HALIFAX, WEDNESDAY, MARCH 20, 2024

 

COMMITTEE OF THE WHOLE ON SUPPLY

 

6:52 P.M.

 

CHAIR

Danielle Barkhouse

 

 

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

 

The honourable Government House Leader.

 

HON. KIM MASLAND: Chair, would you please call Resolutions E12 and E29.

 

THE CHAIR: We shall continue debate on Resolutions E12 and E29.

 

The honourable member for Kings South.

 

HON. KEITH IRVING: Good evening, Minister. I know this must be your favourite time of year, when you get to answer so many questions from us in Opposition on behalf of Nova Scotians. I’m going to primarily focus my questions on infrastructure and the important projects that now fall under your purview and you are responsible to deliver.

 

First of all, I want to review what has happened in this past year. Documents indicate about $50 million underspent from the operational side of the capital plan. We know that there was $538 million estimated to be spent this year on health care infrastructure. I wonder if you could indicate how much has been spent in this past year on the health capital plan.

 

HON. MICHELLE THOMPSON: The projection for the year is $221,991,000. The gap, the variance, is related to unexpected labour and supply chain issues, disruptions.

 

KEITH IRVING: The biggest and most important project that you’re now responsible for is the QEII Halifax Infirmary Expansion Project. We know your government has been working on that project for two and a half years. On May 12, 2023, an announcement was made that a contract had been signed and work would begin. We now understand that that has not happened. Could you explain to us what the delays have been to prevent that project from getting started?

 

MICHELLE THOMPSON: In May 2023, we did commit to the design process and to start enabling works this year. We have progressed the design work. That has progressed. Enabling works started at the beginning of March on the site.

 

KEITH IRVING: I’m going to ask an architectural-type question here for you. I would like to know what stage of the design process we are in. Are we at concept design, schematic design, design development, or construction documents?

 

MICHELLE THOMPSON: We continue to be in the design phase agreement, which is predominantly around technical design. The DPA portion of the project is still under way, and we expect to conclude it by this calendar year.

 

KEITH IRVING: Could you clarify DPA?

 

MICHELLE THOMPSON: Design phase agreement is DPA. Is that what you’re asking, what the acronym is? I’m sorry. I didn’t realize I even used it. The DPA is the design phase agreement stage.

 

KEITH IRVING: Just for clarification, design phase - I’m assuming that’s taking us through the end of design development but not getting into working drawings by the end of the fiscal year?

 

[7:00 p.m.]

 

MICHELLE THOMPSON: That is correct. By the end of the year, we will have what you suggested.

 

KEITH IRVING: In Estimates, in questions to the Minister of Finance and Treasury Board, he indicated that you would be going to market with this project. That indicated to me that perhaps you were going to tender. I ask for clarification on that from the minister. I think that’s an important change that we understand has been happening. I was wondering if the minister could confirm whether this project is being tendered or whether it’s sole source.

 

MICHELLE THOMPSON: I haven’t seen the comments of the Minister of Finance and Treasury Board. I’m just going to go back. The project was tendered originally. There were two proponents. One withdrew from that process, related to changes in market conditions. We are proceeding with the remaining proponent through a collaborative design process that helps to ensure the right product at the right time.

 

KEITH IRVING: This project will be delivered without competitive bidding.

 

Minister, we know that it’s going to take another year to complete the design. Then you will have working drawings. I understand you want to do some excavation work, but when do you anticipate main construction of the building to begin and a completion date?

 

MICHELLE THOMPSON: I guess what I would say in response to that is that there were two proponents through a tendered process. I think we all know that there are only so many companies that are really available, not only provincially but nationally, in order to be able to do a project of this scale. There will be competition in the subtrades in the P3 model. I think that’s important to remember as we move forward.

 

The enabling works have started, which is site preparation in advance of the finalization of the DPA process, which will help us save time on the schedule. It is a concurrent process. Once the DPA is completed, we will have more finalized timelines in terms of actual start and finish of the project.

 

KEITH IRVING: So, we don’t have a schedule for completion. I am very interested in this, of course. I am spending a lot of time, unfortunately, at the VG these days, seeing the condition and talking with staff there who, unfortunately, are discouraged to see how slowly the project is moving, so I’m trying to get some indication for them that this will actually happen. My question for the minister is: Do we have a budget for this project?

 

MICHELLE THOMPSON: I want to assure the member - and on the off chance any of the health care workers from the VG are watching these riveting Estimates sessions - I do want to assure them that there will be a robust and regular communication plan as we move forward. It’s going to be a big project. It’s going to take time, and we do want everybody to understand - folks who are not only within the facility but also in the surrounding areas. When I look at that part of the city, they’ve had a ton of construction over the past few years: renovations of a hotel and a big tower, I think, of apartments. I am sure they are tired, and they are going to want to know regular updates about what is happening on the site.

 

I do want to let you know that we do have conversations about regular and clear communication about how the project is progressing. The total project costs will be clearer when this DPA process is finished. The amount budgeted in the 2024-2025 budget for the enabling works is $90 million.

 

KEITH IRVING: I asked this question to the Minister of Finance and Treasury Board, and he referred me to the Minister of Health and Wellness. My question to the minister is: Is the spending on this project in the four-year fiscal plan for the projects? Does your next four years of spending appear in the four-year fiscal plan in the budget documents?

 

MICHELLE THOMPSON: Obviously, the fiscal plan is quite complex, so there are provisions in the forecast, but those will continue to be updated as we get closer to - as it becomes more refined.

 

I’ll add a note that there are also targeted, strategic, and focused investments in the VG to maintain it, given all the complexities of the old building itself. It is a bit of a complex thing. The budget is huge, but as we get closer, and it becomes more refined, we’ll be able to better provide out-year targets.

 

KEITH IRVING: I guess what I’m hearing is that we still probably have at least two more years before we have any significant construction. I guess those numbers for design should be in the four-year fiscal plan, and without a budget, you have nothing in terms of the actual build in that four-year fiscal plan is what I’m hearing from the information that you have presented.

 

Minister, we did start with two bidders. They did do, presumably, two designs. We have now another design. How many designs have we been through at this stage for this project?

 

MICHELLE THOMPSON: The two proponents each had a design, and then the remaining proponent had a design, but that, of course, has been modified based on the announcement that we had in December 2022. We changed the design to meet the needs of Nova Scotians. So two, and then the modification of the second one.

 

KEITH IRVING: The announcement on December 22^nd, you made changes to what the plans were. It was based on a recommendation to add 144 beds, 4 new operating rooms, an emergency, a new lab, a new cyclotron, et cetera. I noticed then six months later, you announced an addition of 36 beds instead of 144 beds. I’m puzzled with the change in scope. You made a change in scope based on a recommendation for new population to add 144 beds, but you then chose to add 36. Could you help me understand why you aren’t following the advice that you got to readjust the plan from 180 beds and only adding 36 instead of 144?

 

[7:15 p.m.]

 

MICHELLE THOMPSON: I’ll just give you a bit of an overview. In that Wave 1 project that we anticipate, there will be a new emergency department in that build. We originally said there would be 12. In the original design there were 12 operating rooms. We’ve added four for a total 16. The acute care beds, there was an original of 180 with an addition of 36 to a total of 216 additional. There’s only been an addition of 36 on top of the 180.

 

KEITH IRVING: Thank you, Minister, I have that. The recommendation that you received and as was reported in the press on June 21, 2022, was to add 144 beds. My question was why you added 36 and not 144 if you were basing this on new population data, which is now outdated as well. There’s quite a difference there.

 

MICHELLE THOMPSON: I think what’s important to discuss is that is at that particular site, but the plan that we talked about in December of 2022 includes additional beds at Dartmouth General Hospital, at Cobequid Community Health Centre and also the West Bedford site for transition-to-care facility beds. That is just at that site, but there’s also - we’re going to build capacity in other areas as well.

 

KEITH IRVING: When I asked this question a year ago - well, is there any progress on the Dartmouth new emergency centre, the Cobequid Community Health Centre, the mental health and addictions centre, the heart centre or the Nova Scotia Rehabilitation and Arthritis Centre that were announced on December 15^th? Do any of those have at least a facility plan and heading into design?

 

MICHELLE THOMPSON: Around Cobequid, Dartmouth General, mental health hospital, all of that work is part of the Central Zone master planning which will be completed this calendar year. Work is under way in regard to the planning stages of that. The heart centre that you mentioned will be Wave 2. This would be in the Wave 1 project, but the heart centre will be Wave 2.

 

KEITH IRVING: What I heard there is you are still doing master planning for the entire system; that we have not actually identified what is going into each of those buildings or expansions, so there has been no specific progress on those.

 

Let’s move to the transition buildings. You have $16.5 million in this year’s project. Is that for the Bedford or for the Bayers Lake project?

 

MICHELLE THOMPSON: There is $16 million allocated in the budget for both of those projects combined.

 

KEITH IRVING: How much for each one?

 

MICHELLE THOMPSON: It would be $13 million for West Bedford and $3 million for Bayers Lake.

 

KEITH IRVING: I understand the minister had a tender for architectural services for the Halifax Infirmary expansion project. I wonder who you hired and why. As part of that, architects bidding on that job, I believe, were asked to sign an NDA. I find that highly unusual for a public tender. Could you explain that for me? Who was hired and why was an NDA required for a public tender?

 

THE CHAIR: Order. This time has lapsed. It is now time for the NDP Caucus.

 

The honourable member for Dartmouth North.

 

SUSAN LEBLANC: I have Hogan Court questions, but just a few. Great to be back. Yes, I am just going to ask a few questions about Hogan Court, so hopefully we have the right people in the room. My first question is: What aspects of that project was the Department of Health and Wellness responsible for - or is, I should say, not was?

 

MICHELLE THOMPSON: Predominantly, the original purchase of Hogan Court was done with the Department of Health and Wellness. Now that the portfolio has changed, I have more oversight over the entire project.

 

SUSAN LEBLANC: Great. Then you’re the person to be asking the rest of these questions to. What is the current timeline for the opening of Hogan Court?

 

MICHELLE THOMPSON: It will be open by the end of the calendar year.

 

SUSAN LEBLANC: What is the projection of how much the project - the capital cost of the project - will be in the end?

 

MICHELLE THOMPSON: There’s a $17 million capital construction budget, which also includes design, and the purchase price was $34.5 million.

 

SUSAN LEBLANC: How many beds is it going to have now? I know that number has been in flux.

 

MICHELLE THOMPSON: There will be 68 beds.

 

SUSAN LEBLANC: What will the cost per bed be? Is that number concrete now, or is there a chance of it fluctuating before Hogan Court opens?

 

[7:30 p.m.]

 

MICHELLE THOMPSON: Operationally, it’s $544 a day, is what I would say. Is that what you want to know? The operational?

 

SUSAN LEBLANC: Yes, and do you anticipate it staying at $544 a day or changing before it opens?

 

MICHELLE THOMPSON: I think any of the facilities that we have, the operating costs will probably change as wages, et cetera, increase. There may be some increase over time, but it would be difficult to predict. The operations would be around the costs associated with the bed - people, utilities, those types of things.

 

We can expect it to go up, but all of the other places are going to go up too. We expect that it’s just going to be incremental over time and not a big change in that original number, based on the model of care.

 

SUSAN LEBLANC: Yes, that’s what I was getting at. I understand that wages will go up and all that and costs will go up. I just mean before it opens, do you anticipate any kind of: Surprise, it’s actually going to cost $650 a bed?

 

Did you look into other options before this property and building were decided on? Were there other locations discussed?

 

MICHELLE THOMPSON: Yes. There were a number of facilities. There were 17 that were reviewed throughout HRM, and this was identified as the best in terms of the actual build itself.

 

When we looked at the operating pieces, eight organizations were invited to participate, in terms of the operations of the facility. Five vendors were shortlisted as a result of that, and patients looked at a variety of different things. Then questions were asked about service delivery and capability, and as a result, of those five shortlisted, two vendors were further chosen for Phase 2, which included full-day sessions with each of those vendors to review their proposals in order to become the operator for that facility.

 

SUSAN LEBLANC: Right, but that was after you bought it. I’m talking about before you bought the property. Did you look at other properties and - you said 17? Okay.

 

To clarify what you just said, then: You looked at 17, you settled on Hogan Court, and then when you bought it. You did the other stuff with the service providers and then chose a service provider, which is Shannex?

 

MICHELLE THOMPSON: Head nods don’t go into Hansard, so the answer is yes.

 

SUSAN LEBLANC: Can you just remind me of when this began? When was it purchased? When was Hogan Court purchased? Are you, as the Minister of Health and Wellness, happy with the timeline progress on it, or are you disappointed because there have been delays and this, that, and the other thing? Can you let me know how it’s going in that way?

 

MICHELLE THOMPSON: We received approval for the purchase in December 2022, and it was purchased - the deal closed in February 2023.

 

There are a couple things I want to say about that. I am not disappointed at all. I am excited about this West Bedford transition to community facility. We need more beds. We absolutely need more beds. This is a way for us to deliver those beds two years faster than we would if we had to build from scratch, basically.

 

Yes, there are requirements for us to renovate the building - or retrofit or whatever words you want to use. That’s okay. That’s part of - we knew that when we were purchasing a partially built building.

 

I’m quite pleased with the timelines, given where we are in terms of supply chain disruption, the labour market, and those types of things. We’ve seen with other big projects, provincially - we know skilled labour is an issue. We know that supply chains - when we were up at the hospital in Amherst, as an example, seeing it after the flood and the frustration of trying to get what they needed for that facility.

 

It’s a specialized thing. We’re not building a bungalow. You need call bells. You need different things to meet the fire marshal’s requirements. I am pleased with that. I think it’s gone well.

 

I’m excited about the innovation associated with this facility. Long-term care does have a place. That’s where I came from, prior to being elected. It has an important part in our continuum of health care. I also know - I can’t cite a study in front of me - that probably the worst place for a frail, elderly person to be is in hospital. When you go in for your acute illness, that’s one thing, but you decondition there. You decondition there because the skill sets and the expertise of the individuals in that facility are not necessarily frail, elderly people.

 

This facility and the model of care that’s going to be there is going to have that entirely in mind. It is going to be for frail, elderly individuals, with a lens to getting people home. We are going to see a model of care that we haven’t seen before. It’s not here in the Atlantic provinces. In fact, we know there are other provinces now that are going out to RFPs to emulate the model we have here, so I’m really excited about this project.

 

I think it’s an important part of our continuum. We have hospital and long-term care, and a lucky group gets to go home, but now we’re going to have an opportunity for more people to be able to age in place. It’s going to help us slow down the progression of needing to go directly to a nursing home. That’s our belief and our hope. When we talk to experts in the care of the frail and elderly, they tell us the same. I am really pleased with the project. I’m excited. I can’t wait to tour it when it finally opens.

 

SUSAN LEBLANC: As you know, there was some consternation and some pretty scathing - parts of this project, in terms of the procurement and all that when it all started, from the Auditor General. There were several recommendations made by the Auditor General in her report, which we’ll be discussing further next week in Public Accounts.

 

One of the recommendations was that the Nova Scotia Health Authority require a conflict-of-interest disclosure for procurement evaluation team members and the approvers of alternative procurements. Can the minister confirm whether that recommendation has been met? Going forward, is that happening with all the projects that the department is overseeing?

MICHELLE THOMPSON: The Nova Scotia Health Authority does have a conflict-of-interest policy. We have accepted, as government, all of the recommendations from the AG. Work is under way now to look at the recommendations and the current policies and cross-reference them. We are really grateful for the Auditor General’s work on this. I would say, arguably, that if we are going to continue to do more faster - because we can’t wait - there may be other projects in the future.

 

The AG’s recommendations are incredibly helpful for us. If we continue down a different way - the past - we said we can’t keep doing things - the way we have always done them has gotten us to this place. Those will be very helpful, those recommendations, in helping us move forward in the event that there are other projects that we undertake.

 

SUSAN LEBLANC: I want to go back to a couple of questions that we talked about yesterday; just to follow up on a couple things about the app mostly, the YourHealthNS app. Yesterday you mentioned that the Nova Scotia Health Authority’s contract with EY is up on March 31^st, so that is next week - I didn’t really realize that when I was listening to you last night - and then there is an option to extend. Can you confirm? Obviously you must know by now whether that contract will be extended. Can you confirm it will be extended, for what length of time, and at what cost?

 

MICHELLE THOMPSON: We just had to change support staff, so I wonder if the member would mind asking the question again.

 

SUSAN LEBLANC: Yes. Yesterday when we were talking about the YourHealthNS app, the minister mentioned that the contract with EY is up on March 31^st , which is next week, and the minister mentioned that there is an option to extend. Hopefully by now we know - it is March 20^th - hopefully we know if that contract is being extended or not. If it is, can you confirm it and for what length of time and at what cost? If it isn’t, I guess my Part B will be who is getting the contract?

 

[7:45 p.m.]

 

MICHELLE THOMPSON: We’re going to follow up with NSHA about that because they hold the contract.

 

SUSAN LEBLANC: You’ll get me that, though, by the end - great.

 

Yesterday we heard that Think Research is responsible for the chatbot and the navigation features on the app but that the app is expanding to soon include the access to medical records. We had a bit of a conversation about that yesterday.

 

Who is working on that portion of the app? Will it be Think Research, or will it be another third party?

 

MICHELLE THOMPSON: EY will continue to do the work until at least July on the patient record app.

 

SUSAN LEBLANC: EY will be doing the work. Are you answering my first question? My understanding is that what you said yesterday was that EY does some of the app stuff but then Think Research is responsible for the chatbot and the navigation features.

 

My question is about the medical records part: Who is going to be looking after - like when that comes live, I know you are doing a pilot right now with the medical records - who is running that portion of the app?

 

MICHELLE THOMPSON: EY is supporting the work, the test-and-try pilot that we have, but the actual housing of the app is being managed by Nova Scotia Health Authority.

 

SUSAN LEBLANC: You mentioned yesterday that about half of the budgeted $49.6 million for Think Research is for the virtual urgent care. Can you explain what this is and what exactly is the service Think Research is providing? Is it different from VirtualCareNS? Yeah, virtual urgent care.

 

MICHELLE THOMPSON: What I would say is, with the money, some of it is associated with the platform that allows you to actually make that video call and get connected and all the configuration work that has to be done. The other portion is for the clinicians, the clinical services, the nurse practitioners, and physicians who may be on the phone. So, the virtual urgent care is trialing in the rural emergency departments in order to see people, not with emergencies but with virtual urgent care.

 

It’s actually located in the emergency rooms, which is different from VirtualCareNS where people have access to VirtualCareNS at home. This is actually situated - this test-and-try pilot is actually situated in our emergency rooms in some rural hospitals.

 

SUSAN LEBLANC: Okay, so that’s when someone is sick, they go to the emergency room and instead of being triaged to see a human, they get triaged, and they go into a room, and then the do an urgent care appointment online. Is that correct? As opposed to seeing - going through the regular ER process?

 

MICHELLE THOMPSON: What it allows people to do, they go to the facilities. It’s a combination; sometimes it is a virtual practitioner, but there have been other times where, when someone is triaged, they’re given the option to be seen virtually. There are just so many combinations because people are really doing what works for them. So, there’s the rapid assessment unit in some places. Sometimes you can be seen virtually through virtual urgent care and go, really reducing wait times - in and out within 60 to 70 minutes - pretty significant. Then other times that would be the provider that you would see when you were there.

 

SUSAN LEBLANC: Great. Now the Minister just talked about how that was being piloted, but an article from last summer, that I think I have here to table, says that, “Nova Scotia Health says it will be offering virtual urgent care indefinitely.” Does that mean that this partnership with Think Research is also indefinite? I’ll table them at the end.

 

MICHELLE THOMPSON: I’ll have to get that information. It’s so operationally deep - deep into the operations of the Nova Scotia Health Authority. I don’t have that just at the top of my head.

 

SUSAN LEBLANC: Sorry, the question is just virtual care - the Nova Scotia Health Authority says that virtual care is here indefinitely, so the question is: Does that mean Think Research is . . . (interruption). Okay.

 

How many monthly visits are happening with virtual urgent care right now, and how is the success of the program being measured?

 

MICHELLE THOMPSON: Again, this is very detailed information that I must get from the provider. This isn’t stuff from the budget that I would just have. If there’s a list of questions around this, then we can get the statistics, submit them, and table them by the end of the week. This isn’t something I’m going to have. If this is the way questioning is going to continue, I don’t have the answers.

 

SUSAN LEBLANC: I have one more question about the app. We understand that Think Research was recently sold to an investment firm after facing financial challenges. What would a sale or even dissolution of this company mean for our investment in the app and the program? What is the department doing to ensure the protection of the associated personal health information and data?

 

MICHELLE THOMPSON: My understanding is that the contract would be assumed by whoever bought Think, but they’re not holding the personal health information. That’s held here, and we have a chief information officer at the Nova Scotia Health Authority. There’s also the digital services and cybersecurity, and any of the information we have will comply with PHIA.

 

SUSAN LEBLANC: I’m going to move on now from the app. I want to ask a bit more about staffing and recruitment. Does the Province - not the college, but the Province - track how many physician retirements are likely to occur in any given year, and does this impact recruitment efforts? If we know that there are five doctors who’ve said: I’m going to retire by December, in these areas, does that go into the recruitment plan?

 

[8:00 p.m.]

 

MICHELLE THOMPSON: We do have a breakdown. We know the ages of the - all licence types in the province. You know, 904 physicians are between the ages of 31 and 40, so that’s helpful; 895 are between 41 and 50; 744 are between 51 and 60; 487 are between 61 and 70; and there are 146 physicians practising who are 71 years of age and older. Retirement is a very personal choice and there is no mandatory way in which people have to disclose. What we prefer, and we welcome, is that when physicians are nearing retirement, the longer the runway, the greater the chances are that there will be less disruption in service.

 

They have to notify the College that they’re going to retire and then, as soon as the collective “we” catches wind of it - the Department of Health and Wellness, primary care, Medical Affairs, et cetera - everybody leans in to see if there’s anything we can do to support the transition recruitment of that practice. We do work with docs through the physician hotline that was launched last year.

 

The VP of Medicine, when she said we want doctors to feel that they can retire, we heard over and over that doctors were keeping that to themselves because they were feeling guilty. In communities, people were saying: Don’t retire, I need you; or kind of being encouraged to come back. We hear from the college, as well, that there are some docs who just want to finish.

 

That hotline was set up to support physicians who have a variety of different complications, as an example, in their practice, but also for those who are considering retirement, to be able to have a conversation. Fifteen thousand patients have been prevented from going on the Need a Family Practice Registry as a result of that hotline. It has been very effective.

 

We just continue to reach out through different channels - the college, Doctors Nova Scotia, Medical Affairs, and our own physician services to encourage physicians to tell us. I think prior, it was that you closed your practice and you moved on, and there wasn’t an opportunity to transition in and transition out. We really have been looking at the model and trying to encourage a slow change, allowing a new doc to panel up while the senior physician transitions out of practice.

 

SUSAN LEBLANC: The Budget Highlights document notes that the government will spend $360.7 million more for the Nova Scotia Health Authority and IWK Health Centre to deliver their programs and services to a growing population. Can the minister expand on how the funding will be used to serve a growing population? I’m not clear if that means there are specific programs because the population is growing or if it’s just a way of saying that we are spending $360 million more?

 

MICHELLE THOMPSON: I think what the member is referring to is really around access and stabilization of primary care for our growing population. Is that what you wanted to know? Yes.

 

It is really around the investment in health homes. We continue the work that we started last year, looking at our health homes and collaborative practices across the province and making sure that are we recruiting and retaining not only our physicians but also nurse practitioners, family practice nurses, allied health care professionals, et cetera. That work will continue. It is incremental.

 

It’s difficult to say exactly where it’s going to blossom, for lack of a better word, when we look at the ability for the Clare Health Centre, as an example, or when we look at the residency program in the Northern Zone, these types of areas. How people are recruited and where they want to go - we have lots of choices for them. We can’t say: This person is going here or that practice is going - but we work within a system to say: These are the opportunities across the province and what best suits the needs that you have, regardless of the discipline that you’re in.

 

SUSAN LEBLANC: You said that it’s difficult to know where people will go, that kind of thing, but acknowledging that the growing population will primarily exist in HRM - the increase of population, growth - what am I trying to say? The lion’s share of the population growth will be in the HRM. Do you anticipate the need to respond in a particular way to the health needs of the HRM?

 

MICHELLE THOMPSON: I honestly feel a particular need to respond to every part of the province. We’ve talked about the uniqueness of all parts of the province before. Not every strategy will work in the same way.

 

We do look at attachment. We know where the highest numbers of people are unattached. We look at those communities. Of course, we work with municipalities and recruitment organizations. We work with the Nova Scotia Health Authority. All of those things. But sometimes keeping a physician in the province is as essential as anything else.

 

If you talk to the folks at Healthy Pictou County, there’s a lot of - a couple of times, physicians have come through there, and they’ve tried to recruit them, and those physicians have chosen to come somewhere else. But the attitude amongst those recruitment groups - because increasingly they’re working together, doing soft hand-offs to one another is: You know what, this maybe isn’t the place, but here are a physician and a family, so you court them. It sounds like they may work there. Healthy Pictou County will say that any physician who comes into the community, into the province, if they’ve contributed to keeping them and their family here, that is a win.

 

It just depends. We do look, of course, for the numbers, and we give the options of what’s available, and we do look at the family practice. There are times, however, when we look at - as an example, I go back to Clare. We put physicians in the Clare Health Centre with the expectation that they will cover Weymouth and Digby, knowing that they aren’t actually in Digby, but we have to work with them. That is where they wanted to go. They have a connection with that clinic. They felt supported there. Because we were able to meet those needs, we are now able to positively impact individuals who aren’t attached in Weymouth and Digby as a result.

 

We are pretty flexible. If somebody will come and stay here and work here, we want to give them the best option they can have. We have a variety of different ways that happens. But I will say that when people come and they sign a return of service agreement, we expect that to be honoured. That’s part of the way in which we plan. If a physician comes and they go through prep or they have incentives, and we have a return of service, the expectation is that they stay where their return of service is, because if not, there’s no way to plan. Sometimes that’s difficult, I will admit that. Sometimes what you agree to initially may not be where you land in the end, so we do have some issues with that, but we do have to really stick to our guns in order to support communities not only in the HRM but across the province.

 

SUSAN LEBLANC: We’ve heard some newcomers moving into rural areas being shocked about the wait-lists for family physicians in the rural areas. As you’ve just mentioned, there are needs everywhere. Is there a specific focus on decreasing wait times for family physicians, or at least attachment to primary care, in rural areas?

 

MICHELLE THOMPSON: The strengthening of clinics is happening all over the province. I don’t want anyone to think - we are looking at a provincial plan. First of all, the new physician contract incentivises physicians to attach and to provide access to people across the province.

 

That was very important for us and, in fact, when we did interest-based negotiations it was also very important to the physicians, so we have to look. The difference of one physician in a rural community, in terms of the percentages, can have a pretty significant impact, right, versus maybe one physician somewhere else, in a larger centre, where it will have an impact for sure, but the percentages won’t be impacted as greatly, based on the base population.

 

We are looking at all varieties of options. It is not an either/or; it’s an and. Again, we work with physicians, the different residency programs we have. There’s a very robust residency program here, through Dalhousie Family Medicine clincs and other practices, we see in our rural communities expanding and increasing the residency programs there, people getting to have some choice over where they go. We want to keep all of those residents, right?

 

I can’t really say it’s either/or; it’s and. Any physician who comes, we want to place them in the place that they want to be in, to the best of our ability because if not, they won’t stay. The last thing we want is to get a physician into a practice, have them panel up, and then have them move on because the community they are in doesn’t meet their needs.

 

There’s a lot of work happening, through Nova Scotia Health Authority primary care, through Medical Affairs, through the Department of Health and Wellness, to really look at the match of the community and the practitioner, in order to immunize us. The team approach as we build those community collaborative care practices, those health homes, that also immunizes us. If we do have a practitioner who moves on, it wasn’t what they expected or wanted, you now have a health home where other individuals in that environment know you and can work with you - your health home within your health neighbourhood, in order to support your health care needs.

 

SUSAN LEBLANC: Well, listen, since we’re talking about health homes, when is the one in Dartmouth North opening?

 

MICHELLE THOMPSON: I don’t have a date for the member today and I don’t know if I will have it by the end of Estimates. We will get back to her, if we are able.

 

I don’t have a date for you today. I know that work is happening, and I don’t know if I will have a date for you before the end of Estimates but I will just say: to be continued. There’s been a commitment there, and there will be more to say. I’m not (inaudible) the announcement, no.

 

[8:15 p.m.]

 

SUSAN LEBLANC: I tried. You can’t fault me for trying. What are the department’s goals and budgetary commitments for the Nova Scotia Health Authority providing service through VirtualCareNS or telehealth from professionals other than family doctors?

 

MICHELLE THOMPSON: There is a virtual care expansion budget line of $16.6 million, predominantly around increasing access after hours and on weekends. That would be predominantly around wages, et cetera, because the platform exists. Our virtual care policy at the department allows any allied health care professional to use virtual care as an option, providing it’s within their scope of practice.

 

What I believe will happen over time is that we will increasingly see, particularly for some of our chronic disease programs, that we will have opportunities to support people for less travel. I wouldn’t say we’re particularly refined at that right now, but there certainly would have been work, as an example, in the OACs - the hip and knee clinics - that we hear so much about, especially as we were moving away from COVID-19. There would have been online exercise programs, as an example.

 

It would be a combination - it wouldn’t be purely virtual - but I can see a time when we can have virtual exercise programs. If you look on the app and you go into - there’s a part on the app where you can go into programs. In addition, there are several wellness programs listed there: managing time, managing diet, exercise, menopause - there’s a whole bunch of things. You can sign up to have virtual online classes, which would be run by health care professionals.

 

I believe that’s an area where it will expand, and I think, as we look at across the province having - then, of course, there’s the Oncology Transformation Project. We will be able to work not only with actual clinicians but - I’m 100 per cent sure - social workers and other allied health care professionals will contribute to the care of that individual on those platforms over time. We’re getting there. I think there are some that are already in existence. There’s nothing to prevent people from having a virtual care option, as long as they’re practising within their scope.

 

SUSAN LEBLANC: I’m going to give the rest of my time to my colleague, but I wanted to say, if I don’t come back - which I don’t think I will - thank you very much. It’s been a pleasure.

 

THE CHAIR: The honourable member for Cape Breton Centre-Whitney Pier.

 

KENDRA COOMBES: Hopefully, the minister knows this issue well. I have been bringing it forward into the Legislature for a few years now. That is extracorporeal photopheresis. I’m fairly proud of myself that I can actually say that often because it’s a tongue twister. This treatment treats various conditions including graft-versus-host disease. I have a few people in my community who are suffering from it. This happens when you donate organs or when you receive a transplant. Those who are receiving these transplants, often their body starts attacking the organ as if it’s a foreign entity in the body. This creates a whole host of problems, and it’s called graft-versus-host. It’s primarily around bone marrow transplants. It also treats aggressive forms of lymphoma, organ transplant rejection, Crohn’s disease, and other autoimmune disorders. I’m wondering: Has the minister and the Department of Health and Wellness looked at bringing this treatment to Nova Scotia, as it’s such a financial burden for those having to travel to New Brunswick for this treatment?

 

THE CHAIR: The honourable Minister of Health and Wellness, with a note that a minute and a half is left.

 

MICHELLE THOMPSON: What I will say to the member is that the population of individuals requiring this treatment is extremely small. As a result, it’s very hard when you have a patient population that is so small to maintain competency. I don’t foresee in the foreseeable future that we will have that procedure here. We will continue to look to Saint John, I think it’s where folks go in order to have that procedure done, because the population is so small.

 

KENDRA COOMBES: I’m just going to ask a quick snapper here. That is the travel assistance program to support surgical access. From Cape Breton, any time that any patient has to come to Halifax for appointments and that, those aren’t covered under this when it’s a non-surgical appointment. I’m wondering if this pilot project is going to be expanded to help those of us who are in Cape Breton and others across the province to get more access here in Halifax to help us financially.

 

THE CHAIR: Order. This concludes the allotted time for questions from the NDP. We will now proceed with questions from the Liberal caucus.

 

The honourable member for Annapolis.

 

CARMAN KERR: Did the minister want to answer the question on my time? Okay, all right.

 

I’m going to ask a question on behalf of my colleague for Clayton Park West, I believe. She’s asking me about the Bayers Lake Community Outpatient Centre. The minister’s department sent an email to her, dated February 1^st:

 

Thank you for your email. We have recruited family physicians for the primary care clinic attached to the new outpatient centre, and we are actively engaged with other physicians for the area. We’re looking forward to a launch of after-hours service. We have spoken with several physicians in Halifax West who have shown interest.

 

It goes on a little bit. She wanted me to ensure that I thank you on behalf of her for sending that info. Her questions beyond that would be: Specifically how many physicians and are they full-time, would be the first question.

 

MICHELLE THOMPSON: We’ll have to get back to the member opposite. We’ll have to talk to Primary Care. I don’t have that yet.

 

CARMAN KERR: I may ask another one around that same site. Does the minister have any idea of how many new patients will be able to register at that new facility given that current plan? I think she’d be happy with an estimate, but I’m taking a guess there.

 

MICHELLE THOMPSON: That will depend on the number of primary care providers who are in that space. It’s very difficult to give a number in regard to that.

 

CARMAN KERR: I will let my colleague know. My last question on that topic would be on her behalf. When it’s referred to as after hours, what exactly does the minister mean? Does it mean weekends, evenings? Any clarity on that to be provided would be appreciated.

 

MICHELLE THOMPSON: Yes, that’s exactly what it means. We’ll be looking at advanced access, so evenings and weekends.

 

CARMAN KERR: I appreciate the answer. Thank you, Minister. I wanted to ask a question starting off with paramedics. I’m certainly excited to see the new training centres in Yarmouth and Stellarton, but specifically Yarmouth. That’s where most of my constituents would go if Digby were short on hours or Middleton were short on hours. I’m wondering what the budget was for that particular program; maybe how many have graduated from that program, and that would be great.

 

[8:30 p.m.]

 

MICHELLE THOMPSON: The graduating class - there are nine in the class graduating in April 2024. The cost of the tuition for all the students involved was $103,000.

 

CARMAN KERR: My understanding is there is a three-year service agreement, maybe with those graduates?

 

What I’m curious about - I mention this to the minister again today and on the record here in the Legislature - as MLA I can get behind any announcement when I can break it down to people in Annapolis. Excited to have nine graduates, that fee for service or three-year service agreement is in place. What’s the process to ensure that one or more of those graduates land in Western Zone and even more specifically at a base in Annapolis, Bridgetown or Middleton?

 

MICHELLE THOMPSON: The reason we have those locations is so that we can attract people. The company intentionally put the class in Yarmouth for that reason, because we know we need individuals from Western Zone to work. The return of service is with the company itself but those programs are regionally delivered for that reason.

 

We heard that when there was only one place to attend paramedicine training, which was in Dartmouth, people weren’t able to travel from those more outlying communities. The number is small, so I can’t give you too much detail. It’s almost identifiable, similar to accessing their personal information, but the hope is that those individuals will remain in Western Zone, in the communities.

 

I go back to the conversation we had last night around that system status plan. It is similar to “one doctor for every Nova Scotian.” That’s now “a health home for every Nova Scotian.” That’s not the promise. The days of old, where there was a static system, where paramedics went to that base every day and came and went from that base, that’s not the case anymore. I think that changed in the mid-2000s. The reason I remember that is because I used to travel to Halifax in the ambulance, and the ambulance that I travelled with always took me home. Then suddenly I was going home in taxis because those trucks and the paramedics working became a provincial resource, so they could be dispatched all the way along or to where there was an area of need.

 

I would say in the early 2000s, maybe mid-2000s, that’s when that whole system changed. We want them in the region. Of course, they do have a base that they’re attached to but it’s not going to be that old static model that I think people have in their heads. Obviously, we have a complement of people whom we have in each zone but that individual or that truck is actually a provincial resource.

 

CARMAN KERR: I think 60 per cent of tuition at those schools was covered through a subsidy. Could the minister comment on what the total subsidy was budgeted for in this budget?

 

MICHELLE THOMPSON: The total investment was $1.9 million. Since the implementation of the Paramedic Tuition Bursary, there’s been a 15 per cent increase in training enrolments. There were 101 students in 2023, compared to 86 in 2022 and 72 students in 2021 - that’s provincially.

 

CARMAN KERR: I certainly appreciate the staff and the minister finding those numbers. It looks like it’s trending in the right direction from that. This is probably the last question around that.

 

For that Yarmouth program, are there any numbers coming in for applicants or students for the rest of the year? I know we’ve got graduates in April, but is there any indication of numbers going beyond April?

 

MICHELLE THOMPSON: I don’t have that for you right now. I think they’re in the middle of - this crew is graduating in April, so they’ll be looking at the next incoming class. I don’t necessarily know. I don’t have that, and I think that’s probably in the development stage right now.

 

CARMAN KERR: That’s fair. A staffing model for ground ambulance was requested by the Department of Health and Wellness - maybe a year ago - from EMCI, with a due date of September 30, 2023. Does that ring a bell? If so, I’m just wondering if that was completed.

 

MICHELLE THOMPSON: That was submitted. That staffing plan was submitted.

 

CARMAN KERR: The emergency medical responders - I think there was a mention of studying - maybe they started their studies recently or have ended. I think I read something where there are 14 learners who are the first of the 200 emergency medical responders to be trained over the next two years. I think that’s a great announcement. Again, I am trying to figure out - once they are graduated or complete, how many of those could possibly end up in my community to help - you know, Western Zone, or break it down to Annapolis?

 

The second part would be that the minister mentioned, maybe last night, about EMRs serving a role in emergency rooms. I just want a bit more clarity on their role, both in tandem with a paramedic and in an emergency setting.

 

MICHELLE THOMPSON: Just a bit about the emergency medical responders - there is a class that has started. It is a three-month program. We are going to verify the number who are enrolled right now. A couple things about that - there are three places that emergency medical responders can work. The first place that we expect them to be able to work is in off-load areas. Predominantly, we don’t see a real need at some of our more rural sites. Off-loads tend not to be an issue in some of our smaller emergency departments, for obvious reasons. Where we do see those individuals is at the regional sites.

 

What they will be able to do is work - they will be EHS employees, but they will work in the off-load environment to support patients, which will allow paramedics to return to the trucks and be able to respond to calls. They will stay in off-load areas and be part of that interdisciplinary team in the emergency department. They will have roles and responsibilities, and they will be able to report - they won’t necessarily analyze data, but they will collect it and report to their colleagues. It will be an important skill set in the emergency department, particularly where there are off-load teams, et cetera. That is the first place where those individuals can work. You may not see them in your rural communities - in those emergency rooms - but what they will be doing is working at the regional site and allowing paramedics to return into the system to respond to calls. That’s the first thing. The second thing - at times but not often and probably in more densely populated areas - you will see that there will be an opportunity for two EMRs, potentially, to transport together.

 

We talked about the SPEAR unit, and I can give you an example. An individual has their first episode of dizziness - unusual, never happened before. A SPEAR unit attends that individual, puts in an IV, gives them Gravol, and does all the right things, but probably because it is such a significant episode of vertigo - dizziness - the recommendation is that the individual goes to hospital. In theory, that person could go in a car. If you didn’t want them to throw up in your car, as an example - which I didn’t - or the movement of getting them to the vehicle would be too much and perhaps induce their vertigo again, in that scenario we had to wait for two paramedics to come and transport that individual. One hundred per cent that person was safe to go with two EMRs. Different than a clinical transport operator, this person had been treated by SPEAR. We knew we had a course in path, but they did need to go to the emergency room. Absolutely EMRs were the right individuals - grateful for the paramedics - but that would have left a truck in the system for a very low acuity call.

 

[8:45 p.m.]

 

The third place that EMRs would work is that they will work with paramedics on the trucks. They will have three months of training. They will have a variety of skill sets. They will be able to support CPR, as an example. They will be able to support bleeding, you know, emergency response. It really enhances first aid and ability to treat certain - and work with the paramedics.

 

The EMRs’ first three months - or the three months of training will actually mirror the first three months of paramedic training. In the event that they work in that role for a while and decide they want to go into paramedicine, they will have the credit for those first three months going toward their certification.

 

They’re also a regulated health care profession, so they’ll have a standard of practice and a code of ethics and be regulated by the College of Paramedics of Nova Scotia, which I think is really important. Not all jurisdictions have done that, but we in Nova Scotia have chosen to do that, to make sure they’re a regulated profession, which is essential. It’s around public protection, which is what our colleges do - maintain a professional standard.

 

Those are the three areas in which they’ll work. In your community you may actually see an EMR arrive on scene with a paramedic. They will be tending to and treating patients. There may be low-acuity patients in your community, who were transported by two EMRs in the event that it’s deemed appropriate, which it could because now we have EHS Medical Communications Centre physicians, nurses and paramedics who are supporting folks in the field. In some cases, 4 out of 10, up to 6 out of 10 - that’s where we’re going - people will not be transported because there are alternative pathways. Perhaps that’s virtual, perhaps that’s next-day appointment. The nurse in the communications centre is supporting them in terms of connecting them to other services, et cetera.

 

EMRs, I can see their role growing and growing. Seventy per cent of the calls that are received through the EHS system are low-acuity calls. It doesn’t mean they’re not important. And people that call need help. There are many ways to suffer. There can be physical suffering; there can be mental and emotional suffering. So, because this resource is available and because of the training that the EHS professionals have, it’s seen as a lifeline for many people in many ways.

 

Those low-acuity calls are part of what’s prompted EHS and the Department of Health and Wellness to look at a new skill set that is able to respond compassionately and skillfully to lower-acuity calls so that we can free up paramedics, primary care paramedics and advanced care paramedics, to do the work that they’re trained to do.

 

CARMAN KERR: I appreciate that answer. I certainly am looking forward to having paramedics’ off-load times being shorter and obviously getting back into our community faster. If that position leads to that, that’s a good thing. Is there any discussion or thought or planning around urban versus rural settings with that role? For example, I tried to explain to friends in Halifax that there are certain places in Annapolis, one of the biggest constituencies, where we are an hour and a half, two hours from an emergency department. And we need someone there right away; there isn’t a back-up option.

 

Is there any planning for having maybe a double paramedic team in a rural setting, based on certain criteria, where an EMR double team would do better in an urban setting? I hope that makes sense.

 

MICHELLE THOMPSON: The introduction of the EMR role will actually expand capacity throughout the entire system. The other thing to remember, sometimes it’s really hard to knit it all together because there is so much happening. When an ambulance responds to - it dispatches there immediately, and there’s support in the communications centre. There’s the physician who’s available, the nurse - what have you. But now we have the GoodSAM cameras.

 

It’s going to extend - it’s going to have more trucks on the road as a result. It’s going to be able to expand the reach of our current paramedics. We will have more trucks on the road. That staffing level will come up.

 

There are other things that have happened as well. I would say - I recently had the opportunity to speak with one of the physicians from the EHS Medical Communications Centre, and the camera has been an incredible tool for that individual. They can see what’s happening at the scene.

 

When we saw that modality in Denmark, up to and including observing work of breathing or rashes or those types of things, up to and including coaching somebody who’s performing CPR at the scene. If there’s a layperson there - getting that: “Go faster,” “Push a little harder,” those types of things. That GoodSAM camera is in a test-and-try model, but we see that that will expand exponentially for support, not only for paramedics but potentially for patients themselves and for medical first responders from the volunteer fire departments.

 

I think there are going to be a lot of good things that happen out of that modality. There will be more trucks on the road. There will be a variety of skill sets. We’ll be able to use paramedics in different ways. Part of our chronic disease model going forward could include community paramedicine where paramedics are going into long-term care facilities and homes with people living with chronic disease, and of course we have the Special Patient Program that already exists.

 

I see the scope of our primary care and our advanced care paramedics changing as we continue to grow this system. We do have the best paramedics in the world. They’re so well trained. It’s hard to find an equivalent somewhere else in order to bring them here, although we are trying and have had good luck in Australia. We should be very proud of the system. It needs help. There’s no question that they’ve been under a lot of strain, but we feel that the work that we’ve done so far and the competitive contract that we negotiated will be really big bonuses in terms of growing the workforce provincially and also bringing people here from outside.

 

CARMAN KERR: I certainly appreciate our paramedics and family members and know a lot of them intimately. We just want to support them as much as we can. It’s a lonely place on some of those Annapolis County roads, with not a lot of support nearby.

 

Is there any indication that - we’ve pushed for better cell service in rural Nova Scotia. I know a number of MLAs on the government side have also asked for the same thing. I know the recent announcement on cell service following up on research on the cell gap study.

 

My question to the Minister of Health and Wellness is: Are there any restrictions with that doc in a box or that technology needed to get someone through a camera on the ground? Lack of cell service - is that going to create a barrier for that technology and for those first responders?

 

MICHELLE THOMPSON: There is communication capability on the trucks, mobile gateways, I think they’re called. As an example, if somebody has chest pains, cardiograms can - that’s the example I’m familiar with - you can actually transmit a cardiogram so that a physician can analyze and interpret and diagnose from that. There is capability on the trucks already.

 

CARMAN KERR: I read there was mention of a bridging program for EMRs who want to become paramedics. Could the minister provide an update on this bridging program?

 

MICHELLE THOMPSON: We don’t have that yet because the first class of EMRs is just being trained. We don’t want to bridge them right off the bat. We want to give them a little shot at trying out their new role, so that development will come later. We do want to provide an opportunity. More to say, I think, next year when we’re here.

 

CARMAN KERR: That makes total sense. Give them a year, let them breathe, and then think about bridging.

 

I want to switch a bit to the urgent treatment centre in Annapolis. The minister has heard me raise it here several times. We moved from an emergency room to an urgent treatment centre.

 

Recently I’ve learned that the Nova Scotia Health Authority transferred managerial process to the primary care division from the urgent treatment division. Could the minister give me more information on this decision and the reasons for it?

 

MICHELLE THOMPSON: It’s very hard for me to talk about the operations of the Nova Scotia Health Authority. I know very high-level things, but when we get into the minutiae of that, I wouldn’t get anything done if I were trying to run the Nova Scotia Health Authority and trying to understand the department.

 

That is an operational decision, so I really can’t give you any information about that, nor would anyone at the department necessarily have that. We don’t often meddle. They have a job to do, we’re the regulator and the funder, so we get statistics and, obviously, we work very closely with them and the IWK Health Centre, et cetera, but those operational decisions are at the NSHA level.

 

CARMAN KERR: That’s come up a couple of times. What’s the best way for an MLA like me to engage on anything Nova Scotia Health Authority? Is it to meet one-on-one with the VP of operations or meet with a certain team? Is there a certain frequency that other MLAs use to check in? Is it by letter, an email form? Any guidance on the best way forward to get information from the Nova Scotia Health Authority would be appreciated.

 

MICHELLE THOMPSON: I think what I would say is it depends on the site - site leadership, obviously. I think if you spoke to other MLAs, it would be a very different experience. If you were an MLA in HRM, it’s probably not that easy to get your site leads at the QEII, right? I would cultivate relationships with site leads wherever possible and certainly with zone VPs.

 

I would say, as well, that those folks are quite busy. I think we should be really respectful of their time, in terms of how much and how often we want to meet, and very purposeful. They’re not there to update us - and I say that for myself. I don’t get regular updates from my hospital, either, through that avenue. I don’t like to meddle too much in what is happening. I like to know, et cetera, but of course, in my role in the ministry.

 

[9:00 p.m.]

 

We must have a good balance. I think it is around cultivating that relationship, asking if there are concerns: Who do I - are you the best person for me to bring them to, and how would you like to receive them? Then it’s about being mindful of the amount of communication that we have, making sure it is purposeful and deciding whether that’s - I guess it just depends on the area. It is not a very straightforward answer, but I think always of the zone VPs who, in my experience, have always been responsive. We certainly go to them if we get complaints through the Department of Health and Wellness - or compliments. Sometimes we get those, too, and we want to send those to the zone VP, because I don’t always know who the folks I should talk to are, as you kind of cascade through the organization.

 

Really around - and different people have different roles with the complexity - there is primary care, and there is community. There are just different titles for different things. It really is around cultivating the relationship. I think I would start with the site, knowing that, at a high level, the VPs are there, as well as a contact.

 

CARMAN KERR: No, it wasn’t a straightforward answer either. I mean, I do have relationships with the VP and the site managers, but I want to make sure I am asking the appropriate people at the appropriate time. We’re constantly - as I have said to the minister, maybe it’s my constituency assistant background - striving for more information and trying to break down a government announcement to bite-size: what anyone walking into the office could appreciate, understand, or be willing to listen to. It is also my nature.

 

Last year I asked the same questions around the PRAP, so I am thrilled to have the PRAP out of Soldiers Memorial Hospital. Dr. Michelle Saxon has run that program and done an excellent job. I know it is a collaboration with the College of Physicians and Surgeons of Nova Scotia and, I think, Dalhousie University. What I am concerned about is the sustainability of the program. I think last year - without going through all the notes, the minister maybe alluded to - I think the minister did say: What I would say is that we are looking at that model.

 

I didn’t quite know what that meant at the time, but I wonder if the minister could just give a bit of an overview of that program and the sustainability. I would hate to lose that program in Middleton. I am wondering what is being done to keep that sustainable.

 

MICHELLE THOMPSON: We agree. We don’t want that program to go away at all, either. There are some nuances to it, though. We want to maintain what we have, and ideally, we would like to expand it, particularly as the College opens the doors to physicians from other areas. Immigration is a key part of that. We did, through the contract, incent physicians. There is an allocation in the contract for people who will train other physicians, and that does include PRAP. We also must recognize that we have a medical residency program that we are trying to expand.

 

We so deeply appreciate the preceptors and mentors who are working with new physicians, either in the community or with medical residents. We must be mindful around the physicians who are doing the training - their time and their energy. The incentive is there in the contract because of that, to show that we value them. I would also say that we are looking at red tape reduction. We know that doctors are mired in a lot of red tape, a lot of documentation, and things that don’t allow them to see patients or to mentor. We are committed and are working hard to get rid of all the unnecessary, and particularly administrative tasks that physicians are getting bogged down with. We’re doing that through the Office of Regulatory Affairs and Service Effectiveness. So, a number of things are happening. We absolutely agree we want to expand that. We also have to look at our residency program as well so we can build our workforce.

 

CARMAN KERR: Two questions out of that response, and I appreciate the response. On red tape reduction - and that office does amazing work. I remember as a CA working with them on files. Is there a target of how much red tape reduction we’re aiming for in health care, a dollar amount? I guess the second part from that would be: The minister spoke of incentives for PRAP preceptors or PRAP physicians; could you elaborate on what that incentive is in this budget and how much that is? I don’t know if you can get as specific as Soldiers Memorial Hospital, but it would be great to know about that program.

 

MICHELLE THOMPSON: In regard to the physician incentives for taking a student, if they sign up to be a mentor teacher to student physicians PRAP, they get a sign-on bonus of $5,000 and can earn up to $1,000 per week as they mentor students. It’s a good deal. It’s not without its effort for sure, but certainly we want to show them how much we value the training and recruitment of individuals. PRAP is a little bit different. We were looking at the model in terms of: Where do you get your six weeks? How many physicians are involved in that training? There are lots of questions about what the best model is. If you’re my replacement for the summer versus you finally find a physician that you jive with and then you need to move to another community. There are a lot of nuances about that.

 

To date we’ve reduced red tape by about 240,000 hours, 250,000 hours. We have committed to reducing 400,000. I wouldn’t necessarily say there’s a dollar figure associated with that, but it would in theory equate to over two million appointments. I think it’s 2.5 actually. Also, we hear from physicians as well, not fully just appointments, but also work-life balance.

 

There’s always going to be forms to fill out, but if we can get that form from 13 pages to two, that’s a big difference. There’s always going to be some administrative work. One Person One Record will help in terms of the hospital transition, people being able to access, physicians being able to access acute care records if they sign on to that.

 

In the offices we want to look at reducing - we have a practice optimization team to support physicians. Really looking at how we can support a different practice experience with physicians, but it depends on the physician. They really are independent practitioners, our primary care providers, so it’s kind of up to them. They’re independent folks and so what they choose to take advantage of is really up to them.

 

CARMAN KERR: I was going to give a shout out to the member from Kings West, but - I still will, pardon me. The member from Kings West and I have advocated for portable X-ray and installation of digital diagnostic equipment at Soldiers Memorial Hospital. Could the minister comment on how much investment was for that infrastructure, and maybe anything more for Soldiers Memorial in this budget?

 

MICHELLE THOMPSON: I’ll have to get back to you about that. Nova Scotia Health, yes.

 

CARMAN KERR: I’d like to ask the minister about pilot programs at either Soldiers Memorial Hospital or Annapolis, maybe beyond the mobile health clinic. Are there any pilots being funded or considered for either of those sites, going into this year with this budget?

 

MICHELLE THOMPSON: There’s nothing that’s necessarily a test and try there. We did talk last night about some of the enhancements that have happened at Soldiers Memorial Hospital as a result.

 

We talked about in the area around the community cluster, looking at the community pharmacy primary care clinic in Lawrencetown - that’s really still kind of an expanded test and try - looking at the medical day services that were expanded in 2022 and also around the ophthalmology and the vision services that are being expanded there.

 

There are things happening. It doesn’t always have to be a test and try. If the staff have ideas around something they would like to do in a test-and-try environment, they can work through their management structure to put together some thoughts and send it up through the Nova Scotia Health Authority.

 

CARMAN KERR: Last year, I think in Estimates, I asked the minister about virtual emergency and there’s an announcement on physician assistants. I get excited about that announcement and, obviously, I want to see how it impacts people in Annapolis.

 

I think last year the minister mentioned, around physician assistants, that there will be some planning done around readiness to accept those positions. Is that still at a regional level? Would they ever be used in a community hospital setting?

 

MICHELLE THOMPSON: We do recruit, but there is obviously a limited supply, so we started training physician assistants in January and it’s a two-year program at Dalhousie University. Physician assistants are not independent practitioners; they have to work with a physician. In order for them to work in an emergency department there needs to be a physician in the emergency department.

 

[9:15 p.m.]

 

However, there is a role for physician assistants in primary care, so potentially there would be an opportunity for positions, as we get closer, but we are only three months into the program, and it is the original, first program. We expect that there will be a regular intake of those individuals, and that primary care will be a place where they could be utilized in a health-home environment.

 

CARMAN KERR: Is there any breakdown that the minister could provide on this budget and what’s allocated for mobile clinics in either the Western Zone or the Western Zone, Soldiers Memorial Hospital, and Annapolis? Those specific sites?

 

MICHELLE THOMPSON: In the allocation of funding that goes to the Nova Scotia Health Authority in the envelope of money that we use to fund them, mobile services are allocated based on the operational requirement, so those do move around based on need. We scale up, depending on what’s happening. I don’t know that I could say, specifically in a certain area or attached to a certain facility, that there would be, but there is a mobile budget that’s allocated through the operations of the Nova Scotia Health Authority.

 

CARMAN KERR: I want to thank the minister, I want to thank staff for being here, and I’m going to hand my time remaining over to my colleague.

 

THE CHAIR: The honourable member for Sydney-Membertou.

 

HON. DEREK MOMBOURQUETTE: I appreciate the time. I don’t have many questions. I may have a few, or may take a few minutes in the next hour to ask a few questions specific to Cape Breton before we let the minister give her closings remarks. Just so she knows she’s almost there.

 

Again, I bring this up because it is a big discussion at home, and it has been for years. It’s around the hospital redevelopment in the CBRM. It’s been a journey. It’s wonderful to see the work that’s happening there. There were some tough decisions, but the right decisions made at the time by the medical community, who said this was the right path.

 

I specifically want to focus on the Cape Breton Cancer Centre. This is something that I’ve talked to the minister about many times now over the last three years. The history of the cancer centre in Cape Breton - unfortunately, cancer impacts every community, but in Cape Breton specifically we’ve seen very large numbers of people impacted by cancer.

 

A lot of work and advocacy went into having a new cancer centre in Cape Breton. The current centre, I believe, was built at the time to support maybe in the range of 15,000 to 16,000 patients a year, and we were seeing well over 30,000 when we started the conversations, as part of the hospital redevelopment, of what a new cancer centre would look like. The hospital foundation and other donors in the community have rallied throughout the years, as they do in other communities, to help fundraise for important equipment, whether it was the hospital redevelopment - I use the hospice as a great example. Big donations were made. The government came in the day we made the decision to cover the operational costs.

 

I’m going to go to the PET scan. This is something that the doctors have been advocating for in the community. This is something that the community is raising money for - has raised millions of dollars to date to buy the equipment. They’re going to continue to do that, but they need a commitment from the government

 

My question to the minister is: Can she provide an update, to date? Has there been any movement at all? I asked this question in Question Period, but I’d have the opportunity to ask it in Estimates. Is there an update on this? We know a lot of families can’t make that trip. We know there have been maybe some cancellations, as well. I’m going to confirm. Can we get an update on what the future of that important piece of equipment is, not only for Cape Breton, but for the rest of the mainland.

 

MICHELLE THOMPSON: He’s used to asking it, and I’m used to answering it.

 

A feasibility study, as you know, was done, and there are some considerable challenges. You know this; it’s never about the purchase of the equipment. That is the first step. The complexity is around running it - the operationalization of it. There is some work around construction, maintenance, staffing, and reagent production, so there are barriers.

 

I do know it continues to be reviewed. I know there is another submission that’s in and currently being reviewed. I don’t have an update, but I do check in on it periodically for just this reason. It is on the radar.

 

We’re looking at potential solutions to see if it is a possibility to work through some of them, like the reagent, in particular. Then we need to look at what the staffing complement is, if we can get the staff we need, and what the required training is. It’s in a similar place, but there are people reconsidering it. I know the clinicians are working with the management in Cape Breton and talking about what the possibilities are.

 

DEREK MOMBOURQUETTE: I’ll ask this question, and I can appreciate if the minister doesn’t have the information, but if staff could provide it at some point, that would be beneficial to me.

 

The information I’m looking for - and it’s something, because I know there are supports that families utilize to come and take that test. Would the minister of the department be able to provide the numbers of how many Cape Bretoners have travelled to Halifax to take that important test?

 

MICHELLE THOMPSON: I don’t have it specific to Cape Breton, but I do have it for the Eastern Zone.

 

Six hundred twenty-nine patients travelled from the Eastern Zone in 2022 for a PET scan. It is estimated that around 753 patients from Eastern Zone would have been booked for that, and 629 of those have travelled. It could be cancellations, re-bookings, or those types of things. Six hundred twenty-nine statistically accounts for about nine per cent of PET scans in the province.

 

DEREK MOMBOURQUETTE: They’re important numbers and where I’m going with it, too. So, you’re saying 629 patients from the Eastern Zone? In that, has the department had to cancel any of those appointments for people due to logistics on the part of the Department of Health and Wellness? Have any patients who needed to travel for that - have those appointments been cancelled by the Department of Health and Wellness because of accessibility?

 

THE CHAIR: Order. The time for the Liberal caucus has elapsed.

 

The honourable member for Cape Breton Centre-Whitney Pier.

 

KENDRA COOMBES: With the time remaining, I am ceding the NDP time to my colleague for Sydney-Membertou.

 

THE CHAIR: The NDP has ceded their time to the Liberal caucus.

 

MICHELLE THOMPSON: I’m not sure I fully understand the question. It says that it’s recognized through various programs, that 753 patients from Eastern Zone would have received a PET CT, and 629 patients travelled from the Eastern Zone in 2022 for a PET scan. I’m not sure what the gap is. It’s really hard - it’s really granular data for us to know who cancels and why, and all of that, so I’m not really sure. But I will just say too that patients requiring a PET scan in Eastern Zone can receive financial support to travel for the procedure.

 

THE CHAIR: The honourable member for Sydney-Membertou.

 

DEREK MOMBOURQUETTE: I thank the minister for that. That is important. There are some programs there that we’ve utilized in our office to make sure that families could make it, because financial capacity can be a challenge. I guess my question - I wasn’t very clear about it, how I asked it. I guess my question was around, if all those patients made it - I’ve heard stories where people have actually made the trip, and then the appointment was cancelled when they got there. I should have been clearer on that, how I explained it, but I’m hearing those stories. It doesn’t have to be Cape Breton; I just used Cape Breton because that’s where I’m from, but it could be anywhere in the Eastern Zone or the rest of the province, for that matter. I hear these stories that families prepare, they leave work, they have a booking for this important test, and they’ve gotten here - they’ve come to the city - only to find out that the appointment was cancelled.

 

I guess that’s really the question: Has the department, because of capacity - or do they have any statistics around those cancelled appointments?

 

MICHELLE THOMPSON: We can certainly look for that. I acknowledge that that does happen at times, with equipment failure in particular and possibly staffing. I certainly know that in my own family there was an experience where my uncle travelled - maybe it was the same day. My uncle travelled up for his PET scan, and unfortunately, when he arrived he found out that it was cancelled. When you’re sick, it’s a really long drive from Baddeck and from Sydney. We can see if we can find those statistics, and really, the other thing that we’ll look into is how functional they are. We do have a lot of equipment that’s past end-of-life, so I’m not really sure either about whether or not there’s equipment that requires replacement. I can check on that as well.

 

DEREK MOMBOURQUETTE: I appreciate that, and I appreciate that some of that information would be hard to pull up tonight. I think it’s an important conversation, and the minister recognizes it too. We’ve all heard stories that hundreds of people are coming, and they’re travelling to take this test because they can’t get it anywhere else. There are other jurisdictions across the country that actually have two of these, and they’re at separate hospitals based on geography. It helps. Again, I implore not only the minister but the government - I think this piece of equipment and a new state-of-the art cancer centre is important.

 

Those are my questions, so I’m going to pass it over to my colleague for the next 10 minutes, the member for Northside-Westmount.

 

THE CHAIR: The honourable member for Northside-Westmount.

 

FRED TILLEY: They saved the best for last. I have a couple of quick questions. The number one question I have is around the emergency room wait times at Cape Breton Regional Hospital. It’s significantly higher than other jurisdictions, when you do that scan on the app or whatever. It’s always hours more. I unfortunately experienced it myself and had family members who have experienced it as well. Can you tell me what plans are in place to try and improve the wait times at Cape Breton Regional ER?

 

[9:30 p.m.]

 

MICHELLE THOMPSON: There have been a number of investments in the Cape Breton area, so I’ll just highlight a few. I think you’ll probably recall that just over a year ago we had a number of ED initiatives. At that emergency room, there is a FLOAT MD. It’s a Flow Lead and Offload Assessment Team. It actually is a team with additional physician hours associated with it, which is scheduled by the emergency department based on their availability of staff and also their peak periods. Not all emergency departments peak at the same time, although there are some trends. Not everything happens in the same place at the same time, so that is led by a physician. There are waiting room care providers there as well, so some care can be provided in the emergency waiting room, some simple care, and the advocates are there as well. Patient advocates are there; physician assistants as well are assigned to that emergency room; nurse practitioners are also available. There would be lower-acuity streams for individuals.

 

What’s really important in our emergency departments is that CTAS is adhered to - the Canadian Triage and Acuity Scale. Very experienced nurses - I think you need to be a registered nurse for five years before you can actually be a triage nurse. The symptoms and the score that you receive really dictates how quickly you are seen. We do know there are significant staffing barriers, nursing staff in particular, at Cape Breton Regional Hospital. There has been a recruitment process, and I do know that sometimes we have to rob Peter to pay Paul, so I know, as an example, just from other connections in Cape Breton, there have been recently a couple of former emergency room nurses, I believe, who’ve gone back to the emergency department. Staffing, I would say, is probably the primary barrier.

 

I would also say that there is a need for an increase in primary care practitioners. We certainly see that the Northside Urgent Treatment Centre is heavily utilized, and recruitment for physicians for primary care is making sure that there are access points so that people are using the emergency room for the appropriate - we call them complaints. I don’t know - presenting complaints, you know, so people see their options. I think there’s a number of things. Number one is staffing. The nursing school at CBU is important, and the medical school will be amazing too because it’s going to put foot traffic through there. We’ve added those initiatives. Again, staffing is a challenge in those areas.

 

I know that the site lead, as well as the VP of the zone, are working very hard, and I believe too that there’s now an off-load room, so there’s an opportunity for people, as they come in in ambulances, to be cared for in an off-load room that allows trucks to get back on the road.

 

FRED TILLEY: I just want to talk about triage for a little minute. I have a very specific case, which was my own. I showed up at the ER in July with blood pressure of 250 over 135, slurred speech, heaviness on the right side. I waited seven hours, and at no time during the seven hours that I waited - I stood up for two - but at no time during those seven hours was I rechecked, respoken to. As an MLA, you’re not going up to - anyway. I think we have a lot to do with the triage piece, and I just assume a lot of that is because of stress and the large number of people who are at - and I know things can fall through the cracks. I’m no medical professional, but when someone has blood pressure of 250/135 and slurred speech, stroke comes right to mind.

 

My question is regarding the wait times. Have we seen any improvement in wait times at Cape Breton Regional Hospital and can we expect an improvement in those wait times over the coming weeks and months? When can the residents of CBRM expect some improvement there?

 

MICHELLE THOMPSON: I’ll have to get that for you. I don’t have a trend specifically for Cape Breton Regional Hospital, but we can certainly table that - trending over time. Again, it really is around recruitment and retention. I know there have been some specific strategies that have been employed there. We’ll ask the Nova Scotia Health Authority to respond, and we’ll table that, probably - it may not be before Estimates is over, but we will table that.

 

FRED TILLEY: I believe one of the things that may be contributing to the extra numbers at the Regional is the Northside Urgent Treatment Centre. It’s such a good service, it fills up so early. It’s so hard to get in - and the fact that the ER has been shut down in Baddeck, so all the folks from Baddeck must come the extra time. Can we get an idea of when the Baddeck ER may be reopened?

 

MICHELLE THOMPSON: We’re certainly committed to re-opening that emergency room. What’s interesting is, just as people from Baddeck now must head to Sydney, one of the things people were seeing was that people were coming to primary care, to the emergency room in Baddeck, to get - so here we are, coming over the mountain.

 

Baddeck, in some ways, is fortunate. They have several physicians, probably the highest number of physicians in my lifetime that have ever been there, but a portion of those physicians are not able to work in the emergency room or, perhaps at this point in their career, willing. We are working with the physicians there. They do have an urgent treatment model, which is effective and appointment-based, and they too are full most of the time, but it really is around the primary care option. There are 60,000 additional primary care appointments, and I think it really is around - sometimes we don’t give new things a good enough try.

 

Virtual care isn’t for everything, but I think there is opportunity for some things to be seen through virtual care. I think the primary care pharmacy clinics are effective and actually are effective in managing chronic disease. I think it’s important that folks consider what the possibilities are. If you’re on warfarin, as an example, because you need blood thinning, your pharmacist can support you in managing your INR and prescribing your warfarin. I don’t know that everybody knows that, because they have point-of-care testing.

 

Part of the role for us is around patient education. Where is the right place to go to access care? If you have virtual care and need primary care, we can refer you into those - the urgent treatment centres - which are certainly well-utilized - and the mobile clinic.

 

I think it’s not just one thing. I think that in order to access primary care, we need to look at all of the options. People who have a family physician are able to get virtual care, two free sessions a year, through the app. I think there are a number of ways.

 

I think sometimes it’s hard to get our message out, really, so I think that’s part of it, particularly around the low acuity in a busy emerg like Sydney’s, people who present with low acuity can expect to wait for longer periods of time for that reason. So those urgent and virtual options are really important. We’ll take that feedback.

 

Again, we’ve committed to Baddeck that we are going to get that emerg open. We were hopeful - there was a physician who was there for a short period of time and actually had to move along, but we do expect that there will be another physician resource that will be coming by the end of Summer. We’re really hopeful that that will have a positive impact on the emergency room.

 

FRED TILLEY: Well, that’s good news. The Baddeck urgent care has been great. My own family have used it numerous times. It’s a 45-minute run for us, as opposed to waiting 14 hours at the ER, so that’s been good.

 

I’m going to switch gears a little bit. A lot of the issues that we get, similar to my colleague from Sydney-Membertou, are people who are coming to Halifax for tests, and it is frustrating. My own father-in-law, during the big snowstorm, missed his dialysis and then had a heart attack. At the tail end of that storm, we had to come up here and meet him because they were flying him for a dye test. I think that will come to Sydney in the new construction, which is great.

 

It’s around the financial assistance piece. I know there’s the program for those who have to come to Halifax for surgeries. I think I heard you mention that there’s the financial assistance for those coming for PET scans. What other types of funding? I understand it’s 57 cents a kilometre and up to $80 a night, I think, for a hotel. There’s a pilot project for surgeries that we’ve referred a lot of people to. I’m just wondering if there’s any funding for other things that people have to travel to the city for.

 

MICHELLE THOMPSON: In the beginning, it was cancer treatment. People had to travel for cancer treatment. It’s for household incomes, low income, and over-50-kilometre travel, and it was expanded for surgeries.

 

I think we continue to look at ways that we can make sure people have access to care. To your point, in the long range - not just immediately, but in the long range - looking at the cardiac catheterization lab, as an example, and that’s based on the data we have: Why are people travelling to the city - from Sydney to Halifax? It’s a long way, which is also why we’ve put in that fixed-wing flight. It’s the time, and it’s around the system, but it’s also around comfort for the patient.

 

[9:45 p.m.]

 

Most folks can sit up when they are transferred between facilities, but there is room for stretchers on that fixed-wing, as well. There’s probably more to consider. The surgical expansion was last year, and we’ll continue with that. Again, looking at the feedback we get from patients around what some of the barriers are for travel - sometimes it’s that they don’t have a vehicle. It’s not even the expense; it’s that they don’t have access to the transportation they require. In a rural province, that can be difficult, so shuttles, et cetera - we must really start to think about some of those things.

 

There’s more to consider, and certainly we’re willing to understand the barriers better for a program that potentially could be a bit more responsive.

 

FRED TILLEY: I get the honour of telling you, that’s it for us. You get to read the resolution. Thank you for your time.

 

THE CHAIR: There are no more questions for the minister.

 

The honourable Minister of Health and Wellness for her closing remarks and to read her resolution.

 

MICHELLE THOMPSON: I just want to say thank you to everybody from the Department of Health and Wellness who is sitting there anxiously awaiting the questions of my colleagues across the floor, to the folks who have spent many hours preparing this well-loved and beat-up binder for me to be able to appropriately answer questions, and to the folks at the Nova Scotia Health Authority and the IWK Health Centre, as well as other providers. I appreciate the support that you - and EHS - I can’t forget our EHS colleagues. Thank you for all your support and Build Nova Scotia - there they are - for helping me get through this incredibly big and important file.

 

I don’t know what the viewership is. It usually hangs around 50, and the media are probably about three, staff are probably 45, and maybe the other two are my family. Thanks for hanging in here with me. I appreciate it.

 

THE CHAIR: Shall Resolution E12 stand?

 

Resolution E12 stands.

 

Resolution E29 - Resolved that a sum of $8,098,000 be granted to the Lieutenant Governor to defray expenses in respect to the Office of Healthcare Professionals Recruitment, pursuant to the Estimate.

 

THE CHAIR: Shall Resolution E29 carry?

 

Resolution E29 carries.

 

We shall take a short recess to prepare for the next minister. Thank you.

 

[9:48 p.m. The CWH on Supply recessed.]

 

[9:51 p.m. The CWH on Supply reconvened.]

 

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

 

The honourable Government House Leader.

 

HON. KIM MASLAND: Would you please call the Estimates for the Minister of Community Services, Resolution E4.

 

Resolution E4 - Resolved, that a sum not exceeding $1,579,169,000 be granted to the Lieutenant Governor to defray expenses in respect of the Department of Community Services, pursuant to the Estimate.

 

THE CHAIR: I will now invite the Minister of Community Services to make some opening comments if he so wishes, and to introduce his staff to the members of the committee.

 

The honourable Minister of Community Services.

 

HON. BRENDAN MAGUIRE: I’m very pleased and honoured to be here today to present the 2024-25 budget for the Department of Community Services. To my left is Toyin Akindoju, the finance guru. Can I call you the finance guru? The numbers person. To my right is Melissa MacKinnon, deputy minister of the Department of Community Services. Thank you both for being here today with me.

 

Do we know - what time can we go to? 10:52? We’ve got a solid hour. I have a few words to say to start out . . . (interruption).

 

THE CHAIR: 10:54. Sorry.

 

BRENDAN MAGUIRE: 10:54? Okay. 10:54.

 

I’m proud to be here today. Proud to be here today. Some of the things that go through my mind before I jump into the official speech are, Why? “Why,” for me, is a big thing. Why am I here, what brought me here, and how did I get here?

 

I’m very proud to stand here today, not only as the three-term MLA for Halifax Atlantic: Spryfield, Herring Cove, Sambro, Leiblin Park, Purcells Cove, Portuguese Cove, and all the other beautiful communities in between, and J.L. Ilsley High School alumni - the second J.L. Ilsley alumnus in this Chamber, for those who don’t know. The member for Kings South? North? Chris Palmer, Kings West - popped his head out - is also an alumnus of J.L. Ilsley High School. He’s I think about 15 years older than me - I shouldn’t say that. No, he’s a couple of years older than me. He was one of the cool kids, I’m not going to lie. I’m proud to represent J.L. Ilsley and the Spryfield area along with my colleague.

 

“Why am I here” is a very complicated question, and a very windy road. I’m here for a whole host of reasons, and I’ll start back to some of the stories and some of the experiences and some of the individuals along the way. I think back to a five-year-old boy who made his first adult decision. At age five, he made a decision that would impact him for the rest of his life. He was living in a foster home with his sister at the time. He was a ward of the court, and didn’t fully understand what that meant. He knew that he lived in a home with strangers, but his sister was there, so that was always - there was always that comforting piece.

 

He woke up one morning and came out of his room and he came out to the kitchen table. The individuals he was living with at the time - the husband was in the military and the mother was a stay-at-home mother. They lived on this beautiful piece of land in Lake Charlotte, for those who may know the area.

 

He sat down at the kitchen table, and it was just like any other day. Both foster parents happened to be home at the time, which was kind of rare for those who live in a military family. As he was eating breakfast, there was this kind of weird feeling at the table, so he asked what was happening. The mother looked at him - the lady looked at him - and said: We have a question for you. We need you to listen. He was a very hyper kid. He might not have been the best-behaved child. We need you to listen. We need you to process, and we need a decision. And he said: Okay. What is it?

 

She said that her husband had been stationed in Ontario. They were moving to Ontario. “That means we have to sell our house and move. You have a decision to make, and we’re going to allow you and your sister to make that decision.”

 

It was hard for him to process. The decision came down to being able to see his biological brothers, whom he hadn’t lived with for a long, long time, who he was separated from. Three times a year he got an opportunity to sit in this room, with social workers watching and taking notes as he interacted and played with his older brothers - his siblings. That was the extent of his relationship with his brothers.

 

The decision was: You move to Ontario with us and you will never see your brothers again, but you’ll have stability. You’ll be adopted and you’ll have a chance at a real family. If you don’t - if you decide not to - then you get to see your brothers. But you’re too old; no one’s going to adopt a five-year-old.

 

He and his sister were a package deal. They had separated once and it wasn’t good, so the Department of Community Services had decided that of the five, these two were a package deal. His first thought was to leave, to go.

 

Until you experience what it’s like to be taken from a home and then put in another home with strangers, people you don’t know, and told: This is your new home. It’s a feeling that you don’t want to go through. When it happens over and over, you stop trusting adults. You stop trusting people, and you lose faith in humanity. You lose it at a young age.

 

So he decided. He said: Yeah, I think I’m going. I think this is a good thing for me and my sister. At that moment, he looked over at his older sister, who was three years older than him, and he saw something in her. It was fear. She didn’t want to go. She preferred to leave. He stopped and talked to her, and she said: This is your decision to make for us. So he decided to leave.

 

[10:00 p.m.]

 

A couple of weeks later, they were in a new home, and she was happy. He spent the first two days sleeping in the doghouse, because that’s where he was comfortable. He didn’t want to sleep in a bed. He didn’t want to sleep in a home where he didn’t know people, so he would sneak out at night and sleep in the doghouse. Years later - decades later - he found out his sister was not safe in that home. When people ask me why, he thinks back to that. Those memories don’t go away.

 

A few years later, he’s in a home, and he had done something stupid. He had done something - whatever. Kids will be kids. These are moments that change you and make you who you become. For punishment, he was locked in a furnace room - no windows - in a dark furnace room. He screamed until he almost passed out. He decided that day, at 10 years old, that he was never going to let another person - another adult - decide anything for him. He was not going to let people hurt him.

 

I don’t take this job lightly, and I don’t take the job of Minister of Community Services lightly. No matter what anyone in this Chamber thinks of me, before or after I’m gone, I was not supposed to be here. I was told over and over that I would not be here. I have been in homes with people who are brilliant but who did not get the breaks I got, who are on income assistance and struggling every day, who ended up in jail, and who ended up homeless. These are people who didn’t get the break.

 

When I was a - that boy became a teenager, and somewhere along the way, in one of the homes he was living in, they just forgot. They just forgot. It started with a birthday - 12 years old. There was no birthday. He thought it was a joke. He got up. There was no celebration. There was no happy birthday. There was nothing. He thought: Oh, there must be something special planned. There was absolutely nothing. That might seem stupid, it might seem simple, and it might seem petty to some, but it creates the person you become.

 

When I talk about Community Services, I talk about it in a love/hate relationship. It’s a system that broke me, that built me, that hated me, that loved me, that abused me, and that took care of me. I’m not an anomaly. I have heard people say: Well, we’ll see how he does. We’ll see how he does. I don’t care what their expectations are, because whatever they try to put on me, my expectations are even higher. Very few of us have a moment in time. Some of us have been here for a long time, and it’s almost as if we expect or think we have a right to be in this place. Very few people in the history of Nova Scotia get to stand in this Chamber, and even fewer get an opportunity to really effect change. I stand here today as the Minister of Community Services, keenly aware of what this system can do and what it can’t do.

 

Somebody online called me a coward. That’s fine. I’ve been called a lot worse. I don’t feel like a coward, but when I was a teenager, I felt like a coward because at many moments of my life I wanted to take my life. I thought I wasn’t brave enough to do it. I was ashamed to look at myself because I thought only a coward wouldn’t be able to end it.

 

When I talk about being an MLA for my community, it isn’t about - and it’s never been about - a political party. It’s never been about any of this. It’s been about the dozen foster homes that I lived in. It’s about when I was sleeping in an apartment lobby on Tribune Court, a friend’s mother came and saw me there and picked me up and brought me in. It was about Sarah Hubley, who - after school she would sneak me into her house and feed me.

 

It’s about Marg and Harry Poole, who have long since passed away. They saw this 17-year-old who couldn’t get a bottle out of his hand, who tried to drink all his problems away, and for some reason they decided to take him in as a foster child when everybody said not to. It’s about Ruby and Eve, who - at times I don’t know how they put up with me, and at other times I don’t know how I put up with them. It’s about Christine, this beautiful Jamaican lady who decided that she was going to take me in and introduced me to a world of fabulous food, and I probably drove her nuts. In fact, I know I did.

 

When I first ran for election, my partner, my wife, said to me, “I’ve never met somebody with so many mothers. Every person I run into says, ‘Do you know that Brendan’s my son?’” It’s a privilege to have that many people believe in you, but it’s also, at times, difficult because you think of the lack of stability.

 

I am proud to stand here today. There are a lot of people - and it’s kind of ironic that I stand here today to give this speech when one of the guests in the gallery today was Marion Brown. I saw that the member for Chebucto - no. Was it? The member for Halifax Citadel-Sable Island introduced Marion. Marion was my key counsellor when I lived at Phoenix Youth and has worked on several of my elections. I found out today she was moonlighting on the member for Halifax Citadel-Sable Island’s elections too.

 

When I lived at Phoenix Youth, it wasn’t this big organization that it is today. It was one place on Hunter Street, and nobody wanted us there. Nobody wanted us there. It kind of reminds me of what we’re going through with some of the stuff with Community Services around housing and Pallet shelters and all these things where nobody wants them in their community, but they want you to do something about it. We want you to move fast, but we don’t want you to put it in our own community.

 

That is personally insulting to me, and it should be insulting to every Nova Scotian because those individuals who are struggling every day, who need the shelters, who are living in those Pallet homes are somebody’s mom, they’re someone’s father, they’re somebody’s sister, they’re someone’s brother, they’re somebody’s child. A hell of a lot of Nova Scotians are one paycheque away from being in that situation. God forbid that you’re in that situation, and people try to dehumanize you and act like you don’t exist.

 

When I was living at Phoenix Youth, nobody wanted us there. Nobody wanted us there. Everybody on Hunter Street wanted us off the street, the whole area. We were those kids. Nobody wanted anything. I was struggling, and Marion saw that. She was just young; she would have been in her twenties when she was a counsellor there. Tim Crooks, who runs Phoenix Youth now, was a part-time employee, so that tells you how long ago it was. Linda Wilson was the executive director at the time.

 

I came into my bedroom one night and there was - and I still have it to this day - a notebook. It was the 1990s, so it was a notebook that had a pair - it had jeans wrapped around it. I don’t know if people remember those. It was on my bed, and it said: Any time you want to talk, write in this.

 

Marion would work a lot of overnights. I would write down my thoughts and my struggles, and I’d fall asleep. She would come in in the middle of the night, and she’d read it. She always started her messages with: Hey Duder. To this day - I don’t know why - I call my kids duders now.

 

She would write down that message, then she would write these beautiful messages. In a world of chaos, when you find somebody beautiful like that, it is incredible. I am a 48-year-old father of three beautiful children, and I say to this day that I am still a Phoenix youth.

 

I know some people in this Chamber have connections to Phoenix Youth, and they know how much that means to us. The empathy that was shown at Phoenix Youth - I remember, one year I was there, all the kids would go home for Christmas, and I had nowhere to go, so I was the only kid left in the group home. Marion, instead of going home, stayed Christmas Day. She bought me this blue Helly Hansen jacket. I had that jacket - even after I put on 40, 50, 60 pounds, I kept that jacket. It was something I kept with me forever.

 

In the end, I left Phoenix Youth. I had some incredible experiences there, and the impact it had on me - counsellors like Michael Skinner. Linda Wilson, who is now the executive director of Shelter Nova Scotia, is the godmother of my son and somebody who is immensely responsible for the man I am today and the reason I am here. When nobody believed in me, and when I was going through some of the darkest moments of my life, Linda believed in me. It’s funny because she wasn’t a counselor; she was the executive director. For some reason, there was something there. We connected, and we created this beautiful relationship. It’s something that I will treasure forever.

 

I think of that now, and I think of the department’s role in these things. We don’t see the individuals behind the scenes who are helping build and fund these organizations, putting food on the plates of kids, and helping these individuals survive day to day.

 

I’m going to tell you another story about Phoenix Youth, one that will always stay with me. When I was there, they used to bring in - every Wednesday, we’d all go upstairs, and we’d sit around and talk - they would bring in special guests after supper. The first one was Ricky Anderson. I don’t know if people remember Ricky Anderson, the old boxer. So, I said, I want to be a boxer. I went to the gym at Bloomfield and got my head beat off, because I was a skinny little kid - I looked like a lollipop at the time. I said, I don’t want to be a boxer anymore.

 

The second week we were there, they brought in a gentleman who was a broadcaster and who had this beautiful booming voice. It was Allan Rowe. Allan took a moment, and we talked. I was an 18-years old child - kid - at the time. When I got elected in 2013, I sat in that corner beside Allan Rowe. It was one of the greatest moments of my life, that I got to sit there with that man.

 

One of the pieces of advice he gave me early on was - he said: You’ve just got to follow your instincts. You’ve got to follow your gut. You’ve got to realize what you’re here for.

 

That teenager, after he left Phoenix Youth, was a - had some good times but was a mess. He went on from Phoenix Youth to living on his own - in high school - in his own apartment. Going to St. Patrick’s High School - I think he was in his fifth year of high school at the time, and as most of you know, that’s a long time to be in high school. He struggled. He struggled with confidence; he struggled with identity; he struggled with relationships; he struggled with trust.

 

[10:15 p.m.]

 

The one thing that people don’t realize is that when you’re a ward of the court and you’re a foster child, when you’re done, you’re done. You’re done. When you’re out of the system, you’re gone. There’s no parachute. There was no parachute. There was no how-to.

 

Up until I met my wife, people would say to me: What do you want in life? I would say: I want to go home. I didn’t know what home was, but I wanted to go home. I just wanted to go home. I spent my twenties, my teens, and my thirties just wanting to go home. Then when I met Rena, I went home. I went home.

 

One of the things that I’m proud of that this department did - and that was under the leadership of the Premier and the former Minister of Community Services - was a program for kids aging out of care. That is one of the scariest things that can happen to you, because most of us here - if you fall on hard times, if maybe you can’t pay rent this month, or you’re hungry, or maybe you need a little extra money - I would say the vast majority of people could call up their parents, could call up a loved one. When you don’t have that, you haven’t.

 

One of the things was a program for kids aging out of care for the next five years, where they’re able to have money to support them as they get out of care and they go on to the next stage of their life. That is something I’m extremely proud of that this Premier and the former minister were able to implement through this department. That’s in this budget, and it’s going to be life-changing for those children. When they come out of care and they’re struggling to find what’s next in life, they know that there is security there. The department, under the leadership of the deputy and the EDs and everyone from the bottom all the way to the top - I don’t mean that derogatorily - everybody who’s there recognizes that success - no offence to the Department of Public Works - but success is twinning a highway, right? Get the Old Sambro Road paved, will you?

 

Success in the Department of Community Services is much bigger. Success is giving those kids a chance in life when everyone else gave up on them. I want you to think about that for a moment, Chair. How many times I sat in my room and thought: What did I do wrong? What did I do wrong? I don’t talk about this much, but I have regrets in life, for sure, like most people. I’m Brendan Oliver Maguire II, but we don’t put the II on because I don’t want to be named after my biological father. For a long time, and even to this day, I don’t have a lot of time. That’s my own personal thing.

 

I have regrets, because a long time ago, for some reason - even though my siblings are older than me, for some reason they all relied on me. When things went different, or they went down a different road, they would call me and ask for advice and ask for help. I didn’t mind doing that. I love them. We’ve had a very interesting relationship, one that I should probably work harder on, but both of my biological parents died in their 40s. They died for different reasons, different things. I’m not going to get into that.

 

I just could never grasp - I look at my own babies now and I could just never grasp - and I understand, but at the time I couldn’t grasp. As you do this longer and you’re in this role as a leader, as an MLA - we see so many people come into our offices - you start to realize and you start to almost forget because you see the struggles that people go through. One of the things that I am adamant about is that we need to figure out a way to break the poverty cycle. We need to figure a way to get - we see it time after time, where generation after generation of individuals live in poverty.

 

I’ll tell you a story, Chair. It’s such a simple little story as an MLA. We’ve all been able to do incredible things as MLAs. High schools have been built and roads have been paved and programs have been done. One of the stories I’m most proud of is there was a young girl, she was living in public housing when I was knocking on doors. She’d just graduated out of school high. I watched her - like we all do, we attend our high school graduations - and I watched her walk across the stage, and we talked to all of them and all that.

 

When I was knocking on doors, I knocked on a door and she answered, and I recognized her. I said: Oh, six months since you’ve been out of high school. What have you been up to? She said: Well, I’m working over here. She was working a job. I said: Are you enjoying it? She said: No, I want to be a nurse. I said: Well, what’s stopping you? She said: I don’t know how to be a nurse. I said: Well, come to my office, we’ll have a conversation. We’ll help you with your student loans, we’ll go through it. She said: I’m just not comfortable. She was very afraid of the process.

 

Okay, I’m not going to force anything on you. So, I leave. Then it really started eating away at me. Then she was working at a local restaurant. I’d go and get my sub and I’d say: Oh, there’s the nurse. Did you start school yet?

 

Her mom called me one day and said: She really wants to do this, but we feel that she should stay and work. Will you have a conversation with her and make sure that she stays in this job? I said that, first of all, I don’t know if it’s appropriate for me to have a conversation with her to tell her about her life but if she wants to come in and talk we could definitely talk.

She came in and we had a long conversation. We talked about work, but we also talked about student loans. When you’re not around people who have been through post-secondary education, you don’t understand it. Part of the problem is that in order to break the poverty cycle, we have to - education is so powerful and we have to be able to give people the comfort and the courage to do it. I know that for a lot of us in this room, we think, the courage to go to school - what are you talking about? But when it’s so foreign to you, it’s difficult.

 

Anyway, we had his conversation, I got busy, the Summer went by, and then I went to get my sub three months later and asked where she was. They said: She applied for university and she’s gone. She is now a nurse. She broke the poverty cycle because she had somebody there who encouraged her, who showed her the way, and sometimes that’s all it takes.

 

I’m not saying it’s simplistic like that, but I can tell you that without Charmaine Tanner, who was my social worker; without Linda Wilson, who has been like a mother to me; without Yves Campagna, who was a foster father, who was there when I got sworn in; without my wife; without these people who believed in me I wouldn’t be here. I would not be here, and I don’t just mean here, I mean here.

 

I have a lot of faith in this department and I have a lot of faith in the vision and the future and what we can do. I know that the communications people have written this beautiful speech for me, and they’re probably like: When are you going to get to this 62-page speech? We’ll get to it.

 

I just wanted to talk about why this is personal, and why this means a lot to me. I want to be able to express my gratitude for everyone in this Chamber, but for those who believe - who believe that I could do this role. The Premier believed in me. He believed that I could do this role. I will say this, I’ve said it lots of times, and people have heard me talk about party politics and all that stuff: I respond to vision and leadership.

 

Listen, I’ll be the first to say: I’m sure there are more than a few videos of me saying a few things, and chirping a few people, and getting under people’s skin. Sometimes you just have to stop and ask why you’re doing this. That doesn’t mean that I don’t have love for the people across the way, and the last 10 years we spent and all that stuff. I just want to address that. I have a lot of respect for everybody in this Chamber.

 

I believe that we’re given moments in time. I’ve stood here and said what I believe in, and I’ve stood here and said my morals and my values. I think it would have been hypocritical of me to not take an opportunity not just to do this, but to also help fix, and help bring people together, and help direct and create vision for this province. We can all agree that we have massive, massive problems in this province and in this country.

 

I think we need to, more and more, put all of it aside and just work on finding the solutions to these problems, because what I keep hearing over and over from people is that they are tired of the bickering. They’re tired of the fighting. They’re tired of the he said, she said. They just want people to get to work, and they want politicians to find solutions. We weren’t elected and put in this position to become “honourable,” or for a paycheque. We were put here because people believe that we are the right people in this province for the problems we face today, and I believe we have a moral duty to fix those issues and fix those problems, or at least go like hell trying to do it.

 

We face huge issues, and when we talk about the issues that are in the Department of Community Services, these aren’t just issues that impact Community Services. These are issues that impact the Department of Labour, Skills and Immigration, the Department of Education and Early Childhood Development, the Department of Public Works, the Department of Finance and Treasury Board, the Minister of Municipal Affairs and Housing, who - I’ve said it before, and I’ll put it on record - is one of the people that I respect the absolute most. I know when all is said and done - I say to him all the time, we don’t always agree on our politics - we might be getting closer and closer as I get older. He’s somebody whom I’ve loved and respected since the moment I met him. He’s been through a lot, and I’ve never seen anyone carry themselves the way he does. Very few people can do that.

 

We need to rely on each other, not just on the government side but on these sides here. We have issues right now, and I’ll give you a perfect example. We’re looking at housing situations, shelter situations, Pallet situations. I received an email last night from an individual who said: You have made it clear that I have no - I don’t know what the exact quote is - that the decision does not depend on my support. That could not have been further from the truth. I have been absolutely - I’ve reached across the aisle when we’re making these decisions, when I’m working on the issues that are going to impact people’s communities, and I’ll give you a good example: The member for Halifax Citadel-Sable Island was an incredible help on the issue of the encampments - was an incredible help, and I appreciate that.

 

[10:30 p.m.]

 

I am not going to play politics with homelessness. I’m not going to play politics with income assistance. I’m not going to play politics with disability supports. We are going to put people first. If people want to play politics with it, go play in another yard, because you know what people out there right now who are living homeless are not saying? My goodness, I wish I could have a conversation about political parties. Do you know what they don’t care about? Political parties. They want leaders who will find solutions, who will help them.

 

We face a housing crisis, and I get confused, Chair, because on one hand I hear - literally in one day in Question Period, I heard: Why isn’t this being built faster? Go faster, go faster, go faster. On the other hand, I hear: Slow down, do some consulting, consultation. Which is it?

 

If you ask people who are looking for homes, do you know what they’re going to say? We’ve had enough reports. We’ve had enough. Consultation does not get you a roof over your head. Yes, we need to consult; yes, we need to talk. But we’ve got to get these things in the ground, and we’ve got to build now.

 

If a couple of politicians’ feelings get hurt, so be it. So be it. If they think that they’re on the right side by saying, Slow down, build slower, not in my back yard, I’ll be the first to say: Bring the Pallets to Spryfield. I’ve told the department: Bring them to Spryfield. Bring the public housing to Spryfield, Minister. Bring them on in. We’ll take it all. If people in this Chamber don’t want it, we’ll take it, because I will always put the people first.

 

There are people who are homeless who are living day-to-day and struggling, and the last thing they need is 20 town hall meetings. The last thing they need is for someone to say: This may impact my re-election. If your re-election depends on a couple of Pallets, then I would advise you to get back to the doors. I would advise you to do a little bit more work.

 

I don’t mean that in a derogatory manner. I’m going to go like hell in this department, and if the people of Halifax Atlantic want me back, let’s have at ’er. If they don’t, do you know what? I took a big swing, I did what I believed, I was given an opportunity, and I will do everything in my power to make sure I don’t fail. I will get to this speech soon.

 

I think they’re starting to learn. I think the department is starting to learn, as some of my colleagues around here have learned already, that you can put as many notes and speeches in front of me and I’m probably not going to stick to it. I find it much easier just to talk, right? I don’t have many skills in life, but one of them is that I can talk the head off anyone.

 

I think we have to remember that when we make these decisions - I’ll give you a good example. Somebody asked me the other day - this is what they said to me: I’m getting my diabetes covered? I said: Yes. So I can go tomorrow? I said: No, we’ve got to pass the budget. I said we’ve got to do these things first, and they’re like: What do you mean? I was like: Well, we’re debating it, we’re going through it. They’re like: Can you just tell them to cover it? Can you tell them to pass it so I can get help? What are they arguing about? I said: Budgets are complicated. That’s a perfect example of why people don’t care about this. They want leaders and people who will cover their diabetes, who will create a lunch program, who will create a breakfast program, who will help individuals in a housing crisis.

 

And yes, we wish - I know I wish that we could just go around and plunk houses down, and we could just snap our fingers and all of a sudden it comes down from the sky. The magical house fairy just builds them. The truth is that there’s some catching up to do. There’s some catching up to do, right? There really is.

 

We’ve got to start building, and we are looking at solutions. One of the things that was said in this House that really got under my skin was when one of the members of the third Party made a reference to shelters and Pallet homes. They said that they’re not real homes - that Pallet homes were not real homes. Maybe not to you, when you’re living in a $500,000 to $700,000 home. It might not be your idea of a home, but to the people living in there, it’s their home. It’s their safe space. It is demeaning, and it feeds into the narrative of “not in my backyard.” Don’t build public housing, don’t build this stuff in my backyard, because that’s not real housing.

 

What does that say to an individual who’s living in that home? What does it say to these communities where we’re going in and saying that we need to do this and we need to help? What does it say when they hear leaders who talk down and downgrade these things?

 

It’s all part of housing. It’s all part of helping people. I know that I’m kind of treading a little bit into someone else’s department, but it’s all intertwined. It really is. It’s very symbiotic, if that’s the word. In order to take on poverty, in order to help people, we’ve got to work together.

 

One of the things that I will say is that for a long time, what we heard about government and about departments is that they acted in silos. We’ve all heard that, right? We’ve all heard that. We’ve all been part of that. We’ve all heard it if we’ve been around long enough. One of the things that I actually really do appreciate is that there are a few deputy ministers who are assigned a whole bunch of things. It’s incredible how quickly and how fast things get done when you have to deal with Department of Community Services issues that maybe impact -

 

I’ll give you a good example. We’re pulling numbers. We’re working with the Department of Labour, Skills and Immigration and its fantastic minister. The truth is that now we have someone who can go into these things, and they’re doing it all. That’s their job. I remember, I was on the Opposition side when I saw it and was like, Oh yeah, here we go. Then when you see it, you realize that this actually works very, very well. It leads to the idea that we need to get things done. We need to get past the red tape. We need to jump over the hurdles and just get it done.

 

I have a deep appreciation for just putting your head down and getting to work. There are times you’re going to trip up. We’ve seen it this session, where there’s some things where you have to sit back and you have to go: You know what? We’re not just going to bulldoze ahead. We’re going to listen to you. We’re going to hear from you, and if we don’t get things right, we’ll work with you to get those things right.

 

That’s why I firmly believe in the Department of Community Services. I’m reaching out to municipal leaders, business leaders, and anyone and everyone who wants to have a conversation about poverty reduction and how we help people. We will work together. Some of the ideas that we worked together on with the encampments, we brought in some people who had never had any real experience with the department before, but it worked.

 

This a department that wants to get things done, and I do want to say that life is interesting in that you end up landing where you land. Chair, how many - do I have twelve minutes? Is that what it’s saying? Oh my God. I just didn’t - what? (interruption) I’ll answer your question with a speech.

 

I will say that I don’t know what I believe in, but what I do believe in is that when you are given an opportunity, you have to take it. It’s funny how life works. It really is, that I end up here today, that at any point I ended up in this Chamber, that any of us ends up here. I think we’ve got to take advantage of why we are here. I keep saying that because I believe it’s true.

 

I believe that people are just tired. They’re tired - and that’s what I kept hearing over and over again. They’re tired of there being no solutions, or of hearing: We’ve got to wait; let’s wait; we’ll wait and then we’ll go through some things and we’ll figure it out and we’ll do it. No. We’ve got to build housing, we’ve got to deal with poverty, we’ve got to deal with the roads, we’ve got do these things now. We’ve got to deal with health care.

 

For the love of God, these things are all connected. If you don’t have good health care, what do you have? If you don’t have a good education in a post-secondary system, what do you have? These are things that we need to fix and build on for the future. It might mean that the Department of Finance and Treasury Board might have to write a few big cheques. No reaction. (Laughter) No reaction, but I will say that I’m open to any and all ideas. This department is open to any and all ideas. We have some brilliant people in this department, but we also have to start absorbing - me personally - all of us have to start absorbing what else is out there.

 

We have to go to leaders of all industry and have conversations with them, even if we don’t agree with them. I will continue to fight and work hard, and the promise I’ve made to myself, and everyone on this side, and everyone in this Chamber is that I will work like hell, and I will try to be the hardest-working MLA that this institution has. I say that knowing that, I think, the Premier works 18 hours a day. I say that knowing the Minister of Municipal Affairs and Housing. I know the member from Cape Breton. I know these individuals and I know how hard they work, and I know those individuals and I know how hard they work.

 

One of the things I’ve always prided myself on is that - again, I know I’m not the brightest person, definitely not the best-looking person, but I’m not going to be outworked. I am not going to be outworked, and that’s what we’re going to do. There are some things coming down the pipeline and I’m sure we’ll find something wrong with it because that’s what the opposition - that’s their job, they told us - but I’m sure they’ll find some good things about it, right? I think of this budget - and I’m getting a little off track here. I’ve got eight minutes.

 

I think of this budget, and I say this respectfully, but for seven years my former association put forward indexing as a policy for Halifax Atlantic. In fact, the very first time I ever attended a political anything was with my wife. The story goes that a misguided man in his thirties wanted to run for the NDP and they said no. True story. They said no. Then he was all depressed and his wife was like, run for the Liberals. What are you doing? You’re the biggest Liberal on Earth, and likes the Premier, which - we know that. Biggest Liberal on Earth.

 

We go to a Liberal policy thing at Bloomfield, and my partner - she’s been adamant about bracket creep - bracket creep, bracket creep, got to get rid of indexing. It was so frustrating. She explained it to me and I had no idea what she was talking about, but I was like, let’s go. I believe. Let’s go, and so we put it forward that day and we continued to put it forward, and continued to put it forward, and continued to put it forward.

 

When I hear people downplay it, I’m just like, this is a good thing. You don’t have to agree with everything, but you can say this is a good thing. It’s a good thing. Elimination of bracket creep is a good thing. It really is.

 

[10:45 p.m.]

 

The member for Sydney-Membertou stood up, and he gave the government a round of applause for the lunch program. That’s what this should be. We’re not saying everything’s perfect. We like it. We do, just like when other members were on that side, they liked it. That’s how it works.

 

I would say that this is a fantastic budget. It’s a fantastic budget for the Department of Community Services because of the remedy stuff we’re doing. There’s $103 million for people with disabilities and to do the remedy report. It is going to be life changing.

 

We’re closing institutions, and we’re attaching services to the person so they can stay in their community. We take a human-centred approach so they can be around their loved ones and so their loved ones don’t have to drive for hours to go see them. Imagine treating them like humans.

 

This is a positive thing. This is part of this budget, and we are hiring a whole host of people. I think it’s a 20 per cent increase in the budget to bring people in. I’m not a numbers person - I’m not going to lie - but I’ll find the money. These are big things.

 

Not only did - I heard the third party say we were mandated by the courts to do it. You know what? There was some stuff there, but you know what we weren’t mandated to do - $300 per month extra for people with disabilities. There was nothing there. We weren’t mandated to do that. We did it because it was the right thing to do, but they don’t talk about that. They say the other stuff is bad. Everything is bad.

 

These are programs that are going to be life changing. I do think back to the people in my community and the people right across Nova Scotia on whom this is going to have a positive influence. I heard some - there was a bit of wavering on child and youth advocacy.

 

I’ll tell you - how I started this conversation with all of you. If that young boy and that teenager had a voice, life could have been a lot different. It could have been a lot different. One of the reasons I ran - you can look it up, because I did the interview on CBC. I ran because of the former NDP government’s refusal - flat-out refusal - to do an investigation into the Home for Colored Children. That’s one of the reasons I ran. Now we’re helping to implement the recommendations, and they’re saying: No. We want - this isn’t right. We want more details. We want this. Well, like I told them from the beginning, buckle up, because it’s coming.

 

I’ll tell you something about that group home. When I was a kid - and I was in foster care - I had a social worker say to me: You better get into this home, because if you don’t, you’re going over there. You know what they do to children over there? That’s what a social worker said to me. That’s why it was personal.

 

That’s why I am proud that we put that through. Government after government had an opportunity to do it. They didn’t do it. We had people all - listen, I was on the phone nonstop, calling people: Hey, we’re doing this. Some of them were deeply rooted in these parties, and they were doing backflips. They were happy. One guy said to me: I can’t believe a Conservative government would do this. I told him: Progressive Conservative. (Laughter and applause) I’m just telling you what I said.

 

This is personal, but it’s also business. We are going to get things done in this department. We’re also going to tell our stories. We’re going to celebrate. A lot of times - and I’ve said this to the people in the department - when this department makes media, it’s because a lot of it is bad stories. There’s a lot of great stuff going on in this department. There are a lot of people who we’re working with, and we’re going to start telling their stories, and we’re going to start changing the way people view kids in care. We’re going to start changing the way people view people living in poverty and people who need assistance. We’re going to start changing the way people view people who are on disability, and that starts with programs like remedy. That starts with telling our story. That starts with humanizing it, and letting people know that no matter what they say, what I’ve seen is care. I’ve seen a government that cares.

 

A year ago - but do you know what? People have asked me, and I just said: Sometimes you’ve just got to stop. You’ve just got to stop and look, and then you start going: Yeah, I agree with that. Yeah, I agree with that. Yeah, that’s a good one. And then you have to do a gut check, and this has nothing to do with anyone else in this Chamber but me. It was a gut check, and I’m very thankful to be here today. I’m very thankful for the opportunity, and with my 40 seconds I will say that I know there are weighty expectations from people in the sector, people who’ve reached out to me, and again I will say that whatever you put on me is not as heavy as what I’m putting on myself. I’m going to continue to work, I’m going to continue to put people first, and I hope that we all can take a very straightforward look at this budget and see the great stuff that is in there, and not just from the Department of Community Services but right across the board. We have unanimous consent, for the first time in my career, on a budget.

 

THE CHAIR: The honourable member for Sydney-Membertou.

 

HON. DEREK MOMBOURQUETTE: Not much time left. I’m still waiting for the speech that staff wrote, but I will say this in the two minutes. You know, I’ve had the privilege of being here for nine years, and I’ve seen a lot happen. I’ve seen governments come and go. I was involved with them even before I got here, but I do want to say this. Coming from a community that experienced high levels of poverty, a lot of challenges, I have always had a very strong relationship with the Department of Community Services, and I’ll take the two minutes that I have to recognize that staff.

 

I can list a whole pile of initiatives that the deputy minister and her staff have been involved with, whether it’s been the work around adults with intellectual disabilities and the infrastructure that we put in place, working with great organizations like Horizon Achievement, Breton Ability Centre, Haley Street Adult Services Centre, and others, looking at a lot of the programs that help our youth at risk in our community, and communities across the province.

 

I’ve never been really the critic for this department for long, so I’ve also learned a lot as I’ve taken on this role. We are going to have a lot of questions about the budget, particularly around the child and youth office and what that budget looks like, your staffing, some of the nuts and bolts of stuff. But I’m also interested - and I always take this opportunity, because I was on the other side as well, and I had members over there questioning me when I was a minister - to have a conversation about some of the things that I think can also help the department in their journey of trying to help people.

 

You know, I didn’t want to get into questions tonight. We have lots of time for questions tomorrow, but I do want to take this time. You know, on a daily basis we’re in constant contact with the Department of Community Services. Whether it’s housing, whether it’s food related, whether it’s around income, we’re experiencing some of the highest levels of inflation in our history. Every MLA in here is dealing with those calls and trying their best to really help support those families - and really, a lot of the times, the first call we make is to the Department of Community Services.

 

I do want to rise in my place, after nine years of being here, and staff is paying attention tonight - you’ve been nothing but good to me, given nothing but good to my office, and I look forward to the conversation.

 

THE CHAIR: Order. The time allotted for consideration of Supply today has expired.

 

The honourable Government House Leader.

 

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

 

THE CHAIR: The motion is carried.

 

The committee will now rise and report its business to the House.

 

[The committee adjourned at 10:55 p.m.]