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April 11, 2014
House Committees
Meeting topics: 
CWH on Supply (Ed. & Health) - Legislative Chamber (1269)












9:20 A.M.



Ms. Margaret Miller


MADAM CHAIRMAN: The Committee of the Whole on Supply will come to order.


The honourable Government House Leader.


HON. MICHEL SAMSON: Madam Chairman, would you please call the resumption of the estimates of the Minister of Education and Early Childhood Development.


MADAM CHAIRMAN: The honourable member for Pictou East.


MR. TIM HOUSTON: Thank you, Madam Chairman, good morning. I just have a couple of questions this morning, basically around the Highland School in Westville. I know the department received the Fowler report and is going through some of the recommendations there. What I'm thinking about this morning is if we think about the school closure process that has been in effect for a while, I think there have been some flaws in the present system, in some of the ways that we decide which schools we're going to close.


My first question is if we recognize that the present school closure system has flaws, would the department be willing to review some of the really recent school closure decisions?


HON. KAREN CASEY: Madam Chairman, thank you to the member for the question. As the member would know, there have been a number of revisions and reviews to the school closure process for the last, probably, eight years. Initially, part of the - I'm finding it hard to hear.


MADAM CHAIRMAN: Order, please. The minister is having difficulty hearing the questions and responding, so if the House would please respect her and keep the chatter down we would very much appreciate it.


MS. CASEY: Thank you. I was saying that the review process has been revised and tweaked a number of times over the last eight years, and some of the initial concerns with that were that the community did not have enough opportunity during the process to bring forward their ideas or to hear what the impact studies and those other documents were saying.


The other issue was the time frame around it. There were some changes made, but I've not yet seen a school review process that was not controversial in a community. I truly believe that part of that is the need for trust, and I sense that there's not a lot of trust between school boards in some communities, or between school board staff in some communities. We have public meetings where staff will present statistics and communities question them - and I think we heard last night that some communities felt they had to FOIPOP to get the information. That is totally wrong.

If we want to work with a community to try to help them with a difficult decision, then we need to have their trust and we need to be honest with them - and by "we," I'm talking about the board, because the board is currently responsible for school reviews and school closures.


As you've mentioned, the Fowler report will be tabled when we introduce legislation. It speaks to some of those very concerns - what people told Bob Fowler when he was going around the communities was exactly that, the element of trust, the need for consistent criteria, the need for open and consistent data.


I believe the question is: Am I in a position to change the decisions that have been made by boards? The answer to that is no. However, my job is to make sure that we have a process in place that does meet the needs of the community and that does satisfy the boards. We know the boards are looking at square footage and capacity and programming and all of those things, but I think they also need to keep in mind the communities that are impacted by this.


It is a board decision. The minister does not reverse those decisions, but we are hoping that moving forward we can have a process that does not pit communities and boards against each other.


MR. HOUSTON: Thank you. So, thinking about the Highland Consolidated, it was on March 19th that the Chignecto-Central Regional School Board voted to close the Highland building permanently and move the students to MacLeod. I was at the meeting that night and it was interesting hearing the comments that the department can't reverse board decisions and stuff, because while I was at that meeting that night the flaws in the current process were definitely on display. It seemed pretty clear to me, and to most of the people in attendance, that the vote on the closure of the school by the members of the school board was simply a mere formality. It certainly seemed that was a decision that had been made quite early in the process, maybe even before the public consultations would be my fear.


My very specific question on this point is: Can you tell me when the school board reported to the department that Highland would be closed - the date of that report?


MS. CASEY: I've certainly tried to do my homework on Highland Consolidated because I know it is a bit controversial in the community. I know that it was closed because of the odor and the air quality. I believe it was back in April 2012 that first became an issue. I'm also aware of the vote - 12 to1, I think, was the vote on that particular closure meeting.


During those public meetings and meetings with the town council, there were opportunities for board staff to bring the community up to speed on what was going on. I believe the board was concerned about some of the air-quality testing that had been done and looking at a process that would try to eliminate that poor air quality. I think the report said that they would guarantee 80 per cent safety with the air quality, with the assessment that was done. I can't speak for the board, but I would suggest that they were concerned that with an investment of $1.8 million, or whatever it was, there was still no guarantee that the air quality in the school would be safe - 80 per cent safety, I think the board is suggesting, is not enough.


When the department was notified of the vote, it would have been after the vote was taken. I believe, as you said, that vote was a 12 to1 and whether the board members had made up their minds before they went to that meeting, I can't speak to that. I know in that community initially, my understanding is, parents wanted their children out of the building because it was what they considered to be a sick building. They were - I believe the words were - "temporarily moved" to another building.


Then the process began by the school board to look at what it would cost to fix the problem but the guarantee might be the capacity that they had within neighbouring schools - and I believe that is what would have prompted them to put the motion on the floor - but we were not part of that meeting and we do not influence that meeting, but we do get the results of that vote from the board.


MR. HOUSTON: I guess the reference to the vote that night, it was a 12 to 1 vote, and the thing that was most disappointing to me that night was it was clear that many of the board members weren't really up to speed on the issue - they really didn't know what they were voting on and why. Many of them hadn't been to Westville, been at the school where Highland is located.


We even heard things - because the issue of the air quality of the school is not, let's say, cut and dried, there are many reports on both sides - there are lots of reports that say there is no problem with the air quality in that school.


In the discussion leading up to the vote that night, one of the school board members said if there was a problem with the air in the school and people were getting sick and we haven't done anything, then why would it be any different? Now, that is a person who was within minutes of making a vote to close a school and cause some pretty serious ramifications in a community and that person was not aware that, in fact, there had already been close to $1 million spent on changes to that school that may or may not have fixed the air quality. But the mere fact that member was ready to cast a vote and had so little information about what they were voting on was a pretty serious disappointment to me and, presumably, one of the flaws you are seeing in the process.


I guess what I'm really struggling with is how that all went down. The board made a decision that night to close Highland School permanently and move the kids to MacLeod School. There was an offer on the table or some estimates that they could fix Highland for I think $1.8 million or they could do renovations to the MacLeod School, which were in the range of $3.5 million, and that's what they decided to do.


I'm a big boy; I accept decisions that are made, but I like to see that they are made following a good, solid process. That's a decision that that board made, to spend more taxpayers' money, and I just don't know that it was a well-informed decision, so I would really urge the minister to look back into that situation because I will just ask the question again.


It would seem to me that the department, and it's a very recent decision, March 19th, that's less than a month ago, and probably sometime, maybe in the next couple of months, the whole school review process is going to change and I'm really having a hard time accepting the fact that if we know the process is flawed and the flaws are so evident, and we're going to change it - I really have a hard time accepting that, well, too bad for that decision that we just made yesterday, under the old process, and I would just ask one more time if maybe the minister would look at that decision. It's a pretty serious decision to the community, to the school board, and there is lots of taxpayers' money involved. I'd just ask, one more time, if you could look at it.


MS. CASEY: Madam Chairman, I know the member has been involved in those community meetings and I know he is very passionate about it. I do understand the concerns of the community about the process have been made known to the board and we'll be talking to the board about what the concerns were that were brought to their attention. So I'll make the commitment that we'll meet with the board to look at what the concerns were and the rationale for the concerns.

I will say that I hope that the new process will prevent that from happening, but your point is that this is one that was made a month before.


MR. HOUSTON: I appreciate your offer to look at it again with the board. I'll maybe see if I can push that a step further and say would you meet with the Westville Town Council on that, but I'll leave that for you.


Now we have a situation where the board has decided to permanently close the Highland School. There is a lot of talk in the community about what happens to the building now and who owns the building. I understand maybe the department sent a letter to the town council saying they would be turning that building back over to the Town of Westville.


I just thought maybe if you can comment a little bit on what's going to happen to the building and the contents of the building, because there seems to be two issues that are causing some anxiety in the community - one is who owns the building, and what's going to happen to it. The building is full of contents, which the department has been slowly removing from the building, so maybe you can comment about the asset itself and what is going to happen to it.


MS. CASEY: Madam Chairman, schools that were built pre-1982, when they are no longer used for educational purposes, do revert back to the municipality. I believe Highland Consolidated School would have been in that era of pre-1982, so it would go back to the municipality. The contents in that building would belong to the board and/or the department, so the facility itself is what would go back.


I know that speaking of the Fowler report, one of the things we asked Mr. Fowler to do during his public consultations was to meet with municipalities because that's an issue all across the province. It's interesting, depending on where you are, sometimes it's a blessing and sometimes it's not, because if you have a building, a school, that you turn back to a municipality, in metro for example, the land is very valuable and the municipality is glad to get their hands on it. You take a building out in a rural community where there may not be as much growth or may not be as much use for that building, then it becomes a liability.


We asked Mr. Fowler to meet with municipalities. There are certainly recommendations in that report that speak to that, but to talk specifically about Highland Consolidated School, I believe it was pre-1982, so it will revert back to the municipality.


MADAM CHAIRMAN: I would remind honourable members to please direct their questions to the chairman, on behalf of the minister.


MR. HOUSTON: Madam Chairman, I'm really struggling with this whole situation here, to be honest, because if we think about what our job is here in this Chamber, our job is to try and make the lives of Nova Scotians better and if we look at what happened to the community of Westville, we can debate and go back and forth on the school review process, I think we'll both reach the same conclusion, that it probably wasn't fair. They went through a flawed process and reached a decision to close a school. Now we have a building being returned back to a community, I guess. Maybe if we're talking about the contents of the building belonging to the department, are we talking about fixtures and stuff as well? I know there's stuff being removed.


I'd just like to know, when we talk about the contents belonging to the department, should the town now be expecting that it will get the shell of a building back, maybe with no toilets? I mean how deep does that go - what will be removed from the building?


MS. CASEY: Madam Chairman, it would be my belief, my understanding, that what would be removed from the building would be something that could be transferred into another building, to be used for educational purposes. I'm not sure what the member is talking about with fixtures - does that mean sinks off the wall, things like that? I don't know, but perhaps there could be some clarification.


It's my understanding that the furniture that could be used for educational purposes in another building would be what would be removed before it was turned back. If there's other information, I certainly would appreciate hearing that.


MR. HOUSTON: Thank you for your responses today. Maybe we can revisit the fact that maybe we can meet with the town council.


That would be it for my questions for right now. I'd like to pass off to the honourable member for Sydney River-Mira-Louisbourg.


MADAM CHAIRMAN: The honourable member for Sydney River-Mira-Louisbourg.


MR. ALFIE MACLEOD: Madam Chairman, I want to thank you for the opportunity to ask a couple of questions of our minister today.


My first question, through you to the minister is when it comes to the Hogg formula, there is a certain amount of money allocated for schools that have 100 pupils or less, and I would like to ask the minister for some clarification as to how that process works, especially when you consider that in some areas we have complexes, which means there are two schools under the same administration. One of them may be smaller than 100, but because they are complexed with another school I understand that they don't qualify for the Hogg formula and the extra funding. I wonder, could the minister make some clarification about that?


MS. CASEY: Madam Chairman, the member is correct. There is an allocation within the Hogg formula to address what is described as small isolated schools and the allocation of that, it is my understanding, would be based on the numbers of students who are in that building. I believe, if maybe the member could give me the name of the two schools that are under one complex under one administration and I could just check to see where we are with that. What is it? What is the school?


MR. MACLEOD: There are several examples that I could quote in my own constituency: one is the Gowrie School and the Donkin School, which would be the Donkin-Gowrie Complex, and the second one is Mountain View-East Bay Complex together. Those two, in particular, in the Cape Breton- Victoria Regional School Board, are the ones that I know of directly.


MS. CASEY: To repeat, it is my understanding that it is the total student enrolment that determines whether they are considered to be small, isolated. So if the two buildings in one complex together exceed the small schools allocation, then they would not qualify for that funding.


MR. MACLEOD: I guess the challenge is, although the two buildings are under the same administration, they are actually in two different communities and in the rural communities of our province school is the main part of the fabric of the community. When the principal is located in one community, but the school is located in another they seem to still be penalized for being complexed. The complexing was done to be more efficient as a school board, yet there is a hit being taken because they are trying to more efficient.


Trying to keep those rural schools open is very important for the children because of the distances they have to travel and whatnot. I wonder if the minister would make a comment on whether or not there is any consideration about looking at those kinds of situations and dealing with the schools as to their location rather than the complexing with another school.


MS. CASEY: The list of small isolated schools that we are referring to was put together, was developed, I believe, last year and I would be quite happy to sit with the member to look at that and discuss that. The issue he raises is a good one. If they are in different communities, but under the same administration, maybe they should be treated as separate buildings. I will make that commitment to look at that particular circumstance with that member.


MR. MACLEOD: I want to thank the minister for that commitment because I think, as we all know, it is the child who is the most important part of what we're trying to do and accomplish here. In that vein I would like to ask the minister if indeed the department has given any thought to how far a child who is in, say, Primary to Grade 4 should have to travel in order to get to school, because one of the situations that happens now because of our busing system, sometimes we have young children getting on the bus as early as 7:15, 7:20 a.m. so that the bus can accommodate other students who are going even further away to schools. Again, I'm talking about areas that are in rural communities.


I just wonder, is there any thought in the department to talk about how far our children should be bused and under what circumstances? Again, a child needs to have their sleep and their rest and a good breakfast and all those other things to be able to get a positive education in the learning environment, and I just throw that question out to see if the minister has any thoughts or will give it some consideration.


MS. CASEY: I know the distance that students travel and the time they're on buses and those kinds of issues do have an impact on students' ability and readiness when they arrive in a classroom.


There are some provincial guidelines that are shared with boards, but the final decision is left with the boards. If there are concerns that the member has about a specific school or community, I would encourage him to talk to the board. If that has happened without any positive results, I would ask him to share that with me because they say there are provincial guidelines, but the final decision for busing and transportation of students is with the board.


MR. MACLEOD: I want to thank the minister for that answer. I guess my only question to that would be when was the last time the guidelines were looked at and is there a chance for a review of it, or has it been done in the recent past?


MS. CASEY: I can't give you the date; I don't know when they were updated, but they certainly will be reviewed and will become a priority for our department to get a review right away.


MR. MACLEOD: I want to thank the minister for that answer.


Madam Chairman, with your permission I will now turn over our time to the honourable member for Hants West.


MADAM CHAIRMAN: The honourable member for Hants West.


MR. CHUCK PORTER: I'm pleased to have an opportunity to take a few minutes today to ask the minister a few questions regarding education and, specifically, a few of the schools in my area and a little bit about how things are going to be done in the future, perhaps as to how they were done in the past. I can tell you that decisions that have been made in the past, although there were a couple of meetings held, I can assure you that members of communities in those areas that were affected certainly felt jaded and were left out - decisions were made long prior to those meetings ever taking place and it appeared clear, unfortunately.


I was the first to say a long time ago that the relationship between myself and our school board has been very good. We do meetings down there generally quarterly and sometimes a couple of times a year, and then there was a spell where we went maybe a year or more that there was not a meeting scheduled of any kind that we came together for whatever reason. I think at this time when you're making tough decisions around school closures, new schools perhaps or changes, people are emotionally driven - as you know, you've been through these closures and these ideas of changes don't always go well in certain communities, probably in most communities. We've heard a lot of discussion around some of that in other areas - Pictou County, Westville, and so on.


I guess I want to start with a school that I know very, very well, built in the 1960s, Newport Station District Elementary. You would probably be familiar with the process that was formerly in place by way of how you approach a review and a potential closure. It's fairly lengthy actually. It could go on for quite a while and I think it's probably fair to say most would argue that there are pros and cons to that. The board doesn't like that long and drawn-out - I think you're probably familiar with that as well - they want to make a decision based on the economics of that board, and if it's due to close they want to close it. They see that process as rather slow and drawn-out; the community does like it, it gives them an opportunity to put up a fight, if you will, and challenge that.


We went through that in Newport Station District Elementary and that area, and although the number of children attending that elementary school may be in the high 70s, lower 80s - I think 82 at one point it was, and they might have even reached the 70s - does it make sense to close that school? It might, sure. It was decided in the end that that's what the board was going to do anyway.


There were numerous debates that were held outside of that sort of board-held meeting, but I can tell you when it was done, I guess people accepted it for what it was. They were all grown-ups; they were upset, but they did accept it. Then, all of a sudden, we hear of yet another change - oh, we may review that again. So what I really want to ask here, having put those people in that community through that process, the question really is: Is that a done deal, for lack of a better term - there'll be no further reviews on Newport Station District Elementary and it will close in Spring 2015?


MS. CASEY: It's my understanding that the board did pass the motion to close that school. If there was going to be something different done, then the board, in my opinion, would have to rescind their previous motion. I'm not aware of whether they have done that or not, but I believe that would be the proper procedure - they would have to rescind that motion and put forward another one.


MR. PORTER: Thank you, minister. That would be the norm, I guess. I just wanted to clarify with you as minister of the department, if there were any other kind of discussions going on there. This past week we learned that, as part of this closing of Newport Station, there are two other schools in the area that are affected - Three Mile Plains, and Windsor Forks. We hear that there will be a new school, apparently that is what the board has asked for, to replace the three of these.


There had been some previous discussion - and I want to go back just a bit - on the final night of a meeting in Newport Station District Elementary, which I attended, that was a year ago February I believe, and I'll say it was on the 21st, and on the 22nd the board, or at least the superintendent of the board, was at the school in Three Mile Plains with a plan already for his new super school, with no mention of that the night before. So you can see why people in Newport Station, Windsor Forks, and the Three Mile Plains catchment area were upset.


The decision had already been made, even though it didn't appear that way, so people were upset. All of a sudden now on the table there is a new school with potential drawings and the like. Had they been asked about it, or included in it, or given some idea it was going to happen, it may have changed the whole process. And then it sort of died for a while; there was no discussion about it.


As you know, I wrote and came to you and we had some discussions, after the election, with regard to the status of announcements that I made in the Spring of 2009 on behalf of the government of the day, which was the Tory Government, with regard to Three Mile Plains and Hantsport - work that would be done there. Of course, Three Mile Plains has been battling this now for some five years wondering, what is the status? It's been up, it's been down; it's been on, it's been off. Nothing happened, is what has happened to date with Three Mile Plains.


We learned in the media this week - not a call from my office, not an email from the superintendent, nothing to indicate that the board had now made a decision, through this process that has been put in place, as to how they make recommendations for work they'd like to see done in their board district. The new super school - for lack of a better term - to replace the three, is now what has been put forward. Because I've only learned of that in the media, and we take that for what it's worth, that's fine, it's probably accurate, but from the minister's perspective and your office, I just want to confirm for the record and for my people back home I represent - is this in fact what has been done?


In asking that same question, maybe I could just follow it up with this piece because it goes together - that would mean that the work that was allocated for the Three Mile Plains School, which was a gymnasium refurbishment and whatever else was to be done out there, that is now a dead issue - that will not happen?


MS. CASEY: As the member has indicated, we have talked many times about the schools and what is happening. I believe he and I learned at the same time, through the media, what the decision of the board had been and we talked about it that very day. There has been no submission to the department that will reflect the motions that were reported in the media. Boards have until the end of April to give us their submissions for capital. We've asked them to put them in priority order when they submit them and it's to be done on an annual basis.


I did follow up on that when we heard it in the media and the latest I've been told by my staff is that there has been no submission for capital projects from the Annapolis Valley Board that would reflect what we saw and heard in the media.


MR. PORTER: Thank you for that answer. I guess they would have, as per the rules, until the 21st of April, as you've just indicated, to put forward that recommendation. Maybe they'll come back out to the local community, given that is not too many days away now, to advise them. I doubt it, given we haven't heard anything to date.


So having said that very thing, on the record would still be the previous request - I'm only going to assume that, but I'll ask the question for your clarity: The work that was announced in 2009 for Three Mile Plains School, how and where does that sit by way of priorities for you as minister and the government, for that work to be done at Three Miles Plains, based on the very fact that you and I have both admitted to only learning this through the media and you have no formal request? But the request would have come in based on last year, April 21st or whatever the cut-off date was, and you would have had to have made some decisions for the coming years ahead. I just want to clarify, based on things that we don't really know, only what we're hearing and have no confirmation - are the priorities for Three Mile Plains, as it currently stands, still in place or are you going to wait them out to see what comes through in the board as you have just taken back over?


MS. CASEY: I also remember some capital projects that were announced in 2009 and have yet to materialize. What has happened - and I don't know what happened for the first number of years but I know a couple of years ago the government of the day said we're going to clean those all off, everybody has to start new. You submit them on annual basis. Some of those ones, like the member is speaking about, some in my community, some in other communities, are gone. The commitment that a previous government made was not honoured and therefore we are back to the drawing board in those communities.


Having said that, it's my understanding that the request that came from the Annapolis Valley Board for capital that we were considering now was the large, one school replacing three. That was not approved for capital for this year. When they submit their request in April of this year, I don't know what will be on it. I don't know if they will put that back on or if they will put the schools that were part of the motion that we heard about in the media. I don't know what that is.


I'm disappointed that communication between the elected member and the school board seems to have broken down a bit, and it just reinforces what I've said before about municipalities, school boards, government and communities working together, and working together long before any decision is made that will impact a school. Once you start the conversation and everybody is entrenched, things usually break down and, unfortunately, we have a history of that.


MR. PORTER: I would say yes it is a shame things weren't done a little differently and we have no control over that and I understand you certainly have none over it either, given how things have been over recent years. I would, however, suggest, and we both would realize, what has been put out in the media is probably what is coming; we could safely assume that. You are correct, it is too bad that things were not more well informed and I don't even know if the municipal units affected are informed, in all honesty, if there has been any discussion there, but perhaps they don't feel that there is a role for us or that we could assist them through that process whereby I would argue that, and I think we have a big role to play in that, given that we represent these many people.


In that same vein of work that was announced back some time ago in 2009, Hantsport School, as you well know, was announced at that time for some renovations. I don't remember the figure, but I think it was somewhere around $3 million, perhaps, in 2009 it was announced for that renovation for Hantsport. I know that in that renovation they also requested gymnasium upgrades that I believe were not approved at that time, but other work was.


That was a few years getting started, but it did get started and we had some questions recently around whether or not the budget would have allocations in it to complete the work. I did receive a letter from you - I don't have it with me today, I wish I did, but I don't need it. You know what was in it, and we've had discussions on it with regard to work in the coming year being done. The real question is not only in the budget year coming that we've talked about, but for the record I would never assume we've spent money to date, we're going to spend some more, but we're going to spend enough to finish that particular project that has been approved.


It doesn't really say that in the letter. It says "allocations," I think, for 2014-15, but it could, I suppose - maybe that clears it up and it finishes the project. It could run into, I'm going to assume, the 2015-16 budget perhaps, but let's hope it doesn't. The question around this from the community is: The school work that was announced, will it actually be committed to, financially, and completed as approved and awarded?


MS. CASEY: Madam Chairman, again we've talked about that particular school, about Hantsport. We know there are overruns at this point in time and the department is working with the board to try to deal with those overruns, but our commitment is that the project will be completed.


MR. PORTER: Thank you, minister, I just wanted to get that on the record. There were still questions this past Wednesday evening when I was down there for another meeting, a municipal meeting, whether or not that was accurate. I said that I would ask that, just to be clear. That is what I thought from our previous discussions you and I have had on this project - and I appreciate that, by the way, the opportunity to meet with you on occasion and clarify some of those points.


I want to go a little bit on what one of the other members had been asking about - bus routes, time frames and some of that. Like many rural constituencies, we have some lengthy bus drives for our younger students, and our high school students for that matter. My area is no exception. There are some fairly lengthy drives for some young people.


We probably take a number of calls in and about May, as the parents of new children are getting ready for elementary school and we take them again in September; we're pretty busy. I know that the superintendent at the bus garage takes thousands more calls than I do on this very issue and some can get resolved and some cannot. Dave Crouchman does a very fine job, in my opinion, dealing with these issues. I know it's difficult and you're always trying to make life better and safer for these children who are getting on the bus. I think he does well with what he has to try and manage that and the number of buses.


I guess the question comes down to, given that departments have been asked to cut back based on our unfortunate economic times over the past years, and we realize that budgets are tight and there is only so much money, I think most people appreciate that, but that is sometimes hard to convince when the little four-year old or five-year old is getting on that bus - I know we all want our children picked up at the end of our driveways for the safety of that child and, sometimes, for the convenience - are there cuts, if that's the right word, or money not being allocated, and I'll go so far as to ask would there be extra money put into busing and giving those busing superintendents some flexibility to add, if need be?


I know populations around rural Nova Scotia, it has been talked about many times in this House and I heard about it for four years-plus, about how student populations are going down. Perhaps in some areas student populations are going down, but not in every area of this province are student populations dropping. There are still some growth areas in the Province of Nova Scotia, rural Nova Scotia, and we have a couple of those growth areas in my constituency, so this is an issue where busing certainly could use some additional funds, where Dave could have some extra resources to make things happen.


I realize it's a difficult thing to enter into because you try to accommodate as many people, if not everybody, as you can and that is difficult. I'm just curious about - are we status quo, are we taking away, are we adding, are there opportunities there?


MS. CASEY: The Hogg formula - I had spoken about how we would be having a hybrid model of funding this year, which would be some of the original components in the Hogg formula and others that were not driven by enrolment, but were driven by programs.


However, the transportation component is still addressed through the Hogg formula and that means that it is based on kilometres that are travelled. The funding is there. The boards submit what their kilometres are and plug into the formula and the formula determines what their allocation would be.


I'm not aware of boards that are doing things that would increase the length of time on buses in order to save money; I'm not aware of that. I would expect that is not happening. We certainly would be vigilant there but it is a part of a formula and even in poor economic times there are some fixed costs that you cannot change. I've said this: If you have three kids on a bus and it goes 50 kilometres, it costs just as much as if you had 50 kids on the bus. You pay the cost for the distance, not for the number of kids on the bus and that is accommodated in the Hogg formula.


MR. PORTER: I guess maybe I didn't articulate that very well. I didn't mean to insinuate that we were actually doing what you suggested there by way of trying to save money at the expense of the children and extend the bus routes; that wasn't what I was really referring to. We do have both younger and older students who are travelling over an hour, there is no question. I know that past policies stated that we were trying to keep this travel under an hour. We heard our colleague from Cape Breton talk a few minutes ago about the benefits of getting the right amount of rest, breakfast, and all of those things and how it makes a difference, but we have young children who are getting on the bus at shortly after seven in the morning and are staying on it for a lengthy period of time, and the same would apply in the afternoon, unfortunately.


That is what I was getting at, whether or not we were thinking about any changes that may be possible there to keep those time frames, regardless of kilometres. I know that there is a formula for everything, and that is good and bad I guess all around no matter how you look at it, we have to have something to go by - that's acceptable.


What I was getting at there - is there any room to focus solely on making sure, not just writing a policy and hoping to get kids off the bus in less than that hour, is there anything, any room there where that is happening? I'll just use my area for an example, you know, there are places where that may be happening. Does Dave have the ability - or the board, or myself, or somebody - to say look this is just too much? Is there a process that is open for consideration to adding, even in the tough times, resources that might - not might, probably should, in all honesty - be seriously considered?


MS. CASEY: I want to thank the member for the question because it does prompt us to go back to look at the guidelines that we have in place, the provincial guidelines. It is a board responsibility but they do need some guidelines, and we certainly are committing to look at that.


The other thing that boards are doing now, the transportation supervisors from different boards are getting together to talk about best practices and efficiencies because we may have some boards that have some practices in place that help address some of those problems, so the sharing of those ideas between and among boards is important and that process is ongoing.


MR. PORTER: A walking distance review was done - might have even been under your watch as previous minister some years back, I'm not sure - there was a review done and I can't remember if it was when we came in here in 2006 or just prior to that or after that? (Interruption) - I see you're indicating 2007, I knew it was somewhere around there. I assume there are no changes coming to that? As you well know, in rural Nova Scotia there are no sidewalks and one of the biggest concerns we get from parents is children walking lengthy distances to catch their bus and to get off in the afternoon, crossing roads on major routes like Trunk 1 and Trunk 14 in my area, which are heavily travelled.


We can post a speed at 70 or 80 or 90 or whatever we want; you can talk to the traffic analysts, which I have done, great folks who know from doing the measurements and trying to help out in these situations that the vehicles are almost always going 10 or 15 kilometres over posted. It almost makes you wonder if there are changes that need to be made there and we're working on those too. I am fortunate to have a guy by the name of Rob Sweet who does a fabulous job helping us out when it comes to measuring school bus stops and things like that, and working with Dave and others and indicating what those speeds are and measuring them and making recommendations. Some we have changed, fortunately, where it has made sense, and there is probably more that can be done. One of the key issues is the bus stop itself. We have a policy in place, and I'm not sure what year that went in either, there are three stops in 1.6 kilometres. There's a whole variety of things within the bus stop piece. If they go in a gravel road, depending on how long it is, as whether they can stop inside somewhere on that gravel road or not, or at the end of the road - there are any number of examples.


I realize from working with Dave over the years, as well as with Rob, the 1.6 kilometres was set up based on site vision and safety and other things, but there are still a lot of areas around rural Nova Scotia, certainly in my constituency, although there are twists and turns and ups and downs in the roads and all of those site/distance issues, there are other times when you could probably have, I don't know, four or five stops in 1.6 kilometres if you really wanted to, I guess, for lack of a better term.


I do realize we make some exceptions around medical - if there are people who have medical exceptions they are maybe picked up at their driveway or somewhere closer, the mobility issues and what have you. I'm wondering again about the leeway here, is there some way we can apply, to say, look, this just doesn't make sense, outside of that process, or is this solely, again, back to the board to allow them to bring forward, us going to them, recommendations - I just want to know where to go with this because we get a lot of it and it's consistent, and when we get a lot of something and it's consistent, it says it's probably real and there's likely an opportunity to present a change, or at least a recommendation for change and for it to be reviewed.


You don't want to review everything all the time, you get one or two of this or one or two of that. We realize the majority works, but when you get the numbers that we get them in, or that I get them in - I'll only speak for myself and my constituency - that it's an issue that probably really seriously needs to be looked at - so I wonder about that distance opportunity with the bus stops and the number of bus stops.


MS. CASEY: Madam Chairman, to the member - those changes and that review was in 2007. I know that a couple of years ago the government of the day changed the speed limits within school zones, again, all in the interest of safety.


The process the member is talking about, there are exceptions. The process is the board's responsibility; they make decisions to deal with those unique, special circumstances whether it is a dangerous curve, whether it is a road without a sidewalk, whether it is a child with special needs - even the courtesy busing issue that we get into because if buses are going by, they're not full, there are kids who are walking, and sometimes those kids are picked up and driven to the school. But that backfires on the board sometimes because it's a courtesy and people come to expect it, and they expect it in other parts of other routes as well.


I would suggest to the member, and to the constituents and to the families, that if there is a concern they take it to the board. I know in my own community, as a MLA, I work with the municipality and the RCMP because in some places we just need a crosswalk, we need a sign to tell motorists that this is a bus stop - so working with that level of government as well helps.


I would encourage the parents and the member to go first through the board, but also engage the municipality as well, if there are things that can be done that would lead to safer conditions.


MADAM CHAIRMAN: The time has lapsed.


The honourable Leader of the New Democratic Party.


HON. MAUREEN MACDONALD: Thank you very much, Madam Chairman. I'd like to, first of all, say it's great to have an opportunity to ask the Minister of Education and Early Childhood Development a few questions about the education budget and some of the initiatives that are of concern to myself and to people in the constituency that I represent.


Of course education is such a core program of government and something that people really associate with their government. We know that the minister has announced an education review that will be led by the Honourable Myra Freeman who has been a teacher for many, many years, a distinguished teaching career, and additionally I understand there is going to be an advisory group appointed to advise the panel.


I'm curious whether or not the work of this group will include looking at administration in the education system, and to what extent that may be part of their focus. Will it go beyond looking at the curriculum in the classroom and some of these very important issues, to actually look at the structure of our education system, the governance of our education system, any questions around duplication of services, shared services, the current number of boards we have, and what have you?


We all know that there has been quite a significant change in the demographics of the province, and just to give you an idea of one part of the province that I'm familiar with and that would be the Strait, the board in the Strait area where I grew up and where my mother continues to live. Not so long ago I was home visiting my mum and I was reading the local newspaper, the Antigonish Casket - I always loved the name of that newspaper - so I was reading the Antigonish Casket and there was a report in it from the Strait school board. I think the superintendent actually of the Strait school board had done an interview or he had given an annual report, or something somewhere, and in that was the incredible statistic that over, I think, a 10-year period the number of students in that board had gone from over 10,000 to slightly more than 6,000.


So it has dropped - actually I think it was even maybe closer to 12,000 down to slightly more than 6,000 in a very short number of years. And 10 years goes by pretty fast, Madam Chairman, as someone who has been here for 16 years it seems like yesterday. When I read this article I thought, oh my, that's incredible to think about that kind of a drop in enrolment in our schools, yet we still have the same configurations for our boards and what have you.


I'm quite curious about what the mandate is for the review panel and whether or not they will be looking at this at all, and also the time frame - when can we expect the announcement of the advisory group to them and when will the work actually happen in terms of the public consultations?


MS. CASEY: The member, I guess, raises two concerns. The first was a little light- hearted but I never did like the name of that paper, but anyway I guess we can assume that there is a history there with that name. But she also raises another important issue and that is the declining enrolment, and all boards are experiencing it, but some boards in some rural parts of our province more than others. I believe the overall decline for this year is about 1.8 per cent, which translates into over 2,000 fewer students. So it does present a challenge for boards; it presents a challenge for all our communities.


One of the things we have done to try to address that is recognize that funding to boards based solely on enrolment needed to be changed a bit because the programs we deliver, the transportation of students, there are some things that don't cost less just because we have fewer students. We have put together what we consider to be a hybrid for our funding formula for this current year, and some of it does take into consideration enrolment, but other is funding based on programs and services for students.


There's a balance there; we're hoping we can find a balance that works. This is our first tweaking of that formula this year and we will be monitoring that to see if, in fact, we can deliver the programs that we believe students should have an opportunity to have available to them and that we can still live within a reasonable budget.


The member asked the question in particular about the panel review. I've said this and I believe it's the way we want to go, I said the slate is clean. What I mean by that is that we are encouraging people who have ideas about how we can improve our public school system, regardless of whether it's about administration or transportation or programs, whatever it is, that they come forward with those ideas.


Some of the things that have been mentioned, of course, I expect and I hope will be raised and brought to the panel's attention. Our timeline is to have the announcement of the members of the advisory panel this month. I can advise the member that the groups that are represented there we think are a pretty broad range: the Association of Nova Scotia Educational Administrators; the Black Educators Association; the Council on Mi'kmaq Education; the Parents for French; Interuniversity Committee on Teacher Education; Leaders of Today; Nova Scotia Federation of Home and School Associations; Nova Scotia School Boards Association; Nova Scotia Secondary School Student Association; Nova Scotia Teachers Union; Nova Scotia Small Schools; Special Education Programs and Services Committee; Union of Nova Scotia Municipalities; and the Youth Advisory Council.


We believe that gives a broad spectrum in our population an opportunity to come through their organization or through their association to express their concerns.


We also want to hear from teachers, and I have personally written a letter to all teachers asking them to bring their ideas forward. There will be surveys that are distributed with questionnaires to parents and to students to get their input and their ideas. We do believe there will be some changes; we're hoping there will be some changes that will make a positive difference in our public school system. What it will look like at the end of the day, we don't know. We're not going into it with any preconceived ideas, we're going into it to find out what is working and build on that and what needs to be changed - some things may need to be eliminated.


The member spoke about shared services, and I used an example yesterday that we know that in each of our eight school boards we have a payroll department or payroll division, and within each one of those there are probably five, six - I don't know how many but five or six staff members and they're all using the same piece of software to generate the pay for all their employees. I consider that a duplication.


I don't think employees know or care much where their pay comes from, they just want to get it. But that could all be generated, I believe, with a smaller group of employees, who are currently doing in eight places, doing it for the whole province. I think that's an opportunity that we need to look at and I expect that that will come forward - I hope it comes forward because we have to look at efficiencies, and without compromising quality. So that's just one small example; I expect there maybe others that come as well.


The concern, and I commend the Strait board having been perhaps one step ahead of a number of boards in their public school delivery, and they've become very involved with the virtual school. Because we have a rural province and we have many schools where we're not able to have the staff in the school to provide the broad course selection students want, we've implemented the virtual school and the Strait board was one of the first boards to be active in that. The purpose of that, of course, is to give students in those rural areas the same or as many opportunities as we can. They should not be penalized for where they live, so the virtual school is a program that we have committed to and are continuing to develop.


We may hear from the review that we need to broaden that; we have 55 courses that are available to students through the virtual school. I think that's a pretty broad selection and in fact there are students in schools where they have fairly big populations that still don't have access to 55 courses, so we are using that as one of our ways to get programs to students the best way we can and give them the best opportunities possible.


Another comment, or maybe it came as a question from the member, had to do with administration. Wherever you have an organization you look at, and we hear it in the private sector and we hear it in the public sector - top heavy, too much administration. I'm hoping that people will take the opportunity, if they feel that way, to bring that to the attention of the panel. I guess I've said this before - everyone has an opinion, and if that opinion is not shared where it can make a difference, people can't respond to it. So I'm optimistic that people will take advantage, they will get their ideas through to us.


The panel's work is to be completed and a report to me in October. That will form the basis for an action plan which will influence and be reflected in our budget building for the next budget year.


MS. MACDONALD: I want to thank the minister for her response and for that information. I certainly will be encouraging residents in my constituency to participate in the process. There are a lot of young families with Halifax Needham with children in our public school system.


We have excellent schools in Halifax Needham, and one of the things I most like to do is to go to the schools, they are really uplifting and places where you actually leave with a big smile on your face after you spend some time in the classrooms. The kids are wonderful, the teachers are fantastic; and the volunteers and the support staff really care and they invest a lot of themselves.


I had the opportunity during Literacy Week to go and read to the Grade 5s at St. Stephen's Elementary School in the north end of Halifax. That was so fantastic; it was really a lot of fun. It was during African Heritage Month and I got to read the kids a book about Rosa Parks and not only did they know all about Rosa Parks, but these students knew about Viola Desmond. It was just great. It was one of the best hours of my time spent for some time, I have to say. I have great regard for people who do this work and to whom we entrust our kids.


I noticed that there is what I would call a substantial increase, Estimate over Estimate and Estimate over Forecast for Public Education Funding. I want to ask the minister if that is the line item for funding to the boards. I'm looking at the Estimates on Page 7.3 of the Estimates and Supplementary Detail, in that little box, Public Schools Education Funding, the very first line. If the minister could break that out a little bit for me and help me understand where the increased expenditures will be allocated.


One of the reasons I ask this, I've gone through - I've been looking at all of the department expenditures in the budget and clearly the two departments that are getting fairly substantial increases would be the Department of Health and Wellness, obviously, and the Department of Education and Early Childhood Development. These two departments are our two biggest departments of expenditure. Then, within that, certainly in the education field, Public Education Funding constitutes a certain amount of that. I see there is an increase there and I'm just wondering what that constitutes.


MS. CASEY: Madam Chairman, to the member opposite, just a quick comment about spending some time in the classroom. On your worst day as a classroom teacher, when somebody comes up and tugs at your skirt or your pant leg and says, teacher, I love you, all else disappears and it makes you feel really good about what you've done. They do bring life back. It is an uplifting experience and they are so innocent and uninhibited.


We were at the Early Years opening here earlier this week, and there were little 3-year olds and 4-year olds running around there and they were really not too interested in the formalities of it. This little fellow walked right up to the front and he said, is it almost cookie time? So it became cookie time. You have to understand and appreciate because they are so innocent and they are so delightful. I'm glad the member has had a chance to visit the schools and if you are ever having a bad day, that's where you can go.


Another comment based on something the member said is encouraging her constituents to respond to the questionnaires and the opportunities in the education review. I would ask all members of the Legislature to do that. We are in touch with our constituents all the time and if we can encourage them, let them know, encourage them and let their voice be heard because that's what will drive the decisions we make.


Moving on to the particular budget question - for those in the room - the member is speaking about an increase from $916 million to $962 million, Estimate over Estimate, on Public Education Funding. That's an increase of $45 million; that is going directly to school boards. Part of that is to cover wages, and part of it is what we are considering targeted funding. Those targeted funds are funds to support some of the initiatives that we've announced: the class size cap initiative, $7.2 million for that; the student support grants, $2.2 million; the early literacy initiative, $3.5 million; the guidance councillors, bringing them up to the ratio, $900,000; the special-needs support for students with complex needs, $1.5 million; the math strategy, $2.2 million; and continuous school improvement, $200,000. That comes to - I believe if you do the math it comes to $45 million.


I think it's important to note that every one of those dollars is targeted to help support and provide services and supports to students. It is targeted because we feel that with limited and scarce resources, we need to have some mechanism in place to ensure that the students in our classrooms are the ones who are getting the benefit from that. When you target it, really you take away some of the flexibility that boards might have to move money around.


We found with the guidance councillors that when we did our gap analysis to see how close our boards were to meeting the ratio, that there were three boards that had not achieved that. So we are targeting money to those three boards so that they can hire the guidance councillors who, according to the ratio that has been established, are needed in order to deliver the program and support our students. The difference there is, as I said, $45 million, all going into programs and services for students and going through the funding grant to the school boards.


MS. MACDONALD: Thanks to the minister, that's very helpful information to have, and that then brings me to the next two concerns that I would have.


One of the things that I think we all really care about and are concerned about is the growing rate of childhood obesity and the lack of physical activity for a lot of our children. Not so long ago, our caucus had this really quite outstanding presentation from a cardiac surgeon in our health care system who works at both the IWK and in the Capital District Health Authority, Dr. Camille Hancock Friesen, who the minister may be aware of. Dr. Hancock Friesen is the president of the Maritime Heart Centre and she is passionate about children's health and well-being. She is a leading researcher in this area and has done a very interesting program and a very interesting piece of research coming out it.


So there's a program that they have developed called Heart Healthy Kids (H2K). It is a peer mentoring program. They were in, I think, 10 schools throughout the Halifax Board - I think the Halifax Board - I know they were out in some of the suburban areas in the Bedford area. If I understand this program right - I hope I don't misrepresent it - it was voluntary; it was done at lunchtime; and it was done in elementary school. Every two weeks at lunchtime, children voluntarily participated in a program where they got to play and be active, but also learn about how the body works and learn about being healthy and staying healthy, and also about eating healthy snacks and what have you.


They had this lovely little video that they showed us where there were kids in the video who were talking about how important it was to have low rates of sodium in your diet and stuff like that. It was really quite interesting to see these young people; they are like little sponges and they had picked up all of this information and what have you.


The program went over, I think, a 10-week period or something like that, maybe longer, and they had a control group and they test - they evaluated or did an assessment of what kind of an impact, you know, a longer-term impact participating in this kind of a program in the school might have on the young people versus kids who didn't have the opportunity to participate in this kind of a program. They found that there was a significant increase in physical activity for the kids who participated in this program.


I think what Dr. Hancock Friesen and her colleagues would really like to see is they would very much like to see the Province of Nova Scotia adopt this program for our whole province. They've done some costing of that, and it is surprisingly a low-cost kind of program. The reason for that is you don't need a lot of high-priced professionals to be involved. It's, as I said, a peer mentoring program, and it certainly is one where you can get community volunteers who are champions for healthy living, active living, good nutrition and all of that kind of thing. Its approach is really - it's a play-based approach, so it's not an approach that is harsh or something that kids resist. It's attractive to children to participate in these kinds of things.


Having sat - and I know the Minister of Education and Early Childhood Development has also sat in the Department of Health and Wellness - so having sat in those chairs, we know the pressures on our health care system and the concern that, I think, we all have, and certainly people in our medical community, Doctors Nova Scotia for example, have around the need to get children more active. There is no better place to do that than in our school system - absolutely no better place. They are kind of a captive audience; they're there five days a week for a considerable part of the year. We could make better use of the resources that we have and the time when we have them, and during the lunch hour or after school is an obvious time to do it.


I'm wondering if there is any money in this budget to expand physical activity in the schools, if there is any opportunity to see a program like that be adopted province-wide, and how would we go about making that happen?


I think one of the things that concerns me about the current model is that an excellent program like this has to kind of go board by board. Perhaps an initiative like this could be one of those targeted initiatives done in conjunction with the Thrive! program out of the Department of Health and Wellness, which - although it is out of the Department of Health and Wellness - have involved a lot of other departments, including the Department of Education and Early Childhood Development.


I was wondering, is there any new infusion of money in this budget to improve the physical activity of our children - what specifically might be available for this H2K, the Heart Healthy Kids Program?


MS. CASEY: Madam Chairman, the whole issue of healthy living and physically active lifestyles is something that we have all become more aware of and more conscious of over the last number of years. The member is correct in that one of the best places to try to address that is in our schools.


Over the years we have included some mandatory courses that students must participate in; in fact we recognize that a number of years ago you could take a complete Grade 10, 11, and 12, and never have to be involved in a physically active program, so we made a mandatory program - so that in order to graduate every student has to go through that. Now that's only one, but we're hoping that that would excite and stimulate people so that they may want to continue those activities on into their own personal life.


We have healthy living consultants in each board who work with communities and with schools to promote activities within the schools, and that is targeted money. Every board receives the targeted money to have that consultant there who works and coordinates with the schools, with other staff, and with community groups, to build and foster and promote programs that contribute to healthy living.


We have, as the member would know - when she stops at our school next time, maybe go at breakfast time, because I was just amazed at the participants and the support and the excitement when students arrive in the morning, and for no fault of their own, some of them have not had anything to eat or they've had something that is filled with sugar and has them charged up for the day, or maybe they ate early, when the family was up, and then they didn't get to school for another hour - we have boards that promote that, and it's volunteers who come in and run those programs.


When you see the excitement on the kids' faces when they arrive - and I was able to witness this at Tatamagouche Elementary - the buses came in and the kids could hardly get their coats off and their bags down to get down to the cafeteria. It was a healthy breakfast they were getting. Some of them may not have had a healthy breakfast, and some may not have had any. The important thing is that it became a real social environment and a social activity for them, because not only did they get a healthy snack, but they got to talk about what happened at their house the night before.


When I talked to the principal there, I suggested, I said what an opportune time now to get the physical activity component in before they go to the classroom, because they were excited and upbeat. We know that research shows that when kids come into a classroom and they have had a healthy meal and some stimulation to their physical activity, they are in a better state of readiness to learn.


So all of those things that are happening we are trying to support. I would be interested in finding out more information about the program the member mentioned. Of course, through our Healthy Living Consultants, we have requests all the time for what is a program that we might work on in our community or in our school community. So we would want to take a look at that, and if it's one that we feel we can recommend that would be something I would make a commitment to do.


Of course, do we mandate a particular program to be delivered in all boards, or do we ensure that all boards deliver a program and make a program available? I think those are two different questions, but if we have an opportunity to share with some of the boards something that works, proven to work in Nova Scotia's schools and communities, then that gives us an opportunity to share that and perhaps spread that beyond.


The member mentioned Thrive! and of course that is a cross-department initiative. We have a representative from Education and Early Childhood Development on that committee. We have tried to focus on some of the health issues that the medical professionals are telling us are issues that will later on lead to an unhealthy lifestyle and possible disease. So having that inter-departmental - Health and Wellness, Community Services and Education and Early Childhood Development working together - we're all serving the same clients.

Another change that has happened in the Department of Education and Early Childhood Development is the moving over of the Early Learning Division from Community Services - that allows us to start targeting these kids before they ever get to school, and working with their families and working with their parents to ensure that they are aware of healthy habits for kids.


We talked about early identification and early intervention. The same is true - if we can help our kids learn some healthy habits about physical activity and eating and lifestyle, then they will continue. They need to develop it as a habit; it can't be something that somebody tells them. It has to be something that they understand and believe is right.


So in answer to the member's question, we have put $827,000 into boards, targeted for Healthy Living Consultants to coordinate the works within the boards so that programs like the member has mentioned can be implemented.


MS. MACDONALD: I want to thank the minister for her response. If memory serves me right - I don't have a copy of the presentation from the Maritime Heart Centre folks - I think they were saying that this program would cost about $80,000 province-wide. That boggles my mind, it's so inexpensive. They had kids wear pedometers for a period of time, and you know how kids love little gadgets and stuff like that. It is research-based; evidence-based. It's a very interesting study, a very interesting piece of work.


Perhaps afterwards, when estimates are finished, I could get from the minister or her staff a contact person in the department whom I might direct Camille to, to sit down and have a chance to do a presentation. I think you cannot but help be extraordinarily impressed by what they've done. It has been done with a lot of heart - if I can use probably a bad pun - but it also has the science behind it, so it's very good.


I want to conclude my questions for the minister with some questions around the allocation of resources in the budget for learners in the African Nova Scotian community in particular. The Ivany report - one of their goals, I've noticed, is to increase the employment, the rate of participation of members of the African Nova Scotian community, as well as the Mi'kmaq community, in our economy. If you look at the statistics, the participation rate in the economy is significantly lower than the provincial average.


The other day, I was saying that we know this has its genesis in institutional racism and the fact that our educational institutions have not adequately reflected in the curriculum the needs of the learners from African Nova Scotian backgrounds and the Mi'kmaq. I know we have in our department, we have these services that are mandated to address this and to improve and provide educational services. I noticed that the funding for the Black Educators Association remains the same, and I think it has remained the same for many, many years. It just strikes me that if we have an objective to improve the participation rates of individuals from these communities, then that means we absolutely have to improve their success rates in our school system.


I know that those rates are improving and have improved; they have improved the past number of years that I've been here. I remember, Madam Chairman, when I was first elected, going to high school graduations at Queen Elizabeth High School, for example. (Applause) I see my colleague from the south end of Halifax, Halifax Citadel-Sable Island, I guess a graduate of QE probably. I remember going to QE when I was first elected and seeing very few students walk across the stage of African Nova Scotian heritage, and going to the graduation at St. Pat's High and seeing maybe a few more - it seems to be the school of choice, perhaps, in the African Nova Scotia community on the peninsula - but nevertheless being pretty shocked at how few young people were graduating high school from the community I represent.


Knowing - going into the elementary schools and seeing some classes with 50, 60, 70 per cent in elementary school of African Nova Scotian heritage, Joseph Howe Elementary School, to be one example, and Saint Joseph's-Alexander McKay to be another, and then getting to the high school level and saying, where did all of these kids go? They're not graduating.


Now, I've seen a steady improvement in that situation, but still not, I think, where we would want it to be. So my concern is, are we targeting resources and improving the resources that are available and are needed to provide the kinds of really robust curriculum where kids see themselves reflected in? Are we doing enough to ensure that we have the diversity of staff in our system so that kids see themselves reflected in the staff? And how can we do that if we continue to freeze the funding for groups that work and provide those additional supports?


You know, we see this very large increase in funding in the Education and Early Childhood Development budget, yet I don't see any of it directed or targeted at this group. I'm wondering, why is that? What do we say to people who come from those communities? What do I say to parents in my community, from the African Nova Scotian community, about the funding that will support their children and their particular needs in our school system?


MS. CASEY: Madam Chairman, you know, the member speaks to a population that we definitely recognize needs support. As a classroom teacher, I often used to say - you were teaching your students and it would be a month that would be African Nova Scotian Month or African Nova Scotian Day - I used to say it shouldn't be one day or it shouldn't be one month, it should be every day of every month.


One of the books that my Grade 5 and Grade 6 kids enjoyed the most was Underground to Canada. It was probably the most revealing, and the best part of the education that I could deliver to those kids was in the form of that book because it generated so much - it gave a history, but it generated so much conversation and so much discussion about something that, in some parts of rural Nova Scotia where I was teaching and living, it was not common to have African Nova Scotian students in the school. So kids were not learning anything about another culture. I just love that book and I always want to refer to it because it was the best teaching tool I could have.


One of the things that I do want to mention here is that I've met, since coming in in October, with three very important groups that all are, in their own way, looking at supporting our African Nova Scotian learners. Those are the Black Educators Association, it's CACE - the Council on African Canadian Education, it is the Buddy Daye Africentric Learning Institute, and it is our own African Nova Scotian division within the department.


My sense in meeting with all of them is that all groups are well-intended, all groups want to make a difference, but they seem to have been operating in isolation. I've spoken to all of them, and they all agree that we need to have everyone in the room talking about governance, talking about their mandate, but most importantly talking about what they can offer and what they can do to help our African Nova Scotian learners, whether it's research, whether it's program delivery, whatever the support is. I'm looking forward to that because, as I said, all well-intended, all wanting to do their best, but let's look at being united in our direction as to how we move forward.


With respect to the particular budget questions, the Black Educators Association gets a grant of $836,000 from the department; CACE, which is an advisory council to the minister, $390,000; and the division within the department, which provides resources and services for all boards, is $5.1 million. The other category which is targeted is for student support workers in our boards. We target again - and I've spoken about why we target - $882,000 to boards to provide student support workers for a population that is in need.


Is it enough? No, it's never enough. What we want to make sure is that we know exactly where we're going with the dollars that we're investing, and to begin that we're looking at those different groups that do get funding, they do get grants.


Is that investment giving us the return that we want? That process has already begun with my meeting with all of those groups. The next one is all of the groups together, to look at how we can move forward in this province.


We have just recently announced the February holiday. I think it's important that the first day that is celebrated is Viola Desmond Day because that's, again, reflecting a very important part of the history of our province. But I go back to my earlier comment that it should not be one day, it should not be one month - it should be every day of every month.


MS. MACDONALD: Madam Chairman, I want to again thank the minister for the information. I'm wondering if the minister could also provide me any information about funding for the Buddy Daye Africentric Institute. I just want to say that the institute is physically situated in my constituency, and I was so pleased to see that happen. Of course, we all know that Mr. Daye was a very distinguished individual with a very distinguished career, including being the Sergeant-at-Arms here in our House of Assembly, the first African Nova Scotian Sergeant-at-Arms. His picture hangs outside this Chamber.


His many children went on to have distinguished careers as teachers and administrators and, in fact, his daughter Melinda is the African Nova Scotian school board representative in the Halifax Regional School Board, having been successful in the election that was held, I guess, two Septembers ago, and is very passionate about all kids, and certainly African Nova Scotian learners are a top priority for her.


I am interested in knowing what the allocation of funds is for the Africentric Learning Institute, and whether or not there has been any change or increase in their operating funds for the coming fiscal year.


MS. CASEY: Madam Chairman, it's something that I didn't mention, but I've been reminded by the member that there is an elected African Nova Scotian member on every school board. That has not always been, and it certainly does give a voice at the table. I've met Melinda at the Halifax board and I know that those members, as all board members, they come representing their constituency, but when they're at the table, they are part of the broader decision-making. I think that's progress that we've made.


The direct answer to the member's question - I mentioned that we had a $5.1 million budget within the African Nova Scotian division of the department, and $1 million of the dollars that are there are for the Buddy Daye Africentric group.


MS. MACDONALD: Thank you very much, Madam Chairman. I have no further questions for the minister. I just want to, again, thank the minister for the information she provided and thank the staff for being here.


MADAM CHAIRMAN: The honourable member for Pictou Centre.


HON. PAT DUNN: Madam Chairman, could I have permission for an introduction?




MR. DUNN: I just want to make reference to the west gallery - a former high school student of mine, Steven Stewart from Trenton High School, a friend. His parents live just around the corner from where I grew up and where my mother still lives. Steven has been working within the government circles for the past number of years and I just want to welcome him to the House today and ask the members to give him a welcome. (Applause)


I have three quick questions for the minister. Prior to that, I want to know if the minister needs a break for five minutes? Okay, we'll finish off.


My first question is dealing with guidance counsellors. I believe 17 guidance counsellors are going to be eventually inserted into three different school boards, and my question to the minister is: How many guidance counsellors are going into each individual board - what's the ratio for the three boards? And my second question: Are the guidance counsellors going into elementary, middle school or high school, or a combination thereof?


MS. CASEY: Thank you to the member for his offer to give me a break. We'll forge on.


I did mention the guidance counsellors - that we would be funding 17 new guidance counsellors. Three boards - the Annapolis Valley Board, Chignecto, and Halifax - to bring those boards to the ratio is our goal there would be five additional to Annapolis Valley, five to Chignecto, and seven to Halifax, for a total of 17.


The other question, those are targeted to junior/senior high schools, but we also recognize, based on some of the reports we've received, the need for students at elementary to have some kind of guidance. Generally it has been the classroom teacher who does that, along with everything else they do, but that's something we certainly will be looking at - but those are targeted to junior/senior high school.


MR. DUNN: My next question is dealing with civics, perhaps having a mandatory civics program in high school. The one thing that I think all members of the House run into when they're out and about, especially during election times when you're knocking on doors, is that there seems to be a lack of information with regard to actually what's going on in government across the province and across the country. Sometimes you're at the door and they're not sure if you're running for a federal seat or provincial seat or a local one.


Talking to a lot of teachers in the school system, they do in certain schools go out of their way and do as much as they can with regard to a somewhat civics program. I talked earlier in the estimates with the minister, suggesting that perhaps we could use additional credits in high school. You can pick up 24 credits over the three years, Grades 10, 11, and 12, and 18 are required. I guess, very quickly, my question is to ask the minister what her opinion is with regard to having a course such as that in high school - believe it or not, some students actually would like to have it.


MS. CASEY: One of the reasons that I've said we're doing the review is to determine what skill set and knowledge base students need before they leave high school. Then, are we delivering the programs that help them have that skill development and get that knowledge base?


I would be very surprised if civics is not high on the list of things that we need to add as a mandatory course at high school. We know we have integrated within various parts of our social studies curriculum the different levels of government and touch on those briefly, but I agree with the member that many adults who come into my constituency office - it's not just students - but many adults who come into the office do not know the difference between the three levels of government. Sometimes I'll meet them in the store and they'll say oh, are you back to Ottawa this week?


I think we have a huge learning curve here ahead of us. We know that the civics program - CIVIX - that I'm sure the member is aware of, last year went into our schools to help students understand the whole election process. Now the invitation is out and we've given approval for that to go into schools with the MLA.


But that is not dedicated, and I think the message is pretty clear that we need to make sure that if we're talking about a knowledge base that our students have when they leave high school, that civics is one of those.


MR. DUNN: Madam Chairman, I can remember my wife - a retired teacher from New Glasgow middle school, a language arts teacher - always would take a unit on civics, and throughout that particular unit they would have a model town council and she would have permission to take her class to the town council chambers. They would have their mayor and their councillors and they would go through an entire day in the council in the town. It was a very worthwhile activity and an eye-opener for a lot of the students to get them to realize what actually goes on.


My final question for the minister - and she's certainly going to like to hear that word, and when I ask it I'll be sitting down and I will not be standing back up. You mentioned earlier to the member beside me about, I think it was 1.8 per cent fewer students, 2,000 fewer students, so my question: Is that trend higher than the last couple of years, or less, or an average trend?


MS. CASEY: Before I speak to the enrolment decline, I do want to follow up a little bit on the civics. There are some teachers who take a special interest in that when it comes up as part of their integrated curriculum. I commend those who do give their students an opportunity to see council in action or to have members of different levels of government coming into their classroom. What we want to make sure is that all students have that opportunity and get that knowledge base before they leave.


With respect to the enrolment decline, this year is pretty consistent. We've been having enrolment decline for probably the last 12 years or more, but it has kind of levelled off at about 1.8 to 2 per cent. So it's not a huge increase in the decline, but it is a gradual increase in the decline.


MADAM CHAIRMAN: I would offer the minister the opportunity to make some closing remarks.


MS. CASEY: Madam Chairman, just in closing I do want to make a few comments. First of all, I want to thank all of the members for their questions, for the conversation that was generated by those questions and for the ideas of things that are all intended to improve our public school system.

I also want to thank the staff, Nancy and Frank, who are here and who have guided me through some of these questions with background information. I do want to thank all the teachers and all the staff in our schools who, every day, are out delivering programs to students, caring for their needs and who are guiding the student learning so that our young people will leave our high schools well-equipped to go on to the next phase, whether it's work, employment, or post-secondary. As we've stated and as we've told Nova Scotians, education is a priority for this government and we have made the commitment to reinvest the $65 million back into the public school system.


There are a couple of pieces that I was asked to provide for the members opposite and I will, at this point, table those. One of them was the member had asked for information about P3 schools and the expiry dates, so I would table that for the member. The other piece of information that I was asked to table had to do with the $65 million - and I will table this once I have finished speaking from it.


What we did was we knew when we were speaking about the $65 million that it was a real number. Based on the question from the member opposite, we went back to the department to get the numbers that would confirm that and these would be numbers from the budgets of the last three years. If I could just perhaps share that and then table it.


In 2010-11, the total budget for funding to school boards was $1,067,583,400. We move to the next year, 2011-12 where the total funding dropped to $1,053,224,100 and that was a change of $14,359,300 fewer to school boards. At the same time during that year boards were not funded for their inflationary costs, which totalled $14 million. So the total loss in revenue to boards that year from the direct cuts and from assuming inflationary costs came to $28,359,300.


We move on to the year 2012-13, another reduction in funding to school boards. This time, the funding was $1,044,283,100, which was a change - a decline of $8,941,000. Again, boards were asked to pick up their inflationary costs and they were also not funded for salary increases. So when you add those up together you get a net impact of $30,941,000.


Moving on to 2013-14, there was an increase in funding to school boards of $16,692,900, but there was also a clawback of inflationary costs. Boards had to cover $14 million, plus, again, they were not funded for salary increases, which was an $8 million hit. That's a total of $5,307,100 fewer dollars. When you add those three numbers up for those three years, Madam Chairman, you have a total negative impact on boards of $64,607,400. I would table that information.


MADAM CHAIRMAN: Shall the resolution stand?


The resolution stands.


We will take a two minute recess to allow the ministers to change position.

[11:25 a.m. The committee recessed.]


[11:28 a.m. The committee reconvened.]


MR. CHAIRMAN: Order, please. I call the Committee of the Whole on Supply to order.


The honourable Deputy Government House Leader.


MR. TERRY FARRELL: Mr. Chairman, would you please call the estimates of the Department of Health and Wellness.


Resolution E11 - Resolved, that a sum not exceeding $4,104,920,000 be granted to the Lieutenant Governor to defray expenses in respect to the Department of Health and Wellness, pursuant to the Estimate.


MR. CHAIRMAN: I will now invite the Minister of Health and Wellness to make some opening comments and, if he wishes so, to introduce his staff to the members of the committee.


The honourable Minister of Health and Wellness.


HON. LEO GLAVINE: It is indeed a privilege for my first time as Minister of Health and Wellness to discuss the 2014-15 budget for the Department of Health and Wellness and also the Department of Seniors.


Joining me today is Acting Deputy Minister of Health and Wellness Frances Martin, Chief Financial Officer Kevin Elliott. Also, Valerie White will probably be in attendance as well as she is the CEO of the Department of Seniors.


Over the next number of hours - and sometimes we know in Health and Wellness it can also be a number of days when we are looking at such an extensive budget. I do want to say right off the mark to the critics opposite for Health and Wellness for the Progressive Conservative Party and the NDP, we will provide all of the information from our department that we can make available to you to assist in your ongoing work on behalf of your constituents and on behalf of the province. What we may not have available to you right here, we'll certainly provide you with that in the days ahead. We all know how extensive the department is and therefore having everything sometimes at your fingertips is probably not possible.


I do want to say right off, the outstanding support with the hundreds of workers, probably over 500, that work in the Department of Health and Wellness and the Department of Seniors with the work they do each and every day - but also that welcoming and support when a new government and new minister come in and you hand the department a mandate letter about what you want to work to achieve during your time, really the privilege that you've been given to be the Minister of Health and Wellness and to work on policy and programs for the next number of years. I've introduced Deputy Minister Frances and Chief Financial Officer Kevin Elliott; their support to my work has been there each and every day and that I am thankful for.


The Department of Health and Wellness works to provide the strongest leadership possible right across our province to make sure that we have the delivery of care and treatment, and that we are in fact making sure that we're working to prevent illness and injury and that we're promoting health and healthy living at every opportunity. I'll speak more to those areas as I go along with my introduction.


It is no surprise that when you deliver the Health and Wellness budget that we're going to be talking about the largest percentage of the entire provincial budget. It has been that way now for a number of years, and we are certainly at about 41 per cent of the total provincial budget. And my goal as minister is to work to make sure every dollar of that 41 per cent is used effectively and efficiently and providing the best possible health care system for Nova Scotians.


Of the $4.1 billion total budget, 42 per cent of it, or $1.7 billion, goes to the District Health Authorities; in fact, that is actually a cheque you sign in the Department of Health and Wellness. It's one of those moments when your heart kind of skips a beat when you're signing a cheque for $1.7 billion, but I feel very strongly that when it does go out to the districts again, optimizing those dollars in the best interest of Nova Scotians is what I indeed have discovered over the last number of months. Of course, that $1.7 billion is, as we know, very strongly directly towards the acute care that will go on in our regional hospitals as well, of course, our health care centres across the province.


It did come as a little bit of a surprise to find the total number that work in the health care system. We're somewhere in the neighbourhood of 35,000 who keep our health care system running from Sydney to Yarmouth, Bridgewater to Amherst on a daily basis. Also, of that 35,000, we have 12,000 nurses, 2,000 doctors, 800 paramedics, along with hundreds of other health care professionals - our lab technicians, our orderlies, all the way to our clerical staff. Those were some of the really wonderful moments that I've been able to experience already as the Minister of Health and Wellness, to go in a facility and, yes, meet with physicians and nurses, but to reach across and be able to speak to the whole range of health care providers in a number of our facilities across the province and to be able to recognize the kind of work that they do each and every day.


One of the areas that came as no surprise - having a background as an educator and school administrator and a lifelong advocate of healthy living - was to arrive at the Department of Health and Wellness with many of the briefings to really discover, on a very strong factual basis, the general state of the health of Nova Scotians. This does weigh on me in a very, very significant way because with a province that now is identified as first or second in the country with the greatest amount, the greatest burden, of chronic disease, we know the impact that it has on that $4.1 billion that we are spending and, in fact, turning that tide and to set in motion policies and programs that will pave the way for a future that will be less reliant on dollars to look after our illness and our sickness to the level that we have.


People will get sick; we know that. We know that with Canada's largest percentage of population who are now seniors, we know that is the part of the life cycle where we generally will have the greatest number of visits, the greatest number of tests and procedures and calls upon our specialists to help restore our health. That is what our health care system does every day.


We have the aging population now. No longer can we talk about the 10- or 20-year plan to make sure we have everything in place; we are there now - 1,000 Nova Scotians, roughly, turn 65 each and every month. That reality now is one that we have to deal with. Some planning obviously has been part of the system for a number of years, but now it's there and we're actually doing all we can to keep pace with that reality.


When I read a statistic like one in three of our children in Nova Scotia is overweight or obese, that is a real challenge, a real dilemma, for the Minister of Health and Wellness, because to slow that down and work to turn it around will not be a four-year or an eight-year realization. That will, in fact, take considerable time to do. It is an enormous challenge because we know how related that fact of one in three is to the demands on the health care system.


Just this week, right across Canada, there was the launch of the Diabetes Charter. That connection to overweight and obese children and early onset of type 2 diabetes is now a very major part again, of dollars that we have to put in to care for a disease that is generally preventable. Type 2 diabetes is, again - in those early years we can do a lot around prevention.


Having that kind of statistic says right off, how can we move towards a sustainable health care system if we have that kind of, literally, an Achilles' heel that now is a constant demand on trips to the doctor, on trips to the emergency room, trips to the IWK to deal with the impacts of type 2 diabetes in early life.


With this year's budget, we will make significant investments and inroads in addressing the issues that I have just spoken about. When I became Minister of Health and Wellness back in October, my job was clear; I was provided with a number of clear priorities. One of these priorities was to ensure that health care is realigned so that we have the most effective and the most efficient system that we can realize in order to meet the demands of what I have just talked about - that is the needs of patients, families, and individuals first.


The task is a big one but I think our plan is one that can help us realize some of the efficiencies that are required while reaching towards even a higher degree of quality care in our province. We have to be able to utilize, maximize all of our clinicians, all of our programs, all of our facilities right across the province. By looking at this whole restructuring, this is what will be an enabler. It is not being done just as a cost-saving measure. We know we can streamline and we know that some monies can be saved on the administrative level, but really it is now to provide, right across the province, a smoother, a more levelling delivery of health care. Whether it's in Clare or whether it's at Roseway, or in Tatamagouche, in Sheet Harbour, all of our little communities, as well as our regional hospitals, will in fact end up doing more.


In order to say are we moving in the right direction, I believe you have to have measurable. I believe you have to be able to point to - here we were in 2012 or 2013, and in 2016, 2017 or 2018, we can then point to an improvement.


Having been here in the Legislature for the past 10 years, one of the areas that I have constantly been part of advocating and voicing my concerns for is families and individuals having a primary care deliverer. In some cases - in most cases, we would like to have a family doctor, a family physician.


We know that nurse practitioners are filling a very, very vital role in many of our collaborative health care centres; in fact when I see the chairman, who is the member for Clare-Digby, we know that a nurse practitioner in fact has been given one of the strongest primary care health roles on - he may need to correct me here - I think it's Brier Island. You go to Brier before Long, so on Brier Island, we now have a health centre, also the same building being used by EHS to provide emergency response, and it's one of those places that I can assure the member that I will be down to visit. I'll be down to take a look, but to have a nurse practitioner there now to be able to look after that primary health care is a better day for the residents of Brier and Long Island.


It's going to save many citizens that trip into Digby, because not knowing what is happening when you have symptoms that you know now are in fact telling someone that they need to have their blood pressure checked, they have something in their eye, they've had a fall, whatever it may be, having that opportunity now to go to a primary care provider is indeed a very, very strong measure of improvement in health care delivery.


That's a measure - that one example is good measure, and there are many others over the next number of years that we will look to. As I talked about the need for physicians - we have put in place a physician recruitment and retention team. I'm very, very pleased with the work that they have started out with and we're hoping by the end the April - they won't need more time than that - I believe it is April that we're hoping to have a report from this committee headed up by Dr. Celina White of Amherst. We may have to move into May because they want to provide a report that is very easily able to be actioned. That's what we will need - actions to make sure that the number of physicians that we will need for the next decade, and it could be 200 to 300, 400, depending on the number of retirements, how they phase down their careers and so forth.


One of the commitments in our platform was to provide and implement a tuition relief program for medical graduates. We now know that the cost of med school has really risen considerably over the past number of years and, as a result, we feel that this will be one of the tools that will help to attract doctors to our province - by paying $125,000 of their med school expenses. We will have that in the report for sure, but I feel, and the department of Health and Wellness feels very strongly, that by providing four or five strong tools in the tool box of recruitment and retention, we can do a better job.


I would say along with the need for primary care and physicians across Nova Scotia, especially in our small rural communities - and as I toured the province, that was one of the areas that was pointed out, you know, as a 70-year-old doctor in Neils Harbour would say, who is going to come here and replace me? And we hope that this committee will give us some of that insight as to how we will do that.


One of the other areas that all of us who have been in the Legislature for some time, we hear about, is wait lists. In particular, when you have one of those statistics that stand out across the country, having the longest wait list for hip and knee replacements, we know we have to act on that. To the credit of the previous government, they put extra money, $2 million, in for a one-time to increase the number of surgeries.


In 2012 the orthopaedic surgeons of the province came together and started to work on a plan, because they didn't want to have the worst statistic. They have provided a plan that the Department of Health and Wellness, enabled by government, will now go into play with this year's budget, where we will be putting $4.2 million this year and continuing forward with that amount. We will see in fact it does this - how strongly does it support the reduction of wait times?


We will also be announcing the details of a Chronic Disease Innovation Fund. As I stated, when we look at the negative, the downside of what we are facing in health care delivery in the province, we know that chronic disease needs to be managed better and an innovation fund will allow us to be able to put in place, with stakeholders, some very concrete, very direct measures, that will assist those to better manage chronic disease.


Again, if we have a lot of our GP appointments and our trips to the emergency dealing with a chronic disease, it is an enormous expense for our health care system. The hip and knee replacement surgery is really just one piece of a larger plan that is starting to be rolled out for a province-wide surgical plan. In fact, as we restructure health and have one provincial board with the four management zones, this surgical plan for the province will be able to be rolled out just a little easier and we'll be able to get people from one part of the province moving to another for a number of different surgeries, not just hip and knee.


Back a few years ago - the Leader of the NDP may in fact have been Minister of Health and Wellness at the time - we had a significant number of people go from the Capital District to Amherst regional for hernia surgery. It really caught everybody's imagination that we can do a greater amount of integrating and delivering health care in a more even fashion right across the province. So it speaks to where we are going in a significant way.


Also, development of the dementia strategy, this is one, when we roll this out, it will have a number of very key deliverables that people will be able to align the help that their loved one needs, that will be able to keep their mother or father or brother or sister, in their home longer. There is some lead work being done in our province by people like Dr. Ken Rockwood; Janice Keefe at the Mount, with her very practical measures has actually had experiments and pilots in homes and now is able to deduct the impact that it could make on a province-wide dementia strategy; Dr. Chris McKnight; and there are a whole number of others. We brought them together for that opportunity, to take a look at what we could do province-wide. These people want nothing but moving from knowing we have to do something to what and how it can be done.


One of the areas we also talked about in our platform was to designate inflammatory arthritis as a chronic disease and establish a working group. Again, inflammatory arthritis is that chronic condition, as we know, we as legislators who were here prior to the last election, we've had that opportunity to learn. In fact a former member of this House, now the mayor of CBRM, Mr. Clarke, has inflammatory arthritis. He came as one of those spokespeople wanting to have it designated because the designation does allow a different way of treatment, both from the general practitioner and the specialist who can work to keep it under control, to manage it and allow those people who are afflicted with it to manage their disease in a better fashion.


One of the programs that came in under the previous NDP government was the Thrive! program and it was a real refresh of what was going on and really captured the good work of Health Promotion and Protection. In that program we know there are very strong ways in which the health promotion and those kinds of activities can be captured and we will continue to implement Thrive! - it really is a good measure that will bring about a more active, healthier Nova Scotia.


We will continue to advance the Mental Health and Addictions Strategy as well as the development of an accountability mechanism with stakeholders. This has been an ask of all Parties in this House, that we have a stronger mental health program and addictions, both treatment and also prevention. We are doing some lead work and I'll reference a little bit of that as I go along. It's an area I've had a lot of personal stake in, in terms of what happened in the Annapolis Valley back a couple of years ago. The Department of Health and Wellness has responded and we are on our way with some very strong initiatives.

We will also, as you see in this budget, increase the age of eligibility for the children's dental program for 2014. That is the general checkup that is wonderful in terms of wellness, disease prevention. We know a dentist is a front-line health care provider and can pick up some diseases that a person of any age may not realize has to be investigated.


The district health authority tour was something that I could spend the hour talking about in terms of many of the great insights and the information that was received. It is one that I would highly recommend to any Minister of Health to be able to get in a relatively short time, a good working knowledge of the system that we have in place, also those who are on the front line each and every day, and it did give that kind of overview in very early days.


One of the things that you are hit with when you are dealing with the health care providers and going into facilities - our larger regional hospitals, our smaller health care centres - is we are looking after a tremendous amount of illness. We are looking after that true burden that you can see now when you enter a hospital. Patients are indeed sicker, some of them, their stays are long, and that becomes another big cost to the system.


Over the next number of years I hope to engage not just our health care providers, but all Nova Scotians to work on a personal commitment to building healthier lives, keeping wellness top of mind and, in turn, we'll have healthier communities as a result. A line that I will use often, it has a challenge to it, and that is: We are all responsible for our own wellness. We truly have to make that a very strong part of how we look at our personal health because, in turn, we will have a stronger health care system that will enable us to do the work when a Nova Scotian is ill and has come down with a disease that needs long and expensive treatment. That's what we need to be really having a focus on. The more that Nova Scotians can stay out of the health care system by being well, doing all they can to be well - we all know that life can throw a curve ball and we will get sick and we will have to count on our wonderful clinicians to help us recover our health, but if we can do more that will indeed be a great asset.


We know we need to change our health care system, not just to be more effective and efficient, but also to focus on better health outcomes for Nova Scotians. The tour allowed me to listen, to learn, and to engage in a conversation that I know will be significant for myself and for for the department, because I was fortunate to have the Acting Deputy Minister of Health and Wellness with me throughout the tour. I know her conversations and her observations are working to assist me, and the department, in a stronger way. When you can relate to what is going on in a little country hospital in Guysborough, or you go to Roseway or you go to Tatamagouche, you get some great knowledge about what is taking place.


Over the course of a number of years we will streamline administration by establishing four management zones, as well as a provincial board, in addition to the IWK. Really it is to focus on standards, quality of care, accountability, and financial prudence. I believe that for some reason we tend to take a look at administration, and we know that administration will enable us to make some savings, but I think a more highly integrated health care system, focusing on quality, will be the greatest outcome of what we are planning in terms of restructuring.


Many of our current programs really need to be modelled somewhat - as we saw across Nova Scotia - and that is on the cancer care model. The quality of that treatment, whether it is delivered in Sydney, and now fortunately in Yarmouth, in the Annapolis Valley, and there may be some other sites especially where chemotherapy can be delivered, we know that it would only be delivered with a high standard in place in each of those facilities.


Some of the streamlining and the change will be a wonderful enabler. It will be a major piece of work for the Department of Health and Wellness this year and I would like to just simply outline what are becoming very firm timelines for the department - in April or May we will establish a provincial transition team; in May the Department of Health and Wellness will publish a report that outlines simply what we heard on the tour as we met with the current health authorities and literally hundreds of health care providers, the current district health boards, and the community health boards; this Fall we will table legislation to set the framework for realignment; early in 2015 new board members will be appointed; and the final transition to the new board will take place April 1, 2015, in conjunction and in line with the 2015-16 budget.


I want to emphasize that this new structure will guarantee a very strong voice, perhaps even a stronger voice, for local communities. I have known about the work of the community health boards because I happen to live in a part of the province that has had some, what I call, vanguard work from the community health board. And across Nova Scotia - and the deputy minister will remember a few of those occasions where I literally came to my feet at a community health board meeting to applaud the outstanding work that is going on with our community health boards, and the difference that they are making in their communities. We gave them, and I gave them, the assurance that they will continue to be a significant part of the health promotion and prevention of disease in our communities.


Some of the work being done around mental health and what they are doing for our seniors was some of the most heartening moments during the provincial tour. So we will make sure through legislation they know their role, and keeping the 37 community health boards as a guarantee, as a commitment. If we go back and look at Dr. Richard Goldbloom's review of the first version of health care restructuring in the province, this is one of the areas that he pointed to, and that was starting to show the possibilities, but it needed a little more role definition and we will certainly do that this time around - the voice of the local community will be paramount.


One of the areas that the community health boards are currently assisting with - again it's a wonderful project - is the Municipal Alcohol Project, where we are working to make all of our communities take on creating a culture of wellness that clearly demonstrates that we have to work to make sure that harms from abuse and overuse don't show up on the steps of our health care system, in the emergency department and in our GP's office, that we create this culture of wellness and the MAP program. The Municipal Alcohol Project is designed to go into communities and get stakeholders and get advocates that in fact will talk about it, act upon it, and work through their communities.

To focus on wellness, we will continue to use the program Thrive! We know that it is already making some differences in our communities. The after-school programs are a wonderful initiative for our children to live more active lives and to be part of forging and building stronger health communities.


Changing the way we live and making healthier choices, however, will take time and collaboration. Government is leading by example by working together on an interdepartmental committee to ensure Thrive! is integrated into policies and programs right across government. This is one of the areas that I am very excited about. We have already had a number of occasions, as ministers, not to sit down in isolation but to the have the Minister of Finance and Treasury Board, the Minister of Justice, the Minister of Community Services, the Minister of Education and Early Childhood Development looking at some of the same issues from their perspectives, their departments, and how we can shape policies that will create those stronger, healthier communities.


So by working with stakeholders and communities to ensure healthy food choices in schools, more options for transit, walking, and biking in our communities, is an essential part of that healthier community.


We need to focus, as well, on our seniors. Our seniors are moving very quickly to becoming 20 per cent of our population - already we are at over 17 per cent. We know that our population, as it ages, presents challenges for the health care system. That's why I held a Roundtable on Continuing Care in January with a group of key stakeholders with a wide range of backgrounds, a wide range of clinical experience, and a lot of perspectives in helping to review.


We have a very good Continuing Care Strategy, introduced in 2006, and it has had a number of very positive impacts. It was time, however, for a refresh and a refocus. Ultimately we need to know that our most vulnerable citizens are safe and cared for. That is why in 2014-15 we will make the following investments in care for seniors. We know that one-third of Nova Scotia seniors live alone and less than 4 per cent of seniors live in a licensed nursing home; therefore we will continue to spend significantly in our home care delivery, which is now at about $235 million a year. To allow seniors to stay safely in their home is what we hear so often as MLAs, that, if at all, I want to stay in my own home.


This government will, yes, look at the replacement program that needs to be continued, but investing in new nursing homes will be very strategic, filling in some of those geographic gaps that do exist, but when you're already first or second in the country with nursing home bed capacity, and the wave coming at us, we have to look at care in the home and keeping seniors there.


We will invest $1.2 million to expand coverage of medical supplies for people at home. We will invest another $1.6 million so that growth and the caregiver benefit is funded, and resources remain available to help seniors.


We will also continue to make progress on both the dementia strategy and the palliative care initiative. I would say that we have an opportunity - and again, we are in the game when it comes to dealing with dementia. It is not just our government or our Party, it's just that we feel a dementia strategy now and harnessing the tremendous research, the clinicians who are available to our province are really extraordinary - many of them have done work across North America. But we have never really come together to make sure that we have a strong dementia program for our citizens for the future.


We know that it is one of those areas where we are hearing from our GPs, our geriatricians, that this - what I call a real affliction - is in fact increasing in our population.


We have some great palliative care programs in different parts of the province, but having a provincial plan so that our seniors or somebody with a terminal illness gets the palliative care they deserve - very shortly we will be announcing an initiative that is very specific to start, but a program that will continue to evolve over a period of time.


I'm looking forward to the creation of our first continuing care client advisory panel. Applications to participate on this board close April 17th. I expect, as well as the department, we will get some great insights from clients, family members, again, those who deliver home care. I think to get the strongest home care program is to hear from those who receive it and those who deliver it. I believe we can make some adjustments that will make this program very strong.


I want to focus for a little bit on the Department of Seniors. It is important that we think about our seniors outside of the context of Health and Wellness. This is why I am going to switch gears and spend a few minutes talking about the exciting work happening at the Department of Seniors. We are committed to ensuring the inclusion, wellbeing, and independence of seniors by helping them develop policy on aging and programs across government.


As I mentioned earlier 1,000 Nova Scotians a day become senior. In seven years' time when we do the next Canada-wide census, we know the statistic that will show up in Nova Scotia and that is a little over 31 per cent of Nova Scotians will be over the age of 60. That is a phenomenal statistic to look at. Currently we are at almost 18 per cent who are 65 and older, and we have about 14 per cent that are youth. Those two don't line up very well and I think we were told about that very strongly in the Ivany report.


With this budget we are ensuring investments in our communities are being made so that seniors, people with disabilities, and those in need not only get the services they require but they are also supported to live well. That is really the benefit of the grant programs. I think if we look at some of the grant programs that are currently there, and ones we will build on, they will help our seniors move from 60 to 80, 65 to 90. Many of us may realize that as a percentage group, centenarians are now one of the largest groups, percentage-wise, in growth in our population, which is really something to truly celebrate. I know as an MLA to go to an event - and many of us here have gone to that 100th birthday of a centenarian, and to find them in good physical and mental health and have their faculties is a wonderful experience for all of us, and I hope many of the new MLAs will get that opportunity.


I was recently at one of those celebrations and at 100 years of age it was one of those fun moments where I had visited her shortly before her 100th birthday. She was only 99, of course, and she was in hospital. I went to visit her in hospital and I said how are you doing? And she said, well I'd be doing better if the doctors would take my advice. I said well, what do you mean? Well, she said, circulation is not as good and I have a toe that won't heal and if they would just take off my toe so I can get on with life that would be a better day for me. So we know that we have some spunky centenarians out there as well.


The Positive Aging Fund Grant is helping not-for-profit organizations develop and deliver programs that promote health and wellbeing of seniors by encouraging them to be active in their communities, and many of us see those programs working out in our communities where you go down to the Lions Hall, the Legion Hall, and there is an active and engaging program for our seniors as a result of that kind of Positive Aging Fund. Again, many of our communities are working on the total wellbeing and fitness initiatives.


My department also administers the Senior Safety Grant in partnership with the Department of Justice. In my community I've seen this program work to ensure that seniors take all the measures to be safe in their home, safe as they go about the community, and I think working with local detachments of RCMP, Health and Wellness, and Justice, this is one of those real programs that we can put our finger on and say is making a real difference in keeping seniors safe in their homes.


The Age-Friendly Communities is the final grant program and this fund is helping Nova Scotia's municipalities to create and plan for greater accessibility in terms of our structures and services for our seniors.


Mr. Chairman, the Department of Seniors will continue its important work. There are many areas that I would like to go to, and hopefully the members opposite won't mind me being a little longer than I actually had planned, but mental health and addictions is one of those areas that I know many members in this House have spoken passionately about and I would truly be remiss in not talking about - under our previous government they did work on a mental health strategy, and we know that mental health and the use of prescription drugs are sometimes intertwined.


Nova Scotia takes prescription drug misuse extremely seriously. I know that Nova Scotia is not alone in this matter; we are now seeing a national initiative to be able to look at this from a country-wide perspective. It causes me great concern, both as Minister of Health and Wellness and as a citizen of Nova Scotia, that we have a high level of prescription narcotic abuse in our province.


As many in the House know, I work very closely with a young lady who has truly made a difference in our province, and that is Amy Graves, sister of a young man who died from mixing prescription drugs and alcohol. After this tragic loss Amy become somewhat missionary and, really, a tremendous advocate, and I've been really impressed with the knowledge she gained and the work she has done in our communities.


In Nova Scotia we have seen a staggering increase in the number of people going to withdrawal management for opiate dependency. This is a statistic which is alarming and will cause our department and myself, as minister, to make sure we change this direction. We have had a 112 per cent increase in withdrawal management for opiate dependency since 2006 - and that is an alarming statistic, but the fact is we are working now to do all we can, even though it's a great cost pressure we must work to help Nova Scotians become rehabilitated, regain the tools and strengths to manage their lives through methadone programs, and perhaps another that may come along in the next year.


When I became minister, one of the first things I inquired about was what was the province doing to address this issue. While more work needs to be done, the province is working hard to tackle what still remains, from all accounts, a growing problem. That is why I am in contact with people like Mark Mander, head of the Nova Scotia Police Association, around law enforcement and working with our district health authorities.


I'm pleased to say that working with the Department of Education and Early Childhood Development, one of my early requests of the minister to the department was to put in place a strong prescription drug education program in the middle years. This is where I believe we can make a significant difference. This will be launched this Fall and will help educate our youth about the very real dangers of misusing prescription drugs, which are too readily available.


We currently provide services and supports to youth experiencing problems associated with substance use, including prescription drugs, through our SchoolsPlus program and that's rolled out through our families of schools. It gives youth additional access to mental health and addiction resources.


Our province continues to make progress on the recommendation of the Prescription Drug Overdoses in Nova Scotia Working Group, including better information-sharing between our partners and expanded access to opiate dependency treatment. Now, with a national initiative underway, what we have started in this province will get greater credence and greater support.


The Prescription Drug Monitoring Program is available 24/7 to prescribers and pharmacists through eAccess, and I'm pleased to report that we are now working on a just- in-time system that I think will even strengthen what is one of the few prescription drug monitoring programs in the country, by the way. The take-back campaigns through the College of Physicians and Surgeons are being picked up with a national program and is another way of making a difference.

We have released the 2012 Nova Scotia Student Drug Use Survey, which captured data on prescription drug misuse, and the Medical Examiner's Office has committed to drafting a set of standards and guidelines for the collection of information related to prescription drug-related deaths, again something that has emerged over the last couple of years.


Also, in January of this year the Nova Scotia Government, through the Prescription Drug Monitoring Program, introduced a high-volume prescriber program. We know that we are talking about a legal substance, but again it starts with a prescription so there is now greater monitoring, perhaps where we can make a difference with the high-volume prescriber program.


Also note, just in the last couple of weeks we saw profiled the College of Physicians and Surgeons adopting a new policy regarding prescribing of monitored drugs by physicians in our province, so that you have to look at what is the use, the practice and the history of a patient in our province in terms of the use of narcotics.


All of the work mentioned above builds on our first-ever Mental Health and Addictions Strategy introduced in 2012; part of this strategy does address opiate dependency.


What my goals are, that I have stated at all nine community meetings that I participated in, along with Amy Graves, is to make Nova Scotia and Canada a worldwide leader in addressing prescription drug misuse, because we have gone down the path of being now either number one or number two in prescription narcotic use and changing that whole tide and picture is, indeed, an enormous challenge.


In closing, my minute of closure, again I want to touch on all of the services, programs, and the tremendous dedication and skill of thousands of Nova Scotians to deliver a high-quality health care system day in, day out, in this province. I find coming to work as the Minister of Health and Wellness is truly gratifying when I see the extra hours, the dedication to be time-sensitive in producing reports and briefings. I never feel alone in the Department of Health and Wellness with the caring and professionalism that is put in front of me each and every day.


MADAM CHAIRMAN: The honourable member for Hants West.


MR. CHUCK PORTER: Thank you, Madam Chairman, and thank you, minister, for that 20-minute opening statement. When I asked earlier how long the minister thought he might be, he said "about 20 minutes, unless I get on a bit of a tangent."


AN HON. MEMBER: Shouldn't have done the tour.


MR. PORTER: Shouldn't have done the tour, he says. Well that's okay. I would have been quite shocked if he had been able, of all members in this House, having heard him speak in the past, to have done anything in 20 minutes by way of an opening statement. So I'm not surprised but, at the same time, in all seriousness this is the biggest department in this government in this province, with a lot of responsibility, very broad, the issues never go away - more are probably created daily than ever go away at any time, and it has been that way for many years as we all know because we've seen the growth.


I also want to welcome your colleagues you have with you today. We had the honour of seeing your deputy and your chief financial officer earlier this week in the Public Accounts Committee and had the opportunity to question them on a few things. I will say right off the start your CFO is probably not going to be overly busy while I am on my feet. I don't tend to delve into the numbers so much as I do what the issues and concerns are of the people I represent and, of course, around the province.


In all of my years here to date I don't think there has ever been a change as much as one dollar after this process has been done, so the numbers are what they are and I know they are associated accordingly and, although important, and there are times when we'll talk about investments and allocations, I'm not going to be one to really break down things to the dollar. That is just generally how I go through the estimates, more importantly on the issues.


I want to start with something that has been of interest not only this past week, when we did ask questions about it, but since the election, I guess, along with your platform and your government's platform, the idea of the one board and, as we've heard a little bit more and learned a little more about the one board across the province you talked about - my notes here - four management zones. I'd be interested in hearing more about that. I know you laid out a timeline plan and the reports you expect and the legislation in the coming Fall. We tried to get a little more detail on it the other day, but it didn't really flow, and that's okay, I appreciate that as well.


You talked about streamlining administration and management services - I'd like you take a little bit of time, minister, if you would, to go into what that really means, and if you want to also go into it, based on some numbers, even though it doesn't come in until April 1st next year and we'll be looking at the 2015 budget and going forward et cetera, there must also be a cost of doing that business as you ready for that. That has been a number that we have been trying to find as well this week and there was - and maybe wrongfully - a number of $275 million that I threw out earlier after Public Accounts Committee today, and I might have even asked your deputy, around restructuring. When I looked back at that I thought that restructuring may be for all of government for a variety of things, maybe that wasn't specific to Health and Wellness, I don't know.


As I also said when I was asked in the media, you know that might not have been right. If we don't know the number, that's fine, just say we don't know the number, Maybe we don't know it, but as you move forward with a plan, and I think your deputy might have used the "Design Worker", some title like that earlier in the week as well, I'd be interested in hearing because I think all those who are going to be impacted in the coming months and year, of course - little less than a year now - are quite interested to know what this really means. I am sure you are working closely with those stakeholders in the unions and so on and all of the things that transpire.


I would like you, if you would, to describe what that design work looks like and where we are going - what is this cost of transition going to mean and that streamlining bit you talked about in your opening comments, minister? If you'd like to touch on that a bit as well and that might capture a lot of what we are leaning toward here - and I'll start off with that.


MR. GLAVINE: Thank you very much to the member for Hants West, and I am certainly pleased to have you engaged in the questioning and discussion. I know your professional background as a paramedic takes you to not just your work here today but maintaining a lifelong interest in the health care system and the health of Nova Scotians. I do have a great appreciation for that.


Yes, the work of restructuring our health care, as we know it, has gone on in other provinces in different degrees of bumps and so forth along the road. This in many ways set the course for myself, as minister, and our government to take a very slow, deliberate approach to the changes that will be unfolding.


Even when we had very difficult times in the first run at restructuring our province, there were also many strong features that were pointed out when they went from four districts back up to nine. But it is interesting that a lot of the collaboration that started within the four districts really continued onward, and that was one of the remarkable discoveries that I saw and experienced as I did go around the province. From that time on, and I think through initiatives in the Department of Health and Wellness, having a more integrated system for a population of less than a million was a chance at a higher quality of delivering health care, a more integrated, more efficient model.


I think when we talk about the big savings, and I want to get this out there very early in talking about this issue of restructuring, and that is the Ernst &Young report and the Leader of the NDP was the Minister of Health and Wellness at the time. I think the Ernst & Young report was one of those watershed reports that said as we look ahead we also need to go back and say restructuring wasn't all bad and produced great chaos and so on - there were many strengths in it, and as we go forward with shared services, merged services, and looking at four districts again, this should be a model for the future.


It's up to each government to take a look at a report like the Ernst & Young report and say, what are the things that we want to do and we feel will be in the best interests of health care and Nova Scotians? As we looked at that report, that's where we got the information and the desire for the restructuring.


Going to one provincial board and the four management zones will mean that we will have a provincial governance board and we will have a provincial operational board with a CEO for the province.


Outside of that, we know that we have almost half the population of Nova Scotia in one current district; that's just the reality here in Capital. We have about 440,000 people in the Capital Health District that, in fact, extends and embraces the member's whole riding of Hants West. We also know that Capital Health delivers the tertiary care, and they also deliver the highest levels of cancer care, a very strong dialysis program - the whole array of health care services along with a med school, a teaching school, and a teaching hospital. The focus is here.


But the focus of our provincial plan is not decentralized. Nova Scotians want as much health care in their communities, and especially in their regional hospitals, as we can put there safely, competently, and with the highest degree of quality right across the province. That's what the thrust is.


When we end up with this - it will be an ongoing, call it an evolutionary process if you wish - when we end up, we will actually have more in Yarmouth Regional, more in Amherst, more on the South Shore, more in Truro, more in Cape Breton than we currently have. Because at the same time as we're looking at restructuring, we will have a surgical plan for the province, a diagnostic plan for the province, a clinical plan that will roll out for the province. Already seeing some of those pieces, I know there will be more in those areas.


One of the lines that I used a lot on the tour was that every day a patient doesn't have to leave Yarmouth to come to the QE II, or leave Amherst and take the turn in Truro to come to the QE II, or come all the way from Cape Breton, that's a great day for patient care in Nova Scotia and it's a real strong day for a health system that extends across Nova Scotia.


What we will be doing with a very small provincial operational board is to work with leadership teams in each of the management zones. Management now know and have seen that we can have a smaller number of people. Currently - just to bring the House up to speed - we have a CEO on the South Shore who is also the VP of medicine; we have the VP of operations for the South Shore, also the VP of operations for Valley Health District, which is a fair-sized district; and we have the VP of finance looking after Cumberland and looking after Colchester.


We already see what can be done with less in terms of that strict management. What I started to see and what the deputy minister started to see, and those who came with us on the provincial tour, they said in each of the places we have been there are some real natural leaders in the health care system. Those are the people we need to allow to direct both daily operations and people who can look 10 years out and say this is what this area of Nova Scotia really needs and I'm prepared to work towards that. It is in each of our current areas actually delivering more services to those people, I believe that's what we're starting to see, to capture, and to hear - especially as I went around the province.


So we will have announced in late April or early May a transition team primarily led by a respected member of the health care delivery system in the province. That person will be announced, and they will have a team that will go to each of the current nine districts and help in that transition. Where can VPs cover off two districts or three is what we'll be ideally looking for, and who will be some of those natural leaders that we need to select and identify as part of that team? That is what the transition team will do and that will be an advisory team to the minister and the department as well.


This is why when we talk about costs, we can't really say exactly what the costs will be because we didn't put a template in the department and say to a transition team, you make sure we end up with four pretty identical kinds of leadership teams in those management zones - especially when you have almost half your population in one of those zones alone. It will need to look different than the western zone, than the eastern zone and the northern zone.


We can put three small districts that exist now - Pictou, Cumberland, and Colchester - and it doesn't equal the population at some of the tertiary care level that we have in Cape Breton. So that's why we went out to listen, to learn, and to say, what will be the best construct for each of those areas in the province?


There are a lot of people in the system that you just don't park on the sidewalk. That's something that I am very conscious of, as minister. I know the leaders in my local community when it comes to health care delivery and I know them in a good part of the Valley district and I'll respect that, and that's why it will be an evolutionary process as people can look to - some will be retiring, others will find other positions.


We will be announcing who will be those leadership teams. I think keeping some people in place to make sure the transition is smooth, daily operations are not seen any different from March 31st to April 1st or April 30th of next year, that those people who have been the guiding ones, the work people, those who analyze the needs of the system, those who daily troubleshoot - we need to keep those people in place while we make those adjustments. We're already seeing individuals who can work well beyond one district and, in fact, have initiated work across districts in conjunction with the Department of Health and Wellness, but many seeing that better patient care is when somebody leaves Halifax and goes to the Aberdeen and is only waiting 90 days for a knee replacement. That's good health care and that's what we need to do to a much greater degree in our province.


When I met with those who are planning a surgical plan for the province, I went away absolutely excited because I know it will help to address the wait times. The one thing, if we learn anything - and I didn't want to go here - from last week's disruption, when we have almost one third of our population 60 and over, they want zero interruption to their appointment, whether it be a lab appointment, a diagnostic imaging appointment, an appointment with a specialist. I'm part of the baby boomers, we're used to getting our way, and we want no disruptions in the health care - that was the message at the end of the day when I added everything up. Are there other issues to be addressed? Absolutely. But, at the end of the day, Nova Scotians want zero disruption to their health care. It came out strong.


In the meantime, as we work towards a one provincial view, again I was really in some ways maybe caught off guard by the number of people, and especially areas of the province that were hurt by the last iteration of restructuring - those in Yarmouth and those in Cape Breton. I had two full days of meetings where - throw it at me, throw your concerns, put it right to me, because I want to know them and I want to address them. But the number of people who believe we can strengthen our system by operating as one is very strong in this province.


MR. PORTER: I thank the minister for that answer. A few interesting points in all of that. One about the population - just as an example - you said around 440,000 living here. I would be willing to bet there are tens of thousands more, probably over 100,000 transient, in to work each day, that really if you looked at the numbers around midday here, it's quite substantial.


It is interesting when you start talking populations and coverage, but you are correct, and I don't think there's any member in here, from any Party, who would disagree, that Nova Scotians have an expectation that when they're sick they will be looked after; when they need a knee or something else, they'll be looked after, that they're on a list and that they won't be two years getting it. That's not unrealistic right now; that has happened. We know that, as do you from hearing and being in this position as critic for a long time and talking to those very people.


You talked a lot about the transition and the time and not being able to put a cost around that. I credit you for that. I think that's the right answer; that's an acceptable answer. There's nothing wrong with that answer in my opinion. We often delve down and try to say, oh no, you must know, you must know, but you're right, I agree with that - at least in my own opinion - I do agree that we are going to be a little different. There are four zones, population needs are different and so on.


I think that's probably still very early and very difficult to determine. I'm not even sure that you can do it in the one-year time frame you have. But you have a goal, at least you have a goal. I'll give you that; I'll credit you for that. I do hope along the way, because as someone who's been there - I'll make a couple of points here - someone who has worked in health care, someone who has transitioned the ambulance service where there was once upon a time, as you know, more than 50 services in this province into one. I worked for EMC and EHS and through the management side of that as well and in different areas of this province helping different organizations that existed previously transition into the EHS model and EMC model. I know that that's time-consuming, it's difficult, it's a lot of unknowns at times, there are probably costs you can't think about that will happen, unexpected unions - there are all kinds of things that will get in the way, if you will, or be part of and seeing the stakeholders and concerns and issues along the way.


One of the things that always stood out for me in this - it's no surprise, and I've said this in this House - I've been here a number of years now and this will be no shock to anyone that I have been an advocate for a lower number of district health authorities. I've asked many ministers in this House, in this Legislature, to please consider a reduction.


If you talk to the people, they want the same, but they have an expectation. They know that it costs a lot of money, but they want acceptable, timely health care when they need it. For the most part, most will tell you they get it. Whether it's a cardiac event and they end up in the QE II, they'll tell you, there was no wait time, I was treated great - boom, boom, boom I was in, I got my treatment and so on. There are many of those examples that exist.


One of the things that I noticed in my days working on the ambulance with these different district health authorities is we would come out of Windsor, Hants Community, as an example, and if we were transferring a patient to Halifax sometimes or to Truro or wherever it might be, we would have to switch something as simple as IV gear, tubing, et cetera because nothing was consistent. I do hope in part of this transition you're looking at procurement and standardization. If you look at an ambulance today, you can get in in Sydney or in Yarmouth or Halifax, the same cabinet, the same looking item, the same thing will be there and found.


How that has been standardized is a remarkable thing. It is efficient and I'm sure it's saving a great deal of money when you think about being standardized as it is. Did it take a lot to get there? Yes, it did. I'm not sure what the plan for the Department of Health and Wellness is working through all of that, but I do hope some consideration is given to that very thing. When you procure for the entire province versus an area, I'm sure there's a cost saving as supply and demand are usually cheaper when you're buying more, obviously, as we know.


Again, you talked about not having a real cost at this point and you'll work your way through that. I would be interested - you talked about a number of VPs who already hold one or two roles, or maybe more, in different areas and large geographical areas of the province - you again use the term "streamlining" in your opening comments around administration and management, is it . . .


MADAM CHAIRMAN: Order, please. I'd just like to remind the honourable member to please address your comments through the chairman. I know it's much more convenient to speak to each to other, but not quite in parliamentary procedure.


MR. PORTER: Thank you, Madam Chairman. It is pretty laid back in here, I will say that. Thank you very much and I guess having done it a number of times it becomes habit, but that's fine.

Through you, Madam Chairman, to the minister - how was that? It is more formal, unfortunately. I want to ask the minister about cost savings. Is there a predicted cost savings in the number of managers or administrative people in reducing the number of district health authorities in the province or do you see that not happening?


MR. GLAVINE: Madam Chairman, to the member for Hants West - one of the biggest areas that I think we need to address right off is indeed one that the member mentioned, and that is in procurement. Just since the Department of Health and Wellness has started to take a significant look at procurement from a provincial perspective, and also there is more that I believe we can do as Maritime or Atlantic provinces in that area, but to date, the department, across the districts, has realized about a $6 million savings. Again, I know the member also referenced the administrative piece and, indeed, we want to make sure that money saved is for making sure that we do have all of that acute care in place - as the member knows, it's so critical to have in place. So any dollars we can save and we can put into health care delivery, both in our hospitals and in long-term care, it is indeed pretty significant.


It was interesting as I talked with orthopaedic surgeons, and I was speaking very positively about the way they had come together to realize that as individual doctors with their wait lists, they were only going to probably make small gains, and again with the upward spiral of an aging population and in many cases not as healthy. They realized that individually they couldn't pull off great gains in wait times, but they also brought out the fact that we can save money. We have four or five or six different implants, for example that we use, right, different companies. Again, the savings we have made, to the tune of about $6 million, I believe is just the start of a whole area where we can go.


I'm pleased to say that as Minister of Health and Wellness, I'll be meeting in June just with the Atlantic counterparts. I know there is some changes going on in Newfoundland and Labrador, but the other Ministers of Health have reached out and said on many fronts we need to operate as an Atlantic or as a Maritime group and procurement becomes one of those areas. I believe we can make great strides when we start to purchase not for about a million people in Nova Scotia, but two million in Atlantic Canada. I think those are the absolute ways of the future, that as we work to a greater amount of electronic medical records we can actually enhance savings by reaching across our provinces.


But within our province as well, there is still work that can be done. Once again, I feel that operating as one board in the province, there will be this greater amount of integration, and doctors and clinicians will be able to move without the current constraints of having nine different districts.


I believe we've just started on the path of what can be realized in the procurement area. Also, I think as we share even best practices around some of the savings that some of our districts have been able to execute - I mean, it's pretty enlightening when you see one of our nine districts make about a $1 million saving in WCB premiums because they have been able to reduce the amount of sick time due to injury of staff simply by making sure they have been well-trained with lifting patients, moving about their facility and simply that workplace safety consciousness.


If we can put those best practices right across the province into effect, I think there are many savings to be made.


MR. PORTER: Through you, Madam Chairman, thank you to the minister. I agree that the Maritime procurement idea is a great idea. You know, the more we can work together and it creates - I was going to say more savings, but you know in health, health continues to grow. I don't know if "savings" is the right word. I think it's a realignment of spending, a restructuring, or whatever the right word might be - investing in other areas that has been of concern.


I don't know in the years ahead where the continued increases are going to come from to support that - I am hopeful that you will find ways to even things out, if that's the right term, by way of finances.


I want to move on of course with health; there's so much to cover. I want to talk about something that again is probably not shocking to you or to anyone else in this House when it comes to health care. It's a little bit to do with long-term care, but more than that, the single-entry system. That has been a real bone of contention of mine over the years, having seen the simplicity of how it used to work and then, all of a sudden, there were changes.


I've said this before - I remember when we would be sent to the hospital to pick a patient up to be transferred over to one of the local nursing homes, or one had to go - there was no long-term wait for this to happen, there was no great big long structure. All of those things were still there - the need was there, the facility was there, there was still a financial assessment done, but it seemed to be very quick.


This has slowed, unfortunately - terribly unfortunately - to a dead halt and then some, on some days. I certainly don't blame the people working in the system. They're probably overwhelmed with the way that it is trying to be done. There were times in recent years where we discovered there was one person doing the entire province at certain times of the year, with vacations or someone off sick and not replaced and what have you. You can just imagine the challenges that creates, and the difficulties.


What was worse than that in even more recent years was there used to be a time we could call the Department of Health and Wellness and we could ask where Ms. So-and-so or Mr. So-and-so was on the waiting list. I'm sure you took calls as a member in your constituency - we all have, from family members who have waited a fairly long time, basically saying is there anything you can do - can you even find out where we are on the list? At one time we could do that and you could almost ballpark it - not that there was queue-jumping, I don't believe that happened - but it did help by way of finding out and it did give them a little bit of comfort knowing that somebody was paying attention to this file for their parents or their brother, their sister, whoever it might be.


Now you can't even get that. Again, I don't discredit the people on the other end of the phone when you call, now we have rules in place that say let's not give any information out to anyone.


I also know that they'll pass the buck, if you will, and say it is Capital District Health now running it versus the Department of Health and Wellness. Well in all honesty, it's one and the same. There's still somebody managing this process on behalf of the Department of Health and Wellness is what it really comes down to. Regardless of it's managed through a district health authority or otherwise, it's still being managed on behalf of the Department of Health and Wellness.


I'm wondering, is there any hope in this area of seeing some changes that we can work? Even when family members are calling, they are being told nothing. Then they call us, as you know, and we make an attempt. It's a real struggle and most of the time, unfortunately, we're ending up with nothing and that's just not right. That is not right that we do not have the ability to be able to get answers for family members, for those waiting, especially those who have been waiting a long period of time.


I think the rules have probably changed around admissions and how you get entered, not only into the system but actually find your place in a home itself, whether you have family already living there. I mean I know there are a lot of variables but we are being told very little and sometimes nothing. I personally see that as totally unfair to those family members who are calling, our constituents who are calling us, expecting us to work on their behalf and being shut out.


Again I would stress, it doesn't matter to me if it is the Capital District Health Authority, or who it is managing it, they are doing that on behalf your department, on behalf of you the minster. To me this system has been a failure, and I've called it that in this House and I'll call it again today, minister, that system has been a real failure to those who have been waiting. Some have waited a long long time, as you know, and I know you've dealt with them as well.


Through you, Madam Chairman, I would ask you minister: Are there any plans to change how this current process is working, knowing you have challenges with beds and so on? Everybody knows that there is only one way, as a rule, and we know that is for a bed to open up in a long-term care facility. We know how that happens, but you need only read the paper every day to find out there is still a substantial amount of that happening. We'll get into more of it, but I'm just curious - do we foresee any changes around this system?


MR. GLAVINE: The member for Hants West and the Conservative Health Critic asks a really significant, a really important question and especially for families that are in some degree of crisis in terms of looking after their mother and father, and the best placement and also timely nursing home care.


Just in terms of a little bit of background to this question - we have over 7,000 nursing home beds in the province, about 68 facilities of nursing homes, and some other residential care facilities that would have some seniors in them as well. We are pretty well at what I call the break point for the number of nursing home beds, so I think now how we manage them and manage them vis-à-vis stronger care in their home in the community is really the challenge.


One of the developments in our province - and it's one of those areas that I'm certainly looking forward to meeting with other ministerial colleagues from across the country on is how they're looking at this issue as their population ages, but currently, on average, when a Nova Scotia senior goes into a nursing home they will spend 2.9 years there. If we were to get that down to two years, we would have placement of about another four to five hundred Nova Scotians each and every year in some of those 7,000 beds.


In many ways we have looked at the nursing home as that great place of comfort and care for our loved ones and seeing them there, in many cases, for a good number of years. In many European countries, especially the U.K., the average stay in a nursing home is nine months, so a nursing home is a place for the frail, very elderly, and literally last stages of one's life to get the very best of care.


How do we balance this out in our province now is one of the challenges that we are facing based on that very very strong fact and reality that people would rather stay in their home if they can get the care and they are safe and they've got some daily contact because, again, one of the facts about our population is that women, on average, live four years longer than men. Many women, many of our seniors, are also living alone and so the comfort of staying in their own home has to be supported by some kind of care that they can count on.


I just wanted to mention that at first because the availability of a nursing home and knowing when a family member will get in are really tied together. If we have more turnover of our nursing home beds, that would be an advantage. I believe there would be fewer Nova Scotians on that wait list if we had all home care needs looked after. This is why now rather than just a home support worker as that main feature of home support, there are a number of programs that are developing and some in place that actually support seniors staying in their homes.


We know that looking after daily tasks for a frail 90 year old, they need the lawn looked after; in some cases in our rural communities, they want the wood brought in. Those couple of little basic things have to be looked after so making sure they have the kind of programs that keep people in their home shortens the wait list. It is a topic and an area that I really don't mind having some exploration of, in terms of wait lists.


There is also another fact as well about getting on the wait list, and I know people are assessed for the wait list, but it is interesting that while there is a need there is also kind of, like I want to get on the list as a bit of an insurance plan. I want to make sure that I'm on the list for when I really need to go to the nursing home, or my son or daughter moves out of province to work I want to be in a nursing home then.


Because 25 per cent of people who are called, who we now have a bed for, refuse to go. So that list is not a true, full representation of that need for the nursing home bed versus the system that we have developed. This is why "home first" programs are there and developing, and then the nursing home bed becomes the place to give you the best care that our province can provide in latter years or severe dementia, Alzheimer's. Not everybody, but more are looking at in-home during early stage dementia, and we know that is now taking place because there are systems of safeguards and alarms that you can build in to a home and some of the great work that Janice Keefe has done at Mount Saint Vincent is, I think, unbelievably exciting.


They talked about some of their findings this year at the Alzheimer's breakfast and putting goals into a dementia strategy that a family can look at, and this is going to delay the time when you will be on a nursing home list. One of the goals that we all desire in Nova Scotia, and the member opposite has brought it out, and that is to have some degree of knowledge about - are you waiting three months, are you waiting six months? I would hope that maybe that is an issue that can be addressed.


I will tell the member today it is one that I will have a look at with the department, that we start at least to be able to offer some kind of timeline. A timeline also says to families, I know what I have to do for the next three months or four months, based on the availability.

One of the other areas that I do have the department looking at is, again, we sometimes have too long a delay from when somebody passes or moves out. This is another little bit of that phenomenon that sometimes will happen - a person will go to a nursing home, and it's not all about not liking the nursing home, but actually with some good nutrition, with better looking after, appropriate meals for them, getting maybe more nursing and physician care, you actually get some health restoration. As a result, some people actually look at going back home, and this does happen.


There are a lot of elements that are in the mix here, but I do want to assure the member opposite that he has raised a wonderfully important question and, again, it's one that I am prepared to take a look at.


MR. PORTER: Thank you, minister. That's great. That is an issue, as I've mentioned many times. I realize we will always have a wait list probably and we will never have enough beds because that just doesn't make sense, probably. I realize, as I think most family members do, that they don't expect to pick up the phone and call and say oh yes, on June 1st there will be a bed ready. They know that that detail is not available either.

I think what's important here in the review of that and looking, that there are a multitude of variables that fall into place by way of timeline. We have numerous amounts of data - you quoted some of it - that women live longer than men, for whatever reason that might be, that other facts and figures you gave about the time frame in a nursing home, 2.9 years. There should be something in there that says okay, on average, this should be the wait time. I can't see why that can't even be broken down into regions and areas because you know there's enough data over the years that has been gathered on how many people are actually coming out of said area - you know your growth; you talked about those turning 65 and becoming seniors; you know the percentage each year who are looking for care; and you also are doing assessments on all those who call.


I quoted a number in here the other day - it might have been Wednesday in Question Period in a question I posed to you, minister - 2,600-and-some on the waiting list as of the end of the year. You talked about 25 per cent right off the top refusing; I'm aware of that, too. Mom or Dad is not quite ready yet. There's a bit of an assurance there. We know how that works; we know it well. That would take that number automatically down to around 2,000 - 650 right off the top are gone from that.


Is that the real number? Well, let's say that it is. So again when I call and instead of being told no, I'm sorry, I can't tell you anything - well look, there's this number on the wait list. We know from the western end even or within the 100-kilometre circle that we've unfortunately built ourselves into in years past that there is the following number waiting and, on average, it takes this long to get there. It shouldn't really take a mathematician to break that down; it should be quite an easy answer.


Again, I'm not suggesting to you at all, or to the department or to the person doing the entry, that you're going to give me a definitive on June 1st that Mrs. So-and-so is going to move in. That is just not possible. We understand that, and I think most people do. But, you know, yes, we know that Mrs. Jones is on the list. We see her here; here's her file. All things being equal, going through all of the variables we're talking about, looking like it might be three to six months. It might not be - don't hold us to that - but we want to be able to keep you informed. If something changes, look, we're going to be happy to call you. None of that goes on, and I cannot for the life of me figure out why that is so difficult.


I do realize there are rules around confidentiality in this province and so on, but if you or I - which we have our authorization forms that we fill out and we sent into departments on any number of things, signed-off by that family member saying it's okay for you to ask, as my MLA, on my behalf and enquire on any issue, that should not be a problem. Again, I would state, nor should it be a problem, regardless if it's Capital Health-wide and you've transferred the work over to - they're still doing it on behalf of the Department of Health and Wellness. It's still the same ballgame - maybe right field versus left field, if you will, but it's still the same ballgame. It shouldn't really matter.


I appreciate your comments on that, the fact that at least you'll have a look at it - that's more than I've ever gotten in the past, I'll give you that. I think people would be happy if you are held to that and would indeed look at that because they're looking for a better way because it comes back to that piece - all they want is to be looked after.


I also want to talk about - as long-term care is something you've already brought up - with our aging population people do want to stay in their own homes. That's no surprise; we know that. We talk to them all the time as well, all of us do. I'm sure the chairman and every member in here does, or will in the years ahead, have these experiences. They're looking for those programs. You mentioned a few of them - even bringing in the wood. That's real. Those are real issues - and grass cutting and so on. Sometimes families can do that. There's a cost to that obviously, whether it's family doing it or having to hire somebody to do it. There are people living alone who don't necessarily have family here or are able to look after those needs for them.


The programs and investments that will be made and have been made - and certainly as this population grows older and those needs grow, I'm sure you and your department are assessing that and looking at that, and knowing that those numbers are going to grow as well.


We have heard many times what it costs to stay in a nursing home or in a hospital, like a Unit 500, where you're on a waiting list for the nursing home. It's really just another nursing home establishment. I don't know what the right term for it is, but that's it. While we wait - this is a holding area while we wait to get into the official named Haliburton, Dykeland, the Elms or wherever it might be. There are many of these around the province, as we know, and we are tying up medical beds, acute care beds while we wait. It has that impact of transferring downhill, if you will. The emergency departments have no beds and people are waiting in hallways. It's all relative. I've seen it over the years, many, many times over many years, as a health care provider. We've seen how this transition has happened, so it is time to figure this out.


We know the cost of being - $800 or $900 per night - in that hospital waiting versus the cost of doing business at home. Can you give a figure or even a rough figure - a comparative analysis - by way of even investing in programs or keeping someone at home with, we'll call it home care, a broad home care program, meeting the needs of what you've addressed in your opening comments and we've been talking about versus staying in a Unit 500 while we wait? The cost is probably - well no, it wouldn't be fairly close. It's considerably cheaper in the nursing home, long-term care facility than it is in the Unit 500s.


So my question to you and my thoughts around that are - Unit 500 at the Hants Community Hospital, to my knowledge, is always full with waiting patients. One goes out and one comes in, so it's never-ending - at a very high cost. Again, you look at savings or realignments - can you compare the two? How much difference is there truly in cost of having them placed or looked after at home versus them taking up that hospital bed?


MR. GLAVINE: I'm glad the member for Hants West continued to pursue this topic because it's one that is upon us now. It's also one in keeping with our Nova Scotia values of making sure that our seniors get the best care, whether it's in a nursing home or in their own home, or adaptation of a family member's home to accommodate a parent or parents. It's one that I believe is good now, but I think we can build on what we have and make it better.


One of the initiatives in the department is to really take a look at that assessment. The assessment has been very general - by saying, yes, you had a hip replacement and you've recovered well, but really now you qualify and you should be on a list for a nursing home, but meanwhile their recovery has been pretty good and they're doing fine at home. I think the assessment now needs to become one that says this senior has a more urgent need to be placed in a nursing home, while this person can perhaps, one to three years, with the right degree of supports in fact could stay in their home or in the community in some way.


That's why here in Capital Health we've made a very, very significant improvement in getting home support for people, keeping people in their homes and reducing the number of people waiting in hospital for long-term care. In the Valley District Health Authority there has been some significant improvement, but as I went around the province we found that they were maxed out, with a lot of seniors in hospital beds waiting for placement in a nursing home.


I think we have to go to that kind of - yes, you're at the red rating, meaning we need to get you in as quickly as possible; whereas you're in the amber - we've got the warning signs, the signals that we need to be getting you up the list to get in a nursing home; and there is a whole other group that, with the support in their home, they can remain there for quite some time. I think that part of the system can be improved upon and we can get the right people getting into a nursing home in a more timely fashion.


That's one of the areas that we can really see some improvement in the coming years as opposed to - I think we've moved along with that bit of a traditional approach where, you know, Mum's 90 now and really looking after herself is becoming more difficult, we need to get her on the list and get her in a nursing home. I think we balance this out with the kind of supports in the home with those who have a higher degree of urgency and also to keep that ability from patients who go in with something acute to Hants Community Hospital today and perhaps we can now go through some restorative care.


I would have to say that in a couple of the facilities that I visited, such as Digby General and Springhill Hospital, where they both have restorative care programs, it was amazing to hear of the work and see the work in action. They'll take a senior who has had some kind of acute medical need, went in hospital and it was looking for sure like that's the person we need to get into a nursing home, but with this restorative care of helping them regain greater amounts of ambulatory ability in their home, helping them manage in the kitchen again to prepare a meal, going through all that daily routine and seeing them become stronger, gain the confidence to say, yes, I think I can go home, to actually going home.


I see a lot of things in the works that are starting to make a difference. and I think the more we do of that through our health care system and get the right people in a timely fashion going into the nursing home, and families having some degree of knowledge about what that timeline will actually look like, so with the amount of monies that went into the budget last year for home care and the amount that are again this year, I think we will make a lot of significant strides.


MADAM CHAIRMAN: Order. The time allotted for the consideration of Supply today has elapsed. I will have a short recess at this point to wait for the Subcommittee on Supply to finish.


We will resume shortly.


[1:24 p.m. The committee recessed.]


[1:43 p.m. The committee reconvened.]


MADAM CHAIRMAN: The Committee of the Whole on Supply will come to order.


The honourable Deputy Government House Leader.


MR. TERRY FARRELL: Madam Chairman, I move that the committee do now rise and report progress and beg leave to sit again.


MADAM CHAIRMAN: The motion is carried.

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


[The committee adjourned at 1:44 p.m.]