HALIFAX, THURSDAY, MARCH 29, 2007
COMMITTEE OF THE WHOLE HOUSE ON SUPPLY
MR. CHAIRMAN: Order, please. We will continue the estimates of the Department of Health.
The honourable member for Glace Bay.
MR. DAVID WILSON (Glace Bay): Mr. Minister, I know you are familiar with - in December 2006 of last year, there was a bulletin sent out to pharmacists from the Pharmacare Program and they were notified that a maximum allowable cost change would become effective April 1st of this year. It's the maximum allowable cost and special pricing and procedure that is being revised, as of April 1st. It came as quite a surprise to the Pharmacy Association of Nova Scotia and the board and the members of the association as well. They are worried about reductions and pricing that would come at the expense of community pharmacies, and that these cuts would hamper the ability of some community pharmacies to even remain viable.
I know our caucus, and our caucus members, have heard from a number of the members of the Pharmacy Association of Nova Scotia who are concerned about the future of community pharmacies and are concerned about the government. They are opposed, as a matter of fact, to the government legislating rather than negotiating with their association. Now I understand that there is about to be some sort of a delay or a further extension of that date that has been announced or will be announced. I am just wondering if you would take the time now, first of all, to explain to us exactly what is being done with the maximum allowable cost and why that issue is being visited and the revisions that were planned?
MR. CHAIRMAN: The honourable Minister of Health.
HON. CHRISTOPHER D'ENTREMONT: Mr. Chairman, again, it is wonderful to see everyone here interested in the estimates for the Department of Health. I want to, again, thank my Deputy Minister Cheryl Doiron to be here, as well as my CFO, Alan Horsburgh.
MAC pricing is an issue that has been under review for some time. The member for Glace Bay is quite correct that there was a bulletin that would have been sent out through the - there was a pharmacy newsletter that would have been sent out a number of months ago, talking about changing the maximum allowable cost for the pricing of pharmaceuticals, specifically the generic pharmaceuticals that are being purchased through the Nova Scotia Pharmacare Program. So the Seniors' Pharmacare Program at this point or is the (Interruption) Okay, the Seniors' Pharmacare Program.
It is our estimation, by looking at other jurisdictions that have done some of the same things, in this particular case, we looked at what was happening in Ontario. By looking at the same thing here, we would look at a savings to the Pharmacare Program to somewhere near $2 million. Basically, what it does - from our investigation, from our discussions, what we have been able to find out is that most pharmacies, especially the ones that belong to a chain or the larger groups, get a bonus on their purchase of generic drugs. So if you are a Shoppers, if you are a Pharmasave, even a Wal-Mart or what have you - you would be getting a bonus for purchasing bulk sums of pharmaceuticals.
So it was our estimation that we could save about $2 million on changing that because we feel, also, that through the dispensing fee, that pharmacies are being duly compensated for the sale of pharmaceuticals through the Pharmacare Program.
Once we made the industry aware that this was what we were thinking about, of course there was a bit of kick-back and the industry wanted to have some further consultations on this one. What we have done is that this was supposed to come into play, I believe at the first of April and what we have said is that because we still need to do some further consultation with the industry that we would take some more time. So we haven't necessarily put it off to a set time but until our consultations are done - it could be two or three months down the road that we would look at implementing this at this point.
I know the deputy has had the occasion to sit and discuss this with the Pharmacy Association, I can't remember the exact name of the association, but it would be representatives of the large pharmacies across the province to see what their thoughts are, maybe how this could happen or be done differently. Ultimately, we still feel that because of these bonuses - I mean this is over and above wholesale prices, this is over and above dispensing fees - that we can look at some savings for that Pharmacare Program in which we wouldn't have to increase fees year over year, as we have been doing. So we are trying to find savings within the system itself.
That is basically the answer but also I would like to table also some questions that we had from yesterday and I know there will be some copies going to the Opposition members on, I think it was some questions around the Dalhousie Medical School, the dialysis satellite in Berwick for the member for Kings West. There was a chart here for Nova Scotia family doctors, medical graduate retention rates, recruitment retention of rural doctors, et cetera. Ultrasound wait times, I know the member for Halifax Needham asked that question as well. Anyway, there is a good breakdown of the information that was requested from us over the last couple of days of questioning.
MR. DAVID WILSON (Glace Bay): Mr. Chairman, I appreciate the answer of the minister. He referred to the situation in Ontario. It was Bill No. 102 - I think was it in Ontario - that provided the Ontario Government with access to significantly reduced generic drug prices. I understand how you can't ignore those reduced prices and, as a result, you are considering going ahead with this policy change so that you can get the same pricing that would be available to residents in Ontario. I understand that, but I think the minister is reasonable enough to see that the possibility, that could come at the expense of community pharmacies, which are the smaller pharmacies which are located in rural areas in Nova Scotia. These sometimes are perhaps the only pharmacies that are located in these rural areas in order for them to remain viable. It's not only the community pharmacy that offers a wide range of services, they don't only enhance the quality of life, but they also save, I would suggest, the health care system time and money, because you would often seen patients who are going to pharmacies in their area, especially in rural areas, who are getting their blood pressure taken or glucose readings are required, and pharmacists, themselves, are handing out all sorts of information that patients need on self-medication and so on and so forth.
So I would think that it would be a significant worry, at least to the minister, that perhaps if these smaller pharmacies are at risk and what would happen to them. So I'm asking the minister if, indeed, when you say that you're going to do an extension of time on the deadline here, are you going to consult on a direct basis with those pharmacies and the people who are involved?
MR. D'ENTREMONT: Mr. Chairman, to the member for Glace Bay, no, absolutely, we will be consulting with those pharmacies. Of course, there's a main association, the Pharmacy Association of Nova Scotia, that we have been undertaking discussions with, that are representative of some of these smaller pharmacies across Nova Scotia. We will not put pharmacies at risk or pharmacists at risk either. What we're really trying to do is make sure that the Nova Scotia taxpayer is paying for the actual costs of those drugs. We again feel that through the dispensing fee, from the paying of the actual wholesale price, that pharmacists and pharmacies are getting duly compensated, but also by doing this what we feel is that it allows all pharmacies to be charging the same amount for those kinds of drugs.
So, really, what we're also doing, is helping out some of the rural local pharmacies by levelling the playing field, because really what's happening to some of these larger
pharmacies, like Wal-Mart - I don't like to point fingers really, the Wal-Marts, some of the Lawtons, but not all of them - some of the other bigger pharmacies are using pharmacies as loss leaders because they have enough flex within their system in order to drop the prices so people get a better deal when they go to one of these facilities rather than their local pharmacy. What we're trying to do is level that playing field so people can go to the local pharmacies knowing they are getting the best possible price for their pharmaceuticals. So I think there is sort of a little bit of a give and take here, and we'll continue our discussions with the pharmacies and the Pharmacy Association to make sure that no pharmacist will be at risk.
MR. DAVID WILSON (Glace Bay): Mr. Chairman, I don't have much time left in my segment but I did just want to continue along the line of the community pharmacies, because when the minister does talk about those larger pharmacies and so on, we know it's the smaller pharmacies, the community pharmacies that are perhaps open more hours and are available at more appropriate hours to customers and so on. The services that they're offering, as I mentioned, they don't only save the health care system money, but I would submit that it can be argued that they save lives and they also promote a healthy lifestyle as well. So, the proposed changes in the reimbursement model for generic drugs that you're talking about, if they put many of those services in jeopardy, along with other services that are offered as well by rural pharmacies, then if they're not available, if they're not being provided by the pharmacies then, ultimately, they're going to have to be provided by government agencies and government services, and that's going to add to the overall cost of the health care system.
I don't think, to be fair, the people whom I've talked with anyway - and I did have a pharmacist from my area in Glace Bay come in and spent about an hour and a half talking to him to get an idea of exactly what was happening here - I don't think, they are not averse to the effect that this is being, as I said, that you're visiting this area and that you're taking a look at it, they want to save their customers costs as well, you know, they want to do that. What they are concerned about is - I don't know if there has been enough negotiating or consultation previous to this coming up on April 1st, and they're concerned about that, so if these pharmacies are going to survive, again, especially in rural Nova Scotia, then I think it's incumbent upon us right now and on the government to make sure that we're not pitting rural Nova Scotia against urban Nova Scotia, small pharmacy against big pharmacy. As you said, we're doing it overall so you can have that level playing field that has to be there. So the only one who's going to benefit, of course, is the consumer in Nova Scotia, and that would be to the benefit of everybody.
I think they've made their point that they are at a very critical period right now as to whether or not they're actually going to survive in the marketplace, and this is going to have a dramatic effect on them.
So I would just ask the minister in closing if, indeed - and you've said and I appreciate your answer, that you are going to consult with pharmacists across the province but I'd ask if those consultations have taken place yet? [Interruption] That's right, there are privately-run pharmacies in Nova Scotia as well, but not just - let me put it this way, I guess I'm not sure of the situation, but there's a pharmacy association of Nova Scotia. Would the minister make an effort and would the department make an effort to contact all of those stakeholders, whether it be private pharmacy owners or members of the pharmacy association, to consult with all of them at one time or another before any further changes are made?
MR. D'ENTREMONT: Thank you very much, Mr. Chairman, and to the member for Glace Bay. We will be consulting with everybody we possibly can during this process and whether it be the deputy minister, whether it be the division of pharmacy or the pharmaceutical division in the department, we will be getting out as best we can. Plus there is always the option to send in an e-mail and make sure that we understand their side of the story and how they feel it should be working. We'll continue to do that to make sure that influences the information that we'll be bringing forward hopefully soon.
Again, what it boils down to is that most pharmacies - 98 per cent of the pharmacies in Nova Scotia - belong to larger buying groups and they are receiving, from what our studies look at, about 30 to 50 per cent bonuses on the purchase of those pharmaceuticals, which is only about one-third of the total sales are pharmaceuticals within those pharmacies.
So, again, we'll continue to work with that group and make sure that there is a level playing field for all pharmacies in this province.
MR. CHAIRMAN: Order. The time has expired for the honourable member for Glace Bay.
The honourable member for Sackville-Cobequid.
MR. DAVID WILSON (Sackville-Cobequid): Thank you, Mr. Chairman, and again thank you to the minister and his staff. I have just a few minutes and then I'll be sharing my time with some of my colleagues to try to get some questions in relation to constituent issues in their respective areas throughout the province.
I'd like to also first thank - I know there are three members, the minister has two staff here, but I'm sure, as he's well aware. I'd like to thank all those behind the scenes who have been involved in this process, especially our researchers in our caucus office who have worked very hard to try to get some of these issues across to try to get some clarity. So I want to thank them for that.
I'd like to just start a little bit on the staffing and wage issues around home care, especially around the guaranteed hours that some of the facilities have tried to implement to try to attract home care support workers and the variety of professionals they need. I know there are a lot of different titles for them so I think if you move around the province, they are called different things - I think they're trying to get under one banner. It is around the continuing care assistance, with the guaranteed hours they're trying to attract. I believe right now there's an issue, there's a conflict or a misunderstanding between what the Department of Health will pay and what the facilities feel they should be receiving from government. So I'm just wondering if the minister could inform us of changes to the funding mechanism for facilities in the province around those who are starting this guaranteed hours for their workers, what can we see in changes from your department with the relationship with that issue?
MR. D'ENTREMONT: Mr. Chairman, I welcome the member for Sackville-Cobequid for taking the floor once again. The whole issue of guaranteed hours - especially in the range of home care, I think - was a great idea because we really want to have top-notch employees being able to provide services to Nova Scotians. The challenge that I think we've found, and specifically around the last Northwood contract, is where this really sort of came to the forefront, where there has been some real challenges in scheduling the hours for each individual home care worker. Where the guarantee was, I think, eight hours a day for those full time employees and there was another guarantee of six hours and then there was another guarantee depending on how much experience you had and exactly where you fit within that contract.
The challenge that I think that Northwood found was that they really could not schedule around a lot of the cancellations, a lot of the problems they were running into. So instead of getting that eight hours, they were getting six because maybe they had to sit on the side of the road because they had that hour scheduled in, but, because of circumstances, whether it had to be having to go to a doctor's appointment or maybe something else happened, that visit was unable to happen. So there ended up being some gaps in the way it was done. As a department we pay the service so in this case, Northwood, based on the hours of service they provide, there's a gap there. Because they were guaranteed eight hours, we were only paying for the service that was actually given, which would have been six hours, so all of a sudden has started to accumulate a number of hours of monies that we have not given them for the service they haven't done. So it's been a bit of a challenge.
So what we've done - particularly in this case, the Northwood case - is we've helped fund some of the deficiencies there, but also work with the union to try to devise a better scheduling system so we can be more reactive to the possibility of cancellation by either the client, or even the service provider, and being able to truly guarantee those hours. I don't know if we're going to succeed in that, because a lot of things end up being unforeseen. Maybe there has to be more realization of a rolling guarantee, that over the course of the week you are going to be getting an X amount of hours because the daily one has been a
challenge anywhere we had tried it, even though it's something that we would want to strive to have.
MR. DAVID WILSON (Sackville-Cobequid): I think one of the reasons why I bring this up is because with the government's plan, over the next ten years, recruitment is going to be essential. If you don't have the individuals there to work, you could put 10,000 beds in and it's not going to help, because it's not a bed that takes care of these individuals, it's workers. For example, I believe it was Northwood that did this guaranteed hour approach, and I think they were able to hire 17 workers quite quickly. I think it's an approach government is going to need to look at, especially if they want to be successful in their plan over the next several years. I encourage you to continue to look at that issue to hopefully come up with something that's agreeable between the operators and the department.
Along the same lines with wages, we know there has been quite a bit of controversy around the discrepancies between the hourly rates for those residential care workers, continuing care workers or personal care workers who work within a private facility and those who work in the acute care system. There has been somewhat of an imbalance on wage parity. That has always been an issue; I think it will continue to be an issue until those individuals, those professionals who work in our province who do the same job, maybe in different settings but do the same job, should get paid the same wage. We know that not only in health care providers, Mr. Chairman, to the minister, but in any aspect of government. So what is your department doing to close that gap between those who work in acute care settings run by the government and those in the private sector?
MR. D'ENTREMONT: Mr. Chairman, just a couple of things to the first question and then I'll go to the second one. There has been a number of dollars put in this year's budget that are over and above the Continuing Care Strategy when it relates to salary increases and guaranteed hours; about $1.4 million in this year's budget. There's also an adjustment on the travel rates for our home care workers and personal care workers which is about $1.1 million and, again, this is outside the Continuing Care Strategy and the monies that are being focused in that direction.
Levelling of the field, I think, is really important to make sure that we have equity amongst the different groups. They all provide the same service - and it is a phenomenal service, and we thank them every day for the work that they do - but we also have to - I think through contract negotiations we will continue to try to level those fields as best we can because they should be remunerated the same or close to the same as possible, depending on the regions of Nova Scotia that they work in.
MR. DAVID WILSON (Sackville-Cobequid): That's got to be crucial, especially because what we see now I think is the difference between many of them who work in rural communities and those who work in the more central areas like HRM or the Cape Breton Regional Municipality. So we have to ensure - especially our health care workers who are
in our rural communities, we want them to stay there, and we are encouraging more to go there to work - that those wages especially are at par with their colleagues across the province.
I would be remiss if I didn't mention, of course, some of the frustrations among my colleagues and the colleagues of the chairman, or some of the paramedics in the province. Definitely, we have come a long way since I started my career, positively, and I know the chairman would agree with me on that - but they do have some frustrations, some revolve around the wages and what they feel is parity with colleagues across the country, especially with similar- sized provinces. That's a bigger issue, I think, that I will continue to bring up with the minister.
One of the main areas that I have been hearing a lot about from paramedics recently is their frustrations around what their job entails and what their shift actually is made up of. Currently, a large portion of their shift is spent sitting in an emergency room, either here at the QE II or across the province, with a patient on a stretcher. Mr. Chairman, to the minister, I know when I first started as a paramedic, for me to bring a patient, say, to the old VG Hospital or the old Infirmary to wait maybe 15 minutes or 20 minutes was long. I can say now that's not the norm. Four hours, five hours, six hours, paramedics are waiting with a patient on their stretcher before they can transfer that care over to the hospital, to the nurses and the doctors in the emergency room.
What a waste of a resource. These are highly trained individuals. We have said in this House that they have been recognized as one of the best services in the country, if not in North America, and here we have them, for the majority of their shift, sitting in emergency rooms, which leaves many communities unattended by these health care providers, by these emergency care workers.
I'm wondering what the minister could say, and to brief us on what steps his department is taking now to address this issue, because I think it definitely is a waste of resources, and it's only a matter of time before some large event or incident happens, like Swissair, like things that I've witnessed in the past, and we are not going to have the coverage for our citizens - so I am wondering if the minister could briefly tell us what is he doing now to hopefully address that issue with the paramedics in this province?
MR. D'ENTREMONT: Mr. Chairman, there are a number of things going on in the realm of paramedicine, and of course through our emergency health system in partnership with our supplier, which is EMC. Speaking quickly to contract talks and basically how we feel that the next contract talks will unroll - and we have gotten a number of letters of discontent, but more heads-up kinds of letters to tell us that through the next negotiations, which would only be starting after the contract is expired, which is March 31, 2008, that
there are still a couple of issues. We do know paramedics in Nova Scotia are not the lowest- paid paramedics in the country, but they are in that lower group of paramedics.
Let's also not forget that the system itself, as it stands today, this is really only the second contract for paramedics in the province. I think if you look at how other professions have found that equity among their peers across the country it has happened over a number of contracts, and I think that will happen. Also if we look at this last labour negotiation, it was of course finalized through binding arbitration, a method which we feel is probably best for all sides of any negotiation, including, and more importantly, the patients and the people who expect service on a 24-hour basis, seven days a week, especially when it comes to the provision of paramedicine in the province.
The member for Sackville-Cobequid also mentions the problem of bringing patients into emergency rooms and basically having to sit with them for extended periods of time, and in some cases having to sit with two or three stretchers as other paramedics have to go off and do work. I am sure he was going to get to that issue in a couple of minutes; that is a symptom of a larger problem that we have been trying to work on. Let's not forget the ER expansion that we are going to be doing at the Infirmary site. There have been a number of things that have been finally accomplished there and we are still looking forward to the $17.1 million expansion to that facility, which will really take up the issue of that space problem we have been having at that ER and the quantity of people, of course, that we are seeing on a daily basis there. The ER that is there was never designed to see as many people as it does, so we need to continue with that expansion.
Again, it's a symptom of a hospital system that is being held up a little bit by the pressures of alternate level of care and seniors not being able to get into long-term care facilities. So on the backside, we are still doing our work and expanding long-term care facilities in the province, and I think over the next couple of years we will see some dramatic improvements in the way that patients are handled and in the way, of course, our paramedics have to handle those folks and are able to get out and do exactly what we expect them to do - help people in emergency situations out in our communities.
MR. CHAIRMAN: The honourable member for Dartmouth South-Portland Valley.
MS. MARILYN MORE: Thank you, Mr. Chairman. Good afternoon, Mr. Minister. I just want to actually summarize some of the situations that are causing a lot of frustration and crises in my constituency and then I will ask a question. One of the areas of major concern is inadequate home care. A number of my constituents are finding that first of all the home care available is not timely, that patients are being released from hospital, recovering from serious operations and are being told that their home care support will start in a couple of weeks, and especially if you are bedridden with a back operation, or something like that, this just isn't good enough.
The other concern regarding home care is the lack of full entitlement. I suspect this is a staffing problem but I have some constituents who are eligible for 28 hours a week and are possibly getting seven, and they need more, so family, friends and neighbours are having to fill in. This just isn't suitable or appropriate.
The other thing is that many of my constituents just require help getting up in the morning and what I believe is called tuck-in at night. Because I believe staffing shortage is the problem, some of these families are being approached and asked if the client can actually go to bed just after supper in order to accommodate the workload of the home care worker. This isn't appropriate. Someone who is bedridden and is in bed 12 hours a night as it is, doesn't need to be in bed extra time, and the lack of respite. So I just want to mention that those are some of the major concerns regarding home care.
One other area is concern about youth mental health services. I will ask the minister, has the department given any thought or consideration to actually having care coordinators to coordinate the appointments and necessary services that youth in crisis require, especially when they are trying to access mental health services?
MR. D'ENTREMONT: Mr. Chairman, I apologize for taking a little time there, I just wanted to make sure I had the right details with me, and I'll start off with the first comments and go to the mental health issues secondly.
Of course, around the inadequacy of home care, we do know we do have some deficiencies, especially in Capital District, where right now the number of clients waiting on the list as of February 2007 is about 110 individuals. We also know that, especially when we're talking about people going home too early and things like that, I think we're still doing a relatively good job of sending people home in the right amount of time and trying to adhere to very specific discharge guidelines, and actually it's a national standard of how patients are discharged from acute care settings after surgeries and those types of things.
I know that this year we've had the opportunity to invest another $9.6 million for an increased utilization in home care. I'm not too sure on my FTEs exactly where we are for Dartmouth, or at least for Capital, of how we're doing there and maybe I'll try to provide some of that information later on as well - we'll dig that up.
Mental health, if we go to care coordinators, which is that we have put some crisis teams in place, and I'm just trying to think where our crisis teams are in Capital and, of course, working in conjunction with the IWK, you know, families on that wait list are told that the 24/7 crisis teams, they're given information about appropriate community resources and given numbers to call if anything changes, so especially those people who will not be placed in one of our facilities or in a facility with another one of our departments. So as we try to roll out and bring in the new mental health Act, there will be a specific request or
specific requirement for these rapid response mental health crisis teams, especially when it comes to helping youth and youth in crisis.
MS. MORE: Mr. Chairman, I don't particularly want an answer, but I just want to re-emphasize the point I was trying to make about youth in crisis, and it was that families are struggling to navigate among the different services within the system and also the requirements of their own particular child. I think that more timely and appropriate services could be provided if someone within the system was doing the navigating and helping the family to connect with the appropriate programs and services, rather than having huge gaps between different phases of the program that the youth might be in. So I'm just saying that we could probably - and I know one family where there was a gap of two years before the child really got the required service - I'm suggesting that there just needs to be, especially with youth where every day can create a new crisis or situation, that there just has to be a more seamless flow of services.
I just want to mention two other things. An increasing problem within my constituency is the lack of support for assistive devices and lifts within homes, and it strikes me that a family trying to keep a loved one within the home setting is a much more cost-effective way for the government of providing the necessary level of care, and sometimes those families require financial assistance to have the appropriate technology or assistive devices within the home to allow them to do that. So I think that needs to be another priority.
But to get to my real question, Mr. Minister, I'm confused about how your Continuing Care Strategy is going to impact on Dartmouth. I've checked the Web site and I guess I want to ask, through the chairman, how many additional nursing home beds will be available within the former City of Dartmouth, and when?
MR. D'ENTREMONT: Mr. Chairman, to the member for Dartmouth South-Portland Valley, going to the first point which really rolls around to assistive devices in communities, there is the loan program right now that we have on assistive devices in long-term care in nursing homes, we're going to be extending that for usage in the community, and that will be administered through the Red Cross - so we are trying to make strives in getting lifts and those other assistive devices so people can, of course, stay in their homes that much longer.
There is also the home maintenance program which we are now investing $3 million in and I think that is something we'll be sharing, some administrative pieces, with Community Services as well.
As for the beds in Dartmouth, I would probably have to get exactly that number for you of course through the RFP process that would be coming out next week. We'll be more specific in exactly the locations and the areas, and there are also some issues around some of the existing facilities where we're asking for the splitting of the beds, so where you'd have a larger facility we're saying maybe two, and I know that there have been some proposals
that have come to us as talking about splitting and putting them in two different locations - and a couple of them actually being Dartmouth-Cole Harbour and those areas. So what I'll do is I will endeavour to try to get those numbers to you before the end of estimates. Okay?
MS. MORE: Thank you. Mr. Chairman, just to comment, I want to remind the minister that Oakwood Terrace is a top-notch nursing home within my area and it's across the street from a hospital. It's the location of preference for most Dartmouth families, and I just can't emphasize enough the importance of increasing their capacity to take in more residents. Thank you, and I will pass over my time to my colleague.
MR. CHAIRMAN: The honourable member for Dartmouth East.
MS. JOAN MASSEY: Thank you, Mr. Chairman. I have only about 10 minutes or so, so I'm really going to try and talk about some of the issues that constituents have contacted me about. I would like to say, first of all, thanks to the honourable minister and his staff. He does, I know, try to get back to me in a timely fashion with my office - and it's not always the answer I want but I always get an answer. (Interruption) An answer is good.
Some of the issues that I'd like to touch on are: paramedics; wait times, specifically at the Dartmouth General; Pharmacare coverage; long-term care; staff shortage at the Dartmouth General; health care and some health care issues in general; nursing home care; alcohol rehab; mental health issues; home care; and emergency drug coverage. So those are just some of the topics that people in Dartmouth East contact me about and have continued to contact me about over the years since 2003.
I don't see that there has been any really large jump in the amount of services people are getting. There seems to be more people contacting me on health care issues than there were before, and of course I have a high senior population in Dartmouth East also, which may be part of why that's happening - and we know we're all aging as we stand here.
I would like to start off with commending our paramedics in Nova Scotia. I had something happen personally within my family prior to the Christmas season, when paramedics did have to come to a relative's home, and I have to say they were just phenomenal and I had a nice chat with them on the way back to the Dartmouth General - of course I have to put a plug in here for the amount of money that they are being paid for the kind of service that they're doing.
I have issue with the fee that's being charged. I know it's very hard on some people. If you're on assistance I understand that sometimes that would be covered through Community Services, but people who aren't on assistance I often wonder if that would affect them even calling for an ambulance if they don't have the $120.
Also, when I did go through that process, we did spend some time in the hallway at the Dartmouth General, and of course that's an issue with the paramedics having to hang around there while that ambulance sits in the parking lot, literally, so it can't make a call to somebody else who may be in need - so those are some of the issues there. But I would like to say thank you to all those who did help that evening.
Wait times are something that I find run through the course of every health care issue that I seem to deal with. Specifically, I have three constituents now who are waiting for knee surgery - I get the three of them mixed up because there are so many similarities between the three cases - and some of them have been bumped, and the last one I heard was they had heard from, I guess Capital Health or somewhere, that some doctors had maybe left the province, they weren't quite sure what was going on, but their knee surgery was now bumped again.
People who are seniors who are in retirement and are hoping to enjoy their life of retirement and maybe get out and golf once in a while or just to get around their own home, are finding this a real problem, when you've got to wait one or one and a half years to get in for knee surgery. So our people need the mobility, sometimes they need to get back to work - not everybody going in for knee surgery is a senior, there are younger people going in for knee surgeries too, so that's an issue.
Pharmacare coverage - I have to say a big thank you to one of my constituents, Rob MacLeod, who collected, I think, over 800 signatures on a Pharmacare petition. A lot of seniors in my area are upset with the copays continuing to go up and they are finding that is just a hardship - it is very expensive, two people on the program is going to cost $800 a year. Seniors' incomes aren't going up, yet all of these costs to our seniors are going up and it is a hardship, I do believe. Every cent counts when you're on a budget - the cost of food, the costs of rent and heat are rising and your income isn't. So that is one of the problems that we do face, so we'd like to see a lower copay on Pharmacare in Nova Scotia.
Another issue that I see a lot is long-term care, and I will get relatives of people whose loved ones are in a long-term care facility and there just doesn't seem to be sometimes the support available in Nova Scotia to keep people in their own homes, number one, before they get to that part. So there seems to be an issue with us not providing the services at home and then they simply have no recourse but to go into a facility, and of course we know that the Dartmouth General basically is housing a lot of our people right now who really should be in a long-term care facility - and I know that Dartmouth General does just a phenomenal job with the staff they do have in trying to provide services to the people of Nova Scotia who end up in the Dartmouth General in really what is a long-term care transitional unit or whatever you want to call that.
I understand there actually may be a nurse shortage at the Dartmouth General right now on that floor, on the fourth floor that does deal with some folks who are in that
predicament. I know the honourable member for Dartmouth South-Portland Valley was asking you very specifically about how many more long-term care beds are we going to see at the Dartmouth General, and that begs the question also, what are we doing with staffing there? Are we going to be seeing more LPNs, RNs, are we going to see more doctors in that facility, so that we can have more beds?
Mr. Chairman, nursing home care also, I have had some constituents who have had no problem at all with - I never hear problems with the staff in any of these facilities, that is never, ever an issue in my office. The issue is that these people are overworked and there is a problem with communicating the schedules for the comings and goings, whether you're in your home and receiving care or whether you're in a long-term care facility. It might be a nursing home where there seems to be a barrier somewhere with communication, waiting in queues to go into a home care facility closer to where your loved one lives. I'm actually starting to get some of those which is odd, but that definitely is a stressful situation for constituents when they're trying to do the best they can but their loved one does eventually end up in a facility somewhere. They are trying to make sure that they get the best service for their loved ones.
I've had a call to interact with someone who has gone through the alcohol rehab program and is having to come to my office because there is a lack of services, especially for women in Nova Scotia on that issue. This person did have trouble finding a suitable program to get into and did end up paying on their own quite a substantial amount of money which MSI would not give her a rebate for or what have you.
There is a difference between some of the private facilities we have in the province that used to be run by the government, perhaps. I know the Nova Scotia Hospital is trying to do what they can with the amount of money they're given, but I think there's always more that can be done if we put the right resources behind it. So, certainly, that is something that does crop up.
Another recent issue that we've had is emergency drug coverage, specifically for someone who had a transplant and is finding it a hardship to cover the cost of the drugs on that. I think, as we know, cancer rates in Canada - or in the United States and I don't think we're far behind or maybe we're the same - are one in three people. I know the government put x amount of dollars in the budget this year and the budget says we're going to continue to provide the resources that we have but something is going to give here in the end. We have an aging population, a poor record on the environment, we continue to pollute in Nova Scotia and I only see these rates rising higher and higher. Our seniors are aging and we need more long-term care beds and what have you.
I know with just 10 minutes I just made a big 10 minute speech but I'm going to give you a question point blank, how many more LPNs/RNs/doctors are we going to see at the Dartmouth General in the very near future?
MR. D'ENTREMONT: Mr. Chairman, to the member, I do have a lot of comments on some of the things that she has described. I'll try some clarifications as well to the things she has brought forward and maybe by that point we'll have an idea of how many physicians, nurses or LPNs we'll have for the Dartmouth General.
Just for the previous question to the member for Dartmouth South-Portland Valley, beds for Dartmouth would be an additional 68 beds. Paramedics, really working back from the true costs of a transport, which is about $838, I think the $128.16 is a bargain. Plus the issue of working with some low income Nova Scotians and the financial hardship monies we have put aside. We've put aside $432,000 for financial hardship, for those individuals who are just not able to pay for that ride, as well.
Wait times, we talk about the lack of specialists, of course, within our district. Capital Health District was able to recruit 38 new specialists this year alone, which I think will bode well to wait times in a variety of different areas. The issue of Pharmacare, which is an ongoing challenge, also trying to find savings through maximum level cost pricing, as we talked about with the member for Glace Bay. Of course, we're also trying to put some predictability into that program as well, where we're attaching this to a true ratio of 75-25; any increase is not wanted but we need to also have a program that is sustainable as well.
Long-term care, we talked about a couple of issues with regard to that, 68 beds going to Dartmouth. When it comes to long-term care, though, we have some very interim strategies in order to help some of the bed placements and then help some of the emergency room pressures that we have as well.
We just got confirmation that we'll be opening 31 beds at Melville Gardens, most of that contract is complete, so we'll have 31 people being able to be seen in the correct type of facility. We also have Northwood, which will have 40 beds available for our Nova Scotians sometime in August. We recently put out an order for 50 beds within the DHAs, so we'll be making some good moves there to help. Of course, it's not the full 832 beds, but I think it is trying to take some pressure off the system as we see it today.
Nursing home care, yes, we agree that a lot of these individuals are overworked and we do need to have more of these professionals to work in our facilities. We will continue to work with NSCC and through our RN training programs and our LPN training programs, to try to get more people.
The alcohol rehabilitation stuff, I'm not too certain about that. I will have to get back to the member on that one. There have been some additional dollars into that, but there you go. I'll try to get that information to her.
The transplant drugs that we were talking about, making sure we have the right drugs for those individuals, there has been an added $5 million in the program this year as well. We
still don't have the breakdown of how many specialists for Dartmouth General, but I will endeavour to have that information for the member as soon as I can. We have to communicate that, of course, with Capital Health to see what their plans are for that site.
MR. CHAIRMAN: The honourable member for Halifax Citadel.
MR. LEONARD PREYRA: Mr. Chairman, I'd like to start with a general question, more of a political science question and maybe go out to more specific ones. I want to ask the minister to tell us how he defines himself in terms of ministerial responsibility, in terms of things he feels responsible for and things he's not responsible for, things he can be held accountable for or not be held accountable for. Does he have a general sense of his responsibility?
MR. D'ENTREMONT: Now there's a political scientist at his best. I thank the member opposite for his all-sweeping question and it's 3:30 p.m., I figure I can get that done by 7:00 p.m.- what it seems like I'm responsible for and what I think I'm responsible for.
Really, in structure, it's difficult to say where the minister fits in this pyramid of patient care. We really work on a backward pyramid where at the top of the pyramid is the patient and then all the people who fit into helping out and how the care works, it all fits down there. Exactly where the Minister of Health fits, I'm not too sure sometimes, but the responsibility I feel is ensuring that every Nova Scotian receives equitable care, especially when it comes to the issue of emergency care and safe care. I think that's sort of where the buck stops in making sure, from our offices, that the correct procedures, policies, systems and legislation are in place to ensure that to happen. And on the backside of what we're talking about here today, of course, is the budget of the department, to make sure that we have the right types of funding in place as well.
We have to ensure that we have the programs, the funding, the correct monitoring and the quality evaluation that those kinds of things happen and those are the things that I think the Minister of Health is truly responsible for. I think there is a day where I'd like to be out with a paramedic and doing work there, but I think the things we do at the department are very important and those are the things I am responsible for.
MR. PREYRA: Let me ask then about the Capital District Health Authority and ministerial responsibility. Specifically, I wanted to ask you about the Horne case, to follow up on a case we talked about earlier today, where you really appeared to be denying any responsibility for what's going on there. I wanted to know, do you know how much has been spent on this case?
MR. D'ENTREMONT: Mr. Chairman, to the member opposite, of course that would be a piece of information that I can be aware of, it is one that would be held within the district health authority's business plan and the amounts of money that would have been expended in the last year. Our responsibility, when it comes to situations like this, of course, we are responsible for the Health Authorities Act, making sure the legislation is in place for them to function and provide services to Nova Scotians. We also have a part to play in how bylaws are developed and making sure that the things that guide each district health authority are in place, which does also include their dealings with different specialists and different researchers within their facilities. But there is also a share, especially with District Health Authority 9, in how the challenge of their bylaws works, because it a teaching institution as well. So there are a number of things we would help out with yet not being directly responsible for.
MR. PREYRA: I don't think the minister understood my question. I asked him, do you know? I know that he should know. I'm asking if he does know how much has been spent, to date, on the Horne case?
MR. D'ENTREMONT: Mr. Chairman, I don't know, specifically, the exact expenditures of every district health authority. I can get that information for you if you so well please, but it would take me probably until tomorrow before I can have that information for you.
MR. PREYRA: Thank you, yes, I would like to know how much has been spent, to date, on the Horne case, and I appreciate the minister offering it, because I think it is important for this House, especially when talking about the estimates, to know how our money is being spent, especially scarce health care dollars. There is a very strong feeling in the community, both on the research side and the health side, that the government has wasted and continues to waste an extraordinary amount of money pursuing a case which appears very much to be like a vendetta against this, and every single investigating body has essentially told the minister that. I would like to believe that the minister is paying a little bit more attention to this case, because it appears to be a miscarriage of justice and a waste of taxpayers' money.
I wanted to also ask you about the McEvoy case and the Nunn Commission of Inquiry, more specifically a letter written by the Halifax Peninsula Community Health Board, and a number of other agencies as well. The Halifax Peninsula Community Health Board describes itself as the eyes, ears and voice of the community and they've done quite an extensive consultation. One of the conclusions they have reached - and these conclusions support the Nunn inquiry - is that we really do need to establish a diversion program, we need to get into a prevention program, we need to cut off the supply of criminal behaviour and support youth at risk and their parents. Specific to that, the Nunn inquiry made a number of very good recommendations, and let me specifically go through some of them. One of
them is the need to develop a public comprehensive and collaborative interdepartmental strategy to coordinate provincial programs, services and support for youth at risk.
The Nunn inquiry essentially found that the lead departments were essentially functioning as silos and the Health Department didn't know what the Community Services Department was doing, and they didn't know what the Education Department was doing. I would like to ask specifically about mental health programs for youth and children, particularly what the department is doing for suicide prevention for dealing with ADHD, for dealing with depression and things like that in response to the Nunn inquiry?
MR. D'ENTREMONT: Mr. Chairman, I know there are a number of strategies on depression and, of course, some strategies on suicide that have been developed over the last number of years within the Department of Health.
When it comes to the Nunn inquiry, I think that was a really good piece of information for all departments to show them exactly where the deficiencies were. I think with the collaborative approach that we have going now with the Departments of Community Services, Justice, Health, and Health Promotion and Protection, I think there has now been sort of a recognition that we cannot work in silence when it comes to youth justice issues, which will lead towards the development of that youth strategy, to have a better coordination for all services that youth at risk will be able to receive.
Of course in this year's budget, specifically towards the Nunn Commission findings and towards our youth strategy, there has been another addition of funding through the youth attendance centre, which we're partnering with Justice, about $208,000, also through court-ordered assessments through the IWK, which is another $461,000 invested. We'll continue to work hand in hand with the departments required and I'm looking forward to that youth strategy that will be available for all individuals in need of that help.
Going back also to the issues brought forward by the member in regard to the way that the district health authorities are governed, how they are run, the district health authorities account for $1.3 billion worth of expenditures of taxpayers' dollars. Of that, $600 million is expended by the Capital District Health Authority and I think - I need to know what those big numbers are and ultimately the expenditures happening, I think, on the bottom side are difficult to know, but I will endeavour to get the information that the honourable member has asked for.
We have done a fair amount of work with the CDHA to ensure that other episodes like what happened with Dr. Horne, revolve around making sure that we have the correct type of people governing that organization. We have had some changes happen at the board level, we've had some changes happen at the CEO level. There have been some changes in the last number of months to those bylaws. I don't know if they are complete but I'm pretty
sure they are, I've seen some drafts and some reiterations of it, to ensure that situations like that do not happen again.
MR. PREYRA: Thank you, Mr. Chairman. I do appreciate the distinction between policies and operations, but I think what the Nunn Commission said was that we needed some leadership at the top, at the departmental level, and I know that a committee of deputy ministers has been struck to provide that kind of leadership.
Also, with the Horne case, there are some cases, especially when you're into several millions of dollars, that there is a place for the minister to get in and say, what are we doing to respond to these. I appreciate very much the minister's and the government's response to Nunn, essentially the government adopted all of the 34 recommendations and said it would follow up on that. So I don't expect that you would have already done so; I'm just asking what type of leadership you're taking at the policy level to make sure that essentially what Nunn said, that we need to move to cut off the supply of criminals, if you can describe them as such, and the best way to do that is to provide for mental health programs, drug addiction prevention strategies and things like that and those come within the mandate of the Department of Health.
One suggestion that wasn't mentioned in Nunn but sounds like it was implied was the question of a navigator system for youth at risk and parents of youth at risk. The Nunn inquiry essentially - if I could find that quote I would read it, but what Merlin Nunn said about the case is that Archie Billard was an individual with his own concerns, feelings, challenges and background. The justice system's responses to him when he committed his crimes in 2004 can be understood only by looking beyond his charges to the person behind the charges. What led him to be joyriding in a stolen car, high on drugs, at the intersection of Connaught Avenue and Almon Street in October. His journey to that intersection did not begin on the morning of October 14th, or even with his release from custody on October 12th. His journey went through his difficult schooling and aborted education, past his strained interactions with his family and peers and appeared to bypass the myriad supports offered to him by agencies and services of our province. He lacked any map to his journey and all of this led to his wrong turn into crime.
So my question is, is there any way of helping youth at risk and families of these youths at risk, to help them navigate their way through the system? Is the department contemplating anything of that scale?
MR. D'ENTREMONT: Thank you very much. Even before the Nunn inquiry, I think a lot of departments and divisions realized that there was not enough being done, especially in the coordination of services and making sure that families and youth know how to navigate that system, which is why there is a youth strategy within the department of how we're going to be dealing with this, as well as putting in place those rapid crisis response teams that help families and youth get through this system.
Ultimately, all through this issue, my compliments go to the McEvoy family for the faith that they put into the system in trying to correct itself and making sure that there are positive results out of such a tragic loss. I do enjoy sitting down with my colleagues and talking about this stuff because I know that it is probably the first time in a long time that this type of dialogue has been going on amongst the partners of Health and Community Services and Justice and HP&P. So it is a lot less on that silo issue, but working towards that common goal and what I feel is important, which is patient first, but in this case it is youth first, making sure that that person you are trying to help is at the top of that pyramid.
MR. PREYRA; Mr. Chairman, I do agree with what the minister said and I think the McEvoy family is to be commended for their attitude and really we would be disrespecting the McEvoy family if we didn't take their generous offer and say we're not going to follow up on those recommendations.
I have my last set of questions revolving around research. A letter from the doctors' organization here in my constituency says only one-tenth of one per cent of our provincial Health budget is spent on clinical research. As you know, clinical research is important, it has a huge role to play in the prevention and early detection and assessment of medication, finding the more effective treatments in terms of the prevention of diseases as well, which I know is a priority of the department.
My question, is there a strategy within the department, is there a general sense of the department or how you allocate money to research and other programs?
MR. D'ENTREMONT: Mr. Chairman, that has been a challenge as well, to balance the priorities of providing acute care services to Nova Scotians, just on the demand on that system and trying to carve out some dollars to put it into a place that I think is very important on a couple of issues, of course, trying to find better ways to provide care and better therapies and better strategies on health care and trying to balance that with retention of specialists and researchers and, of course, those clinicians.
I know that- I don't necessarily have exact dollar amounts here - but through the Premier's innovation fund, about half of that budget, of course, goes to health research. We have the Nova Scotia Health Research Foundation, whose $4.9 million budget, I think, is probably one-third of some of these research grants that it does use for attraction of other funds from national organizations and/or groups that fund health research.
There have been a couple of proposals that have come forward to us looking at trying to put together, even buy a resource centre, other researchers, the research that can happen through Dalhousie University and other health facilities in the province. I think it is very
important that we try to find ways and try to carve out even more dollars to invest in that specific area, because I think the outcomes of it are extremely important.
We only have to look at our investments through, let's say, the Brain Research Repair Centre and the work that is happening there, of how it's really impacting the lives of Nova Scotians. So we need to continue to focus there. The Brain Repair Centre, of course, is a great example because, not only do we have this research going on in Nova Scotia, we probably have one of the best neurologists in all of North America working right here in Halifax because of that research opportunity that he possibly has. Dr. Mendez, of course, is who I am speaking of and we need to find more people just like him to come to our province and provide us with the best care possible.
MR. PREYRA: Thank you, Mr. Chairman, one last question. Not only Dr. Mendez but Dr. Noni MacDonald and Stan Kutcher and a number of great researchers at the IWK in particular. I just want to make a final comment, I've looked very closely at the IWK's mission statement, its vision statement, and one of its priorities is developing research - is the lifeblood of the IWK and building a reputation as a learning centre in health sciences and becoming a leader in translating research and knowledge into practice. They have a tremendous goal. I've met with them and I hope very much that you will look carefully at the mission statement and try to breathe some life into this mission statement. Thank you.
MR. D'ENTREMONT: Mr. Chairman, to the member for Halifax Citadel, I thank him for those questions and I do subscribe quite strongly to the mission statement of the IWK and had the opportunity to sit and talk with the board about this very issue a number of weeks ago and will continue to support them in meeting that mission and, of course, to the long-term sustainability and viability of such a wonderful institution like the IWK.
MR. CHAIRMAN: The honourable member for Hants East.
MR. JOHN MACDONELL: Mr. Chairman, I want to thank the minister and his staff for allowing me a few minutes to question them. I guess number one, for me, an issue I hear about is desire for dialysis at the Resource Centre in Elmsdale. I think it's the Capital Health District that is in charge of where dialysis goes in the province. Can you outline parameters that they would look at, because there's a real need in my area and we'd certainly like to have more service in the Resource Centre, but dialysis and X-ray are two of them. Certainly, there are people in my area, but also in riding of the member for Colchester-Musquodoboit Valley, from his area as well; we have quite a catchment who are going to Truro, Halifax, wherever. So if you could give me some idea of the parameters around how the Capital Health District would make those decisions as to who would get dialyses and who wouldn't?
MR. D'ENTREMONT: Mr. Chairman, I welcome the member for Hants East for these questions. It sort of reminiscent of days when I was answering questions on the
Department of Agriculture and, of course, one that I know the member opposite holds well to his heart.
In regard to dialysis, especially to the Hants East area, Capital Health is sort of the provincial coordinator for dialysis in the province, except for two locations, the Yarmouth site and the Cape Breton Regional, where they manage their own.
There have been a couple of things that have been going on over the last number of years where we've been developing a provincial strategy on dialysis and part of that study really looks at population trends, where people are moving, what their ages are, what's the prevalence of renal failure, and also trying to balance the issues of the cost per site. What are the costs going to be? What kind of education are we going to have to do on those specialists? How are we going to have the specialists, the nephrologists, being able to come in to do that oversight.
Ultimately it is a very complex system in trying to identify sites and where more Nova Scotians, of course, can get a service closer to home. The other challenge is the proximity of Hants East to the Capital Region, because we do have three sites right now in Capital Region - the IWK, the VG site and Dartmouth General.
So there is a bit of a challenge because of that catchment area. We'd either have to move one of those sites to head out to Hants East, or create a new one that is within proximity to a couple of the other ones.
The issue of the complex system and how to work some more of these satellite areas- there's a pilot project happening now through Antigonish and a previous minister, I'm sure, is very happy with the opening of that wonderful clinic not so long ago. I know he did a fair amount of work bringing that to his area. So maybe you might have an opportunity to talk to him about how he did it. But ultimately, what we're trying to do is work on that other model of care so the nursing staff is trained in a different way, utilized in a different way, and then the nephrologists are still residing here in Halifax, providing that oversight and only have to visit on a clinic basis, on a semi-regular basis.
So there are some challenges I think we can continue to work down and I can provide some more information to, but I just don't have it here with me.
MR. MACDONELL: Thank you for the answer, Mr. Minister. I have challenge enough trying to get roads taken care of by the Minister of Transportation and Public Works so I have to go after him for dialysis. That'll be a little too draining, I think. I have to say that there are lots of days I wonder about the placement of East Hants in the health district that we're in. When I look at the movement of the people in my constituency, if you take the Hants North region, which I'll include the Rawdons and the Waltons and Kennetcook, a lot of those people go to Windsor, which is Capital District. If you look at the corridor area
which is Enfield to Shubenacadie, most of those people go to Halifax, which is Capital District. And if you look at Mount Uniacke, that's in the Capital District. That's not even in the same district as the rest of East Hants.
So we have this little narrow sliver along maybe part of Shubenacadie up to Highway No. 215, to South Maitland - roughly Maitland, maybe, where some of those people actually go to Truro, and some of them don't. So there's a very small part of my constituency, I think, that actually goes in the Truro direction and practically all of the rest of it goes to the Capital District. I think the members of my community health board are somewhat fearful that we'll be a smaller fish in a bigger pond if we go to the Capital District, but I have to say, I'm not all that enamored with the way we're treated in this present DHA. We're still hammering for a clinic in Rawdon, which seems to be going over like a lead balloon with the DHA and the Department of Health, and Mary Jane Hampton's consulting firm is doing a study presently. There seems to be a lot of coordination by the DHA on that. I'm not sure how much free rein she actually has to do that. Actually, I was really quite impressed that it was her that was going to do it. I have a high regard for her work.
Is it possible for the minister to give me some kind of readout, and I'm not expecting him to do that off the top of his head today but tomorrow or as soon as he could. I'd like to know how much of our DHA's budget, last year, was spent in East Hants compared to what was spent outside of East Hants. I think the people in my area would like to know that. I know I'm running out of time. I want to just raise an issue for a local residential facility in Shubenacadie. It used to be Bennett's, but now it's called Willow and it's come under new management; Mr. Dorey, I believe, is the new owner.
I think we were notified that the province, I think, is allocating 71 or 77 nursing home beds for East Hants. So the DHA, I guess, is allocating them. I was told that the movement, because of the lack of facilities in my area, that facilities like this one, a residential care facility, is able to apply for nursing home beds. So Mr. Dorey raises the concern about the timelines in that process, that it seems to be particularly long. So I'm just wondering if we don't have any nursing home beds in East Hants, can that be expedited in some way, for these facilities that are applying, and maybe the minister has some general comments around that as well?
MR. D'ENTREMONT: Mr. Chairman, to the member, I'll work on the second one first and the first one second. In regard to nursing home placements within the area of Hants East, I forget the exact number and I'll try to get that number before I sit down again. Ultimately, through this process, and the process has been designed where the RFP process - so people are now aware generally of where beds are going to be placed. I know that Hants East will be receiving a fair number of beds because it is extremely under-served, just like the whole Colchester area, sort of in that corridor. Because of population growth, we really need to put some more beds in that area.
The timeline for this is that people have been aware for a number of weeks now of the possibility. The RFP process will come out sometime late next week, Thursday I believe, which I think is April 5th. There will then be that first phase of identifying what the care is going to be, what the structures are going to look like, what our requirements are going to be for beds, the room sizes, all that stuff will be available; then the RFP itself could probably go, we think, until August 23rd, for the closing of that RFP process. During that whole period, there are a couple of steps to make sure that we know we can continue along in that process, so we're actually trying to help out as best we can with individual owners, like the Willow, and being able to bid to the system.
So I can provide you a little more on the timelines when I know exactly how many beds you're looking at, and then it would be up to the community or some private operators to bid for those beds. If things work out the way we think they are going to work out, soon after that August piece, we should be starting to award some contracts out because we would have known by the time that closes, pretty much the guys who have done the work will be the ones who are going to be winning the RFP process. So I think it's a pretty well-laid-out system.
Thank you for that. East Hants will be receiving 59 nursing home beds; 12 are residential care facility beds, which will be designed to a nursing home standard. So for future growth and future need they can change, so for a total of 71 beds.
To the first question, in regard to population and the issue of where the line of where district health authorities are, and hopefully the member for Truro-Bible Hill will not shoot me down as I'm standing here, but I think we too, in the department, agree that maybe the line is not quite in the right place because of this reason; about 75 per cent of the population in your area receives services in Halifax, because for the most part they work in Halifax and since they're coming in this direction, they're receiving their services here.
Out of the $50 million budget of the Colchester-East Hants District Health Authority, I think you probably work back your population of that group, so we don't have the exact number of what the dollars would be paid to East Hants. I know we've done some investments in the clinic and those kinds of things, but ultimately it does underline an issue that we might have to address sometime soon, exactly where that line goes, and maybe make a couple of adjustments in that range. There are no plans to do that today, but it is something that we do know we might have to do in the future, because it does throw those population issues off of where people are going to be receiving services as well. So I think that answers most of the issues brought up by the honorable member.
MR. MACDONELL: Thank you, Mr. Minister, I really appreciate it, and staff too.
MR. CHAIRMAN: The honourable member for Pictou West.
MR. CHARLES PARKER: Thank you, Mr. Chairman, and I'm pleased to have a couple of minutes here to ask the minister some questions perhaps specific to the North Shore of the area where I come from. As you know, Mr. Minister, I've been asking some questions in Question Period around the need for more doctors, first of all, for specialists at the Aberdeen Hospital, particularly internists, although there are other specialists required there; and also at the Lillian Fraser Memorial Hospital in Tatamagouche, where we just need more family doctors to help man the emergency department in particular. It boils down to the same thing, more doctors are required, whether it's at one hospital or the other.
I'd like to perhaps start off by asking the minister - I know it's the DHA that's recruiting, or trying to recruit these medical professionals, but what is the role of the Department of Health in assisting or DHAs, or specifically, does the department have a role to play here in recruiting these specialists, or GPs that are required?
MR. D'ENTREMONT: Thank you very much, Mr. Chairman, and to the member for Pictou West, I thank him for the question. I know we've talked about this one on a number of occasions. I'll start off with the internists for Aberdeen and I know I have talked to him and the member for Pictou East as well on this one - and that Pictou Centre guy, I talk to him a lot, too, in regard to this one.
Basically, what we understand now is that through our provincial recruiter, through our Physician Services division, that there are apparently two possibilities for that site and there are ongoing negotiations with those internists. I don't know what the outcome is going to be, if we are going to be successful with those two. My hope is that we would be. We are providing, I think, fair and comparable remuneration for them and especially to work within that team of, I believe, four people. Four people really makes a big difference in who is working and when. Right now, with three, I know that those individuals and those specialists are working a little beyond probably what they should be, but I thank them for their added service and providing services to the people in New Glasgow and area.
When it comes to the North Shore, in talking about Tatamagouche for a minute, there has been a challenge there to have some more family practitioners and some individuals, of course, who could work in the emergency room. I know that we have been working with the Colchester-East Hants District Health Authority on finding some family physicians for that one. But I think it also has to work in with the master agreement that we are going to be negotiating over the next few years with Doctors Nova Scotia, trying to find a way to build in maybe some more - not return for service, I guess is the wrong word for it, but more appreciation to get some of the attending physicians to work in these emergency rooms.
Even if it's only on a temporary basis, it would be nice to have that extra manpower to provide fill-in, because what we are really finding in places like Tatamagouche, places like Glace Bay, places like Digby, we have a complement of doctors and if they go off on vacation, we end up really being stuck in trying to find replacements for them, yet there are a number of doctors in the area who probably could provide that for us.
Again, as I said in a number of questions over the last number of days and weeks, the family practitioners, we have had a net gain of 26 family practitioners in the province. I think the challenge right now is just trying to find a better placement for those. The other issue for Tatamagouche, as well, is there is a commitment for a $2 million primary health care project to help with renovating the facility as it stands today and trying to focus a little more on community health and family practice and those kind of things, which I think not only help in emergency situations in providing triage and those kinds of things, but also working toward making the community and surrounding areas even more healthy.
MR. PARKER: Mr. Chairman, I guess I want to ask specifically, as I recall in past years, there were recruitment or retention specialists within the Department of Health and I'm asking, do you still have that person or persons, and perhaps who is that individual or individuals who have that role at this time? What do they do? Do they work with the district health authorities? Do they specifically work with the Aberdeen Hospital or the Lillian Fraser Memorial Hospital to help them find the specialist or the GPs they require? I guess I'm just asking, do you have somebody on staff and who is that person?
MR. D'ENTREMONT: Mr. Chairman, to the member, yes, we do have a provincial recruiter and that provincial recruiter is Frank Peters. He provides services across the system. He works specifically with district health authorities. Most district health authorities would have a physician recruitment group and what they do is a lot of the legwork, but from a provincial standpoint, we send Frank out to many of these shows and recruiting times and those kind of things, to provide more of a standard right across the province.
MR. PARKER: Mr. Chairman, I'm going to switch gears here a little bit. The other issue that has been a real concern is around wait times. I'm hearing from quite a few constituents who are waiting weeks, months or even longer, years, for a particular operation. I had a constituent call me the other day who has to have an operation for repair of an aneurysm and I guess it's an aorta, near the heart, that needs to be repaired. He's been waiting now for four months for this operation.
I had a lady contact me a few weeks ago and I think I wrote you a letter, Mr. Minister, she is waiting for an operation, again, to repair, I think it's gastro reflux - I forget the name of the particular operation, but it's to repair that problem. She has been waiting, believe it or not, about three years now for her specialist - to have that operation. I know you've been working on wait times, I know there's a federal initiative in that regard but, briefly, Mr. Minister, could you tell us why wait times are so long and what is it your department is doing
about it? I am not looking for a half-hour answer, I am looking for a fairly short answer if you can give us one in a nutshell, please.
MR. D'ENTREMONT: Mr. Chairman, I know in regard to the issue that the member brings forward when it comes to, I think it was an orthopaedic-type surgery for one of his constituents, and I know there are some further details being researched on that one to figure out exactly why that particular individual is waiting so long, because it is even beyond the norm of what our wait times are at this point, basic answer to why our wait times are so long and sort of trying to compare that to Canadian situations, and we're very similar and all try to adhere to certain benchmarks, but ultimately our population is aging and requiring more specific type surgeries, technology is changing, and hopefully for the better in most cases. We are doing way more surgeries than we have in the past. I forget the percentage increase just in orthopaedics has been phenomenal.
But the other point to that is since the technology is changing so much, we're having some marvellous outcomes. I know those folks who've had the opportunity to have knee replacements, hip replacements or those kinds of things, are finding that those types of surgeries and the outcomes of them to be very good.
We've done a number of things in the last number of months trying to really get at the issue of wait times in the province. Really, almost everything we do sort of has that overarching policy of trying to invest in places where we're going to be improving access to Nova Scotians which, on the backside, fixes and tries to help out on the wait times.
There have been 38 new specialists hired for Capital District in a range of different specialties including orthopaedics, including cardiac and those types of things. Just on Monday, I had the opportunity to stand with the federal Minister of Health and announce $48 million and creating a guarantee that individuals requiring cancer therapy or radiation therapy would not wait more than eight weeks.
We are doing quite well, I believe, in cardiac care. We're actually on the national benchmark when it comes to eyes or cataract use. Plus we've also tried to focus in on two pilot projects out of that $48 million, which one of them, of course, is toward orthopaedic or what is called active wait time. So, actually, we have an opportunity to have that single list that we've so really wanted over the last number of years, to know exactly how long those lists are going to be, plus giving the option to the patient to know where they are on that list and know why they've been either dropped back a little bit or why they're going forward, those kinds of things. So we're really happy about that.
Of course, through diagnostics, we're working with the Canadian Association of Radiologists and instituting a program which will actually help make sure the people have the right test taken, depending on what their possible symptoms are, and making sure they go to the right diagnostic, whether it be an MRI, whether it be an X-ray or what have you.
So there are a lot of things going on and, overarching-wise, through the committee, our wait times committee, we've been able to set up a true strategy, and that strategy is now available on the Web site, and we'll continue to focus dollars in that realm.
MR. PARKER: Mr. Minister, you've referred to, I guess, one of the letters I wrote to you not too far back on orthopaedics, it's actually a neurosurgeon that he's waiting for. He's a young man who was injured on the job, self-employed, actually, and is not able to work, not able to carry on any type of business. He's in a lot of pain. He can't sit, he can't stand. It's really very difficult for him. I have a letter here from his neurosurgeon stating that they're not very happy with these long wait times either, and basically indicating a good part of the crisis in the long wait times is because of a shortage of anaesthesiologists, and I've heard that before. So could you give us an update on how serious the problem here is with anaesthesiologists and is that part of the reason why we're having such long wait times?
MR. D'ENTREMONT: Mr. Chairman, the recruiting of anaesthetists has been one that has been quite successful in the last number of months. We have had the opportunity from Capital Health, and this is really rolling out to the other districts as well, in that we have been able to recruit eight new anaesthetists in Capital Health. We are also utilizing anaesthesia assistants so we can actually use the anaesthetist across the system. We continue to do recruiting in all the regions because really, a lot of times we do have the specialists to do the operation but we are having a shortage of some of those other specialties that we need, whether it be anaesthesiologists or what have you. We will really continue to push in there but we have had some success here in Capital. Normally, when we have a success here in Capital, it actually pushes out to the districts to alleviate pressures there as well.
MR. CHAIRMAN: The honourable member for Pictou East.
MR. CLARRIE MACKINNON: Mr. Chairman, I have just a couple of local issues that I would like to raise. I realize there has been a lot of discussion on general policy over many hours. However, the issue that I want to put forward has been raised with the minister on an individual basis and I want to say that this minister is a minister who is very good to deal with the members opposite from him in relationship to individual situations that exist.
What I want to talk about for just a couple of moments, because I feel it's very important to get on the record in relationship to what is happening at the Aberdeen Hospital in New Glasgow, I have been tag-teaming with the member for Pictou West and also dealing with the member for Pictou Centre, as well, but the Aberdeen Hospital is the facility that is looking after 89 per cent of its intake and that's very high. When you look at some of the situations that exist around the hospital where perhaps the high 60s, low 70s, and there is a lot of referral, but the Aberdeen Hospital is involved with about 10 per cent to 11 per cent referral. It's doing a good job. It has an excellent administrator. We are very happy with a lot of things that are happening there.
However, having said that, we have a situation that exists at the Aberdeen Hospital where internal medicine is down to three doctors and that is a serious situation. We need four or five doctors in the internal medicine and that hospital, within weeks, could be in a crisis mode because of the fact that we don't have a fourth person there. I asked the minister, what is coming about in relationship to that because you, I know, have been working on this issue and we have raised it with you on a couple of occasions. I know you're trying to do something but, for the record, could you please elaborate just a bit?
MR. D'ENTREMONT: Mr. Chairman, I want to thank the member for Pictou East for his questions. Really, I can refer back to the answer to the member for Pictou West, as well, in regard to internists at the Aberdeen Hospital. You know, ultimately, the best way to address this would be to have probably one or two more internists in order to make sure that workload goes down a little bit for these individuals who are providing, I think ,well beyond their mandate to us. Again, I thank them for providing these services to Nova Scotians.
Ultimately, what we're really trying to do, as well, while we're trying to recruit for the Aberdeen Hospital, is see if we can find those one or two, where there are apparently two individuals who are being identified at this point. Now, how those negotiations are going to go, I'm not too sure and I'm not going to speak more than that and try to influence that outcome, but there is a greater strategy that we're trying to work on through Physician Services as well, in collaboration with Doctors Nova Scotia, in trying to stabilize the practice of internal medicine as well as emergency rooms.
So, you know, there are a couple of things that we're really trying to negotiate and work with a true strategy with physicians. As soon as we have more details on that, and as I have committed to the members, I will provide them with updates as we know how things are going with those negotiations. I also, as well, appreciate the work of the administrator there, of course, Mr. Pat Lee, who is a native New Brunswicker from Saint John - just like my deputy minister - you know, who does a phenomenal job in that district. As well, I want to thank the chair there, Mr. Murray Hill, for the work that he provides to us on an ongoing basis.
Again, I want to thank the members for bringing this issue forward and, of course, continue to work very hard. I know my Uncle Arnold would make sure that I work with the member for Pictou East, as he used to work with him for a long period of time, and I know the member opposite hasn't said it on many occasions, on the record, but I think the member for Pictou East knew me when I was probably riding my bicycle down the hill from my Uncle Arnold's. So that's one of those guys I sort of have to listen to - he's almost my favourite NDP.
MR. MACKINNON: Thank you very much. I went from being his favourite Social Democrat to his favourite MacKinnon at one point, and I think he only knows about three MacKinnons. However, having said that, I'm very pleased that the minister has indicated that he is willing to listen to me and I hope that translates into action. What I am amazed with is the fact that the Aberdeen Hospital has between 19 and 24 patients, at any given time, who are actually seniors awaiting a bed. Having said that, we had announcements, promises made throughout the province for additional nursing home beds and Pictou County got zippo-zap, nothing in relationship to that - absolutely nothing, not one unit.
Now, I know there is talk of replacement of the Shiretown Nursing Home, which I understand is a privately owned nursing home, somewhere in the order of 30 to 35 years old, but I'm wondering, why was there a decision made to replace a nursing home that is still fundamentally sound and not one single unit for Pictou County?
MR. D'ENTREMONT: Mr. Chairman, I thank the member opposite for bringing this issue forward, because it gives me an opportunity to talk a little bit about our bed expansions across the province. When we looked at all jurisdictions in the province, we talked to seniors, we looked at population trends, we talked to district health authorities. We looked at a bunch of different issues like frailty indexes and those kinds of statistics, to look at the frailty of seniors. What we're trying to do in this first order of business of levelling the field per se of beds in areas, which is the 832, the area of Pictou has - I'm just trying to see how many beds they have now in that district.
Basically we're trying to have 100 to 115 beds available per population of folks over 75. What you'll find in the facilities in Pictou County, you're going to find a lot of people from Antigonish, Guysborough and even as far as Port Hawkesbury, and you're going to find a lot of people from Truro, Colchester and those areas. So what has happened, because there were no beds in those other areas and there were a decent number of beds in the Pictou area, we had a migration of people there.
What we do know is, once we construct those beds in those other areas, people will end up going back home, which is what we want them to do. We want people to be as close to home as possible and then we can start reviewing, when I know the NDP has brought forward as a very important issue, which is the 100-kilometre rule. So ultimately, even though we did not announce any new beds for Pictou County, there will be a dramatic change for the residents of Pictou County who will be able to access those homes in their areas.
I know there has been a lot of work done and I stand by the numbers that have been presented and I look forward to getting those beds put across the province and seeing the change that it will do for the residents of all areas, including Pictou County.
MR. MACKINNON: Mr. Chairman, I would think and I certainly know some of the 19 to 20 there at any given time. I would think that most of those would, in fact, be from
Pictou County and we are dealing with a situation where we are looking at sending someone from Pictou County to the Annapolis Valley. I still didn't get the question answered in relation to the replacement of the Shiretown - and I'm not saying anything against that replacement, I'm just wondering why we are dealing with a replacement facility when we could use a new facility somewhere in Pictou County. I feel very strongly about that and just wanted to make a statement in relation to it.
The other point about not getting any new units, we can tie in out-migration with that as well and there are a lot of people being left in Pictou County who are in that baby boom generation. There are going to be people who are on the early end of that baby boom generation like this honourable member, who will be needing some kind of a facility probably down the road. I'm sort of on the leading edge of those baby boomers and there are going to be many, many more behind me. I think the minister at some point better look for some new beds for Pictou County.
The member for Pictou West has, in fact, talked about waiting times. I believe that from a local perspective there would be many more questions here today and I would have asked for much more time had the Aberdeen Hospital not been doing such a good job. I have a situation in my riding where a fish harvester in Lismore is no longer able to work on his boat. He has a very rare disease in the arm and he's not talking months in relation to getting treatment, he is talking years. We are looking at a couple of years perhaps, a year and a half, two years. This person has already been affected by not being able to work on the boat that his father owns and we, in this province, are trying to look at intergenerational transfers of licences. Here is a licence that was going to be transferred from the father to the son and we are in a situation where that cannot take place because the son is not able to work on the boat.
So that is my example of someone who needs to be looked after within the next few months, not a year and a half or two years, and this degeneration continues to take place and it can be halted. It's a serious degeneration that is taking place in the one arm. I know you have already responded to the wait times, I only asked for a few minutes to raise some local issues and I appreciate the fact that we can raise one on one with this minister. Thank you.
MR. D'ENTREMONT: Mr. Chairman, just quickly, going back to DHA 6 and the placement of beds right now, there are 507 beds available in Pictou County or within that district area. Again, the first set of beds is about putting the beds where the most need is, but because we are putting them in the places of most need, we know that there are individuals staying in homes where they don't want to be and are a little too far from home and will move back to those new facilities. So we're making beds available in areas and we know Pictou County will become available to people in that area.
The issue around the fish harvester in Lismore, I'd like to have a little more detail maybe on that one because if it is a WCB case - it might be, because he is working on a boat. I'm not too sure, so you'd have to provide some more information on that. Of course, people
injured on the job who are in receipt of WCB are exempt from the Canada Health Act insofar as they can jump the queue. There has been some blitzing and some more work being done, I think, in Kentville right now for orthopaedics. There is also a project being planned and being looked at for Pictou County through the Aberdeen, so you might want to provide some more information to me on that one and we can see what more we can do on that one. I thank the member opposite for his questions.
MR. CHAIRMAN: A short recess, Mr. Minister? We will take a few minutes and come back for Acadian Affairs.
[4:29 p.m. The committee recessed.]
[4:30 p.m. The committee reconvened.]
MR. CHAIRMAN: The honourable member for Halifax Fairview and we will be debating Acadian Affairs.
MR. GRAHAM STEELE: The minister has just finished a number of hours of debate on the Health estimates. One of his other responsibilities is, of course, Acadian Affairs for which I am the critic. I had advised the minister, in advance, that it was my intention and we agreed between ourselves that this particular conversation would take place in French. Mr. Chairman, I think you have been notified of that as well.
Alors, Monsieur le président, c'est pour moi un grand plaisir d'être içi en tant que porte-parole pour le NPD en matières d'affaires acadiennes. Après que mon collègue Kevin Deveaux a démissioné, je suis maintenant le porte-parole. Je veux posé quelques questions au ministre au sujet de son budget et pour tout que nous savons, c'est peut-être la première fois que le débat sur le budget a déroulée en français. Ce n'est pas possible d'être certain, mais c'est un bon chose en discuttant ce budget.
Dans le discours du budget, le vendredi passer, j'étais bien intéresser à entendre le ministre de Finance dissant le suivant: "En partenariat, avec le gouvernement fédérale, ce budget inclus $688,000 pour épanouir le progrès considérable qui était fais dans la provision des services en français, durant l'année passé. Quand j'ai entendu ça, j'ai cru que c'est un montant d'argent de plus, en plus de ce qui était dépensé l'année passé. Mais ce que j'ai découvert, en étudiant le budget, c'est que ce n'est pas quelque chose du nouveau de tout. En effet, il y en a eu de budget à budget un plus court de presque 10 pour-cent dans le budget de l'Office des affaires acadiennes. Avec les dépenses actuelles à ce budget c'est à-peu-près la même chose. Est-ce que le ministre peut confirmé qu'il y a dans le budget de l'office cette année un léger baisse dans le budget?
MR. D'ENTREMONT: Monsieur le président, à le membre de Halifax-Fairview, je le remercie pour ses questions et pour me donner l'opportunité de faire un peu de débat en
français. Quand ça vient au budget de fonctionnement du l'Office des affaires acadiennes c'est essentiellement le même que l'année dernière. Ce qu'on voit vraiment c'est une changement de presque 30 mille additionelle pour la conférence nationale sur la francophonie canadienne qu'on vise d'avoir en quelque temps, je pense en septembre ou quelque chose.
Se qu'on voit dans le baisse d'argent c'est vraiment la classification des salaires. A ce moment içi on approche cinq personnes qui travaille au bureau dans l'Office des affaires acadiennes donc c'était vraiment justement de ces personnage là. L'autre chose qu'on vraiment voit pas dans le budget des affaires acadiennes c'est l'argent fédérale qui viens du ministère de patrimoine canadien et puis qui est égaler ou jumeler avec des argents de différents ministères du gouvernement qui offerent des services aux acadiens et francophones de la Nouvelle-Ecosse.
MR. STEELE: Alors la chose le plus important n'est pas exactement le montant d'argent, c'est ce qu'ont va faire avec cet argent. Alors j'ai étudié le plan d'affaire pour l'Office des affaires acadiennes puis il identifie 14 priorités pour l'année 2007-2008. Mais ce qui est surprenant dans ce plan d'affaire c'est dans la colonne pour les résultats cibler, ce qu'on va faire avec l'argent pour les 14 priorités, il y a 11 dans cette colonne qui sont vide. Comment est-ce que cette assemblée peut savoir ce que l'office va faire avec ses montants d'argent s'il n'y est pas même dans le plan d'affaire des résultats cibler?
MR. D'ENTREMONT: Monsieur le président, à le membre de Halifax Fairview, ce n'est pas nécessairement qu'est-ce qui est important. Qu'est-ce qui est important c'est le plan d'affaire des affaires acadiennes mais c'est le plan d'affaire de chaque ministère qui vont maintenant avoir des choses pour offrir des services à la population acadiennes. Donc de savoir que la population acadiennes dans nos régions, même içi à Halifax, ont besoin de service. Ca qu'on voit vraiment de l'Office des affaires acadiennes à ce moment c'est l'organisation centrale pour le soutien de l'ensemble du gouvernement. Le travaille que nous faissons dépends vraiment sur les demandes reçu des ministères.
Ceçi est seulement le deuxième plan d'affaire pour l'office donc si sa rassemble qu'il n'y a pas beaucoup de choses dedans où peut-etre des choses qui ne sont pas avec des résultats cibler c'est à cause que c'est vraiment la deuxième année qu'on vise vraiment de travailler encore avec les autres ministères quand ça viens à des services. Beaucoup de nos mésures de randement sont nouvelles donc on n'a pas de base pour trouver des résultats. Nous allons bâtir nos bases de donner et renforcer notre capacité de rapporter sur nos priorités.
A moi et à Madame Madden, la directrice, nous serons efficace quand il aura une augmentation dans les nombres de services gouvernementaux,. A moi c'est ce qui est plus important, le gouvernementaux en français et quand ses services répondront aux besoins de la communauté. Donc les choses qu'ont veut faire, qu'ont va faire, c'est travaillé en collaboration avec le comité de coordination des services en français pour mettre en ordre
des stratégies globale pour l'amélioration et l'augmentation des services en français, fournir des conseilles sur les politiques et les communications, offrir des services de traduction- se qu'on fait maintenant- et appuyer financièrement les ministères des autres institutions publique afin de les permettre d'élaborer leur politique ou créer des programmes qui augmenterons les services disponibles en français.
Nous allons offrir des possibilités de formation ou de l'amélioration des compétences linguistiques en français, continuer le dialogue avec la communauté acadienne et francophone - c'est quelque chose qu'on va faire souvent - et un autre, maximiser l'utilisation des resources disponibles, les fondements, des partenariat nationaux et même des partenariat internationaux.
MR. STEELE: Monsieur le président, en plus d'avoir des priorités sans résultats cibler j'ai aussi une problème avec le fait que beaucoup de ces priorités sont si vague. Ce n'est pas une problème seulement avec l'Office des affaires acadiennes, c'est une problème qu'on trouve dans les plans d'affaires à travers le gouvernement. Je veux cité quelques examples, par example, le priorité no.3, les ministères reçoivent des soutiens pour les aider a communiquer leur services en français. Comment est-ce qu'on peut mésurer ce soutien? Combien de soutiens? Le plan d'affaire nous dissons rien. Le priorité no. 5, les ministères obtien des fonds en provenance de l'Entente Canada - Nouvelle-Écosse, relative aux services en français mais combien d'argent? Le plan d'affaire ne dit rien. Si on gagne un seul dollar du gouvernement fédérale on peut dire que c'est un priorité réussi.
Ce n'est pas assez pour nous içi dans l'assemblée de savoir ce que fait l'Office des affaires acadiennes. Un autre example, priorité no.8, la communauté acadienne et francophone est mieux connu dans la communauté francophone internationale. Par qui? Comment? Combien? Il n'y a rien dans le plan d'affaire alors j'ai de la difficulté en savant si le montant d'argent requis par l'office est assez ou pas assez parce-que ces priorités sont tellement vague. Est-ce que le ministre peut nous promettre que dans les plans d'affaires dans l'avenir on va avoir, pour chaque priorité, quelque chose plus exacte et avec chacun de ces priorités des résultats cibler? Il y a une expression si on ne sais pas où on va, on ne peut pas jamais y parvenir. Est-ce que vous pouvez nous donner cette promesse?
MR. D'ENTREMONT: Simplement dit comme j'ai répondu justement que c'est vraiment notre deuxième plan d'affaire. C'est quelque chose qu'on a vraiment penser mais c'était aussi de regarder ce qu'on fais dans le signe du gouvernement, essayer d'être le conseil, d'être le système central pour offrir des soins mais aussi pour faire certain qu'il y en a de l'argent pour cibler avec l'argent de chaque ministères. L'autre chose que, même si ce n'est pas dans le plan d'affaire que le membre parle de, on va déposé un rapport sur les services en français içi dans la Chambre avant qu'on est fini nos débats. Je pense d'en avoir fini dans un couple de semaines, je pense dans deux semaines donc je va offrir l'opportunité du député de regarder se qu'on fait, se qu'on a fait et puis je va faire une petite liste içi des
choses que moi je trouve comme des choses importantes qu'on a pu faire pendant la dernière année.
C'est vraiment les institutions publiques désigner aurons publié leur plan de service en français et auront executé ces plan qu'on va voir, une augmentation des nombres de documents communiqués du presse, information sur les sites webs et des affichages en français, le programme Bonjour - quelque chose que je suis vraiment excité de voir - d'avoir plus affichages et plus de brochures pour nos travailleurs qui sont bilingues. Il sera plus visible afin de identifier les bureaux et les personnels en français dans les services de français.
Les consultations publiques offront aux acadiens et francophones l'occasion de participer en français donc ce qu'on pousse maintenant c'est vraiment quand on va en district en district, même avec la consultation justice, quand on va a Yarmouth et d'autre endroit que ont pense qu'il y a un population acadien, on va avoir des traductions et des choses comme ça qui vont être publier. Donc même si notre plan d'affaire de cette année n'a pas toutes les informations qu'on aimerait d'avoir c'est seulement qu'on n'a pas de base pour vraiment cibler avec. Ce qu'on va voir prochainement dans les prochaines plans d'affaires est plus d'information va être disponible pour toutes les néo-Écossais et nos membres.
MR. STEELE: Ministre, mon dernier question. La chose la plus importante n'est pas ce que l'office va faire pour moi ou pour les députés dans cette assemblée mais c'est ce que l'office peut faire pour aider les acadiens et acadiennes. Je n'ai pas trouvé la réponse dans le plan d'affaire de l'office alors je vais posé la question au ministre. Pour les acadiens et acadiennes dans l'année à venir, quels sont les changements concrête dans la vie quotidienne qu'ils vont remarqué dans leur vie à cause des actions de l'office?
MR. D'ENTREMONT: Une autre fois, ça me donne la chance de discuter les choses qu'on va voir. Vraiment j'aimerais remercié même tous les membres içi pendant le projet de loi sur les services en français pour leur support pendant la réglementation qui est maintenant en vigueure depuis la fin de l'année de 2006. On va voir des institutions publiques designée et ils vont publié leur plan d'affaire de services en français ils auront exécuté. Les choses qu'on va voir dans nos régions c'est notre programme Bonjour. On va voir plus de personnes dans les centres de services de la Nouvelle-Écosse, même dans les régimes de santés dans les hopitaux on va voir des membres avec Bonjour et les auxiliaires médical qui vont avoir Bonjour sur eu qui peut offrir des services en français.
On va avoir plus de consultations avec la communauté. On envisage un parteneriat avec la Fédération acadienne de vraiment travailler avec la communauté parce-qu'on a vraiment besoin de faire deux choses, ce n'est pas seulement d'avoir des services disponibles mais on a besoin de vendre l'idée à les acadiens dans les régions pour utiliser les services qui sont là. C'est avec cette utilisation là qu'on peut prendre les membres, on peut parler avec les autres ministères pour en offrir d'autres. Ca c'est la travaille qu'on veut faire pour les
acadiens, c'est des choses qu'on va voir pour les acadiens. Je pense qu'on a fait des grands pas pendants les derniers deux, trois ans et c'est des pas qu'on va tiendre à prendre pour les services en français pour nos acadiens dans la Nouvelle-Écosse.
MR. STEELE: Monsieur le président, cela complète mes questions pour le ministre. Mr. Chairman, that concludes my questions for the Minister of Acadian Affairs.
MR. D'ENTREMONT: Thank you again, Mr. Chairman, for the opportunity and to the member for Halifax Fairview, for allowing me the opportunity to do a bit of debate in French, because it's something that we don't get to do enough and I think in maternal language, it's actually a lot of fun to do.
Mr. Chairman, I rise in my place to move Resolution E11.
MR. CHAIRMAN: Shall Resolution E11 stand?
Resolution E11 stands.
MR. D'ENTREMONT: Mr. Chairman, the second resolution is Resolution E17.
Resolution E17 - Resolved, that a sum not exceeding $28,012,000 be granted to the Lieutenant Governor to defray expenses in respect of the Executive Council, pursuant to the Estimate, of which Acadian Affairs represents $688,000.
MR. CHAIRMAN: Shall Resolution E17 carry?
Resolution E17 is carried.
Thank you, Mr. Minister. We will now take a five-minute recess to allow the Minister of Community Services to prepare and gather her staff.
[4:47 p.m. The committee recessed.]
[4:51 p.m. The committee reconvened.]
MR. CHAIRMAN: We will now commence with the estimates of the Department of Community Services.
Resolution E2 - Resolved, that a sum not exceeding $781,783,000 be granted to the Lieutenant Governor to defray expenses in respect of the Department of Community Services, pursuant to the Estimate, and the business plan of the Nova Scotia Housing Development Corporation be approved.
MR. CHAIRMAN: The honourable Minister of Community Services.
HON. JUDY STREATCH: Mr. Chairman, it is indeed an honour to appear before this committee and present the Department of Community Services budget for the 2007-08 fiscal year. I am pleased to have with me today two senior staff people who work with the numbers day in and day out, and for these estimate days, I will be counting on their support. George Hudson is the Executive Director of Finance and Administration, and Bonnie LeFrank is Manager of Budgets and Results. Without the two of them, I indeed would be very lonely today and in the days to come. This estimate's debate gives me a chance to profile the Department of Community Services and to provide a preview of our programs and services for the upcoming fiscal year.
The most important piece of news, Mr. Chairman, is that our overall departmental budget is increasing, allowing us to direct more money to where it is most needed. The Community Services budget for 2007-08 is $781,783,000. That's an increase of $33.7 million, over last year. That's millions more in support of thousands of Nova Scotians in need.
Mr. Chairman, in light of the fiscal demands on this government and the competing desires of every department to do more, I am grateful that Community Services clients are being looked after. In fact, we will be widening our reach within some programs, to touch more people with this additional funding. I will give you an outline of where this funding will be directed.
There are four key program areas within the Department of Community Services: Employment Support and Income Assistance, Family and Children Services, Services for Persons with Disabilities, and Housing.
Mr. Chairman, the Employment Support and Income Assistance section takes up a huge amount of our department's budget, almost half in fact. I am pleased to report that for the fourth consecutive year, income assistance rates will increase. Effective October 1, 2007, all income assistant recipients will receive a monthly personal allowance increase, which will be based on the consumer price index. We will be investing $1.6 million, annually, on behalf of some 32,500 clients. While we are increasing benefits for our clients, our overall caseload is declining. Accordingly, the overall budget for income assistance is declining. I am pleased to report that there are about 2,000 fewer people on income assistance than last year.
Staff with our Employment Support Services program are helping clients determine their plan for future employment. Staff are helping them prepare resumés, get the training or experience they need to return to the workforce. This allows us to provide more funding to the people who depend upon us for income support.
Mr. Chairman, last Fall we launched the Low Income Pharmacare for Children. This year we are dedicating $2 million to ensure that children of parents receiving the Nova Scotia Child Tax Benefit are eligible to receive the medications they need to stay healthy. As well, government is increasing funding under the Income Assistance Pharmacare Program. We are adding $3 million to the Pharmacare budget to ensure that those individuals and families most in need continue to have access to prescription drug coverage.
As everyone knows, Mr. Chairman, this government is committed to implementing all 34 of the recommendations contained in Justice Merlin Nunn's report. Community Services will be investing $3 million to develop and implement a strategy aimed at helping Nova Scotian youth and their families. We will create a new family and youth services division. Together, with our fellow Departments of Justice, Health, Education, and Health Promotion and Protection, we will work to improve the delivery of services for children and youth in our province. We are committed to collaboration on government-wide policies, which may translate into legislation to protect children and programs for their benefit.
Now, Mr. Chairman, it is not an overstatement to say that I am thrilled with the injection of about $7 million in new federal funding to support the creation of more sustainable child care spaces throughout Nova Scotia. This is an ongoing commitment which will increase in the future at 3 per cent per year. Now we welcome this funding from our federal partners which will complement our made-in-Nova Scotia, 10-year early learning and child care plan and help families access quality care for their children. Our original plan included an investment of more than $130 million which will result in approximately 1,000 new full-day licensed child care spaces.
We are pleased to continue our partnership with the federal government, to extend our agreements on early childhood education with another $7 million for this year alone and the continuation of those agreements to 2014, much more can be done for parents of pre-school-age children looking for choice in daycare services. Funding for children with special needs will double and help approximately 530 more Nova Scotian children. We recently announced the child care operating grant funding. This funding is available to all licensed, full-day child centres and streamlines our existing grant system.
We have also provided over $600,000 in repair and renovation funds to 30 child care centres across the province to make improvements to their facilities, like replacing windows, installing accessibility ramps and adding energy efficient furnaces. Mr. Chairman, my department looks forward to working with the child care sector to identify opportunities and spaces this year so that parents can find affordable and safe child care.
Mr. Chairman, it is most rewarding to see the positive impact some of our programs are having on the lives of those Nova Scotians who are coping with mental or physical challenges. Through our services for Persons with Disabilities Renewal Project, the department continues to make progressive strides in providing a more responsive, accessible and sustainable system of supports for Nova Scotians with disabilities. Independence is what they seek and our support is what they need.
We have rolled out three new and expanded programs: Direct Family Support, Alternate Family Support and Independent Living Support. These are important steps that will provide a broader range of options to support people with disabilities by enabling them to stay in their own homes or find additional support within their community. Cape Breton served as a pilot region for the Independent Living Support Program last year. Just last week, the program was rolled out in the northern region and the other two regions will be added this year. We are investing an additional $2.2 million in these three community-based programs to make services available to even more people.
In the 2007-08 budget, the Finance Minister announced that our government would be embarking on a new pilot program aimed at helping Nova Scotia seniors stay at home with help from family members or care providers. The government recognizes that many seniors need a helping hand to remain in their own homes instead of moving to a senior facility away from their community. An investment of $800,000 will be available to fund those costs that might otherwise mean the difference between staying in a family home or moving to a care facility.
Mr. Chairman, this government's total investment in housing repair programs in 2007-08 will reach $18.2 million, an increase of $4 million. These programs will enable seniors and low- to modest-income households to make the necessary repairs to their homes, enabling them to remain in their own homes.
Mr. Chairman, in 2007-08 we will be investing a total of $18.9 million in affordable housing as part of our plan to increase and preserve the supply of affordable housing across Nova Scotia. With funds available from Phase II of the Affordable Housing Agreement, a total of $11.5 million will be invested in the creation of new, affordable housing options and the preservation of existing housing stock, to ensure Nova Scotians have access to safe, adequate and affordable housing. We look forward to continuing our partnership with the federal government and the private sector on these affordable housing initiatives. A total of $7.3 million from the affordable and off-reserve Aboriginal housing trusts will also be invested. Working with representatives of our Aboriginal communities in the provincial Office of Aboriginal Affairs, we will spend more than $1.5 million, this year, to help address the housing needs of our Aboriginal people.
Also, $3.25 million of this funding will be used to help improve accessibility and mobility within senior citizens housing. Many seniors enter senior citizens housing units
when they turn 65 and mobility is not a major issue. Over the time, the average age of our clients has grown as they stay within units for longer periods. We are pleased to invest in senior citizens housing, throughout the province, by installing 13 new elevators. Elevators increase the ability for clients to age in place, Mr. Chairman, enabling them to stay in the units they consider home. We will continue to accommodate these mobility issues and challenges as soon as we can.
The remaining $2.5 million will be used this year to create additional affordable housing options for low-income Nova Scotians. Our government is committed to maintaining a stable and skilled workforce. We have allocated wage increases of approximately $11 million to cover negotiated settlements for wages, salaries and benefits for staff of the department and our service delivery partners. We are making significant investments in programs offered by Community Services, which will benefit the Nova Scotians who find themselves in need of our support.
Mr. Chairman, I look forward to sharing more details of our budgets with members of the committee through their questions. Thank you. Merci.
MR. CHAIRMAN: Thank you, Madam Minister, for those opening comments. We will now begin debate with the NDP caucus. The honourable member for Dartmouth North.
MR. TREVOR ZINCK: Thank you, Mr. Chairman. I want to take the opportunity to thank the honourable minister for her opening comments on the budget that is presented before us. Congratulations on making it through your first year as the Minister of Community Services, and thank you to your staff for taking the time today to come in and assist the minister.
I stand before you today with 10 months under my belt as a critic - 10 months under my belt as Community Services Critic - and I can tell you that it has indeed been an eye-opener. When you, as an MLA, have individuals and constituents come into your office and share their situations with you, be it an easy problem to solve or a difficult problem to solve, I think that all of us in here, it's been stated many times, the majority of the situations and issues that we deal with are social issues.
This is a huge part of the budget for this province, Community Services, and in recent months I am encouraged to know that there have been several resolutions passed on the floor of Conservative conventions. I'm encouraged by the Third Party, the Liberal Party, in pushing forward on a poverty strategy bill. I can tell you today, however, that we still have a long way to go and in the hours and the days coming, we, as a caucus, hope to point out some of the inefficiencies or key concerns that we have to address.
I want to personally thank the Department of Community Services that represents the Dartmouth area. I want to personally thank Supervisors Greg Cromwell, Ron Hann and Jim
Burgess for all their efforts in making my job easy. We have great communication at my office with the department. However, as stated, there's much more work, because as a Community Services Critic for the Official Opposition, I have many calls from not just my constituency, but from around the province, and I have had success with the Dartmouth office. I have had success with the minister's office immediately here in Halifax, the previous deputy minister.
However, throughout the province, there are issues that come to me that I would encourage all other MLAs to bring to the department as well, whatever political stripe they take up, it doesn't matter. It's an issue that they should bring right to the department.
We spoke on silos and I think that this government now realizes the importance of communication between Community Services, Justice, Education and the Department of Health. I think it's crucial that we begin to look at situations and cases as individuals and how we can better each individual case instead of pushing it off. I think the minister and her department, as other ministers are doing, recognize that that is key and crucial if we're actually going to help the most vulnerable in our society.
With those opening comments, the line of questioning that I'm going to take in the next hour will be talking around the ESIA programs, I want to speak to concerns that constituents have brought to me in and around communication with caseworkers and supervisors. I want to also speak to the importance of child welfare and child protection situations, many that have been brought to my attention throughout the province. I'll speak to several issues in and around the daycare program, the made in Nova Scotia 10-year plan; I'll comment on our housing stock, or the lack of affordable housing; programs such as Career Seek; the advisory committee that was struck by the minister regarding child protection and child welfare; and key issues such as clawbacks, the 70/30 split. What I'll start with, first of all, is the ESIA program.
The minister stated that there will be an increase based on the consumer price index in October. Correct me if I'm wrong, I understand this will be the fourth year consecutively that we've had an increase; last year was $10 and the year before it was $6. The consumer price index is, I believe, between 1 per cent and 3 per cent. Are we looking at another $10 increase for personal allowance and possibly another $15 increase on shelter?
MS. STREATCH: Mr. Chairman, not to take up my honourable colleague's time, but I do want to recognize the hard work that the member for Dartmouth North has done over the past 10 months, though it may seem like 10 years for him, it indeed has only been 10 months. I, as well as my department staff and my political staffers, have welcomed the member to the department, we've welcomed discussion. It has always been thoughtful, it has always been sincere and even when it needed to be critical, it has always been done in a manner that was critical for positive results. So I want to stand in my place today and recognize that and thank him for his professionalism, his dedication to his constituents and
for the respectful manner in which he interacts with my staff. It is noted and it is appreciated and I wanted to make that perfectly clear.
My honourable colleague made reference to a couple of other points that I will reference. I know he did have quite a long list of issues he wants to bring up, but I think one of the points that he made, that is extremely important, is the necessity to seek all the input we can possibly gain.
I was writing notes as he was speaking and reflecting upon the Senate report that is coming down and will discuss poverty in rural communities, I'm looking forward to receiving that; the Face to Face report that I received just this past week regarding issues across the province as they pertain to poverty, employment and income assistance; the standing committee that presented documents to me had a two-day follow-up on their Poverty Forum, the constructive information that can come out of those reports; as well as the initiatives from all three political Parties in this province.
I think it's important that we do look beyond political agendas and political lines when we deal with issues that affect everyone - issues that do not have political agendas, but have broad-based importance and ramifications for all of us. So I'll look forward to continuing those discussions and working with my honourable colleague throughout the months to come, and perhaps years, as we deal with some of those documents and factor those in.
Specifically to my honourable colleague's question, I stood in my place last year and was pleased to be able to bring, for a third year in a row, an increase to the personal allowance, as my honourable colleague has identified and as I mentioned in my opening remarks, we will be pleased to do that again for the fourth year in a row. It will come into effect October 1st, as the last increase came into effect October 1st, so we will piggyback on that, Mr. Chairman. We will use the CPI as committed, to provide that increase, as we know that there are many pressures on our clientele, so we will be providing that on an annual basis, according to the consumer price index.
MR. ZINCK: Mr Chairman, my next question, I want to go to Page 4.10 of the Estimates Book, Supplementary Detail, the Income Assistance Payments line that has been reduced from $226,564,900 down to $213,386,500. My next question would be, can you explain why that drop has taken place and could you provide some figures as to the overall reduction in the number of clients that this could possibly represent?
MS. STREATCH: Mr. Chairman, as my honourable colleague across the way knows, the Income Assistance Program provides financial support for those individuals who are in financial need, for a variety of reasons. The line that he is referencing, Income Assistance Payments, indeed does reflect a decline in the estimate to forecast. It is with pleasure that we see a decline, because that means that there has been a reduction in caseload. A reduction in
caseload is positive, because that means more people are coming off income assistance and transitioning into the workforce.
My honourable colleague asked for specifics. The caseload continues to decline from 30,387 identified clients, 50,000 total beneficiaries in January 2006, to 29,103 identified clients, 46,802 total beneficiaries in January 2007. I can provide those numbers after the fact, if I went too fast in my numbers. Basically, it's a decrease of over 1,200 identified clients in the last calendar year.
MR. ZINCK: So the nearly $14 million reduction in that forecast has been stated, I can almost guarantee you are well aware of the allowances that we give to individuals on the ESIA, the personal allowance and the shelter is never nearly enough with the cost of living today. If you break it down, $14 million, if it is indeed a reduction in caseload, why wouldn't you take that extra money that is there and possibly spread it out again and boost it up over and above the CPI? It would probably work out, based on the cases, to about $35 to $40 extra. It could be food, it could go toward a power bill or it could go toward a phone. Was that a possibility that you considered?
MS. STREATCH: Mr. Chairman, we are always faced with challenges when it comes to the end of the line dollars. When we see the decrease, the opportunity that presented to us for the last three and now four years, to increase the personal allowance, as well as having increased the shelter rates. So we have chosen to reinvest in those program areas with the increase but certainly, should we continue to see a decline, then we would be more than happy to look at reinvesting in other areas where it is most needed.
MR. ZINCK: Mr. Chairman, I will go a little simpler. I think probably all MLAs have had this situation, I know especially here in metro. Many of the cases that I get, and it's from seniors, whether they're on fixed income, or individuals on the ESIA, or individuals who are receiving disability, with the allowed or the allotted shelter and personal allowance - and I will give you an example. A recent call to my office, an individual is on disability, their maximum on the shelter allowance is $535 and $200 personal allowance, maybe some special diet added in. The gentleman is informed that his rent is going up. His rent was under that level. However, now he is calling my office saying, Trevor, what do we do? My rent is going up to $575.
These are individuals who need to be healthy. These are individuals who will, if they are unhealthy, fall into the Health Department, get on the wait list, create havoc in the health care system. There are too many of these cases. So if you can give me some advice. What can I say to an individual like that, who knows that there is no means for employment, they are disabled and their rent is going up? In HRM in particular, with some major players in the real estate industry, it's happening on a regular basis, whether you are a senior or someone on
disability or ESIA. What do we tell individuals? Where do we go to make up the balance of that rent?
MS. STREATCH: Mr. Chairman, it never ceases to amaze me that the true passion and compassion that I hear in my honourable colleague's voice, because I know that it's for the benefit of those individuals that he brings cases like this to the floor. It is a never-ending challenge. As we move forward to attempt to provide resources, support, programs for all those Nova Scotians who find themselves in need, we do end up making decisions and having challenges, in the same way that low-income working Nova Scotians would have those challenges. I would encourage the member to continue to work with his constituent, to attempt to exhaust the services and resources that are available. The member is always welcome and we have varieties of programs and opportunities. Perhaps there is something we can find within those programs and opportunities that would alleviate some of the stress for this particular member.
MR. ZINCK: Mr. Chairman, I appreciate the comments from the minister. The unfortunate part is that when a case like this is presented to my office, the first thing we do is one thing, I need a budget. We sit down with the individual, we create a budget. Something that I believe that when an individual first approaches the government or social assistance or ESIA programs that should be instilled in that individual by a caseworker - an actual budget. When you go through the budget, then we are put in a position to what programs can we tap into? What areas can we exhaust to find more funding? Usually, whether it's transportation or special diet, it's still, whether we tap into it or not - take special diet, for example, $68 maximum. If we tap into that and we are allotted the extra funds for that individual, that individual is a disabled individual, they still need to eat healthily.
So all we're doing is we're taking from the system to make up for that rent. The individual is still not going to be able to eat healthily and we are kind of robbing the system instead of going in and making the necessary changes to where things are really at today. I know it's a difficult decision. I know, as far as budgets and money, it's a difficult position to put the government into.
However, I look at individuals, individuals who are asked to find shelter on $300 or possibly $315 or $310 in October. When an individual is reaching out at the last resort, coming to the Department of Community Services, where do we tell this individual, who is at their lowest point, the last resort, to find a place to live, based on that shelter allowance? That includes heat, that includes power, which is rising as well. The difficulty in this escalates because it comes into a health factor for this individual, whether it be physical, emotional, mental. If you don't have a nickel in your pocket, you're feeling that. I understand that the department is the last resort, but what are we telling individuals, and how do we get them beyond this? What kind of poverty strategy would we be able to install or implement to get these people past this point if we don't give them the basic necessities?
In a recent AGM held by Capital Health in the Fall, they came up with six key points to a healthy lifestyle. Two of those key points were income and shelter, and if we don't adequately meet those demands by those individuals who are most vulnerable in our society, we're never going to eradicate poverty. If an individual doesn't have enough shelter allowance allotted to them, how can they get up the next day and go to work, if they're not living in a safe community?
I looked at the business plan and some of the goals and strategic plans and points, it's client focused. It's eradicating poverty and elevating somebody out of that, and I think the taxpayer and the burden that's put on the taxpayer by individuals on this system, they would benefit. They would applaud you for helping these people, give them enough up front that would take them beyond this point. But what happens, unfortunately, is caseworkers are out there telling people to go to food banks.
What are we saying to individuals? If you could share some comments on that, that is the point. If we do not allow - and we've met with several organizations in 10 months and I'm sure you've had reports from the organizations, these are key points. Maybe next year another organization will pop up and come up with the same sort of points presented to your caucus, to our caucus. If we don't make changes in these two key factors, we will never begin to even eradicate poverty. I'd like your comments on that.
MS. STREATCH: Thank you very much, Mr. Chairman. My honourable colleague raises numerous good points in that questioning, and it takes me to that, the opening comment that nearly half of the department's budget goes to ESIA. The challenge and the question always is, is it enough? When you have the pressures of government, one can never have enough. It would be a perfect world. But the advances, the commitments, the programs, the resources that we're able to put in place, I feel, are good programs. They're good use of the taxpayers' dollars. The four-year-in-a-row increase, the increase two years in a row with the shelter, again, is it enough? No. Is it a move in the right direction? Yes. Do we continue to move in that direction? Yes, but it's not only those two issues.
I think the opportunity that we have through this poverty-reduction strategy is extremely valuable, because it needs to deal with a cross-sector responsibility, business, community, government and across the governments. I think it becomes a collective responsibility. I will look forward to including those reports that I indicated earlier. I will also look forward to going out and consulting with some of our advocates that are out there on the ground every day, who see the issues the same as each MLA in this room sees, who sees those issues, to truly understand the real challenges, not the challenges on paper, the real challenges people have in their lives.
I leaned in and asked, you know - the budget for special needs, for example, $20 million for special needs. That can cover a variety of components. We need to look at specifically what those special needs are. Should some of them be factored into an automatic
allowance? Are they truly special, or are they matters of survival? I think we need to look at those types of issues as we move forward with the poverty-reduction strategy?
As well, the housing challenges, it's a never-ending challenge; $90 million will be invested in a seven-year period in this province for affordable housing, for upgrades to our social housing. Again, that's a phenomenal commitment. It's a huge amount of money. Can it ever be enough? We're going in the right direction. It's the preservation of units, it's the creation of the new units, it's those rent supplements that are key, it's continuing to work with our co-operatives in the province. It's all of those issues that come together.
We know we can't lump them into a category. We can't say it's a housing issue, it's an IA issue, we know that it has to be a collective. So as we move forward, it's certainly been my goal to bring those issues together and to not deal with them individually and segregate an issue, because they are individuals - they may be an individual issue, but they are individuals and they are, indeed, the clients who need our collective approach the most.
MR. ZINCK: Thank you for those words. Speaking of individuals, I will move on. I want to touch on some of the strategic goals and the actual business plan, and one in particular. I'm going to move to the discussion on caseworkers and supervisors.
One of the strategic goals mentioned in the business plan was to create an integrated client-focused, quality-service delivery system. I think that's a wonderful goal. It's something that I have been saying that should happen immediately when someone reaches their last resort and has to approach the department for help, because it is a difficult decision, it's a difficult step. It's sometimes, most times, an embarrassing step to have to take. So when an individual approaches a department, that is indeed what they're looking for - not a handout, necessarily, but a hand up, some guidance, some support. So I was very pleased to see that as being part of the strategic goals. In saying that, one of the concerns that has been brought to my attention on numerous occasions from individuals approaching a department for social assistance is the lack of communication in the up front.
Initially, when they go to the department, they are told to produce an income statement, a bank statement, and we look at what kind of shelter they need, an existing residence, and we determine whether or not they qualify. But it's so important that the individual is explained, and communicated to, the amounts and the many programs that could be made available because, again, the individual is at their lowest point. They are coming to the department for a hand up. What I'm hearing is that doesn't take place. There is a lack of communication. I'm wondering if you can comment on that.
MS. STREATCH: Mr. Chairman, an extremely important point. We often talk about, do we communicate too much, do we communicate too little, do people truly understand what's available? It never ceases to amaze me how we learn about new programs and departments every day. As minister, I learn about programs in other departments every day
that I didn't even know existed. The $3 million investment in the ICM program, I believe, is truly a very valuable investment. It does exactly as we indicated in "strategic goal" to create that integrated client-focused, quality-service delivery system. So that is a commitment and investment to do just that.
The other issue, you will see on the lines, is that we have an increase in our communication budget - additional staff, resources, we have a Web master. Now I know it can't all be done on-line. Don't get me wrong, I'm not saying we substitute the written word or communications through our staff for on-line - but I was very impressed, I travelled around to a couple of trade shows that pertained to child care. I was at an event where we were talking about housing, and there was actual information there, in pamphlet form, that the individual could take home, take with them, that had numbers, that had facts and figures, contacts. I don't think we can do enough of that.
I think truly getting the word out is a key component. I won't say it's as important as the program, but it is a key component to the success of your program and to the delivery of that program, because it is those individuals who find themselves at a place in their lives where it may not always be easy for them to come looking for that help, to know the questions to ask. They have advocates, they have political advocates, they have family or friend advocates, but we have to make sure that the front line is wide open so when they go and ask the question, the answer is given and the door is opened even wider and they don't get discouraged.
MR. ZINCK: I think your points are very valid. The reason I bring it up is exactly what you said, but I'd like to see it go beyond more than just receiving a pamphlet. I've stated in the past and I've spoken to you, as well, regarding what I believe is crucial in giving that individual further support, a follow-up - and not necessarily a six-month follow-up or a yearly follow-up, I'm talking about an individual who is at a crucial point in their lives, and if we really wanted to eradicate or eliminate them and further remove them from the system and really get them beyond the point that they're at, it's more than taking that pamphlet. That's the beginning - putting that pamphlet in their hand and saying, I'm here to support you, I'm here to guide you in some sort of way. So I'm glad to hear that.
I encourage the department to maybe have a change in policy or allow caseworkers to further be more active, maybe, with individuals who they come into contact with. I think it's of huge importance in the way we deal with individuals, rather than just giving them that monthly cheque. It's saying that, indeed, even though it's not our mandate, we care.
I think it's a benefit to the government, as well, because it lessens caseloads. Eventually that individual, if you work with them, if you coordinate things with them, they will see their way off the system. I've been successful now, working with your department
in elevating people out of those situations by bringing a collective body together, those who make the decisions that implement the policies and present them in front of that individual, and that individual, they may be in awe, but they also see a support system there that, at the time of approaching the department for that assistance, just isn't there. So I look forward to see that develop further.
I want to briefly touch on - you made mention of special needs, and many times situations arise where perhaps a power bill is out of whack and it needs to be eradicated and the department's called in, or someone is moving and once every two years you're allowed to have the department assist you in moving. However, a lot of times what it results in is an overpayment. The situation is, the client is thinking that it's being taken care of by the department, but the next month it's off their cheque. The question I pose - and upon your answer, I'll respond - the maximum for that overpayment is $45 and when an overpayment is applied, why - and I understand why, but I want to hear it from the minister - is it always applied initially at the maximum level of $45?
MS. STREATCH: To my honourable colleague's first comment before he moved on to the question - I just want to go back to communication for a moment - to be proactive is so important. The more we can do on a proactive, preventive manner, the better. Now saying that, I know that I don't want to add to the pressure that's already on my caseworkers, because they have a phenomenal amount of pressure and responsibility on their shoulders, so I welcome the suggestion and I know that as the department works with our caseworkers and our front-line workers, they are sensitive to the necessity to be proactive, as well. So we will continue to encourage that in a professional development manner and seek opportunities to further the proactive. So I make mention of that.
Mr. Chairman, the issue of overpayments is a challenging one, there's no question, and it's an issue I struggle with. I have, as MLA, as well as minister, had many challenging situations come before me where individuals have found themselves in these exact situations where they have for one reason or another found themselves in need of extra assistance, it's been provided, and whether it's miscommunication or a misunderstanding and they felt that it was being looked after, and then charged back as an overpayment, is something that I do struggle with.
I think it's key that any time dollars or resources are being advanced, that it's clearly articulated, that it's clearly understood to the client that this is an advance; this is not an elimination of that challenge for you, of that issue, of that resource challenge, this is an advance. I think that will go a long way to the struggles that the clients then have when they're faced with how do I pay that back, I thought that was looked after. I think that's the first thing we have to do. The $45 a month, indeed, is the maximum. To be quite honest with you and to be blunt, the reason for automatically going for the $45 per month, I don't have an answer for you for that.
MR. ZINCK: I appreciate your honesty. I can tell you the process that I go through when this is presented to me. Again, usually if there is a situation, an individual walks into my office, the first thing I do with any matter is, let's sit down and let's do a budget, I really want to give you an understanding as to where you are. I have had individuals where I have had to say that you can't afford to live here based on what you're allotted. It's a difficult decision to tell someone to uproot their family and move, but I have no recourse based on the allotments that are given through the department.
The first thing I do when I see that, it's a red flag - I know why, because the department has to try to recoup that money as quickly as possible - the first thing I do is call the supervisor and say, on an individual case, this person cannot, off a $200 personal allowance, whether it includes special diet or not, afford to lose $45 a month. Let's not even include a special diet, let's say it's $200 off their personal allowance, but it's slapped on there right away, the individual gets their cheque and they are short. How am I going to eat? I can't pay my phone bill, or I'm delaying my power bill.
Well, that's a whole different can of worms, because the next month they're right back in my office and I'm making a call to Nova Scotia Power, and it's a pain in the butt for them as well. The first thing I do is I pick up the phone and I call the supervisor and say, this individual, here's their budget, they can't afford this. Do you know what happens? It's a reduction immediately; low point of $10, usually $15, and that's appreciated. I look good in front of the client and the supervisor looks like he's responding to the needs of the client.
I guess my point is, why doesn't that happen right away? If they're helping the individual, if a caseworker is contacted, and said that this is necessary, I need this extra funding, why can't that caseworker go back and communicate that to the supervisor and say I know this is the process but this individual can't afford to lose $45, can we make it at this level? I know it will take longer to pay it back, but at least it's getting paid back and it's not as big of an impact on an individual or a young family.
I'm going to move on, I'm going to touch briefly - because I know we have communicated in the last week or so on this, but I want to talk just briefly - on one of the other strategic goals that impressed me: to create or strengthen service provider relationships and leverage opportunities for collaboration. I know I had brought to your attention a week or so ago a situation with a particular home for addictions. There are many across this province that seek funding through the department or through the Department of Health Promotion and Protection what continuously happens. I'm bringing this up again, because I want to get it on record and I want to hear it from the minister. What continuously happens every year with these group homes or homes for addiction recovery centres is that the funding runs out.
One particular men's home for addictions, the Freedom Foundation in Dartmouth North which has been operating for 17 years, has continuously on a yearly basis, year in, year
out, found themselves in need of funding. I know that they were receiving funding from the Gaming Foundation; however, this year it has ended. When the situation was brought to my attention, I said to Joe Gibson, who is the coordinator, you shouldn't have to go through this process every year. Based on the fact of what you're doing, what you are accomplishing with the individuals who come from all across this province to Dartmouth North in this men's home for addictions, the burden that you take off the justice system, the burden you take off the Health Department, the burden you take off the Department of Community Services, why can't we come up with a sustainable funding model? I would just like to hear or see what direction the department is going to officially go in there.
MS. STREATCH: Mr. Chairman, to my honourable colleague's first point - I was nodding my head as you were talking about the calls to the supervisor to have it reduced. Do you know, you are absolutely correct - you look good in front of your constituent and that works for you. I will go back and ask for a review of that policy to get a clearer understanding. I would concur that it is indeed an attempt to recoup the costs as quickly as possible to lessen the long-term burden on the client. Is it a Catch-22, long-term burden versus immediate burden, and which one is more stressful? So I certainly will ask for clarification.
I am pleased to hear that the supervisors and the caseworkers do respond, and certainly it would be my hope and my intention they would continue to respond in such a manner when members and concerned individuals contact them and that they do take those budgeting - I think it's commendable that you do that, and I would encourage all members, and I certainly would anticipate and hope and will encourage the caseworkers and the front- line workers to do that as well. Perhaps the burden wouldn't be quite as immediate in that case, so I will certainly have a look at that policy and discuss that with you at another date.
Yes, we have discussed the recovery centres. We have a vast knowledge base and experience in this province, whether it's the women's centres, the men's treatment centres, the recovery centres - do you know, the work that goes on in those homes is just amazing. I've had the opportunity to visit a few across the province, and I have been nothing but encouraged and amazed at what they do with what they have. I know that they rely on community, and I have encouraged some of them to go out and seek some corporate and some business connections that perhaps they're a little bit leery of doing.
I think in the environment today, I really do believe that business and the corporate world are more encouraged or more apt to get involved and support centres for women and children, or treatment centres or recovery centres. I think that the feeling in the general public is one of much more acceptance than it would have been years ago. So I think corporate Nova Scotia and the business world would look more favourably upon helping out or assisting with those groups.
Now I was very pleased last year with the women's centres. We were able to take $55,000 that was provided from Economic Development on a yearly basis, but it wasn't considered core - we were able to transfer that, and we now offer that as core funding through the Department of Community Services for those women's centres to the tune of $155,000. The recovery centres, as their funding is peeled back from the gambling foundation, we certainly will be replacing that funding.
It will be my intention to ask staff to look at that very type of core funding that provides the stability for the centres. We know those needs aren't going anywhere, so the core funding just makes it easier for the executive directors and the boards to say okay, there is the core funding, now let's go out and let's try to tackle the corporate world, let's go out and try to tackle how we handle our own budget. But if they know that core funding is there I think it provides them with more stability, so we will certainly be looking to do that in the days to come.
MR. ZINCK: Mr. Chairman, I am pleased to hear that. They do indeed provide tremendous - I know the Freedom Foundation, Mr. Gibson, often gets calls from judges, and Joe will say to me the judge called me in and said, Joe, can you take this guy, and he's not even from Dartmouth North, he's from Sydney or Yarmouth - they do a tremendous job. If we can eliminate the fact that they have to go back continuously, year in, year out, and basically beg for funding to provide a service that across departments is justified, that is great.
I'm going to move on to a tough one - I really hate to end my time with this, because it could possibly take some time. In 10 months, I cannot count on two hands and two feet how many cases have come to my attention about individuals, youth, in particular - and we mention the Nunn report - parents calling me saying my daughter's on the street, she's out of control and I have no idea what to do and the department won't help me. There are numerous cases, and some which I've brought to your attention, to your EA's attention, as well, and many more. I can tell you right now, Madam Minister, there are many more in the coming months that I would love the opportunity to sit down and bring to your attention.
I want to say that parents are struggling. Along with that, individuals in our communities, in our society, youth, are struggling. I'm a particular individual who believes there are not bad children, bad things happen to children which cause them to act out. And I believe there has to be a process in place, whether it's with your department, or Health or Justice, there has to be that collective effort in bringing in that individual who is struggling, and allowing a parent to have access to programs that they can reach out for and not be punished for, and not have Child Protection brought in and have a case immediately trumped up against them.
In the best interests of the child, it's a parent a lot of the times - many of the cases that I've dealt with - who comes to me and says, Trevor, I need help, my child is worth saving, but I don't know what to do. As an MLA, it's a youth that I see, at the age of 14, 15 or 16, who may end up on the streets prostituting, experiencing drugs, and may end up someday on my doorstep, pregnant, saying I need help, I need social assistance.
There is a necessity for programs, and if you could elaborate a little bit more. This is just the first part of this, because it's going to carry over because, like I said, it's very complex, and I have many questions to ask in relation to child welfare. If you can just tell me about some of the efforts that your department, in particular, would like to accomplish and would like to communicate with other departments in hopes that we can give parents the necessary tools and programs that can help bring and rein that child back in and give that child the sort of life that they deserve.
MS. STREATCH: Thank you very much, Mr. Chairman, and we could spend 80 hours, 80 days. There's no question that the challenges that come along with the child welfare and the family services division of this department are likely the ones that are the most gut-wrenching - all of our challenges push us to our limits, but those ones tend to be the most gut-wrenching. I know, as my honourable colleague mentioned, he has brought issues to us, and we've all struggled in trying to find the best possible avenue, path, for some of those individuals who find themselves, and some of those families who find themselves with children and individuals who have seemed to have lost their way.
My eyes were thrown wide open. My 15 years teaching, there were many challenges out there that we faced each and every day, within our own communities, within our schools, and now as I find myself responding, as we did, as the government did, to the Nunn Commission, and the reports - when you read that report, and I'm sure my honourable colleague did, and I read it from cover to cover, I was captivated by the report, I really was. I was captivated by the challenges.
I was also captivated by that disconnect. That, to me, is the biggest challenge that we have, because we could have a multitude - and I firmly believe we do have a multitude - of services and programs. When you go to the back of the response and you see them individually, by department, you think, wow, there shouldn't be a problem in the province. When you look at all of these, but it's that integration, that knocking down of those silos that I think is key, because, yes, we will invest $3 million through our department, with the recommendations.
We will create a family and youth services section, we will put a youth strategy in place, and we will hire directors in the regions, which is all extremely important, but at the end of the day if we do not bring the programs and the services together and break down those silos, we will never truly conquer the challenges that come along that these families find themselves in, and they range from one end of the province to the other; it's not an urban
or a rural issue, it's straight across the board. It's not just a Dartmouth North issue, it's an issue all across the province. That's why it's important that we have the collective of the departments and that we have one ministry that all the other departments are accountable to, so it isn't just that, oh, it didn't happen in this department, it did happen over here, so that's why we have a lag. I think that's key.
The working group that's already up and operating on that strategy, the director is being sought. That individual will pool together the resources and the information that we have out there now, to better put in place our go-forward. I look forward to that information, but we're not stalling while we're doing that.
We've got the deputy minister's collective committee that's working under the leadership of the Deputy Minister of Community Services and again, that coming together of the departments is key, but the challenges are there. They're very real and as we move forward and put some of the programs in place and collectively bring them together, unify them, I hope to have continual good-news stories when it comes to some of these challenging cases.
MR. ZINCK: Thank you, Mr. Chairman, and I believe the minister is absolutely right in making the statement that it's not a Dartmouth North issue, by no stretch of the imagination. And like I said, as the Community Services Critic, I'm not going to say daily or weekly, but I've had numerous cases from across this province, of individuals and parents who have contacted my office and said, I don't know what to do, and to the department's credit we've been able to remedy several. There is one situation, and again, I think as you state, bring the programs together.
I know the minister's had a difficult year with particular cases where people have called on her to step out and represent individuals in certain cases - individuals who are wards of the state or in care of the government. Difficult situations, but I can't help but think that these are individuals who need that - who not only need all of those numerous programs, but they need, along with the services that they are provided with, the doctors, the psychiatrists, the effort to put them in group homes and emphasize how important education is. A lot of these individual youth need that focus, concentration on getting them past and beyond where they're at.
Again, I want to encourage the department. It's one thing for me to go to a psychiatrist, get an example and tell my story, then go to my doctor and give him a story, go to someone else, but if they're not collectively communicating and have my best interest at hand and coordinate a path which they want me to go on, it's all for nothing.
There are individuals, there are youths in our society today who are in situations where they don't have the necessary concentrated support. They are out there, they are the Archie Billards and it's unfortunate, because even though there may have been programs
available to Archie, there wasn't that collective group. There was a mother who couldn't control her child, who was reaching out for help potentially but I encourage the department, when they have a particular situation that they're faced with, to bring all interested parties together and present themselves to that individual who is in care or who could potentially end up in care, and say we care about you, we want to get you beyond these points and you have to be part of that process, you have to be active.
A lot of these individuals around 15 or 16 years of age think they are adults and they are closely approaching adult age, soon to be able to vote, soon some of them out of the care of the province at age 19 or potentially 21, but a lot of them don't have the skills. I met one individual recently who has been in care of the department since the age of seven and a half and they're 16 now. This individual can't fill out a job application; this individual is continuously in and out breaching curfews, and they're reading at a Grade 4 level but they're in Grade 9.
I just have to beg to question - seven and a half in the care of the government, now 16 - what have we done and why are these individuals, at this point in their lives, unable to cope because, keep in mind, two or three years potentially out of the care, where are they at? They're not off the system per se because they're coming to my office saying I need social assistance, I need this, but then they can't even fill out an apartment application.
So I want to encourage the department, when they're presented with a case, and I will approach your department in the coming months with several, because I believe every child has a chance. They have to play a role in that, but I believe also, if we can collectively come together and allow an individual to have the support that they really need, the parent to support, I think we're on our way to eliminating future individuals who find themselves in poverty and just better instilling the pride in getting them on that path. I think that's our role, we have a role in that.
I'll touch on - I know we don't have much time, but I just want to prepare this for tomorrow, you can speak on it briefly - child protection. There's an advisory committee that is stated in the Act to be set up on a yearly basis to monitor the system - Section 88, I believe it is. Yes, Section 88. Can you tell me where that committee is at now in reviewing some of the many cases that come before the courts as far as child protection?
MR. CHAIRMAN: Order, please. If the member would indulge, I'm just going to permit the Minister of Economic Development to make an introduction.
The honourable Minister of Economic Development.
HON. RICHARD HURLBURT: Mr. Chairman, to all members of the House, I'm very honoured today to rise in my place to introduce four great citizens from my home community of Yarmouth. One very special one of the group is my granddaughter, Megan
Hurlburt; her mother, Shelley; and her grandparents, Rick and Paulette Goodwin. I would ask for them to stand and receive the warm welcome of the House. (Applause)
MR. CHAIRMAN: Welcome.
The honourable Minister of Community Services.
MS. STREATCH: Mr. Chairman, I wanted to make reference - yes, I know, we'll get to the advisory committee stuff. I wanted to make reference to the acknowledgment of my honourable colleague mentioning the responsibility across the board that I certainly respect and would reiterate.
MR. CHAIRMAN: Order, please.
We've reached the moment of interruption. We'll recess debate for approximately 30 minutes.
[6:00 p.m. The CWH on Supply recessed.]
[6:30 p.m. CWH on Supply resumed.]
MR. CHAIRMAN: We'll now resume debate on Supply.
The honourable member for Dartmouth North.
MR. TREVOR ZINCK: Mr. Chairman, I know we only have a few minutes here, so I just want to reiterate my last question to the minister in hopes of hearing some comments, which I would insist we elaborate on tomorrow as well.
My last question was in and around the advisory committee that was struck by the minister, as per Section 88 of the Child and Family Services Act. My question to the minister is, can she tell me where exactly that committee is at as far as initiating a report, and membership? Please elaborate.
MS. STREATCH: As Hansard will reflect, the continuation of the discussion we started earlier, I would like, with my honourable colleague's indulgence, just to go back to the point he was making earlier regarding the challenges we face with some of the more challenging child welfare cases.
I think, again, to use some of the experiences that I had in the teaching sector, case conferencing is invaluable. When we pool together the resources that come from the experts - the psychologists, the psychiatrists, the social workers and we put that together with the
family members and the youth, I think the information and the value that comes out of that case conferencing is key.
I was very pleased to hear my honourable colleague mention that there's no question that, as individuals, each player has a responsibility to own their own circumstance. Sometimes circumstances are out of the control of the youth and we recognize that. That's when, even more so, they need our assistance, guidance and help. But that case conferencing and that ownership of responsibility, I think, is worthwhile repeating and mentioning.
I was thinking as the member was talking, there were three or four immediate components that came to my mind. Of course, there are the schools, the school system, which my honourable colleague, the Minister of Education, and I have had numerous conversations about how to better utilize the time. When you think about the time we have our youth in schools, it's more time than we have them, really, anywhere else. So that time in the school system is extremely important and valuable and we need to maximize our resources there and use those schools, use them to our benefit.
So as we move forward with this strategy, I'm looking forward to new ideas and creative ideas of how we can utilize our schools and the resources that are there to better serve the needs of those youth who need us particularly, as well as the family resource centres.
They are an amazing resource in our communities. Again, we have them all across the province. Some of them are more grandiose in their programming and their approach, others are smaller scale. But I think those family resource centres are key, especially in areas where we don't have other resources readily available, other community groups and other opportunities. Those family resources are something that I look forward to expanding on their mandate and continuing to see how they can better meet the needs of those youth in our communities where it's most needed.
Service clubs, you can never underestimate the importance, the value of our service clubs and the work they do. Anyway, we can support them as a government or as members, I think is key.
MR. CHAIRMAN: Order, please. The time has expired for the NDP caucus.
The honourable member for Glace Bay.
MR. DAVID WILSON (Glace Bay): Mr. Chairman, there's a couple of - I hear noises, but I'm not sure from where - issues I'd like to bring up tonight before I share the rest of the time with my colleague, the member for Cape Breton South. The first one I'd like to bring up to the minister is the current contract negotiations which are taking place between the employees of Town Daycare in Glace Bay and the CAW.
As the minister well knows, this is a daycare that has just recently been - it has been around for some time, but the building itself is brand, spanking new, because the minister and her department . . .
MR. CHAIRMAN: Order, please. I can't hear the honourable member for Glace Bay.
MR. DAVID WILSON (Glace Bay): Most of the trouble is coming from that corner over there, I think. Thank you. The department has put in about $700,000 towards the building of that structure. There are about, I believe, 15 daycare workers who are employed, 15 staff at the Town Daycare in Glace Bay. There are 94 children at the centre.
The daycare is a non-profit and 80 per cent of the funding comes from the Province of Nova Scotia, from the Department of Community Services. I know, and I would expect that what the minister is going to say, when I ask the question, is that this is a labour dispute; this is contract negotiations; we don't want to interfere; we can't do this; we can't do that. I'd like to hear her comments and I'd like to ask her if everything possible is being done, especially since the province - Mr. Chairman, I find it impossible here tonight to try and get a point across.
MR. CHAIRMAN: Order, please. The honourable member for Glace Bay has the floor and I would note that it's quite noisy in the Chamber and I cannot hear him. The honourable member for Glace Bay.
MR. DAVID WILSON (Glace Bay): Again, the fact of the matter is, I'd like to hear from the minister on what her department is doing. I don't expect her department to interfere in this case, but I wanted to know if indeed, Madam Minister, if you'd put the pressure on, through the Department of Labour, to make sure these workers don't walk out on the picket line, that 94 children aren't left without a place to go tomorrow.
MS. STREATCH: I welcome my honourable colleague for Glace Bay to the debate, the discussion here this evening. I'll use my earpiece, Mr. Chairman, if I can't hear him, I'll make sure I put my earpiece in.
MR. CHAIRMAN: Order, please. Thank you and I appreciate the quietness of the Chamber at this moment.
MS. STREATCH: Thank you very much. Again, to my honourable colleague across the way, I'll use my earpiece if I have a problem hearing him because I know the issues he brings forth are issues of the utmost importance to him and his constituents.
I'm extremely pleased to hear my honourable colleague acknowledge the program at Town Daycare is second to none. It's a wonderful facility; we were extremely pleased to partake in the expansion of that facility. Indeed, it was the first outing that I made as minister
and I joined my honourable colleague for Glace Bay at the event as we unveiled the plaque and looked forward to the expansion. I was pleased to have him there alongside me and committed to him that I would be encouraged to go back again and I'd be happy to go back for the official opening and investigate other opportunities in the Glace Bay area.
Specifically to Town Daycare, my honourable colleague is absolutely correct in his assumption that I would stand and acknowledge this is a labour issue and that there is definitely a process that needs to be respected. As that process unfolds, I am extremely pleased to learn that they have returned to negotiations and that the two sides are again talking. I think that's extremely important. I know that those dedicated workers at Town Daycare are committed to providing quality child care to the children they serve. They have wonderful programs there for special needs children as well as the mainstream programming.
I know they were especially pleased when we brought in the operational grants just this past month that will be retroactive to January, that provide them with more funding to be able to stabilize the programs they offer there. I do have faith that the process will unfold as it needs to between an employer and the labour issue is resolved in a positive manner.
MR. DAVID WILSON (Glace Bay): I'm sure, as I pretty well guessed, I knew that would be the response from the minister. It's the normal response that we can't get involved because it's contract negotiations that are taking place, but I want to make sure the minister is aware and is doing everything possible so that there are not 94 children left without a place to go. These are daycare workers, they don't want to go out on strike, they want to be there to take care of the children who are in their care. The increase they're seeking is 2.9 per cent in each year over a three-year period, and what they've been offered is nothing - 0 per cent is what the board has offered.
The board falls back on the excuse that it's 80 per cent funded from the provincial government and they're not getting any increase from the provincial government in their funding, so how can they afford it? They have other costs incurred now with the new building, which they are deeply appreciative of, but the new building has left them in a position where they're really not sure how much the heating costs and all that are going to be because it's the first time with the new building. I just wanted to make sure the minister is aware of this and hopefully keeping on top of it.
There's another subject I wanted to broach, Madam Minister, and that's the appeal process through your department. There have been three recent instances that I've been involved with, appeals that involved the Highland Fisheries workers. Initially, they were denied benefits, and the reason they were denied - and I'm sure the minister is familiar with the case because they were locked out from their employment with Highland Fisheries, and because the case was originally determined to be a lockout, which is a labour dispute, and your policy clearly states you cannot give benefits to anyone involved in a labour dispute, whether it is a strike or a lockout, your policy clearly states that, and that was the case at the
first of Highland Fisheries. But during the appeal process, when those cases were finally heard by the appeals commissioner in Glace Bay, all three cases were overturned. They were all overturned by the appeals commission, Darren McFadgen, which was the name of the appeals commissioner. One of the reasons cited in those appeals decisions was that there had been independent evidence that was available to the Department of Community Services that should have been enough for the Department of Community Services to make its own decision.
When I say that, the Department of Community Services at first stated that those workers were denied benefits because of a decision that was made by Service Canada, HRDSC it was named at the time, what we all commonly called employment insurance. Employment insurance turned them down because, as your policy states, they were involved in a strike or lockout, they were not deemed eligible for employment insurance.
When that happened, that case was appealed through Service Canada, the appeals process, it went to a Board of Referees with Employment Insurance Canada. That case was overturned and the appeal was allowed, however, it was then determined by Service Canada that they would appeal that decision and that was going to take some time to get before an umpire in their appeals process.
Through all of this and before it even got to that stage, there was a letter that came from Highland Fisheries, actually it came from the legal firm that represented Highland Fisheries, to the Canadian Auto Workers. In that letter, it clearly stated - this was the letter that was used by the appeals process by the Board of Referees to overturn the original decision - in the letter it stated that the company was no longer going to operate the fish plant until this year - perhaps. In other words, it was a letter that clearly stated just not a lockout, this is a closure. That was what the appeal was fought on, the fact this was no longer a labour dispute, this was clearly a closure by the company. In the event of a closure, under their rules, the federal rules, of course you qualify for employment insurance.
My point, I may be taking a long way around trying to get to my point, but my point is, I couldn't understand, and I tried to make that known to the commissioner in the appeals process, in your appeals process, why the Department of Community Services didn't make its own independent decision at the time - they clearly had the evidence, and that was in the appeals process - why they didn't make a clear, independent decision instead of relying on the decision of the federal department, Service Canada?
It was stated in the media and it was stated to me this is because it is a federal decision, we can't go against that federal decision, it is involved in a labour dispute. I would like to know why that was, but more importantly, I would like to know that since the time of those appeals, has anything changed and are things going to change in the appeals process?
Remember, and as the minister would well know, these were workers who were turned down. They were not on strike anymore. They were locked out by the company originally. The company closed. They were not being paid strike pay. They were not getting employment insurance. Then, when they went to your department - the department, as we always say, of the last resort, where you go for help - they were turned down when they arrived at your door as well, based on a federal decision that wasn't fair in the first place. So, I'm wondering if anything is going to be done, or could you possibly take a look into the fact that perhaps your department and the appeals process in your department, should have a little more independence in the future.
MS. STREATCH: I thank my honourable colleague for the opportunity to discuss this. It indeed was my honourable colleague who brought this to the floor of the House in the Fall sitting and spoke to me afterwards privately and made sure I fully understood the reality of this situation for his constituents and for those folks.
Oftentimes we learn invaluable lessons and through this process I have learned quite a few pieces of information, quite a few lessons, if I will. My honourable colleague is absolutely correct in his unfolding of the events. We do, in our department, by means of policy, respect the issue as it pertains to a labour disruption, be it a lock-out, a strike, et cetera. We do take that information and respect that information as it's presented to us.
As my honourable colleague identified, there was then the opportunity for the appeal of those cases and it was indeed through our own independent arbitrator at that point, that my honourable colleague is correct in stating, and we were pleased that our own arbitrator was able to make that ruling, that these individuals were not in a strike position, they were out of work and so then, of course, they did qualify for income assistance.
I raised this issue with the federal minister and I raised concerns about the interpretation of the policy. I certainly would not want to indicate that we would do anything that would contravene the policy as it pertains to labour issues, but I think it's important to recognize that policy exists for the protection of individuals. In this case, when some of those individuals did come to our department, we were able to, even though we couldn't provide income assistance on a regular basis because of the interpretation at that point, we were able to provide some emergency funding and some special needs funding that I know wasn't enough, given the restrictions of the policy we were dealing with, but we were certainly pleased to be able to do that.
I do know that the member opposite is, I'm sure, equally as pleased, if not more pleased than I am, that this has been resolved and that those individuals who qualified are currently in receipt of income assistance and/or employment insurance benefits, as they qualify for that.
The department will not be looking at those appeals. We will not be arguing the appeal ruling of the arbitrator.
MR. CHAIRMAN: The honourable member for Preston.
MR. KEITH COLWELL: Thank you Mr. Chairman and thank you members for allowing me to make an introduction. In the west gallery, we have a very special group with us this evening to watch the proceedings. It's not very often we have visitors in when we're going through the estimate debates, so I'm sure they will enjoy it very much. Actually, we have the 1st Lawrencetown Cubs here this evening. There are 10 cubs all together and we have the two leaders, Andy MacKay and Rob LaPrade, I hope I've pronounced their names properly, as well as some parents, Michelle McStay, Carson Andrews, Wendy Harnish, Diana Hicks, Cathy Harris and a very special lady here, along with her Mom this evening, Haley McStay. I would ask the House to give them a warm welcome to the House of Assembly. (Applause)
MR. CHAIRMAN: Welcome. The honourable member for Glace Bay.
MR. DAVID WILSON (Glace Bay): The minister was saying, and I appreciate the comments, but there are a couple of things here that just didn't sit right with me. Number one, in certain cases, the department allowed the medical expenses to be okayed for some of the people who had applied but were not receiving benefits, but did give them their meds.
That, to me, is not a problem, but it's sort of perplexing, that if you qualify for medical coverage through your department, why don't you qualify for full coverage through your department? In terms of income assistance, if you're good enough, if your budget, or so on, is good enough to meet the medical requirements, then why don't you meet the requirement for full income assistance?
It took a long time to get to the stage, remember, where the appeals were finally overturned. In the meantime, these people had absolutely nowhere to go, and as a matter of fact they were told, it doesn't matter who, but they were told by one employee of the Department of Community Services that the best place, and the only place they could go right now, is to the food bank. The food bank was scared to death that a large number of people would show up because their shelves weren't stocked well enough to take on a large number of cases.
Now, it's not the first time that I've been a critic of the fact that, on occasion, the Department of Community Services will refer people to the food bank because they can't help out. I personally have a problem with that because I feel that the Department of Community Services is the last resort and should be able to help out without referring to a food bank.
However, I know there are rules to be followed and I've stated here before, and I'll state very clearly, that you have tremendous caseworkers at Glace Bay who handle caseloads that are beyond comprehension, which is another problem I could get into but I'll leave that up to my colleague, the member for Cape Breton South. He has that, I think, on his agenda, the fact that you have caseworkers that are handling literally hundreds of cases in Glace Bay and elsewhere.
Again, my questions and my problems around the Highland Fisheries workers were why it dragged on so long. I know your commissioners are - I know you call them independent and I guess your definition of independent and my definition of independent, Madam Minister, may be two different things. But, I'll stretch it to say they're independent commissioners because, in this case, he made the right rulings. But, other than that, I don't know about that independence part because they're appointed by government, you know that as well as I do and their political stripe usually is the same stripe as the government. Now, that may be a coincidence again, but anyway, in this case the matter was handled properly.
But, it took some time to get to that stage before it was finally handled. I'd say the first thing - and I know that your department's and your first number one priority is always the care of the individuals who go to your department seeking help. I've seen that in many, many instances in an office in Glace Bay that handles, as I said, horrendous caseloads, but they have tremendous workers. They do tremendous work there and you should be very proud of those workers in Glace Bay and of the people who are managing that office because they do a tremendous job.
Again, my final comment, it seemed strange to me that in some cases the department, in this particular instance, in the case of Highland Fisheries workers, would say you qualify for medical expenses, they're covered, but you don't qualify for income assistance and again, why the department, in the first place, didn't approve that without having to send it to the appeals commissioner. The evidence was clearly there, as we pointed out during the three cases that were appealed, in each individual case the ruling was the same, there was enough independent evidence there to make a decision on your own and to say regardless of what the federal department is saying, you can go ahead and rule that.
Again, one of the things that was not taken into consideration was that through that federal process, when that decision was appealed, after the board of referees stage and moved on to the umpire's stage, you could have been looking at six months or more before an umpire actually visited the Sydney area to hold a hearing. So you could have easily stretched into a year without even considering it and that would not have been necessary if they had qualified for Community Services benefits.
After having said all of that, of course, if they got Community Services benefits and they're awarded their EI, they'd have to pay back Community Services benefits. In this case the fisheries workers were made to jump through so many hoops that they became really
frustrated at the end of it and in some cases, they moved on. Fortunately, in some cases, they found other employment. But in several cases that I know of they pulled up stakes and left Glace Bay and are now either working out West or in other areas and it was all because of the regulatory hoops they were made to go through and the bureaucracy that was there that just stopped them from getting what, in my opinion, I thought they were entitled to in the first place.
Mr. Chairman, I don't know if the minister wants to comment on any of that, but it certainly concludes my questioning for her anyway. Thank you.
MR. CHAIRMAN: The honourable Premier on an introduction.
THE PREMIER: Just to be very quick, I thank you for the time. Joining us in the east gallery is a constituent of mine from Inverness, an individual who is very involved in her community and the Fire Club, very involved in a number of organizations. She also happens to be very involved in the Progressive Conservative Association at that local level, obviously a very fine, smart individual. I would like the House to welcome Bonnie MacIsaac from Inverness and welcome her to the Chamber this evening. (Applause)
MR. CHAIRMAN: The honourable Minister of Community Services.
MS. STREATCH: I want to thank my honourable colleague, I won't occupy a whole lot of the time here this evening responding to this, but I do want to thank my honourable colleague, first of all, for a couple of comments.
First and foremost, I am proud. I am proud of all the individuals who work for the department, the caseworkers, the front-line workers, they indeed go above and beyond. I appreciate my honourable colleague stating that for the record and I take every opportunity that I am presented with to acknowledge that publicly. I know the caseworkers appreciate that acknowledgment, because I know there are many days when they don't feel valued to the degree that we, indeed, do value them.
I do want to add, as well, my colleague brought forward a very important concept and a very important point. Hindsight is always 20/20. When we look back on events, we can say, we should have, we could have. In this case, I know those fine workers and those fine caseworkers and staff were trying to find ways to assist. It is questionable and it is challenging. Well, how do you get special needs funding if you don't qualify? Shouldn't you have to qualify for base funding before you get special needs funding?
I know that it was the compassion of the workers that allowed us to provide the funding and the resources that we did. I know and I hope that it was of some assistance to those families. Again, we learn from every lesson and the lessons we've taken away from this
one are valuable lessons and I certainly commit to my colleague that we will continue to learn from those lessons and hopefully not have a repeat of this situation.
MR. CHAIRMAN: The honourable member for Cape Breton South.
MR. MANNING MACDONALD: Thank you. How much time do I have?
MR. CHAIRMAN: You have 11 minutes.
MR. MANNING MACDONALD: Thank you. I've been listening with some interest to the comments of the minister to date on Community Services. As I was listening, my mind was wandering back to the days - I do have some history in this particular department as a front-line worker with the municipal government. When I decided in 1978 to run for mayor of Sydney, I thought I was moving into a more difficult job and the mayoralty turned out to be a walk in the park compared to the 10 years I spent on the front lines in Community Services, which by the way was called the Municipal Welfare Department in those days. Then it went to the lofty title of Social Assistance Department, and now it has moved on to the Community Services Department, and I think there might have been one more in between there, name of the department.
But the role of the department in the past number of years has changed significantly, and I think it's because the problems, Madam Minister, that you're dealing with today are quite different than the problems that I dealt with three decades ago, because in those days it was a work problem, with heads of the family, be they female or male, either unemployed or underemployed and had to access programs that the Welfare Department or Social Assistance had available to them at the time. The result, of course, of no employment or underemployment was municipal social services, or in the case of disability, accessing one of the provincial programs at the time. As you may or may not know, municipal social services was a municipal responsibility back in my day. There were some 52 municipal units at the time in Nova Scotia, and every one of them had a different standard. So not only did we have many problems with our own people in the City of Sydney in terms of trying to provide assistance, people from less affluent municipalities would move into Sydney to get better rates at the Community Services Department in those days. They all had different criteria for eligibility; criteria for the amounts of money they could access.
But today things have changed in the department, Madam Minister. Now we're dealing with a recent phenomenon in Nova Scotia, when I say recent, at least the past decade or so - single-parent families in Nova Scotia. Most of them, unfortunately, female single- parent families who are trying to cope with bringing up a family on little or no income, or again, underemployed, and they have to access your department for services. I don't think the department has caught up with the needs that are out there. For example, a lot of single
moms who I know, they're single for a number of reasons, a husband has left or they were single to begin with and had children, or they were perhaps divorced, all kinds of reasons, but the reasons are less important than the fact that we had, for most cases, single females, heads of households, who are trying to bring up their kids on very limited income, and most of them trying to get off the system to make a better life for themselves and their children.
Some of the problems they faced, Madam Minister, would be, I'll give you an example, if they wanted to go back to school, the support system wasn't there to the extent that it should be. It's starting to improve a bit, but it wasn't there. Any other income that they could derive or any other income they had before they entered the system was clawed back if there were any advances made. In other words, it became extremely difficult for their situation to get better. We also had the situation with the disabled in our community, which is growing. We have the situation with the elderly.
All of these groups, I don't think have the kind of advocates they used to have in the community. As a matter of fact, MLAs from all Parties in this House see themselves as advocates for these groups in trying to access benefits. I don't think, Madam Minister, that access to your department's resources are as available today as they were years ago. I'll tell you, there was a hands-on, one-on-one with client and worker that doesn't exist anymore because of caseload sizes, because of the computer, because of compartmentalizing people who are told what they're eligible for right down to the dollar, and there's going to be no deviation from that.
You mentioned in your remarks earlier, Madam Minister, and I think it's, again, a sign of the times, in your opening remarks you made a statement that I picked up on, you said the fine people who are accompanying you here today are here watching the dollars of your department. They are very fine people, and I said it here in estimates last year. However, what is missing along there are the social workers in the department at the senior level, whose responsibility is looking after the people in your department, not the finances of your department. I think it's more important for us, as legislators and advocates, to be questioning you on what can be done for the clients who have to access your services and not so much what can we do to save money in that department.
You mentioned again, Madam Minister, that people are exiting the system. Unfortunately, they're not exiting it fast enough. I would like to be able to stand in my place in this House and say, we don't have a Department of Community Services anymore, when it comes to income and that. That would be a happy day. However, that's not about to happen any time soon, I don't think, in this province.
Again, who is looking after - I remember when I was working with the Department of Welfare and Social Services, I reported, at the senior levels of the provincial government, to a number of senior employees all at the master or doctorate level in social work. Somewhere along the line the focus shifted and they were not calling the shots anymore,
rather, Madam Minister, we have now as deputy minister, a lawyer, a very fine lawyer, worked in another department. She has gone up the system to deputy minister. I know her personally and I know her family personally. She's a tremendous lawyer and has done great work in the various departments she has been employed with, but I just wonder about the focus of the department. I would have been more comfortable had a person come up through the system at the graduate social work level, could be trusted to be the Deputy Minister of the Department of Community Services and Housing. Now maybe that's dreaming in this day and age. Maybe we do need lawyers at the top, no matter what the department is. Maybe we need chartered accountants at the top, but I maintain that serious thought should be given at the senior level in your department to having the direction to your department guided by social workers. Because that, after all, is the reason for being, this department, the raison d'etre.
That may happen yet, I don't know. Maybe I'll convince you that we should be looking at employing more social workers and shifting the emphasis on the department to actually getting back to dealing with clients on a one-on-one basis. We have some great social workers out there, as my colleague for Glace Bay mentioned, we have some great workers. But we also have some people working for your department who feel it's their role to make sure that clients who have entered into overpayment situations with your department, for one reason or another- and I'll give you a couple of good examples, Canada Pension Plan awards, money that was given on the basis of waiting for that, being clawed back; EI payments, while waiting for them, access benefits from your department and then be told they have to pay that back when they get EI.
Now these are people who are scratching every week for a quart of milk, or a loaf of bread, or to get something on the backs of their children so they can go to school, to make sure they provide healthy meals, and then to be told that well, you got your EI now and we advanced you money, so you have to pay that back. I mean, when your government - or the previous government, when we were in power - we write off millions of dollars a year from corporations, yet we claw back payments from people who are sometimes making less than $10,000 or $11,000 a year, certainly in the case of some disabled people.
Also, being able to claw back payments made by deadbeat dads, through the court system, I mean, when they can collect if from them, finally when they collect from deadbeat dads - and there are a number of them out there - when they collect from them, then immediately they're told that money is clawed back. And it's not clawed back by intimidation or anything like that, it's clawed back right through the courts, because your department has the right to have that money sent directly to them. Then when the Department of Community Services can't get that blood from the stone, you know, then they send it over to Service Nova Scotia and Municipal Relations. Service Nova Scotia and Municipal Relations employs bill collectors who harass these people on a daily basis. I'm telling you, they harass them for payments.
MR. CHAIRMAN: Order, please. The time for debate of Committee of the Whole House on Supply has expired for today.
The honourable Government House Leader.
MR. PATRICK DUNN: Mr. Chairman, I move that the committee do now rise, report progress and beg leave to sit again.
MR. CHAIRMAN: Is it agreed?
It is agreed.
[The committee adjourned at 7:10 p.m.]