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16 avril 2010
Comités pléniers
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4:27 P.M.



Mr. Alfie MacLeod


MR. CHAIRMAN: The time is now 9:16 a.m. and we shall begin with the Department of Health Promotion and Protection.


The honourable member for Halifax Clayton Park.


MS. DIANA WHALEN: Thank you very much, Mr. Chairman. Last night when we began our questioning on this subject of Health Promotion and Protection, we didn't have too much time. I had about half an hour and we got started around the many issues that the minister brought up in her opening statement. I must say she did a really good job - for the members who weren't here - walking us through the Department of Health Promotion and Protection.


I would also say that she had given strong support for the separate department. I know there are members in the House who are interested in that and know the history of the Department of Health Promotion and Protection and would like to see it remain as a stand-alone department or a stand-alone entity, however that might look, but we want it to have its own identity and its own opportunity to voice concerns around the health of Nova Scotians.


The discussion we had just as we began to get answers from the minister was moving into the area of alcohol and its very damaging effect on the health of Nova Scotians. The minister gave a figure in her response to me, which I didn't have, which I know was somewhat anecdotal, but saying that our Chief Public Health Officer has estimated that about 10 per cent of hospital admissions are related to alcohol problems, injuries, disease-related, because of alcoholism, and so on.




I certainly know that we have an awful lot of visits to the emergency room and we are very concerned here in the House about how do we best use our emergency rooms. In metro, of course, it has a lot to do with the waits at emergency rooms and the fact that there are so many people there, and when you know that every weekend you're going to have a spike in visits and you're going to have people in the emergency room who have had too much to drink and have hurt themselves in one way or another, that is a real concern.


The minister had talked about having a conference coming up, the second annual conference that is going to be looking at that. I wanted to look at several issues around this. The part that I was concerned about, which I think is maybe just indicative of the culture that we're talking about, was about the Nova Scotia Liquor Corporation and the way it markets its products. There is no question that provincial liquor corporations have gotten a lot more retail-based. They are much more pleasant stores to visit; they are using all the marketing and retail tactics or practices that you see in big retail operations. In fact, many years ago when I was a university student I worked in a liquor store and it was very bare bones. There was nothing fancy in it, no fancy signing, nothing like that. It was just the product there to pick up. There were no taste tests or anything of that nature, so it has changed remarkably.


I think the store in Bayers Lake, in my riding, is their signature store. If I'm not mistaken, looking at the annual report, it is the largest volume sales location, the Bayers Lake store. We know they are getting very sophisticated, the marketing is getting sophisticated, the segmentation of the market is getting more sophisticated. My concern to the minister had been about the aim to sell more liquor to women in Nova Scotia. I wonder if we could start with that issue again today because I don't know - you know we were talking generally around that alcohol culture and I think, as I said yesterday, that this is an excellent place, during estimates, for us to raise this issue because I think all members of the House should be concerned about it and be aware of it. In every corner of the province we have youth who are drinking, we have justice issues around their underage drinking, and health and societal and family issues that are a really big concern.


When you have drinking that is out of control, you are going to have sexual assaults, you are going to have people who get alcohol poisoning. We heard yesterday - just because I was mentioning this to a friend of mine, they spoke about a junior high girl who had to have her stomach pumped. These are very frightening things for what are, really, children. The minister yesterday mentioned a nine-year-old who she had been called by a school about, a nine-year old with alcohol addiction, so we have to look at that.


These are the kind of issues that, if we start to bring them to light here and give them the airing that they need, get society more aware of them, start talking about them in our communities, we can work at changing the attitudes and again helping the minister and the Department of Health Promotion and Protection change their policies and rules, which can help to support us there.


There was a little article in the paper not very long ago - I don't know that I have the date on it, but it wasn't very long ago - and it said: shining the light on the issue of sex and alcohol. The minister may have seen it, it was, I think, more of an opinion piece, by Rachel Brighton in the ChronicleHerald. There were some figures in that that were really alarming. Susan Wilson of the Avalon Sexual Assault Centre in Halifax said that in a seven month period, beginning last August, the Sexual Assault Nurse Examiner program responded to about 10 cases a month. In 60 per cent of those cases victims had consumed alcohol among this group, 20 per cent of the victims were age 13 to 16.


Those kinds of figures are very alarming. Again, the alcohol advertising is another thing we could go to, which features women - well, it suggests that women who are drinking are going to be sexually active is really what it suggests. It is misleading and it puts a lot of pressure, I think, on young women as well. So there are a lot of reasons why I think we don't want to be encouraging women to drink more than they do already.


Alcohol has a place in society, but we don't want to be encouraging, I think, the improper use of it, or even targeting women to be more active in their drinking, because we also have the Fetal Alcohol Spectrum Disorder concern. Over 9,000 Nova Scotians are affected by that condition because they had been exposed to alcohol before they were born. We know there are many reasons to protect women from just the abuse of alcohol.


I'd like to ask the minister if she could speak specifically to how the Department of Health Promotion and Protection has interacted with the Nova Scotia Liquor Corporation and whether or not this issue has been raised, if she could just talk about that in terms of the social responsibility.


HON. MAUREEN MACDONALD: Thank you very much, Mr. Chairman. The member brings up, and continues in the vein of last night's opening remarks, a good issue to discuss, the issue of alcohol abuse, indeed substance abuse we could talk about. If we're going to focus on alcohol for a bit, there are many things we can talk about. Specifically the member has honed in on the Nova Scotia Liquor Corporation and what their approach will be with respect to responsible drinking. I would suggest to the member, because I have had discussions with the minister who is responsible for the Nova Scotia Liquor Corporation, that the lens through which the Liquor Corporation develops their marketing and retail is a responsible drinking lens. I think that has been the orientation of the Nova Scotia Liquor Corporation for awhile. They do have a campaign around this, they have been doing some advertising, social marketing with respect to responsible drinking and it seems to me that those ads are probably aimed at young men - the ones that I've seen so far appear to be aimed at young men, although I don't know that. I haven't sat down to talk with officials at the Nova Scotia Liquor Corporation with respect to those particular advertisements.


I think it's very important that there be communication between the Department of Health Promotion and Protection and the Nova Scotia Liquor Corporation with respect to our joint interest, I think, in having consistent messages in reinforcing those messages. I think our messages are all about responsible drinking and they should be about responsible drinking. We need to view all of our policy with respect to alcohol consumption through that lens.


It's really so interesting, I don't profess to have any expertise in this area at all but it's interesting if you look at the history of social movements, for example, the movement for women getting the vote was very much a movement that was tied into a movement around Prohibition. A lot of the suffragettes of that era were also leaders in the Prohibition movement. They believed very firmly and the conversation of the day was that alcohol was leading to the destruction of families and the breakdown in society of good values and all of that kind of stuff.


If you read any of the speeches and the commentary with respect to that particular first wave of the women's movement in both Canada and the United States, it is so strongly aligned with Prohibition and the prohibitionist movement. They used this argument that because women didn't drink and were opposed to these kinds of ills in our society, they had a kind of moral superiority that should be reflected and included in parliamentary processes and the political arena. It's quite an interesting literature to delve into. The counter-balance to that, of course, was that it was presumed that women didn't drink and the only women who did drink were women who were of really terrible moral character. The idea was that the hand that rocks the cradle had to be a steady hand. You would see those kind of things spoken of in the speeches that they gave and the discussions that went on. Some people say there are no new ideas, we just have a certain set of ideas that keep reinventing themselves at different periods of time.


Last evening the member indicated she wasn't somebody who supported Prohibition. That wasn't the direction she wasn't suggesting and I know that's the case. We have to come to grips with the fact that Prohibition actually didn't work very well. Even more so than that, alcohol is a feature of our society so it's about, how do we regulate it, how do we educate around it, and what are the kinds of things that we can in this regard? So I think in that light, that this government and previous governments, in fact, and the Department of Health Promotion and Protection continue to do their work.


[9:30 a.m.]


I want to be a little less esoteric and go to some of the more pragmatic things that can be done. Among those are, for example, the Alcohol Ignition Interlock Program. HPP provides Addiction Services in the DHAs $102,000 for their responsibilities within the Alcohol Ignition Interlock Program. Approximately 260 clients were registered with Addiction Services in DHAs for that program. Nova Scotia is currently the only jurisdiction in the world that has Addiction Services involved in the monitoring component of the Alcohol Ignition Interlock Program. An evaluation of the program is being conducted by the Traffic Injury Research Foundation. It is examining the impact of Nova Scotia's interlock program around its effectiveness to reduce drinking and driving and identifying potential improvements.


This program is a provincial program and it is administered by the Registry of Motor Vehicles. It is voluntary for most first offences and mandatory for second and third offences, including causing bodily harm and death. Addiction Services is responsible for reviewing bimonthly interlock data and conducting alcohol bimonthly monitoring sessions, ongoing assessment, and the provision of counselling and/or referral when it is appropriate, as well as conducting a follow-up session six months post program exit.


It is a new program and the number of clients represents a small proportion - about 10 per cent - of the overall driving-while-impaired clients seen at Addiction Services. Here is a very concrete example of a program within the department that really is levering the resources of other departments and collaborating with other entities out there in the system. I think this is really important, that we have some concrete examples of what we're doing that can and hopefully will make a significant difference in those statistics that we talk about in terms of hospital admissions and the use of the health care system.


From time to time, we see in our newspapers the repeat offenders in terms of impairment and driving. It is shocking when you see people who have had 15 and 20 convictions for drinking and driving and this is still occurring. So it is very important, I think, to intervene early, assess the impact of doing that, and having these kinds of programs that hopefully will really save lives. We drive our highways in this province and each and every one of us sees those little crosses on the sides of the road. They are becoming more and more common on the shoulders of our highways. You know that somebody has died at those sites as a result of impaired driving.


It is incumbent on all of us to find effective ways to get the message out with respect to responsible driving or drinking, and to find those kinds of mechanisms - pragmatic, practical things that we can do to change the statistics, and to reduce the number of tragedies that result from the abuse/misuse of alcohol.


MS. WHALEN: I think it is interesting to note that this interlock program is being done in conjunction with the Motor Vehicles and others departments, because we do like to see that interdepartmental co-operation on issues like this. It is very important. We know that by yourself, Health Promotion and Protection can't effect the change that you need to. But if you work with Justice and the other departments, you can.


I wanted to ask about this sharing, sort of, between departments around the education piece, because there is quite a bit of drug education done in the schools. I don't know whether they're focusing heavily - in fact, again, yesterday, because I had raised this and was planning to talk to the minister about it - I was taking to a parent in my area who said that although drugs are a big issue for them, she said talk about alcohol, because the problem with alcohol is that it has become more normalized for the kids. Although it is against the law, there is a sense that it is a normal rite of passage and, as I mentioned yesterday, a sense that this experimentation, this exposure to it is happening at an earlier and earlier age. It was suggested to me that we need to have some focus on that when they're in the schools talking about the evils of drugs and marijuana and other things like that.


I was going to table one more picture today that I think kind of highlights the normalization at younger ages, and it is around advertising, again. This is a Toys "R" Us store with a big, big Toys R' Us sign, and right underneath it is an NSLC sign. They are both very large and very prominent. You know, obviously, the market for Toys "R" Us are all the children and the families in and out of there. But it is just the liquor commission with its nice logo and so is so prominently displayed in juxtaposition with a Toys "R" Us store. I am going to table that just for the use of record. So it is on the record.


But I think that is what we need to look at, especially when we're trying to be more alert and concerned about how we are positioning alcohol in our society. Again, I go back to the idea of the bare bones store that didn't have any particular advertising, you just came in, found the product you wanted and you left.


I'm noticing now these big full page ads that are for sales. I mean why do we have sales in the NSLC? Do we want to discount product to get people through the doors like they do at Wal-Mart? Or do we know if there is a demand for it and it's a special occasion, or a party or whatever people are planning, that they will come and get the product they want. It begs the question of why we would have full page ads in The ChronicleHerald to try and get people in the doors of a liquor commission?


So, in that regard, I guess I'd be asking the minister to speak again to ask, how closely are you working with NSLC? Some of these questions, perhaps, I should go to the Finance Minister with, because he is responsible for that entity. But I think it is important that we ask ourselves that question: Why a government entity that's a monopoly, let's face it, just about the only game in town. We have let a few private wine stores open up, but very few, and I just think we have to be questioning on how we're, again, marketing those products.


So with that, I guess my one question was around drug education, including alcohol in the schools, and if we have any money directed from our budget into the Department of Education that would help. I guess, we want to get back to the finances here, because we are looking at a $88 million budget, for those members who are here watching the debate today and anybody in the public who is paying attention. It is important to know that we're spending $88 million on various initiatives for Health Promotion and Protection. I know you have a wide mandate, but if you could speak to, perhaps, any funds going into drug and alcohol education in the schools, and whether or not your department could put more emphasis on the alcohol in schools as well?

MS. MAUREEN MACDONALD: Mr. Chairman, to the honourable member, the first thing - as staff are looking to see if we can get some numbers on drug and alcohol education in the schools - I can tell the honourable member that the department staff are certainly very much involved with the Department of Education with respect to curriculum development in this regard. The department also conducts the Atlantic Student Drug Use Survey, it is involved in this drug survey, and last evening we talked a bit about some of the statistics that we get from that survey and, indeed, that survey is consistently identifying alcohol as the key problem.


It is really interesting , Mr. Chairman, in the last few days we have had a fair amount of coverage on the situation at a high school in the Cumberland County area with respect, I think, to hashish or marijuana, and it has gotten a lot of play. Perhaps that isn't a serious problem but, really, our surveys consistently show that a much larger problem is alcohol use, and indeed children of a younger and younger age are using alcohol, and that is information that comes out of the survey. So we are very much involved in using the information that we get from those surveys and shaping what it is we do and the work of curriculum development, in fact.


Back to the Nova Scotia Liquor Commission, the department shares information with the Nova Scotia Liquor Commission, and as I indicated to you, I certainly have discussions with my colleague, as he does with me. I think one of the benefits of the province owning the Nova Scotia Liquor Commission, in fact, is we do have some direct control over the Nova Scotia Liquor Commission and therefore we have an ability, again, to harmonize what it is that we are doing, the messages we want to give, the direction we want to go in, and all of that kind of stuff. So it does allow for a level of collaboration that you wouldn't necessarily have in a situation where we had no ownership over the commission.


With respect to their advertising budget and their strategies, and all of these questions that the member is raising - their retail strategy, their marketing strategy - I would concur with the member that the minister responsible for the Liquor Commission is the best person to answer those questions. He would be much more intimately aware of what it is that they are doing, and I know that he would be happy to have this discussion with the member when he is up in the Red Room.


MR. CHAIRMAN: The time allotted for the Liberal caucus has now expired.


We will move to the Progressive Conservative caucus and the honourable member for Inverness.


MR. ALLAN MACMASTER: Mr. Chairman, thank you minister and staff. Health Promotion and Protection, I think, is a department or an office - it was very wise that the province set this up. We were the first province in the country to do so, and I used to work there, so I have some intimate knowledge of the office.

The first question I would like to ask involves the future vision for the office. I know it belongs to the same ministry now, the Ministry of Health, but what do you see for the future of Health Promotion, do you see it becoming more a part of the Department of Health?


MS. MAUREEN MACDONALD: Mr. Chairman, I had quite, I think, a unique experience back in the Fall when the H1N1 pandemic occurred. I was Minister of Health and Minister of Health Promotion and Protection. We were a new government with a new Cabinet. What people in Nova Scotia don't necessarily understand, and people who are very close to government - and sometimes people who are in government - don't understand, didn't understand, still don't understand, is that the bulk of the work that went on around H1N1 went on in this tiny little department. It did not go on in the Department of Health. Not that the Department of Health wasn't engaged in some pretty significant work around H1N1, because we had to do all of the work of preparing to protect our acute care facilities from the potential of a big loss of staff if large numbers got sick or a big influx of people with H1N1 if there was a pandemic sweeping through the community and the pressure on emergency departments and ICUs and what have you started to occur.


[9:45 a.m.]


Public Health is in the Department of Health Promotion and Protection. Our Chief Medical Officer is in the Department of Health Promotion and Protection. He and his team, all of the folks who did the planning for the mass vaccination program that happened across the province in all of the DHAs through Public Health, and indeed, with family doctors and what have you - that occurred in HPP.


I reflect on that time quite often, thinking just how difficult it would have been if we had had two separate ministers, one speaking from HPP around the vaccination program and that whole initiative and another minister who would be the Minister of Health speaking on protecting the health system. It would have complicated the situation tremendously and it was complicated enough. It would have added another level of complexity. It would have made things very, very difficult - not that they weren't already difficult enough. I think about some of the heightened semi-hysteria that occurred not only in the public, but frankly, in my view - and this may just be my view - but in this House of Assembly where members called an emergency debate, for example.


I think that in that situation I saw very concretely - and this is my own bias because of my experience - that in that situation, it was definitely advantageous to have one minister and not have two. Now, should that hold forever? I don't know, but there is a lesson to be learned from that. That's my point more than anything. That's the first thing I would say.


The second thing I would say is that, I know that the member for Halifax Clayton Park made reference to a quote from either a World Health Organization document or some national health organization in Canada, I think, some statement that they made back in the 1990s about separating out health promotion from health. I understand that thinking. That was thinking that was shaped in a particular context, though, which we may not necessarily be in anymore. I think that there has been a significant shift in the thinking of the population and policymakers, including in the Department of Health. I see this all the time.


People in the Department of Health are very much in tune with a health perspective and a health promotion philosophy and direction in many respects. There is much more discussion about primary health care; there is much more discussion about chronic disease prevention and management. From that, I think, a much better appreciation of the importance of having a really strong continuum. But that is not to say that I think we should merge the departments. I just think that we need a very thoughtful evaluation of the situation today and what is in the best interest of providing really good public policy in terms of health and wellness.


I can guarantee the member that that is the kind of approach that I, as minister, and this government will take. We will take a very considered and thoughtful approach to these two departments.


The financial difficulties that the province faces, although they will drive some decisions, they will not drive every decision. Particularly, they will not drive bad decisions. If decisions would not make sense in terms of good public policy, then I would suggest that they shouldn't be done, particularly in the field of health. We've seen too many bad decisions made that result in high costs on the other end. So you have to really ground your decision making in what ultimately is going to give you good health outcomes. Having a strong component of government agencies that are doing health promotion and protection is very important, having a strong public health system is very important, having a good acute care system is very important. So it is a continuum, it is one system.


To suggest - and I know that there were some who did suggest - that having one minister for both of these departments was an omen that the departments would be merged, is a statement that was premature in my view. At least one organization made that statement before I had been in the seat for 24 hours. My preference is that you give the government a chance to demonstrate where they're going before you make those kinds of judgments, before you rush to judgments. I have admonished the person, or the organization, that rushed to judgment. I am, as most people in this House know, fairly open and transparent and straightforward in what I have to say and I don't mince words . I've let people know that you have to be fair and I didn't think that was really all that fair.


What I do know is that the future for Health Promotion and Protection is a bright future. This department has been tasked with some pretty important initiatives of the government and I can't think of any initiative that is more important than tackling the question of childhood obesity.


This, I think, is not the only health care challenge of our time but it probably is right up there at the top in terms of challenges that we have. We're seeing a dramatic change in the lifestyles of young people and in the diets of young people. This is resulting in a generation of young people who are demonstrating early symptoms of diabetes and heart disease and all of the other chronic illnesses that go with poor nutrition and a lack of exercise. So we really need to address this.


There will be a very important role for this department and in whatever form that takes. There are no plans - I have no plans, as I stand here today, to alter the form in which we currently have these two departments. I can say that we are very pleased with the work of this department. The staff in this department are leaders and they're experts in their field. The people who do sports and recreation programming in that area are outstanding; the people who work on nutrition and these kinds of issues are just phenomenal. So we have a very strong, capable group of staff and they are very valued, the work that they do is very valued, and I can assure the honourable member that that is not going to change.


MR. MACMASTER: Mr. Chairman, my next question involves an issue that was brought to me by a couple of stakeholder groups. The Minister of Finance had made some remarks, I believe, at a chamber of commerce dinner, questioning the value of Health Promotion and Protection. I want to be careful about what I'm saying here, Madam Minister, because this has come to me from another organization, but I think the gist of the remarks were that perhaps the value of the work of Health Promotion and Protection may not be understood; perhaps the ability to save money in our society through the work of Health Promotion and Protection may not be fully understood.


It was raised as a concern to me by a couple of stakeholder groups, and I don't know if you have had discussions with the Minister of Finance. I know that there is a budget for Health Promotion and Protection this year, so that's a good sign, but I will just read a couple of statistics here. One was on economic benefits of decreased physical inactivity in Nova Scotia, from the Colman report on the cost of chronic disease in 2002. One of the results of that study was that a 10 per cent reduction in physical inactivity could save $7.5 million in health care spending.


Another stakeholder group had indicated that it is important to remember that the cost of health promotion must be weighed against the cost of tertiary clinical interventions after disease has been diagnosed. The question is not simply how much prevention costs, but how much it costs compared to treatment of a disease that could have been averted.


I think most people understand the value of this, and in fairness to the Minister of Finance, he may understand the value of it as well, but there was a comment that was picked up by a couple of stakeholder groups. I wonder if you might clarify the government's position on the value of Health Promotion and Protection with respect to saving costs for our society and government.

MS. MAUREEN MACDONALD: Mr. Chairman, the honourable Minister of Finance and I have a really good relationship and we talk frequently - often here in the House we talk, but also outside, and we have worked together for a long time. I did speak to the honourable member with respect to his remarks because I wasn't at the chamber of commerce dinner.


When I saw correspondence or a press release or something from the Heart & Stroke Foundation and the Cancer Foundation, the honourable member was somewhat surprised at the release because he indicated to me that he did not call into question the value of Health Promotion and Protection. His remarks were more to the point of the length of time it takes to reap any financial benefits in terms of Health Promotion and Protection initiatives. I think that is common knowledge. I think that it is well established in the literature that many Health Promotion and Protection kinds of initiatives may take as long as 10 years or so before you actually see a return of the investment that you put into these initiatives.


I think about the strategy around childhood obesity. That is not a scenario that will be turned around within a year, let's say, of a strategy being developed. Resources will have to be attached to implementing a strategy, the implementation of any strategy is going to require some investments. Those investments may not be seen for a number of years and I think that is the point that the Minister of Finance was making. That's a point that I take no umbrage with. I think it's a valid and reasonable point and it's not just valid and reasonable, but it's something that is very commonly understood and can be demonstrated empirically. It takes awhile for these initiatives to achieve the results, and therefore you start seeing the benefits in terms of less pressure on your health care resources.


[10:00 a.m.]


Political people are often criticized and criticized by policy folks for not having the courage to initiative and invest in long-term policy change because the payoff is beyond the political cycle. So politicians like to do things that give them a payoff within the electoral cycle and those things tend to be more short-term and often very expensive. In the health system, in acute care, you can run out and unveil a new piece of equipment or open a wing of a hospital or a nursing home or something like that. It is much more difficult to get the public excited and their attention about stopping the level of salt that's in food products, reducing the amount of sugar in processed foods and cereals. All of these kinds of initiatives really will give you greater payoff in terms of the health status of the population.


Again, I just want to say that I support the Minister of Finance when he has opened frank discussions - what he likes to call "adult conversation" - on the finances of the province and on our need to have a thoughtful discussion about what it is that we collectively want to do as a province, how we want to use our precious resources to get the kinds of results that we want to get. I would hope that all of our stakeholder partners, including the Cancer Society and the Heart & Stroke Foundation, are prepared to engage with us on that level and have these very serious discussions.

I welcome an opportunity to talk with them further about these things because I think it is very important to have the discussion and that we not circle the wagons, so to speak, and become so entrenched in a particular mindset that we miss the opportunity for some significant change that I think we could have in the province. But we have to have everybody participating in that as willing partners, with some openness and not in a closed way, and that sometimes concerns me.


MR. MACMASTER: Thank you, minister, for the clarification. I would like to go into a few priority areas of Health Promotion beginning with tobacco. One of the initiatives - and I think one of the best things the province ever did in recent years - was to outlaw smoking in public places, it made a real difference. I think if you looked back on it, it made the most difference to help reduce smoking in the province. I think it sends a message to young people when they don't see people smoking, there is less chance that they're going to start smoking themselves. It is less socially acceptable, and I think that's a good thing, at least for the sake of people's health. I know that there are smokers who would disagree with me, but I think for the sake of people's health and for young people, they're better off not getting involved in tobacco use.


The other nice thing about it, although it may have cost some businesses money at first - I think everybody's on the same level playing field, so that's fair - but this was an initiative that didn't cost any money for government. I think that is also great, when we can come up with ways to get tangible results without spending a lot of money.


A question to the minister, and I can appreciate that this may fall somewhat outside of your ministerial responsibilities, but do you think we have reached a ceiling or a threshold with respect to taxes for tobacco? The reason I ask this question is because I know that the more tobacco tax is increased the more contraband we have, and there almost comes a point where, perhaps, the more you increase you don't necessarily get any more benefit.


MS. MAUREEN MACDONALD: Mr. Chairman, I know that probably 10 or 15 years ago research around the world indicated that increasing the cost of tobacco would have a direct correlation with a decline in tobacco use, and particularly it would have a significant impact on the decline in the number of young people who would take up the habit.


I remember being in the U.K., actually, when I was studying there, and a big study came out about the correlation between the cost of tobacco and the number of people who smoked, and the projection, as you increased the cost of tobacco, how the number of people smoking would drop. I remember when the Blair Government, the Labour Government, was first elected, one of the first things they did was they just slapped this huge amount of taxes on tobacco, but I think over time the amount of smoking in that country has declined quite substantially.


In terms of the future of tobacco taxes in Nova Scotia, this is something the Minister of Finance is probably best able to respond to, although I would say to the honourable member, Mr. Chairman, that HPP and Finance are constantly in communication with respect to this matter.


For the information of the honourable member and all members, the Department of Health Promotion and Protection will spend in the coming year, for nicotine treatment in the DHAs, $1,435,028 on those programs to help people quit smoking. As the honourable member knows, we have had a comprehensive tobacco control strategy in Nova Scotia since it was adopted in 2001.


The honourable member reminds me of when I first arrived in this place in 1998. I was the Health Critic for our Party, and one of the first questions and first issues I took up with the Minister of Health of the day was when were we going to do something about the high rates of tobacco use in Nova Scotia, and why weren't we prepared to develop a no-smoking policy? I remember a little skirmish that occurred, as they sometimes do, outside the Chamber, when the Minister of Health was, in fact, asked what the government's position was on having no smoking in public places. In 1998, you could smoke in restaurants and bars and all of these places, and this was a significant change that occurred in our province in a very short period of time.


At any rate, the position of the government of the day was to let each local community, municipality by municipality, make those decisions and we - and I - were pushing really hard for a province-wide policy. I remember the subsequent government having legislation to remove tobacco products from drug stores in that particular stage in the movement toward really having a better control over tobacco and its use.


In 2001, the Tobacco Control Strategy was adopted. The overall smoking rates have declined from 30 per cent in 2000 to 20 per cent in 2008. Smoking rates for youth 15 to 19 years of age now stand at 14 per cent. Overall smoking rates, however, have been relatively unchanged for the past five years, ranging from 20 to 22 per cent. Tobacco use rates remain high for young adults at 26 per cent. Given the level of smoking rates, government initiated a process to renew the provincial Tobacco Control Strategy, beginning in 2006.


I anticipate that this new strategy will be coming to Cabinet later on this Spring or early summer. When I have the approval of my colleagues for that strategy, we will be releasing the details to the public. But certainly we need to address and focus on the behavior of the tobacco industry in Nova Scotia; we need to continue to build the kind of social norms and values around being tobacco free; we need to advance the social determinants of our health agenda; we need to address the disparities in tobacco use across the population as a priority; and we need to realign and establish how tobacco cessation is delivered.


We particularly want to continue to focus on young people and keep the next generation of smokers from becoming the next generation of smokers. We know that age group, the young adult age group, has a higher proportion of smokers than any other group. We need to tackle that. We need to address that.


So there are many things that we will be dealing with when we have approval for the next round of the Tobacco Control Strategy and I look forward to hearing from members on what they think should be in that strategy.


MR. MACMASTER: Mr. Chairman, my next question is somewhat connected to tobacco. I've heard the connection between drug use and it triggering mental illness. Is the minister aware of any - I guess first of all, do you have any comment on that? What I have heard is that sometimes when young people start getting into drugs, even if it is something like marijuana, if they get into it to a certain degree there may be resulting mental illness as a result. Is there anything in place to warn young people about this as something they should be aware of before they start to get involved in drug use?


MS. MAUREEN MACDONALD: Mr. Chairman, well, certainly, I know from having a little bit of work in the field that there is a concern that there can be a linkage between mental illness and drug use, and I know that continues to be a concern. But not being an expert, I don't want to go down that road too far.


[10:15 a.m.]


We are going to be having a mental health conference here in the Fall with people from all over Atlantic Canada. It gives us an opportunity to have people with direct experience and expertise that we can all learn more from and get up to date on the research and the best practices, treatments and what have you. So I'm looking forward to being involved in that and learning more.


We in the Department of Health Promotion and Protection stay very up to date on the latest research and information, that is utilized in curriculum development. We have personnel from the department who are involved with the Department of Education and school boards in terms of delivering curriculum out across the province in our schools that help young people understand a whole host of issues around substance use and abuse and the impact of that.


We have 43 Teen Health Centres across the province. Many of them are in schools, most of them are in schools, staffed by qualified nursing personnel. These are areas where young people - and I think that a very large number of young people in a school, as many as 50 per cent of the students, will take advantage of having a Teen Health Centre. It's a place where they are not necessarily seen for clinical services, they can get information in the Teen Health Centres on all of the programs and the initiatives that we're involved in, which would include our tobacco control strategy. Any of the things we're doing with respect to mental health and certainly substance abuse would be available there.


I know that the federal government and Health Canada through many of their programs into the regions, they very much work to promote public health and good health information .They would be partners, as well, in doing some of the educational piece.


MR. MACMASTER: Thank you, minister. My next question is, are there any current initiatives with respect to injury prevention?


MS. MAUREEN MACDONALD: In a nutshell, yes, we're doing lots of work with respect to injury prevention and we have a real crackerjack in the department who kind of leads this initiative. You may, in fact, know some of the folks - Julian Young, I don't know if you know Julian. So let me tell you about some of the work that's going on around injury prevention. First of all, injury is the leading cause of death and disability during the first 45 years of life. It kills 425 Nova Scotians every year and it costs our economy about $518 million annually. In 2003 Nova Scotia became the first province in Canada to establish a government-led and funded injury prevention strategy, and in 2007 HPP partnered with Injury Free Nova Scotia to co-lead the process of renewing this strategy. After consultation with our stakeholders, the renewed strategy is complete and will be released in the coming weeks.


The renewed strategy creates a shared agenda for the next three to five years. While HPP leads the strategy, its success is driven by the collective efforts of many government departments, community organizations, and partners. It is not intended to be HPP's strategy; rather, it belongs to all Nova Scotians and they're a shared responsibility for success.


One of the things I would like to put a more concrete feature on is what this means when we talk about injury prevention strategies. So we're doing work with folks around head injuries and the importance of using helmets, helmets when kids are skateboarding, helmets when you're skiing. We have partnerships with some of the ski operators or the association of ski hill operators. This has been a really important initiative. We evaluate, we build in a process where we make sure that we have partners with leadership and capacity to implement a strategy. We try to integrate the strategy into the activities and events that are going on in a particular area. We observe and collect information and data. There is a surveillance piece and we analyze the data, evaluate the effectiveness of the programs that we're delivering, then we reach some conclusions, and we use those then to advocate for further change that's required.


So this is all the approach that we're taking. We're looking at injury prevention when it comes to children and playgrounds, and young people in the activities they're doing, whether it is, as I've said, skateboarding for example, but it could be biking, it could be other kinds of sport activities. There was a group here, back in the Spring, made up of a number of organizations that, I think, have a bit of a base out of the IWK, and they have an initiative to try to prevent injuries, and we partner with them and support them.


The 2010-11 budget for injury prevention is $823,700, which includes both administration and program funding. So the group that we work with is, I think, Child Safety Link and there are a number of organizations that make up that group.


We also have a suicide prevention strategy. We have leadership around child safety seats; falls re seniors, we've partnered with the Community Links organization, and the suicide prevention piece is a strategy that links up with the Canadian Mental Health Association, Nova Scotia Branch. So we have a number of pieces within the injury prevention strategy.


The issues, concretely, again just to be clear - and I spoke a bit last night about the road safety working group across four areas of Cabinet - the priority issues are road safety, seniors' falls, suicide, and attempted suicide. The priority populations are children and youth, seniors, and other populations at greater risk of injury. The priority settings for the strategy are schools, workplaces, homes, communities, roads and streets, health care settings, and recreation and leisure settings. You might go to a hospital and you'll see posters throughout most of our hospitals about how to prevent falls in these areas. They're posted in every area - waiting rooms, the individual wards throughout these places.


So there's lots of good work being done, and we know if you look at that amount of money - $518 million annually in costs to the economy by lost work time, lost productivity, the costs on the health care system - it's significant. So this is a really important piece of work that goes on in our department and it will continue in the coming year.


MR. MACMASTER: Thank you, minister. My next question is about physical activity. I think some of the money that's spent by government in the area of physical activity through facility development is some of the best dollars spent when you consider the leverage of other fundraising efforts from communities, and when you consider that in a lot of rural areas, oftentimes recreation facilities are one of the main sources of social infrastructure. How does the budget look this year? Does it look similar to last year with respect to money allocations, dollar allocations for facilities? I would think of - I don't know if they've changed the name of the programs, but I think of the Recreation Facility Development Program and the Community Capital Grant Program.


MS. MAUREEN MACDONALD: We have $9,817,300 allocated for the coming year for recreational facility development. Now, a large piece of that - probably $7 million of that, I would say - is B-FIT money that has already been committed. The B-FIT Program, as members would know because I've said it enough, is a $68 million program which was intended to extend over a 10-year period, ending in 2016, and it has been fully committed. It was fully committed in a four-year period, but all $68 million of that program didn't appear magically in the budget, because it was intended to be over a 10-year period at a rate of $7 million a year. So the $7 million is in our budget for this year and on a go-forward basis we will be fulfilling the commitments under B-FIT.


We have an additional recreational facility improvement kind of program, and eligible projects qualify for up to $150,000 for that program. So there are many, many needs for recreational infrastructure around the province. I recognize that, but boy, we're going to have some amazing facilities out of the B-FIT Program over the next few years. We are already seeing some of those, but it's going to be quite a fabulous addition to the recreational infrastructure around the province.


Last evening - and of course, we have places like the new stadium that's coming on out in Clayton Park, for example, and the honourable member for Halifax Clayton Park last night was broadly hinting that she wanted to tour that facility fairly soon. I would very much like to tour that facility fairly soon as well, as soon as it makes practical sense to be able to go safely into that site. Every time I go out to that part of the community, I get more and more excited when I see the building. I very much look forward to having a tour of that facility and I will make sure that when I do, the honourable member who represents the area will be invited along.


[10:30 a.m.]


There are other facilities around the province that I hear are very exciting as well. The honourable member for Cape Breton Nova last evening was talking about the Cape Breton Regional Municipality, I think it's at the Cape Breton University. It's quite a fabulous facility and I haven't had a chance to see that one, but I'm hoping that I will.


I think we'll have an opportunity to see some very important additional infrastructure in the recreation area in the coming years as a result of the B-FIT money, $68 million is a significant investment in health and recreation kinds of infrastructure around the province. We hadn't seen that kind of a program in Nova Scotia forever, I guess, really and so it was very much needed. There'll be many projects coming on line from that. Communities will benefit. I hope they will take full advantage of these facilities. I sometimes worry a little bit that recreational facilities that are being built, people won't take up the opportunity to use them. That's going to be the next challenge that we have is to make sure they are used.


We'll be seeing new facilities in Liverpool, Bridgewater, Lunenburg, Truro, Colchester County and Pictou, as well as in Berwick - the Apple Dome. I think already we have new facilities in the Antigonish area, they have a new track there at St. F.X.; Acadia has a new track; the Amherst Stadium - the arena was updated; and the Apple Dome rink development in the province.


B-FIT assisted in the building of trails. We had the Bear River-Sissiboo Trail developed with B-FIT money. Yesterday in the House there was a question to the honourable member of Natural Resources about the Brigadoon Children's Camp and whether or not the honourable member could secure property for that camp. Brigadoon Children's Camp was awarded B-FIT money in the amount of $1.65 million, so they have been a recipient of B-FIT money.


The Brooklyn Civic Centre in Hants West has received $400,000; the Canning District Recreation Commission, arena upgrades; Cape Breton University, the indoor soccer facility track; CBRM, the Renwick Park trail development; Church Memorial Park, arena upgrades; the Dartmouth Y, some pool upgrades; East Hants, a second ice pad; Eskasoni Band Council, arena upgrades; the four-pad with the Halifax Regional Municipality; Hants Aquatic, a bathhouse and change-room construction; Highland District Soccer, an indoor soccer facility; HRM, Prospect Road Recreation Centre; the Inverness County Memorial Ballfield Society, field development, in the member's riding, $113,500 from B-FIT; Kings County Trails Society, $155,000; the Maritime Muslim Academy, gym facility construction; Colchester and the Town of Truro, an arena and pool construction; Northside Community Civic Centre, an arena; Port Hood and District Recreation Commission, there's an arena upgrade in that area; the region of Queens, an arena construction; Ski Ben Eoin, ski-hill upgrades.


There's also, I think, the South Shore Annapolis Valley Recreational Trail Association; as well as the South Shore Fieldhouse Society for an indoor soccer facility; St. F.X., the track turf field; the Town of Bridgewater, the arena and pool construction; the Town of Stellarton, track construction; the Village of Port Williams, a community centre upgrade; Trenton arena upgrades; Windsor Curling Club; World Canoe and World Laser.


A lot of those projects have been completed but there are many projects yet to come and to be completed. As I said, a $68 million commitment, which is a substantial investment for recreational infrastructure but many communities will benefit for many years to come.


MR. MACMASTER: Thank you, minister, and I would be remiss if I did not commend the previous government for their vision, for recognizing the importance of long-term planning for facilities and the timely nature of that funding commitment. As we know, there were a lot of facilities across the province that were built 25 and 30 years ago and they were due to be refurbished or reconstructed. I should also point out that they were quite equally distributed around the province as well.


My last question, because I think this will be my last one and I would like if the minister could - this involves something that I saw I thought was great, the Annapolis Valley after-school program. They're helping young people in the community after school with exposure, particularly young people who don't have a lot of exposure to physical activity and I think this is great. I think it's a way to try to help young people that might be falling through the cracks, who might grow up in families where they don't have the resources to join organized sport and I think this is great.


My question, if the minister could try to focus her response on this part of it, how can we implement this type of program in other areas of the province? If I had a community group come to me and say, Allan, this looks like a great thing, we'd like to do it in our area, could you try to give us a quick synopsis of who we should contact and how we could get the ball rolling?


MS. MAUREEN MACDONALD: Mr. Chairman, we have regional offices, we have six regional offices around the province and the best thing for the honourable member to do would be to contact his regional office, which would be the Sydney office - Larry Maxwell in the Sydney office - and initiate a meeting to talk about how the Annapolis Valley program could be adapted, let's say, into his area.


As I indicated in my opening remarks last night - and I'm glad to hear that the honourable member was paying attention - it's an amazingly inexpensive program. I think there are four partners, brought $500 to the table each, and the result of that is this phenomenal after-school-type program, recreational program, that has a very broad involvement of a lot of different players, and the participation and the access to recreation for young people who wouldn't necessarily have this opportunity.


So I would encourage that member and all members to really get to know the staff in the regional offices. The staff in these regional offices are really excellent, very excellent, and I have my own example of when I was first elected. I was not a member of government, I was a member of the Opposition. I have in my constituency in the north end of Halifax a public housing development called Mulgrave Park and there was a playground in Mulgrave Park that was so disgraceful it was unbelievable. Nobody could use it. It was one of those old metal swing sets and, you know, teeter-totters and what have you. They were all rusted out and just in terrible condition.


This is an area where there are a lot of families with young children and no place for kids to play except the street and busy streets, you know, not safe. A couple of young mothers with young children approached me and said, can you help us? I got two students from the School of Social Work to do their field placements that they have to do in my constituency office and we did a survey - they did a survey. They went door-to-door in Mulgrave Park with the survey and we identified what the priorities of people in the community were for recreational space. We helped the tenants form a tenants' association and we started the work to plan for a playground.


The regional representative from HPP for the metro area was just fantastic to work with and the result of that work is that today in Mulgrave Park there is a lovely playground for young children. It's for really little kids, little tots, preschool children. That's where the community wanted to start. We have the Needham Centre which the honourable member for Clayton Park was making reference to last evening, which is quite a nice recreational facility - a big gym, swimming pool and what have you - run by HRM, not the province. We have the Needham Centre quite close to that community and, in fact, many of the staff at the Needham Centre are residents of Mulgrave Park.


There are opportunities there for teenagers and just pre-teenagers to do basketball, swim and to do a variety of activities at the Needham Centre, but really for little kids who are preschool , to get them outside, to get them onto a playground, to have them there with their parents, no place, zero, no place. But we now have, and we've had for a number years now, this absolutely beautiful playground with lots of opportunity for little tykes to get outside. So these are the kinds of things that can be done.


Communities are powerful. When they harness their efforts to build recreational facilities, they are very powerful. I'm very fortunate, I live in a part of the north end of Halifax quite close to a small water park for kids, and in the summertime we can sit on our back porches and hear the squeals of the little kids who are over there on a hot day running through all of those big arcs of water and people come from all over. It's a fabulous place. It's actually been a neighborhood that has attracted a lot of young families simply because you have this amazing recreational opportunity and it's very family-friendly, it's very family-oriented. It's this lush green little spot in the middle of this urban setting where you don't necessarily expect you'd come upon this wonderful place. I know HPP was involved in supporting infrastructure there and in the Uniacke Square area, where there is now a water park for children in the summertime as well.


[10:45 a.m.]


Mr. Chairman, people like myself and the honourable member and probably you, we are all very fortunate. We grew up in the coastal communities in Nova Scotia and we had swimming holes and little coves and beaches that we could go to when we were kids, and we probably spent a lot of time there as children. Kids in some of the urban environments don't have those same opportunities, especially if they live in high-rise apartment buildings and the so-called concrete jungles - although we don't really have what I would call concrete jungles here in Nova Scotia, compared to some places.


We need to also provide recreational opportunities for children in the urban settings. HPP is involved in partnering with the municipal units in some of these smaller projects, and $20,000, $25,000 can make a huge difference in terms of getting a nice playground in a local community or contribute to a small wading pool or whatever. It doesn't have to be a big flashy $68 million pot of money to result in some very fine recreational opportunities. I can assure the honourable member of that, and on some level, given the financial situation in the province, that reflects my vision.


MR. CHAIRMAN: Thank you. The time for the honourable member for Inverness has expired for this round.


The honourable member for Halifax Clayton Park.


MS. DIANA WHALEN: I certainly enjoyed listening to the minister discuss the community efforts that are underway in every corner of this province and how the individuals in communities often see the need. She struck a chord with me there on things that I see in my community, and sometimes the need for MLAs to show some leadership and to help communities come together. I think that is often necessary, especially in communities that maybe don't understand how best to organize themselves and to be able to talk to the powers that be to get some help along the way. We've had some terrific examples of that in Clayton Park as well, and I really take the point that it doesn't always have to be an expensive project in the millions of dollars.


As I said yesterday, I'm absolutely delighted with the centre that's coming along for the Canada Games, and in this hour I do want to ask some questions about the Canada Games and our funding around that. Before we go to the big project - and I think that the Canada Games Centre is the right size and in the right place because it's a regional centre, although I said we have literally thousands of people who can walk to that centre, who are within a 10-minute walk, and it goes back to the high density of Clayton Park. I've said it before in the House, but just to remind the minister - it's not a concrete jungle, but we have 9,000 apartment units in Clayton Park, so when I communicate with my riding it's 9,000 households that are in apartments or condominiums and about 4,000 homes. So relatively speaking, we're a high-density area. More than two-thirds of the residents that I represent would be in apartment buildings.


I'm very conscious of the kind of facilities we had available, especially for children. We do have trails in Clayton Park, which means the older people can get out and you can walk your dog or you can jog, but young children need places to run and play. They need playgrounds or water parks or places where they can be more active. I think working with municipalities to try to make sure that it's built into the way that we look at municipal development is so important.


Again, representing Clayton Park - I previously was the councillor for that area as a lot of this development was underway, and we don't have standards, municipal standards, that would ensure that we put in an open space. We do have a requirement that a developer dedicate a certain amount of space for municipal use, but it can be absolutely just a piece of land that's not useable. There aren't standards that say it will be developed into a playground or it will be a playing field. I think there's a role to be played here from Health Promotion and Protection.


There's a lot of work being done on things like walkability - a new word I'm seeing now on the Internet - when you talk about are communities walkable: have we developed them with the right trails and connections; have we looked at making it a healthy community, so that people don't have to drive their cars to go somewhere quite close by simply because you've got barriers or obstacles in the way?


So there's a lot that can be done and I hope you've got somebody in the department who works on that. I'm not sure that you do but, to me, this is very fundamental and it's bringing best practices and new ideas to the table for our municipalities because we can't allow them, I think, just to continue to do business the way they always have. Neighbourhoods are changing. Density is not a bad thing. I started by talking to the minister about the population density of Clayton Park and there has been a sense, even when I was on council, that is somehow not a good thing - we don't want to look like that, we want to have single-family homes spread over many acres like perhaps some of the areas in Hammonds Plains and other areas that are not serviced lands. They don't have water and sewer; therefore, they have big lots.


To me, that isn't the ideal way to develop. That's not good for the environment. It's not good for people walking. If you live in an area like that, you can't service it with transit because there's too much space between homes. In Clayton Park where we run transit, that is one of the very few - I forget which bus route it is, but I think it's the No. 4 - that the routes through Clayton Park actually do provide a lot of revenue to Metro Transit and they're one of the few lines that pay for themselves.


Now, I don't believe, really, we should be paying for our transit from the ridership alone, I think we should be helping to subsidize it. We subsidize roads and we subsidize other infrastructure. I just think it's really important that within the department - so if the minister could make note of that question - have you had somebody dedicated to looking at walkability and urban design and helping? Because to go back to the earlier question around the recreation centre we needed in Clayton Park, HRM had not built a new pool in over 25 years, so they didn't have - and I would say even today don't really have - the expertise about what is the best kind of pool for the population and so on.


They're not doing this on a regular basis but there are people and were people in the facilities area of the province who knew and have a better handle on what are the current trends, what's needed and what's available, and they weren't being consulted, initially, on that project. I'm going back now to 2003, 2004, 2005.


The city was thinking they could do it alone and that they knew exactly what was required and they weren't asking for the expertise that came from Sport Nova Scotia - I think that's where you have them housed, but people who really did work on facility development and had done projects in other parts of the province and would have been more up to date on that because these are pretty exceptional projects when you're talking about large recreation centres and replacing a pool. That's just not something that even HRM does on a very regular basis. So I had at the time been trying to urge HRM to go to the experts, to talk to the people who understood this in the province, so that we could at least leverage the best information possible.


I wanted to look at some of the smaller facilities and to talk about the budget that might be available for that. The minister had mentioned the water park, which I think HRM had put in that area, probably with some help from the community and from the province. In my own area we have a couple of outdoor rinks and I think the North End had really the first of the outdoor rinks that was community-driven and all the volunteers maintain it. I think they're fantastic for winter activity and for bringing families together and I had, myself, made some donations to the rink in Rockingham and it has been going now over five years, built on a municipal tennis court and built because the community got behind it.


On that very same site in Rockingham there had been an old ballfield. The neighbourhood got together and said that park, much like the one you talked about in Mulgrave Park, that this particular playground was probably about 40 years old. It had been built when the neighbourhood was first built and they said it was inadequate, it didn't meet their needs and nobody was playing ball on the Little League ball diamond. It wasn't a big area because it was close to homes so it could only have been young children using it.


The community in that case did get together to form a neighbourhood association, put in applications for grants and help from the province and the city, and were able to completely transform that area. That has been over about a five-year period. They now have a playground and I must tell the minister that during the election I stopped in because there were a great number of people at the playground. I shook hands and talked to people and, much to my surprise, most of the people were from other districts. They had come to that playground because it's so great, and that was a nice thing for me to see, that we created such a great play area that other people were coming in to use. But again, they were driving there, and we talked about how it's important to have great facilities in your community. A playground is a wonderful investment of dollars because it brings community together as well. It's more than building a big, expensive facility. We need to look at more things like that.


I wonder, could the minister tell me about the programs that are available that might help in those municipal projects? You have, I think, a pot of money you said for facility improvement. I'd like to review with you - these are not really facilities, these are more like community-led small projects that need an infusion of capital, a little help from the province as they put together their business plan to build new playgrounds, or skating rinks, or ball parks, that are small and will serve the local needs. Again, I think that's so important.


The other question was, do you have somebody who's an expert on municipal planning who can help? I'm thinking around the recreational and importance of planning. My district, just for the minister's knowledge, is not finished yet, we still have another new big neighbourhood going in that will house about 2,500 people. It's called Mount Royal Subdivision, it's laid out now, but I still see brand new development in the 10 years I've been either a municipal or provincial representative in Clayton Park, I've seen so much development and not enough space for the younger children that need to play.


MS. MAUREEN MACDONALD: I want to thank the honourable member for her questions. I think the first thing I would say is that it is increasingly important for governments to break down the barriers between governments to work more collaboratively. I want to assure the honourable member that, in fact, I think that is occurring.


While municipalities have responsibility to do land-use planning, there is a lot of collaboration that goes on between the province and municipalities around the various developments. In the Department of Health Promotion and Protection there is a person whose name is David Malloy, who has a lot of expertise in terms of the planning of recreational facilities. He works very closely with the municipalities and he's been involved, for example, around the B-FIT program, doing some of the assessments of projects and all of this kind of work.


To give the member an example of some of the grants that are available, and grants that have been given in the past year, I had made reference to B-FIT, which is now fully taken up and that was a program that - some projects got as much as $10 million, others got $110,000. It had a very broad spectrum of projects, but we do have this recreational fund, I think it's called the Recreation Facility Development Grant Program. It can fund up to $150,000 of a project, that's the maximum you can get.


To give the member an example of some of the projects that have been done, the Dartmouth Sportsplex resurfaced their indoor running track at a capital cost of about $110,000 - slightly more. That was the total capital cost of that project, the grant was for $30,000. Another example would be McIntosh Run Watershed Association to develop a trail. They received $20,000 from that fund. East Preston Recreation Centre developed a multi-purpose outdoor court, this grant was for $15,000. The entire project was more than that, it was $60,000, but they were able to secure a portion of that from this grant.


[11:00 a.m.]


The Shubenacadie Canal Commission, which has been raised here a number of times, has made application to this project, or for money from this, but it has still not secured funding through this grant. I think that this grant has been used for trails, for playgrounds, for skate parks, for indoor running tracks, for community playgrounds. It is available to various recreational groups and there is an assessment process that is used to determine funding, or some portion of funding, for these grants.


This program funding continues in our budget and this year the budget is $2,817,300 in that pocket of money. There is a substantial amount of money there to help in those kinds of smaller projects that the honourable member refers to. Indeed, when I look at the North End outdoor skating rink, that particular initiative, which is a very community-driven initiative on existing tennis courts, started with one pad and it expanded to two and the last few years there were three or four pads going. Again, as the member says, you can pop up there with your skates to have a skate and find that there are people from all over the municipality, they drive in from Cole Harbour and different places because people love to skate outside.


We haven't necessarily had the kind of winter that would give us very much skating. It didn't get much use this year, I'm afraid, because of how mild the winter was, a little bit of use but not a great deal. In the years when we have had our traditional winter, I can tell you that the place is packed. It has really brought the neighborhood together. You see so many young people out there and the second they're out of school they're right up to skate, it's fabulous, it's really excellent. They have dedicated areas for the young fellows who play hockey and then there are the areas just for family skate. You get a lot of younger children starting out, learning to skate, they're out there with their moms and dads, falling over and it's great. It's just a really great neighborhood opportunity facility, another piece of building strong communities and getting people active.


Back to the idea of planning, planned communities, and having active transportation, because there is a physical inactivity crisis in Nova Scotia and, indeed, in Canada. We do have an active transportation and a built and national environment kind of initiative underway in the department. Since 2006 there has been something called the Pathways for People Framework for Action where attention and resources have been allocated at both the provincial and local levels of government across sectors such as recreation, health, environment, tourism and transportation. Active transportation is supported provincially by HPP through something called the Municipal Physical Activity Leadership Program. Trail development, organizational support and partnerships are the focus of this program. In 2009, the Union of Nova Scotia Municipalities formed the Active Transportation Committee, which includes representatives from municipal and provincial governments as well as the volunteer sector. There are some in the active transportation community that feel the use of highway vehicles and ATVs are mutually exclusive on shared-use trails. They meet regularly and they are trying to develop a more comprehensive approach to increasing walking and biking and other active modes of travel for recreation and transportation.


These are, I think, some examples of partnerships that we have, that encourage walking and wheeling and other forms of transportation between HPP and certain groups. We have the Heart & Stroke Foundation, the Walkabout initiative, which includes federal bilateral funding; Bicycle Nova Scotia, the Bikeways vision, CAN-BIKE training and the provincial Cycling Summit; the Ecology Action Centre, Active & Safe Routes to School; Making Tracks and the Sustainable Transportation; the Active Transportation Community Toolkit Project - you see those speed-bump bumper stickers that people who drive under the speed limit actually - the Union of Nova Scotia Municipalities on the AT Committee, which I've mentioned; Recreation Nova Scotia is a partner on the Pathways for People; and Doctors Nova Scotia on the Youth Running Program.


The department certainly is involved with a number of initiatives and supporting a number of initiatives with respect to active transportation, that includes not only walking but biking and other forms. Certainly working closely with municipalities around their land-use planning needs and plans.


MS. WHALEN: I appreciated the list of some of the projects under B-FIT. I wonder if the minister could table that list. You had mentioned the Dartmouth Sportsplex, McIntosh Run and East Preston, that would be interesting for us to have a list, I think, if it's available. (Interruption) Okay, that would be great.


There was another list, which you didn't hold up but you were talking about, again, these things like the co-operation with Bicycle Nova Scotia, Tracks, UNSM, Active Transportation Committee and so on. Is there a budget associated with each of those? That seemed to be a bundle of projects. It was the second list you were reading from, you said about the municipal Leadership Development Program and then broke down some things like Tracks, Bicycle Nova Scotia, UNSM, Active Transportation. Is there a dollar figure associated with those? I know we have to confer with the financial experts for the department but maybe you could just check and see if that is lumped into one list and if we would be able to see that as an item just, again, to acquaint ourselves with the commitment that is there now.


I'm glad to hear of those different things. I'm certainly aware of the active transportation initiative to see more kids walking to school. Every school in my area has a problem around parking and traffic, and really a dangerous situation with children being dropped off and picked up. I don't know about the other urban members. I see quite a few rural members here and in the rural areas your children are virtually all bused, even if they live quite close to a school; in the city, although, there is some busing for children who might have disabilities or asthma or some condition that would require it. A lot of the children are within walking distance to come to school but parents are not comfortable letting their children go that distance, especially the little ones, and they drive them.


I get calls often that I have to refer to the municipal councillor because it's not my role to change parking or that sort of thing around a school. Again, if we have more paths and more connections, we would have, I think, greater help on that.


It is a concern though because children not even walking to school means less activity. There are 20 minutes or 10 minutes less each way that they're going to be active each day and I know the minister mentioned that obesity is probably our biggest issue that needs to be tackled. So the physical activity strategy is really important to me. Just in the last few days, in anticipation of being here today, I have looked at a recent report, May 2009, so it's just a year old, A Comprehensive Provincial Physical Activity Strategy.


Now, I'm not sure exactly what the provincial role was in it but three DHAs had a role to play. I was looking at who the partners were but it's a great list of groups that have come together to say this is a health issue and an important issue. So you have the Canadian Cancer Society and the Nova Scotia Cancer Care, Canadian Diabetes, the Dieticians of Canada, the Heart & Stroke Foundation, Recreation Nova Scotia, and then the medical officer of three of the DHAs that got involved to put this together. It's very readable. I'm sure the minister has been through it. Throughout it has quotes on why we should be healthy, why we should look after this component of our health. There's no question that if we could get people to be just a little bit more active, and again we talked yesterday about alcohol strategy and again today, but even if we could make a small dent in that, there are direct and measurable savings.


I think it's almost one of those things at a tipping point where it doesn't take a lot to get a bigger return. We know that now with physical activity. You don't need to be a marathon runner to see great increases in your cardiac health. If you just walk 30 minutes or 20 minutes, they say it can really make a difference. So the amount of time is not as great as we might previously have thought if you're sedentary and thinking, oh, I just can't do that or I don't have time. There is every reason to take that little step to even add 10 minutes of activity. Well, unfortunately, our children aren't doing that.


I guess just as we're talking about that, I've been really interested in the last few days about seeing this ball hockey issue going on in Eastern Passage, or it was Enfield I think. (Interruption) This time it was Enfield, you're right, but it has come up in other places and I know the Minister of Transportation and Infrastructure Renewal has said he thinks it's a Canadian tradition and why would we stop that? In my earlier comments I said we need the kind of recreation that children can have close to home because again, parents are not always there to drive them far. If they don't have the second car, if they don't have access to transportation, they won't be going to a lot of organized sport, and what better thing than to step out into a cul-de-sac or a side street and set up a game of ball hockey that brings all kids together at all ages?


I read the letters to the editor, I think there were three yesterday that were for and one that complained of the noise but I noticed the minister talked about the lovely noise you hear when the water park is going and it drifts over to your house. Now, I know there's a little bit of banging of sticks on the ground and so on but when I think of what those kids would be doing if they're not out playing ball hockey, well, perhaps they'll be drinking in the nearest park, that they can hide under the bushes. Or some other unhealthy activity, or we'll say go inside, you're noisy, go play the computer, go watch TV. Well, we know they're doing that something like 40 hours a week - I forget, perhaps the minister knows the screen time.

I was at a launch for Girls Soar which is a program that the province is involved in. It's an HRM initiative but I know the provincial representatives were at this launch at the Keshen Goodman Public Library - it's the second year that I had attended - and it is aimed at teenage girls particularly. The minister mentioned in her opening comments that by the time girls get to Grade 11 less than 1 per cent of them are getting what's considered moderate exercise during the week, a moderate level of healthy exercise. So we're down to less than one in 100 getting that exercise. That's astounding and a terrible prognosis for the future of those girls. Boys are not a lot better. I mean they're 10 per cent I think, around 10 per cent, which is still not great for the boys but they are 10 times better than the girls in terms of being active. We need to focus on both and help those kids be more active all the way around.


In this study anyway, I'm not sure where we're going with this strategy, whether the province has adopted it, what action you're going to take. I think we're on the same page in identifying the fact that we have a tremendous problem around physical activity. I'll go back to the ball hockey. I don't know if there's a role that Health Promotion and Protection can play to try to help people realize that the alternative is a tremendous cost to us to have unhealthy, inactive, sedentary, overweight children .


[11:15 a.m.]


You know, I just think it sounds so much like a curmudgeon to say that you don't like the kids playing near your house. It's so short-sighted. We should be so delighted that children are getting out and doing something as healthy and as normal as that in a safe, controlled way. I realize some roads are busy but mostly this is happening, in my area, on the very quiet side streets and the kids are looking for a place where they're not going to be interrupted a lot. So I think maybe there's a role to be played, and I can't ask the Minister of Transportation and Infrastructure Renewal today, but if there's a rule that's preventing it, maybe we can adjust that rule.


This issue comes up not just in Nova Scotia but in other provinces. Occasionally you'll see it on the national news popping up from another place, but it's just an example of how we've restricted young people to the point where they don't have the opportunity to get out and play. The minister spoke about swimming holes and fields and being able to run and have a good time as a child and have a little bit of freedom. Well, that doesn't exist in the city where parents are nervous to have their children out of sight and it's a sad commentary that we are frightened to have them anywhere away from us, but something like ball hockey, any kind of activity where they're playing on your own street and in your own neighbourhood, should be encouraged as long as they're not on a busy street.


So I would like to know if there's a role you can play in Health Promotion and Protection, even in the debate, because we need to let people know what the alternatives are if we're not letting our children have some fun. It has become a little bit of a sour atmosphere when you're not allowing kids to get out there and have a good time.


In the appendices to the physical activity strategy they have one that's an account of the health status of Nova Scotians, and physical activity affects all of these. It says Nova Scotia has some of the poorest health statistics in the country. This department that we're talking to today, Health Promotion and Protection, has the opportunity to address a lot of this but when we're talking about the second highest rate of cardiovascular disease - and again, it's growing tremendously in women, I think we may be number one almost now - but smoking again, when the minister spoke about women previously having sort of the moral high ground and not being drinkers and smokers, the smoking rate did flip. More girls were smoking than boys, and I think they still are. I think girls have now taken that position in the smoking statistics although our tobacco strategy is working well, I know.


I would like to talk about this report that was done for the physical activity strategy. I would like to know if you have any funds committed and I would like to reference $5 million - I'm not sure where I picked that one out, because I don't see it in your estimates - but I have there that it works out to about $5 a person, $5 million from Health Promotion and Protection budget dedicated to an all-ages, comprehensive physical activity strategy. So if that is in those figures, perhaps you could tell me where it is in the budget and tell me where you're moving with this because this is an urgent matter for all Nova Scotians.


One of the figures we hear - just before I turn it over to the minister - is that young people today living in Canada are not expected to have as long a lifespan as those of us who are older and that's because of their early inactivity and the lack of, perhaps, opportunities and a societal shift away from active, healthy children. So what are we going to do now in this physical activity strategy?


MS. MAUREEN MACDONALD: Mr. Chairman, first to the honourable member, the honourable member was asking if there's a budget for MPAL and the municipal group, and we will get a breakout of information shortly for you. We don't have that right now. Secondly, I'm not sure which strategy or which piece of work - is it the Active Kids Healthy Kids?


MS. WHALEN: It's called A Comprehensive Provincial Physical Activity Strategy.


MS. MAUREEN MACDONALD: And the date on it is?


MS. WHALEN: May 2009.


MS. MAUREEN MACDONALD: I don't think we have anything and is HRM or is it ours? (Interruption) Right, okay, so it's not a report of the department then. We're just trying to get straight which publication the member was referring to. We've had an Active Kids Healthy Kids strategy since 2002, and there has been attention and resources allocated at the provincial and local levels of government and across sectors such as recreation and sport, health, education, economic development, and environment. As well, the Heart & Stroke Foundation of Nova Scotia and the Alliance for Healthy Eating and Physical Activity are advocating for a funding strategy aimed at the whole population level.


We've seen this over these issues that the member refers to as initiatives that many different groups are taking up in various parts of the province, I guess. Certainly I'd be interested in seeing that particular report, as would people in the department. No doubt, people in the department are aware of it and perhaps people who are on our staff in the DHAs may have been involved in it. I'm not really sure, I can't respond to it without actually seeing it. As I said, there are many reports and many initiatives going on.


The honourable member certainly touches on a lot of very important issues. One of the issues she has touched on is the inactivity of young women. It's interesting, in the department there is, I believe, an initiative underway to look more specifically at this question of inactivity among young women and, as well, to identify what it is that might entice or interest them in terms of getting young girls more active in recreational opportunities.


I have this question sometimes when we do discussions around funding, around hockey and ice arenas and what have you. It's a very important part of our Canadian culture and we all love hockey and we all love the local hockey arenas. I sometimes ask, if we're all so concerned about equity and equitable opportunities and funding, do young women use these facilities? Are there barriers to getting young women involved in the use of ice time? Is there something we should be doing to pull down those barriers? Is that a waste of our time?


Even if there are barriers and we remove them, would it make a difference? Maybe it's just not an attractive thing for what young women want to do. Perhaps they're more interested in yoga and dance, aerobics, I've heard people talk about these other areas. Although, I have to say, having watched the women's hockey games during the Olympics, that last game, in particular, was really good ice hockey.


I think we still have a lot of unknowns in terms of the diversity of the population and what exactly is an initiative that would excite people, would motivate people and give people access. The member will know that we do have a kind of tax credit in place for children who become involved in recreational opportunities. It's kind of a children and youth tax credit, and the cut-off is for young people who are 19 years of age and under can qualify. If parents are investing in recreation for their children, they can receive some kind of benefit.


This has its positive features but it also has its limitations, and that perhaps for very low income to make that investment in the first place is difficult. One of the things that I would say HPP is very aware of and is really good about is on the equity piece. They understand that inequitable opportunities are counterproductive to our mandate, and so there's always a desire to find ways to minimize the barriers to being involved in recreational opportunities.


We partner with KidSport, who have expanded their programs for children who have families with limited financial means to invest in recreation so that kids will have a greater opportunity to play in a sport. I had an opportunity to meet with the executive director of that organization. They're very committed to kids having good recreational opportunities regardless of their family's financial circumstance. They literally support hundreds of kids. It's interesting - one of the things that really makes a huge difference is collaboration, is the working with others. You can maximize your limited resources the more you pool your efforts. So they work with other groups and I think they've been doing some work with school boards, perhaps, to try to create greater opportunities and get their programs to the right kids. Again, it's really important that we're able to have good information and really understand who are being left out of the equation when it comes to having recreational opportunities.


I think that there's a whole area, and we certainly do need to focus on children and youth, but we also - the member talked earlier about seniors walking around the fire halls or whatever as a form of recreation. I'm frequently contacted by seniors in my own riding who want to have recreational opportunities, and there's a real limited focus on seniors' recreation. Perhaps it's because we are a society that tends to stereotype seniors in a way, that we don't see them as active participants in our society with recreational needs. I think we're missing the boat on that. There are many, many seniors who are just hungry to be able to have recreational opportunities, and of course the problem walking in the wintertime when it's icy can be very dangerous so you do need those places, those indoor walking facilities in particular, that don't have the potholes and the cracks and the ice and all of those things that can lead to falls.


The member asked about ball hockey in terms of the department and our involvement, if any involvement, around that issue. I was glad to see what the Minister of Transportation and Infrastructure Renewal had to say on that, and I concurred with his comments entirely. I think, though, when I take a step back and I think about this issue - not just in the isolated context of that particular incident, but when I think about it much more broadly, I think we really need to have a balanced approach where we always use our common sense.


Here I am - I have a department that's also responsible for injury prevention. So we have to make sure that kids aren't playing road hockey in the middle of Highway No. 101 or something like that, and they present a hazard to themselves and to other people where we would be dealing with a much more serious outcome. At the same time, again, I take the honourable member's point entirely - playing road hockey on your side cul-de-sac is a Canadian tradition in some ways.


[11:30 a.m.]


It's a good recreational opportunity for kids close to home. They're right under the eyes of the neighbours, if not their moms and dads, and there's no harm in it as long as there's no harm in it. I think that's the fundamental point: using some judgment, using some common sense, making sure that they are safe while they're having fun and they're out there doing something that's healthy. I suppose every incident has to be judged on its own merit. In some cases it may not be safe depending on the traffic patterns and where kids decide to do these things, but in other areas, certainly, safety would be good. So yes, I guess it's something we need to look at on a more case-by-case basis.


MS. WHALEN: Thank you very much, and I appreciate those comments. It seems best if I ask several questions at a time and then we get several back, so I think I'll continue to do that in the time that's left here for me. On the ball hockey one, there may be some sensible measures, and perhaps the Minister of Transportation and Infrastructure Renewal would also have a listen. I know the municipalities set road counts. They know how many cars or traffic counts and how many cars are on different streets.


In fact, to get a crosswalk you have to have something like 2,500 cars that go by in a given day, which means they won't put a crosswalk - they won't actually paint one on a street that doesn't get a lot of activity. They say it's not worth it, we're not going to do that. They would know when you're on a residential street, even if it's a through street that has a very small number of cars that pass on a given day. I think that could be a measure on where it makes sense to allow ball hockey, or maybe even a time limit that says, well, we have to have the game gone for the rush hour when people are coming home from work. Maybe nobody plays between 5:00 p.m. and 6:30 p.m., or something like that.


As you mentioned, common sense. Let's try to work with something that works well for young people and for families. Let's try to work around the safety aspect, and there may be something we can do there. This may be a unique issue in Canada and nowhere else, but I think we need to look at it because again, to me, it's just a little window into how we restrict young people and prevent them from doing things that are good and healthy, and send them entirely the wrong signal. We're not supporting community and we're not supporting that idea that it takes a village to raise a child; we're saying go inside and close the door and don't make any noise, you're bothering me. That's really why people would complain. They're not complaining because they're concerned about the safety of the children. They're complaining because they think it's a nuisance, and I'm taking that more from the letters to the editor than otherwise.


Again, even as a councillor, I had issues a couple of times that related to that, but I just think we have to make people think, is it better to have them there or would you rather have them doing vandalism or hurting something in the community? I mean, again, graffiti and things like that are rampant in our playgrounds, too, when we build a nice facility - because kids are bored and we need to give them more things to do and more healthy things to do.


On the issue of equity, I'm really pleased to hear as well the minister talk about a gender lens, I guess, when you're looking at projects and the funding of projects. It is important to note women's hockey in Canada is increasing. In my neighbourhood we've had a number of the girls on a provincial team that went to Newfoundland and Labrador for the provincials - or, no, regionals. I guess that would be the Atlantic regionals that were held. So they're a winning team of high school girls. We have to celebrate that, too, but there has been a difficulty for girls to get into the rinks for girls' hockey and for ringette - it's primarily girls who are playing ringette. I know over the years people have complained they can't get in. So if we're going to fund these projects and allow the facilities or help the facilities, we have to make sure that there's equity in how they allocate the time available, and I certainly agree with that.


In terms of finding other activities that girls like, I note that some schools are offering things like yoga in their programs. Some of the new schools have not really a gym, but they have a little bit of gym equipment in it that rather than maybe going to a traditional gym class, you could go and use an elliptical or a treadmill and that sort of thing, which might be more in keeping with what some of the girls want, and boys too perhaps. I know that I had seen that in some of the new schools that were built in my neighbourhood - I think the Park West School had one. Anyway, I do think it's the right thing to do.


I was going to mention something around physical activity and learning that I think the minister is probably aware of but, again, this study is a really good one to look at. Although it's not a departmental study, it's a very good one to look at in terms of its overall - but it does talk about learning and physical activity and the strong evidence that when you're physically active, actually your memory is better and you learn better. There was a documentary on CBC, just on the news hour, so maybe a 10-minute documentary that focused on a school in, I believe it was inner-city Winnipeg. I don't know if anybody from the department had seen that, it was on the evening news on CBC, perhaps about a year ago, but it really struck home with me that educators should be looking at this.


It was a school with kids who were struggling and it was a math class that they went into. The teacher actually had treadmills in the classroom and the students started by spending about 15 minutes or 20 minutes on the treadmill and then went straight to their desks and started their math lessons. They were measured before they began this and afterwards. They did talk about the resistence from some of these kids who thought they were pretty cool and maybe didn't want to do it, but they all did participate and their marks went up measurably, a marked improvement in their marks, their understanding, their comprehension, their ability to sit still, and any of the ADD or ADHD inattentiveness seemed to be addressed.


It was just, to me, a sign that we're missing something here when we've cut out a lot of the activity in schools and daily physical education, or even recesses that are active. We're limiting the kids' ability to learn and, again, if we want to improve our learning outcomes and kids enjoying school and staying in school and doing well in their studies, there's a really developed link now that we can look at.


There is some mention of that in this report, as well, about it being demonstrated that you will learn more and I haven't put enough sticky notes on this report to know exactly where that is, but it was very clear that this has been measured by people who study physical activity. So I think that we should be working with our schools to see - and even if we did it, Mr. Chairman, through you to the minister, it's a bit of an appeal to the minister, but even if we could appeal to the education community, I guess, to pilot it somewhere, to try it in one of the schools where results are poor or where the children have a lot of issues. Inactivity, again, is connected to mental health, to depression, to so many other negative impacts. So if we can look at a pilot and we could measure it ourselves, I think we would come out with enough evidence to try to expand that program because what we need to do is find ways that we can link good health with just a stronger foundation for our kids.


I think that we would find it good. I mean maybe it isn't having actual treadmills, maybe it is actually having something else that you do, you know, you go for a walk or a run, or a dance class, and then bring them back in, but I was really impressed by what happened and this was an inner-city school with a lot of children who had difficult home lives, a lot of bad influences around them, and they were really responding to this new approach to studying math, which isn't the easiest of subjects for many kids. So I wanted to mention that and to suggest - and perhaps the minister could tell me if she's interested in that - but I think these are the sort of things we could pilot here, that we could start looking at in our own province.


Going back to another issue that we talked about earlier, I would like to ask about - and this would just be my final comment, probably, on the alcohol one - is could we look at a cost benefit. I just noticed a big stack of studies I've now got on alcohol. I put them aside because we've had our discussion on that, but these are a lot of big studies that we've funded through the department, the prevalent studies, the continuing surveys that you're doing with students, but we don't have a cost benefit and I know with gambling some time ago, maybe in the late 1990s, there was an attempt to do a cost benefit on gambling revenue and what the costs are to society and direct costs. Is there any talk about doing a cost benefit on that? That would be a direct question for the minister. Perhaps I'll leave her to talk about that.


Just before I finish on the physical fitness, because there is an awful lot there, one section in this report says Mental Health, and it gives a backgrounder on that. Clearly it's important to our mental health to be more active but they have a chart here that says Nova Scotians have the second highest self-reporting of probable depression in Canada. So self-reporting, Nova Scotia is 8.7 per cent of the population and Canada-wide is 4.6, so not quite double but considerably higher than the Canadian average.


The other footnote says that studies have found that physical activity is at least as effective at treating depression as is medication. We've got, again, a compelling reason why if we're getting out and socializing and being active, our own body is just better regulated and I guess we are happier, it's good for us. I don't know if that's endorphins or not but there's something there that makes us feel better. I think that we could be looking at that, as well, under mental health and I'm wondering if the department is connecting the dots between mental health and physical activity, as well as what we've talked about around childhood obesity.


MS. MAUREEN MACDONALD: There are a number of issues that the member brought up. Let me first say that I think the report that the member has been referring to is an initiative led by HRM for HRM but we have had some involvement in that. I think we contributed $25,000 toward that initiative and we are very interested in it and will be continuing on with that.


We are seeing in our schools a significant increase in the numbers of young girls that are interested in yoga. I think that was something that was just recently introduced into the curriculum as an option.


With respect to the inner-city program, I didn't see the program that the member is referring to but as she was speaking, I started thinking about one of the inner-city schools in my own community, St. Joseph's-Alexander McKay, a small elementary school that I think has had a very similar program for two or three years now under a really remarkable principal who we all totally love in the North End of Halifax. It's kind of an after-school program that combines recreation and education. It's a program where kids who need a little bit of extra help in their studies, in their subject areas, including math and reading, get some extra help after the school hours.


They also do a huge amount of recreational activities, including the thing that the kids most like to do, when I was told about this program, which is running in school. Remember when we were kids you weren't allowed to run in school? You'd run and the teachers would always make you stop and they'd say "walk" and you weren't allowed to run. Well, the kids are allowed to run in school as much as they want after school hours in this program, and they just love it.


It has been awhile since I was given the information on this program, but what I recall is that the school was able to secure funds to financially support this program through some kind of a national grant. It was one of the only schools in Nova Scotia to get this funding and the number of kids who could participate in the program was limited, they could handle so many kids. I think the children who were involved were mostly kids who were in Grades 5 and 6, and they saw a marked change in their performance in their studies in terms of participating in this program. I don't know, it may not be the same program, but as you were speaking it struck me it sounded very much like the same program.


[11:45 a.m.]


One of the things that is probably a strength and a weakness of our school system is the autonomy. There is a certain amount of autonomy in the system that we have for schools to develop their own little initiatives based on the needs that the staff at the local level in a school identify. That's a strength that "one size fits all" will miss, I think. At the same time, I don't know that we're all that good about sharing our successes - when you have a little program like this that really benefits a group of kids and is something that we should be proud of and be able to not only hold up as an example but then be able to export to other schools. I don't know how well we do that, but I think our school boards actually are doing some interesting things that we don't necessarily know about because sometimes they don't have time to tell us about them.


This little program at St. Joseph's-Alexander McKay is just an excellent program and if you talk to the teachers and you talk to the parents, it's really been very successful and people are very excited about it, and it's been going on for awhile. I don't know if they're doing it this year or not because sadly, as Minister of Health, I haven't had much time to spend in my local schools, which is something that I used to always have a bit more time for.


I want to finish by talking a bit about - back on the alcohol, the work that we're doing around alcohol abuse. The member is right. There have been a number of studies. Whether or not there has been any cost benefit, I'm not sure if I can answer that or not, but I will get the information and provide it for the member.


When the member talks about depression and mental health and the relationship between being active and lessening depression, it's really interesting. We are going to be developing a mental health strategy in the Department of Health. I very much want that strategy to have the involvement of HPP as we move forward, for a number of reasons. The suicide prevention work is being done in HPP. We know that depression is one of the largest areas of mental health and unwellness that we have. I think that you can't divorce people's physical well-being from their mental well-being. I understand this; many people who are practising in the field understand this. There is a very strong relationship. Again, in a way, it points out the false dichotomy of having a Department of Health Promotion and Protection and a Department of Health and not seeing it as interconnected and relational, and in the field of mental health I see that very clearly.


Anyway, having said that, those are the points I would make.


MR. CHAIRMAN: We're going to take a recess. We'll reconvene when the minister gets back.


[11:49 a.m. The committee recessed.]


[11:58 a.m. The committee reconvened.]


MR. CHAIRMAN: I now call the Committee of the Whole House on Supply back to order.


The honourable member for Cumberland South.


HON. MURRAY SCOTT: Thank you, Mr. Chairman, and I just want to say welcome to the minister and deputy and her staff who are here today and thank them again for answering questions. I know they are very important to constituents of mine.


I want to begin by - there was a program - and, minister, this is actually a Department of Health question and I know you won't have the answer for me today and I apologize for not asking you the other night, I didn't have it with me. I'm hoping that if it's okay with you, you can maybe make note of this question and take it back and maybe even respond to me at some later date, in writing.


The previous government had launched a program in conjunction with Cancer Care Nova Scotia, an awareness program. It had to do with colorectal cancer. I believe at the time, to raise awareness, kits were sent out by the department, I think they were province-wide. I'm just really curious if the minister could find out for me from the department, how many kits were actually mailed out and then how many responses were there? I didn't think you'd have the answer today, and maybe the number of responses received back from that campaign.


MS. MAUREEN MACDONALD: Thank you very much and indeed, I don't have the information today, but I will go back to the department and see what I can find out. I'm not sure exactly who would have done the mailing out of these kits, if it would have been a DHA, if it would have been Cancer Care Nova Scotia, let's say, what have you. I doubt very much that it would have been the Department of Health, for example. It would have been an initiative of some entity of the health care system out there, outside the Department of Health. So we will do our best to track that down.


[12:00 noon]


Do you know, honourable member, through the Chair, if the kits were just distributed in your area? Is this something that has happened in your area or more broadly?


MR. SCOTT: Thank you. No, actually it was a program that was launched, I believe, in the Bridgewater area. Again, it was an awareness campaign, and some sort of a partnership was formed between Cancer Care Nova Scotia, and the DHA of that area could have been involved. What I was really interested in - and I almost think it was a province-wide mail-out, but I'm not sure of that either. So I'm just curious if the minister could find out how many kits were mailed and what the response was, as opposed to the traditional way of people getting them through their doctor or whatever, it would be great. Thank you.


The other evening when I asked the minister some questions around Lyme disease, the minister indicated at the time that Lyme disease was more appropriate to be asked here, and I appreciate the information you gave me the other night. It was ironic because I got another call from a lady between then and now in regard to an issue. She has been diagnosed, she visits a doctor, I believe, in the Antigonish area. She tells me that it is quite difficult to get a doctor to actually - and I think the minister indicated the other night it is not easily identified, Lyme disease, and it's probably not something that is very apparent in a lot of cases. She tells me that to get doctors, particularly in our area of Cumberland - I don't know what it's like in the rest of the province - to actually identify the disease is difficult. You have to go outside the area and then a lot of people are going outside of the province for treatment.


I guess I have two questions for the minister. One is, who do we - obviously she is going to her own physician, but her own physician is saying that they don't feel that they have a lot of opportunity to direct that disease to anyone. Who should we direct folks like that to?


The second thing is, I believe the government has initiated a new program in this budget in regard to people going outside the province to access treatment that I believe is not available in this province. Would the treatment for Lyme disease come under that program as well?


MS. MAUREEN MACDONALD: Thank you very much. I'm really glad that the honourable member has raised this question with me again, because I kind of went off on my own answering it when he raised it the other night, and I want to make sure that I give accurate information to the member.


I said the other evening that Lyme disease is difficult to diagnose and that is true, Lyme disease is difficult to diagnose. I also said that the symptoms may be the same as many other diseases. I said there is no real test for Lyme disease. Well, that's not exactly true, there is a test for Lyme disease. We can test for it in this province and if the test comes back positive, it is sent to the national lab for further testing. That is what was getting me mucked up a little bit. I knew that we would send out of province, that we didn't necessarily just stop at making a determination here in this province.


The way Lyme disease is treated when it is diagnosed is very straightforward. There are antibiotics that people receive and that's it. We, in Nova Scotia, would have specialists who treat infectious diseases who are the most qualified to treat Lyme disease. As I said to the member the other evening, there have been 48 cases of confirmed Lyme disease in Nova Scotia since 2002. We track this very carefully because it is a public health issue, 15 of those new cases occurred over the past year. The difficulty I suppose would be if someone was having difficulty getting a diagnosis at the level of the family physician.


Family doctors are the entry point into the health care system for most people. If you're feeling really terrible and you have aches and pains and symptoms, you generally go to see your family physician. You describe what you're going through and they may have some idea right off the bat of what it is that you're presenting to them. They may want to confirm that by doing some diagnostic tests and they may need to get diagnostic tests by drawing blood and perhaps a urine or stool sample. Whatever they suspect you have, they know which way to get a confirmation of a diagnosis by doing some follow-up testing.


Once this occurs then the treatment will start. If getting a diagnosis is tough, you won't necessarily be referred to an infectious disease specialist if your family physician doesn't suspect you have an infectious disease. This is the difficulty with Lyme disease. It's not easy to diagnose and it's particularly not easy to diagnose just by discussing your symptoms necessarily with a family physician.


I think we have here with Lyme disease a division between the Department of Health and the Department of Health Promotion and Protection. Dr. Strang, our Chief Medical Officer, stays very up to date on the number of cases that are being reported and where they're being reported. He is charged with the responsibility of the public health piece of that especially since we know that deer ticks are carrying this disease and people can very well be exposed and bitten by a tick that's carrying the disease. I think there's a fair amount of monitoring going on to try to establish the geographic areas where we are identifying ticks that are carrying Lyme disease in the province.


There is some work going on by Health Canada with respect to deer bait stations in the Lunenburg area where it has been identified that deer have been carrying ticks with this disease. It will continue to be monitored. That's the public health side.


The health care side that you're raising is really around the treatment of people if they do contact Lyme disease. Again, it's like any other illness. You present your symptoms to your physician and then they have in their skill set the ability to diagnose you, refer you for more diagnostic tests and depending on the finding of those tests, refer you to an infectious disease specialist who can then order the appropriate treatment. We have plenty of those specialists in the province.


Really, the bottom line is someone in your constituency should not have to travel outside of your area to see a family doctor who can arrive at a diagnosis of Lyme disease. You may have to travel outside for an infectious disease specialist, but I doubt it. I would think that there are infectious disease people in the Cumberland County District Health Authority, as well, who could diagnose and treat Lyme disease.


MR. SCOTT: Thanks to the minister for the answer. There was one other part of that that I asked. So if someone was diagnosed with Lyme disease in Nova Scotia - you're saying that whatever level of treatment that's required is available in Nova Scotia. Once it's diagnosed, the treatment is here. If it wasn't available, is the out-of-province travel for medical treatment that's been introduced in the new budget for all and any disease or is it for specific ones? If it's only specific ones, is Lyme disease one of those diseases?


MS. MAUREEN MACDONALD: The out-of-province travel policy that we announced a few weeks ago is for Nova Scotians who require health care services that are not provided in Nova Scotia, that are not available here.


For example, in the Province of Nova Scotia we do not do lung transplants. It's not possible to have a lung transplant - we don't have a transplant team, we don't have a program. People in Nova Scotia who require a lung transplant, generally speaking, travel to London, Ontario or Toronto, I think. We have children from time to time who have rare illnesses, for whom we do not provide the kind of treatment they require. They may go to Sick Kids in Toronto.


The travel policy is designed to support the travel and accommodation of Nova Scotians who have a health care need that we recognize as a health care need, for whom there is no treatment for that condition in the Province of Nova Scotia. Lyme disease would not qualify under that policy because we do have treatment for Lyme disease in Nova Scotia. We have infectious disease specialists in the province. Once somebody is diagnosed, treatment is very straightforward - it's antibiotics, I'm told - but acquiring the diagnosis can be more difficult.


MR. SCOTT: Thanks to the minister for the answer. I'm just going to jump around a little bit - I have a few questions here. I think I may have asked you this earlier on as well, but I'm going to ask you again because I want to get it on today's record.


There are addiction services provided in Springhill at All Saints Hospital right now, and there's been some rumour - hopefully it's only a rumour - in the community that we may lose the addiction services both from All Saints, but also possibly from Cumberland County altogether. I wonder if the minister could just respond to that suggestion.

MS. MAUREEN MACDONALD: First off, I want to tell the honourable member, Mr. Chairman, that there is no plan in HPP to discontinue addiction services in DHA 4. Last year HPP provided $689,993 for addiction services. This wouldn't be just to DHA 4 - oh, yes (Interruption) No, there won't be any change. (Laughter) We have no plans to change.


So last year addiction services from HPP to Cumberland was $632,913 and this year it is $633,477. So there are no plans to withdraw or eliminate services in that DHA for addiction programming.


[12:15 p.m.]


MR. SCOTT: I thank the minister for both answers. Could the minister - and I apologize because you may have been asked this question already because I know that it was something that was asked, I think, outside this room in other venues - but I wonder if the minister could tell me about the future plans for HPP. I know there have been some discussions about merging or a lessening of services or whatever and I'm just wondering, could the minister tell me what the plans are for the future in regard to HPP?


MS. MAUREEN MACDONALD: What is that phrase about the rumour of my death is exaggerated, it's greatly exaggerated. I think that the rumour that HPP is being merged into the Department of Health is just that, it is a rumour. I don't know where this rumour got started. I have enough to worry about as Minister of Health without having to worry about rumours. So if I ever find the person who started this rumour, they're in trouble, Mr. Chairman.


But in all seriousness, I think that it is always valid to look at what we're doing and to ask ourselves, just because we've been doing this now for 10 years, does that mean we should do it this way forever? We can continue to do it if it is working really well and it makes a lot of sense and there aren't any advantages to making changes. But if there are some advantages to making some changes, I think we would be really short-sighted not to take an opportunity to make those changes.


I pointed out in an earlier debate or discussion around this with one of the colleagues of the honourable member that certainly, as Minister of both Health and Health Promotion and Protection, back during the H1N1 pandemic I saw a clear advantage to having one minister in this position. I mean, I have a bias. I really like both of my departments. I make no bones about that. I like both of these departments. I see great benefit in looking at health very broadly and I'm not someone who denigrates acute care as a health care area in spite of the fact that it does take up so much resources.


I see and have great compassion for people who are sick, who need acute care resources, and I understand that they're extraordinarily expensive and they're going to continue to be extraordinarily expensive, and chances are that most of us in this room at some point in our lives are going to need them. So I have very little patience, frankly, when people denigrate, not meaning to necessarily, but talk about acute care and that side of the health care spectrum as if it's wrong-headed, because it isn't. You know, trying to give people hope and some quality of life when they're really ill and they're at the end of their life is not something that I think we should take lightly or be disrespectful of.


Having said that, we have way too much chronic illness in our province. We're not alone in that. This is something that is shared throughout western society. We have our own particular characteristics to be concerned about. There are things that we can legitimately do about those and so we should, and the way to do that is by improving our health promotion and our health protection efforts and initiatives. That means having a great deal of balance in how we approach these things and I have an enormous amount of respect, and hope that by investing in this end of the health and wellness spectrum we will realize some real benefits on the acute care side.


But I harbour no illusions that we're going to be able to transform the path of human endeavour. We are biological beings. We suffer from diseases and illnesses, many that we don't understand what their origins are. Some, yes, are clearly identified with our lifestyle and our environment but we still carry a fair amount of genetic material and as far as I know, the last time I checked, genetics is a piece of the determinants of health and many of us are more susceptible to certain kinds of diseases than other kinds of disease as a result of our biology.


So I think it is a very complicated issue and it should not be reduced to a debate about either/or, are you for health promotion and protection or are you for health and should they be in two different - that's a use of my energy, in some ways as minister, that I would prefer not to have to spend a lot of time on when there are so many really important and big issues to spend time on.


However, if I'm put in that position, I guess I will have to deal with it as it comes. It reminds me a little bit, though, I mean - these debates, you see them all the time in women's studies in universities. There is just this whole thing: should you have women's studies programs or should every program have a component of looking at gender issues? So it's the same debate in a different form in some way, and it is not necessarily one that will get us too far.


I think the most important thing is what our commitments are to advancing the wellness of people in Nova Scotia. What is this government going to do to improve the status of people's health and, specifically, what is the commitment that was made in the Speech from the Throne and how are we going to get there?


The former government, I'll say this - Dr. Hamm, one of your former Leaders, one of our former Premiers - in establishing the office and then the department, was very clearly thinking, and it was really important, particularly at that point in time, that this is an important initiative of government and we're going to invest in improving the health status of the public of Nova Scotia. With this government, I think what's important to know is that we're going to continue those initiatives. We support those initiatives; we're going to continue those initiatives; we're going to build on those initiatives; we're going to build on those initiatives; we're going to add to those initiatives. To me, that's very important and that's our commitment.


It's difficult because of the financial situation to find all of the resources that you would want to bring to bear on those. This means we're going to have to work harder with the same resources. We're going to have to make the same resources work harder for at least a period of time until we have a different resource picture, but I think that is achievable and we are starting with the child obesity strategy - that is the new piece. Now, there's a fair amount of work that has already gone on in the department around that. We have the nutrition policy and that is being expanded now to licensed child care facilities and other health care institutions in the province.


We will build on this in a kind of step-by-step, incremental way, and at the end of the day we will see some really very important results for the population. We have to get the inactivity piece addressed. There has also been some work done on that as well, but there's a lot more to be done and we're very committed to doing that.


MR. SCOTT: Mr. Chairman, I thank the minister for the answer. I'm pleased to hear that that was just a rumour. I have no idea where it started but I know where it stopped, that was right here, and that's good to hear. You're right, I'm pretty proud of the previous government under Dr. Hamm. I believe I'm right in saying this, it was the first jurisdiction in Canada, if I remember rightly, to have a separate Department of Health Promotion and Protection from Health. The former Premier, Premier Rodney MacDonald, was the first minister. I think there was a tremendous amount of work that was done under that department that continues today. So I'm really pleased to hear you say that that will continue.


Just a couple really quick questions. On Page 14.2 - this is a financial question - it talks about funded staff. I wonder if the minister could explain, the estimate in 2009-10 for the totally funded staff was 152, and I see this year for 2010-11 it's 148. For the external agency staff which I assume - well, I better not, I'll let you explain - it's (15) and (10), and then the total departmental funded staff is 137 to 138. I wonder, could the minister explain the variation in those numbers?


MS. MAUREEN MACDONALD: Mr. Chairman, the decrease in funded staff is due to the Panorama project which is a database for collecting immunization information. So the decrease is due to the Panorama project being delayed for another full year. No layoffs occurred. Staff assumed previous roles in HPP but staff had been seconded to this project. So they've gone back to their previous positions in HPP and in two positions there were secondments from the Capital District Health Authority. So they've returned to the Capital District Health Authority. I'm advised that five full-time equivalents were affected.


MR. SCOTT: Mr. Chairman, thank you to the minister for the answer. I guess just arising from that, could the minister tell me, if I understand, you said there's one program that has been delayed. Are there any programs in HPP through this budgetary process or are there any programs that you know of throughout the province that will be cancelled?


MS. MAUREEN MACDONALD: Mr. Chairman, if I could just make one clarification around the Panorama project and the delay. The project has been delayed because of the H1N1 virus, and this has occurred right across the country - not the delay. The Panorama project is a national initiative right across the country and it has been delayed because of H1N1. It has just been put off for a year. So that's the first thing. The second thing is the honourable member asks about the reduction or the cancellation of any HPP projects. (Interruption) No, I'm not aware of any, certainly not as a result of this budget.


[12:30 p.m.]


MR. SCOTT: Mr. Chairman, thank you again to the minister and this is my last question. I guess it's a bit of a local question. Are you aware of the Lansdowne Outdoor Recreational Development Association - I believe it's called LORDA - that recently announced they're not open there after 24 years because they fell short of funding their goals? They've had about $55,000, I think, in requests from the government in regard to helping them at this time, and I'm wondering if the minister can just update the House in regard to that application. I'm told that it's more than just a park; it's one of its kind in the province, apparently, that assists seniors and those with disabilities. So I guess there's a concern around the future of that park, and I'm wondering if the minister could explain what she knows about the ability to help that organization at this time.


MS. MAUREEN MACDONALD: Mr. Chairman, I want to thank the honourable member for giving me an opportunity to talk about this particular park, this particular facility. I've never been there. I would love to go. I've seen the news reports on television and it really looks like a very beautiful place, I have to say. I remember seeing reports of this park long before the recent difficulties that they were having, and it does sound like it's one of these places that we really benefit from having as a province.


So there are a couple of things that I can say specifically about HPP and what's happening around this park, but I want to first of all clarify for all members of the House what HPP does with respect to recreational facilities, because I think there is a lot of confusion in the public's mind about what department of government provides funding and for what. Of course, there are so many programs, there are so many departments, it's hard for the public to keep things clear.


The Department of Health Promotion and Protection assists community groups and municipalities in the building of recreational infrastructure, and we assist them - we have the B-FIT Program, for example, and that will see new facilities built. It's capital construction in the building of new facilities or it's major renovations to existing facilities that needed a major overhaul in some area. In the building of trails, some of the money went into the building of trails and facilities.


So we build facilities, but once a facility is built, that isn't the end of the story for that facility. That facility has to generally hire a manager to manage the facility and maybe some other staff. They have to pay the light bill and they have to have a cleaning contract. The operating costs of keeping these facilities going is not something that the Department of Health Promotion and Protection gets involved in. Operating costs of facilities generally fall to the owners and the operators of those facilities, which are most likely to be municipalities. They are generally municipalities, but in some cases they might not be a municipality. They might be a Lions Club or some other community-based organization.


We do frequently get organizations that are in trouble with their operating costs, not their capital, not their infrastructure but with their operating costs, coming to HPP looking for assistance in operating their facility. We have no programs for operating facilities. This is largely the responsibility of either the municipal government or the private operator.


In the case of this particular park, I'm advised that we have provided some funding to them in the past but that funding has never been part of their regular operating budget. More recently, because of the difficulties, we have been approached by the operators of this park and we are working with them, currently, to complete an application for funding for capital upgrades. That is what we do, we help operators bring their facilities up to the acceptable standards but we do not provide core operating funding.


As you can appreciate, it's a road, to be frank, that I wouldn't want to go down because I think about all of the Ys around the province, for example, that have had difficulty over the years, from time to time, with their operating costs. We're there for capital costs. We have another program in addition to the B-FIT program, which I had spoken about earlier, which is the recreational facilities development grants and organizations will qualify for up to $150,000 toward any capital work that they need done, but this is not for operational funding.


MR. CHAIRMAN: The honourable member for Cumberland South.


MR. SCOTT: Mr. Chairman, that's the end of my questions at this point. I just want to say to the minister and to her staff, thank you very much for the answers today and your frankness and your offer to come back to me at a later date with information I've asked for that maybe today is not readily available.


I just want to say about those programs that it's difficult for people to understand programs and really it's in all departments. I found that myself even being on that side of the House for 10 years, a lot of times there are programs that the public at large are not aware of and I think a lot of organizations aren't aware. In fact, the illustration you just used - and sometimes those organizations are using their own money for capital work and then coming looking for help with operating when actually, if they knew about it ahead of time, they would use their own funds toward operating and then come look to the programs for help for capital. I think a lot of times organizations are just not aware of what's available and what's not available and what they would qualify for and maybe what not. I don't know how you overcome that because it's a huge task and I know there are so many programs across departments.


Anyway, I appreciate the answer you've given today and again, thank you very much to you and your staff. That's the end of my questions at this point, thank you.


MR. CHAIRMAN: The honourable member for Richmond.


HON. MICHEL SAMSON: Mr. Chairman, I'm just curious, I have the Public Accounts Volume III Supplementary Information for the fiscal year ending March 31, 2009. Do you have that information, as well, if I ask you questions regarding some of the figures that are in here? If you don't, I'm wondering if your staff would know when we can expect this supplementary information, if that's going to be available any time soon, because other than that I don't have anything to go on as to the specific spending in your department. Maybe if you could just advise that but I have a few questions here. I think your staff will be able to answer them but I'm just curious if you know when we can have that information.


MS. MAUREEN MACDONALD: Mr. Chairman, we don't have the information. We could probably get it within 10 or 15 minutes if the honourable member would like to ask any other questions while we're waiting for that.


MR. SAMSON: Well, I'll ask a few questions and if you don't have the information you can advise but I think you'll probably be able to. I'm just curious, I'm looking through some of the salaries here for the staff at the Department of Health Promotion and Protection and I'm just curious in trying to better understand how that specific department works. I see, for example, Maureen Baikie, I believe, could you advise what Ms. Baikie does with the department?


MS. MAUREEN MACDONALD: Mr. Chairman, I thank the honourable member for the question. That would be Dr. Maureen Baikie. Dr. Baikie is the Deputy Chief Medical Officer for the Province of Nova Scotia so she is next in line to Dr. Strang in our department.


MR. SAMSON: Thank you. I wonder if you could advise me who Richard Gould is and what his role is with the department.

MS. MAUREEN MACDONALD: Mr. Chairman, I thank the honourable member for the question. Richard Gould is Dr. Richard Gould and he is the regional medical officer of health in DHAs 1, 2 and 3. He covers three DHAs. The members may recall back in August, I think, when our Auditor General issued his report on our pandemic plan, one of the recommendations in his plan was that we had a number of medical officers of health positions unfilled in our province and he was very concerned about this in terms of the impending pandemic.


There was a good reason for that. It's extremely difficult to find qualified medical officers. All jurisdictions in Canada, I was advised at the time, were having difficulty recruiting people into these positions and we had a number of openings in the province. Dr. Gould has been with us though, I believe, for awhile. We have been actively recruiting to fill those positions and if I'm not mistaken maybe we've been successful a little bit in at least one DHA, if I remember correctly. I hope that answers the honourable member's question.


MR. SAMSON: Yes, thank you. I'm looking here, Shelly Sarwal, if the minister could advise who that individual is.


MS. MAUREEN MACDONALD: Mr. Chairman, Dr. Shelly Sarwal is also a regional medical officer of health. She currently is on secondment to the Public Health Agency of Canada.


MR. SAMSON: I'm just curious, I'm looking at Dr. Strang for example. Are these full-time positions or are these regional doctors who have a private practice as well, billing MSI as well? Or is this their total salary for the year coming from the Department of Health Promotion and Protection?


MS. MAUREEN MACDONALD: Dr. Strang, as the honourable member knows, is our Chief Medical Officer for Public Health. These other physicians who are regional medical officers of health all are full-time medical officers of health in the various regions. They report to Dr. Strang. They deal with matters of public health and they do not have any other practice. They don't have a private practice or any other duties.


[12:45 p.m.]


MR. SAMSON: I'm wondering about Gaynor Watson-Creed.


MS. MAUREEN MACDONALD: Mr. Chairman, Dr. Gaynor Watson Creed is the very capable medical officer of health in the Capital District Health Authority. She was very prominently involved in the H1N1 situation and she really, I think, was able to articulate in a very clear, common-sense way for the public, how the district health authorities were preparing for H1N1.


MR. SAMSON: I don't know if there's a way of correcting this for the future, but I think it would be very helpful if we could actually see the designation "doctor" with these names because as parliamentarians looking at this - and I haven't mentioned what the salaries were. They are in the public record, so anyone who wants to look can go and look. I don't feel it necessary to have to indicate what they are, but it would certainly be a lot easier following this if you would see the designation "doctor" because it would be very clear who they are or what their role is, but I'm sure that someone who is looking at these salaries would be wondering why they are so high, but certainly knowing now what their titles are and the work they do, it is quite clear. I'm just wondering about Tracey Williams.


MS. MAUREEN MACDONALD: Ms. Williams is the senior director of Policy and Addictions in the department.


MR. SAMSON: And what about Farida Gabbani?


MS. MAUREEN MACDONALD: Thank you very much. Ms. Gabanni is the senior director of Policy and Physical Activity and Recreation in the department.


MR. SAMSON: Going into Grants and Contributions, just to get a bit of a better sense - they are alphabetical so I'll start with alphabetical. I'm looking, for example, last year $3 million was given to the Annapolis Valley District Health Authority. I wonder if the minister could give a sense of what the $3 million was for.


MS. MAUREEN MACDONALD: Mr. Chairman, I'd be happy to provide a breakdown to the honourable member on this. DHA 3 is the Annapolis Valley DHA and the honourable member is correct in indicating that last year approximately $2,999,233 was for public health and addiction services. It breaks out in the following way. The DHA received $536,917 for Healthy Beginnings. Now, Healthy Beginnings is the program where there are visits to families with newborn children, over a three-year period, I think. They can participate in the program, identified at risk, and they provide support to new parents. It's a program that has received very high evaluations in terms of its impact.


In addition, that DHA received $370,390 for enhanced home visiting and some percentage of this funding is federal money that is flowing through. I can't tell you exactly how much but probably that's something I could get, if you really wanted to know.


In addition to that, we provided $569,476 for school-age children and youth, including Health Promoting Schools. This would have been programs aimed at kids in the schools. The youth health centres received $76,018.


Mr. Chairman, to the member, I think often the staff in the youth health centres, the teen health centres, they are actually staffed through the district health authority and we support that by flowing money to the DHA. They received $311,372 for chronic disease and injury prevention. We had an opportunity to talk a little bit earlier about some of those initiatives that we're doing around injury prevention and falls and things like this.


In addition, communicable disease prevention and control, $219,349; immunization, $167,769; emergency preparedness, in terms of the public health pandemic planning - oh, I'm sorry, Public Health, administration, $334,342.


Now, in addition to that, we fund Addiction Services in that DHA. We would have provided funding for tobacco, the nicotine treatment, problem gambling services, problem gambling strategy, rural women and health strategy. Some funding is flowing through from the former Gaming Foundation funding and additionally, a small grant around Addiction Services administration. So it all comes out to that initial amount, which is pretty much $3 million. Those are the items that make up this.


We have Addiction Services in each of the DHAs, Mr. Chairman. I think what people - again, it's kind of a structure of how these things work. The HPP, because Public Health is a very big item in the Department of Health Promotion and Protection and programs that fall under Public Health, we have a decentralized health care system with DHAs around the province and they are close to the ground, in the communities, with their own facilities and what have you, rather than having public health nurses all sitting in our offices in downtown Halifax, they are decentralized into the different regions. The regional medical officers of health are in the DHAs out in the regions. The public health nurses who are doing the Healthy Beginnings Program are out in the regions in the offices of the DHAs. It's a very decentralized kind of structure and system.


I had an opportunity when I toured the Cape Breton District Health Authority - when I go to Yarmouth to the regional hospital or to the Cape Breton Regional Hospital, when the staff are organizing these visits, as Minister of Health, I make it a point to say make sure you schedule an opportunity to meet with Public Health and the HPP folks into my visit.


I have both departments. I want to meet the staff. I want to know about the environment in which they're working and the projects that they're working on and the demands on their time and all of that kind of thing, and so I do that.


There's a very large group of public health nurses in the Cape Breton area and I had an opportunity to meet with them. They were phenomenal. I met with some of the public health nurses who are in GASHA, which is the district health authority of the member for Richmond. What an enthusiastic and incredibly experienced group of health nurses they are. I have to say I had my H1N1 vaccine in GASHA back in the Fall.


I have to tell this little story. Some people have heard this story, but it was a Thursday afternoon and I had gone up to visit my mom and dad. My dad hadn't been all that well, so I decided to spend a few extra days in the area. I was home and my mother asked if I had gotten my H1N1 vaccination, and I said, no, I haven't had time. They had just opened the vaccine up for anybody, so my mother said, there's a clinic at the fire hall in Tracadie this afternoon, why don't you go and get your vaccine?


So I said that sounded like a good plan. I had a number of little errands I had to run for my mother, and I did them and then I went to the fire hall. I went into the fire hall and got in line and I was making my way along as the line was moving, and when I got up to the desk where I had to give my health card and what have you, I handed the woman my health card. She looked at the card and she said, oh, you're from the Halifax area, what brings you here?


I said I grew up in the area and my parents still live here so I'm visiting, and I thought it was a good chance to get vaccinated. She said, so what do you do in Halifax? I said to her, well, I'm the Minister of Health. She kind of looked at me and she said, get out, what do you really do? So when I visited the public health nurses in GASHA, they had all heard about the story. We had quite a laugh about it. It was very good. It was a great clinic, a great group of public health nurses, and they are all over the province.


I hope that helps explain for the honourable member where we spent our money or how the Annapolis Valley money was allocated. I would suggest that if we looked at each DHA, this would be pretty much the pattern that would be repeated. These are the line items.


MR. SAMSON: I should tell the minister that although Nova Scotia is just under one million population, it is still a small place, because the person who greeted her for her vaccination was my next-door neighbour growing up. So I heard this story before that and the version I heard was that she also advised you that it was a BlackBerry-free zone for you to go in to get your immunization. Just when we think after being elected 12 years in this House, both you and I, that people know who we are and recognize us that it certainly brings us back to reality that unfortunately many still don't know what it is that we are doing here. Happy to hear the minister did stand in line with all other Nova Scotians to get her vaccination. I did have a good laugh when the story was shared with me just before Christmas.


[1:00 p.m.]


I'm looking here at Trampoline Creative Inc., which has a line item of $302,000. I'm wondering, what did we get from Trampoline Creative for $300,000?


MS. MAUREEN MACDONALD: I'm wondering if the honourable member can tell me what page he's on in the Supplement? I have Volume 3 of the Supplement, but I can't find it on the page.


MR. SAMSON: I'm at Page 149, which is the Other of the Supplementary Information, if that helps.

MS. MAUREEN MACDONALD: We're checking right now to get more detailed information. Preliminary response is that they're a social marketing company. Some of the social marketing campaigns that we do in the department, there are a variety of them, that's what that line item would have been for. I will get you more details in a few minutes, as soon as we can.


MR. SAMSON: My first curiosity when I saw it was, did we buy a bunch of trampolines for the province? That was my first assumption. I'm not saying there's anything wrong with that, but I'd just be curious if we're in the business of buying trampolines. But for $300,000, certainly I'd appreciate if the minister could give a breakdown.


That leads me to my next one which is on Page 148, Extreme Communications Ltd. is there for $479,000. Almost $0.5 million went to that one company which I know does - they don't sell trampolines, that's obvious, but I know they do different marketing. But for $480,000, could the minister provide a breakdown and if she doesn't have that with her today, if she could commit to providing me with that?


MS. MAUREEN MACDONALD: I will certainly undertake to make that information known to the honourable member. I'll get a breakdown on it. Extreme Communications, obviously, is a communications company. They do social marketing for us. I think they did some of the H1N1 communications campaign but I don't know that for sure.


Just to elaborate a wee bit more on the social marketing aspect. HPP, we do a fair amount of social marketing. When we say social marketing, we do a fair amount of advertising. Most people would recognize it as advertising, it's kind of a fancy word for advertising. Some of the advertisements that people will relate to HPP are some of the anti-smoking advertising that's gone on over a period of time; the breast-feeding campaigns that you will have seen more recently; we're currently running the fresh, frozen and canned, eat vegetables and fruit social marketing campaign; and the Yellow Flag Campaign. So there are quite a few. We've had quite a few advertising campaigns hoping to get people thinking in a different way about health and wellness and some of the choices that we make.


When we hire these social marketing companies, as I understand, we pay them from beginning to end to develop the concept, to test its effectiveness, do focus groups. They do a tremendous amount of research. It goes into determining what the final product will be that we see on our TV screens, and then some of the contract involves the media buys that they do, none of which comes all that cheaply. It may mean that we're going to be using the Web sites now and the Web, which is becoming so prevalent, particularly if we're aiming our messages at a younger generation. We also have been doing a fair amount of social marketing in movie theatres.


The television ads that we see are just a very small piece of what it is we do. We use bus interiors - bus shelters and exteriors as well - on-line, and of course, there's the print media in various community newspapers, as well as The ChronicleHerald and The Coast, and we make use of our radio stations around the province too. So we have had campaigns developed targeting young people, trying to demonstrate that smoking is not the norm, it's not the cool thing to do; breast-feeding, as I said; the fruit and vegetable campaign; and various other campaigns. The Yellow Flag Campaign, I should say, is the campaign that's related to the abuse of alcohol and the risk that's associated with alcohol.


So Extreme Communications - I know, because I've had an opportunity to meet with them on one of the campaigns that they're designing, they are an extremely cheeky and very creative group of people. This is often reflected in their approach. Trampoline Creative Inc., I can't explicitly say which campaigns they've been involved on and what that breaks down to, but I'm advised that they are the folks who do the Yellow Flag commercials around the alcohol, the risky behaviour associated with alcohol, and You Are Not Alone ads. So if we can get the honourable member additional information on that, we certainly will. Extreme have been doing the breast-feeding and the tobacco advertisements.


MR. SAMSON: I would certainly appreciate getting that information, because while there's no question those are worthwhile campaigns, that's a significant amount of money - $480,000 for Extreme Communication; Trampoline Creative, $302,000 - we're talking major dollars there, to say the least. I'm looking at a couple more here. I see J.H. Fletcher's courier delivery for $58,000. I'm wondering, what did we get delivered for $58,000?


MS. MAUREEN MACDONALD: It's a courier service that we use in the department. It's a service that delivers regular correspondence, but also was the courier service for the vaccines.


MR. SAMSON: Would the minister be able to provide a breakdown of that, because $58,000 does appear to be quite a high figure for courier services? Maybe it isn't, but I would be curious to see a breakdown of that. I see just below that K2 Discovery Inc. for $53,000. I'm wondering what that is.


MS. MAUREEN MACDONALD: We certainly can get a more detailed breakdown of the courier delivery service. I can't tell the honourable member at this moment what K2 Discovery Inc. is but we will get you that information.


MR. SAMSON: Madam Minister, you know, when I'm looking at the Extreme Communications, $479,000, and Trampoline Creative, $302,000, the minister has indicated, I believe, that includes the media buys in those prices. That being the case, when I look over on Page 148 and I look at Communications Nova Scotia - I would assume that's where the media buys were being done - Communications Nova Scotia adds up to about $1.8 million of your budget. So you have $1.8 million within the government service and then, I'm sure if I keep looking I'm going to find more here but, needless to say, add those up, and we're over $2 million now in communications which, again, may be reasonable and maybe that's what the price is of doing business now and communicating with Nova Scotians, but it certainly seems to be figures that jump out at me. I'm thinking of how many recreational facilities could be using that money, that $2 million that currently is going for such expenses.


There's one here and I'm seeing here - and the minister could probably touch on this - I'm assuming that Health Promotion and Protection is buying a variety of different drugs from companies based on - I'm seeing Merck Frosst, that's fairly obvious what that would be. I see Wyeth Pharmaceuticals for $2.5 million. I'm assuming those are drugs as well. I'm wondering, this one on Page 147, VANOC, $1.8 million. Is that pharmaceuticals, as well, and who's getting the pharmaceuticals that Health Promotion and Protection is purchasing?


MS. MAUREEN MACDONALD: Mr. Chairman, it is the case that we buy drugs - we buy vaccines from drug companies, I should say. So Merck Frosst, you're seeing the line item here for Merck Frosst, this is for vaccine. The VANOC line is the previous government's commitment to the Vancouver Olympics.


MR. SAMSON: So it was a $1.8 million commitment is what it was. Was that the total commitment for the province? So there's more, okay. So the minister can probably elaborate on that.


Let me make things a bit easier, maybe for myself and for the minister. Most of these expenditures were done prior to you becoming the minister. I'm curious now that you've had the opportunity to review these expenditures, are there any that were undertaken prior to your arrival which have caused you any level of concern?


MS. MAUREEN MACDONALD: Mr. Chairman, I would be happy to give the honourable member a breakdown of how we spent money allocated for the Olympics. I think this was primarily committed to, as the honourable member said, this was a commitment that was signed in a memorandum of understanding prior to my becoming minister and I believe in keeping our commitments that were outlined in a memorandum of understanding.


The approved budget was $2.8 million, and in total it turned out that we spent $2,568,500. The breakdown is this. We spent $1.5 million on the Contributing Province/Territory Program, and that got us, as I understand, certain things like the Torch coming through - I think that got us the Torch coming through - and I know there were a variety of other things that it got us.


[1:15 p.m.]


In addition to that, just let me say a little bit more about that program. It meant that there would be a Nova Scotia Day at the Olympics. Now, we still had to do more things to make that day happen, but it is kind of like a sponsorship. You subscribe, you purchase at a certain level, and it got you certain things. Every province participated in this Contributing Province/Territory Program, with the exception of New Brunswick.


So that was $1.5 million and I think when the Torch was here in metro that evening, Premier Campbell was here, so all of that kind of stuff. The four Atlantic Provinces went in together on a pavilion called Atlantic Canada House pavilion and our share of that pavilion was $500,000. I did a resolution, I think the other day, that pavilion was voted the third best pavilion at the Olympics. It had literally thousands and thousands of visitors - 3,000 visitors per day over a 14- or 15-day period.


There was also a Cultural Olympiad that cost $200,000, and this gave an opportunity for Nova Scotian craftspeople and artisans to showcase their crafts and their products. There were $14,000 in ticket purchases. Nova Scotia Day cost $175,000 and that would be for the performers and this kind of thing. The Torch Relay, expenses associated with that, $20,000.


A large part of these games were the involvement of Aboriginal people and there were several Aboriginal people from Nova Scotia involved, including Aboriginal youth and there was an Aboriginal youth gathering there, so $43,000 went toward that. Because business leaders from all over the world come to the Olympics, Nova Scotia Business Inc. was involved with that end of the Olympics and there was a business activation strategy, it cost $80,000. There was a production that was shown at the Olympics, at Atlantic Canada House, that cost $20,000 to produce, the music and film part of that.


I'm not exactly sure what this next piece is but there was $5,000 allocated for Place de la Francophonie. So there must have been - I don't know if it would have been some representation of the Acadian community, but there is a small piece. I could find more about that if you would like. There was a showcase, $7,500 - I don't know exactly what that is - and the Olympic red mittens, $4,000. So it comes to a total of $2,568,500 was our contribution.


Again, Nova Scotia, like all of the other provinces and three territories, excluding New Brunswick, signed on to the Contributing Province/Territory Program. The cost of our participation in the agreement was $1.5 billion and I'm advised these funds went to support Own the Podium, Vancouver 2010 Cultural Olympiad, the Olympic as well as the Paralympic - I should have mentioned that - Torch Relays, the general staging of the Games, the opportunity for our province to organize Nova Scotia Day, encourage Aboriginal participation in the Games, access to participate in the Indigenous Youth Gathering, opportunities for marketing and promotion on an international stage, priority access to tickets, and accreditation for dignitaries.


We partnered with three other Atlantic Provinces and ACOA to fund the Atlantic Canada House Olympic pavilion, and as I said, this turned out to be a great success with quite a few visitors through that pavilion.

I don't mind telling the honourable member that we were a new government arriving when the planning for the Olympics and Nova Scotia's participation was happening, and our Premier and our Cabinet made a decision that the only person who would attend the Olympics on behalf of the Province of Nova Scotia as an elected person and in official capacity would be the Premier. Other members of Cabinet felt that given the financial circumstances of the province it would not be appropriate for us to attend at the expense of the public purse. That did not occur, and I think that was the right decision to take, but at the same time I think it was also very important for our Premier to be there.


I think we all watched the Olympics. I have a friend who is just about the furthest thing that you could ever imagine as anybody who would ever go near a sport of any kind, who was glued to the television set for two weeks. She said she couldn't believe how much television she watched - first of all she doesn't watch television; how much sports she watched on television; and how much she loved the events. She was just captivated. I think her experience was the experience of Canadians all across this country. We watched the Olympics. They were our Games even though they were on the other side of the country, and we took great pride in our athletes. What a superb group of young women and men. They made us very proud and we all felt very good, so it is the case that our Premier was at the Olympics.


MR. CHAIRMAN: The time allotted for debate in Committee of the Whole House on Supply has now expired.


The honourable Government House Leader.


HON. FRANK CORBETT: Mr. Chairman, I move the committee do now rise, report progress and beg leave to sit again.


MR. CHAIRMAN: Is it agreed?


It is agreed.


Would all those in favour of the motion please say Aye. Contrary minded, Nay.


The motion is carried.


[The committee adjourned at 1:24 p.m.]