of willingness to hear - not to talk about us, not to listen, but to hear us, to understand us.

 

            Government needs to work toward healing and helping all constituencies, not just the ones that matter in their own little bubble. I find this across all political spectrums - federal, provincial, European, whichever one you want to look at - we don’t focus, and we don’t listen. You need to hear us. Things are not working.

 

            Mentally, I’ve not been able to do my job. I work from home. I haven’t been able to do my job fully. I haven’t been able to support my family fully. I haven’t been able to be emotionally there for my family over this past year, and that’s debilitating. That’s what this panel has talked about - that I contribute to this society, but my politicians are not contributing to my society. I need that. We, as women, need that, and it has been historic over the decades.

 

            When I was 23 years old - a long time ago, I know, can’t remember - I wanted to have a tubal ligation. We had had twin girls. I was told we were probably going to have multiples again, and that wasn’t happening in my household. I’m sorry. Two was enough - twin girls. I went to my doctor to request a tubal ligation, and I was told, “Unfortunately, you’re too young, and you have no sons.”

 

Okay? We’re talking - 23, and I’m 59, so everybody can do the math. If not, how long ago was that?

 

            THE CHAIR: Thirty-six years.

 

            KIM WHITE: A couple decades. Right. Let’s fast forward that to one of my beautiful twin daughters at roughly the same age - well, a little older because she had three sons - three grandsons. She was told the exact same thing; she was too young. She wanted to have a tubal ligation. She had three children, she wanted to not have any more, and she was told no.

 

That’s 25 years later, which is only 13 years ago. Has it changed? I don’t believe so. I’m wondering if the doctor at the table - the gynecologist, maybe - can help me understand if maybe that’s still a policy. I don’t know. Maybe any other doctor on the panel - is there a doctor, a medical professional? No. Mr. Wilson - oh sorry - MLA Wilson.

 

I want to be respectful. That’s why I didn’t read my remarks today. I’m a respectful person, and I respect government, but what I can’t respect is being tossed out of the car into the ditch and being left for dead. That’s the way a lot of women feel, that we’re being tossed aside, put in the ditch, and left to defend ourselves.

 

            You’re going to find out that we can’t do it anymore. Women are going to start dying by their own hands or by the hands of government if something doesn’t start getting done now. Do I still have a few minutes?

 

            THE CHAIR: Yes, sure. Ms. White.

 

            KIM WHITE: Now, we’ve talked about women’s health and gender-diverse health, but I also want to talk about health care in general. I know you’ve all read my story. I apologize if you haven’t all read the full details of my timeline, which I included, but what I experienced with my post-surgical infection was not right.

 

An EMS came into my home and told me, in front of two witnesses, that they wouldn’t - they could take me to the hospital because I was so infected - what I later found out was almost teetering on sepsis. They left me at my home because they said the hospital - my hospital - wouldn’t touch me and that I should call my surgeon. My surgeon is in Halifax, and I have a number where I leave a message. How is that helpful to someone who’s got an infected breast and there’s pus oozing out of it? I lay there - 15 hours, throwing up, fever of 102 to 103 - and they leave me there.

 

Thank God for Dr. Faryniuk because she told me the next morning - I eventually had to go through eight weeks of excruciating pain. My breast incision - the lower one where the tumor was taken away - completely opened up.

 

            I’m sure a lot of women in this room - and I’m sure a lot of husbands in this room - would not want to see the inside of their breast. My husband had to experience that because he was my caregiver.

 

What happened to me didn’t just happen to me. It happened to my whole family. I became not the same person. I became less of a person. I became just a fat woman who didn’t deserve surgery because she was fat, and that’s not right.

 

            People in power have responsibility, according to our Premier. Well, where’s that responsibility with doctors, anaesthesiologists, and technicians to treat their patients - not just a statistic or a policy. That’s what we need to do.

 

            Because of what happened to me, I’m going to inform you all now, you’ve created a monster. I think you probably are all aware that I’m maybe dinged a bit in my armour, but I’m a strong person. I’m going to advocate the hell out of this, and I’m going to make sure that - he may not hear me or listen to me, but I’m going to have a little conversation with Mr. Houston at some point. Sorry. Premier Houston. I want to be respectful.

 

I got involved in a group. We wanted to call it WHEN, believe it or not, but we call it Watch. There are a lot of women across this province who have not received care - timely care. They’ve gone out of province to get care. There have been human rights violations by this Province to women in this province.

 

            There were supposed to be changes to the BMI policies. I haven’t seen those changes and, obviously, by my daughter’s experience with her breast reduction, those changes have not been made because she was declined her surgery. So we need change now. We need collaborative care departments, we need health departments, we need doctors, we need politicians, we need women, we need men - everybody. We especially need the media because the only way our voices are getting out there is through them, because this government right now - the PC government in particular - is not truly focused.

 

            When you are spending I think it’s $1.2 billion to operate the government, I’m pretty sure a percentage of that could have been taken away to help the people of this province, not the social programs that are supposed to lift us up. I couldn’t believe it when I saw that. But we are going to protest. I call to arms the ladies of Nova Scotia. What would an Irish woman say? Come on, come on.

 

            THE CHAIR: Ms. White, would you mind if we tabled your opening remarks so they can be shared with - a lot of the members agree that it can be distributed? Is that okay with you?

 

            KIM WHITE: Absolutely. You can share them.

 

            THE CHAIR: Thank you very much and thank you for your comments. I really appreciated that.

 

            KIM WHITE: I just want to say one more thing.

 

            THE CHAIR: Okay.

 

            KIM WHITE: I would like to thank my family, especially my husband, my daughter, my daughters, my children, my MLA, Dr. Rod Wilson from the NDP, who read my last year’s statement, for bringing this forward, and to the Liberal Party for being supportive of me being here. I really appreciate it. Thank you so much.

 

            THE CHAIR: Thank you, Ms. White.

 

            With that, I would like to thank the witnesses for coming, and you are free to leave now, if you want.

 

            I will call a 30-second recess until we do committee business.

 

            [2:58 p.m. The committee recessed.]

 

[3:01 p.m. The committee reconvened.]

 

            THE CHAIR: Order. Could I have the MLAs please return to the committee table? I would like to report the committee did vote, and agreed in consensus, to extend the meeting until 3:10 p.m. We’ll start that now. Committee business is on next agenda-setting so we’re looking at May 12^th. Each caucus is asked to send topics and witness proposals to the clerk by Wednesday, April 29^th. There are two topics left on the current agenda. The clerk is setting up the meeting of Brotherhood and Sisterhood programs for June 9^th. That’s confirmed and okay to go. We’re looking for more topics so if you guys want to bring more topics, send them to the clerk by April 29^th, and on May 12^th, we’ll have an agenda-setting meeting, if that’s okay with everybody.

 

            We’ll want to finish another piece of business as well. The next item is witnesses for a meeting on emergency department closures. Dr. Nicole Boutilier and her staff will represent the Nova Scotia Health Authority in Karen Oldfield’s absence. In the motion passed in agenda-setting on October 14, 2025, the witnesses named were the Department of Health and Wellness deputy minister; the Nova Scotia Health Authority interim president and CEO Karen Oldfield; and most importantly, the vice-president of medicine, Dr. Nicole Boutilier.

 

            MLA Fadare.

 

            ADEGOKE FADARE: We understand, referring to Karen Oldfield, that there was questionnaire sent out (inaudible) rules. We’re asking that the committee should write so we have an understanding exactly - just for clarification - who will be in attendance when this topic is scheduled. I was asking if, as a committee, we can write to have a bit of clarification on that.

 

            THE CHAIR: Is everyone okay with that? (Interruption)

 

            Nova Scotia Health Authority has written us and asked if it’s okay if just Nicole Boutilier attended. Is the committee okay with that?

 

            MLA Wilson.

 

            ROD WILSON: We objected to that last time, and we continue to object to that. I do think it’s important to hear from the CEO. We’re looking at strategic stuff. Also, there’s no real front-line emergency physicians attending. I do think it’s important that the CEO attend. It’s not either/or.

 

            THE CHAIR: MLA Corkum-Greek.

 

            SUSAN CORKUM-GREEK: I think the intention of my honourable colleague was to write again, realizing that some time has passed. It is our understanding that Ms. Oldfield will be back. She was away for an extended absence. That is why we are asking for a letter to see about our original request, which would be for her to appear.

 

            THE CHAIR: Perfect, so we’ll go with the MLA Fadare’s original idea to write a letter and ask them about her availability. Okay?

 

            MLA Wilson.

 

            ROD WILSON: I think I get it. She’s back, and what we’re looking for is just a request that - she’s back as interim, so to speak for several months, and we just request her attendance. Is that correct? (Interruption) Okay.

 

            THE CHAIR: We’re good with that? Okay.

 

            We still have five minutes if there’s more committee business we want to get to.

 

            JUDY KAVANAGH: There is some correspondence to be received during committee and discussed if they wish.

 

            THE CHAIR: There’s correspondence. You would have all received copies.

 

·       A letter from the Department of Health and Wellness on March 12^th, in response to requests for information made at the December 9, 2025, meeting on Seniors’ and Family Pharmacare programs. We can accept that, unless there’s discussion. No discussion?

 

·       An email from Nova Scotia Health Authority on February 11^th, following up on the February 10^th meeting on the Early Years program, with links to further information and two attached brochures. This is just extra information they sent voluntarily. Is there any discussion? Are we accepting it as correspondence? Thank you.

 

·       A letter and cover email from Melody MacQuin, March 11^th, regarding consideration of supported decision-making frameworks in Nova Scotia. We can accept that for correspondence, unless there’s discussion.

 

Our next meeting is Tuesday, May 12^th. As discussed, it will be an agenda-setting meeting.

 

Thank you all for being here today, and we’ll see you on May 12^th, if not sooner.

 

            [The committee adjourned at 3:06 p.m.]