HALIFAX, THURSDAY, APRIL 8, 2021

COMMITTEE OF THE WHOLE ON SUPPLY

2:14 P.M.

CHAIR

Barbara Adams

THE CHAIR: The Committee of the Whole on Supply will come to order.

The honourable Government House Leader.

HON. GEOFF MACLELLAN: Madam Chair, we will continue with Resolution E10, the Estimates for the Department of Health and Wellness.

THE CHAIR: The honourable member for Dartmouth North.

SUSAN LEBLANC: Good day to the minister. When we last spoke, I had asked a question and then I gave up the rest of my time to another member, so I’m back at that question.

My question was about the Back to Balance plan, referring to the $96 million less that will be in health funding next year. The first thing I’m wondering is: Can the minister please commit to providing a list of where the reductions in the health budget will come from?

[2:15 p.m.]

HON. ZACH CHURCHILL: I can confirm there will be no reduction. There’s no planned reduction, currently, for mental health and health services or programming. Where we do anticipate some savings to occur - currently, there’s well over $200 million that we invest in COVID-19-related initiatives, including PPE. Vaccines would be included in that figure as well.

Obviously, as we get to herd immunity and start seeing the light at the end of the tunnel here for COVID-19, we expect those costs associated with COVID-19 measures to be reduced. That is where the member will see savings. It’s not from the core programming budget from the health care department. It’s specifically related to COVID-19 measure spending.

SUSAN LEBLANC: I get that and that makes sense to me, except that experts are signalling that COVID-19 is not going away any time soon. We may need booster vaccines for years to come. Presumably, PPE needs to be maintained into the future.

There have been many lessons learned, as everyone keeps saying, with this pandemic, and one of those things is the massive need for attention to disease control and infection control. More investment in PPE is probably a really good idea.

Can the minister explain how or where he sees we will spend less health care dollars related to COVID-19? The minister has said vaccines, PPE, but those things may need to continue.

I guess my question for the minister is: Are there other things that the Minister could be more specific about, and if what he’s saying is vaccines and PPE, then if there is a need for them next year, where will the reductions come from or will those reductions be pushed to further years?

ZACH CHURCHILL: Again, these are estimates, and there still will be millions of dollars that are allocated in the budget for COVID-19 measures. Where we are expecting there to be some lowering of operational pressure related to COVID-19, specifically around the testing centres, we are expecting to require that less.

Again, if the epidemiology changes or the situation with the virus changes, we’ll of course adapt our forecasting to that.

Other areas would be the ICU beds that we’re holding for potential COVID-19 patients, as well as the RCUs that are in place to remove active COVID-19 positive cases from our long-term care facilities. There are some operational pressures that we are anticipating overuse as we get to herd immunity and hopefully what will be the end of the pandemic.

There’s $275 million that we’re expensing right now for COVID-19 measures. The reduction, if it’s accurate - I don’t even know if that calculation that the member presented is accurate - that’s not even half of the money that we have allocated here. We are expecting some operational reduction of pressure.

SUSAN LEBLANC: I think the minister can probably count on my excellent math skills to know that that number is pretty accurate. He saw what I did with some algebra a few days ago. We can count on that $96 million.

I’m also wondering if the minister can explain whether or not there will be any reduction in cost to implement IPAC measures in long-term care, with that reduction in budget numbers.

ZACH CHURCHILL: The majority of the IPAC measures will still be in place, particularly the human resource capacity that we’ve infused into the system. That won’t change.

Where you might not see re-ocurring costs would be on the one-time capital expenditures to create dividers and spaces in our facilities. There are some costs associated with IPAC recommendations that would be one-time costs, so you wouldn’t see those reoccurring.

SUSAN LEBLANC: Before I move on from this, I just want to ask the minister once again: If possible, could the minister provide the House with a list of those potential reductions that he has mentioned not just now, but in the answer before, with perhaps some numbers attached to them?

The last thing I would like to ask in this line of questions is: Can the minister confirm that there will not be any layoffs in next year’s Department of Health and Wellness and Nova Scotia Health Authority staffing budgets?

ZACH CHURCHILL: We can confirm that there will be no reduction in permanent staff.

SUSAN LEBLANC: The other night in Estimates, the minister listed for the member for Argyle-Barrington four recommendations that are not being implemented from the Fitch report on EHS services. The minister did not list increasing ambulance fees as one of the recommendations they will not be implementing.

Can the minister confirm whether or not the minister will be changing the ambulance fee structure?

ZACH CHURCHILL: There is no plan at this time to change the ambulance fee structure or amount.

SUSAN LEBLANC: One more question on this: What is the total amount collected in ambulance fees each year?

ZACH CHURCHILL: The total annually for 2020-21 would be just over $13.5 million, and that would include use of ambulances for non-Nova Scotians.

SUSAN LEBLANC: I understand that the priority - sorry, just so the minister knows, I’m going to just ask some short snappers here with all kinds of different subjects.

I understand that the priority in vaccine rollout in long-term care was given to licensed and publicly funded long-term care facilities. I’m wondering: What is the timeline for completing vaccinations in privately-run long-term care facilities, and what was the public health rationale for doing those sites later than the licensed facilities?

ZACH CHURCHILL: To answer the first part of her question, in terms of timing, the unlicensed assisted living homes are scheduled to have their first dose by the end of April and their second dose by the end of May. The rationale for prioritizing the licensed facilities would be because that’s where the more vulnerable people live. In the private, unlicensed facilities, those are assisted living facilities, so the residents there tend to be more mobile and require less support. The folks that are in the licensed facilities are not as healthy, generally speaking, as those in the assisted living facilities, so the priority was to focus on the most vulnerable people first.

[2:30 p.m.]

SUSAN LEBLANC: We were glad to see the government extend provision of virtual billing codes to primary care providers during the beginning of the pandemic. Virtual appointments can make a great difference to people.

What information or evaluation is this government specifically looking for in order to be able to make this service available permanently to Nova Scotians?

ZACH CHURCHILL: Virtual care is here to stay. It did exist before COVID-19. In fact, it has been around since, I believe, the early 1990s. Of course, during the last year it was expanded pretty significantly, and we believe there is no going back from that.

We are going to take a year to evaluate several metrics related to this. One would be access: Is it enhancing access to Nova Scotians? Its safety: Are there any safety concerns related to virtual care? Its comprehensiveness. Its integration with the rest of our system and how smooth that’s operating. We want to evaluate which specialties will benefit the most from this tool, and, of course, we want to evaluate the patient and provider experience, as well as the cost associated with virtual care expansion. That would be a high-level list of categories under which we will be evaluating the service.

SUSAN LEBLANC: Yes, that makes sense to me.

From what we understand, the virtual billing codes are not available for use by physicians who are working in walk-in clinics or for unattached patients.

First of all, is that correct? And, secondly, if it is correct, what is the rationale behind that policy?

ZACH CHURCHILL: That would not be correct. We are treating all physicians the same with these billing codes.

SUSAN LEBLANC: So I can call a walk-in clinic in Nova Scotia and get a virtual appointment as a walk-in, as an unattached patient?

ZACH CHURCHILL: That would be subject to the judgment of the physician or the health care provider.

SUSAN LEBLANC: Did that change recently? Because our understanding is that doctors who worked in walk-in clinics were not able to bill for virtual appointments. I just want to get clarification on when that changed. And I have another question.

ZACH CHURCHILL: This option has been available to physicians working in walk-in clinics since April 2020.

SUSAN LEBLANC: Speaking of walk-in clinics, Madam Chair, the other night the minister - I think it was when he was talking with the member for Argyle-Barrington - mentioned that in Nova Scotia, none of the walk-in clinics are publicly run, they are all private clinics. My understanding is that there is a clinic now opened, or about to open, in Kearney Lake that is specifically for people who are on the 811 registry but are not yet attached to a family doctor.

I’m wondering if the minister can confirm that that is the case. That’s my first question about that.

ZACH CHURCHILL: Just to clarify, walk-in clinics are physician-run, they are not run by the Nova Scotia Health Authority. We’re not familiar with any walk-in clinics that are run by the NSHA. However, the NSHA can provide funding to support the doctors with those walk-in clinics and they can support funding for the electronic medical records, for nursing, for supplies, to help subsidize rent. These would be some examples of the support that the NSHA does provide to these physician-run clinics.

However, there are also primary care clinics, which Kearney would fit under, that are designed to support those individuals who are on the 811 registry, who are unattached from a family physician. There were a number of these across the province. I know we have one in the Yarmouth Regional Hospital, Kentville, Bridgewater, Sydney. I listed some of the locations last night. Kearney Lake would be one of these as well.

These are not walk-in clinics. They would be clinics that are available to unattached patients on the registry through appointment. This one in Kearney Lake would be a Nova Scotia Health Authority primary care clinic, but not a walk-in clinic, based on the way the program has been explained to me. That’s my understanding.

SUSAN LEBLANC: That was going to be my next question, actually. Are there other models around the province or other examples of that kind of model around the province? I think it’s great because I have a lot of constituents who are unattached to primary care, and I‘ve been able to say, there’s this place opening in Kearney Lake. If there are a number of clinics all over the province that are for people who are unattached to primary care, then why don’t we just make them permanent and then those people would be attached to primary care? Maybe I’m missing something in there. I will just leave that in the ether for people to ruminate on.

Moving on for a moment, I have heard through the grapevine many very positive accounts about the services that are available at mental health and addictions drop-in programs at the Lunenburg and Yarmouth hospitals. There’s no wait time for these services, and people can access immediate mental health and nursing support. I’m wondering, is there consideration in this budget of expanding this particular model to other parts of the province, which is drop-in medical mental health and addictions support?

I understand. We’ve gone over the e-mental health, the hubs, the single sessions, and all of that stuff. I understand all those and I don’t need the minister to re-outline those ones, but what I’m asking about is the specific programs that take place at the Lunenburg and Yarmouth hospitals that may be emulated in other places.

ZACH CHURCHILL: On the issue of the primary care clinics and why they are stopgap measures as opposed to clinics that patients will be continuously attached to, it is because the physicians who volunteer to work at these clinics - it’s fluid. These would mostly be family doctors who have their own panel of patients and are also working with the NSHA to provide these other access points for primary care for unattached patients.

Individuals going to those clinics wouldn’t necessarily always see the same physician, and there are also nurse practitioners there that they may be seeing, with physician oversight. That would be the reason why they’re not - the model is not to attach those patients; it’s a stopgap to support patients who are unattached because of the reason that I referenced.

We’re not aware of the walk-in mental health spaces that the member is talking about. I am wondering if she is referring to community‑based supports that we provide funding to, or if she is speaking of the supports available directly in hospital. If I could get a bit more information on the program that she is referencing, I will be able to do a better job getting an answer for her.

[2:45 p.m.]

SUSAN LEBLANC: I’ll get that information to the minister in due time. I’m going to move on from that for a moment. Why is the new CCA Registry being hosted ‑ no, no. I’ve already asked that question. Sorry. Pardon me.

The other day we were talking about the CCA Registry. We had a back and forth, as the minister may remember, about the difference between a privacy commissioner and a review officer. Everyone agreed that it was semantics. In any case, I never really got an answer to my question, which was what the Information and Privacy Commissioner said about the arrangement of the CCA Registry. I am wondering if the minister could share what the privacy commissioner said about the arrangement and what measures are being taken to ensure confidentiality?

ZACH CHURCHILL: I would like to thank the member for the question. I very much enjoyed that back and forth last night on the language of the ‑ I mean the Privacy Review Officer Act. It would have been the Director of Privacy and the legal folks in‑house here at the Department of Health and Wellness who would have conducted the review and assessment of the registry.

SUSAN LEBLANC: This is getting ridiculous, Madam Chair. It doesn’t matter who it was, I’m just wondering what they said about it.

I would like to ask the minister: How can the minister assure us that there are measures being taken to ensure confidentiality of the folks who go on the CCA Registry?

ZACH CHURCHILL: I can tell the member specifically what the Director of Privacy and our legal team’s conclusion was. It was that the proposed CCA Registry honours and protects the personal information of registrants. That was the determination of that …

THE CHAIR: Order, please. The time allotted for the New Democratic Party has expired. We will now move on to the Progressive Conservative Party of Nova Scotia.

The honourable member for Dartmouth East.

TIM HALMAN: Thank you, Madam Chair. Very nice to see you in that chair. Through you, Madam Chair, good afternoon, minister, and good afternoon, staff.

Minister, you may recall a few weeks ago in Question Period I’d asked a question with respect to MSI supports for breast cancer patients, and I have a few follow-up questions. I’m hoping we can engage in a discussion on breast cancer supports.

First of all, I want to thank the department for getting back to me with respect to what is currently provided as supports. It was pointed out to me through the department that MSI provides support for breast prosthesis: up to $150 every two years for a breast prosthesis per mastectomy, and additional financial assistance of $150 - $300 for a double mastectomy, and $40 towards a mastectomy bra. This is available once every two years for residents who have a total gross income of less than $30,000 as indicated by line 150 of the individual’s income tax notice of assessment or re-assessment issued by the Canada Revenue Agency.

Then also, minister, they pointed out the generosity of donors via the Canadian Cancer Society. I know all of us will say they’re the gold standard of supports for cancer patients.

My first question to the minister, is: What are the criteria used to determine these supports, specifically breast cancer supports? What are the criteria used?

ZACH CHURCHILL: We’re going to get the specific language for that criteria to provide to the member, to make sure it’s accurate.

TIM HALMAN: I appreciate that, minister. Thank you. My concern is that there may be an inequality that will prevail here. I’ll just lay out the scenario to the minister. Medical Services Insurance gives all mastectomy patients two options: reconstructive surgery or breast prosthesis. My understanding is that reconstructive surgery is covered by MSI 100 per cent, which is a cost of about $10,000 to $50,000. My understanding is that income plays no role in that option. There’s no charge to the patient.

However, the patients who have chosen not to avail themselves of that option and have opted for the non-surgical choice - my late wife, for example, that’s what she chose. My understanding is that they’re offered, as I just outlined in response, the department gave $150 every two years, and if the income is under $30,000, more is available financially, and there’s a process that needs to be applied.

The bottom line question is this: Will MSI and the department consider increasing financial assistance for the breast forms and the necessary mastectomy bras required by patients?

[3:00 p.m.]

ZACH CHURCHILL: Thank you very much for the patience of the House and the member. We’re again getting the specific criteria up. That’s what we’ve been searching for - to go through that with the member.

The member was fairly accurate on the criteria that he outlined. I appreciate how close this is to the member’s heart and life, as well. My condolences to you and the family. We can only imagine the pain that comes with the loss of a partner. The member, I know, has done her legacy great service in the Chamber. I remember your speech about her being your Rock of Gibraltar. I don’t think I’ll ever forget that speech in the Chamber. There weren’t too many dry eyes in the Chamber at that time.

In terms of the scope of coverage, there is good news on that front. In fact, there is a review that is under way right now. We do expect recommendations to be coming forward within the next year around expansion of the scope of coverage for these critical services for women in our province.

We do have the criteria up that we’ll go through. Again, thanks for the patience.

According to the documents we have, the regulations state a resident as defined in the regulations respecting Medical Services Insurance made pursuant to the Health Services and Insurance Act who has undergone a mastectomy or lumpectomy who in the opinion of a physician requires the use of a conventional mastectomy prothesis will receive financial assistance up to a maximum of $150 per prosthesis once every two years.

There’s also an additional low-income program for individuals who are under $30,000 of income a year. That’s funded by Cancer Care Canada but offers an additional payment of up to a maximum of $300 per prosthesis and up to a maximum $40 for the purchase of the supporting bra.

The member was dead-on with his description of the criteria. Again, this is under review with the expectation that recommendations are coming forward in the not-too-distant future for the expansion of coverage. I’d like to thank the member very much for the question.

TIM HALMAN: I’d like to thank the minister for his very kind and generous remarks. I greatly appreciate it. In all honesty, I probably couldn’t have asked the questions here a few years ago, but I feel I’m at a point now where I can safely ask these while keeping some dry eyes here. Thank you very much for your kind remarks.

Thank you for outlining the criteria. At the end of the day, it’s good to hear that there’ll be a review of how these decisions are made. I know this will be of great comfort to a lot of families and a lot of individuals who are battling this disease.

As my colleague for Argyle-Barrington pointed out in his speech on the Supply motion, part of our role as Opposition is to point out areas we think the government needs to shine some light on. Just one final question before I hand this over to my colleague for Northside-Westmount. It’s with respect to cranial hair prostheses.

While facing a major health crisis such as breast cancer, a total loss of hair adds another layer of emotional devastation. In many respects, this is not the private hell of breast cancer patients - it’s a very public announcement of the diagnosis and the struggle that the patient and the families are going through.

My final question to the minister is: In the scope of that review, will MSI look at expanding the financial boundaries that include the cranial hair prostheses?

ZACH CHURCHILL: I’d like to thank the member for the question and the suggestion. That currently is not part of the ongoing review that has been taking place but I’ve asked staff in the room to include a recommendation in that regard as part of that review.

TIM HALMAN: I’d like to thank the minister and staff for their time. I believe that in this short conversation, I think in the very fact that we have a government that is looking into it - that I hope is always constantly reviewing policies, specifically this - I think it will be of great comfort to a lot of Nova Scotians.

That being said, I pass this on to my colleague from Northside-Westmount.

THE CHAIR: The honourable member for Northside-Westmount.

MURRAY RYAN: I’d like to thank the minister for granting me a few moments of his time this afternoon. My questions are around the Northside-Westmount area, obviously. Specifically, I’m interested in the health care redevelopment plan that’s going on down here.

Currently with Northside General, the hospital has 45 acute care beds and those are currently occupied by short-term acute care patients who are in for a variety of illnesses and what have you. None of them are there on a long-term basis.

As part of the redevelopment plan, we will have 12 acute care beds, so it’s a decrease of about 33. If I look over in New Waterford, they will be going from 21 down to 12, and then at the regional hospital, they are adding 72 beds. So for the region as a whole, there is a net increase of 30 beds.

I’m wondering about a couple of things related to this. These 12 beds that are going here in the new facility have been designated as 72-hour beds. I’m just wondering - I’ve been looking for some information and I’m trying to figure out: How do you determine who is a 72-hour patient? How do you set that parameter?

ZACH CHURCHILL: There are two primary factors that would dictate a patient’s longevity of stay, and it can be anticipated that a patient stay would be between one and three days, based on the disease entity that they’re dealing with. Doctors determine that based on this disease or this health challenge. You require one to three days.

It’s also available for patients who have been treated and who will be recovering and need monitoring. Also, this program was designed to utilize their residents who are in training in Cape Breton as well. The number 12 is the number that was decided - and this was also built by the physicians at Northside and New Waterford, so they were the ones advising on this model. The 12 beds was deemed by the clinicians to be the number that allowed them to manage the staff and the ratio most effectively with those beds.

MURRAY RYAN: It’s very much appreciated that the local physicians, clinicians are listened to. I know in the initial iteration of this redevelopment plan, there were no acute care beds, and it was through the hard work of some local physicians in the area working with the Department of Health and Wellness, lobbying with them and making their case that these 12 beds were identified and were added to this facility.

That’s always a good thing. What’s been lacking, if you will, is from a communications standpoint. I get constituents coming into my office asking questions about this whole redevelopment, and the whole thing is a very hot topic, if you will, or can be.

Tied into that, Northside General currently has 45 acute care beds. I’ve had personal experience going in there to visit with family members, my parents, what have you. For families and caregivers, they can visit their ill family members much more easily having them in their own home community.

So my second question to the minister is: While I was definitely relieved to see the 12 beds added to the initial redevelopment plan, I’m wondering, what was the reasoning in the overall plan? I know this predates the minister, but what was the overall planning and thinking behind the residents on the Northside?

Northside General is going to be down 33 acute care beds as part of this overall plan. The ER is going to be moved over - relocated - to Sydney. I’m just wondering: What was the thinking behind that thought, reassigning 33 of our long-term care beds?

THE CHAIR: Order, please.

We’re going to take our 15-minute break, so the minister will be able to address this question after the break,

We will break now and come back at 3:30 p.m. Thank you.

[3:15 p.m. The committee recessed.]

[3:30 p.m. The committee reconvened.]

THE CHAIR: Order, please.

The honourable Minister of Health and Wellness.

ZACH CHURCHILL: This is a once-in-a-generation project to reshape health delivery in Cape Breton. It’s one that did include a lot of consultation. In fact, the current deputy minister of our department was the senior medical director at the time in industrial Cape Breton, and was a big part of this, as well as doctors, nurses, allied health care professionals, the municipal government, and community services groups also were consulted. There was public communication that was fairly regular, which did include information set up at the mall. There is, of course, the public announcement and follow-up information that was provided fairly consistently to the community.

While there is a reduction in the acute care beds, the reason for that was based on a clinical assessment, and the fact was that a lot of the beds - 24 in New Waterford and 22 in the Northside - were actually being used for what’s referred to as alternative level of care beds, which would essentially be folks who are waiting to get into long-term care. The new complement of acute care beds will be more in line with what the acute care needs would be based on the clinical assessment of doctors and others in that community.

What actually is happening is a net increase of beds for long-term care, which will accommodate the ALC patients who were in those beds waiting to get into long-term care facilities and some of the increased demand that they’re seeing in that area. I’ll make sure my math is right here, but they’re going from the 24 in New Waterford and 22 beds which were being used for alternative level of care, so folks waiting to get into long-term care - they’re actually getting 60 new long-term care beds in both communities, so 120 beds that will be there, and that will represent a net increase of 74 new beds in that facility.

It would have been clinical assessments that made the determination on the allocation of beds, and there is a net increase where the greatest pressure was, which was on the long-term care side.

MURRAY RYAN: Currently, there are 45 acute care beds, and then there’s the 22-bed long-term care wing at the Northside General, and then there’s 12 short-term, or that interim transitional long-term care beds. My information was that those were separate from the 45, and the 45 were actually acute.

My final question to the minister relates to the discussion that we were having yesterday in Question Period, but also more specifically, it came out of some questioning from my colleague in Cape Breton Centre. She was asking you some questions during the Committee of the Whole House on Supply meeting related to the New Waterford Hospital ER.

I’m assuming that when the minister was answering the MLA from Cape Breton Centre that I can make the assumption that when he was talking about New Waterford ER that I could use the same logic for the Northside General ER. The minister stated that the ER could reopen if they could get doctors to work the ER, but doctors aren’t willing to staff the ERs.

Prior to March 2020, there were doctors willing to staff the ER at Northside General and there had been dating back to 1954. Prior to Covid-19, when there were ER closures, what was communicated to the residents was that was due to doctor shortages. Now, based on what the minister said yesterday, we’re hearing the issue was that it’s not that they can’t find doctors, the issue is that they can’t find doctors who are willing to work in the ER. Not that there are actual doctor shortages per se.

I was wondering if the minister could clarify that: Is it a matter of shortages or they’re not willing to work?

ZACH CHURCHILL: What I’m being told was at the time, there was a decision made by the physicians that were staffing the Northside to withdraw services for the emergency department. I'm not certain on what the reasons were for that, but I do have an update for the member on Northside. It is that the health authority has recently had meetings looking at what would be necessary from a staffing perspective and what would be possible to re-establish ED services at that hospital.

THE CHAIR: The honourable member for Northside-Westmount is on mute.

MURRAY RYAN: So I am. I've had a good run for about three days where I was not missing that. I want to thank the minister for the answer. If he could keep me apprised of those developments, that would be greatly appreciated.

That finishes my questioning and I’d like to hand off to my colleague for Cumberland North. Thank you.

THE CHAIR: The honourable member for Cumberland North.

ELIZABETH SMITH-MCCROSSIN: Thank you, minister. I’m looking forward to asking you some questions on behalf of the people here in Cumberland North.

My first question is a financial question. Historically, pre-pandemic, we’ve enjoyed shared health care services with our neighbouring province. They come here, we go there. Traditionally, our people have gone to New Brunswick for MRIs, CAT scans, oncology, a lot of dialyses, some surgery, and they’ve traditionally come to our area for obstetrics, ENT and surgery.

I’m wondering what kind of cost savings our province would have experienced in the last 12 months, knowing that many of our constituents here have had their surgeries and diagnostic tests cancelled by the neighbouring province simply because they are living here in Nova Scotia?

ZACH CHURCHILL: [Inaudible] services out of province. We don’t have that specific just to New Brunswick. That would be for the folks who go to Ontario for specialized treatment as well. There would be a savings in that particular budget line of approximately $7.6 million.

However, what’s unknown is how many of those procedures were then conducted here in Nova Scotia. There’s no easy way to calculate that. So while in our budget there will be a reduction in that budget line number, there very well could have been an additional cost associated with any procedures that could have been done here in the province.

[3:45 p.m.]

I do have an update for the member on the vaccine question she asked in Question Period, if she’s okay with me providing that update. There were no vaccines taken out of the Cumberland area. I just wanted to make sure we clarified that. We did check with our vaccination folks, and that wasn’t the case.

ELIZABETH SMITH-MCCROSSIN: We have two issues going on right now. I’m going to finish off with the New Brunswick issue, and then I’ll address your last comment that was made.

With New Brunswick, what I would ask is your department is: Would the department be willing to look at the cost savings that they have experienced and look at what we are going to do for the future here?

We don’t know how long this pandemic is going to last. We certainly haven’t seen our federal counterparts stand up for people here. They’re not ensuring the Canada Health Act is being upheld. If the pandemic continues and New Brunswick sticks to their guns like they have done, I can’t continue to sit back and listen to people who have had their surgeries cancelled and not rescheduled.

Most have not been rescheduled, minister. I have cataract surgery and hip surgery, and it’s continuous. It’s continuing to happen. I had a call on the weekend from somebody who was scheduled this week and while they were doing their pre-questions, as soon as they found out that he’s across the Nova Scotia border, they cancelled him.

The fact is we can’t continue this. Either we need to take that cost savings and start making those services available to the people in this area, in Nova Scotia, or we need to come to some sort of an agreement that will hold the Canadian provinces all accountable to make sure people are not going without health care services. I would be really interested to know what sort of money savings has been experienced and in helping the government to come up with some sort of a plan to make sure all Nova Scotians have the same access to health care services.

With regard to the vaccine, I can assure you that vaccine was reallocated. It was allocated originally to the Amherst Pharmasave. They were supposed to be administering the vaccine. It was supposed to be given on April 5^th, which was Monday, and I was told last night by the person from the Pharmacy Association of Nova Scotia that a decision was made to reallocate that vaccine from the Amherst Pharmasave pharmacy clinic to HRM. I can assure you I was told that by two different people, both the pharmacy clinic that was supposed to receive the vaccine that was cancelled, and by the Pharmacy Association of Nova Scotia.

They did not tell me who made the decision. I don’t know if it was the Pharmacy Association of Nova Scotia that made the decision or if somebody from the Department of Health and Wellness told them to make the decision, but I can assure you that the Pfizer vaccine that was allocated to come to Cumberland for April 5^th was reallocated to HRM.

That second part of that vaccine was AstraZeneca vaccine that was allocated to the Northern Zone. None is being brought to Cumberland. In your last response in Question Period, you did ask the question: is it because there’s nobody to administer it? Again, I will tell you we have people who are willing to administer the vaccine. We have pharmacy clinics that actually hired staff that they have no work for because they were told they were getting vaccine. They have staff waiting for the vaccine supply and no work. We have health care professionals to administer it, I want to assure you that. We just don’t have the supply.

I’m not sure where you got your information, but that’s the information I was given.

THE CHAIR: I would like to remind all members to go through the Chair when speaking with ministers and vice versa. Try to avoid using “you.” Speak through the Chair and refer to people in the third person.

The honourable Minister of Health and Wellness.

ZACH CHURCHILL: I can confirm with the member that there has been no reallocation of vaccines from Cumberland to anywhere else in the province, so that information would not be accurate.

I’m not certain what information the member might be getting from PANS. We are relying on our partnership with PANS and their network of pharmacists - we work through them - for them to work with their network of pharmacies to deliver this. They will be delivering the vast majority of our vaccines. But from the department standpoint, there is absolutely no reallocation of vaccines from Amherst to anywhere else in the province. I want to confirm that with the member. If she has documentation from PANS that she’d like me to take a look at for us to try to understand where the miscommunication is on this, I’d be very happy to do that, but we’ve confirmed with our vaccine folks that that did not happen - from our perspective.

On the cataract hip and knee replacement surgeries, there are two sides to that coin. There is an item - the budget line savings is about $7.6 million but many of those surgeries, particularly the ones that happen in New Brunswick, can happen here in Nova Scotia. They would have been or can be conducted here, so there would be an additional cost on this side. Furthermore, it has actually been a net loss because more people come from out of province to get surgeries here than vice versa, so there was actually a loss to the department of $12.5 million because we didn’t bill for surgeries that folks usually in Atlantic Canada are coming into the province for. There’s actually a net loss on that.

Furthermore, any surgeries that can be provided here in Nova Scotia, and I’m told that a lot of the ones that are done in New Brunswick would be and can be reassigned here in the province and we are working through those wait times that have built up over COVID-19 and we have hit 95 per cent. I don’t know if that number has changed in the last couple of weeks, but 95 per cent of those surgeries, the elective surgeries, that were cancelled over COVID-19 have either been rebooked or have happened. During COVID-19, all of the essential surgeries - the urgent ones like cancer treatment and those critical ones - did take place.

ELIZABETH SMITH-MCCROSSIN: I don’t really understand why you’re trying to discredit what I’m saying. I'm going to just . . .

THE CHAIR: Order, please. I’m going to remind the honourable member to speak through the Chair to the minister.

ELIZABETH SMITH-MCCROSSIN: I’m speaking through you, Madam Chair.

THE CHAIR: You’re not allowed to speak to the minister directly so using the word “you” - you need to refer to the minister in the third person through me.

ELIZABETH SMITH-MCCROSSIN: Thank you for that reminder. I’ll just say to Madam Chair that the minister can check his references and resources. We have a pharmacy - I will say this again, for the third time - we have a pharmacy that was allocated Pfizer vaccine for April 5^th and I was told by the Pharmacy Association of Nova Scotia last night that a decision was made to reallocate that Pfizer vaccine from Cumberland to Halifax. I’m not sure who gave them the direction to do that, but I can assure you this is what I was told, both by a pharmacy here as well as the Pharmacy Association of Nova Scotia.

I think what we’re listening to right now is maybe why we see such a disarray of this vaccine implementation plan - the left hand doesn’t know what the right hand is doing. The fact that we have Doctors Nova Scotia, the Pharmacy Association of Nova Scotia, the Department of Health and Wellness, Public Health - and nobody seems to know who’s reallocating and moving vaccine around the province. Maybe it’s why we’re seeing so many problems. I’m going to leave that with the minister to discuss with his department. I can assure you that I have been told this not just by one person.

With regard to the medical services that have been cancelled by our neighbouring province, this has been going on for a year. Many of the people here have not had their surgeries rescheduled. If the Province of Nova Scotia is not billing the other provinces for surgeries done here, I would say the Province may need to look at their accounting services and who is taking care of that. If the Province has a net loss of $12.5 million, that’s a problem. Maybe the Province needs to look at doing a little better job with financial management within the department. I’m concerned about the people here in Cumberland North who have had surgeries cancelled and diagnostic tests cancelled due to the pandemic.

[4:00 p.m.]

What I’m asking the minister is: Is the department willing to look at a plan for the future? Because if this pandemic continues and no one is going to uphold the Canada Health Act to ensure people can receive health care services in different provinces, then our province has a responsibility to ensure all people in Nova Scotia, including those who live in a border community, have timely access to health care services. Right now, they don’t.

ZACH CHURCHILL: Of course, the pandemic has created challenges in our health care system. We’ve had borders shut down for the first time in living memory between provinces to protect each other from the spread of this virus. We have had to delay elective surgeries to create capacity in our hospitals to respond to what could have been the potential impacts.

I know the member is very well educated on this pandemic. She’s a medical professional. She sees what’s happening in other provinces where hospitals have been overrun or are currently being overrun as in Ontario, where they are in the midst of another lockdown. It was prudent to make these decisions.

We have been fortunate here because of strong public health policy and an incredible amount of compliance with the population to prioritize the health and safety of everybody. For the member to suggest that we had control over the impacts of this pandemic and that we shouldn’t have responded as brutally as we did to create capacity in our hospitals I don’t think is fair.

We are trying very hard right now to catch up with those elective surgery wait‑lists and we’ve had some success on that. Folks who were scheduled to go in another province would have to be re‑referred to a specialist here and assessed by a specialist here to receive that surgery in Nova Scotia or whatever the procedure may be and that would be funded.

That process is ongoing, but I know the member can appreciate the reasons why these challenges have occurred and why these wait‑lists have been exacerbated, because the threat of COVID-19 is real and still hanging over our shoulders. We don’t need to look too far to see what the consequences could be if we do not remain vigilant and cautious and if we fail to follow public health protocols.

Listen, I am not questioning the member’s credibility on this on the vaccine issue, but what I can tell her is that it has been confirmed by the staff here in the department. Again, I haven’t seen any documentation from the member or from the Pharmacy Association and, as I mentioned, I am happy to take a look at that to try and get to the bottom of this. But to suggest that from a department standpoint ‑ to suggest that there’s been a reallocation from Cumberland with vaccines, nobody here understands why that assertion would be made because from our perspective, that is not true and there is nothing that would have happened for that.

Again, I will offer to the member to provide documentation to substantiate this and we can help get to the bottom of where this information is coming from. I have been assured by our staff here who deal with the vaccines every day and who oversee this program that the information the member has shared is not accurate.

I know that the Opposition has been very focused on the vaccine rollout and I think that’s a good thing. We want to make sure that our vaccine rollout is going as smooth as possible, but the way that the Opposition is trying to paint this as being a disaster is not accurate.

We held back second doses, which was a prudent decision at the time based on the federal guidelines for when second doses should happen. That has impacted how many first doses got into people’s arms, because we held those back. We’ve had 100,000 people in Nova Scotia with first doses. We’ve got 30,000 with second doses. We are leading the country in vaccinations in our long‑term care facilities, and we are going to look at having doses in everybody’s arms, if supply stays up, by the end of June.

Let’s go back a year ago and think about where we are right now. I know everyone can remember the fear in our minds and in our communities a year ago. People were saying it might be three to five years before we have a vaccine available. Nobody knew how to manage this. Lockdowns were happening. Everyone was doing their very best to stay up to speed on the developing science around this virus, and here we are, a little over a year later, and we are administering vaccines and getting them in people’s arms in an orderly way, utilizing our health care professionals in Nova Scotia.

There is not disorganization because we are working with partners, as the member suggested. We are lucky to have incredible partners like Doctors Nova Scotia and the Pharmacy Association of Nova Scotia that will be distributing the vast majority of our vaccines in their clinics. The number of clinics has expanded as supply has increased and we are having very serious growth in the number of vaccines that are being administered every week. We had 27,000 doses administered last week and 40,000 administered this week. We’re anticipating 50,000 the week after and 60,000 the week after that.

We are starting to see, particularly with supply increasing from the federal government, because it’s all contingent on supply. We’re not producing vaccines here. The federal government is procuring these vaccines from the global marketplace and distributing them. We are seeing growth in the number of vaccines that we are distributing every single week.

I do think that we all have a responsibility to support the public in being confident about this process, about the science behind the vaccines themselves, and also support them in getting the necessary information that they need. I know people are frustrated with some elements . .

THE CHAIR: Order. Time has elapsed. We’ll now turn it over to the NDP.

The honourable member for Dartmouth North.

SUSAN LEBLANC: I’d like to continue asking a variety of questions of the minister.

My first question for this section is: Sexual Health Nova Scotia gets only $275,000 to cover the entire province with their work. In contrast, women’s centres get over $200,000 per centre, and let me say that they probably need a lot more than that. I understand that it’s difficult for the organization - Sexual Health Nova Scotia - to fulfill its mandate within this budget.

Was it considered to increase the budget of Sexual Health Nova Scotia?

ZACH CHURCHILL: I’d like to thank the member for her patience on that. I believe the member asked about the grant to Sexual Health Nova Scotia. It’s an organization that does proactive education on positive sexual health in our community. That grant is $275,000 annually that they receive. What’s budgeted in this budget is the same amount, so we’re staying consistent with the grant that’s provided at this time.

SUSAN LEBLANC: Great. Can the minister explain what is in the budget that is being earmarked for greater access to health care services in the Province’s prisons? If he could point to increases and what lines they are reflected in, and if he could explain what program improvements are being implemented or considered.

[4:15 p.m.]

ZACH CHURCHILL: That would not be reflected in the department’s budget. There would be a carry-through with the Nova Scotia Health Authority’s budget, so we are going to see if we can find that information from the health authority for the member.

I do know that there were enhanced COVID-19 protocols and measures that took place in our provincial correctional facilities, again to be separated from the federal correction facilities, where the federal government pays for the health care of individuals there. We can see if we can get some detailed budgetary information for the member from the health authority, which would oversee the delivery of those health services.

SUSAN LEBLANC: I look forward to getting that information.

I just wanted to go back on something that I was asking the minister about in my last hour. That was mental health and addictions programs in the Western Zone, and the minister said he hadn’t heard of this particular program. This is from the Nova Scotia Health website:

“The Wellness Clinic is an ongoing client-focused program that is based on what the client or group of clients want to work on that day. There is no waitlist or referral process. The client or family member simply walks in, meets with staff to form a care plan with them and gets started.”

It’s a mental health and addictions wellness program. It’s in the Western Zone at two of the hospitals.

The minister hadn’t heard of the program. I wanted to clarify the name of the program and what the description of the program is and I guess I want to reiterate if - or the question which was: Is this type of program being looked at for other places in the province? Because through the grapevine, I’ve heard lots of really excellent things about this program.

ZACH CHURCHILL: Yes, I am familiar with these wellness hubs that focus on mental health and addictions. Thanks for clarifying which facilities you were referencing.

We do now in the west have three locations: one at Yarmouth Regional Hospital, and in Lunenburg as the member said, and also in Middleton at Soldiers Memorial Hospital. These are actually the models of hubs that we are expanding into other zones and expanding across the province.

The new addictions and withdrawal hubs that are in this budget are modelled off these examples, so there is an expansion happening here based on these programs and every zone will have access to at least one hub.

SUSAN LEBLANC: I thank the minister for that answer. Great to hear.

Our office received a freedom of information request recently that explained that in the entirety of time since the department started collecting complaints about home care in 2017, which was also when the department ceased auditing complaints, there have been a total of 58 complaints collected. This change took place after the Auditor General expressed concerns about accountability processes in home care.

My first question is: Does this number of 58 complaints, from 2017 to 2021 - does that seem low to the minister?

ZACH CHURCHILL: I’m not sure how to assess whether that’s high or low. I think, considering the volume of patients we see and site visits that happen, that does seem to be proportionally a decent number, which would be an indication to me that we’ve got high-quality services that people are generally and genuinely satisfied with.

SUSAN LEBLANC: I feel like it is low. I feel like that doesn’t seem like a reasonable number to me. In my office alone, we get complaints about home care. I don’t know how many we’ve had since I’ve been elected, but quite a few, so I can’t imagine all of the complaints are happening in Dartmouth North, yet only 58 have been documented since 2017.

In what is now a complaint-based system, considering that this year there were over 15,000 home care clients across the province, 58 complaints in the span of four years means that complaints must be getting missed. Would the minister agree with that?

ZACH CHURCHILL: These are the only complaints that we do have in the department. It’s possible that there are complaints that are going directly to the agencies which wouldn’t be coming to us. Presumably, those would be handled at the agency level.

The member’s point is taken. Perhaps people are finding other outlets besides the Department of Health and Wellness to voice their concerns. Maybe it’s MLA offices. I certainly haven’t had any complaints that I can remember about home care in my community from the VON or any of the other providers. Folks generally have been quite satisfied with those services.

Maybe their complaints are going somewhere else, but the official ones that we have on record in the department would be 58. I can only speak to those.

SUSAN LEBLANC: I agree, it’s a tricky question because that’s the number, and it’s hard to know what we don’t know. I’m wondering what the department does to ensure - because for sure I know the ones who have come to my office, families have already complained to the home care providers, the agencies, or whatever, and they’re not getting anywhere with them, for instance, so then they come to the MLA as the next step.

I’m wondering what the department might do to ensure the clients and their families are aware of the accountability processes in home care.

ZACH CHURCHILL: There are a number of things on this front. Through the Nova Scotia Health Authority, there are care coordinators whose responsibility would be to communicate to the clients their rights, and also the processes to deal with any issues they would have with individuals or the agencies. Not often do those get escalated to the department.

Generally speaking, the feedback on the home care support network has been positive, based on the information I’ve been given by staff. The health authority has just completed a satisfaction survey for which we do not have the details on yet, but should be available soon. That’s another tool, I think, that’s being used to assess people’s satisfaction and overall thoughts or concerns on the services they’re receiving.

There have been a lot of enhancements to these services in recent years and during COVID-19. We also do have high-quality agencies, generally speaking, that deliver these services, including VON which has a really great reputation. I’d say the biggest complaints we hear are usually around scheduling, and I’ve heard complaints from the actual CCAs on that. Staff tell me those are primarily the areas of complaints that come from the clients as well.

That’s an ongoing challenge, but generally speaking, there seems to be a high level of satisfaction with the service. We’ll have more information when we get the results from this NSHA satisfaction survey that’s been conducted.

THE CHAIR: Order. We’ll take our COVID-19 break now for 15 minutes. We’ll return at 4:44 p.m.

[4:29 p.m. The House recessed.]

[4:44 p.m. The House reconvened.]

THE CHAIR: Order.

The honourable member for Cape Breton Centre.

KENDRA COOMBES: I want to go back to paid sick days. Paid sick day policies have been proven to reduce the spread of diseases by increasing the rate at which workers stay at home when sick.

In the United States, cities with paid sick days saw a 40 per cent reduction in influenza rates during flu waves compared to cities without. By enabling food service workers to stay at home when they have the stomach flu or other infectious diseases, paid sick days are associated with a 22 per cent decline in rates of food-borne illnesses.

This is all from the report Before It’s Too Late: How to close the paid sick days gap during COVID-19 and beyond, which I’ll be happy to table. It’s from a network of health providers based in Ontario who advocate for better health by addressing employment conditions. My question for the minister is: Does the minister agree that this is a general public health issue outside of COVID-19?

ZACH CHURCHILL: That would be an item for discussion with the Department of Labour and Advanced Education.

KENDRA COOMBES: Somehow I knew that was going to be the answer. I don’t know why. The minister is responsible for the health and wellness of Nova Scotians. So I think, particularly, that it would be prudent upon his department to be looking at policies such as sick days with regard to public health. Again, I would ask the minister: Doesn’t he think this is generally a good public health policy?

ZACH CHURCHILL: Our public health policy around COVID-19 belongs to this department. Our health programming, our service delivery, our access to primary care - all these things fall under the jurisdiction of the Department of Health and Wellness. The member is asking questions that are obviously related to the Department of Labour Relations, which is, I’m sure, why she would have anticipated my answer to that question. It is that department which has jurisdiction over those decisions, so I would suggest that if the member does have questions in relation to labour policy that she direct them appropriately.

KENDRA COOMBES: The only reason I thought I could anticipate it is because I’ve heard this answer from the minister before with regard to labour relations. I would like to ask the minister: Does he agree with his Chief Medical Officer, Dr. Strang, that sick days is a good policy?

ZACH CHURCHILL: The role that we have in this - so of course during a pandemic we wanted to support people to stay home whom we didn’t want to go to their workplace if they were experiencing symptoms. Of course I agree with Dr. Strang, and that’s exactly why we brought in the isolation pay that I referenced, I believe, with another member of the NDP caucus. That was a program that we brought in to assist those who were waiting for federal supports to come in to provide immediate, quick funding in the event that they needed to stay home.

The department did provide funding during the pandemic to assist with that. Dr. Strang was consulted on that as well, and of course I believe that was good public policy, which is why we invested those dollars there.

KENDRA COOMBES: I would like to point out that Dr. Robert Strang said:

“Certainly from a public health perspective, for not just COVID-19, it is a longstanding challenge. Whether it’s salmonella in a restaurant or influenza every year, there are a lot of reasons why people don’t stay home or are unable to stay home. It’s absolutely important that we work together to recognize the barriers that may limit people’s ability to stay home and find ways to collectively reduce those barriers.”

Therefore, with all due respect to the minister, this is a public health issue. Therefore I truly believe that it is in the purview of the Minister of Health and Wellness to look at these potential guiding lights of public health policy, including paid sick days.

Does the Minister of Health and Wellness agree with his Chief Medical Officer that not just COVID-19 but in cases such as influenza, that this is a good public health measure?

ZACH CHURCHILL: Of course we agree in principle with that. But in terms of how that program is administered, how compensation happens, the framework of what paid sick leaves would look like in Nova Scotia - that does not fall under the purview of the Department of Health and Wellness. I believe that the member understands that. For these specific questions related to that area, they need to be directed to the appropriate minister and department.

KENDRA COOMBES: I’ll move on a tad bit, not too far from this line of questioning. The minister referenced a number of programs the other night that had been available throughout the pandemic to Nova Scotians who have to miss work, but none of them are permanent, automatic, legislated in the Labour Standards Code. I know the minister is going to say that this is Labour Relations with regard to paid sick days, but can the minister confirm that he does not support permanent, paid sick time?

ZACH CHURCHILL: The measures that the Department of Health and Wellness took were in response to the COVID-19 pandemic. Those measures were appropriate, from a department standpoint.

The member just referenced the Labour Code. The Labour Code does not fall under the legislation of the Department of Health and Wellness. It’s overseen by another department. I’m not sure how more clear the legislation could be on this matter or how more clear I can be with the member on that.

The member does have opportunities to direct these questions to the appropriate minister who has the legislative authority to speak on behalf of government about these issues. There are 40 hours of Estimates. We will be hitting the 20-hour mark here, halfway through, in Health alone, but the member does have the opportunity to direct those questions appropriately.

I can speak to the measures that we took on a temporary basis, because we were responding to a public health crisis with the pandemic. I’m happy to talk about those measures and to speak directly to those. But the member is referencing legislation and questions that do not fall under the purview or authority of this department. I’m not sure what else I can say on that.

KENDRA COOMBES: I appreciate where that minister is coming from, I really do. I said this the other night and I’m going to say it again: my hope is that when it comes to issues that also involve your department, you are going to have policy discussions with your counterparts in other departments on these issues, such as paid sick leave, which again I will say that influenza and other transmitted illnesses are public health issues.

I’ll move on to another area where the minister hopefully will have some answers for me. Nova Scotia is one of the last provinces to use the controversial practice known as birth alerts, which have been widely condemned for targeting Indigenous and other racialized women. It is a child welfare practice but - and this why I’m asking the minister - it does require hospitals to administer the practice.

Is the Minister of Health and Wellness and his department engaged in conversations about ending this practice with the Department of Community Services?

THE CHAIR: Just a reminder to address the Chair and go through the Chair rather than addressing the minister directly.

ZACH CHURCHILL: That would fall under child and youth protection, which would be in the Department of Community Services. Those policies and practices wouldn’t involve the Department of Health and Wellness.

KENDRA COOMBES: I just want to clarify, Madam Chair. The minister is saying that his department is not in conversations with the Department of Community Services. Am I correct in that assumption?

ZACH CHURCHILL: We’re not aware of any overtures from the Department of Community Services’ child welfare in relation to this issue.

KENDRA COOMBES: I’m wondering if the minister knows of or if his department is committing to further funding pre-natal and post-natal care and other programs to help expecting parents.

[5:00 p.m.]

ZACH CHURCHILL: On top of the funding that we do provide to the midwifery program, as well as the IWK Health Centre, there is an enhancement to what’s called the Healthy Beginnings: Enhanced Home Visiting program.

This is a perinatal program, so it’s for pre- and post-natal support for vulnerable families. It focuses on supporting parents by promoting healthy parent-child relationships, fostering healthy childhood development, and linking families with other community resources that are available. It is offered prenatally and for the first three years of a child’s life. It’s offered through the Nova Scotia Health Authority.

In the budget, the member will see an increase in funding of Public Health. A portion of that increased funding will be going toward this program.

KENDRA COOMBES: Through you to the minister, I’d like to thank him for that answer; I truly appreciate it. I would like to ask another question, and I’m going to skip around here.

For the last many number of years, this government has taken the approach of encouraging home care over long-term care. We know that there are significant resourcing challenges to meet the home care demands, and at a recent Health Committee meeting, we heard from the Department of Health and Wellness that compared to January of last year - which was 2020 - Nova Scotians are waiting about 35 per cent longer to receive home care services. This was something that was shared by our Deputy Minister Orrell.

I’m wondering, can the department commit to providing this information on a more regular basis?

ZACH CHURCHILL: Could the member repeat the question, please? I did miss the question.

KENDRA COOMBES: I’m not sure if the minister had heard the whole thing, but I’m wondering: Can the department commit to providing the information on the wait times for home care on a regular basis?

ZACH CHURCHILL: What’s tracked is the wait-list. The people who are waiting to receive home care, that is what we track. What’s not tracked is the scheduling times for folks who are receiving a wide range of services, sometimes partial services, sometimes full services.

The wait-list we do track. We can provide that. We can provide the wait-list to the House.

KENDRA COOMBES: I would say that is greatly appreciated. I look forward to seeing that on a more regular basis.

I’m wondering if the minister could tell us what the current wait times for home care services are, and when I say that I’m talking about the ones that we are tracking at this time.

ZACH CHURCHILL: The wait-lists are actually available through the online open portal through government, so those are available for public consumption at any time if the member wants to check on those regularly. We can send the most updated snapshot of that wait-list to the House if that would make it easier for her. That is available online through the open portal.

KENDRA COOMBES: I’d like to clarify something, just so I know if I heard it correctly. Did the minister say that they’re not tracking scheduling times - scheduling times being how long somebody who is receiving home care is waiting for appointments? What I’m talking about are the wait times to actually receive home care services. I’m not sure if we’re talking about different things.

ZACH CHURCHILL: I’m told times are not tracked. They have not been tracked in the province. The wait-list is what’s tracked, so the wait-list would be the people waiting to get on a home care service. That would be what’s tracked.

KENDRA COOMBES: I’m just wondering if the minister could tell us how long people are waiting. If they’re tracking that, they would know how long people are waiting, so that is what I’m asking.

ZACH CHURCHILL: Yes, what is tracked are the individuals who are on the wait-list. What’s not tracked is the wait times. I guess that’s never been a practice in place in Nova Scotia, because of the complication supposedly associated with that, because many people are waiting for partial services and some are waiting for full services.

Also, there are programs in place while people are waiting that do provide alternative services as well. Those include the Home First services. Those are provided through the Nova Scotia Health Authority, which is covering alternative services outside of the home care provider that support those individuals. As well, the department provides direct funding that allows people to - and we’ve increased that budget pretty substantially, by close to 20 per cent - so they can self-direct for self-managed care, supportive care, the Caregiver Benefit, the Personal Alert Assistance Program and various other programs.

While people are on the wait-list, they also have access to these other financial supports to get them the supports they need.

KENDRA COOMBES: I understand the minister believes that pay is negotiated through Labour Relations. I understand that, but this only applies to the unionized settings and there are a significant number of people who work in long-term care who don’t fall into this category.

Moreover, both British Columbia and Quebec’s government took the approach of intervening in the compensation dynamic of long-term care because of the unprecedented global health emergency that required they ensure safety and adequate staffing in their long-term care facilities.

Does the minister believe that these governments took a wrong or irresponsible approach?

ZACH CHURCHILL: My job certainly isn’t to lay judgement on our counterparts across the province in the decisions that they make. We’re all elected on mandates and we’re all elected to make the best decisions we can on behalf of our constituents and the provinces make their decisions. It’s not my place to assess the success or the priorities of those governments. That responsibility belongs to the people who elect them.

KENDRA COOMBES: Madam Chair, I am so happy that the minister talked about those who elected us all to this hallowed Chamber. I’d like to add that the Nursing Homes of Nova Scotia Association in their paper Enough Talk - and I’ll table that if the minister would like to have it - has recommended that the Department of Health and Wellness conduct a full compensation review of all roles in long-term care.

At a recent committee meeting, the deputy minister expressed some openness to this idea. Although I know the minister does state that compensation does not fall under his purview, the recruitment and retention of continuing care assistants hopefully would fall under his purview and he might want to be in policy discussion about how we can recruit and retain. A full compensation review might be something that’s very important in his department.

I would like to ask the minister: Is this being undertaken? If so, when will it be completed?

[5:15 p.m.]

ZACH CHURCHILL: Just to clarify, the vast majority of our long-term care employees, CCAs, are represented by unions. They function under the collective agreements, and we do have a well-established process to negotiate those here in the province. Again, very few of our CCAs are non-unionized, based on the information I received from staff.

There is an established process for collective bargaining that they do undergo for compensation. Of course, we have an interest in that compensation being competitive. We have an interest in recruitment, retention, and skills development of that workforce, without question. Those are priorities for the department. That is why we do invest significantly into training incentive CCA programs. I can run through some of those programs that we do have available.

We do have a number of bursaries, including the CCA bursary program. This was one of the recommendations from the expert advisory panel. That is for people who are looking to become CCAs. We do have a bursary program that we have enhanced as a result of that recommendation. We also have a Recognition of Prior Learning assistance pilot program, in which we recognize other professional experience that folks have, and we eliminate their fees associated with becoming a CCA, which I believe is $800. The bursaries are up to $4,000. This is very much an area of interest for the rest of the department.

Workforce management support is a priority as well, which is why we have brought the legislation in this week to create a mandatory registry. Right now, one of the workforce planning challenges we have is that less than 10 per cent of our CCAs are actually registered in a voluntary registry, which does create issues for recruitment, for retention, and for planning. This is an area that we do take absolutely very seriously. Without intervening in the collective bargaining process, we do invest pretty significantly in opportunities for people to become CCAs and to upgrade their skills.

KENDRA COOMBES: I do appreciate the fact that the minister has stated that this is very important to him, but the minister is just talking as if all those in long-term care are unionized, and they’re not.

Let’s go on with this. I would also like to clarify - and this was a clarification that was made earlier in the Committee of the Whole on Supply. The minister said that there was wage parity among CCAs. This may be true for unionized CCAs, but there are so many who aren’t in this category. The minister can peruse the job postings to see that there are regular postings for non-unionized positions at $12.55 per hour. I won’t mention the employers in the particular instance I’m thinking of, but hopefully the minister can take my word that this is the case.

Given this, and given that there is an incredible shortage of CCAs in the province, and these numbers obtained from the department’s estimates - there were about 388 job openings for CCAs at nursing homes based on a survey taken last September - and that there are incredible recruitment and retention challenges in this sector and that understaffing in long‑term care and home care create health and safety issues, can the minister explain his position that policy that considers compensation in long‑term care is not within his purview when it is about retention and recruitment?

ZACH CHURCHILL: I believe I have answered that question sufficiently for the member. Out of the 90 facilities that we do have, five of them are not unionized. That’s only five out of the 90 and it is incumbent upon those providers to provide competitive wages that oftentimes ‑ I mean, the information …

THE CHAIR: Order. Time has elapsed for the New Democratic Party. We will turn it over to the Progressive Conservative Party for one hour.

The honourable member for Cumberland North.

ELIZABETH SMITH-MCCROSSIN: I would like to ask the minister: Can the minister provide information on how many psychiatrists are being recruited for the Cumberland Regional Health Care Centre?

ZACH CHURCHILL: There are two full-time equivalents currently being recruited for that region in psychiatry.

ELIZABETH SMITH-MCCROSSIN: Can the minister let us know if there’s any plan to have 24-hour, seven-day-a-week on-call service for psychiatry in the Cumberland Regional Health Care Centre?

ZACH CHURCHILL: In terms of the local hours of operation, I’m told that would be determined by the physician group, and that wouldn’t just be the psychiatrists. It could also be the other mental health and clinical support staff, including social workers and psychologists. They would have to make determinations based on their human resource capacity, what they’re able to do.

[5:30 p.m.]

Of course, there are other disciplines outside of psychiatry that are utilized for mental health supports. We do have 24/7 service available to all Nova Scotians through our crisis line. For every single person, no matter where they are in this province, they do have access to that 24/7 crisis line where they can call and have an intervention with a mental health clinician.

ELIZABETH SMITH-MCCROSSIN: Can the minister provide a report of staffing shortages and ambulances that are left parked in EHS garages in both Pugwash and Amherst since January 2020?

ZACH CHURCHILL: It doesn’t look like we’re going to be able to produce that number immediately, but we have reached out to EMC to get that data for the member. I’m not sure when we’ll receive that from them, but as soon as we do, we will forward it.

ELIZABETH SMITH-MCCROSSIN: Some of our acute care beds have been closed because of a nursing shortage, as well as many of our constituents have been denied nursing and housekeeping care due to lack of staffing with VON. I’m looking to see if the minister has any plans to increase the human resource capacity for nursing as well as CCAs in Cumberland?

ZACH CHURCHILL: For any shortages or vacancies that are unfilled in any zone, the NSHA would continually be working to fill those positions and recruit nurses - in the case of the member’s question - to fill those. We are also focused on training more nurses here in Nova Scotia and in this budget, there is funding to increase the nursing seats at CBU and at Dalhousie to train more nurses here in the province as well.

We do have a shortage of CCAs, so there are a number of things that are going on to assist with retention on the CCA front. One would be better workforce planning through a mandatory registry. That is a bill that is tabled before - that has been introduced in the House and will be working its way through the legislative process.

Right now, only 10 per cent of our CCAs are on the voluntary registry which exists. Under 10 per cent are actually registering, so that creates challenges in terms of workforce planning.

We experienced the value of this sort of registry when I was at the Department of Education and Early Childhood Development with early childhood educators. We really utilized that resource to draw in people who were trained as early childhood educators who had practiced as early childhood educators, to being them back into the system. We utilized that very effectively and we actually have one of the great folks who worked in the Department of Education and Early Childhood Development on that recruitment in the Department of Health and Wellness right now helping us with the CCAs.

That is more of a mid- to long-term solution. That comes from the long-term care expert panel recommendations as well - focused on CCA training to incentivize more people to be involved in that meaningful career.

We do have some very generous bursaries to get into that program, up to $4,000 either at the NSCC or a private career college, as well as the Recognition of Prior Learning program, which allows folks with applicable experience to transition easily into the CCA sector. We’ve eliminated the fees associated with that as well. So these are priority areas for the department, without question.

ELIZABETH SMITH-MCCROSSIN: Madam Chair, I’d like to share the time with my colleague from Sackville-Cobequid.

THE CHAIR: The honourable member for Sackville-Cobequid.

STEVE CRAIG: It’s an honour to be here in this House virtually and ask some questions of the minister. Certainly, I appreciate the scope and enormity of the minister’s role and responsibilities and I do thank him this evening for taking some of my questions.

To help the minister’s staff, I’m going to be focusing around the Cobequid Community Health Centre in Lower Sackville. I have a few questions around that, so this should give the staff some time to get oriented, I would believe. I’m going to have a few questions again around that. Then my last question will be around doctor shortages and recruitment in my particular area. After I ask that question, I’ll be turning it over to my colleague from Cole Harbour-Eastern Passage.

[5:45 p.m.]

First a little bit of history, if I could. It was mentioned earlier there were differing views - a statement of facts, I suppose - on the value of history. I have to tell you, the Cobequid Community Health Centre used to be called the Cobequid Multi-Service Centre, and that came about in the 1980s because of two registered nurses - Shirley Freer and Carol Crosby. They were advocating for the Cobequid Multi-Service Centre with a couple of MLAs of the day. They actually had an agreement in Cabinet and of the government of the day to build on the former site of a liquor commission, which is now the site of Quest: A Society for Adult Support and Rehabilitation here in Lower Sackville.

I was on the board of that Cobequid Multi-Service Centre way back when. At that time, the facilities had their own boards and that’s where I first got my feet wet, if you will, in health care. My executive director of the day - and you may recognize the name of Kevin McNamara. That’s where Kevin started out. He became, naturally, the Deputy Minister of Health at one point.

It came about at a time when Shirley and Carol were looking for innovative ways to do things in a greatly growing community. The community at that time would have been comprised of Bedford, Sackville, Waverley-Fall River, Lucasville, and Beaver Bank. They established the first - the very first in Canada, I am led to believe - free-standing emergency centre, and with that, of course, all the things that you needed. You needed laboratory, you needed imaging, and other services. The service side of it grew, too, so we had things like IWK Mental Health, we had rehab, we had physio, and cancer care came later, but certainly it’s grown as the needs of the community have grown.

Not too many years ago now, the new Cobequid Community Health Centre was built on its current site at the end of the lane called Freer Lane, after Shirley Freer. It’s got a big history, and the amount of services that have been in there has continuously grown, and the important thing to note is that it’s grown with the needs of the community. It’s grown to the point where we do need to see some additional services.

Cobequid doesn’t have any hospital beds. People are either discharged or transferred to the Infirmary, the IWK, or the Dartmouth General. Now, naturally, we know that the off-load problems with paramedics and the number of people waiting in hospitals for placement elsewhere like long-term care . . .

THE CHAIR: Order. We’ll take our 15-minute COVID break. I thought I’d be able to do that before the minister answered, but the question seems to be taking some time to formulate.

We need to take this break. I apologize for interrupting the member, but we will resume in 15 minutes, which will be 6:02 p.m.

[5:47 p.m. The committee recessed.]

[6:02 p.m. The committee reconvened.]

THE CHAIR: Order, please. Just before we resume questions to the Minister of Health and Wellness, I have two things Zoom-related to say. Number one is when you are speaking, please don’t forget to take yourself off mute. Even if you haven’t muted yourself, it’s possible that Legislative Television has muted you because they need to preserve the quality of the audio for the video.

Secondly, for those of you who are asking questions, it would be great for the Chair if when you’re finished your question, you actually do put yourself on mute so it signifies to the Chair that you’re finished your question and then I will recognize the minister.

The honourable member for Sackville-Cobequid.

STEVE CRAIG: It’s good to be back. I just want to continue with my preamble before I get into the questions to the minister. It is around the Cobequid Community Health Centre. That will be the line of my questioning. I will have one question following my last question before I turn it over to my colleague from Cole Harbour-Eastern Passage, and that will be on doctor recruitment in my area.

I want to finish off before I get into my first question. The Cobequid Community Health Centre is located in Lower Sackville, for those of you who don’t know, just off Exit 4 on Highway No. 102, and that’s where the Burnside-Bedford-Sackville connector will terminate. It’s close to the Stanfield International Airport, and it serves the growing areas of Bedford, Sackville, Waverley, Fall River, and beyond. I’m sure there is so much more that Cobequid can be used for to help the health care system, however I haven’t seen anything in the budget.

A couple of years ago, there was an expansion of medical day surgery clinics, and it was to provide follow-up care for multiple disciplines that were previously or maybe even still delivered at the QEII Health Sciences Centre clinics, and now they’re provided here in Lower Sackville. There is room for expansion physically, up and out if you will, and also to provide for more services. I’m sure more can be done.

When the QEII Health Sciences Centre redevelopment talks took place, it talked about the Dartmouth General Hospital, it talked about the Halifax Infirmary, Hospice Halifax, the QEII Cancer Centre, the Community Outpatient Centre in Bayers Lake, and the Hants Community Hospital, and yet there’s nothing for the Cobequid Community Health Centre. My questions are going to revolve around this. My first one will have to do with the emergency department.

When we talk about closures of emergency departments, Sackville does not have a 24-hour emergency room. It’s open daily from 7 a.m. to midnight, and after hours, emergency people go to the Infirmary, the Dartmouth General Hospital, or the IWK Health Centre. In my opinion, it’s about the best functioning emergency department in the province, notwithstanding the services from others around the province.

My understanding is that before the doors open in the morning, the staff need to be on hand. Also after midnight, they have patients still in the emergency department, sometimes until opening the next day. Again, staff are required to be there until the patients are either discharged or transferred. So with no hospital beds, they’re either discharged again or with the off-load problems that we have that are causing problems with people waiting here in the hospital for placement elsewhere, you get long-term care programs where in-patients are just waiting there.

My question to the minister is: What is the process and timing to re-examine the possibility of making the Cobequid Community Health Centre an emergency centre department and a 24-hour operation?

ZACH CHURCHILL: There is quite a bit of history here with this facility. I do want to take a moment to thank the member for sharing with me some information that I certainly wasn’t aware of in relation to the history of the Cobequid health clinic and thank him for his previous work on the board there. I didn’t realize that was where the member began his career in public service, in the health care sector in that way. Now it goes far beyond, far later than that. Anyway, I very much appreciate the question.

Staff have informed me that there has been a review over the last eight years that included looking at demographics, population, staffing, and facility capacity. It was determined - and, of course, clinicians would have been involved in this review - that to extend the model of the emergency department delivery wouldn’t be possible.

I know they even looked at bringing in a dialysis unit there, but it was deemed that the facility didn’t have the capacity for that. I do know that there has been a review done on that that involved clinicians and it was determined to maintain Cobequid as a community health centre. I do believe that these reviews are fairly continuous, fluid, and I am sure the assessments of that facility and what its future holds has not been concluded on all fronts.

STEVE CRAIG: Yes, absolutely - through successive governments, looking at 24‑hour care emergency delivery has been noted, and it is quite expensive. What the minister referred to about eight years or so ago meant an expansion from 10:00 p.m. to midnight at a cost of about $1.5 million. So, if you take that as a benchmark it will give you an idea of the cost to increase, if you can get the physicians ‑ if you can get everybody else to do that work. So, that is important with a process that continuously needs to be renewed.

When I go back to the QEII redevelopment, I question it because I didn’t see it. I might have missed it and if somebody can point it out to me, that would be great - what the actual implications of having 24‑hour care at Cobequid would have been to the overall redesign.

I would like to ask: Is the minister aware of any expansion or increased mental health services at Cobequid Community Health Centre, whether they be through the department ‑ I was going to say ‑ I was dating myself ‑ NSAHO, but either through IWK or through the health authority?

[6:15 p.m.]

ZACH CHURCHILL: Thanks to the member for the patience. He has history and understanding of this facility very specifically that I don’t have, but I am benefiting from some institutional knowledge that I have around me.

In terms of the review that happened and the determination that it would not be advantageous to extend the emergency department to 24/7, based on the information that I’ve been able to gather quickly during this conversation, it mostly had to do with the physical capacity of the facility not having in-patient capacity in particular and therefore creating a situation that could impact efficiency of the ED services there and creating overcapacity in the emergency department. That seems to have been the conclusion at the time.

I am told there have been various expansions of services for the Cobequid Community Health Centre, including mental health and addictions. They do have a team there - and there’s no plan to remove that team, they will remain there - as well as lab services, occupational therapy services and physiotherapy services. I think over time there have been expansions there, based on what I’m being told.

As the QEII redevelopment happens, there will be continual evaluation of the spaces that we have, which would include Cobequid. So there very well might be adjustments, changes, enhancements to the services that are provided there that we might not know about right now, depending on what the future holds and what those future analyses tell us.

STEVE CRAIG: I thank the minister for expanding a little bit on that. It never occurred to me that there would be a reduction in services even contemplated at Cobequid.

However, the minister, Madam Chair, did not answer my question about the mental health services. He indicated that the current system will stay in place, but did not touch on the IWK and mental health. I’m not going to go there. I’ll pursue that another way at another time.

My question now around again Cobequid - the minister’s touched on it a couple of times, and, actually, unprompted he mentioned dialysis. People who are at the Cobequid Community Health Centre have been asking about dialysis - and, by the way, just for the information, I was not only on the board, but was treasurer of the initial Cobequid Community Health Quality Services Centre. In recent years, up until 2012, I was chair of the foundation there, so I have a little bit of institutional knowledge as well.

When it comes to dialysis, we were considered. Cobequid was considered for dialysis. The need was great, as the minister would be well aware. What’s been decided is that there will be 24 dialysis chairs at the new centre at Bayers Lake, and that will open up in about 2023.

My question is: Why is it that Cobequid wasn’t seriously considered? I’ve heard - and I’d like clarification on this - the reason for the services not going back to Cobequid or being increased is because of the physical size of the facility. That they don’t have the space. That’s a good thing, because the space was meant to be utilized.

The building was built, my understanding, with capacity to grow and to grow up and to grow out. There’s plenty of room there to do that.

I wonder if the minister would speak as to what really the procedure would be to take a look at any service that might be contemplated for the Cobequid Community Health Centre, and what the decision-making criteria will be. If the space is not available, what do we do to go about getting more space?

[6:30 p.m.]

ZACH CHURCHILL: Evidently, there’s a lot of history on this building that I’m trying to learn about very quickly in the room here to answer members’ questions.

In terms of the IWK Health Centre and the expansion of mental health services there, there has been an expansion of eight mental health clinicians at the IWK. Of course, they also provide community support at at least three different facilities in Halifax, including Cobequid, so there were eight additional mental health clinicians that have been hired for that.

In terms of the dialysis question, which is where the bulk of the conversation here has been in the room, to bring me up to speed on this, it was determined that more beds were needed in the Central Zone. They looked at multiple sites. Cobequid was looked at. It was determined after an architecture, engineering and cost analysis that Cobequid was not the most cost-effective site and there was also some potential difficulty related to the architecture and engineering. I believe that’s related to the geography of that location.

It was determined then that the chairs would be built in an attachment to the Dartmouth General Hospital. That’s what impacted the decision to build that new facility at the Dartmouth General, which is brand new and is in service right now. Cobequid was considered but as I think the member recognized, there was no space within the facility itself to put those chairs, so it was analyzed to see if an expansion of that building was possible. For various reasons, it was determined that that was a more challenging site to build those chair spaces on.

STEVE CRAIG: I thank the minister for that response. I think one of my objectives of asking the questions here this evening was to educate members on just the multi-service aspect of this facility here in Sackville - that it can be utilized much more and there’s probably a case to be made for expanding services and expanding the footprint of that building, either out or up.

Just before I go on, in my former capacity as Chair of the board out there, I recognize a former Health Minister, whose name I cannot mention, and just want to indicate that I had many meetings and occasions to be with him and I always welcomed him out in Cobequid in Lower Sackville and he was very well received and very gracious in his time to give to the board and to the facility itself.

My last question, before I pass it on to the member for Cole Harbour-Eastern Passage, is around doctor shortages and retainment and recruitment. In the area of emergency services, for example, we were faced a number of years ago with having more people coming in to the facility who did not require what we would all recognize as true emergency service, so we went into a whole big triage system.

Also, too, just down the road, next door in fact, was built the Cobequid Centre. In there, we had the pharmacy and a walk-in clinic. Part of that was to take the load off the emergency. That was done with the private sector and done quite well. So just thinking about those things and how we can reduce the number of people who were required to be serviced in an emergency centre is a good thing.

Now we’re seeing that reversal because people don’t have a family doctor. This time last year, my doctor for over 50 years, who has been in the community, Dr. Tom Chui, passed away. He was a family friend and as I say, he was my physician for close to 50 years but he left thousands without a physician. His patients were suddenly left to look for another one.

I looked at the stats on the waiting list as of February just last month or the month before. In Sackville, it’s 680. This time last year, it was 393, so we have an increase of 58 per cent. That may be understated because people did not go to the waiting list and made some other arrangements, and they’re just not there.

My question to the minster is: Is he aware of any recruitment efforts and what they might be out in the Cobequid area and Lower Sackville, Bedford, Waverley-Fall River, Lucasville, and Beaver Bank?

ZACH CHURCHILL: We are going to run out of time here, so I’ll provide the member with the information that I have.

Currently, the NSHA is actively recruiting for five emergency department positions for which there are vacancies. They are being actively recruited for right now.

We do have a list of 17 new physicians who are coming to Nova Scotia from abroad who will be here for a number of areas, including the Halifax area. They will have a say in terms of where they are practicing in consultation with the health authority and physician services. We do have a number of those who are coming this April. We do have 17 family doctors who are on the docket to get here very soon.

Sorry, that includes specialists, as well. There are some specialists in that number, as well. So, we do have some new folks coming in . . .

THE CHAIR: Order, please. The time for the PC caucus has elapsed. We will now move on to the NDP caucus.

The honourable member for Cape Breton Centre.

KENDRA COOMBES: I want to start off with two clarifying questions. I want to go back to long-term care and CCAs.

To clarify: the minister and the department are not entertaining the full compensation review of all long-term care roles, even though it is vital to retention and recruitment within the Department of Health and Wellness.

ZACH CHURCHILL: I feel I have answered this question sufficiently. Out of our 98 facilities that are licensed, there are only five that do not have unionized staff. There is a collective bargaining process that is followed with all of those unionized staff. We will follow that process. I’m certain we’ll be consulted by the Department of Labour Relations as we head into those processes, but we will not be the department that leads that work for rationale that I previously expressed to the member, but I will reiterate, since she does keep asking the same questions.

The reason we have established a Department of Labour Relations is precisely so that the line departments whose responsibility it is to deliver services to Nova Scotians, to enhance those services, adapt them to the changing needs of Nova Scotia - so that our time is not spent in this continuous collective bargaining cycle. There are a lot of bargaining units that we deal with, with public sector unions, so that work is continuously happening year over year, and our previous Premier made a decision on that. Particularly after we lived through a very real example in education, where the reform agenda that we were trying to bring to education was stalled because of collective bargaining, which impacted that service delivery to students in a real way.

I think I would guess living through that experience and seeing the distraction that happens from the core mandate of these departments, which is on the service delivery and support programming for people, it was determined to put another department in charge of that. That makes very good sense. That was a wise decision. It allows ministers like myself who are responsible for, in the case of the Department of Health and Wellness, almost half or 40 per cent of provincial money, who oversees critical care for people from when they’re born to when they are in our long-term care facilities and even on their death beds - it allows me to focus on that service delivery and focus on the mandate letters that we have for change and adjustments to these services.

I realize that the member is very interested in labour-related questions. She’s made that very clear. I will say again she is directing those questions in this case not to the appropriate minister, and if the member does want to focus on the questions related to programming of the Department of Health and Wellness, service delivery for mental health, long-term care, primary care, that’s where our time is best spent.

This process was also made specifically to go over the budget, which is why this is called Estimates, because we’re actually supposed to be talking of budget forecasts and budget line items, and there are 40 hours in there in case people do want to go through line by line to give ample time for that. I’m not sure what else I can explain to the member on this, but for very good reasons, for good rationale, there’s another minister responsible for the collective bargaining process. I think that’s a very good decision that we made.

That said, recruitment and retention of our CCAs is absolutely a priority for this department, and we’re engaged in those initiatives in very real and significant ways. We have financial support available through this department outside of the collective bargaining process to help those who are interested in training to become a CCA do so while reducing the financial burdens to them. We have bursaries in place that support our CCAs in the amount of $4,000.

We have the Recognition of Prior Learning process, which makes it easier for people who have applicable experience in this field to become certified as a CCA and to practice. We also waive the fees for that. That’s an $800 fee. The workforce management is important, which is why we’re bringing in a very important tool, an effective tool that’s going to help us do this critical work for recruitment and retention and workforce planning through a mandatory registry. That is going to be operated by a third party, the Nova Scotia Health Association. They’re the folks who currently oversee the voluntary registry.

[6:45 p.m.]

I know it was asked by the Party about the privacy, so I hope I’ve answered that question as well. The appropriate people in-house who help us ask and answer questions related to people’s privacy, including our legal team and our privacy director, reviewed that legislation. These are the ways that the department engages in recruitment and retention and support for that workforce.

KENDRA COOMBES: I’m going to assume, then, that the answer is a no.

I want to do another clarifying question with the minister, Madam Chair, regarding home care. It’s because I still have not received a response from the minister on this.

If the deputy minister, Dr. Orrell, can tell us that Nova Scotians are waiting 35 per cent longer to receive home care services, what are the current wait times that make up this 35 per cent? Are people waiting one month? Six months? One year? That is what I’m asking. What are the wait times for that 35 per cent?

ZACH CHURCHILL: Just to be clear, the member put words in my mouth that we do not care about competitive compensation for staff that we’re trying to recruit and retain, so I just want to clarify for the record that that’s not true. I certainly don’t appreciate that characterization of our discussion. I’m simply pointing out the fact that we have a process for collective bargaining, and we follow that process.

Of course, I believe that competitive compensation is important. I believe that financial support to help on the training side and I believe that facilitating the inclusion of people who have applicable life and work experience to the sector are all good things.

The member, I think, really does understand what my point is and it’s that she’s directing labour questions to a minister who does not oversee that process. I do not appreciate the characterization of my stance on compensation. I wanted to clarify that for the record.

In relation to Deputy Orrell’s comments, he was specifically speaking to the wait-lists.

KENDRA COOMBES: I’d like to ask, if Dr. Orrell was to talk about the wait-list, how long are people waiting? How long are people waiting on that list?

ZACH CHURCHILL: The care coordinators of this system are in contact with clients who are waiting for these services. Again, the wait times are not tracked. I am told there are complexities with that because of the partial services and various factors that impact that, so that’s not something that has ever been tracked in the province, under any government.

The care workers reach out to those clients directly to inform them, while they are waiting for services, of the other direct funding supports available for them to employ their own services or to provide the caregivers benefit to a loved one who wants to support that individual, and also for supportive care and other services, as well as the Home First services that are provided through the NSHA.

Every individual in our home care setting who is on the wait-list would have access to that information so that they can get that funding that is available through the NSHA and/or through the department.

KENDRA COOMBES: I’ll move on. I’d like to ask the minister how many gynecologists there are currently in the province.

ZACH CHURCHILL: The answer is 71 gynecologists currently employed in Nova Scotia.

KENDRA COOMBES: I thank the minister for that response. I would also like to ask the minister: What is the current wait time to see a gynecologist, outside of pregnancy?

ZACH CHURCHILL: We might not be able to produce that number in the time that we have left, so we’ll make sure that we follow up with the member to provide her with that information, because I do know we require a few minutes to pass the resolution at the end of this. That is something that if we do not produce in the next couple of minutes for the member, we will ensure that she gets that info.

KENDRA COOMBES: I’d appreciate that information when the minister is able to provide it.

I would like to go on and ask the minister a few questions about children and adolescent mental health care. The minister may know that there are wait times in the dozens and even hundreds of days for children seeking non-urgent care.

For example, at the industrial Cape Breton clinics, most people wait 66 days for the first appointment and then 133 days for the second. At the IWK Health Centre, the wait time website lists 37 days for the first appointment and 34 days for the second appointment. But anecdotally, we have heard of someone who was only able to get an appointment for their child three months from now.

The minister might also know that there are virtually no private clinics that are taking on new children as patients, adding another layer of complexity for those who are fortunate enough to have coverage or ability to pay. All of this creates, of course, incredible stress on a family.

My question for the minister is: What is being done to increase the capacity in our public clinics?

ZACH CHURCHILL: There have been significant improvements in the wait times for the urgent and non-urgent supports that are available for those with mental health issues. For the non-urgent, the wait time used to be over a year in the province and we have brought that down to a median of 26 days wait time for non-urgent cases. For urgent cases, the median wait is two days.

For Cape Breton, comparing wait times for 2019 to 2021 for industrial Cape Breton, the children and youth non-urgent median wait time was reduced by 73 per cent from 137 days to 37 for non-urgent. For non-urgent adults in Cape Breton, the median wait time was reduced by 86 per cent, from 209 days to 29 days. There’s been some demonstrable change in this area on those wait times.

KENDRA COOMBES: I appreciate the answer from the minister. I’d like to go back a little bit and ask the minister: What funding is allocated to the new endometriosis clinic at the IWK Health Centre?

ZACH CHURCHILL: We would have to source that information from the IWK. We’ll endeavour to do that for the member.

KENDRA COOMBES: I would like to ask the minister a question that our caucus received. A constituent contacted us to let us know that according to this person, the Seniors’ Pharmacare Program phone line to pay this year’s premium is perpetually busy. People want to be able to pay using their credit card, but no one is answering the phone and there is no online way to do this, and it would be very helpful to set this up. That was a direct quote. Does the minister have any information about this?

ZACH CHURCHILL: I’m told that the mailout does have a spot on it where you can include the credit card information.

KENDRA COOMBES: I’m just wondering if the minister has any information with regard to paying by phone.

ZACH CHURCHILL: We believe you can pay by phone but we can confirm that.

KENDRA COOMBES: I’d like to tell the minister that you can pay by phone but they were having issues. Are they doing anything to fix those issues?

[7:00 p.m.]

ZACH CHURCHILL: Yes, of course. We’re always looking . . .

THE CHAIR: Order, please. The time for questions for this evening has elapsed.

The honourable Government House Leader.

HON. GEOFF MACLELLAN: Madam Chair, I move that the committee do now rise and that you report progress and beg leave to sit again.

THE CHAIR: The motion is carried.

The committee will now rise and report its business to the House after a 15-minute break.

[The committee adjourned at 7:00 p.m.]