HALIFAX, TUESDAY, APRIL 5, 2022

COMMITTEE OF THE WHOLE ON SUPPLY

3:57 p.m.

CHAIR

Chris Palmer

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

The honourable Government House Leader.

HON. KIM MASLAND: Mr. Chair, would you please call Resolution E11.

Resolution E11 – Resolved, that a sum not exceeding $4,266,326,000 be granted to the Lieutenant Governor to defray expenses in respect of the Department of Health and Wellness, pursuant to the Estimate.

THE CHAIR: At this time, we would like to open it up for questioning again and bring it back to the Liberal Party, which has 38 minutes.

The honourable member for Clayton Park West.

RAFAH DICOSTANZO: I’ll get used to this. I was looking forward to seeing the minister and Dr. Orrell.

My first thing to the minister. I wanted to start with a very positive remark and thank her for the refugee clinic. I reached out to them to see what else is happening at the refugee clinic and what they need. I have had a very positive response. They are doing very well, and finally, they have enough staff to do the work. That was thanks to the minister.

They thanked me for the advocacy. Honestly, my reply was that I did it for the refugees, for the patients, but more also for our health dollars. Imagine, without the refugee clinic, all those patients would be going to emergency.

The number of visits that I did as an interpreter at the emergency that took hours and hours, and they kept going back to emergency. This clinic saves us so many visits to emergency that I could not imagine not having this refugee clinic, when they said they were closing their doors. In fact, it was COVID-19 that saved them. They were ready to close because they were trying to get more funding for another doctor or two, full-time staff, and a social worker.

THE CHAIR: If I could interrupt the member, at this point we might have to take a little pause. We don’t have the minster, so at this point we’ll just take a quick pause and recess. We’ll make contact with the minister and then we’ll bring things back.

[4:00 p.m. The committee recessed.]

[4:04 p.m. The committee reconvened.]

THE CHAIR: Order, please.

The honourable member for Clayton Park West.

RAFAH DICOSTANZO: We’ll start again. I guess the minister is here virtually. I would love to see the person that I’m speaking to, but I guess that’s not how it’s going to work.

I will start my questioning. The information is regarding . . .

THE CHAIR: Sorry to interrupt. We may have to just ask you to pause again.

RAFAH DICOSTANZO: I’m not going to stand and speak until I see her. How about that? (Laughter)

They should introduce themselves, maybe, tonight and then I’ll speak. It’s really wrong. It’s very awkward, actually.

THE CHAIR: Order, please. Before we begin, I would just like to recognize the Minister of Health and Wellness to acknowledge that you can hear us and everything is working on your end and, if you could, to introduce any staff who may be with you for this afternoon.

The honourable Minister of Health and Wellness.

HON. MICHELLE THOMPSON: Good afternoon. Can you hear me?

THE CHAIR: Yes, we can.

MICHELLE THOMPSON: Great. I have Shelley Bonang with me, I have Deputy Minister Jeannine Lagassé with me, and I have Dr. Kevin Orrell with me.

THE CHAIR: The honourable member for Clayton Park West to begin the Liberal questioning.

RAFAH DICOSTANZO: Welcome from home or from the office to the minister and to the staff. I had a few questions that I want to start, but I really wanted to start by thanking you.

I reached out to the refugee clinic to see if they have any issues or any updates on what is happening. They were very pleased with the work that the minister has done in supplying the staffing that was required for them to keep their doors open and also the social worker. Things are moving very well. They’re receiving refugees from Afghanistan and others, and they’re also expecting refugees maybe from Ukraine.

I just wanted to say how thankful I am because this is not just for the refugees, but also for our tax dollars. I knew that if they closed their doors, the number of visits to our emergency rooms would have been doubled up, truly. Those refugees when they arrive, they do not have the language and the only place where they can get an interpreter service would be at the emergency. That’s the only way they can communicate.

The savings to our government is incredible and wonderful and I thank the minister for moving fast on this. We are going to have an increase in the number of refugees, as we expect, and this was a disaster waiting to happen if they had closed their doors.

Maybe I can ask if they know how many patients that this clinic services and what is the expectation? Do they have the number of patients that they expect this clinic to provide care for, if you could answer that one, please?

MICHELLE THOMPSON: The Newcomer Health Clinic services approximately 2,400 clients.

RAFAH DICOSTANZO: Is this number just for this year? What is the expectation with our immigration numbers increasing? Do we know what pressure will be on this Newcomer Health Clinic for the future? Do you have one-year, four-year, or five-year projections?

MICHELLE THOMPSON: We expect that the number would stay fairly static year over year. It is what we would consider a transition clinic. After a certain period of time, ideally six months - but we know that there are some people who may need to stay on longer - we would transition the newcomers to private care providers in the community, and then be able to welcome more.

That’s how I would see that. That we would continually move people along to the community and then accept new folks as they come. We continue to work with the clinic around the capacity, their expected intake, et cetera in order to ensure that the clinic is functional.

THE CHAIR: If I could ask the honourable minister, when you are prepared to make a response, just give me a little head nod, if possible, then I can easily recognize you that way.

[4:15 p.m.]

RAFAH DICOSTANZO: The expectations are, actually, it would take them about a year before they move them out of the Newcomer Health Clinic, before they adjust. What happens when there are no doctors taking them? What are the solutions for those? How long is it taking right now, in numbers, before they are moved to a regular community family doctor?

MICHELLE THOMPSON: What’s happened in the past is that those patients have stayed with the clinic. I think in the Fall we had some capacity issues and we were able to support some patients to move to a primary care provider, so that’s what we would do. We need to make sure that they do have a provider in the community and in the event that there is no one, they would stay as a patient at that clinic until such time as we can transition their care.

RAFAH DICOSTANZO: I’m familiar with the work they do but I do know that there are very few doctors who are taking new patients. I hope this will work for the Newcomer Health Clinic and, again, I just want to end this with a very positive thing that you were able to help them so they don’t close the door. Thank you for that.

The second thing that I wanted to talk about is the different professions and the internationally trained pharmacists, I’m going to start with that. Again, I have something positive. I guess Nova Scotia is a leader when it came to a program that the Nova Scotia College of Pharmacists started. Apparently, we have a program to train internationally-trained pharmacists in Nova Scotia and it wasn’t working very well because it required 20 weeks of training, 12 in a community pharmacy and eight in a hospital setting. It was very difficult to find the space in a hospital setting, so that program never worked until about 2013, when they changed it and removed the requirement for the hospital eight hours and allowed the whole 20 weeks’ training to take place at a community level.

This has made a huge difference, honestly, and I’m thankful for that. I see, especially in my riding, at the Shoppers Drug Mart, there are many internationally-trained pharmacists who are taking their 20-week internship program through the different pharmacies. I think that was an amazing thing and we don’t have a shortage in pharmacists, hopefully, because of that, because we are trying to train them. This training is allowed to start after the first exam. Pharmacists need to take three exams and the first exam is - I believe it’s called the evaluation exam, and then right after that they can start their 20 weeks, which is very important because as they’re practising, they are learning the system and it makes it easier for them to pass the second- and third-level exams.

We are doing very well in that. That program is probably one of the best in Canada, across all the jurisdictions, and that’s called the structured practical training program. That is, again, something positive by the College of Pharmacists that they’ve worked on, something that was not working, and they maneuvered it so that we can have more pharmacists trained.

I do want to ask how many internationally-trained pharmacists have gone through this internship program and how many are working in Nova Scotia?

MICHELLE THOMPSON: That’s something I’d have to reach out to the Pharmacy Association of Nova Scotia for, if we’re able to gather those numbers. That is not something that we track in the department.

RAFAH DICOSTANZO: I would appreciate getting those numbers, just to see how well that program is working compared to other years. What is the cost of the program? Who is paying for this program? If I may ask that as well.

MICHELLE THOMPSON: That actually is a program that’s not run out of the Department of Health and Wellness. That would be run through the Nova Scotia College of Pharmacists. It’s not something that we have oversight over. The College would do that. The member would be able to reach out to the College. It doesn’t come through the department currently at all.

RAFAH DICOSTANZO: I was trying to get to a different profession, which is the physicians, internationally-trained physicians, to see where we are. It has been a very difficult country to have physicians who are internationally trained to work in Nova Scotia. Many years ago, doctors were driving taxis. Honestly, I remember in 2016, when I had a cousin who wanted to come who is a pediatric doctor. His kids had both just graduated from medical school. I told them, don’t come here because it will take a very long time to get your licence in Nova Scotia. They ended up in Australia, and they’re both working, and I’m sad that this is the story. It’s still continuing today.

We have many issues with internationally-trained doctors, and as much as we have a need for doctors, we have not found different pathways to help those doctors get into similar - for example, to the pathway that the pharmacies have been able to find, where they are actually working, making money, as an assistant to the pharmacist while they are learning. Are there any negotiations with the College of Physicians and Surgeons of Nova Scotia to work on some pathways that would allow internationally-trained doctors to be actually working as a physician assistant while earning some money, and putting food on the table for their kids, and having a program, whether it’s a year or two years? Is the department of recruitment working with the College of Physicians and Surgeons of Nova Scotia to see what programs they have?

MICHELLE THOMPSON: There are a few things to say about that. There are three countries that we have reciprocal agreements with: the U.K., the United States, and Australia. The physicians that enter Canada, Nova Scotia, from those countries have reciprocal agreements. All internationally-trained physicians write an evaluation exam. Once that is passed, they then go into a Practice-Ready Assessment stream, which we are currently working to expand.

In past years, the number in the Practice-Ready Assessment group was six. This year there are nine physicians in the Practice-Ready Assessment group. Once the Practice-Ready Assessment is completed, those physicians are able to work under a restricted licence and have 60 months to complete their training.

If the physician who comes into Nova Scotia is not licensable, for a variety of reasons, or they don’t pass their Practice-Ready Assessment, those physicians can work under clinical associates, working with qualified physicians in order to deliver care in some specialties.

RAFAH DICOSTANZO: If I wanted to understand this, I know that the Practice-Ready Assessment, the PRA, requires a two-year residency, and that is our residency in Canada, and in maybe one or two other countries. In other countries of the world, whether it’s India, whether it’s the Middle East, in many other countries, they have different residency lengths of time, so it could be 12 months, it could be 18 months.

That restriction, that one requirement, has made a huge - and when you’re telling me there’s six to nine, there’s so many, maybe 100 doctors, who could qualify to do their Practice-Ready, but because in their country the residency is a different number of months, they’re out, they don’t get a chance. Are you aware of this issue that is happening?

MICHELLE THOMPSON: The folks who do the Practice-Ready Assessment do not require a residency program, as long as they pass the Medical Council of Canada exam, they have 60 months to be certified, so it is different.

There are internationally-trained graduates who may require a residency exam, but that is separate from a Practice-Ready Assessment.

RAFAH DICOSTANZO: I was just speaking to somebody this morning and this is the case here, in fact, in two other jurisdictions - in Saskatchewan and Manitoba - they have removed that two years for internationally trained doctors. It is still here that in order to take the PRA they have to have a residency. That is the information I received today from internationally-trained doctors. Sometimes they have experience, but their training did not complete two years because that was part of their training, a different number of months, and it’s still an issue here. However, this requirement has been removed in Saskatchewan and in Manitoba. I was given that information just this morning.

MICHELLE THOMPSON: I think there are a number of different things there to the member’s point, I think there’s a number of different streams. It’s very complicated. So I think the best thing would be for the member to reach out to the Office of Healthcare Professionals Recruitment and get the information she is looking for.

There are a number of streams of physicians. Some require Practice-Ready Assessments; some need to be on a world list of medical schools. I think it is very complicated, and I think you’d get the best information if you spoke directly to the office.

[4:30 p.m.]

RAFAH DICOSTANZO: These are constituents of mine, and they know this is what is happening here; in fact, they’re moving to other provinces because of this issue. It’s not that I’m not understanding the streams. I know all the streams. A lot of the people I am in contact with are doctors who’ve been here. In fact, many of the interpreters I’ve worked with were doctors who are qualified in other countries. That was the case, and it still is the case, unfortunately.

I also wanted to know - as I said, there should be some programs that allow - sorry. Another issue that we have is that we only have two residency spots for internationally trained IMDs. Again, that is a very, very small number. It’s normally given to our kids who’ve gone to the Caribbean or gone to Poland to get their International MD part, and then they come back. Just two spots, and those are not given opportunity to internationally- trained doctors.

Is there any change to increase the number from two spots - is there any hope that this number will increase?

MICHELLE THOMPSON: There are some capacity issues currently at Dalhousie and the Office of Healthcare Professionals Recruitment is working with Dal to understand how we can increase that capacity.

RAFAH DICOSTANZO: I do hope they increase it. Two is a very small number when we have 189 doctors who are over 65 years old who are going to retire. We need all the help - and these are people who are already here. These are medical professionals who are just trying to get their licence in Nova Scotia.

The other question I have is, for example, we have a stream that is called the clinical assistant pathway at the hospitals. They are paid as a full-time job to work with a specialist or with a doctor at the hospital while they do their training and learn. I want to know, how successful is this program, and how many do we have enrolled in the clinical assistant pathway at hospitals?

MICHELLE THOMPSON: There are a small number working in the province. We are going to confirm the number for you. There are three in Cape Breton who work with psychiatry. These are permanent positions, as you mentioned, but they do not advance to a licensable physician. They have chosen that in lieu of qualifications. We are looking to expand the program and understand where these clinical assistants may be able to support other specialties throughout the system. We will confirm the number. It is a small number, but it is something that we are looking into.

RAFAH DICOSTANZO: Yes, I apologize. I did know that, that they are not moving or studying to move forward. They have chosen this as their job, as an assistant to a specialist, and work in the hospital in that capacity.

I’m also thinking, is the department preparing - because there is such a desire for doctors to come and live in Nova Scotia and work in Nova Scotia and we have this opportunity with all these family doctors who are about to retire. They have the knowledge, and they know the system. To me, it is so difficult. A lot of the internationally-trained doctors, it is not the theory that they struggle with or that we need to work with them on, but it is the system.

The Nova Scotia medical system is different, and in each country it’s different. The medications are different. If they worked under the family doctor, those 189 who are retiring can have an internationally trained doctor working under them similar to the clinical assistant for a few years, and they can be paid as an assistant while they gain skills and knowledge of the Canadian system, then once that whatever number of years you would give for that to be taken, or number of clinical hours at the family doctor’s office, then they would be the right person to take over for that doctor who is retiring or he can work part-time. Is there a program?

Are we looking at being leaders in something like this, which is so obvious to us, and we have so many who would want to do that? Is the office of recruitment working with Doctors Nova Scotia to prepare a pathway so that we can help our family doctors who are going to retire?

MICHELLE THOMPSON: When folks move to Nova Scotia, they have to have graduated from a recognized school in the World Directory of Medical Schools. That’s the first thing. We need to have a basic understanding of the education that physicians receive prior to coming. They do prepare for evaluation and can go into a Practice-Ready Assessment after that.

I would say that amongst the physician community, we are looking at increasing capacity, but not every physician or health care provider is willing to take on a mentorship role. We need to do that in collaboration with physicians who are interested in providing that mentorship.

To the member’s earlier question, there are 31 clinical assistants working in the province.

RAFAH DICOSTANZO: Thank you to the minister for that number. The 31, and they’re working in hospitals. Imagine if we can get maybe 100 working with family doctors. I think this is an idea that we really need to look at. A lot of the recruitment that was going to the three countries - Ireland, I believe Australia, and I don’t remember the third one, that we accept their education as equivalent to ours - and the United States, I believe, as being equivalent to ours. Those ones, their education is recognized, and if it’s not then we can give them the training. The ones who are from those three countries, they can come and work directly, they do not need to be under supervision, while the others can work for a couple of years under supervision and take the required Canadian exams. At least they have a job when they’re here and they’re earning money and putting some food on the table for their families as well. I hope that we can be creative and take advantage of a pathway similar to the one that we’re taking at the hospitals, in order to take over some of the load from the retiring physicians.

The third profession that I’m going to talk about, and it’s an incident that happened not even a month ago where I had two nurses from India, who are my constituents, who dropped in to get a notary public. As I was talking to them and reading the information that I’m signing, they were sending the registration to Australia for the nursing board in Australia. I said why are you registering in Australia? Why aren’t you doing it here?

The story goes that they’ve been here, both nurses have come to Canada as students, that was the easiest and the fastest way they can come to this country. She studied leadership and management at the College of Nursing in Ontario. Then they heard that PR was faster to obtain if they came to Nova Scotia. She came and took a course of general arts and science at Dalhousie just so that she can apply for a PR. These are highly qualified nurses from India, who speak English. So I asked, but why Australia? It doesn’t make sense.

The reason is, again, there’s obstacles that we’ve put in in getting the licence in Nova Scotia and one of them is the language testing. The language testing has a listening and speaking - I’m an interpreter and I remember how difficult that was when you’re speaking to a machine, and when there is an accent it is very difficult. It makes it much more difficult even though they were educated in English. They’re nurses. It is difficult because the terminology and the Canadian accent to another. It takes time.

The way she explained it to me, the fact that she is applying to Australia, she will actually get - because she’s registered in Australia - then Ontario will accept her directly, but Nova Scotia will not. Do you know anything about this one, please?

[4:45 p.m.]

MICHELLE THOMPSON: Certainly the English language test has been a barrier for people in the past. We have been working with the Nova Scotia College of Nursing to support internationally-trained graduates whose second language is English. Now what’s happening is that there’s an attestation process where an employer can testify that the person’s English is good and that will suffice over the English exams.

To your point around the licensing process, we do continue to understand the barriers for licensing. People who come in from other areas to come work here do have to start as continuing care assistants. We have a pathway to support them in terms of their education and moving forward to licenced practical nurse or registered nurse, depending on what their original qualifications are.

The office is looking at the barriers and how we can support folks in moving through that process in a more timely fashion.

THE CHAIR: The honourable member for Clayton Park West. You have approximately 1 minute and 50 seconds.

RAFAH DICOSTANZO: Perfect. So I’ll do it very fast. I’m sorry. I took an hour?

THE CHAIR: You had 38 minutes.

RAFAH DICOSTANZO: Maybe I’ll just mention that we are travelling to Dubai and Singapore to look for nurses and doctors and they are here waiting to get into our system, but we’re not reaching out to nurses who are here, either studying, trying to get their PR, in order to get their qualifications. I hope that we have some coordination in connecting with these different communities, whether it’s the Indian community, or the Filipino community in my riding, they will tell you how many nurses are here and trying to get their licensing. I hope that we can work on getting those because they’re already in Canada, and they have studied in our colleges or universities.

I guess with that, maybe I get some numbers of how many nurses are getting their designation for this year and next year? What do we have and what do we expect in numbers?

THE CHAIR: Order. The time for the Liberal caucus questioning is now complete. It is now time for the NDP caucus.

The honourable member for Dartmouth North.

SUSAN LEBLANC: I’m happy to be back for a third exciting day of Budget Estimates in health.

When I last asked a question of the minister, I asked this one. Because the minister ran out of time to answer it, I’m going to ask it again: At a committee meeting last year, Dr. Strang explained the importance of people being able to stay home from work when they are sick.

He said, “Certainly, from a public health perspective for not just COVID-19, it’s a long-standing 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 is absolutely important that we work together to recognize the barriers that are there that may limit people’s ability to stay home and find ways to collectively reduce those barriers.”

Of course, COVID-19 has compounded this issue, and we see that the workplace is a significant site of transmission. I will just refer to our Question Period today where there were an awful lot of questions about COVID-19 and restrictions and numbers and all of that. It seems like we are in another upswing of cases. We know that there are 600 and some employees of the Nova Scotia Health Authority off work today because of COVID-19.

My question is: Does the minister agree with the Chief Medical Officer of Health that we need to do what it takes to ensure that people can stay home when they’re sick?

MICHELLE THOMPSON: Of course, I agree that if there are protocols around isolation, they should be adhered to. It’s very important that we manage that, particularly in workplaces, to prevent spread of not just COVID-19 but other illnesses.

The majority of people who work in Nova Scotia Health or in the health care system are in the fortunate position to have benefits and able to utilize sick time, and I know that that’s not the case for everyone.

I can speak to the folks who are under the purview of the Department of Health and Wellness, Nova Scotia Health, in regard to having sick time benefits.

SUSAN LEBLANC: Yes, absolutely, the Nova Scotia Health employees, most of them probably do have benefits, and that’s great, they can take off the time that they need to get healthy and well and to reduce the spread of illness in their workplaces. But as the minister has said, there are many Nova Scotians who don’t have sick benefits. We know that even as numbers are beginning to rise again in Nova Scotia, our sick benefits, the three days of paid sick days that Nova Scotia was providing have ended.

I’m wondering if the minister would agree in principle that as a key person responsible for Nova Scotians’ health and well-being - hate to pile that responsibility on the minister - would she agree that it is necessary for us as a province to find ways for people to stay home when they’re sick, at all times, not just during the COVID-19 pandemic?

MICHELLE THOMPSON: I recognize that Public Health protocols in relation to quarantine and being off related to communicable diseases - it’s very essential that those protocols are followed.

SUSAN LEBLANC: I hear the minister say that protocols are important for reducing the spread of illness, but I’m wondering how people can follow protocols if they don’t have any coverage for sick days.

If someone doesn’t have coverage to take time off, it means that they’re losing hours, and generally, in a job where you’re losing hours because you don’t have sick time, those hours are probably pretty precious, I would say. Throughout the pandemic and beyond, or before, a number of constituents have come to me worried about the lack of sick days, people going to work sick because they can’t afford to take the time off.

The alternative is untenable, because it means not being able to pay rent or not being able to buy food for their children. I would just like a solid answer on the sick day question. Does the minister agree that we should have paid sick days permanently in Nova Scotia?

MICHELLE THOMPSON: I would say that whenever possible, we want employees to work with their employers in regard to sick time coverage. That’s certainly not something that I’m able to speak to from my Budget Estimates. That is not something that I have purview over.

SUSAN LEBLANC: Moving on to other public health questions. Understandably, Public Health resources have been reallocated to COVID-19 efforts. Pre-COVID-19, Public Health would be responsible for post-natal visits and supports to parents, as well as some infant vaccinations. My understanding is that these services are entirely or largely on pause. My first question is, is that actually still the case?

MICHELLE THOMPSON: No, they are not entirely on pause. There has been reallocation of people back to the Early Years work that’s been happening throughout the province. That program is being re-established and has been up and running in a different capacity, I would say, over the last number of months.

SUSAN LEBLANC: Can the minister explain a little bit more about what the different capacity means? Are there still home visits happening from public health nurses to newborn babies, post-natal visits?

MICHELLE THOMPSON: We will get more information about to what degree home visits are happening. I do know that moms are being contacted by Public Health and screened and I know there has been some work that’s been happening, but I don’t have all the details around it, so we’ll get back to you. I have to reach out to Public Health.

SUSAN LEBLANC: That would be great. Thank you to the minister for getting that information. I will just say quickly that way before COVID-19, when I had my first baby, the visit from the Public Health nurse was life changing, honestly. I got home with this baby and wasn’t breastfeeding properly. She wasn’t eating enough, and I was in a lot of pain and the nurse came one day. I was like, okay, that would be great if you would come over to my house. She came over and looked at what I was doing, and she went “pop” and it made all the difference. That kid ate properly for the next two years. She doesn’t eat so well anymore. She rejects quite a lot of food, but anyhow, it makes a huge difference.

Again, I will reiterate, that I am someone who has access to family around me and I had lots of sisters with babies around me and it was a really important visit.

I want to turn my questions a little bit to safe supply and harm reduction in the province. I want to ask the first question about Mainline Needle Exchange. Mainline is one organization in Nova Scotia that does critical harm-reduction work with drug users. They are in need of funding to expand the important work they do, including conducting more regular needle searches throughout Halifax. Is there an increase of funding for Mainline in the budget?

MICHELLE THOMPSON: I’m going to ask the member to save that question for Minister Comer, who would have the information that you’re seeking.

SUSAN LEBLANC: I have quite a lot of questions about safe supply of drugs and harm reduction. I would like clarification because my understanding is that - well, I don’t know what the expectation is. Is Minister Comer appearing in Estimates as part of the Health Budget? Or how would I ask those questions to him? I’d be happy to, I didn’t realize that Minister Comer would be appearing.

MICHELLE THOMPSON: First, Minister Comer will be appearing for the Office of Addictions and Mental Health. There is some crossover between us. The Department of Health and Wellness does fund Public Health, $1.53 million, and $991,000 goes to Mainline.

[5:00 p.m.]

SUSAN LEBLANC: I didn’t actually get the number that the minister said for Mainline. I just want to clarify - that comes from the Public Health budget? Also, is it an increase in funding?

MICHELLE THOMPSON: The number is $991,000; that was the original number. It is an increase of $198,000, almost $199,000.

SUSAN LEBLANC: I think I will just try these questions to the minister. They are harm reduction questions which generally are Public Health questions, not Addictions and Mental Health. I’ll put them out there.

The increase in opioid use has translated into an increase in preventable overdoses, illness, and risky and dangerous behaviour. The number of confirmed and probable opioid toxicity deaths in Nova Scotia is in the dozens each year, and hundreds of people have died in the last decade. I’m wondering if there is any new funding in this current budget to address the opioid crisis, and what work is under way with that funding?

MICHELLE THOMPSON: There is $500,000 for opioid harm reduction and the safe needle program. The overdose deaths over a number of years have reduced slightly. In 2019, there were 57; in 2020, there were 51; in 2021, there were again around 50 deaths, so it is holding around the same is what I would say.

SUSAN LEBLANC: So the budget number just referred to, is that status quo, decrease, or increase for this year’s budget?

MICHELLE THOMPSON: The $500,000 was the increase, so for harm reduction it was $1.75 million and went up to $2.22 million. It was an increase of $500,000.

The prevention strategy, just so we’re clear, sits with the Department of Health and Wellness, but addiction treatment would sit with the Office of Addictions and Mental Health.

SUSAN LEBLANC: I did want to say I worked just recently with an NDP colleague - he’s a federal colleague - from British Columbia who’s doing a tour to raise awareness on a federal bill that he’s tabling around safe supply and harm reduction. What he says - and I trust he’s done quite a lot of work in this area - is that there is a bigger crisis coming toward us in Nova Scotia, in the Atlantic Provinces. There is an increased poisoning of the drug supply on the street - and it’s going to get worse.

I also want to say that in terms of deaths related to overdose, there are often lots of deaths that are listed as suicides or recorded as suicides, or just mis-recorded. I think that number of 50 or so overdoses could be low.

Given all that I’ve just said, safe supply is crucial for the health and well-being of people who use drugs and has the potential to have a direct impact on the health and dignity of those who use drugs. As illicit street drugs continue to increase in fentanyl or carfentanil quantities, it is imperative for those particularly at risk of overdoses that they have access to drugs and that they know that the drugs they have access to will not lead to overdose or death.

Is the department working toward ensuring access to a safe supply of drugs? The minister has referenced a $500,000 increase, but I want to know exactly what that is going toward.

MICHELLE THOMPSON: We do support overdose prevention sites. Direction 180, the Ally Centre of Cape Breton, and the Mi’kmaw Native Friendship Centre all run programs. The prescribed safe supply falls under the purview of the Office of Addictions and Mental Health.

SUSAN LEBLANC: I have to write myself notes so I don’t forget to ask people later.

I just want to pause the public health questions for a second and ask a question about a line in the budget that appears to be an $11-million reduction in the IT budget in the Department of Health and Wellness. I’m wondering why that is there. Is it to do with One Person One Record coming down the pike? Why is there an $11-million reduction in the IT budget?

MICHELLE THOMPSON: That budget line that you’re referring to is actually one-time federal funding from the Safe Restart Agreement. That was used for IT initiatives, things like licences, access to immunization portals, supporting some virtual care. It’s not an actual reduction in budget, it is one-time funding that was not renewed from the feds.

SUSAN LEBLANC: I’m so sorry, but now I’m going to go back to public health. Can the minister explain what money in this budget is being earmarked for greater access to health care services in the province’s prisons? If there are increases, which lines show those increases to money being earmarked for health care in prisons?

MICHELLE THOMPSON: The primary care that is provided in prisons is actually through the Nova Scotia Health operations, but there was no specific request for increase or any specific funding designated for health care in prisons.

SUSAN LEBLANC: Sexual health services are generally underfunded, Mr. Chair, and rely on community fundraising to provide services. Advocates have specified that the lack of stable long-term funding for sexual health organizations has required centres to reduce the number of appointments offered and the amount of testing offered.

[5:15 p.m.]

Sexual Health Nova Scotia gets only $275,000 to cover the entire province with their programs. In contrast - and I’m not saying that this is a bad thing because I think this is important and needs to be increased as well - women’s centers get over $200,000 per centre. I understand that it’s difficult for the organization to fulfill its mandate within the budget of $275,000.

I’m wondering, has the budget of Sexual Health Nova Scotia been increased with this provincial budget?

MICHELLE THOMPSON: There’s been no increase to that particular organization.

SUSAN LEBLANC: prideHealth is also chronically underfunded. The services that prideHealth provides are critical ones like navigation through the health care system, workshops and learning opportunities on 2SLGBTQIA+ health, 2SLGBTQIA+ cultural competency training for health professionals and family practices, general health and wellness information, sexual health information, referrals for addictions, mental health and other health services, information and referrals for transgender and gender identity issues.

I understand that the service operates with less than one full-time-equivalent person. Is that correct, number one? My second question is: Is there increased funding for prideHealth in the budget?

MICHELLE THOMPSON: There is a 0.5 position that works out of Nova Scotia Health at Mumford Road and there is a 0.8 FTE as well. One is a navigator position. There is no increased funding in this budget specifically for prideHealth, I would say, this year. Certainly, we have been working towards improving our work with equity-seeking populations. We will continue to review and see what opportunities exist in the future.

SUSAN LEBLANC: Certainly, I think, given the conversation we had last night about gender-affirming care, I would expect that when consultation is done that there will be, I would say, advocacy around more people hired as navigators and advocates in the health care system itself.

Speaking of equity-seeking groups, I’m wondering if the minister can explain what gender-based analysis is conducted on policies developed and implemented by the department? Gender-based analysis on policies in the Department of Health and Wellness.

MICHELLE THOMPSON: There is no specific gender-based analysis that happens but the department does use an equity, diversity, and inclusion analysis.

SUSAN LEBLANC: Does that include 2SLGBTQIA+ analysis in that equity seeking, because that’s going to be my next question - an equity-seeking or anti-racist analysis? I’m just wondering if the minister can expand on that a little bit and talk about what that would look like if a policy comes forward. What does that analysis look like in an on-the-ground picture?

MICHELLE THOMPSON: There is a lens that is applied and it does also consider 2SLGBTQIA+ folks. There is an analysis that’s done to ensure that our policies don’t unfairly disadvantage individuals. Now there is a newly formed office of equity, diversity, and inclusion that will be formalizing and helping us mature the work that’s happening in this department.

SUSAN LEBLANC: As the minister noted yesterday, or made reference to, the race-based demographic data initiative, I’m wondering if she could give us an update, what the timeline is for the beginning of the collection of that data?

MICHELLE THOMPSON: The community consultation of work that was happening is almost complete. We expect to begin race-based data collection in June of this year.

SUSAN LEBLANC: Can the minister provide an update on the development of an African Nova Scotian Health Strategy?

MICHELLE THOMPSON: There is work happening around part of the health equity framework that’s happening at the Department of Health and Wellness that would include a number of folks. Also, over the next year, expectation of the new legislation that was passed means that we will have that work completed by July 2023.

SUSAN LEBLANC: Jumping around again, I’m going to ask a question about massage therapy. Nova Scotia is the only Atlantic province that does not have comprehensive regulatory legislation to oversee massage therapy. The lack of regulation has created significant problems, putting the safety and well-being of therapists and their patients at risk.

In effect, this regulatory issue translates to a medical field that lacks comprehensive regulations regarding licensing, training, background checks, or disciplinary action. The push for regulations began in 2003 when the Massage Therapy Act was passed but was never proclaimed. Can the minister please provide an update on this work including a timeline on the work and if the minister can explain what’s resulting in the delay for the work for the Act to be passed?

MICHELLE THOMPSON: There is some work happening in the department around people who are self-regulating, so there’s 22 self-regulating health professions that independently regulate their professions. We’re looking at having a common Act.

There is stakeholder work happening now with the various bodies to inform that work. There will be overarching legislation for all regulated folks and then there will be different regulations that are profession-specific. That work is happening now and will continue over the next number of months.

SUSAN LEBLANC: Is it reasonable to suggest that the reason for the delay for the massage therapists is because of that work being done for this new Act, or is there something else at play with the massage therapy profession?

MICHELLE THOMPSON: This work that is happening around the common legislation is currently where our focus is and we’ll continue with that to bring all regulated professions in under that Act eventually.

SUSAN LEBLANC: I’m going to ask a few questions related to some of the recommendations of the latest advocacy from the Canadian Cancer Society. It is specific to the budget but I just want to give the caveat that some of the questions may not relate exactly to the Department of Health and Wellness budget. However, I am asking these questions of the Minister of Health and Wellness because of the implication to health and wellness related to tobacco use.

The Canadian Cancer Society recommends increasing taxes on tobacco products. Nova Scotia’s tobacco tax rates are currently substantially lower than the tobacco tax rates in Newfoundland and Labrador and a tobacco tax increase would close the gap.

According to the Canadian Cancer Society, with the province already committed to lowering the smoking rate, raising taxes on tobacco can not only provide much-needed revenue but would also have the effect of lowering the rates of smoking and tobacco use throughout the province. The World Health Organization suggests that the significant increases in the taxes and prices of tobacco products is the most cost-effective measure to reducing tobacco use.

So acknowledging that tobacco tax is not in the budget of Health and Wellness, I am asking, is the minister advocating for this change, with her colleagues? Why or why not?

MICHELLE THOMPSON: Currently it has not been identified as a significant gap to date, but we are always open to working with our colleagues in the Department of Finance and Treasury Board as well as with Public Health, to understand what the implications could be.

SUSAN LEBLANC: The Canadian Cancer Society also recommends increasing the retail licence fee for tobacco and e-cigarette vendors. Nova Scotia currently requires a retailer to obtain a retail vendor licence to sell tobacco products and e-cigarette products, but the fee is only $42 per year respectively.

[5:30 p.m.]

Is the minister advocating for a change to this fee, i.e., would the minister advocate for a significant increase in the fee to license retailers for tobacco products and e-cigarettes?

MICHELLE THOMPSON: That may be a future initiative that we would look at, but we haven’t had a discussion about that as of yet.

SUSAN LEBLANC: The Canadian Cancer Society also recommends including Public Health measures in the tobacco settlement negotiations. It says that Nova Scotia and other provinces are currently in major negotiations with tobacco companies to settle provincial Medicare cost recovery lawsuits. Nova Scotia must ensure that significant Public Health measures to reduce tobacco use are the priority in the negotiations. Measures should include reforming tobacco industry behaviour as well as the requirement that at least 10 per cent of the proceeds from any arrangement be allocated to an independent fund to carry out tobacco control initiatives.

The question is: Is the minister advocating for this to happen?

MICHELLE THOMPSON: At this time, I’m not able to speak to that directly, because there is an active litigation process that’s happening.

SUSAN LEBLANC: The Canadian Cancer Society is also urging the government to continue to advance the implementation of the palliative care strategy. The society says that currently, palliative care in Nova Scotia is fragmented and limited in its availability. Canadians should have access to affordable, high-quality palliative care regardless of where they live and in what setting they choose to receive their care. The Canadian Cancer Society recognizes that facing life-threatening illness, especially in relation to pain and suffering, can cause great concern and severe hardship for people and believes that all Canadians should be able to choose the best care for themselves throughout their cancer journey.

My question for the minister is: Is there an increase in the budget for palliative care programs, an expansion, or an improvement? Can the minister talk about the budget for palliative care?

MICHELLE THOMPSON: There is funding available to the provincial hospice program in Halifax, Kentville, and Cape Breton that’s included in the budget.

SUSAN LEBLANC: I’m not just talking about the hospice programs, but also palliative care within - maybe I’m not understanding but my understanding is that there’s the hospice but there’s also palliative care in hospitals or at home.

My question would be: The money that the minister is referring to for hospice, is there an increase in that money? I guess I’m asking possibly a separate budget line which would be palliative care, and if there’s an increase or decrease in that budget line? What’s the change?

MICHELLE THOMPSON: There is $591,000 for the three hospices. There is a conversion of beds at Fishermen’s Memorial Hospital which was $1.1 million in funding. In terms of the program itself, we’re working with the Nova Scotia Health Authority to develop strategies to support both hospice programs and multiple palliative care programs.

SUSAN LEBLANC: I’m sorry but the sound is a bit muffled, so I heard a million dollars and something to do with Fishermen’s Memorial Hospital, but I couldn’t hear what the minister said there, so if that could just be clarified that would be great.

I guess, again I’ll go back to my question: Is there an increase in this year’s budget for palliative care?

MICHELLE THOMPSON: The conversion of beds at Fishermen’s Memorial Hospital is a $1.1 million increase.

SUSAN LEBLANC: I feel like the minister may be avoiding this question. I can’t tell if I’m not asking it clearly or not. I hear that there’s a $1.1 million increase for Fishermen’s Memorial Hospital. I assume if the minister has not mentioned any other programs, then there’s no increase so I’m going to leave it there but would love some clarification on that eventually.

I want to turn some questions toward MSI coverage, MSI as a full MSI system, for a minute. A key challenge for international students is that they are excluded from access to health coverage until they have been in Nova Scotia for 13 months. This means that for that first 13 months they have to pay for expensive private health coverage while they wait. Is the department planning on extending MSI coverage to all residents, including students, so that international students can have health coverage from the day that they arrive in Nova Scotia?

MICHELLE THOMPSON: At this time, we are considering options. I’ve been in discussions with Minister Wong and his department. Currently, students do have coverage on the first day of the 13^th month they’re here. All students are required to have a health plan, private insurance, when they come and the universities also have some responsibility, as well, to ensure that there is a health plan available to students.

SUSAN LEBLANC: I also want to ask about an issue around accessibility to MSI. To get an application form for MSI, not a renewal form, you have to call, and they’ll only mail you or fax you the application form. They will not email it. The MSI office is still closed due to COVID-19, so you can’t go and pick up a form.

I have heard about this from a constituent who has requested a number of application forms and has never received them in the mail. This person is eligible and receives mail from other sources to their address, so it’s not a question of their address not being correct, or whatever. They have called and asked MSI for a courier or some other workaround but MSI won’t work with them. This is an example of where, for instance, someone with visual impairment also would not be able to access the form. Can the minister explain if there is any work under way to improve access to applying to MSI?

MICHELLE THOMPSON: We recently negotiated a contract with Medavie Blue Cross and in that contract there is an expectation of significant increase in tech capability, which would include a portal so that folks could access things online. That should come online over the next year. But if there are specific cases, certainly we can have MSI follow up with them directly.

THE CHAIR: I would like to remind the member there’s roughly around five minutes left in this round of questioning.

[5:45 p.m.]

SUSAN LEBLANC: That’s good news. Another thing around accessibility for MSI is this: the government recently announced an option - I guess it wasn’t that recently anymore - to not have an M or an F marker on the health card, which is a great step. You don’t have to have a male or female marker. A government press release from the time states that people can now choose to have an X as an option for gender identity or to have no gender displayed. However, the renewal form at MSI does not display this option. Rather, a person must leave the field blank and indicate that they wish for their gender to not appear.

It has been pointed out by advocates that this is a hostile design choice. Is the minister aware of this issue? Can she explain why it is or when it will be possible for people to indicate an X as their gender on their health card on the renewal form?

MICHELLE THOMPSON: I thank the member for raising that. We will bring that back to the department to discuss.

SUSAN LEBLANC: The direct cost of unintended pregnancies in Canada has been estimated at about $320 million but MSI does not cover prescription contraceptives. MSI does cover a number of reproductive services or technologies including hysterectomies, vasectomies, tubal ligation, surgical abortion, the abortion pill, which I can’t pronounce, so I’m not going to. Is the department looking at expanding access to birth control through MSI?

MICHELLE THOMPSON: Birth control, oral contraceptives, are available through the Nova Scotia Family Pharmacare Program.

SUSAN LEBLANC: Yes, I understand that they are currently available through the Family Pharmacare Program. Is the department looking at expanding the coverage of oral contraceptives so that folks, anyone who wants them and needs them, does not have to pay - that they can just go and get them in the same way that they would be able to pick up the Mifegymiso? The question is, is the department looking at covering oral contraceptives for everybody, not just people on Family Pharmacare?

MICHELLE THOMPSON: At this time, we are not considering that. We know that there are options through the Family Pharmacare Program and also, we understand that our partners in the Department of Community Services also will provide contraception.

SUSAN LEBLANC: Well, let us hope for the Liberal - NDP federal deal resulting in a pharmacare program in this country very soon, so we don’t ever have to ask this question again.

In my last minute I will ask this question, the Government of Nova Scotia is currently running an ad campaign called, “Let’s get back out there.” The video features shots of large groups of people at restaurants, weddings, and sports events and not wearing masks. I’m wondering, was the department consulted on this campaign and does the minister have an opinion about the timing for this campaign?

MICHELLE THOMPSON: That campaign was reviewed about a month ago by a Public Health colleague.

THE CHAIR: Order. The first round of questioning is now complete, and I’ve been advised by our Clerk that we are running about 10 to 15 minutes ahead of our subcommittee room. I think what we’ll do is we’ll take a recess of about 10 minutes and then we will reconvene in about 10 minutes.

[5:50 p.m. The committee recessed.]

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

THE CHAIR: Order. At this point now, we will continue on with our questioning and throw it back to the Liberal caucus for a round of questioning for one hour.

The honourable member for Annapolis.

CARMAN KERR: I’ll pick up from where I left off last night, speaking to virtual care. I’m pleased that this government has expanded upon virtual care, which our government started. In my local office in Annapolis, we’re working hard to sign people up for virtual care. I wonder if the minister or the department has considered maybe a tour of some sort to help sign up Nova Scotians en masse, a bit of a PR campaign.

MICHELLE THOMPSON: Everyone who is on the Need a Family Practice Registry does receive a direct invitation in order to sign up. Certainly, everyone who was on the list in January was contacted directly to validate whether or not they still needed to remain on the list. We did discuss last night. For folks who don’t have email, there is ability at libraries for people to go to, and libraries will assist them in gaining email access, setting up an email account.

CARMAN KERR: Mr. Chair, my second question would be around our community navigators.

I was part of a committee to recruit and retain doctors in the Annapolis Valley. We hired a community navigator who does great work - it’s recognized by the community and by the department.

I’m wondering: Are community navigators still funded by the Department of Communities, Culture, Tourism and Heritage or is it funded by the Department of Health and Wellness?

MICHELLE THOMPSON: To the best of our knowledge, they are funded through the Department of Communities, Culture, Tourism and Heritage. We don’t fund them through the department here. Whether there are specific funding models related to municipalities or foundations or things like that, I can’t speak to that. We do understand that CCTH does fund some community navigators in the province.

CARMAN KERR: I want to thank the minister for that clarification. I guess the segue to my next question would be: Is there an opportunity currently through the CCTH? Navigators aren’t funded for salaries, and I wonder if there’s room in the budget or in future for that position to be funded through the department.

MICHELLE THOMPSON: Through the Nova Scotia Health operational funding, there are actually recruiters who are funded in terms of recruitment in each of the zones. We don’t have any immediate plans to fund community navigators, but we do fund the recruiters through the NSH.

CARMAN KERR: Our federal health transfers are population adjusted I believe. I think at one point they were age adjusted, but I just wonder if the minister can confirm: Is our federal health transfer age adjusted as well?

MICHELLE THOMPSON: The transfer doesn’t come directly to us; it comes through the Department of Finance and Treasury Board. That would actually be a question that would be best answered by the Department of Finance and Treasury Board.

CARMAN KERR: I will ask the Department of Finance and Treasury Board.

Regarding the Practice Readiness Assessment Program (NSPRAP), we have a great program in the Middleton catchment shared with the honourable Chair and led by Drs. Carol Elliott and Michele Saxon.

My question is with the NSPRAP, are there matching options for couples or spouses or partners who practice both in primary care?

MICHELLE THOMPSON: We do try our best. There was previously a ranking system, but that ranking system has been removed. It better allows us to be more flexible and accommodate couples where possible.

CARMAN KERR: Is the same true for the CaRMS program?

MICHELLE THOMPSON: CaRMS does have a portion of the application form that does allow couples to identify on that form.

CARMAN KERR: My final question: With rural practice the three predictors of working rurally are: being from a rural area, having a partner from a rural area, training in a rural area. I know it’s tough for government to develop policy that targets partners of primary care staff in rural areas.

My question specifically is: What are we doing to recruit local students from rural Nova Scotia who want to practice in rural Nova Scotia?

MICHELLE THOMPSON: We currently don’t have any designated seats through Dalhousie, in terms of supporting rural students but it is something that we’ve been discussing and trying to better understand how we would allocate that.

The residency programs that we have are in rural communities, as you mentioned before. To your point, we do find that when folks train in rural communities there is a retention rate of about 60 to 70 per cent. There is more work to do in that program in terms of how we identify students early, in high schools, and support them through their journey but currently there are not any designated seats.

CARMAN KERR: I appreciate that answer from the minister, so thank you. I did say that was my final question but maybe one more. I just got an email from a constituent, I won’t get into the details but her experience made her reach out to me and ask, is the department or the minister looking at offering patients in the ER, I guess, a discharge summary? I don’t know the technical term but you leave the ER and you are given a summary of what the assessment has been. I don’t know if that currently is the case but if not, could it be? If so, I’d like to hear that as well.

MICHELLE THOMPSON: That has not been a typical practice that I can recall from my days in emergency and certainly we’re not aware of it here, that folks would get that. Typically, what would happen is that if you are an attached patient, your primary care provider would get notification that you were in emergency and a summary of what happened there.

Part of what’s coming up in terms of our commitment is that we want to invest in IT solutions that support people, as we progress with One Person One Record, but also the learnings that we’ve had, particularly around our ability to access our own immunization records, as an example, with CANImmunize. This is an area that certainly needs to be developed and that we need to understand better. Currently the practice is not routine. The patient may be able to ask for that as they’re leaving the department, but otherwise, it would not be done on a routine basis.

[6:15 p.m.]

CARMAN KERR: Those are all my questions. I just want to thank the minister for her time.

THE CHAIR: The honourable member for Cole Harbour-Dartmouth.

LORELEI NICOLL: Thank you, Mr. Chair. You’re doing a great job.

I apologize if my questions may have already been addressed. I tried to keep up in listening. I know some of the questions have been asked by previous members, meaning especially the hospices in Nova Scotia.

I just wondered if the minister could answer how many hospices data show are needed, how many are planned for and where, and is the development of hospices in the future going to continue to be placed on not-for-profit organizations? Or does the government itself have a plan to expand and initiate locations for hospices in the future?

MICHELLE THOMPSON: The Halifax and Valley hospices are currently operational. Cape Breton has completed construction and will be accepting patients in Spring 2022. Discussions are under way in Yarmouth and Amherst related to appropriate local settings for hospice. South Shore is currently moving forward with a palliative unit at Fishermen’s Memorial Hospital. There are conversations as well under way with the IWK and Halifax Hospice regarding serving the pediatric population. We continue to work with a variety of partners around how we would best develop and deliver hospice in the province.

LORELEI NICOLL: My understanding then is you’re going to continue partnering with not-for-profit organizations to provide hospice services. I just wondered if the government provides operating for these hospices.

MICHELLE THOMPSON: The agreement is with the Nova Scotia Health Authority. We do provide operational funding through them to hospices.

LORELEI NICOLL: I wanted to ask, what is this government’s plan for vaccinating children under the age of five? As you can imagine, the anxiety is high among parents who have children under five. I just wondered where that is currently and when might they be available?

MICHELLE THOMPSON: Currently, we are waiting for direction from NACI. That would not be something that we would undertake on our own. If and when NACI does come out with recommendations around immunizing children under the age of five, then we will move with that recommendation. It is not something that we would undertake on our own.

LORELEI NICOLL: Just to close that question, I just wondered if there was an update, if you’re hearing more as to when it might be possible. They were hoping that by Spring, we could know more. I just wondered if there was anything more positive you can give in that regard. What is NACI saying right now?

MICHELLE THOMPSON: As the member mentioned, it is anticipated in Spring 2022, so we are waiting as well. We have not had a recent update about that.

LORELEI NICOLL: Is there a plan for the government to hire more fertility doctors? There’s only one fertility clinic servicing the entire province, plus much of Atlantic Canada, resulting in a minimum of 12 months waiting to get a consultation and initial assessment. Many of these wait times issues could be solved by adding more fertility doctors to this practice. I just wondered if you’re looking at that.

MICHELLE THOMPSON: The fertility clinic is not an insured service and in fact it’s a private clinic and so we don’t have any operational influence with regard to those practices. But I do believe that the fact that we’ve introduced the fertility tax credit is an important step because it will help increase demand and as a result it will grow that organization. It is private and we are not in charge of the recruitment to that program.

LORELEI NICOLL: Waiting to see a fertility doctor is not always feasible for some individuals, because of valuable time that cannot be wasted waiting for their appointment. Given the newly announced tax credit that you just mentioned, does this government have any plans for decreasing the wait times to receive fertility treatment and if so, how?

MICHELLE THOMPSON: Again, because that lies outside of the publicly funded system, that’s not something that we have influence over. That would be part of the business model of the physicians involved in the clinic.

LORELEI NICOLL: Given the long wait times to receive fertility treatments in the province many have to go to Toronto, or even overseas, to receive timely treatments. Is the newly announced tax credit only eligible for fertility treatments that occur within Nova Scotia and how are the rebates supporting individuals receiving treatment outside the province, because they can’t afford to wait over a year to get an initial assessment?

MICHELLE THOMPSON: The regulations around that - it is the Income Tax Act so I think that would be best answered by our colleagues in the Department of Finance and Treasury Board, to get to the finer details of that question.

LORELEI NICOLL: Just to clarify, we don’t know yet whether the people who go outside Nova Scotia for fertility treatments, whether they will be eligible for the rebate that was announced?

MICHELLE THOMPSON: Just to clarify, I’ll get back to you about the details on that because it does say that it needs to be a Nova Scotia provider. I want to understand if there’s a referral outside the province, what the stipulations are around that. I just need to get the clarification; I don’t want to give you the wrong information.

LORELEI NICOLL: What is the government’s plan for preventive health? How are they investing in keeping our population healthy, improving the overall health of the population, keeping people guided by the social determinants of health and social inequalities based on Nova Scotia data?

Do we actually have data in that regard? Whether it’s smoking, drinking, gambling, et cetera? I’m just wondering how are we going to be more proactive in preventing issues, keeping people out of the hospitals, and healthy?

MICHELLE THOMPSON: I’d like to thank the member for this humongous question. We could probably talk for the rest of Estimates about this. This is something that is really quite dear to my heart. It is important. I mentioned last night in Estimates that I could probably be considered the Minister of Health Care or the Minister of Illness, really, because a lot of the work that we do is around front-facing care for the Nova Scotians that require it. Population health sits in Public Health and so do all of the social determinants of health. My colleagues at Cabinet, I will tell them, are also ministers of health. Our education system, economic development, all the different ministries that we have really contribute to the health of Nova Scotians, so when they are strong, we are strong.

I think it starts as early as how we work with our moms prenatally and support families in terms of how we work with our early childhood years. We know that from zero to five years is the most important time in our brain development and it sets us on a trajectory. There’s a lot of work that can be done in terms of how we lean in to families, particularly at-risk or higher-risk families. I could talk about that for ages as well.

Then we need to look at some of the modifying behaviours that we have around lifestyle and how do we support people in making the healthy choice the easy choice. That sits in policy, that sits in planning. These are things we’re looking at and they are necessary for us to put Nova Scotians on a trajectory of health.

There has been a $6.1 million increase to strengthen the work of Public Health, both at the department and in front-facing public health at the Nova Scotia Health Authority. It is top of mind. We do population health, we do surveillance, and we use that to inform some of the decisions. I think that’s an area where we can get stronger and better in order to put Nova Scotians on a trajectory to health.

LORELEI NICOLL: I thank the minister for that answer because I am equally as passionate about preventive health, so I hope to continue the conversation and see good policy put in place in this House.

Can the minister provide an update on the universal mental health care plan, as outlined in the government’s platform? I know you manage the money and I know that Minister Comer is Responsible for the Office of Addictions and Mental Health. Universal mental health care in itself - and correct me if I’m wrong - is it not about taking it, I guess, to the point that we were talking about fertility treatments earlier, in that they’re private practitioners - the whole plan with universal mental health care, or universal health care in itself, is about paying private practitioners with an MSI card. I just wondered where this was going, at the end of the day.

MICHELLE THOMPSON: I will ask you to speak with my colleague, Minister Comer, about the work that’s happening there. That’s all on Minister Comer and I know that he’s been doing some excellent work in that area, so I’m going to defer that question because I think the detail that you would want is not something that I have. I’m quite confident you’ll get your answers from him.

LORELEI NICOLL: Minister Comer, you’ve been put on notice. We will chat.

I just wondered, are we putting all our eggs in one basket with regards to virtual care? We’ve been hearing it come up a lot and I just wondered, is there a plan to hire more doctors to be in person? I mean, virtual care is great, but you need somebody at the other end to actually give you that medical attention that you required.

MICHELLE THOMPSON: To your point, virtual care is very successful with a percentage of the population and everybody that is on the Need a Family Practice Registry does have that, as we wait to permanently attach them. There are other things that are happening in the province. In addition to virtual health and access through virtual health, there are also some pilots that are happening - the nurse practitioner and pharmacy pilot that’s happening in Pictou County as a proof of concept, and I think there’s also one in the Northern Zone looking at that and understanding how we support patients in accessing primary care. There are the urgent treatment centres in Parrsboro and North Sydney for episodic complaints and getting people the treatment that they need and diverting them away from emergency rooms.

[6:30 p.m.]

There are a number of initiatives that are happening. We continue to work in community to find and leverage the resources that are there in order to support patients in accessing primary care. It is a very useful and important tool. There are people who really enjoy it. I think we want to continue and grow that. We’re just in the process of doing a full evaluation of virtual care, understanding where it works well, who it works well with, and where some of the barriers are. I think over time it’s something that we will develop and will actually be targeted and honed. It is one strategy amongst many.

THE CHAIR: I would just like to remind the minister, when referring to another minister from another department, try not to use the last name of the minister. Just refer to them as the minister of whatever department.

LORELEI NICOLL: Just to clarify, I know the member for Dartmouth North mentioned the $11-million reduction in IT - that was one-time money, I think you said. There was no offset? This didn’t impact virtual care? I just wondered if a similar investment was put into virtual care and what that amount might be.

MICHELLE THOMPSON: The $11 million was one-time funding, but we have invested $14.5 million into virtual care in this budget.

LORELEI NICOLL: With the recent surge and our population growing, especially in HRM, how are we going to manage or get ahead of the long wait times for family doctors? We’re talking a lot about growing the population, so I just wondered, what’s the plan to catch up with all the procedures and surgeries that had to be postponed due to COVID‑19?

MICHELLE THOMPSON: There is $17.5 million allocated to surgeries and addressing the surgical backlog. There would be 2,500 surgeries at the HI site. We want to expand operating hours. The Dartmouth General is looking at beds to support surgeries there as well. Maybe two weeks or 10 days ago, we were made aware that there is a significant federal investment as well, of $58 million. We’re waiting for the parameters around that funding in order to help us address surgical backlogs. That $58 million was part of a significant investment recognizing that across the country there are significant backlogs. The plan is under way, and we will continue to work towards the surgical backlog in a timely fashion.

LORELEI NICOLL: Many, if not all of us in this House, receive calls daily from frustrated constituents regarding the health care system currently. I received a call yesterday from a constituent about a pain management appointment that this person was waiting a long time to hear from. She got her appointment, and it’s scheduled for September 2024.

Not only does the delay in these appointments potentially cause their physical condition to get worse, and I can only imagine with pain management, but can also have a huge impact on a person’s mental health while they’re waiting, and their well-being. I just wondered, while they anticipate these medical appointments, what is being done to address these wait times currently and for someone like the person who called me yesterday?

MICHELLE THOMPSON: We’ll circle back to that. We have reached out to someone to ask around the pain management services in the province, and I think it would take a bit of time, so we’ll circle back when I get the information that you’ve asked.

LORELEI NICOLL: I appreciate that, because she is very upset and will be calling the office again today.

More women will no doubt get cancer. Only 25 per cent of Canadian women had been tested for any type of cancer in the past year. Women need to stay on top of their annual checkups, and I just wondered, cancer screening, how has it been going in Nova Scotia in the past year, and has the pandemic had any impact on that?

MICHELLE THOMPSON: Cancer screening has continued. There was a bit of a disruption early in the pandemic, but there has been ongoing screening. Urgent and emergent care is always prioritized, as the member will probably know, but we do work with our partners at the Nova Scotia Health Authority to understand how best to make sure that cancer screening is taking place.

In terms of diagnostic backlog or anything like that, there are some extended hours in Central Zone in particular to address some of those backlogs, and the extended hours have shown good success in terms of addressing the wait-list.

LORELEI NICOLL: It will come as no surprise that I’m asking this next question, which will be my last question. Do we have data on infant loss from miscarriages or stillbirths in Nova Scotia? I ask because without data, how can the health care system respond? It could be prudent to get actual data, as there are many reports indicating a higher probability of infant loss during the pandemic due to the added stress and anxiety, so I just wondered, do we have data collection taking place now?

MICHELLE THOMPSON: I know from the previous sitting that this is an issue that’s very close to your heart. There is a provincial perinatal team that does gather data from the Nova Scotia Health Authority as well as the IWK. Those stats are gathered and are used to form clinical pathways as well as care in the province.

LORELEI NICOLL: I’m only closing with a statement, just so that the minister is aware that during the pandemic, many did not receive postnatal care because of no in-person – virtual care can only go so far – so I just wanted to make her aware of that.

THE CHAIR: The honourable member for Clare.

RONNIE LEBLANC: I just have a few questions around health services in French. I know a lot of Acadian communities and communities in Halifax who have residents who speak French. Could you elaborate on your plan to recruit physicians who speak French - nurses – and are you visiting countries that would tend to have French-speaking health professionals?

MICHELLE THOMPSON: You’ll have to forgive me, my French is not great, but we did have a wonderful meeting with Réseau Santé Nouvelle-Écosse in the Fall to discuss some of the issues that you raised. Certainly, recently in Clare, the Office of Healthcare Professionals Recruitment was able to work with a senior physician there to support the recruitment of three physicians who are bilingual. It is something that we are mindful of, and also when there is not a French-speaking physician available, particularly in the hospital, there are options for interpretive services through Nova Scotia Health.

There are some options but certainly, it is one of the things that we consider, and if we do have a healthcare provider who is bilingual or speaks other languages, we look at where they may be the best fit in our province in order to support Nova Scotians.

RONNIE LEBLANC: Right now, the Province or the government is funding three seats in University of Sherbrooke Medical School that are reserved for French-speaking students who are in Nova Scotia. When they’re done and they have to go into residency, from my understanding, and you can correct me if I’m wrong, but it’s Dalhousie that’s doing the placement.

One thing I’ve noticed, and from my experience, is they don’t take French into consideration when doing those placements. A med student doing a residency who speaks French could maybe be placed in an English community, while an English person could be placed say, in Clare, where the health centre operates in both official languages.

I know that’s Dalhousie, but I’m wondering if there’s any way that your department can look at that, or try to work with Dalhousie to modify and improve the way residents are placed in those clinics?

MICHELLE THOMPSON: There are a couple of parts to that question.

The residents, when they apply to the CaRMS program, which is a residency-matching program that’s done nationally, they can identify their choices to have a French-speaking residency, but it does not happen within Nova Scotia. It would be a residency that would happen outside of Nova Scotia.

[6:45 p.m.]

To your point, the residencies in Nova Scotia are through Dalhousie University and currently there isn’t enough capacity to support a full residency in French. However, it is something that we can flag with Dalhousie as something that they could consider when they are matching their residents to a family practice or practitioners throughout the province.

RONNIE LEBLANC: I appreciate that you will try to look into that. My last question is specific to my riding, the Municipality of Clare, la circonscription de Clare. I think we’re the only municipality that owns and operates a collaborative care health centre. I could spend maybe 20 minutes talking on this, but essentially, I have to give a bit of context.

In 2003, the municipality faced a situation where we needed a new health centre. Physicians were looking to go elsewhere. In order for the municipality to continue having French-speaking physicians, the municipality at the time decided that we would put a committee in place to work on a health centre and a recruiting strategy to ensure that residents of Clare would be able to see physicians in their own language.

We established a committee with health care workers and made recommendations to council. In the end, the municipality decided to spend $4 million on building a health centre. We probably invested another $500,000 plus on recruiting. We find ourselves today with a beautiful health centre, and six physicians, most of whom are preceptors.

Right now, Clare finds itself in a position where the health centre is too small to accommodate the number of family medicine residents who are looking to come and do their residency. The municipality is looking at expanding that centre. The idea there would be that it would help other areas, and I did have discussions with the MLA for Digby-Annapolis. I think there’s a lot of potential there, so I raise this today because it’s a unique situation where the centre is owned by the municipality.

Would there be any interest in the department in having conversations with the municipality or, at least considering looking at participating or partnering in that expansion? Specifically around having the classrooms and the ability to have those residents come in for their two years. This is a rural setting which would encourage rural recruitment. That’s my last question. I appreciate the time.

MICHELLE THOMPSON: I thank the member for bringing that to our attention. Dr. Orrell is here raving about that clinic and telling me about it, which is why I was on mute for a little bit longer.

We do know, and I have an invitation to visit there, that it’s an excellent model. The model that you have has allowed you to be able to recruit to that community. We are open to those discussions to understand what we can do. Hopefully over the warmer months, I will be able to get down and visit the clinic and learn more about it. Thank you for raising it today.

THE CHAIR: The honourable member for Bedford South.

BRAEDON CLARK: Mr. Chair, I would like to ask the minister first and foremost - my understanding is that last night she committed to getting data on the total number of positive self-reported or rapid tests between December and March. I’m just wondering if the minister has that number and can share it with us, and if not, when we might expect it.

MICHELLE THOMPSON: There were 35,000 rapid tests from December 2021 to April 1, 2022.

BRAEDON CLARK: I did also want to ask about a few other numbers. As we talked about today, some of these numbers are more difficult to get than they once were, so we have to go through this option. I’m interested in booster doses as well. Prior to the data being turned to weekly reporting, I was noticing that the rate of booster shots was declining significantly and just inching up by a tenth of a per cent every couple of days or so, in the low 60s, if memory serves. I would like to ask the minister, right now, today, what percentage of Nova Scotians have received a third booster shot?

MICHELLE THOMPSON: I’ll give you the information that I have in front of me. I’ll just do the whole group, so you can kind of understand the vaccination status of the province. So 92.1 per cent of all Nova Scotians have received at least one dose of COVID‑19 vaccine; 5.3 per cent are partially vaccinated; 86.8 per cent are fully vaccinated; and 52 per cent received their third dose, or booster, and that was as of March 2^nd. We’ll update those numbers for you. This is what I have immediately in front of me.

What I would say around that third dose is that we are pleased with the uptake of the third dose. It is not unexpected that a third dose would be less than those who would have completed their primary series.

BRAEDON CLARK: I’m also curious about the numbers related to the last age group to become eligible for vaccination and that’s, of course, children between the ages of 5 and 11. If memory serves, the government’s hope was to have up to 80 per cent of those children double-vaccinated by Christmastime. I don’t believe we got close to that mark.

I’m just wondering if the minister can give us the most recent numbers, similar to the last answer, I guess, but specific for the 5-to-11 age group.

MICHELLE THOMPSON: The vaccine was available in the late Fall. There are 69 per cent of 5- to 11-year-olds with their first dose and there are 43.7 per cent with their second dose.

One of the caveats around this is that there were some recommendations that changed. If any of us had COVID-19, then we needed to wait a certain amount of time in order to get our booster or our second dose or wherever we were in the series. There may be some interruption related to folks who may have had COVID-19 as well.

THE CHAIR: I’ll remind the member that there are just over five minutes left in this round of questioning.

BRAEDON CLARK: I’m just curious if the minister would agree that there is a challenge, perhaps, in keeping vaccination rates steady and increasing. As we get to a point where some people might think that the pandemic is over or waning - of course, that’s not the case at this point - does the minister worry about the likelihood of people not being as willing to get their first, second or third dose - whatever the case may be - as we continue to move forward? If she does have that concern, how does the department plan to address that?

MICHELLE THOMPSON: I feel very pleased with the vaccination coverage rates that we have in the total population - 92.1 per cent is pretty significant. I gave you the breakdown.

In terms of when you become able to have your second shot, there is an email that is sent to individuals to remind them. We do have contact with individuals. We have new guidance, effective today, around a fourth dose of vaccine for high-risk populations. We see across demographics that there are some changes, but we do anticipate that there will be good uptake in terms of the fourth dose that will become available in the coming weeks for those high-risk populations.

Overall, I think we should be really proud about our vaccination coverage rates in

in the province. Nova Scotians surely did their best and came out to get vaccinated. We continue to talk about the risk associated with being unvaccinated and partially vaccinated and encourage people that at any point if someone wants to start that primary series, it’s available to them.

BRAEDON CLARK: In my remaining time here, I wanted to call back to something that was discussed, I think, during Question Period today in terms of reporting on Panorama, breaking down some of the data for vaccination coverage by age group, which was, of course, on there for quite some time. It is no longer there at this point. My impression was that the minister was going to take a look at that and investigate it. I wonder if the minister has been able to do that and if it’s possible that that data will be returned to Panorama in the near future.

[7:00 p.m.]

MICHELLE THOMPSON: I do pride myself on being fairly efficient, but I have to say, between the House and scooting over here for Estimates, I haven’t had an opportunity to do that. I do know that you’re looking for it. I’ll get working on that.

BRAEDON CLARK: I do appreciate that the minister has quite a lot on her plate these days, so I don’t begrudge her that, by any means. It is something that I think is important and certainly worth taking a look at.

In the remaining minute I have here, I just want to move quickly to paramedics, if I could, just on the issue of vacancies and labour shortages within paramedic services. The Office of Health Care Professionals Recruitment says there are 29 permanent paramedic vacancies at this point. The union believes there are over 200 vacancies related to burnout and sick leave - all of these issues that paramedics have been dealing with, working so hard for the last two years.

I’m just wondering if the minister could quickly, if she could, indicate what the actual numbers are. We know of the 29 permanent vacancies. How many paramedics are on leave due to sick leave and/or burnout of any kind?

MICHELLE THOMPSON: In terms of the people that are off, there are 181 paramedics and communications officers off currently.

THE CHAIR: Order. That concludes the round of questioning for the Liberals at this time. Now we’ll move on to the NDP caucus again for their next round of questioning.

The honourable member for Dartmouth North.

SUSAN LEBLANC: I will apologize in advance to the minister and her staff because, again, I’m going to sort of jump around all over the place for this last bit of time that I have to ask some questions, and follow up on a couple of things that I asked yesterday. Anyhow, it won’t be too painful.

My understanding is that there was a provincial pain strategy being written in the last couple of years. We haven’t heard much about it lately, so I’m just wondering if the minister could provide an update on that strategy, if it’s still being worked on, and when we can expect to see it.

MICHELLE THOMPSON: We’re just reaching in to the department to get some more information about that. We can come back to that if you wish.

SUSAN LEBLANC: That would be great, thank you to the minister for that. Another strategy that I wanted to ask about is the brain injury strategy. Concussion and brain injury recovery is not well understood and can have a massive impact on quality of life and mental health. We were of the understanding that there is brain injury strategy under development with the previous government, so I’m wondering if the minister could provide an update on that work.

MICHELLE THOMPSON: We just want to clarify, is it the Acquired Brain Injury Program that the member is referring to?

SUSAN LEBLANC: Yes. I wasn’t sure of the exact title, but that sounds about right. It is about acquired brain injury.

MICHELLE THOMPSON: That strategy was completed, as far as we understand, a number of years ago and was actually led by Continuing Care. We’ll look into it, but I think that will be a question that would go to the Minister of Seniors and Long-term Care. We can reach back into the department and through her and either she or I can address that.

SUSAN LEBLANC: Yes, thank you. I don’t know if that would be the one. My understanding from someone who contacted our office was that the previous government, the Liberals, were working on a new acquired brain injury strategy. Maybe I have my wires crossed, but if the minister can look into it and figure out where we can get more information, that would be great.

I wanted to ask a high-level question about the budget for the Department of Health and Wellness and that is: Where can we find the federal funding programs within the Health and Wellness budget? Of the total increase in the Health and Wellness budget, how much is federal funding?

MICHELLE THOMPSON: It is a bit tricky for us to tell you that. That actually is a question that would be better answered by the Minister of Finance and Treasury Board. It doesn’t flow directly to the department. It flows through them. They would be in a better position to answer that and how it’s allocated across the three ministries, now that there are three. You can save that question for our colleagues in the Department of Finance and Treasury Board if you don’t mind.

SUSAN LEBLANC: Okay, great. We will do that. I want to go back to doctor recruitment for a second and just go back to the specific need for more OB/GYN specialists. Are there any specific plans for OB/GYN recruitment? Is there a specific budget line for recruiting OB/GYNs?

MICHELLE THOMPSON: We work with our partners at NSH and the IWK to look at the services they provide but there is no specific budget line for that. It would be based on the planning that they do in their own facilities.

SUSAN LEBLANC: This is kind of another high-level question. In that case, how do we get that information from the IWK or Nova Scotia Health? I’m wondering - again, we talked last night about how those entities are funded by the department but how can one access the budget and ask these exact questions of those entities?

MICHELLE THOMPSON: The vacancies would follow under the purview of the Office of Healthcare Professionals Recruitment and they would keep track of that, and they work with our partners. Those things can change fairly quickly but the budget, in terms of what is spent year over year, would be through Physician Services. That’s where the cost of OB/GYNs in the province would be tracked.

[7:15 p.m.]

SUSAN LEBLANC: So Physician Services is part of the department - that’s correct? Therefore, I guess if that is the case then how would the minister - I don’t mean this in a disrespectful way - if the Physician Services budget is in the department, then how is it that the minister wouldn’t know if there is a specific line dedicated to OB/GYNs?

MICHELLE THOMPSON: So there are AFPs, we can’t give you the breakdown exactly of where and what and who but there’s $11.5 million for AFP OB/GYNs including oncology. There’s $6.5 million on APPs and we’re looking to find the number for any fee-for-service physicians, under that OB/GYN.

SUSAN LEBLANC: I heard APP and I heard the third thing, but what was the first thing? I am not familiar with that acronym - can the minister explain what that acronym is?

MICHELLE THOMPSON: AFP stands for Academic Funding Plan. These are folks who have university affiliation and are funded in that way.

SUSAN LEBLANC: Thanks for the clarification. I’m wondering what the department is thinking and the minister is thinking around budgeting for wage increases in the health care workforce over the next few years? We just saw the bump in CCA wages, we know the paramedics need a similar bump, and we know that negotiations for a number of health care unions will be coming up in the next, I think, year or two. So I’m wondering - how are the upcoming contract negotiations reflected in the fiscal plan for the department?

MICHELLE THOMPSON: The contractual agreements that are in place now, that money is allocated in the budget year over year. Any increase in the negotiated compensation for health care professionals is funded through Treasury and Policy Board as those negotiations are completed or ratified - or whatever the right terminology is.

THE CHAIR: I’d like the minister to repeat her answer, please.

MICHELLE THOMPSON: Year over year, wages are worked into the budget so when we have a contract, we know what the increases are over the life of the contract, and each of those are planned for in the annual budget.

Negotiations, we don’t anticipate, we don’t go in with a predisposed amount or what have you, so through the negotiation process if there is an increase that is negotiated then we go to Treasury and Policy Board to have that negotiation included in our budget.

SUSAN LEBLANC: I appreciate the minister repeating that answer. Sometimes it is harder to hear when there is - I don’t know what the deal is but sometimes the microphone sounds muffled. I just want to put that out there. I know the system is not perfect so I beg your indulgence if I can’t hear properly.

That makes sense to me, that you would go to Finance and Treasury Board to get the money that gets negotiated. We also have seen the pay bump, like I said, for the CCAs, which was not a negotiated increase - then there’s also inflation.

I just want to know when you’re looking forward in the next five years, there must be ballparks - there must be a realm that you’re in when you’re talking about budget planning. Would it be fair to say, then, based on the minister’s answer that there are no other planned increases outside of the upcoming negotiations?

MICHELLE THOMPSON: No, there is no plan to do that. No.

SUSAN LEBLANC: Great. Earlier tonight we were talking about mental health and addictions and the opioid crisis. The minister explained a little bit about how those issues are sort of spread over the two departments or the Office of Addictions and Mental Health and the Department of Health and Wellness. I just want to recap that to make sure I’ve got it.

My understanding is that anything to do with treatment of disorders would be Mental Health and Addictions and prescribing safe supply would fall under Mental Health and Addictions, but the other sort of public health part of it, in terms of harm reduction, would be Public Health.

I’m wondering if there are other areas of overlap between the Department of Health and Wellness and the Office of Addictions and Mental Health that the minister can sort of clarify or illuminate for us so that we are prepared when we get to speak to the minister responsible for the Office of Addictions and Mental Health.

MICHELLE THOMPSON: To your point, we would be in the domain of health promotion. Some of the places that we would cross over: The harm reduction actually would sit in both of our mandates, so that would be shared. Youth health centres also would be one of those things that straddle both departments, and recruitment and retention and HHR planning would be areas where we would share.

Generally in term of treatments, that will sit with the minister responsible for the Office of Addictions and Mental Health. I think that might be the easiest way to clarify.

SUSAN LEBLANC: The minister had mentioned health promotion. I had this amazing experience with a guy named Dan Steeves who worked in the office of Health Promotion for, I thought, Mental Health and Addictions. This was maybe before this government came in, though.

His and his office’s work is about community health and health promotion in the community. They’re all amazing. Which department would he be in, at this point? It’s health promotion but it’s connected to mental health.

MICHELLE THOMPSON: I’m going to ask the member to take a breath when I tell you this. My apologies. That position would actually sit with Nova Scotia Health. I know that’s a bit complicated and convoluted. There is public health that happens in the department and prevention at policy level and kind of oversight level. When there’s front-facing practitioners who are operationalizing that work, that would actually sit at Nova Scotia Health or IWK.

I appreciate that it’s convoluted a little bit. I’m happy to talk about anything that you’re wondering about in regard to where things sit.

SUSAN LEBLANC: No, no that’s fine. All I will say about that, though, before I move on is that I think that work is really excellent. In Dartmouth North we encountered Dan and his team. I forget exactly how. Somebody else at the department made the introduction.

Anyway, his work with our community was really excellent. It has stalled at this point, but I really hope that it continues. That type of investment in very upstream community health is very exciting. It makes lots of sense. Apropos of the conversation we had last night around what’s next, once health care is fixed in Nova Scotia, I really think that that type of work on the community level is very worthy of investment.

I’m going to ask a general, high-level question about health care in Cape Breton. I’m wondering if the minister can talk about the approach to health care in Cape Breton generally. We know that there are higher rates of chronic illnesses. There are higher death rates at the Cape Breton hospitals, higher instances of ER closures, and a shortage of workers. I’m wondering if the minister can talk about any specific Cape Breton-focused strategies that are happening.

MICHELLE THOMPSON: There are a couple of things there. Certainly, in terms of services available, there is a significant investment happening with the Cape Breton Regional redevelopment program that’s happening there, that infrastructure investment. Also looking at how we would increase services like OR time in Cape Breton.

We do strive to have consistency across all communities in the province in terms of how we deliver health care, recognizing that there is some uniqueness to certain regions. At a front-facing level, I would say that there are folks who work in Public Health and who work in the zone - leadership in the zone - who work very hard to understand what communities need and how to address some of the challenges that individual communities may be facing. The operationalization of that does sit with the Nova Scotia Health Authority and the leads in the zones. Certainly, we are good partners to them, and we help problem solve and are very open to discussions around some of the uniqueness of these communities or regions and how best we can support.

Again, back to the art and the science, it’s a little bit of both. Certainly, the health leadership team - now having all entities at the table, has been a significant support and has been very helpful in moving initiatives forward.

SUSAN LEBLANC: Speaking of the redevelopment of the Cape Breton Regional, have there been any changes in the redevelopment plan at the Cape Breton Regional since this government took office?

MICHELLE THOMPSON: No, there have been no changes to the redevelopment project.

SUSAN LEBLANC: What about the redevelopment plans at the QEII?

MICHELLE THOMPSON: There have been no changes.

SUSAN LEBLANC: In British Columbia, the government has applied to the federal government to have the Criminal Code related to drug possession not apply in the province as a way to address the terrible opioid crisis there. I’m wondering if we’re looking at anything similar in Nova Scotia. Again, that is to have the Criminal Code related to drug possession not apply in the province.

[7:30 p.m.]

MICHELLE THOMPSON: The Department of Health and Wellness is not currently working on any plan with the Department of Justice around decriminalization, but that may be a question that you want to reach out to the Office of Addictions and Mental Health when you have them in front of you to see if there are any efforts there.

SUSAN LEBLANC: What work is Public Health or the Health Department doing to upgrade ventilation in public buildings in light of the evidence around airborne transmission of disease?

The Department of Education and Early Childhood Development bought HEPA filters for schools. I’m wondering if there will be more improvements to ventilation, and if so, when, and is it in the budget anywhere?

MICHELLE THOMPSON: The health authorities have repair and renewal funding that is in their budget, so that would be something they would prioritize based on the needs of the facilities. That would be something that would sit within their purview.

SUSAN LEBLANC: With my next question, I just want to say before I ask it that I fully am aware that I’m either going to get a whole bunch of new social media followers and fans, or I’m going to lose all credibility with Nova Scotians, but I’m just going to say it. I am a big fan of Grey’s Anatomy, and in Grey’s Anatomy, one of the best parts about the hospital, Grey + Sloan, is the daycare. All the doctors and nurses can take their kids – they all have these amazing careers, and they all have child care right there in the building, so if they’re working a 24-hour shift, they just go and pick up their kid afterwards. It’s awesome.

I understand there is a pilot in Nova Scotia to provide child care for employees at long-term care homes in the province. I’m wondering: Are there any other similar planned pilots for health worksites in Nova Scotia?

MICHELLE THOMPSON: There are two pilots in continuing care, and certainly, we will wait to see how those pilots unfold, but we do not have any immediate plans to open child care facilities.

SUSAN LEBLANC: Ugh, Twitter is starting to come alive. No, I’m kidding, Mr. Chair, no one cares that I like Grey’s Anatomy. Last November, the Sydney Family Practice walk-in clinic was on the brink of closure, if you recall. I understand that the clinic is a private business, but the government has stepped in to support the clinic in the past, given the serious access issue in Cape Breton to primary care. Can the minister provide an update on the status of the clinic, and is there any money in the budget to help the clinic stay open?

MICHELLE THOMPSON: No, we are not currently working with that clinic.

SUSAN LEBLANC: Going back to paramedics for a second, I wanted to know - my understanding is that the paramedic union, IUOE Local 727, has requested a meeting with the minister, the actual minister. I’m wondering if the minister will agree to meet with the union.

MICHELLE THOMPSON: I actually did meet with the union in the Fall, as well as the College of Paramedics of Nova Scotia, and the Association as well.

The Department of Health and Wellness has struck a committee that meets on a regular basis and the union also sits at that table. There’s a lot of access for the union leadership to meet with the Department of Health and Wellness, as well as other partners, like Nova Scotia Health and the College of Paramedics of Nova Scotia. I did meet with the union in the Fall. I believe it was in October.

SUSAN LEBLANC: I apologize for that. I may have old information. Speaking of paramedics, can the minister talk about what contract oversight is in place for EMCI? It seems that the provider is not meeting key metrics, such as response time. I’m wondering if there are penalties in the contract and if so, what are they? Are they being enforced?

MICHELLE THOMPSON: There is an executive committee that’s made up of leadership from EMCI as well as the Department of Health and Wellness and we meet on a regular basis. We look at the contractual obligations, including KPIs - key performance indicators - as well as patient quality and safety data, but there are currently no penalties associated with that contract.

SUSAN LEBLANC: The minister might remember the tragic death of 19-year-old Kai Matthews, who last year died in hospital from meningitis. He was sent home from the ER twice. His family is advocating for a vaccination program for meningococcal B, which is not included in the normal childhood vaccination regimen. What work has the department undertaken since this tragedy, to improve awareness and treatment round meningitis B?

MICHELLE THOMPSON: I am familiar with the story. There was a quality review that was undertaken by both EHS and Nova Scotia Health, and the recommendations will be acted on from that quality review by both of those entities.

For many of the publicly funded vaccinations - not all, but many - we do follow the NACI guidelines, and NACI does not currently recommend a publicly-funded program for that immunization.

SUSAN LEBLANC: The Province is writing off $15.8 million in debts considered uncollectable as of March 31, 2022. A news release says, “Most of them are uncollectable ambulance fees and Pharmacare premiums at Health and Wellness, various unpaid fines at Justice, outstanding loan balances at Agriculture, and unpaid student loans at Advanced Education.”

Can the minister please walk us through the write-offs from her department in 2021-22?

MICHELLE THOMPSON: Our departmental breakdown is $2.9 million for ambulance fees and $245,000 for Pharmacare.

SUSAN LEBLANC: Just on the ambulance fees, does the minister have a number on how much they collect in ambulance fees, and how that compares to what’s not collected, or what’s charged but written off?

MICHELLE THOMPSON: We collected $14.4 million in ambulance user fees on an annual basis.

SUSAN LEBLANC: I just want to circle back to the quality review on the death of Kai Matthews. I’m wondering if the department will be sharing the review recommendations from those two reviews. I know the public is interested in knowing what those are.

MICHELLE THOMPSON: Because the entities that were involved did the quality review, the recommendations actually sit with those two entities - with Nova Scotia Health and EHS. The Department of Health and Wellness would not have that information and be able to share it.

SUSAN LEBLANC: That seems like a strange situation. Is there any way to compel an organization that receives funding from the department to release a report? I honestly don’t know, but it seems like a strange. I’ll follow up on that one and figure out if there is a way to advocate for that to be released.

Does the minister have an update on the number of people who have opted out of organ and tissue donation since the awareness campaign was launched last year?

[7:45 p.m.]

MICHELLE THOMPSON: We know that 64,237 people have opted out of deemed consent, which is about 6 per cent.

SUSAN LEBLANC: The New Brunswick government has said that it has not found evidence of a common unknown illness that patients and families are worried about that could be a new neurological condition after a spate of unusual illnesses in the Acadian peninsula. Nonetheless, people remain worried about how little is known about the phenomenon. I’m wondering if the minister or the department does any monitoring or information sharing with New Brunswick around this issue.

MICHELLE THOMPSON: This has not been an active consideration in Nova Scotia. We have no evidence to tell us that we have a similar issue in this province.

SUSAN LEBLANC: Can the minister please share how many ambulance pickups there are every year in Nova Scotia and how many visits to the hospital there are in a year?

MICHELLE THOMPSON: We would have to reach out to EHS for that. We don’t have that at our fingertips.

SUSAN LEBLANC: I just have a couple more questions before I pass it on over to my colleague.

I’m wondering if the minister can talk to us about - has Public Health given any input into the plans to develop an online casino? If so, what was the input?

MICHELLE THOMPSON: There would be ongoing discussions between Public Health, the Office of Addictions and Mental Health, and the Nova Scotia Gaming Corporation in regard to that initiative. There’s nothing that I have at my fingertips to share, but I know that there have been discussions and they are ongoing.

SUSAN LEBLANC: Similarly, what about discussions about the home delivery of alcohol?

MICHELLE THOMPSON: As that initiative was being rolled out, there were some consultations between the entities that we talked about - the Office of Addictions and Mental Health, Public Health, and Minister MacMaster’s group that has oversight over NSLC.

SUSAN LEBLANC: My last question for the minister - and before I end, I would like to thank the minister and her staff who are with her, for all of the back and forth and the patience and I look forward to receiving the information that wasn’t available that has been promised.

I will end with this question, Mr. Chair: Word on the street is that there’s a plan to fix health care coming. I’m wondering if the minister can tell us if it will arrive before we finish this Spring session of the Legislature?

MICHELLE THOMPSON: We do expect it to be imminent in this session, unless the session ends more quickly than we expected it to. In the words of my colleague from Queens, change is coming.

SUSAN LEBLANC: Well, I look forward to it. It must be good if they’re bringing it in front of the session, because there’s going to be a lot of chances to criticize it. Sorry. No, I’m excited to see the plan, obviously.

Now, Mr. Chair, in an unprecedented move of generosity, I’d like to cede the rest of my time to my colleague from Halifax Atlantic.

THE CHAIR: The honourable member for Halifax Atlantic.

HON. BRENDAN MAGUIRE: How much time do we have in total? Is there still time left for the Liberals or is it just 13 minutes?

THE CHAIR: You have 13 minutes in this round, and I believe 22 minutes remaining after that.

BRENDAN MAGUIRE: Perfect. For the minister’s sake, I’ll spend 12 minutes adjusting my tie.

First of all, I want to thank the minister and her staff for being here tonight. I think this is day three of many more to come. I know it’s not easy to do, so we appreciate the time.

I just want to clear up something from the minister. My colleague from Bedford South had asked about the numbers that we had requested last night, which was specifically the rapid test positive results, not the PCR test results. Did the minister say that from mid-December to March, I think it was, there were 36,000 self-reported rapid test positive results?

MICHELLE THOMPSON: There were 35,000.

BRENDAN MAGUIRE: Again, was that 35,000 rapid test positives, plus the 32,000 PRC positives that she had quoted last time? Last night she said there were 32,000 PCR positives. Is she saying that in addition to that there were another 35,000, so a total of 67,000 positive COVID-19 test results from PCRs and rapid tests?

MICHELLE THOMPSON: There were 35,000 rapid tests and there were 54,000 PCR tests, but the issue would be that there would be a number of people who would go and have a confirmed PCR test after their rapid test, and we have no ability to understand which ones are which. We know a percentage of those, would actually be positive rapids that were then confirmed by PCR, so it isn’t an accumulative number.

BRENDAN MAGUIRE: Just to clear things up, there were over 80,000 positive tests, but what you’re saying is some of those could have been duplicate, triplicate results?

MICHELLE THOMPSON: I don’t know if they would be triplicate, unless people went and got two PCRs to confirm their rapid, but there would be people who would have a positive rapid and then go have a PCR test, so it is not accumulative. You can’t add the numbers. There would be some that were captured in both of those numbers.

BRENDAN MAGUIRE: Even if we said that everybody who took - even if we just cut it in half and said that everyone who did a rapid took a PCR, we’re still looking at over 40,000, but obviously that’s not an exact number, so I’m not going to quote that number.

I want to get into some other things, and one of them is around LPNs. I know that the minister had said that she had some discussions with the union, I think it’s probably in your portfolio in particular, it’s probably extremely important to keep a close relationship with union leaders and with the workforce. The average LPN in Nova Scotia makes $23.75 an hour. Across Canada it’s almost $6 more an hour. We did see this government move quickly for CCAs (Applause) who haven’t received their - I don’t see the minister clapping yet - as of last week they hadn’t received their pay yet. (Interruption) You might want to check it.

Anyway, I’m not going to get into a back-and-forth with the Minister of Seniors and Long-term Care. It was a good thing that they received that well-deserved pay raise. That’s one of the things that LPNs have complained about, obviously. Part of the health care system is retention, as the minister is well aware of. When there’s a six-dollar average gap between what Nova Scotians are being paid and the rest of Canada is being paid, it’s something that - this government has set a precedent and addressed these issues outside of collective bargaining. Is this something the minister is looking to do in the coming days, months, weeks, outside of collective bargaining?

MICHELLE THOMPSON: To your point, Nova Scotia LPNs have the highest maximum salaries among the Atlantic provinces, so we do continue to be competitive within the Atlantic provinces, and we know that there are other provinces with bigger population bases that are higher-salaried than us across all designations. Currently there is no plan for us to work in our ministry, in the Department of Health and Wellness, to work outside of our collective agreements.

[8:00 p.m.]

BRENDAN MAGUIRE: Respectfully, this may not be a question that the minister can answer. Why pick one side over the other? We do know that our CCAs are some of the lowest paid in Canada. The LPNs who do critical work in the health care system, they are well-paid looking at our Atlantic Bubble, but outside of our Atlantic Bubble they’re much further behind. If we want to continue to attract and keep the LPNs, they will have to have a competitive salary right across Canada.

I’m just wondering if the minister has any insight as to why CCAs were rightfully given that raise and LPNs were told that it’s not coming.

MICHELLE THOMPSON: We continue to work with the Office of Healthcare Professionals Recruitment in terms of supporting our health care professionals across all designations in terms of the recruitment piece. We know that retention is an important part.

We will continue to work through the collective agreement process that we have for a period of time. We will negotiate salaries as those contracts come up for negotiation and we’ll continue along that course.

BRENDAN MAGUIRE: Obviously this government was elected on a health care budget and health care priorities. I would think it would be a bit of a disadvantage - does the minister think that bringing the LPNs up to the current standard across Canada will make her job easier attracting talent and retaining talent?

MICHELLE THOMPSON: We always look at remuneration for our professionals. I do think though that there are other things that are important to people. We want to continue to recruit and retain. We want to look and make sure that our LPNs and RNs and our health care workers have a good, positive working environment. We want to make sure that they have a work/life balance. We want to ensure that they have insured benefits so that they’re able to look after themselves.

There are a number of different things that we want to do. We heard directly on the tour about some things that negatively impacted the work/life balance or the work that they are doing. We want to ensure that we hear voices so that people have agency over the health care environments where they’re working. It’s really important that the people have influence in terms of some of the decision making or some of the processes that happen.

I know that remuneration is important, but I don’t believe it is the only thing. I think that there are things that we heard on the tour, good information that was shared with us. We may never be able to fully compete with some of those larger places in terms of their tax base and their ability to pay. I don’t know that we will ever be the highest paid in Canada.

We will ensure that our health care workers are the most respected and that we continue to listen to them and hear from them and make changes that create meaningful workplaces for them to care for Nova Scotians. I think it’s a package and not just one thing.

BRENDAN MAGUIRE: Could you, just quickly as we only have a minute left, define what work/life balance for an LPN means to you?

MICHELLE THOMPSON: I certainly can’t speak on behalf of all of the nurses in the province in terms of what work/life balance means. I do think it means, for me, that we would ensure that our facilities are adequately staffed, that people have agency over their ability to influence decisions, that they are heard and seen and feel included in their workplace.

It would mean that there was a good social support at work so that it’s a welcoming, inclusive, and diverse culture at their place of employment. It would mean that they have access to benefits so that they can use their days off to participate in self-care, that there would be things that they could do that gave them enjoyment. For me, those are the things that are important to me, but I don’t think I can define that for every health care worker in the province. Those are some of the things that we did hear about on the tour . . .

THE CHAIR: Order. The round of questioning for the NDP caucus slash Liberals is over. We will now move on to one final round of questioning - to the Liberal caucus. This hour has 22 minutes (Interruption)

MICHELLE THOMPSON: Well done, Mr. Chair. That was good.

THE CHAIR: Thank you. The honourable member for Halifax Atlantic.

BRENDAN MAGUIRE: I have to say, that was really good. I have flashbacks from that show. My wife worked on that show for over 10 years, so I can tell you that that hour had a lot more than 22 minutes.

I just want to jump around a little bit if that’s okay with the minister. There were some unfortunate retirements, and I spoke to her department about this. One was a retirement, and one was a family doctor who moved on to a different position. One of the doctors in particular was what we like to call one of the old-school doctors. Your staff would know better how many patients he had. Some estimate it could be up to 7,000 people he was seeing. He retired unexpectedly, and it left not just the people of Spryfield and surrounding areas, but I would argue it’s probably going to leave HRM - this doctor originally ran the Gladstone Professional Centre. His patients were from all over Halifax and HRM.

My question to the minister is: When a doctor like that retires - we do know that it’s going to take multiple family doctors to replace him, three to four family doctors to take on his caseload - what is the response from the department? Specifically for this doctor - I don’t know if it has come to the minister’s attention yet - what do we do for those 7,000, 8,000, or 9,000 Nova Scotians who just lost their family doctor?

MICHELLE THOMPSON: I am familiar with the situation that you have discussed. The effort in an unplanned retirement such as that is to keep the practice intact. Initially we would look at recruiting long-term locums in order to stabilize the practice and then, looking at the panel that the physician was carrying, recruit the number of FTEs that would be required to replace that physician.

In the case of unexpected retirements, that’s one of the things that the office is working hard to do, to develop a network and understand what physicians’ intentions are and understand the panel size. This is in order for us to be able to plan accordingly when that retirement comes, and whether or not we can work with them to transition the new position in and have a transition-out plan. There is potential for a mentorship program as well.

BRENDAN MAGUIRE: I want to thank the minister for being aware of the situation. Personally, I will say that I know this doctor quite well. He was my family doctor for a long time and one of the nicest human beings you’ll ever meet, so it is sad when someone has to retire unexpectedly like that.

My experience, and I started reaching out to other people, you’d be surprised when a family doctor like that retires how many people reach out to you and say, so and so is my family doctor, what do I do?

My experience with the resources in place I have to say were not good. I waited on hold - I think it was 811 - for over two hours; nobody answered. People reached out to me and I asked them to call 811 and they had the same response: I’ve been waiting on hold forever, nobody is answering.

I understand they are very busy, but I would argue that two hours is probably a little too much time to wait. People get frustrated. Again, I was unable to put my name on the list, so I did what most people would do, I went online - and I encourage people to go online and fill out the information online - and received error messages. So I actually couldn’t submit my name or the names of others on the online Need a Family Practice Registry form.

Is this something the minister has heard of? Do you know what the average wait time is for 811, when people call to put their name on the Need a Family Practice Registry list?

MICHELLE THOMPSON: I had not heard about the error messages. It hadn’t been brought to our attention, but we can certainly reach out and ensure that that has been corrected and understand if there were any concerns around that.

In regard to the calls, the call volume changes on a day-to-day basis. While we do monitor that, there may be days that there is a high volume of calls and may contribute to that. We haven’t heard consistently about extended wait times. If you have the dates or if you are hearing that consistently in your constituency, we’d be happy to reach back to 811 and let them know.

BRENDAN MAGUIRE: The 811 service, I apologize for not knowing this but is the 811 service an out-sourced service or is it an in-house, government employee service?

MICHELLE THOMPSON: Mr. Chair, 811 is a contracted service with Medavie Blue Cross.

BRENDAN MAGUIRE: Is there any type of information - obviously there is an agreement in place - are there standards set forward in the contract on call time, volumes, and response time?

MICHELLE THOMPSON: That’s something that I’ll have to look into. I don’t know if there are key performance indicators associated with that contract or not but I will have a look.

BRENDAN MAGUIRE: Is that something that she could table here in the House?

MICHELLE THOMPSON: If there are standards or KPIs we will be able to table that information.

[8:15 p.m.]

BRENDAN MAGUIRE: What I’m looking for here is for the KPIs to be tabled and the standards to be tabled and what’s actually - obviously, if there are standards in place, the department must have a way of monitoring and tracking to make sure that those standards are met. What I’m wondering is: Can the minister not only table those KPIs and the standards in the agreement, but also the actual numbers on, let’s say, a month-to-month basis for the last three or four months?

MICHELLE THOMPSON: If there are performance standards, we can do that. There is some call volume data as well, so we’ll reach back and see what’s available.

BRENDAN MAGUIRE: If you could also change the hold music, that would be great because it’s not good hold music either (Laughs). I’m just wondering if there’s anything in this budget for type 1 diabetes.

MICHELLE THOMPSON: There is some investment for chronic disease management, but not specifically for diabetes.

BRENDAN MAGUIRE: What I was looking for specifically was the glucose monitoring. Can I ask why there was no investment in type 1 diabetes, specifically the glucose monitoring? We know that during the last general election there was a push from advocates on this, and a lot of the government members actually took the test and posted online and committed to having this taken care of if they were elected. I’m just wondering why that was left out of this budget.

MICHELLE THOMPSON: I will tell the member that I answered a similar question last night that we are looking at in terms of the sensor. We just didn’t have it available, so we are continuing to look at that program and understand the clinical benefits to that.

BRENDAN MAGUIRE: I also want to touch on one of the other promises that was made and respectfully was kept, and it was something that I was glad to see, and that was around fertility. It’s very difficult for individuals to have to go through that, and I was glad to see the minister delivering on that promise as soon as the first budget came out.

The one thing I will say is obviously nothing’s perfect, and it was a fairly good start, but it did leave out a lot of Nova Scotians and a lot of people who can’t afford to pay for that price and that cost up front and then wait for a rebate or people who just can’t afford it even with the rebate. What happens to the people who actually can’t afford to wait for a rebate? What happens to those who can’t afford the cost? What would you say to them?

MICHELLE THOMPSON: I recognize that there are financial challenges around fertility treatments, and unfortunately at this time it is not an insured benefit. We are very proud of the initial steps that we’ve taken to offer this rebate to Nova Scotians, so that’s what I would say. It was an important first step, and we’re pleased and proud to be able to offer this initial step.

BRENDAN MAGUIRE: Again, I will congratulate the minister on delivering on that immediately. I think it’s extremely important. Will the minister commit here today to reviewing the program and further expanding it so that all Nova Scotians, no matter the size of their wallet or bank account, have access to this program?

MICHELLE THOMPSON: The program that we’ve introduced with the tax, the fertility and surrogacy rebate, that will be the first step and we’ll evaluate that program. We’ll evaluate the uptake and we’ll continue to monitor that program is what I would say today.

BRENDAN MAGUIRE: I’m going to take that as a soft yes. I appreciate you at least monitoring the program and taking a hard look at it.

My last question before I pass it on is, when it comes to the health care budget, specifically the amount being spent on COVID-19, we know that a lot of money has been spent here in Nova Scotia and right across Canada. Is the COVID-19 budget for the coming year for testing, vaccines, and response teams to seniors’ homes and different resources static? Is it decreasing or is it increasing, considering that right now we’re in the middle of a wave that’s probably the worst we’ve ever had?

MICHELLE THOMPSON: Last year’s budget was $204 million and this year’s budget is $177 million, so there’s a couple of things that would impact that. First of all, our vaccination rollout, while we’ll have to do a portion of that, the likelihood of our having to go through the effort that we did in the past budget year is probably limited.

However, we know that COVID-19 is a fluid situation and we will not be holding any resource back if it’s necessary for us to respond. It is a fluid number and we do anticipate that there would be reduced costs, for a variety of reasons. But again, if it’s required, we will invest as necessary, in order to mount an appropriate COVID-19 response.

THE CHAIR: I’ll point out to the member that there is roughly just over four minutes left.

The honourable member for Bedford South.

BRAEDON CLARK: I had just a quick question for the minister. This is an issue that was brought to my attention by a constituent of mine who was referred for a colonoscopy way back in February 2019. Her sister unfortunately passed as a result of colon cancer, which makes this constituent of mine high risk.

As I mentioned, she has been waiting for this procedure for up to 37 months. She followed up about a year ago and was told that the backlog was starting in 2017 at that time so this even predates COVID-19.

I’m just wondering if the minister could give us an update on this procedure in particular and the serious backlog for folks who are at high risk in particular.

MICHELLE THOMPSON: Recognizing that there is a wait-list, there is an additional $2.7 million allocated in the budget to address the endoscopy and cystoscopy wait-list. That is one of the areas that we will be planning and looking at how we leverage our current capacity, and what opportunities there are for us to increase those procedures and address the backlog.

BRAEDON CLARK: I’ll bring that to my constituent. I’m sure she’ll be happy to hear that. I also want to thank the minister’s special assistant or adviser - I’m not sure what the term is these days, who was very helpful in getting me some answers on that issue as well. I’m sure she’ll pass that along to him.

Just quickly in my last couple of minutes here, I wanted to touch on the need for emergency medicine. The greatest need is here in Central Zone, about 18.5 FTEs required. That’s according to a FOIPOP we received at our caucus office, which is basically unchanged since August. I’m just wondering if the minister could give us a sense of how this issue might be resolved. Of course, all of these things are interconnected, but having almost 20 vacancies, FTEs required, in emergency medicine in Central, obviously is a significant issue. If she could just update us on efforts to bring that number down.

MICHELLE THOMPSON: I would have to talk to the member directly about the information that he has. We would need it clarified. We don’t feel that there is an 18.5-FTE vacancy here - not to be argumentative, but just to better understand the information that you have. Certainly, we are working with residents and doing some improvement to look at our vacancies across the province. I think, if you don’t mind, it would be easier if I had a look at that, or we could have a conversation to better understand what information it is that you have.

BRAEDON CLARK: It’s late, and I don’t want to be argumentative either, so I will accept that with no issues whatsoever and take my place.

THE CHAIR: Order. The time for questioning has now ended. I recognize the Government House Leader.

HON. KIM MASLAND: I move that the committee do now rise and report progress and beg leave to sit again on a future date.

THE CHAIR: There is a motion on the floor that this committee now rise and report progress to the House and beg leave to sit again on a future date.

All those in favour? Contrary minded? Thank you.

The motion is carried.

The committee will now rise and report to the House.

[The committee adjourned at 8:28 p.m.]