HALIFAX, THURSDAY, APRIL 19, 2012

 

COMMITTEE OF THE WHOLE HOUSE ON SUPPLY

 

3:07 P.M.

 

CHAIRMAN

Ms. Becky Kent

 

MADAM CHAIRMAN: Order, please. The Committee of the Whole House on Supply will come to order. We are debating Resolution No. E11, the Department of Health and Wellness. The Liberal caucus has 16 minutes remaining.

 

The honourable member for Halifax Clayton Park.

 

MS. DIANA WHALEN: Thank you very much, Madam Chairman, and I appreciate having just a little bit of time. I was the past Health Critic for the Liberal Party and now, not having that role, I haven't had a chance to ask any questions, so today I'm just taking the 16 minutes.

 

I have just one area I want to ask about today and I want to ask about internationally trained medical graduates. I'm doing that with my hat on as the Immigration Critic of the Official Opposition. I think the minister knows that in the past I have asked about this issue anyway because I have a very diverse community, a lot of people from around the world, and I am frequently being met by pharmacists or doctors or nurses from other countries who are desperately trying to get through the requirements.

 

Today I'd like to focus on the internationally trained medical graduates, the doctors, if we could because I don't have very much time and I'd like to ask the minister, I want to get to some of the budget items, so I'd like to ask the minister where in the budget would I find, or could she provide, the budget that we would have allocated for the CAPP.

 

HON. MAUREEN MACDONALD: I want to welcome the honourable member to the Health and Wellness budget estimates and thank you, I know that you do have long-standing interest in this area, and it's a really important area. The area of the budget that this particular matter would fall under is Physician Services. As staff are looking to drill down and get more detail just let me give a very short overview of Physician Services.

 

267

 

Physician Services in the Department of Health and Wellness budget accounts for about 17 or 19 per cent, in that vicinity, it's over $700 million, this, I'm sure, would be a very, very small proportion of that but nevertheless not an insignificant or unimportant proportion. It is through this program that we've been able to get physicians into some of our hard-to-service areas. I look forward to providing some more details to the member.

 

Actually, it's in the Physician Services envelope under what is being called Other Programs. The CAPP is $4,609,000, that was in the 2011-12 budget. The forecast for this year is pretty close to all of that, it fell short by $350,000 this year, less than expected. As I indicated, this is a very important part of the program, we can talk some more about the features of some of that.

 

MS. WHALEN: I just had a good look at, and I guess it's on Page 13.5 of the Estimates Book. There is a line Physician Services - Other Programs, and it is showing $21 million last year, in 2012-13 estimates $22.3 million. I wonder if as a request we could get a breakdown of that $22.27 million, I would like to have that, if not today, then at a future point if we could. I know we've made a number of requests for breakdowns.

 

I'm trying to write down what was being said and I didn't quite get where it fell short this year. Could you just communicate, did we not spend what we had allocated in the estimates or are you saying that the forecast came in short? I know the need is really great. The number of people who are in the international medical graduates group are quite large, they have got an association, there are a lot of people in our province trying to access those programs.

 

MS. MAUREEN MACDONALD: For the information of people who aren't familiar with this program who are watching at home or perhaps those in the gallery, CAPP stands for the Clinical Assessment for Practice Program. This is a program where in Nova Scotia, if we have people who are residing in our province who are physicians who trained outside of Canada, who trained internationally, who want to get a medical licence then this is the program under which they go through a clinical assessment. They are often mentored by physicians in the province and are able to practise and get a licence in Nova Scotia.

 

There are a set number of seats that are available for people to go into this program where they will be assessed. It is a competitive process to get into the program, it is not a program that is overseen by the Department of Health and Wellness in terms of being administered. We do not get applicants, we do not screen applicants, and we do not make decisions about which applicants actually will get those seats. That process is arm's length from the Department of Health and Wellness and is a process that, to the best of my knowledge, is actually a national standard kind of program that is used across the country. It is a program that has been adopted by various colleges as well as medical schools. So this is the process that's used, and as I indicated, this year we had budgeted $4.6 million in that program and we spent $4.2 million. So there was $350,000 less than we had budgeted for.

 

What I can tell the member, in terms of the CAPP, is that today we have 20.6 FTE participants remaining in the program at some stage in their CAPP contract. So they go through an assessment and they're accepted into one of these seats. I think that they get placed and they have some kind of a return of service agreement, and they go into an area where there are physician mentors on a contract for a particular period of time. Since 2005-06 there have been eight different groups of CAPP physicians who have gone through the province to the tune of about 46.6 full-time equivalents over that period of time.

 

MS. WHALEN: Madam Chairman, I'm asking the minister about the international medical graduates. You indicate it is a competitive process, and I understand it's the College of Physicians and Surgeons that oversees that process, but what I am concerned about is - and I think it's really important that we look at it departmentally and so on - if the government has a certain amount of money allocated for those spaces each year, which would be funded positions for the physicians to be out in mentored practices, then is that what is dictating how many get through the CAPP assessment or is it a genuine assessment of their abilities?

 

The reason I ask that is the failure rate is still unacceptably high for people who've already passed their Canadian medical exams and written exams. This final CAPP exam is a clinical assessment, so they're going through a process of pretending to be in a practice and seeing a whole range of simulated patients with different problems, and they have doctors or academics - doctors perhaps - who are there measuring how they're doing. I think it's really important - I know our time is going to be short - we only give these newcomers to Canada two chances on this high-stakes OSCE exam. Two chances. Two strikes, you're out, and five years out of practice, if you've been away from your country five years, learning the language, trying to get your proper medical terminology, taking your written tests, and finally getting to the CAPP test, your five years can go by fast and you may not have another chance to write that, because you're now five years out of practice, plus if they fail twice - failing being a kind of subjective measure that they're borderline in things. I've seen a number of people come in who say, well, I was borderline in this and this and this so I wasn't.

 

It's not that you're bad, it's not that you're awful, because you've passed your written exams, you've been accepted under those circumstances, and anyway, there's a real feeling that the stakes are so high, the immigrants are paying so much themselves - I think they pay $6,000 to sit that exam, and the last year that I looked at it may not be the most current, but six out of 36 were successful. I just question, if it is actually that the number is dictated more by the funding, then should we not be honest and let people come back and try again? It isn't that they're no good, and that we're not sending that message to them, we're telling them the door slams in their face, they cannot be a practising physician here in Nova Scotia.

 

So I would like to see if the minister could answer that, and because we only have four minutes left, I would like to ask if in looking at this, the minister would have any say in asking that people who have settled in Nova Scotia get precedence in this exam, because because people are coming here to take the CAPP exam from other parts of Canada, newcomers nonetheless, people who are new to our country and who are trying to get licensed, and they are coming here without bringing their families, passing that, doing their mentorship here. Their families are still living in Ontario and elsewhere, but we have other families that are living here; their children are in our schools; they are paying taxes; they are trying to make a living here and they are not getting any preference. I guess I'm saying there should be preference or some sort of points allotted for people who live here. Thank you.

 

MS. MAUREEN MACDONALD: Thank you. There are quite a few questions there and very little time. It is a complex subject so I am a bit concerned that I'm not going to be able to get it all in. Let me say this, that it is a regulated profession. There isn't an unlimited number of seats available for foreign-trained medical graduates in Nova Scotia. We need to ensure that there is a good, objective, fair process in place for people to be able to have their skills assessed and then to be successful.

 

To me, it is regrettable that we cannot take everyone into the program, that we do not have enough seats. You have to also remember that we need mentors; we need physicians in the communities who are willing and able to have a CAPP doctor, that that can be a factor in this. So it isn't simply a question of how much money you're going to devote to a program, it's also about all of your health human resources that surround and support that person as they are integrated.

 

The question of mobility and residency is also a very difficult one, in medicine in particular. It's a highly mobile population on a regular basis. Right now from the Dalhousie Medical School there are many students who come from out of province and study at Dal and stay in the province to practise and there are many Nova Scotians who study at Dal Medical School who end up working in other provinces. Then there are many of our own residents who end up staying here.

 

We're doing the physician resource plan and it's helping us identify a bit of the trends and the existing patterns of where we are drawing our physicians from. We will have a physician resource plan shortly and the whole piece around internationally educated practitioners will certainly formulate a piece of that. It will have to formulate a piece of that as we go forward.

 

The member wanted to know what other things were in the Physician Services, the other things that we do in that. Locum is there, physician recruitment, return of service, in terms of the rural retention, payments for unattached patients, patients who don't have a doctor and some other programs are in this particular category.

 

MADAM CHAIRMAN: Thank you. The time allotted to the Official Opposition has elapsed.

 

The honourable member for Inverness.

 

MR. ALLAN MACMASTER: Thank you, Madam Chairman. Minister, just for the benefit of yourself and your staff, I really have just one health question. I suppose I could have many but there's really just one I'd like to ask today and the remainder of the questions I have are with respect to the Office of Gaelic Affairs.

 

My health question is around, and I know that the district health authorities make decisions about - I'm not going to talk about surgery today either so don't worry about that because I know that's being worked on and I don't think it's something that is necessary to be discussed here today. What I'm going to ask about is the CT scan. I know the district health authority decides the priority for their area but I guess just kind of looking, before the dollars even get to them, the cost of transportation to move people around from Inverness to hospitals where they do have a CT scan is quite expensive. As I understand, the cost could be recovered, likely, within two years, it's a pretty safe estimate. So if a CT scan was purchased by the DHA this year, let's say, within two years it would be paid for and from then on it would be saving those transportation costs that we're incurring now.

 

Does it make sense to encourage the DHA to make that purchase now, recognizing that it can be amortized over the life of the asset and the fact that if we buy it today it's going to start saving the government money within a couple of years?

 

MS. MAUREEN MACDONALD: I wish I had an answer that would answer your question. What I can say it that after we met to talk about this - and I have the letter from the community - that request goes into the department for staff to do the assessment and the district health authority will be a part of that. They will look at those numbers that were discussed at our meeting when the number of transfers, patients being transferred to the regional hospitals for CAT scans at a cost to the public system, that will all be factored in.

 

Let me tell you about the decision-making process for capital equipment in the department and in the DHAs, and if I don't have it exactly right I know staff will help me with that. I think this is the way it goes, I think on an annual basis we put a memo out to the DHAs asking them to provide their capital list of requirements for the next year in priority. We want them to give us some priorities. Then we do an assessment of what has been asked for and there are criteria that are looked at. For example if it's equipment that is being replaced, that already exists in a facility, we look at the age of what's being replaced and a number of other things. For new capital equipment I would imagine one of the things that we would look at is the population that's being served, that's looked at, certainly, around the replacement of equipment as well.

 

I think the thing that we don't want to have happen as a department is that we tie a lot of our precious, limited, health resource dollars up in very expensive equipment that isn't utilized at capacity. That's why there isn't an MRI everywhere, they're very expensive and they aren't necessarily efficient and they don't necessarily make medicine better in that area either. One of the key things that will go into looking at a CAT scan in your area will be utilization and what is the need. So we're able to look at, over a period of time, what the need has been and, as you say, perhaps there is a financial case to be made. I don't know, I don't have that information at this stage but that certainly will be a piece of what will be looked at.

 

MR. MACMASTER: Madam Chairman, yes, I appreciate the answer, minister, and I know that as far as the establishment of the need, I think the DHA recognizes the need but I don't know if - I mean they may advance it this year in their business planning but I guess there's the chance that they may not. It just seemed to me that it was worth asking. If you happen to find out, perhaps you could share with me sort of the reasoning if they're going to delay this purchase because people will be asking in Inverness County and it would be good if people have information, sometimes that helps.

 

So I'll move from Health and Wellness and I do have a few questions with respect to the Office of Gaelic Affairs. I did ask the Minister of Education a number of questions with respect to the Gaelic language and culture the other evening. Because, of course, through the school system there's a lot of activity the last number of years to support Gaelic and it has been appreciated. I think the important thing for people out there to remember, who might question the investment in Gaelic, is that there is a demand there coming from the students.

 

We're in a unique situation where many people who have that background in this province don't really understand much about the background. We're in the unique situation of - I don't want to speak too harshly- but there was essentially an ethnic cleansing at one point in time and many people don't really know their history, thus they cling to things that may not really be a significant part of their history but only because it's what's seen. For instance, if you went up to Citadel Hill, you would see lots of bagpipes and kilts. But if we go back not too far into the past in Scotland, we would know that the Redcoats who were up on Citadel Hill today would be fighting against the Gaelic people in Scotland. A lot of the soldiers who were pressed into service after the Battle of Culloden, a lot of the decision was not made because of pride in nation but more so because of probably things like starvation and poverty and there was no other option.

 

But enough on that, I don't want to be negative. We have lots of positive things happening for Gaelic and I do have some questions for you today as they relate to the actual Office of Gaelic Affairs. I guess the first thing I would like to point out, as I know you are aware, culture has to be authentic for it to have relevance in society. I think the efforts of the Office of Gaelic Affairs are contributing to the authenticity of the culture by helping young people and adults as well. I know a lot of people in my area who are retired actually want to learn Gaelic. So the language - a fellow said to me many years ago, a culture without a language is a culture without a soul and you need the language.

 

So recognizing the importance of language and the fact that many of the cultural exponents of Gaelic helped to generate activity that was estimated 10 years ago to just under $24 million a year to the province's economy, my first question, people I believe, as we see, will learn Gaelic and take an interest in Gaelic courses based on their own ethnic pride. But there need to be opportunities for learners, and my first question is, what kind of an economic base has the Office of Gaelic Affairs been building to create an environment for young Gaelic speakers and, secondary to that, might there by any job targets? I'm not talking big job numbers but even small numbers, every step is a help.

 

MS. MAUREEN MACDONALD: Madam Chairman, it is certainly the case that the office has done a lot to raise the profile of the Gaelic language in the province, including having, I think we had Gaelic Awareness Month and some young people came from Citadel High to the Red Room and sang in Gaelic, which was quite lovely.

 

The opportunity for young Gaelic learners, I think, is primarily in the Department of Education's Gaelic classes that they're offering in four different school boards, if I'm not mistaken. I know that there is the Gaelic class that I mentioned here at Citadel High, which is probably one of the largest in the province, which is quite interesting. Then I know there are classes in Pictou County and in Antigonish; certainly, in Cape Breton, in the Strait area, in your home area, and in Sydney. So it seems to be growing. There seems to be more and more interest, which is very interesting and it's quite lovely.

 

I know that the member and I, Madam Chairman, were in Port Hawkesbury last year to the annual meeting of the Gaelic Council and it was a very nice evening. We were at the fire hall in Port Hawkesbury and the guest speaker was Linden MacIntyre. Now everybody knows Linden MacIntyre as the stellar CBC investigative reporter with the fifth estate and we've come to know him as an author, having written now three novels of some note. I think one won the Giller prize, so we know him in that way. What I didn't know, which I found absolutely fascinating, was that he was a student at St. F.X. and was one of a small number of students, probably back in the late 1960s, early 1970s, who really were the instigators, I suppose in some way, of seeing the Gaelic language preserved.

 

He mentioned that evening some of the people who influenced him as a young man. There was a Catholic sister, I think a Sister of Saint Martha, who was there. He had taken classes from her at St. F.X. and then he also told the story of how they recruited the first Gaelic teacher into the school board in Cape Breton. I think this is the story that will stick with me the most. He told a story about how this small, little group of young people who wanted to see Gaelic taught in the school board, went and appeared before the school board. They requested that the school board hire a Gaelic-speaking teacher and start teaching the Gaelic language in the board.

 

The board said, yes, we'll do that but here are the conditions. So they laid out these conditions - the teacher had to be thoroughly fluent in Gaelic and so on and so on. According to Mr. MacIntyre, they laid out the conditions in a way that they thought could never possibly be fulfilled. Well lo and behold, Linden MacIntyre went to Scotland and he tracked down a young woman with a teacher's licence and brought her back to Cape Breton. The board had no option, because they had gone on the record saying what it was that would be required but if this was provided, they would be more than happy to fund this.

 

This was the kind of origin and I just found that evening so - it was just a very wonderful, very warm gathering and lovely evening, great storytelling. Mary Jane Lamond was there as well; I think she was sort of the host or the MC, and it was just a lovely night.

 

So I think we are seeing from that period of time that Linden MacIntyre described, which would have been in the 1960s and 1970s, this kind of reawakening of awareness in the young people of which he was a member of that generation, wanting to be able to preserve - and not just preserve but also to recover the Gaelic language. Today we have the Gaelic language in so many classes in the schools, and I think that's wonderful.

 

Now as I understand - and I have no expertise in this whatsoever; I defer to others - that while the classroom learning is excellent, it's probably not enough. Probably what it does is kindle a desire for people to learn, but then you're really on your own, unless there are other opportunities, as the member said. I think this is where the Office of Gaelic Affairs has been quite innovative in the various programs that it has available to people to go on then and really develop a facility with the language by having Gaelic in the home, so people on a regular basis can go to identified residences and have an evening where you just speak in the language and you learn how to do that.

 

Madam Chairman, I want to tell the members that it was my plan to do that this winter. Other events overtook those plans, but it's still on my list. There are two places here in the metro area that I'm aware of, one out in the Sackville area and I believe one on the peninsula, where they open their homes every Wednesday night, over a period of six or eight weeks, and you can go and develop some basic facility in the language. It would make my grandfather - God rest his soul - very, very happy if I would do that, because he was a Gaelic speaker.

 

As the member indicated, a lot of that language was lost. It is the case that people weren't necessarily allowed to speak the language in the school system and were punished, sometimes very harshly, for learning the language and what have you.

 

I'm sorry, I have to admit I've lost the second part of your question, so if you want to ask it to me again, I'd be happy to answer it. But I guess the thing I would say is that, as the member knows, we've gone through a difficult financial time in the province, where we haven't been able to do a lot of investing in programs. I suppose on some level we're trying to do more with less, something the Scots are very good at doing - the Gaels. I see a very healthy number of initiatives in this particular office and in the network of organizations that are dealing with Gaelic culture around our province.

 

I think it is something that has not just an entertaining benefit for people but an economic impact, and it has potential for great economic impact. I don't know if members realize that the Scottish government, because of a memorandum of understanding with Nova Scotia, has now offered a scholarship to Nova Scotian residents to go abroad to Scotland and study the Gaelic language. So this again is another wonderful opportunity for young people in the province to learn more about the language and the historical development of the culture and what have you. I think building those networks can only result in economic benefit. I mean we really do see it in the cultural industries around music and Celtic Colours and what have you when they have their big festival.

 

Quite often, the performers who come from the British Isles, Scotland and Ireland are both just left speechless at the depth of Scottish culture, in Cape Breton in particular, and I know that one year one of their opening concerts was, you know, probably 80 per cent of the Gaelic language, all of the performances. People talked about how pure the language still was here in Nova Scotia and what a surprise that was. I think if we can promote that in Scotland and develop more of a network, then there are probably lots of different possibilities for us culturally, educationally, in terms of our economy and what have you. I want to just remind the member that there are a whole bunch of folks up in the gallery from Economic and Rural Development and Tourism. So your questions are falling on perhaps some fertile ground up there as well.

 

MR. MACMASTER: Madam Chairman, yes, it's certainly a good thing if they're up there and hearing our conversation. The government, by way of having the office and by increasing the exposure for young people in the school system is creating jobs and, of course, there have to be jobs created from the community itself. You can't have all the responsibility on the government obviously. It might be something worth looking at, just keeping some kind of a track on the jobs that are created in the Gaelic cultural economy. I know we can expand it broadly in things like Celtic Colours, there's a lot of economic activity that comes into the province by way of that. When I say job targets, I mean I guess positions that are for people who are actually speaking Gaelic and I'm not sure what they might be doing.

 

Obviously, we're not living in a world where a lot of business is conducted in Gaelic but, do you know what? Sometimes a person is surprised that you actually can find that. So it may be something worth keeping track of because I think what I'm trying to focus on is that for these young people who are learning the language- and because it is an issue of the government to try to keep the culture alive for the benefits it has brought to the province and for the social benefit, of course - that there are opportunities for young people as they progress and become fluent speakers. I was going to ask a question about programs to motivate young people towards taking Gaelic but I think, just the fact that it's available is most important and from young people taking it, it's going to get other young people interested in taking it, too, and that's a good thing.

 

The other thing I was going to ask about was, and actually just one thing you had mentioned was the partnership with Scotland. I know there is the memorandum of understanding that was signed a few years back and that is positive news about the scholarships. It's quite a thing really when another country gives money to our province. I think what they're recognizing is that the cultural world doesn't know geographic boundaries. They know that our efforts here to learn the language that was widely spoken in Scotland, and still is in some parts of Scotland, that having people here speak the language is good for their Gaelic economy as well.

 

My next question is, I know that there has sort of been a focus on immersion and I think of myself, I took some Gaelic at St. F.X. and I learned some. I probably learned some as well from just my interactions with my friends who spoke Gaelic back at the time when I was taking it in university and I was starting to catch on to it. But then you move on, I started working in Halifax here and tried to keep it up over the years. I think one thing we've all realized is that it's fine to take Gaelic in a classroom setting but there's nothing more powerful than to be immersed in it for a period of time where it's significant enough that you actually start making rapid gains. It's just the same as when we were all toddlers and we started to learn to speak our first language. You're not thinking about grammar, you're just thinking about communicating in its purest form.

 

Minister, if you have any comments on immersion activities but also on-line activities, because there's still a place for on-line learning. I'm aware that the Atlantic Gaelic Academy has a Skype-based Gaelic curriculum that was developed here in Nova Scotia and apparently it has been hailed as one of the best on-line Gaelic-learning programs in the world, compared to the one at Sabhal Mòr Ostaig in Scotland. I visited there years ago. As I understand, it's not receiving any government funding at the moment, but is that something that the office is looking at, in terms of helping people to learn through other mediums?

 

MS. MAUREEN MACDONALD: Madam Chairman, I do agree with the honourable member that immersion learning is probably, in this instance, the most effective way, because of the nature of this language, as much as anything. I'm not sure, maybe language generally isn't something you should really learn in the classroom, unless you really have to, but it seems to me that we know from all kinds of other languages, that if you want to learn Italian, take a cooking class at the Italian Cultural Centre and drink a little wine and the Italian sort of comes to you much quicker, I think, so I hear, I've been told.

 

The on-line learning, I am aware of this particular resource but that's all I can really say, is that I am aware of it. I don't know if there has been any proposal to the office or anything like that, I'm not aware of any but I will look into that, for sure, and see.

 

I just want to go back to the idea of immersing oneself in opportunities that would allow you to learn more about the language and the culture. I know that throughout Cape Breton we have some really excellent facilities that offer opportunities for people, like the Highland Village and the college. I've often wondered whether we do enough to invest in those areas for week-long camps, month-long camps, programs, special festivals and activities, re-enactments and things that would draw people into those areas.

 

I remember as a child, my family going to the Highland Village and spending a day and ending the day with a concert under the stars and it was all very wonderful. We loved doing stuff like that and the shieling, that whole area which I think is probably in the member's constituency, I remember going there and then wanting to know more about the history of this form of little building and that word, the shieling and all of that stuff and then doing a lot of reading around Culloden.

 

I think that it's all meaningful if you have the opportunity to learn a bit about history and you get those explanations of what the historical conflicts were that led to the highland clearances, that led to so many people being displaced as the development of the day went from a feudal kind of cycle where so many people lived hand to mouth, really, but that was security. Even though that wasn't security, it was security. Imagine coming to a place where there was nothing and having to start all over - really daunting but, at the same time, probably quite freeing for people as well, not to live under the kind of oppression and shackles of the kind of system that people found themselves in.

 

I often think of what it is that we teach in our schools, in terms of the culture. I know that we have become much more sensitive now, as a society, to all of the different cultural groups that make up our province. Because I'm not a teacher in the school system, I would be the first to admit I don't really have a good knowledge of some of the opportunities in the school system to really have knowledge of what's in the curriculum.

 

I think if you don't get it in the school system, it's not too late to get it, I guess is my point. We still, hopefully, are lifelong learners and we can continue to learn these things throughout our lives. There's no better way to do it than in the actual opportunity to see how things were, how people lived their lives, re-enactments and those kinds of things. Again, I think those activities are not only entertainment, I think they are very educational and have real economic potential.

 

The member used the word "authentic". I think in our fast-paced world of Facebook and Twitter and all of that kind of stuff, there are a lot of people writing about our desire for authenticity. We want authentic opportunities and experiences. I think if we have, at the community level, supported by government - because my view is that government shouldn't be creating this stuff, it should be supporting what comes from the communities, so it's a partnership with the community - if we have people who are either entrepreneurs or are in not-for-profit organizations, who have a passion for this and a vision, then we should find ways to work with them and I think we could create a lot of very interesting opportunities for people for authentic experiences around the Gaelic language and culture that would meet many needs.

 

They would meet our needs in terms of preserving the language and the culture and promoting the language and the culture and would have job opportunities, would have economic impact and spinoff. The member would appreciate that I don't have a lot of time to give to this little office in terms of the larger monster, the Department of Health and Wellness, but if I had time, I would spend more time with communities and people in communities, talking about what they think about that and what kinds of ideas they have to do more development at a community level that government could support.

 

MR. MACMASTER: Thank you, minister. I appreciate your comments. My next question is - I'll give you an example of a project that might come from a community, and I guess the question would be how would projects like these be encouraged by government. I don't know if you've seen a short little film called The Wake of Calum MacLeod. I saw it one night and I enjoyed it. It's a great little film. It was really appreciated in Scotland and it has been played on television there. I think there was a contract just renewed for another three years to keep showing it on television there.

 

What can we do to encourage more of this activity? It's an example. It was a Gaelic film. You didn't even have to speak Gaelic to appreciate what was happening in the film, but it was in Gaelic. So it's encouraging activity. It's turning the efforts of learning Gaelic toward the Gaelic economy. What can the government be doing to encourage more of this activity?

 

MS. MAUREEEN MACDONALD: Mr. Chairman, one of the things that I think is beneath the Premier's decision to have a new department - the Communities, Culture and Heritage Department - was to look at putting the various offices into a larger department, to get some synergy between the departments and between these offices. I think that there is a lot to be said for not being isolated, wherever you are, whether you're in a university department or in a company or whatever, as a small office. I think there is a lot of synergy to be gotten when you work in a grouping that has similar but diverse focuses. So the new department - and I know the minister of the new department - are still doing the process of establishing a secretariat and what that secretariat will do, and realigning some of the services that will be provided and what have you. So I think that is one thing. I do know that little film and it's hysterical, it's lovely, it's the funniest. If anybody hasn't seen it, they really should see it.

 

There are lots of other things I suppose we can do. Actually, as the member was talking about the film, I have a funny story to tell. I know the member will appreciate this. The CEO of the district health authority in Guysborough and the Strait retired after many, many years. I think he's a resident of your constituency - a lovely man, Kevin MacDonald. The district health authority folks organized a little going-away dinner for him, a retirement dinner at St. Andrews in Antigonish. I was very pleased to be able to go, and that evening, Dr. John Chiasson, who is the - he's not only a family doctor in the area, he is the President of Doctors Nova Scotia, was part of the head table.

 

When he went up to the microphone to make a few remarks about Kevin, he started by talking about his - he had been reflecting on all of the names of the district health authorities and he had realized that when you looked at the acronyms of each district health authority that in fact, there was some sort of a Gaelic conspiracy going on, that in fact, they were all Gaelic names. Then he proceeded to help us pronounce each one of the district health authorities in Gaelic according to their acronym. It was very funny, he did a very good job.

 

I think there are many ways that Gaelic, within the Office of Culture, which now has an expanded arts division, will have an opportunity for those kinds of synergies that I talk about. So let's say there was a production company and a producer who had a really good idea for a small film about the highland clearances, people arriving and setting up life in a part of our province and they wanted to pursue this in some way. I mean there they are, they've got a department that isn't just the Office of Gaelic Affairs now, but a department that's got all of these other entities - the arts council, or Arts Nova Scotia I think it's called, and different components that they would be able to - I guess the idea is kind of like more one-stop shopping groups to be able to get access to different government programs and services and supports in a way that is much harder to do when you operate in isolation. That's how I would see where we're going, in terms of being able to promote.

 

The same would be true for other of the small offices, like the Office of African Nova Scotia Affairs. I think these offices will continue to have their distinct identity and purpose because they are very different. Their focus is different, their audience is different, but there are great synergies to be had among these groups and then embedded in an office that has responsibility for museums, for the arts and, indeed, for community development and that whole idea I talked about. The preservation and the promotion of culture has to come from the community, not from the government. It has to come from below and then find support at the top.

 

MR. MACMASTER: Mr. Chairman, I have just one last question for the minister and the question would be, does the demand for learners, the increasing demand by learners, require additional investment to offer programs in more locations?

 

When I think about that I think about what is happening in Highland Village, which you've referenced, and also things like Feis an Eilein, the programs they are offering there are as good as you'll find anywhere. There may be other locations in the province where people want to learn, could those models be expanded and would you be supportive of that? Thank you.

 

MS. MAUREEN MACDONALD: The answer to that is yes and yes. I think that they could be expanded and I think that probably we will see some expansion. It was really interesting, I have travelled the province over the years; there aren't many places in Nova Scotia I've never been to because I just love Nova Scotia and I love to travel in the province and I've done a lot of it over my life.

 

The one area I had never been to was the Pugwash area, until last year, I guess. I was just blown away when I went there. First of all, it's extraordinarily beautiful and probably people who have been there recognize that it's really a beautiful area, as are most places in Nova Scotia. It has a very big, significant, Scottish population. All of the road signs up there are also in English and Gaelic, which was my first clue. I was kind of looking at these Gaelic signs everywhere I went, so I started asking about it, well what's the history? I found out a lot about the history of that area - Oxford, Pugwash, all in there - and it's fascinating.

 

This is an area that - I'm not a Cape Bretoner, I always say I missed out on Cape Breton by about 15 miles, so I'm not from Cape Breton. I'm from the Strait area, though. I always think of the Scottish population in the province being in Cape Breton, Antigonish, Pictou and what have you, and I really was not aware, until last year, of the significant Scottish population in the Pugwash-Oxford area and its significance.

 

It has a fascinating history. Some of the churches there, the old Scottish Presbyterian churches are there. You'd see St. Margaret's of Scotland churches here, there and everywhere and signs in Gaelic and then a lot of the different - one of the little towns, and I'm not sure if it's Pugwash, I think it is Pugwash, but a lot of the little streets, very Scottish names on the streets and stuff like that. I had no idea, it was really interesting.

 

This is not an area where I think we have much presence, as an Office of Gaelic Affairs, and I would think that in the area there would be people - I know that there is clan activity there, some of the various clans have reunions in that area and I think that there is probably a pipe band that has come from that area that I recall. So it all makes sense to me that there are other places in the province where there is a cultural, ethnic connection to the Gaelic language and perhaps we should explore expansion.

 

MR. MACMASTER: Thank you, minister, for all of those responses and thank you, Mr. Chairman, I appreciate having a chance to ask some questions about Gaelic here. It's something that is very important to me and I think as well to our province.

 

I'm going to allow my colleague to continue asking questions of the Department of Health and Wellness.

 

MR. CHAIRMAN: The honourable member for Hants West with about 10 minutes remaining.

 

MR. CHUCK PORTER: Thank you, Mr. Chairman, and how the time flies. As was the case the other day, I got up, I had only a few minutes to speak and I'll try to pick up today where I left off and maybe get an opportunity to come back a little bit later on.

 

I was speaking the other day with regard to dialysis in my area and I went on about some of the patients in Hants Community and it being a wonderful opportunity to expand dialysis for patients, to keep them from travelling, both here to the city and, of course, to the Berwick area.

 

I started talking a bit about the home dialysis unit and the training that had gone on there and what was required and how it just doesn't work for everybody.

 

I can tell you, Mr. Chairman, that I got underway in talking about the costs associated with some of these things and how there was some waste involved in that if people didn't work out or people were done with this. There could be thousands upon thousands of dollars sitting there that ended up as waste because it couldn't be brought back, and this was from the people who are on the dialysis that were telling these. I don't claim to be any great specialist, although I've got a bit of a medical background. I certainly have no extensive knowledge per se in something as specific as dialysis - some background, but not extensive.

 

I want to move on to some other topics because I know my time is somewhat short. I want to talk a bit about the mental health programs that we have. I guess we've heard an awful lot about mental health, Mr. Chairman, as we came into this session. I know that you yourself have stood in this House and made comments, as have others, and I'm sure there will be a lot more to be brought forward on that as we go ahead.

 

With regard to the programs and cuts to programs, I have received calls from families in my area. I'll give you an example. One day I had a call from a parent saying, you need to remove your child from the IWK program that exists. We're thinking about sending him to Truro but he needs to go home in the interim.

 

Of course, you can just imagine the panic that instilled in this parent. The parent goes immediately into Halifax, and gets on the phone and actually calls me from there, from her cellphone. There was a worker from the Department of Health and Wellness there who did come on the phone and did speak, but through no fault of her own, she was unable to explain. She may have been from the Department of Community Services, in all honesty, who was dealing with this file and with this case. She really couldn't give me any detail. She had no authorization from anyone, although verbally she was given the authorization from the mom who was there with the child, and still she was hesitant to really get into that.

 

I can appreciate that, given her position in all of this, and it had all just transpired. I'm sure she didn't want to get into divulging much and didn't have authorization from the department or anybody above her. That is what it is, and you can't blame her for that. She's following policy. But at the same time I guess what we need to recognize is the fact that here we have programs that are being cut in a place like the IWK. We've seen the good folks who work there and others and families come out, and they've protested along the front gates here on Hollis Street and around the building, with their displeasure of where this is all going.

 

Now, we all know the importance and the number of issues with regard to mental health in this province, whether they be in our youth or adults. We know that youth mental health problems are a very serious issue for a whole variety of reasons, and we don't have to get into every one of them specifically, but there are a lot of issues. In the years that I've been an MLA I've actually been quite surprised by how many youth mental health issues I've had to deal with, unfortunately. It is something that doesn't appear to be getting better, although I think that some of the people who are working in those programs that we've offered have done very, very well. The people in Community Services on another local case that I've dealt with have been so involved.

 

These don't just come and go. These tend to stay throughout the course of these folks' lives, through young - some of them very young - all the way up through their teen years and then into adult, and there are still issues. We've got long-term history - generational, unfortunately. Some of these things continue to go for many years and we need to continue to improve that.

 

I know that as we stand here, we will work at that and continue to work on that as Opposition, and I know that the government is working on programs as well. We need to make sure that the programs are in place, the challenges that face us, and again it all comes back to money. We all know that. We're here talking about the budget and the estimates. Everything, unfortunately, has to come to the God Almighty dollar, I guess, when it comes right down to it. I also know and I appreciate the very fact that there is only so much money in that bucket.

 

I also know that the Department of Health and Wellness takes up a very large portion, and later on we'll hear the minister quote that figure of what the estimates are for her department. It's tremendous how big that number is. The question is, what are we doing in order to control it? It continues, although there's a small growth. There are cuts that are affected. Money changes from one hand to another, so to speak, when it comes to specifying programs and where it's going to go.

 

I want to talk about a few other things. I want to talk about home care specifically, and long-term care. I know I've only got a few minutes left, and I know the minister has heard me say this before, ever since I've been over here, and probably on the other side too, with regard to long-term care. We have had issues for many years with long-term care.

 

The single-entry system, I've stood here in my place and I've called it what it is, I've called it a failure before, I'll continue to call it a failure again because that's what it is. The minister also knows that I've not only criticized this when she has been in that seat, I have criticized this in previous days, when other members in this House, previous ministers, were in that place, that I disagree with that. I spoke with them and brought forward the concerns that were associated with the long-term waits.

 

I know that she is aware of all kinds - not just from my area - all kinds of individuals who have had long wait-times to get into facilities and it's too bad that this still exists. Here we are talking about building new beds and opening new homes. We're not increasing the number of beds at all. It's really unfortunate that we built the new Windsor Elms, which is a beautiful facility, a wonderful facility and we're very glad to have it. It was much-needed. We have the same number of patients, or clients, whatever you want to refer to them as, residents living in that facility. It's too bad that was the time then to make a decision, knowing full well that our population was going to get older and our number of seniors and our number of needs and requirements for long-term care is only going up. What an opportunity it would have been to add to that facility very easily and made it maybe 150 beds instead of the 108 beds that it is.

 

Instead, we continue to have seniors and others who are waiting for months and months, for a whole variety of reasons, to try to get where they need to be. I've got Unit 500 over there that remains full - that's hospital beds that are being taken up. We've turned it into a semi-nursing home facility and it's sort of a holding area while we wait to go somewhere, whether that's locally or we're going to ship them somewhere out within the 100-kilometre area.

 

Again, this continues to be something that is not working, that we've seen absolutely no change in. You can talk about all the new home openings that you want and you can talk about introducing all the new beds you want, it doesn't seem to have an impact on the number of people who are always waiting.

 

Now people are continuing to get older, they are continuing to get sick, they are continuing to have to have care provided for them by way of long-term care and long-term care homes. Unfortunately we don't have more beds opening up.

 

Now we've had a recent story, as we saw publicly on TV, a constituent of mine, Shirley Dykens, waited for a good many months. Her circumstance was a little different, she wasn't in Unit 500 or the hospital, she was home. At the same time, she was being passed back and forth between sisters who were trying to care for her. The stress is no different, the stress is very much there on those family members as well who are looking after their loved ones and it's a very, very difficult task, as much as you might like to think it's easy to look after one of your own, it's very difficult. It's even more difficult than having somebody in the hospital and being looked after, or in a nursing home and being looked after. It's stressful, it's tiring, it's hard, you never know if you are making the right decisions for their care and you always want to do more and you want to do a better job for them.

 

Madam Chairman, we continue to struggle with this. I don't know where we're going to end up because you can talk about all the strategies and all the plans and all the studies you want, there has to be a solution somehow. I'll get into it a little bit later when I have the opportunity. I know my time is drawing near, I have only a few seconds left here. This is something that needs a lot of discussion, a lot of work needs to be in this area. I look forward to some of that and I now I'll have a few more comments on that but since my time has expired now, I will thank you and take my seat.

 

MADAM CHAIRMAN: The honourable member for Halifax Clayton Park.

 

MS. DIANA WHALEN: Thank you, Madam Chairman, and I'm glad to be able to get into my place in time to continue the talk that we were having on international grads, so it will be a medical question and not the Gaelic questions that I've been listening to as well in the last hour.

I wanted to go back because I know the minister was rushed in her ability to answer - I think there were only four minutes left and we have a big subject before us. The subject is the international doctors who come here, they are trained - and graduates of other countries. Many of them have practiced for a considerable length of time in those other countries. Because I have a little bit more time, I think it's important to mention that our federal government has quite a disconnect with the professional associations as well because they are going overseas, targeting highly-educated professionals to come to Canada.

 

They have really made a mistake or a discredit to the people they are attracting because they have not made it clear how difficult it is when they get here. I think there are some plans now afoot which I heard at ISIS that there will be more information on-line and people who are living in another country - I'm thinking of doctors living in another country - can at least begin some of that process while they are still practising. They can begin to get their credentials together, the educational certificates and so on that they would need, the transcripts that could be reviewed, at least get the process started. That might save them a year or so, where they are still practising and the clock isn't ticking toward the time when they will not be accepted or looked at in Canada through the College of Physicians and Surgeons.

 

Again, I mention there's a five-year wait or time limit where it is felt that the person is then out of practice too long and would need more upgrading. That creates a great deal of stress, and I'm assuming that the minister as well has met and spoken to some of the people who are affected. There's a very high level of stress on them.

 

I said it was a very high-stakes game when they go to the CAPP exam, because so much rests on how they do while they are being watched and monitored in each and every situation. I have talked to somebody in the last year who actually took the CAPP test the first time with very little preparation. She was able to get her name on that list, paid the thousands of dollars - I think it is $6,000 - to sit that exam.

 

I see the Minister of Immigration is interested in this too, and I think that's really important. It is a tragedy on a personal level to see people who are so highly educated and sought after by the federal government arriving on our shores with tremendous challenges to get their credentials.

 

I was hoping that, first, the minister could give me a copy of the breakdown of physician services, the other programs, just so that I could have it and see the total. It would help me. Otherwise, I could go through it again and jot everything down. So that's question number one.

 

The second question is going back to the process that's in place. I understand that the minister relies, as we do with all the regulated professions, on that profession, in this case the College of Physicians and Surgeons, to run the assessment test. My question is whether or not the funds available for the year are influencing the number who are given the nod, given that blessing that they've scored high enough to be accepted into the program.

 

If somebody is scoring high, I think they should be told that and not limited to two tries. It might be that there's just - you know, if there were 70 per cent of the people sitting that test who do well, then they should be told they've done well but there's only room for the top six. That happens with applications to medical school and other things that come up, that you are not in the top group but it doesn't mean that you are a failure. I'm just concerned that - as I said, the last year I had the figures for was six out of 36, and maybe a question for the minister would be, over that period of time - we went over the period from 2005-06, that there were eight groups that graduated or went through this clinical assessment - could we get the numbers who sat the exam and the number who were successful each year? I know in the initial period it was also a very low number and I'd love to see if that has increased in any way. Maybe we could just start with that.

 

MS. MAUREEN MACDONALD: Thank you very much, Madam Chairman. The first thing I would say to the honourable member is that we will get you the information of the breakdown around physician services, other programs, what's in that. We will provide you with that. We're not going to do that right tonight, but we will provide you with a list of what is in that.

 

With respect to the CAPP, as I indicated, this program, the Clinician Assessment for Practice Program, is not a program of the Department of Health and Wellness per se. It's arm's length from us. It's a program that is run by the college, so the number of people who sat the exam and all of that kind of stuff is information that is with the college, not with the department. We are not involved in that aspect. Our involvement is with respect to the financial envelope that is available for CAPP physicians to be accepted with the CAPP licence and the return of service and the mentoring component with physicians around the province.

 

I guess, Madam Chairman, I would say that this particular program is like every other program in the Department of Health and Wellness, we have a budget for it. It isn't an unlimited amount of money. We set a budget; we have to be able to do that, every government has done that and you determine that you have this amount of money.

 

The college requests funding for the program, based on their, I would imagine, perceived ability to place people around the province, in terms of what kinds of openings and opportunities there would be, but we would not have an open-ended program. I don't think there's any province in the country that has an open-ended, foreign-educated, physician program. If the member is aware of one, then I'd be happy to know about it but I would be very surprised. I would think that the programs are limited, as I indicated, they are limited by the resources that you have available and those resources aren't only financial resources; those resources also are mentor resources. So realistically, you have to look at the additional demand it places on your health care system and educators in the system and practitioners in the system.

I know myself, because as the member knows, I have spoken with many foreign-trained doctors who haven't been successful in getting into the CAPP program. Ironically, some of them are Nova Scotians who have trained outside of the country as well because being a resident of the province doesn't guarantee you access to a residency or a placement here in Nova Scotia.

 

MS. WHALEN: Thank you, and there are a number of questions that I would like to follow up with there. One is that there certainly is an envelope of money, and you mentioned there's a return for service, a mentoring fee and a few others. Do we give any money at all to the College of Physicians and Surgeons to administer the CAPP exam? Are we doing anything to support them in offering that clinical assessment?

 

MS. MAUREEN MACDONALD: I think it is part of that program, that $2 million-odd dollars. We give them the lump sum and part of that is to administer the program.

 

MS. WHALEN: The minister will be aware that last Spring we had the College of Physicians and Surgeons at Public Accounts Committee, as well as somebody from ISIS who has worked a lot to try to bring all the parties together. I must say she is a very diplomatic person, who is working hard, and I think she is currently on a secondment with government to try and work hard on this issue, so we had a chance to look at it.

 

One of the things that the college said was their members are subsidizing this program. I have a hard time believing that if they had 36 people take the test, the last year I know of, and each were paying about $6,000, that means to organize this day and bring in the simulated patients and the physicians to do it, and book a room and whatever else happens afterwards, that's almost $300,000 - $276,000 is what I got from these people themselves, who very often have borrowed this money to take the test.

 

I did want to know if that would be something of interest to the minister, that if our money is also going there, I can't believe that they are not making enough money. I think, in fact, it could be a money-maker for them, which would be a bad thing. I think they were trying to deny that there was any money to be made in it.

 

The fact is that there is the concern, they have the complete control over it but we are, at the other end, receiving the successful people through and into the mentorships. So the question I would have is, does the College of Physicians and Surgeons know in advance exactly how many mentorships would be possible? At the beginning of the year, before they even sit the OSCE or do the CAPP, do they know if you have what is essentially a financial cap on the number that can be absorbed?

 

MS. MAUREEN MACDONALD: Yes, I believe - and I said earlier in my opening remarks on this - that there are a set number of seats, six or seven, and they are aware of that. To administer the program is about $200,000, so the rest of the money they get is to support the actual seats that are filled.

MS. WHALEN: Would the minister then assume that if the crop of IMGs who are sitting that exam have themselves put in about $275,000, that money is used to administer the program at the college? Or is it $200,000 that is provided by the Department of Health and Wellness?

 

MS. MAUREEN MACDONALD: I think, Madam Chairman, it's more complicated than that. The system, as I explained, is also a national system; it's a national assessment and exam. I don't know what the costs are to administer the exam, for example, and whether or not there are fees that are paid to a national body.

 

In the grant, if you will, from the department to the college, is $200,000 toward administration of the program, but that doesn't necessarily mean there aren't costs that the college incurs with respect to the administering of the national exam.

 

MS. WHALEN: Thank you very much. I know I'm going to get a breakdown, at least somewhat, of the Physician Services, but if it is $4 million a year that we're giving toward the CAPP, would the rest of that be going to the number of people who the minister referred, who are still in the process? I think it's a two- or three-year mentorship, so you'd have them in different years of that. So the $4 million would be going to give an extra amount to the doctor who mentors and to pay the fee or pay a salary to the new Canadian doctor, or immigrant doctor, who now has a licence? Does it cover their salaries too?

 

MS. MAUREEN MACDONALD: I can't answer that with absolute certainty, but I think so. Many of the doctors who are mentoring are on fee-for-service, but they obviously receive some remuneration for mentoring the physicians. But as I said, we'll get you that information.

 

MS. WHALEN: Thank you very much. I have just one final question. I know the Health Critic would like to come back and have some more, so could you just tell me, as the minister, if there are any other monies going in that would help in some of the other avenues that help immigrant doctors? I'm thinking of some of the - like Capital Health District and perhaps some of the other health districts have some clinical positions or they've made available where a person can come in and work at their DHA level in the hospitals.

 

There are special categories - there's not many of them, but there are some - we are deliberately trying to make space and positions for IMGs and those have been successful, I believe. Are there any other major funding initiatives that we're doing to help immigrant doctors? If you could just talk about a couple of the others, and I don't expect it to be extensive in the answer, but if we could just highlight where the monies are going?

 

MS. MAUREEN MACDONALD: Madam Chairman, it is the case, and it's primarily in the Capital District, that there are arrangements that are made with foreign-trained doctors for certain specialty services. This tends to crop and be used from time to time in areas where there are shortages. Anaesthesiology comes to mind as an area that I know in the past we really needed to do some recruitment around. So yes, that's the case, but it would not really occur outside of the Capital District, except on very rare occasions, I would say.

 

MS. WHALEN: Can I just ask the minister if there are any pilot projects planned or anything further that we're looking at doing, at this point, to perhaps create another residency position, through Dalhousie or through the Department of Health and Wellness, anything that we're doing that would add to the numbers? Very few, one or two immigrants are taken in, I think at third year in the medical school, to come in and join that medical class and get a year or two of training at the Dalhousie Medical School, in order to practice and get on the track with other Canadians who are going through.

 

Are we funding any new ones? Has the minister been asked to do a few more and is there any plan to try another pilot or do anything that would help to move some of these highly-skilled, well-trained people back into their profession of medicine?

 

MS. MAUREEN MACDONALD: A couple of things, just for clarity. The budget for the CAPP includes salaries for physicians for a four-year contract, plus we pay for 13 months of mentoring. It's about $1,000 to $2,000 per month, the mentoring piece.

 

I indicated earlier that the department has undertaken the work of a physician resource plan for the province and that work is close to completion. I want to impress on members that I and everyone else in the government and certainly in the department, are very aware and we're very sympathetic to the situation of people who are foreign-trained physicians who, as the member indicated, sometimes are recruited here through the federal programs. I know in the federal election there was great emphasis placed on recruiting foreign-trained doctors to meet the physician shortage in Canada.

 

With all due respect to the federal government, they don't operate on the ground. They have no idea what specialties are required and they have no idea where people need to be practising. So on some level, their efforts aren't necessarily helpful to the provinces unless there is coordination.

 

Yes, you are correct, people end up here in these situations where they thought it was going to be easy because they hear this kind of conversation around doctor shortages and then they find out it's not easy to get a position. So if there are shortages, what's the problem?

 

From my perspective as Minister of Health and Wellness, I cannot plan the delivery of health care services around the needs of people who are trained as doctors. We have to plan our health care system around the needs of patients and around the needs of communities. I keep, through the budget estimates, talking to people about patient-centred health care, health care that starts with planning for the patient, health care that is about putting the patient in the centre of the health care system and building a system that gets that patient care. For too long we've had a health care system that has been driven around the needs of people who work in the health care system and not around the needs of people who need health care. We're changing that.

 

The physician resource plan is very important because we have an aging physician population in Nova Scotia. Over the next 10 years in the Province of Nova Scotia, we will see literally hundreds of physicians retire. We have to be sure that we have sufficient physicians being trained. They need to be trained in the areas of practice that we need, that correspond with the population's needs in terms of chronic disease, in terms of our aging population, in terms of our rural population - a dropping population - and in terms of our urban population.

 

The physician resource plan is looking at the best predictors we can have, based on the data we have today, on what that workforce is going to look like over the next 10 years and what it should look like and how we ensure that we have it. There will be the need for an action plan to address physician resources, and that action plan will have to take into account the foreign-trained doctor and their place in our health care system. So because we have a CAPP today doesn't mean we will have a CAPP in the future. We may have a very different kind of program for foreign-trained doctors.

 

I don't know what that is going to look like. What I would say is that - and I said this earlier - doctors are very mobile. They are mobile inside a jurisdiction like Canada and they are mobile across international boundaries, and that's not going to change. We welcome physicians who are trained elsewhere. We will always have those physicians in our system. It's quite interesting to see the number of physicians that we have in our system right now who are foreign-trained. A significant proportion of our physicians are foreign-trained physicians today.

 

I mentioned being in Cape Breton with the Medical Society dinner, their annual meeting. It's like being at the United Nations. The doctors in Cape Breton are from all over the world. I think Dr. Naqvi told me there were 150-some countries represented in their physician population. It's certainly no different here in the Capital Health District. You can go around the province and you will see the same thing. You know, GASHA - Guysborough Antigonish Strait Health Authority - there are many doctors who work in that district who are foreign-trained.

 

It's not like the doors are closed to practice in Nova Scotia for foreign-trained doctors. That's certainly not the case whatsoever. There's a very, very large proportion of our physicians who are foreign-trained, and we do have this program. We run it in the way that I indicated. It's the College of Physicians and Surgeons that does it. There is money in this year's budget for it, on a go-forward basis. We will have the physician resource plan finalized fairly soon, and then the heavy lifting of looking at how are we going to ensure that we replace an aging physician population will occur. How do we make sure that the physicians we need are in the places we need them? How do we ensure that we have the right mix, that we have specialty services and that we have that significant body of family practitioners and generalists that we require in a profession that has drifted more and more towards specialization, leaving the generalist on the sidelines.

 

This is certainly work that is well underway and a conversation that we will be having with Nova Scotians and with our physician community in the very near future.

 

MS. WHALEN: A lot of my concern is around the CAPP and the number of doctors who do not have the door open for them, the door is slammed. A lot of them are traumatized, they have come under false pretences, maybe not enough information. They got top marks from the federal government and, as the minister said, there's a disconnect between what the federal government has given them points for in coming to Canada and what the reality is when they get here.

 

I know we have a multicultural group in our health care system and they are coming through different avenues. Maybe some of them are older and came when it was a very different system or just a different way to be marked and assessed and brought into the system. I know that today there are a lot, many from the Middle East particularly, who are facing this countdown to the five years - you've been out of practice and the countdown to having only two chances to take the CAPP exam, even if they're willing to pay.

 

I'm not convinced that the CAPP exam is actually measuring how good they are, I think it's looking for the top six or the top seven, based on what the government has available in the way of mentorships. So if that is the case, I don't think people should be restricted from having another go at it, they shouldn't have the door slammed in their face.

 

My final request, I guess, would be two-fold; one would be to ask why they couldn't have more than two opportunities to try and go through that CAPP assessment, really, and get an honest assessment. The minister used the words "fair and transparent and open" - it should be very clear that it really is measuring your ability and it isn't a guarantee of a job at the end of the day. If people are taking it with the idea that there will definitely be a spot, that would be wrong because there's only, let us say, six spots a year. It should be an assessment of whether or not they have the skills, not whether or not they make the grade for those six.

 

I would like that to be clarified and I think the minister should be aware that there's a lot of feeling that it is not a just system, that it's not as transparent and as open as it should be. People are not sitting the exam with really the right premise, that it's a measurement of their capability rather than a measurement of how many the province will absorb.

 

I would like to mention again that something that has been mentioned to me is that there should be a preference for those who have already put down roots and have been doing their studies and living here in Nova Scotia as they prepare. Because remember, the OSCE or the CAPP exam is the culmination of a lot of other steps that they've already taken - written exams and so on that they've gone through to be recognized by the Canadian Medical Association and so on.

The idea of giving preference to people who are actually living here, rather than doctors who literally will have their family in another province, work for the week and then fly home to Toronto. One of my doctors actually, in Clayton Park did exactly that, kept her family in Toronto and worked through the week and had an apartment in Clayton Park.

 

That's not the same as people making a commitment to our province. So because they are immigrants, I think it's a little bit different than the process that's in place for young medical students or even older people going back and going through medical school. I understand they have mobility but these are people who have chosen a province to live in as an immigrant and then are going forward, trying to make this their home where they can have a practice.

 

I think giving them preference would be a good thing and perhaps the minister or the Department of Health and Wellness would have some influence since the $200,000 a year is used to fund at least the administration of that program. That's my final question on that. Thank you. I'm finished.

 

MADAM CHAIRMAN: I just want to know, are you looking for an answer or are you offering the floor to your colleague?

 

MS. WHALEN: I'd like an answer, if I could.

 

MS. MAUREEN MACDONALD: Madam Chairman, 30 per cent of the physicians who practise in Nova Scotia today are foreign-trained, so almost one-third of our physician population are, in fact, foreign-trained.

 

I say to the honourable member, I know her concern and I know that she is sincere. I know that she has met with many of these people and I have, indeed, had the privilege of meeting people who have come here who have trained elsewhere. They have very compelling stories to tell and they are deeply disappointed when they are unable to secure a spot in a profession that they have already been practising and, in some cases, have trained for years for, so I certainly recognize this.

 

I have said and it's my understanding - we don't administer the CAPP program but I often find myself speaking to people about the CAPP and personally I never indicate that it's a program that I perceive as judging their capability. It is a competitive program and I say that. It is a competitive program because it's not an open-ended program. It is a program that has a limited number of seats. You write an exam and the people whose results are the highest are the people who are successful. It doesn't mean that people who aren't in the top six or seven are flawed in some way, it just means that they did not end up in those top six or seven spots. That is the reality, we do not have an unlimited number of mentors, placements or seats that are available.

 

As far as what the standards are around how many times you can write these exams, again I would say to the member, this is a program that is arm's length from the Department of Health and Wellness, it is not a program that I or staff in the department developed. This is a program that was developed - I believe it was developed out of the one of the western provinces but I stand to be corrected on that. It has a national set of criteria which has been agreed to across the medical profession. They establish the standards, the rules and all of that kind of stuff that will meet their professional standards.

 

In terms of applying some political pressure on them to relax or to alter their requirements or their standards, I'm not sure that I feel comfortable doing that. It is a process, as I said, that the colleges look at and I think that the colleges are the ones that need to set those standards, just as they set the licensing requirements for physicians.

 

So this is what I would say. Staff are advising me that there is no limit on the number of people who can apply to the program but they have to pass the test first and that the college does establish the standard and they would have to speak to those standards.

 

I would like to table for the member the breakdown of Physician Services - Other Programs that she requested earlier in her time. Thank you, Madam Chairman.

 

MS. WHALEN: Thank you again, Madam Chairman. I wasn't intending to get up again but I think it's really important to get to the distinction that the minister has made, that it's a competitive process. I think the immigrants who are entering into this CAPP final test are seeing it as a measurement of whether or not they have met Canadian standards.

 

If the aim is to get six people for the mentorship and if only six are passing, people are being told, you don't meet the Canadian standards, that you are somehow substandard; you have failed to pass.

 

I think it's important that the College of Physicians and Surgeons be frank and honest, it's not about passing and failing in a knowledge level, it's that they are not the top six. But these immigrants, each one of them, are given their assessments back and shown where they were borderline or they failed. I think that somehow we're not telling the story straight to the people who are sitting it and because they are limited to two shots, even if they were deficient, they're not even allowed to come back for a third try. So frankly, the door slams in their face and they are more than dejected; they are often depressed, suicidal, ready to go home; they have to leave and go back to their own countries.

 

Life, for somebody who has studied as a physician and now has a door slammed in their face, it really is like life is over for them; they are so devastated. But the minister is telling us that really it is a competition for the seats available. I can accept that but I don't believe that's the premise under which the college is approaching it. That's why I think there is a disconnect, that it is really important that we get to the bottom of it. I think only the minister can do it, really, the minister or the department could do that. Otherwise, we can't. Offering people the opportunity to pay the big bucks to come back and try a third time, or future times, would be fair if the limitation is the financial resources, at the end of the day, to sponsor them into the health system. That is a fully-understood thing and if that was the case, they would realize that each year they'd have the same chance to get in there and hopefully score higher and get those seats.

 

I just feel we need to be an advocate for these people because they've chosen Nova Scotia and they've been misled in so many ways. We need to help them. They've worked hard, they have passed Canadian exams for knowledge and they go into these high-stakes OSCE exams with a heck of a lot of stress and it's make or break for them. They are often thousands of dollars in debt because they've been borrowing so much to get ready for these exams. You can only imagine the stress on them, I'm not even sure it's an accurate reflection of their abilities.

 

With that, I'm going to turn it over to my colleague from Kings West.

 

MADAM CHAIRMAN: The honourable member for Kings West.

 

MR. LEO GLAVINE: Thank you, Madam Chairman. I want to first of all welcome Deputy Minister Kevin McNamara to proceedings today. I thought perhaps maybe the minister brought him in to deal with Gaelic Affairs but I'm sure that's probably not the case.

 

I want to spend the remaining time of this hour dealing with some mental health questions on addictions services. A couple are a little bit of a repeat after evaluating and looking at some of the responses earlier, during estimates.

 

First of all, has the minister seen the final recommendations from the advisory committee working on the Mental Health and Addictions Strategy? The minister now talks about it being very close to that point where we will have a public document, so I'm wondering if the minister has been apprised of some of the recommendations, seeing that some developments are taking place in the Capital District with the discontinuation of the 28-day in-patient program for addictions and also the changes currently happening at the IWK. I'm wondering if the minister has actually had some briefings on that document.

 

MS. MAUREEN MACDONALD: Madam Chairman, I want to thank the member for the question. I think we've had quite a lengthy exchange around what has occurred at the IWK with respect to the shift in the model of service delivery there and so I'm not sure that we need to go through this in terms of my providing any new information. I certainly can reiterate all of the information I've already provided and I'm more than prepared to do that. However, with respect to the Capital District Health Authority, the 28-day, in-patient program, I have been advised by the Capital District folks that this program was not being fully taken up to the extent that the program had vacancies for more than 40 per cent of the time even though we were resourcing it for 100 per cent occupancy, 100 per cent of the time.

 

So again, we are living a reality that is this reality, the reality is that the dollars for health have to be used for health. They have to be used to deliver services and they have to be used to give us outcomes. The days are gone when governments can afford - and mind you we never really could afford - but for too long governments paid for empty beds. We funded ineffective services that were not providing the kinds of outcomes we required and the people who are often best able to determine that are people who work in these services who observe this and who manage these services.

 

Now, the folks over at the Capital District Health Authority, in both Addictions Services and the Mental Health Services, have been looking at what the situation is and where the weaknesses and deficiencies are in their services, where were they receiving resources for services that weren't being provided, and how they could do things differently. Having their beds in the 28-day program empty for more than 40 per cent of the time, even though they were getting dollars predicated on the assumption that those beds were full and people were receiving services, at the same time as other programs had wait-lists and they were crying out for resources to address these services, they quite sensibly decided there's something we can do about this and there's something we should do about this.

 

So once again, like the IWK, there has been no cut in the funding to the addictions program. What staff have decided to do is to refocus their programs to reflect the patients' needs, not the needs of the workforce that currently existed. Again, it's about providing patient-centred care; it's about providing services to people with limited health dollars; it's about eliminating waste and inefficiency in the health care system, and it's about getting better care sooner to people who otherwise would be languishing on a wait-list until they developed into a crisis, in some situations, and required crisis services.

 

So this is the situation in the Capital District with respect to the in-patient program and I am fairly well versed on what occurred there, why it occurred, and I'm fully in support of that. In addition, the Mental Health Services in the Capital District have also, in the last year or more, gone through some real analysis and real reflecting on their programs and what they could do better with their existing resources. They have made some significant changes and they've adopted some new models. There are some very exciting things happening in that program and I'm pleased to see these changes. I have said on more than one occasion that it's not necessary to wait for a mental health strategy before you do things that need to be done.

 

The mental health strategy is something that will help us move forward but while we're doing the necessary research and planning for that, there are many things that we know from past pieces of research and various reports that have come along, that need to be done. So we have acted on those when we have the information and the resources, and the planning is in place, and we're able to do that. It's for that reason that we were able to do a number of things - mental health courts, put funding into the EIBI program for autistic kids, open up the psychiatric intensive care unit, moved the forensic unit to Waterville from the IWK.

 

I want to say to the member for Kings West, I don't know if he ever toured the Forensic Unit on 4 South over at the IWK, but I was more than a little disappointed today to hear your Leader say that was simply shuffling services from one place to another. That was an unfortunate characterization of what will be a significant improvement in the care for kids in the Forensic Services and a significant improvement for kids on 4 South who are being housed together in circumstances that serve neither one of those populations at all.

 

The clinical staff at the IWK, as I understand it, have been crying out to government, to the Department of Health and Wellness, for a considerable period of time, to address that serious problem in the best interest of kids on those units. I have to say when I toured the unit, it was crystal clear to me why they were asking for our help and we acted immediately to address that and it is anything but a simple transfer of a service from one location to another without any benefit to young people.

 

This is something that will have immediate benefit to young people who are in both of those services and I feel, and have no difficulty - I understand the role of the Legislature, it's a time for government to be accountable and held to account. I am more than prepared to stand here and be accountable for decisions but I'll tell you, comments like that around services that are so vital for our kids, do not have a place in this place.

 

MR. GLAVINE: Thank you, minister, for providing that kind of insight. It is, indeed, appreciated. Here's an area that could have some change and since I don't have a lot of time on this one, I will speak to a situation that I am very familiar with and based on reports. In a 2011 report on Middleton's 21-day program, alcohol at 69 per cent and non-prescription drug use at 19 per cent were the predominant treatment issues in patients accepted into the program. The Annapolis Valley Health received a report in March 2011 about a pilot project called Screening: Brief intervention Consultation & Referral Pilot Project. This was a pilot project where they had clinical therapists from AVH Addiction Services placed at different local and medical practices. After the six-month pilot project, AVH reported that prescription drug use was the most frequently reported substance use issue with 48 per cent of the clients and this was followed by alcohol at 20 per cent. The Middleton 21-day program seems to be focused on treating alcohol abuse when the community still requires much help on the prescription drug abuse issue.

 

The only other option, methadone - and I know the Valley was pleased at the implementation of the methadone program and doctors and other related professionals who have taken advantage of the opportunity to be educated and to also now have the required hours to be engaged in that program. Methadone, the top experts will say, is only a small portion of addiction recovery. The question is, when will treatment programs in Nova Scotia change to reflect the needs of individuals seeking help?

 

MS. MAUREEN MACDONALD: I want to thank the member for the question. The point he raises is a point that my own colleague, the member for Kings North, certainly has talked with me about. The member for Kings North, as the member for Kings West would know, has worked for many years in the addictions field and has a very good knowledge of the developments in this field, as have people in my department and people in the Annapolis Valley District Health Authority such as Dr. John Campbell who was here earlier today in our gallery.

 

It certainly is the case that Addictions Services, I think, grew out of a particular focus and tradition around alcohol abuse, but we now know that addictions are much more complex and we have seen an exponential growth in the amount of prescription drug abuse and non-prescription drug abuse, sometimes coupled with alcohol abuse, not only in Nova Scotia, not only in the Annapolis Valley, not only in the province, but this is a phenomenon that you certainly see across the country and North America. Treatment programs are still trying to transform themselves to meet this new reality.

 

The people who are in the field tend to be the people who are examining all of the new treatment modalities and what is the most effective way to work with people, particularly people with drug addictions. We also have a growing awareness and an understanding, although an imperfect understanding, of concurrent addictions and disorders. When I say concurrent disorders, I'm talking about mental illnesses and addictions in combination.

 

Our province right now is working to develop some joint system standards for concurrent disorders between substance abuse and mental health disorders. It's a very serious problem. It's one that we see more and more. We have had a system that has separated mental health from addictions where there needs to be much greater collaboration. So I think what we are experiencing are a number of different programs and services being tested. The member makes reference to a pilot project in his area; pilot projects are a very useful way to test out new approaches, the effectiveness of those approaches, and to learn from them in terms of whether or not they need to be adopted more widely.

 

So we are doing this, we are in the process of finalizing, as I indicated, the Mental Health and Addictions Strategy. We will see a variety of measures that will help us have a better system, a system that will respond more to, again, the patients' needs, based on what the data shows us of what those needs actually are.

 

MR. GLAVINE: Madam Chairman, with the new monies that are going to the Annapolis Valley District Health in this particular budget year, an identified line item, is that going entirely for the methadone program or will it also impact some other work of Addiction Services?

 

MS. MAUREEN MACDONALD: Madam Chairman, I think it basically does support the opiate treatment program. These programs, as you know, are not inexpensive but at the same time, I think when we looked at the numbers, when the Annapolis Valley District Health Authority actually looked at the numbers of people on wait-lists, and people who are waiting both for services inside the district and perhaps may even have been receiving services outside the district, it was determined that a program of this nature was required.

So that additional amount of money is for that particular program and I want to say to the honourable member that that program is being looked at from other districts. It probably will be a gold standard kind of program, not only for other districts but for other provinces to look at. One of the really unique features is the dissemination of that program across various practices so that it's not one practice that's carrying all of the load, if you will, that there are other, a multiplicity of physician services around the Annapolis Valley. This is really my hope for where we could go with similar programs around the province.

 

MADAM CHAIRMAN: The time allotted for the Official Opposition has expired. Seeing no speakers from the Progressive Conservative Party, I recognize the honourable member for Bedford-Birch Cove.

 

MS. KELLY REGAN: Thank you, Madam Chairman, and I would like to thank the minister and her officials for coming in today. Probably not to the minister's surprise, I would just like to ask her a bit about the Lyme disease strategy for the province. I'm wondering at what point we're going to get the advertising underway, what plans there are this year, is it any different from what we've done over the past few years, and I'm just wondering how we're going to publicize this and do we have any indication that Lyme disease bearing ticks have moved into new areas?

 

MS. MAUREEN MACDONALD: Lyme disease is an issue that is of concern here in Nova Scotia and it certainly is of concern in the area of public health. The folks in the department who follow this are Dr. Bob Strang, our Chief Medical Officer, and his shop. We know that the number of Lyme disease cases has increased in Nova Scotia from previous years and we know that there is concern and fear in some parts of the population that this is a disease that physicians are unable to adequately identify or test for and what have you.

 

I want to start by reassuring people that this is not the case. I had an opportunity - well, of course, I have an opportunity to be briefed by Dr. Strang on this - but I also had an opportunity to meet with some of the infectious control specialists to get a better understanding of where they fit in the continuum of treatment for Lyme disease and that was a very informative discussion with them. So it's actually a relatively straightforward test for Lyme disease and a relatively straightforward treatment that is available to people who have Lyme disease. It's a serious disease that if it goes undetected and untreated, it is very, very serious, so one should never minimize that reality. Undetected and untreated it can be very, significantly serious. However, the rate of detection and treatment is actually quite good.

 

I had a friend, in fact, who lives in one of the parts of the province that was early identified as an area where the black tick is and a carrier of Lyme disease. She had a bite and the bull's eye rash and she immediately went to her GP who started her on the antibiotic before the test results came back because it was so apparent that this was the case. She was very successfully treated and indeed when the test results came back, they confirmed that this is what it was and so it was very straightforward.

The thing that we have to do, according to Dr. Strang and people in Public Health, is we have to inform and educate the public around two or three things. We have to first of all help people in Nova Scotia recognize that the ticks are here, that while we have identified hot spots, that doesn't mean that the ticks are only going to stay within those hot spots and that in fact we need to be vigilant wherever we are in the province. When we're out camping and enjoying the lovely outdoors in our province, we need to, first of all, if we can, dress appropriately and if we are exposed, if our skin is exposed and there's a potential for ticks, we need to check ourselves and we need to do that regularly and we need to pay attention to those things.

 

We have to get involved in our own health care and make sure that we pay attention, whether or not we have a bite, if we have a tick on us, or what have you; and we need to follow up if we find a tick, if we are bitten, if we have one of these bull's eye rashes, for example. There are five areas of the province where we know that the blacklegged tick is certainly there in numbers that we should be concerned about. They are areas around the Gavelton,Yarmouth County area; Pictou County around the beautiful Melmerby Beach, Egerton, Kings Head and Pine Tree; in Lunenburg County around Blue Rocks, Garden Lots and Heckman's Island, First Peninsula; in Halifax County, in Admirals Cove out in Bedford; in Shelburne County, in Gunning Cove.

 

Now, there has been surveillance through the Department of Natural Resources that has helped us identify where these ticks are and we have a tick surveillance program in place but as I said, there could very well be other parts of the province where we have ticks. We have certainly birds and deer that move about the province and could be carriers. There are several areas that have been identified for further field work, including Milton in the Liverpool, Queens County area; Economy, up in Cumberland County; and Maitland in Hants County, and in places in the Truro area. So I think the surveillance program with Natural Resources is continuing.

 

The member asks as well about when we're going to be publicizing tick season and what to do and what to watch for. As we all know, we see now that we're entering into what seems to be the beginnings of Spring, let's hope so, it seems to be a little earlier than usual. So we are planning ads, radio advertisements and other advertisements, and I think one is starting in a very few days, perhaps on the weekend sometime coming, to start the process.

 

What we do is, we do some things at a provincial level, but every district health authority in the province has a medical officer of health who works with Dr. Strang as part of our Public Health program. These folks out in the various district health authorities are the ones who are providing advisories and information into the local media, the local radio stations and what have you. In addition, we work very closely with Doctors Nova Scotia. They have a regular newsletter to their members and when tick season is upon us, we get information into the newsletters of Doctors Nova Scotia and we work closely with them in publicizing information and making sure that we have good, strong communications for public awareness. People do need to be aware that the possibility of being bitten by a blacklegged tick is very real and we need to do as much as we can to protect ourselves.

However, as I said, we also want to increase people's awareness in terms of what they should do if they are unfortunate enough to be bitten by one of these ticks. The department will be working with our infectious disease physicians this year, as we have in the past. In the past we have done webinars, which is a kind of continuing education for GPs around the province, where they can log on for a webinar with the infectious disease physicians here in the Capital District and receive information and have questions answered, and what have you, around the identification and treatment of Lyme disease. These are some of the things we do.

 

We do advise the public of any new risk areas that we identify through the surveillance as soon as we have the evidence validated, and we will continue to do this. The infectious disease doctors here in the Capital District are very familiar with this disease and certainly they provide support to family physicians throughout the province. Thank you.

 

MS. REGAN: I was remiss in not thanking the minister for making those infectious disease doctors available to me. I did meet with them earlier this year and they walked me through some of the process. I am still waiting for a couple of studies that they referenced about the treatment of chronic Lyme and placebos, so I would still like to get my hands on those - not that I would have a clue what they say but I could actually have someone with a scientific background walking me through it.

 

I did want to bring up a couple of quick points around Lyme disease. Certainly what I saw last Fall was that people thought that since the summer was over, they didn't have to worry about blacklegged ticks anymore and they could play football outside, with impunity, in an area known to have blacklegged ticks, and I'm not just talking about the odd tick. You usually go out there and if you were to do a drag test, you could come away with a lot of ticks. My concern is that people don't realize that, in fact, these ticks are active far longer than you would maybe normally think ticks would be active.

 

Another concern I have is that, in fact, the areas are expanding. I know that if you look on-line, the Bedford listing, for example, just says Admiral's Cove. Well the ticks have gone well beyond Admiral's Cove and it's in all kinds of neighbourhoods in Bedford, so I guess I would be concerned that that information be updated because at this point it's not quite accurate from what I can see.

 

We do need to get information out because people just don't seem to be aware of the disease and what its symptoms are. It's funny because a couple of weeks ago I had dinner with a couple of doctors who are here, they came from Winnipeg originally where they had ticks and Lyme disease, et cetera, and they're quite comfortable with it because they grew up with it and everybody knows how you're supposed to act. The problem is that we have not grown up with it and people don't know what to do with Lyme disease and they often don't even realize that that flu-like symptom they have, or that weird rash that they have, means something. So I would encourage the minister to encourage people to get started on that particular information program because I just really feel that a lot of the cases of people who have gone elsewhere for treatment might not have had to do that if they had been caught early and in fact, had the proper treatment at the right time.

 

From there, I was just wondering, I did want to echo my colleague's comments on the foreign-trained doctors. I think there's nothing more heartbreaking than to talk to a doctor from say Iran who has given up her practice, which was a successful practice, to move to Canada because the federal program said to her, oh, we want you, in fact, we're not going to even interview you, you're a doctor, you have a medical degree, you have a thriving practice and you're in. They arrive here and they get the shock of their lives to discover that in fact not only are they not in, they have to start over from scratch. They have to go back to school and there are only a few spots. It's not even like baseball, it's two strikes and you're out, you can't take it a third time. You know, basically this person has moved halfway around the world and my concern is that the federal government is doing one thing, the province has a different perspective. In fact the federal government needs to be told that what they're doing is wrong and they are causing problems for untrained doctors.

 

MS. MAUREEN MACDONALD: Madam Chairman, first of all, I want to go back to the Lyme disease issue and I would like to table the advertisement that will be appearing fairly soon. This advertisement outlines how to check for or prevent tick bites. It's one that the Public Health folks have been working on and, again, it's what will be appearing throughout the province. I have quite a substantial list of initiatives that our government has undertaken over the past year to inform the public of the presence of blacklegged ticks that potentially carry Lyme disease and what have you.

 

I think that perhaps it's just because I'm a country girl at heart and I grew up in the country. So I do just assume that if, in my constituency, let's say there were blacklegged ticks found in Fort Needham, in the north end of Halifax, and I live pretty close to Fort Needham, I would pretty much assume that I don't necessarily have to go up onto Fort Needham to run into blacklegged ticks. I would be thinking about that every time I walked through the Hydrostone but that probably is because I am a country girl and I know how these things kind of work. So I guess that we need to do a lot of information and communicating with people who don't necessarily think about how these things move from one site to another. A dog running up on Fort Needham and then running on the boulevards in the Hydrostone may have picked up and may transport some of these little critters and this is how they travel but I think, you know, the message certainly is that they're here. They're in the province. There are places where we have identified them in sufficient numbers to be concerned in those areas and people need to take precautions and those precautions are kind of commonsensical in a way. They're about how you dress when you go out into areas where the ticks might be and they're about checking yourself after you do that.

 

I'm told that less than 1 per cent of blacklegged tick bites result in Lyme disease and so I think while it is again a serious disease to contract, if that happens, I think we need to put it in perspective and we need to encourage people to do their utmost in terms of prevention and early identification and then seeing their GP. Lyme disease is a bacterial-based disease and it's very easily treated with antibiotics. It's not some unknown kind of infection for which there is no treatment and I think that's really important that we reassure the public that it is something that is treatable and its rate of occurrence is not off the charts, it's very small. We do have to be vigilant, everybody has to be vigilant. Lyme disease is not a reason not to enjoy outdoors either. We really need to go outside and we need to enjoy recreation in the outdoors. I think that's very important.

 

MS. REGAN: I would like to thank the minister for that. I just wanted to say I think this looks very much like the ad that was out last year which I thought was very helpful. I would just like to, sort of as a closing remark because I know that the minister probably wants to get to her closing statement, that a lot of people don't get the newspaper anymore so if there could be a social media component to this campaign, that would be most helpful. Certainly having advertisements on the radio would be helpful as well, because sometimes people get Lyme disease and have no idea they have it and if they don't get the paper, they're not going to know about it. So if we can just not do print ads but include radio and a few other places, that would be awesome.

 

MADAM CHAIRMAN: The honourable Minister of Health and Wellness on closing remarks and to move her estimates.

 

MS. MAUREEN MACDONALD: Madam Chairman, how time flies when you're having fun. I think that there were quite a number of things that I was thinking about saying in my closing statement but I'm not going to. What I'm going to do is table a few documents that respond to questions I was asked. There was a lot of discussion and the honourable member for Argyle was really interested in understanding the full-time equivalent situation in the department, and the way it is in the Estimates Book is confusing, I recognize and acknowledge that. Staff have done a fabulous job of breaking everything out and making it much more understandable, so I table that for the member.

 

I also have a breakdown of where the almost $1 million in new money for dialysis is being spent, last year where it was spent and I'd like to table that for the member for Hants West.

 

The only other thing I would like to say and this is for the member for Cape Breton North, who asked me a question about the Liberation Therapy for MS patients and the clinical trials. He requested information on where the clinical trials were and expressed some disappointment that Nova Scotia had not set aside money as yet to participate in those trials.

 

Just today or yesterday, we received an update from the federal government on where those clinical trials are. The research team that was successful in the application process has been chosen but their research proposal now has to be vetted through an ethical process, to ensure it meets the ethical research standards that all clinical trials have to go through. When that has concluded, the successful research team will be announced.

I have information on that somewhere here in this pile of binders and e-mail. I'll fish it out and table it before we leave here today, for the member. So that, I think, ties up any outstanding questions or issues that were raised.

 

MADAM CHAIRMAN: Shall Resolution E11 stand?

 

The resolution stands.

We're approaching the moment of interruption so we will now rise and report progress to the House.

 

[5:58 p.m. The committee recessed.]

 

[6:30 p.m. The committee reconvened.]

 

MADAM CHAIRMAN: Order, please. The Committee of the Whole House on Supply will come to order.

 

The honourable Government House Leader.

 

HON. FRANK CORBETT: Madam Chairman, could you please call the Estimates for the Department of Economic and Rural Development and Tourism.

 

Resolution E4 - Resolved, that a sum not exceeding $187,353,000 be granted to the Lieutenant Governor to defray expenses in respect of the Department of Economic and Rural Development and Tourism, pursuant to the Estimate.

 

MADAM CHAIRMAN: The honourable Minister of Economic and Rural Development and Tourism for opening remarks and perhaps if he has the time to introduce the staff who are with him today, thank you.

 

HON. PERCY PARIS: Thank you Madam Chairman and it's nice for me to rise this evening and talk about the estimates for Economic and Rural Development and Tourism. However before I do proceed, I've been requested on behalf of the Minister of Health and Wellness, she mentioned during her estimates that she would like to table something and I will table that on her behalf.

 

Thank you for the opportunity to speak about this year's budget for Economic and Rural Development and Tourism and the valuable work that's being done by our staff. I am pleased to have several colleagues with me here today. I am joined by Simon d'Entremont, the new Deputy Minister for Economic and Rural Development and Tourism, and Joyce McDonald, Director of Finance.

 

There is also a number of senior staff from the department and our agencies in the gallery this evening. I'd like to welcome Stephen Lund, President and CEO of Nova Scotia Business Inc.; Colin MacLean, President and CEO of the Waterfront Development Corporation; Scott Ferguson, President and CEO of Trade Centre Limited.

 

Of course, not all of the staff can join us here this evening in the gallery. However, our department is served by dedicated and hard-working people in branches which include Investment In Trade, Regional Planning and Development, Productivity and Innovation, Tourism, Procurement, Policy and Planning, the Nova Scotia Gateway Secretariat and, of course, supported by Finance, Human Resources and Communications. I want to take a very brief moment to thank each and every one of them for their hard work and their dedication to Nova Scotians.

 

Not too long ago, Nova Scotia was facing a bleak economic future, twenty years of slow economic growth behind us now, and an inability to keep up with the changing global market. Today we find ourselves in a much different situation, a positive situation, a situation that breeds optimism for the future of Nova Scotia. Our province now finds itself on the cusp of some new, real game changers that have the potential to create a better future for all Nova Scotians, opportunities that will enable this province to face the future with confidence.

 

These game changers are: the development of hydroelectric power out of Lower Churchill; the construction of the Maritime transmission link, linking power from Lower Churchill to Nova Scotia; the dredging of Sydney Harbour and development in the Port of Sydney; the commitment of Shell Canada to explore Nova Scotia's offshore and, of course, the federal shipbuilding contract. These are unlike any that we have ever seen before. While we ramp ourselves up for the undoubtedly exciting times ahead and prepare to take advantage of these opportunities, we also recognize that some industries face challenges in remaining competitive.

 

Over the last year the NewPage mill in Point Tupper and the Bowater mill in Liverpool have faced difficult financial times and an uncertain future. The province naturally banded together to offer help and support to the forestry industry. We authorized $23.75 million for the land purchase of Bowater Mersey and a $25 million forgivable capital loan for energy efficiency projects. We also authorized $1.5 million for employee training through the Productivity Investment Program. For NewPage the province authorized $26 million for the Forestry Infrastructure Fund to support the wood supply chain.

 

We are committed to helping the forestry industry and this budget helps us to take on these challenges. The 2012-13 budget for Economic and Rural Development and Tourism is $187.3 million. This is an increase of $61.74 million over the 2011-12 departmental budget. This increase is primarily due to an increase in the Nova Scotia Jobs Fund and an increase in funding to further implement jobsHere. This year our department has a total of $72.58 million for the Nova Scotia Jobs Fund. This budget will be used to assist the forestry industry in Nova Scotia, helping to support thousands of forest jobs and help grow the economy in rural communities. The Nova Scotia Jobs Fund will also be used to support opportunities in shipbuilding, opportunities in fisheries, and opportunities in manufacturing. This will create good jobs and grow our economy.

 

An industry that will require a lot of attention is, of course, shipbuilding and the many professions and sectors that will support the federal shipbuilding contract. These shipbuilding contracts represent the single most important opportunity Nova Scotia has ever seen to create jobs and propel our economy into the future. Just last month government was finally able to announce the role the province played in the success of the Irving bid. As part of Irving's successful bid and in order to ensure jobs, training and spinoffs for Nova Scotians, the Province of Nova Scotia committed to invest more than $300 million in Irving Shipbuilding over the next 30 years.

 

This was the single largest investment in jobs and growing the economy in Nova Scotia's history. This financial assistance package includes a forgivable loan worth up to $260 million and a repayable marine industry loan worth $44 million for human resource development, technology and industrial development. This represents just 6 per cent of the tax revenue the province expects to receive in return. This investment will produce a return on investment for the province that will generate billions of dollars for taxpayers. Without this investment, we would not be facing 30 years of sustainable jobs for thousands of Nova Scotians and spinoff opportunities for many more of us not directly involved in shipbuilding.

 

As part of the agreement, Irving Shipbuilding will contribute $250,000 a year over the next 30 years. This will support the Irving Shipbuilding Centre of Excellence at the Nova Scotia Community College. This investment will help train and retain the best shipbuilders in the world and will provide information on careers in shipbuilding with an emphasis on recruiting and training Aboriginals, visible minorities and women. The province will also work with Irving to develop an early apprenticeship program and a 10-year workforce plan to ensure that Nova Scotians are aware of future opportunities. Our education and training institutions are now in a position to plan and deliver on relevant training.

 

We have reason to celebrate in this province, not just because of opportunities such as the Irving bid, but because today we have an economic plan in place that will help take advantage of these game changers to the best of our abilities. jobsHere, the plan to grow our economy, has been in place for over a year and we have seen the results. We are making great strides in helping businesses all over the province to succeed and to prosper. With jobsHere, hundreds of businesses from Sydney to Yarmouth have become more innovative, have become globally competitive and have trained their employees. With the help of jobsHere we are on a positive path. Nova Scotia has the lowest unemployment rate in Atlantic Canada. Compared to this time last year, Nova Scotia employment is up by 3,300 jobs and the Department of Finance's numbers indicate that the year-to-date unemployment rates for every region are below what they were last year.

 

Furthermore, our budget's economic forecast for just the unemployment rate will continue to fall. Because of jobsHere, government has the flexibility to respond to changes in economic conditions. We have the ability now to capitalize on opportunities such as Irving. In addition, we will continue to work with the economic development agencies and their partners within and outside of government to achieve these priorities.

 

Last year under jobsHere, Madam Chairman, the province launched a series of strategies and initiatives to help businesses and individuals succeed. This year the focus will be on putting the strategies into action, which requires additional funding. Part of this action includes programs such as the Nova Scotia Business Development Program, the establishment of the major investment and projects team, the Productivity and Innovation Voucher Accelerated Program, the Cooperative Graduate Placement Program, and so many others.

 

One of these other programs is the Productivity Investment Program, or more affectionately, as we call it, PIP. Through PIP the province has helped businesses in every region of the province become more productive, become more innovative, to be more globally competitive and skilled with investments and capital in workplace training. The forecast update saw $16 million committed for PIP funding in capital and workplace training for 2011-12. The workplace innovation and productivity skills incentives stream of PIP helped more than 6,300 Nova Scotian employees to get better trained last year while the capital investment and incentive stream of PIP saw $11.6 million of government funding leverage $52.4 million in new capital investments. It was companies such as Copol International Limited, Oxford Frozen Foods, TecBox International Limited, Galloping Cows Farm Market and Fine Foods, and Cook's Dairy Farm that benefit from these investments.

 

Madam Chairman, because of PIP, an Amherst-based manufacturing company, PolyCello, will become more efficient and become more competitive in the global economy with a PIP investment for innovative new equipment. Through PIP the province is able to contribute $1 million towards the purchase of a 10-colour printing press, allowing PolyCello to become more efficient and attract new customers. The province is also investing $90,600 for additional cost-saving equipment. The total value of the upgrade is almost $9 million.

 

In addition, a metal fabrication shop, Mulgrave Machine Works in Guysborough County, will receive $96,541 through PIP to update equipment and train workers. The company will receive $85,791 from the Capital Investment Incentive stream of PIP for a new metal cutting machine, allowing specialized design cutting with more control and greater accuracy. The equipment will be used to meet the needs of clients in Canada, Cuba and Brazil. Mulgrave Machine Works will also receive $10,750 from PIP's Workplace Innovation and Productivity Skills Incentive for training to manage human resources more effectively.

 

Madam Chairman, this year PIP will receive a total of $25 million, helping more businesses make upgrades in machinery, clean technology, software, hardware and employee skills training. Budget 2012 is helping Nova Scotia businesses to be more competitive globally. With the help of an additional $1.55 million this Spring, we will launch the International Commerce Strategy. This is a strategy that will help us more effectively support the needs of businesses engaged in international activities. It will also increase the amount of two-way flow for trade, investment, skills, ideas and innovation in and out of Nova Scotia.

 

Great international work is already happening in Nova Scotia. We want to support these companies. We want to support them in being globally competitive and encourage other companies to do the same. This strategy will align Nova Scotia's trade and investment policy, program activities, and research priorities, with the needs of internationally trading companies and it will give a broader level of support to firms looking to enter the international market.

 

Madam Chairman, this budget also helps new graduates secure jobs right here in Nova Scotia. With $400,000 to implement the new Cooperative Graduate Placement Program, this program gives our students another reason to stay in Nova Scotia after graduating, by helping them secure good jobs. The program will provide a 50 per cent wage subsidy for the first three months of employment, up to a maximum of $7,500. The program is expected to support 50 job placements in 2012-13. The program encourages employers to hire recent co-operative education graduates in high demand areas. It gives graduates the chance to develop the skills they need for good jobs; that is what jobsHere is all about.

 

Madam Chairman, we have seen great success through our Productivity and Innovation Voucher Program, which helps build and strengthen links between small businesses, universities and colleges. Last year, 35 Nova Scotia businesses took advantage of this program. Those businesses are now working with universities and colleges to increase their productivity and to be more innovative.

 

To build on the success of this program, we piloted the Productivity and Innovation Voucher Accelerated Program. This gives previous voucher recipients $25,000 to access expertise at universities and colleges, to further increase their productivity and their innovation. The vouchers will help the recipients explore new business opportunities, explore existing products and to refine their operations. This year the Productivity and Innovation Voucher Program will receive an additional $500,000, which will assist even more Nova Scotia businesses.

 

Madam Chairman, we've implemented the Nova Scotia Jobs Fund, which will help government pursue regional economic initiatives, support programs that provide assistance to small businesses, provide community economic sustainability where needed and support investments in businesses, such as the thousands of jobs we're supporting at Bowater and Irving Shipbuilding.

In December, Madam Chairman, we launched a one-stop-service for businesses looking for economic development programs and initiatives. Business.novascotia.ca is a Web-based entry point to a broad range of economic development programs and services. It simplifies navigation and provides more efficient access to government programs, services and information for businesses in Nova Scotia and to those interested in investing in the province and growing our Nova Scotia economy.

 

Madam Chairman, while this is a tremendous first step, we are working to build on the site, to add more functionality and information for businesses. Budget 2012 will continue to support business.novascotia.ca to create an integrated approach to economic development for businesses with $350,000 this year alone. This year's budget also gives $200,000 to develop a social enterprise strategy, which will support communities and businesses and enhance their contributions to Nova Scotia's economy.

 

This government has also committed to provide loan guarantees for social enterprise with a pilot of up to $2 million. This two-year pilot program will provide a loan guarantee of 90 per cent up to $150,000 for social enterprises through the network of credit unions and will be administered by the Nova Scotia Co-operative Council. The province's Community and Economic Development Investment Funds, or CEDIF, raised capital for a variety of interesting ventures throughout all of Nova Scotia. CEDIFs help keep investment dollars working in our Nova Scotia communities. They support locally produced products and services, create jobs and stimulate economic growth.

 

Madam Chairman, last year Nova Scotians supported local communities and businesses by investing more than $7.5 million in CEDIFs. CEDIFs do encourage innovation, entrepreneurship and productivity throughout the province by allowing Nova Scotians to keep investment capital in their own local communities. A great example of this is the Colchester-Cumberland Wind Farm, which has been able to raise shared capital through the province's CEDIF program. Since 2007 the company has been able to bring in more than $1.2 million for the development of its wind field and the CEDIF tax credits have allowed the wind field to reach even more investors from across the province.

 

Madam Chairman, last year our department, along with Labour and Advanced Education, launched the Workforce Strategy, an initiative of jobsHere. The Workforce Strategy lays out how the province will support Nova Scotia's workforce to develop the right skills for good jobs. In essence, the Workforce Strategy is about connecting people to opportunities to increase their skills, to increase their learning and training so that they can be ready for the jobs of the future.

 

Madam Chairman, over 40 small businesses in Nova Scotia continue to thrive with help from the Nova Scotia Business Development Program. Last year the program, which encourages small business start-ups and helps existing businesses to expand, contributed a total of $300,000 to businesses in every region of the province. Economic and Rural Development and Tourism responded to the high demand for the program by increasing the funding that was available since its inception. Government will increase the fund to a total of $540,000 for the 2012-13 fiscal year.

 

Madam Chairman, it has been a year since this government implemented the procurement governance initiative, an initiative that will ensure all public sector entities such as hospitals, schools, municipalities and government departments work together to get best value for the goods and services that they buy. We estimate that public sector entities procured more than $2 billion during 2011. The Public Procurement Act allowed the province to develop a new procurement governance structure, including a chief procurement officer for the province. In addition, a procurement advisory group of public procurement professionals throughout the province has been created to identify efficiencies, share best practices, and implement greater standardization.

The Act also mandates supplier debriefing sessions, a common vendor complaint process, a code of ethics for all public procurement professionals, and posting tender notices, winning bidder, and award amounts on-line. All of these things lead to even more transparency within our government. The provincial government procurement initiative helps advance the priorities of jobsHere. It gives more opportunities for local businesses to develop the skills necessary to apply for public sector procurement, better preparing them to compete globally.

 

We have the Community Access Program, or CAP, which remains a valued resource in our rural communities. There has been recent discussion concerning cuts to this program in relation to the federal government's contribution. I am here to reiterate today that the province will keep its commitment to provide $348,000 in funding to CAP sites. We are currently evaluating what the lack of federal dollars could mean for that program. We will be working with the communities and our stakeholders to determine the best way forward.

 

Our productivity and innovation division remains hard at work creating and delivering programs and initiatives to help Nova Scotia businesses succeed and thrive. The province is close to launching a new productivity and innovation strategy. This will ensure that the activities and investments of government, along with those of key partners in the province, are coordinated and focused on our common goal of supporting innovation and productivity to grow our economy.

 

During the last year, we also continued to work on detailed research and analysis of high-growth sectors so that we have the information we need to leverage opportunities within them. To date, we have completed studies in the ocean technology and financial services sector and we will continue to work with others, including information, communications, technology, aerospace and defence, and clean technology.

 

In addition, the productivity and innovation division continues making valuable investments through the Nova Scotia Research Innovation Trust. This trust matches funding from the Canada Foundation for Innovation. In the last 10 years the trust has supported more than 340 projects with over $66 million in funding to Nova Scotia institutions that receive national research funding. The trust funds have brought more than $100 million in additional investments in Nova Scotia-based research. The most recent investment was $1.8 million in a $4.1 million world-class research project to develop high-performance, low-cost lithium batteries. The research has strong commercial potential in the automotive, medical, and power storage industries.

 

Our trade team continues its efforts to profile Nova Scotia's interest in the ongoing negotiations of the Comprehensive Economic and Trade Agreement, CETA - certainly with the European Union. We are working with experts. We are working with businesses and interest groups to fully understand what is in the best interest of all Nova Scotians. The European Union is a long-standing and important partner in Nova Scotia's international trade and investment. We look forward to enhancing that relationship through these negotiations.

 

Madam Chairman, helping rural Nova Scotia grow and prosper remains a priority for this department. In December we announced strategic new investments in the creation of an economic council in southwest Nova Scotia. This regional economic council is supported by the provincial and federal governments and by eight municipal governments, with a provincial contribution of $142,000. This new council will work to attract, expand, and retain businesses all throughout southwest Nova Scotia. Through the direction of jobsHere, the council will guide economic development in the area, build trust and collaboration among partners, and collaborate on a longer-term regional economic development structure.

 

I would also like to speak to the important work done by the regional development authorities, more commonly known as RDAs. RDAs work across the province to bring leadership. They help spur economic growth and development to their respective regions. They help with business start-ups, identify opportunities, and support the retention and the expansion of businesses in all areas of Nova Scotia. Nova Scotia's RDAs plan and deliver regional development strategies and action plans that further the development of their communities. To ensure ongoing accountability, RDAs participate in mid-year reviews and annual audits. The evaluations contribute to the ongoing improvement of these organizations so that they can maximize their contributions to their communities.

 

Our department's Regional Planning and Development Division employs field staff across the province to work with RDAs and to work with businesses and community organizations to foster economic development opportunities. Through Regional Planning and Development, ERDT invested over $7 million in businesses, economic development partners, and community organizations in 2011-12. This investment represents a direct, significant contribution to growing Nova Scotia's economy where it matters the most: in the community.

 

In addition to all the valuable programs and initiatives we have to help Nova Scotians, we recognize that a key part of boosting our economy lies right here within the province itself. Nova Scotia tourism is a $1.8 billion industry, an important economic driver in the province, and a key source of employment for Nova Scotians in every region. The industry helps support more than 22,000 direct jobs and generates provincial tax revenues of $126 million, which supports essential services such as health and education.

 

The majority of the Tourism Division's $25.5 million budget goes directly toward product development, branding, marketing, partnerships, and the provincial visitor information centres to build Nova Scotia's tourism industry. With prudent fiscal management, the Tourism Division continues to develop innovative ways to attract visitors to the province from key markets, including Ontario, the United Kingdom, Germany, and the northeastern United States. These places have been identified through comprehensive research on the part of ERDT.

 

Key tourism indicators of 2011 were on par with 2010 and varied by region. These figures are comparable to other jurisdictions in this challenging economic environment, but let it be known, Madam Chairman, that we are not satisfied with these results. Through the new Nova Scotia Tourism Agency, the province is taking a new approach to tourism. We are working in partnership with the industry to create a long-term strategy for the sector that will promote innovation and competitiveness as part of government's jobsHere plan to grow our economy. The Nova Scotia Tourism Agency will fall under the current budget of Economic and Rural Development and Tourism. The interim board and Tourism staff are working hard on a number of measures to ensure we meet our objectives. Government and industry have been working in true partnership through the long-term strategy committee of the interim board. They're putting in many volunteer hours to analyze the results of our industry feedback and to develop a strategic framework.

 

We have reached out to tourism stakeholders and business leaders throughout the province. We are receiving feedback on strategic ideas that will help build the industry and allow Nova Scotia to reach its fullest capacity. We have been conducting a national executive search for a CEO to lead our new agency, one who can successfully design and implement the Nova Scotia Tourism Agency's final structure and exercise the strong, committed leadership the industry needs to build the sector.

 

We have a request for proposals for a tourism agency of record to help the province identify a strategic marketing partner, one that will offer flexibility and potential savings and ensure the Nova Scotia Tourism Agency has the marketing support it needs to implement the annual tourism plans. We are also in the process of establishing a permanent board for the new agency, one that will attract a high calibre of industry and business leaders and work to ensure that Nova Scotia's tourism industry is highly competitive and brings economic benefit to the Province of Nova Scotia.

 

This is an exciting time for Nova Scotia. Our time is now. Nova Scotia has been named a top global destination in 2012. Our natural assets, paired with an outstanding summer of major events, make this the year to come and enjoy everything our beautiful province has to offer. We are getting set to host some amazing festivals and events this year, including the return of the Tall Ships Festival; the relaunch of a Canadian icon, Bluenose II; the award-winning Celtic Colours International Festival; and the TELUS World Skins Game, just to name a few.

 

We know, Madam Chairman, that our greatest asset is our people. The warm, friendly spirit of Nova Scotians is what keeps bringing our visitors back again and again. This year we are encouraging all Nova Scotians to participate in the Visit My Nova Scotia program. We want every Nova Scotian to be an ambassador and ask their friends and relatives from around the globe to come visit. The Visit My Nova Scotia program stems from our national pride in our spectacular province. We have so much to offer and we want to let the world know that now is the time to come to visit Nova Scotia.

 

Of course, there is the important work of our agencies. I will start off with Nova Scotia Business Incorporated, the province's business development agency. NSBI is governed by a board of directors made up of business leaders from various industries and regions throughout the province. The agency has four client-focused business units: business financing, trade development, venture capital, and investment attraction. NSBI helps Nova Scotia businesses and it introduces Nova Scotia to the world. NSBI attracts global investment into Nova Scotia. The agency is client-centred, strategic, and proactive, growing key sectors of our economy with the Department of Economic and Rural Development and Tourism and with many, many other partners throughout the province.

 

Over the past year our companies with NSBI have done business in 47 countries, places like the Caribbean, China, India and Israel. Just in recent months NSBI and its partners led trade missions to the United Arab Emirates, Qatar and in the Caribbean. As for trade shows, they brought Nova Scotia companies to Oceanology International and the Game Developers Conference, just to name a couple. In the next few months NSBI and its partners are headed to Germany for one of the biggest biotechnology shows in the world. It is seeing first-hand the linkages our global focus companies are making on the world stage.

 

Madam Chairman, I'm proud to say homegrown successes in the companies attracted to Nova Scotia are providing high-paying, world-class career opportunities for young Nova Scotians. They are generating new tax dollars and helping build a stronger economy. They are bringing our expats home and we know Nova Scotia has the ingredients to compete. In a recent KPMG report, Halifax ranked number one among Canadian and U.S. cities in four industries: precision component manufacturing, software development, video game production, and international financial services.

 

Madam Chairman, this is great news for Nova Scotia. Through the work of NSBI, Nova Scotia is gaining recognition as a growing global financial services centre and in 2012-13 NSBI will continue to focus on proactivity, attracting new investments into the province. They will do this through foreign direct investment, strategic partnerships, domestic business growth and expansion, and generating awareness about Nova Scotia. Looking ahead, by growing our domestic supplier base, we can facilitate partnerships with our anchor companies and leverage these strengths to attract more investment.

We are seeing existing companies go further. We are seeing Nova Scotia companies working with us in investing to be more productive, to be more innovative and to be more competitive. Madam Chairman, we also have another one of our agencies, InNOVAcorp. As Nova Scotia's early stage venture capital organization, InNOVAcorp plays an important role in the province's jobsHere plan. The young, knowledge-based companies that InNOVAcorp invests in and assists are innovative and globally competitive and they create good jobs. These start-ups are vital to growing our economy. In 2011-12 InNOVAcorp refined its business model to ensure all activities are investment led, which ultimately improves the support provided to early-stage, knowledge-based companies.

 

We all know capital is the lifeblood of any early-stage company. Along with capital investment, InNOVAcorp provides tailored, hands-on business guidance and mentoring to the companies it invests in. It also offers world-class incubation services and facilities, places that Nova Scotia's technology entrepreneurs can call home. Last year, through InNOVAcorp, the province made CEED investments in eight promising technology companies. With these new additions the province's Nova Scotia First Fund now has 19 investments under active management.

 

Several of InNOVAcorp's recent investments were made through the new $24 million clean tech fund that targets Nova Scotia's clean technology sectors. These sectors have potential to improve our economy, to improve on our communities and on our environment. The new fund has come at a time of ever increasing international demand for clean technologies and solutions and we look forward we look forward to helping bring Nova Scotia's green innovations to the marketplace.

 

Last year, Madam Chairman, InNOVAcorp also launched the Nova Scotia Clean Tech Open, an international competition to find and fund highly potential, early-stage clean technology companies. The competition also puts a spotlight on Nova Scotia. It puts the spotlight on Nova Scotia as an ideal location for these companies to grow. The goal is to attract the best clean technology companies in the world to Nova Scotia. The winner of the Clean Tech Open will be announced within the next few weeks.

 

InNOVAcorp also ran a provincial I-3 Technology Start-Up Competition in 2011-12. The competition's goal is to find and support early stage Nova Scotia knowledge-based companies and encourage entrepreneurial activity right across the province. Since the pilot in 2006, the competition has received a remarkable 414 start-ups - 414 start-up submissions - reflecting the high level of entrepreneurship right across the Province of Nova Scotia. In the most recent competition, InNOVAcorp attracted a record breaking 142 submissions from across Nova Scotia, from Chester and Lawerencetown to New Glasgow and Cheticamp. This year the overall provincial I-3 winner was NovaMed, a start-up biotech company founded by a Dalhousie University scientist and operating out of a new laboratory at the IWK Health Centre.

 

InNOVAcorp also continues to play an integral part in the creation of the regional venture capital fund. This government, along with New Brunswick, has each committed $15 million towards the creation of this new privately managed fund which will target opportunities throughout Atlantic Canada. InNOVAcorp has been working on behalf of the two provinces to set up the fund and secure additional investors. Through InNOVAcorp we are also working to strengthen the capacity to commercialize Nova Scotia's post-secondary research and increase entrepreneurial activity at our universities and colleges.

 

The knowledge economy, Madam Chairman, plays a critical role in the future prosperity of this province. InNOVAcorp's work to increase innovation, entrepreneurship and business success stories in Nova Scotia is an important part of jobsHere - our plan to grow our economy.

 

Madam Chairman, Trade Centre Limited, TCL, creates economic and community benefits by attracting people to Halifax and to Nova Scotia. Their ability to connect people through events contributes to a prosperous provincial economy. In 2012-13 TCL is committed to ensuring that the events it hosts drive economic activity in Nova Scotia with an estimated 750 events that will be result in $70 million in direct expenditures. This year TCL expects to generate combined operating revenues, for Trade Centre Limited and the Metro Centre of $20 million from a broad range of events.

 

As strategic events approach, we'll align event attraction activities with Nova Scotia's key growth sectors with a focus on attracting international convention activity in the oceans and life science sectors where Nova Scotia is recognized as the leader. A province-wide event attraction by Events Nova Scotia will continue again this year. In 2012 Halifax will host the TELUS World Skins golfing event while Yarmouth will host the World Junior A Hockey Challenge. Key major events or bids will include the 2014 World under-17 Hockey Challenge Cape Breton;, 2013, Skate Canada International in Halifax; and in 2014, Canadian Figure Skating Championships in Halifax. With its partners and through its activities, TCL will continue to promote the growth of Nova Scotia events sector to drive the economy. This will benefit the entire region.

 

Madam Chairman, we also have Film Nova Scotia. Film Nova Scotia grows the audio-visual industry here in Nova Scotia, it grows it by supporting local producers and promoting the province as a premier filming destination internationally. The corporation offers loan and investment programs to support audiovisual production in Nova Scotia, it administers the Nova Scotia film industry tax credit. This credit, which ranges from 50 per cent of eligible labour for film in HRM, to 60 per cent in rural Nova Scotia, is one of the highest in Canada. It makes Nova Scotia an attractive shooting destination.

 

Film Nova Scotia, Madam Chairman, provides equity investment, provides development in marketing programs to the local audiovisual industry. These programs enable the industry to leverage funds available through federal programs, such as Telefilm Canada and the Canada Media Fund and private sources, such as broadcasters, distributors and investment funds. In addition, the corporation offers production services, including a locations resource and reference centre and supports professional development, training, marketing and distribution for the Nova Scotia audiovisual industry.

Film Nova Scotia strives to create new opportunities for producers in the province. In 2011 Film Nova Scotia entered into an exciting new partnership with Eastlink TV to fund Nova Scotia-based television production. Eastlink committed an initial amount of $1.3 million and is expected to annually contribute approximately $700,000 to the fund. Nova Scotia generated approximately $100 million in production activity in 2010-11. This marks an increase in production over the previous years.

 

Madam Chairman, we have the Waterfront Development Corporation which just completed its 18th consecutive year of generating a financial surplus from its operations of waterfront properties in Halifax and Lunenburg. During this time the surpluses have enabled waterfront development to invest more than $30 million in public infrastructure. This infrastructure has led to the Halifax and Lunenburg waterfronts becoming the two most visited destinations in the Province of Nova Scotia. Waterfront development is moving development forward on the waterfront in the capital region and in Lunenburg. The Cunard block mixed-used development on the Halifax waterfront will see construction commence next year.

 

In Dartmouth, the design for mixed-use residential building on the property known as WDC1 is almost complete and waterfront development in HRM are partner to develop a comprehensive plan for Dartmouth Cove. On the Bedford waterfront, the $30 million residential commercial waterfront development known as Dockside Development is well underway.

 

The work of Waterfront Development Corporation will continue to leverage strength on all waterfronts for economic advantage and the enjoyment of all Nova Scotians.

 

Madam Chairman, as you can see, we have made great strides in helping to propel Nova Scotia from a stagnant economic outlook to a vibrant, growing and competitive province. Through jobsHere, the province has invested in hundreds of businesses in every region of the province. Our various programs and our investments are working to create a better provincial economy with businesses that are more innovative, businesses that are more productive and businesses that are globally competitive.

 

Madam Chairman, this budget will help us stay the course in helping Nova Scotia businesses excel. This budget will help us create the right economic conditions for growth and prosperity. This budget will help us take advantage of the great economic prospects that are before us, prospects that will change the trajectory of this province.

 

I look forward to another year of jobsHere, another year of building our provincial economy and another year of great opportunities for this province. Thank you, Madam Chairman. With that, I will take my place and I will be more than happy to take any questions directed my way.

 

MADAM CHAIRMAN: The honourable member for Glace Bay.

MR. GEOFF MACLELLAN: Thank you, Madam Chairman, and I certainly want to thank the minister for his opening comments. There are lots of interesting things there that certainly we'll get into, in quite a bit of detail, over the next few minutes and into tomorrow and next week.

 

I'd also welcome Simon and Joyce to the House for the estimates process. It'll certainly be interesting and I'm sure you'll have lots of things to add to the debate, for sure. I'd also welcome Stephen Lund from NSBI and the department staff that are here. I can't see them so I don't know for sure but I'll take your word for it that they certainly are up there.

 

I really am looking forward to this process. It's a sad thing to say that I was actually excited going through the line by line for the budget because this is what I do. Some things I'm not so comfortable with when it comes to topics and discussions and debates. But when it comes to economic development and it comes to jobs - certainly coming from Cape Breton and knowing the challenges that we've had in those departments; it's a provincial issue certainly, not just a Cape Breton issue, but looking at those things and trying to figure out what the best decisions are with the taxpayers' money is something that I'm definitely looking forward to.

 

You know we talk about these things politically when we're in the Legislature, Madam Chairman, and you kind of forget sometimes that first of all we're talking about taxpayers' dollars and being stewards of those dollars. When you really look and dissect these budgets, it's a lot of money, $187 million for economic development initiatives that certainly are there to provide stimulus and keep the economy moving and certainly growing but they are taxpayers' dollars. What I see, without question, is this is a vital link in this department and how these dollars are spent is the difference between keeping families here and not. We all know the Fort McMurray stories, everyone has one, but for us certainly in Cape Breton and in Glace Bay, it seems like things are only getting worse and those two on/two off and those "21 and nine" trips to Fort Mc and Kearl Lake and all over Alberta and the West, seems to be an easy choice for people. That's an unfortunate thing that I hope we can halt, as a provincial government, and this is where the rubber hits the road, if you will.

 

Things are great in Halifax and the minister mentioned several times since I've been here and certainly in the last little bit and this evening about the ships contract. The Lower Churchill project which will run ashore in Cape Breton and the offshore work being performed by Shell - all great things. Again, anything that stimulates the economy and adds to the economy, we're all for and it's a stimulant, no doubt and as they say, the economic studies and the economic information would suggest you have to have a strong capital. Halifax is absolutely booming, it's a great city, we're all proud of it, had the fortune to be here a lot as a kid, playing sports, went to school here at Dal, so it's a pretty great place and we love it here and even now, as a MLA, I hate to leave Glace Bay but it's nice to come to Halifax and enjoy what it all has to offer.

 

The reality is, and I know that it's always a political conversation and political argument, but the rural areas are struggling. Cape Breton is one, Yarmouth is the other, but you take any of the counties in any region of the province, we're losing our people. That's an important thing to remember and we have to make sure we do things for Yarmouth and for Digby and for Pictou and for Antigonish and Cape Breton to make sure.

 

The minister mentioned early in his comments about jobsHere when talking about his plan, that we're seeing the results. We use those expressions and we use that rhetoric sometimes but at the end of the day, it is difficult, again. Outside of Halifax we're not growing jobs and things aren't taking place as the minister suggested in his opening comments. Those employment numbers, if you look at the provincial average, Halifax is less than the national average. That obviously weighs down what our provincial numbers would be for unemployment. When you look at the regions, those numbers fluctuate. I've been looking at those numbers monthly for the last three or four years and I think anyone that looks at those would agree they go up and down. They're cyclical.

 

Obviously there's a part-time job - and that's what we've been experiencing here as a province, there are a lot of part-time job stimulation and injections but obviously they're part-time jobs. They're the type of things that affect those numbers and so I don't think they're the kind of things where we want to rest on our laurels and hang our hat on the fact that numbers may drop by a percentage point in one region or the other.

 

Again, this is something that keeps our kids here and it's $187 million, a significant piece of the provincial coffers and the provincial pie. The minister and I have had many conversations about this publicly, certainly in Question Period, about the need for job targets. We'll get into some of the initiatives that are used by the Department of Economic and Rural Development and Tourism to stimulate and to support business and those types of things.

 

I certainly do have questions and I have concerns around how you go about making an investment when there are no specific job targets. I've used this analogy many times in the Legislature but if you're a private business, if you're a start-up - I know there are line items for entrepreneurs and for innovation and those types of things, start-ups, and again we'll get to those in detail, but no business, no entrepreneur goes to a bank without a business plan. I've been there myself, I understand how these things go and you don't get that money without showing your financials, showing your growth, showing your opportunities.

 

If you're showing financials, obviously you have human resources built into those so obviously you can create - you don't have to have a specific number as a province and hit that number, that doesn't become your ceiling or your floor, it just becomes a range of jobs. If you're investing $187 million, as we are here with Economic and Rural Development and Tourism for the 2012-13 year, then naturally we've got a way to create a range. If we hit that range we've succeeded as a department and if we haven't then obviously there are questions.

I think as we get into discussions about the estimates and where the money is going to be, where the jobs are going to come from, I think that's an important conversation to have. I certainly look forward to some of the minister's reactions on that stuff with the help of the department officials who are here and who are absolutely - to say it up front - who are the people who are on the ground for the province. Their job isn't political, their job is to create employment for people in this province. That's an important thing. I certainly do look forward to hearing the minster's candid comments when we're outside of the politics of the question period and we're just talking as two people who are concerned about the economic future of our province - what he really thinks and where he thinks we can grow, where he thinks the ideas are.

 

The minister mentioned on a few occasions about opportunities and regional opportunities. That's the thing that I support and I think is so critical to this process and to the Economic and Rural Development and Tourism Department. Every region has opportunities whether it's Yarmouth or the South Shore or it's central Nova Scotia, the Eastern Shore, Cape Breton of course. We have opportunities and one of those, the opportunities for Cape Breton, we have the port which has been a hot one. I remember during an economic forum a few months ago it was an incredible thing that Provincial Energy Ventures, without any public dollars, invested $75 million into that port. For us that's a great sign.

 

Does the Sydney port have to compete with Halifax? Absolutely not. Does the Sydney port have to augment Halifax? It would probably be beneficial, depending on what we're talking about here, but I think if you look at the model for the Sydney port and what it offers, in contrast, the Halifax port is certainly in contrast to the Melford terminal. I think we're looking at bulk carrying and commodities and that makes sense.

 

The amount of jobs the Halifax Harbour has and the Halifax port system, it's massive. Sydney's never going to be there but that's okay because if there were an extra 50 jobs into the Cape Breton economy, they're significant. If it's an extra 100, that's even more significant. These things are opportunities that we have that we certainly have to take advantage of.

 

Another interesting number the minister mentioned was $1.8 billion, with a 'b', that's the tourism injection here in this province. Tourism, to everybody, is one of those pillars of kind of what we are. From end to end of this province, we have beauty, we have history, we have culture, we have incredible landmarks, things we've done. My own neighbourhood was the initial site of Guglielmo Marconi's first trans-Atlantic message in 1902. So I grew up - we used to go up there and shoot pucks off the side of the monument, not knowing really what it meant.

 

I'm rambling too long here, I'm getting too honest, but as you get older and you kind of understand what these things mean and their significance, it's an incredible thing. We've got tremendous opportunities. Tourism is certainly going to play a key role but to be perfectly honest, I know there are some steps being made and certainly within the budget, which we'll get to line by line and then sort of the philosophy later - the fact that tourism is so important but from my experience and understanding, tourism operators and tourism agencies all over the province, they're not feeling that love. They feel they can do more and they feel there are opportunities left on the table, if you will, for growing our economy, growing that vehicle traffic, growing the visits to all regions of Nova Scotia. That's important.

 

I think that's where your research comes in. You have to have that primary research and figure out where people are coming ashore - whether it's through New Brunswick, Newfoundland and Labrador, whether it's by air. Whether the impact of the Yarmouth ferry - which I really do- I know the department has undertaken a tourism strategy that moved it around to talk to community stakeholders to try to figure out what things were important to them. I have a pretty good feeling based on the few that I attended that the Yarmouth ferry's going to come up pretty high.

 

I know that the government - we disagree, probably on what the vessel is, it's kind of turned into that The Cat wasn't the right boat. If that's the argument then so be it, but I don't think we've had the heavy research to show that investment wasn't worth what it brought in. We'll have that conversation certainly. I'm not here to turn this into an argument already but I think that's one that's important. Economic and Rural Development and Tourism, obviously they're critical pieces that go hand in hand. That's a conversation that we look forward to having.

 

Back to Cape Breton with the Centre for Sustainability in Energy and the Environment, there's our future. I know the Minister of Energy talks about it a lot in terms of where we're going to go with waste-water management, with renewable energies, with those types of things. That's the future. We're famous in Canada for our research, as the minister said, but we're not so famous for the commercialization of that research.

 

At the end of the day, that's what it's about, it's about stimulating economic dollars from the research that we do at our universities and our institutions and facilities. All important things, and this gives us a chance to crack open the department and look at some of these things and figure out where we're going. I think it's my job as an Opposition critic and as part of the Official Opposition here in the province to find these things out. I know from the bottom of his heart - listening to the minister and debating these things back and forth - that he believes that his plan is the answer. From the bottom of my heart, I hope he's right because we're in a crisis mode, certainly in rural Nova Scotia and that's not fear mongering, that's the truth.

 

I don't need anyone to correct me on the fact that people leave and if it weren't for these on and offs to Fort McMurray and if it weren't for these companies who see the value in Nova Scotia's workforce to get them there and get them back so they can keep their roots and see their families, we would be in a lot of trouble. It's my job here and my role to make sure that we're doing our part and we're spending this money wisely. Again, I look forward to the next little bit where we see what the minister has in mind and where these dollars are going to be spent and how we can see a clear indication and the writing on the wall that we're going to produce these jobs. Nova Scotians are looking for these things, they're looking for opportunities to work, they're looking for opportunities to stay home, to keep their families here.

 

When we look at the backdrop with what's happening with education, with health care, with all the social programs that mean so much to us, $187 million is a significant investment for our province. When you look at some of these numbers, of course, there are all kinds - I'll be the first one to say as we go line by line - we can certainly see the value in the wise investment. When you talk about the Nova Scotia Jobs Fund that was the former IEF that was criticized by this government when they were in Opposition, I think it's important to see and to question and to evaluate how has this changed that it protects those dollars so much more?

 

I said this publicly, it's in Hansard, that I believe NSBI would be the stewards of those kinds of dollars; I think it's to the tune of about $73 million. I think they would be the ones that would look at this and make sure that those dollars are well spent.

 

Again, I want to thank the minister for his opening comments, I want to thank the staff for being here. I look forward to the conversations and the debate and the questioning in the next couple of days. With that, I will take my place. Thank you.

 

MADAM CHAIRMAN: Order, please. The time allotted for the Committee of the Whole House on Supply has elapsed.

 

The honourable Acting Deputy Government House Leader.

 

MR. MAT WHYNOTT: Madam Chairman, I move the committee now rise and report progress.

 

MADAM CHAIRMAN: The motion is carried.

 

[The committee adjourned at 7:47 p.m.]