MR. CHAIRMAN: Good afternoon. I would like to call the committee to order. We will continue with the estimates of the Department of Health. The time is 4:27 p.m., the clock is ticking. It is the Liberals' turn, a one hour turn.
The honourable member for Dartmouth East.
DR. JAMES SMITH: Mr. Chairman, not to miss a chance, but I just wanted to explain that through mutual agreement we have agreed that the NDP will lead off. We will defer our time, and then follow the NDP. I think there are other commitments that have to be met.
MR. CHAIRMAN: The honourable Leader of the Opposition.
MR. DARRELL DEXTER: Mr. Chairman, I appreciate it, and I thank the Liberal Health Critic for the opportunity to go first. I just have a few questions that I want to go over with the minister, and then we will pass it back to him.
We have had this conversation around the whole question of MRI clinics, and I know that the minister has probably heard enough about this, but I have a few follow-up questions because I wasn't satisfied with some of the responses I got. I am not sure if the minister even understands what this means. I want to ask the minister if he has ever been to a private MRI clinic?
[4:30 p.m.]
MR. CHAIRMAN: The honourable Minister of Health.
HON. JAMES MUIR: Mr. Chairman, I don't think I have.
MR. DEXTER: I am not sure what the minister means by saying, I don't think I have. Let me ask him this, have you ever been to a private medical clinic outside of the Province of Nova Scotia?
MR. MUIR: I am trying to answer this question accurately. I am not sure when Medicare came in, exactly what year. I have to go back to that. That is why I am going back. The one time (Interruptions) What year did Medicare come in? I am embarrassed I don't know that.
MR. DEXTER: I think, in fairness to the minister, I am not interested in his time in Virginia, when he was going to school there, or any of that, although I have said repeatedly that I believe his view of health care is coloured by his years in the United States. I think that is a fair observation to make, but that is not the one I was attempting to make at this point in time. In the last five years, has the minister been to a private medical clinic outside the province?
MR. MUIR: Mr. Chairman, no.
MR. DEXTER: Okay, that is fine. I guess the reason why I wanted to pursue that a little bit is I wondered if the minister understood how these clinics operated, how payment was made, and how the services were delivered. If he was there, then he might be able to respond to that. He wasn't, so that is the end of my examination on that particular topic.
I did want to point out to the minister that in 1996-97, the Nova Scotia prescription drug formulary was introduced with the objective of improving patient care and of controlling costs of the program. What I wanted to ask, or observe is that this really hasn't worked. The reality is that the total costs of the program have gone from $83.218 million to $116 million, so it hasn't controlled the costs. From the government's perspective, of course the government's contribution has gone from, in 1996-97, 72.4 per cent down to, this year, 69.6 per cent of the costs.
Overall, there hasn't been the same kind of dramatic increase in the province's numbers, but there has been an increase in the overall cost of the program. I wanted to ask whether or not you have given any thought to reviewing the success of the formulary?
MR. MUIR: Mr. Chairman, the formulary is reviewed regularly. It is reviewed in a number of ways. I think, first of all, as the honourable member knows, there are about 3,500 things that are on the formulary, and there are more added than are taken off each year. One of the ways the formulary works is that once we get into the generic business for particular drugs, and obviously the formulary would pay for the product that does the job and costs the least. It does operate that way, so that is one of the ongoing things.
Mr. Chairman, we are extremely concerned with the increasing costs of drugs to the province, not only the Seniors' Pharmacare Program, but there are high-end drugs that the province pays for. Our actual costs of our Pharmacare Program, not only the seniors, is more than $116 million, it is more like $183 million, I think, roughly $180-some million. In the case of the Seniors' Pharmacare Program - keep in mind that drugs aren't insured under the Canada Health Act - when it was introduced, I am told that sort of the going rate was that it would probably be about 50 per cent for the seniors and 50 per cent for the government.
The way those percentages worked out, when we go back to 1995-96, the government was paying about 78 per cent; in 1996-97, it had gone to about 72.4 per cent; in 1997-98, it was 72.6 per cent; in 1998-99, it was about 73.9 per cent. What was happening was that we had been around 78 per cent, but the province's share, because there had been no adjustments made to recognize the increasing costs, and where we are, last year, was roughly about 77 per cent being paid for by the province, and about 23 per cent being paid for by the seniors.
We predict that in 2000-01 - we have not gotten the final numbers in - it will probably be about 74 per cent for the province, roughly, it will be around 26 per cent for the seniors. Four and five years ago, it was basically about 73 per cent, so I do not know really what the optimum thing is, but we have to have a program that provides quality, meets the needs of our citizens, but at the same time it has to be affordable.
I mentioned, I think it was on Thursday last, that on Wednesday I had the opportunity to meet with the Executive Vice-President of the Bayer pharmaceutical company here in Canada. One of the things that he was telling me, some things that I did not know, is that the increase in the cost of pharmaceuticals in Canada last year was about 19 per cent. In point, he was saying if it keeps going at 19 per cent each year, it is really going to get out of hand. Compared to other countries - and there is some organization that does worldwide evaluations in this thing - and in Canada, we are over the average or the norm.
For example, what they are doing in Denmark, or perhaps Germany or the United States, or wherever it is, this is done on a national basis. I do not know the details of their Pharmacare Programs, but whatever they are doing, in terms of the average - when they set these indices, that Canada is above the average in some of these - obviously, you have an average, half are above and half are below. We are above, significantly above.
The fact of the matter is, in Canada last year, I believe that the Canadian cost for prescription drugs exceeded the costs of physician payments. So the increasing role, the increasing percentage, and the potential impact on health budgets is really very dramatic. The challenge for any government is to provide a quality program and if one looks at our Seniors' Pharmacare Program, regardless of whether it does everything everybody wants, it would rate among the top four in the country.
A couple of other advantages of our program is that it is a universal program and there are a number of other provinces, for example, our partner up there in New Brunswick, they provide a Pharmacare Program only for people who receive the GIS payment. Our program is not everything for everybody, but it is among the best in the country.
Another thing that we did - I guess it was done the year before government changed, when the member for Dartmouth East was the Health Minister - was to move the province to insurer of last resort and what that meant was that if a person had a private insurance plan that would pay for drugs, let's say, like the plan, these would be mainly a lot of national companies, if they paid for a prescription in Ontario, then they would have to do the same thing for a Nova Scotia resident. So that took a fair number off the books and we lost about 2,500 last year.
MR. DEXTER: I thank the minister very much for his response and I have really quick questions and I do not know if he will consider them to have long answers or not, but I have a couple of them left, Mr. Chairman.
The first one is, I wanted to know what initiatives is the minister considering - and not only considering - is undertaking to provide medication awareness education programs for seniors?
MR. MUIR: This has been an initiative that has been suggested through the Senior Citizens' Secretariat. We have suggested that the secretariat take some steps in that regard. Similarly, with the health and wellness money that is being allocated to the community health boards, we had hoped that their primary responsibility this year certainly would be with smoking cessation, but we also hope that a good portion of this primary care education would be in the wise use of pharmaceuticals.
MR. DEXTER: Finally, I know that the group of nine has submitted some recommendations for improvement to the Pharmacare Program. I would like to ask the minister what action is planned with respect to these recommendations?
MR. MUIR: As the honourable member knows, Mr. Chairman, the group of nine does provide advice to us with regard to the Seniors' Pharmacare Program. We meet with them on an ongoing basis. One of their recommendations indeed was the point that he just raised before. We are taking a look at that. Another thing that we are able to do this year that
the group of nine had indicated, they did not want any increase in the Pharmacare premiums or co-pay this year and we were able to hold the line on that and I want to tell you it was not all that easy. I believe there were six other recommendations and I would have to go back and refresh my memory of what they were before I could specifically answer that question.
MR. DEXTER: With that, Mr. Chairman, those finish my questions of the minister and I will hand it back over to the Health Critic for the Liberal Party.
MR. CHAIRMAN: I would now recognize the member from the Liberal caucus, Dartmouth East.
DR. JAMES SMITH: The questioning has been fairly extensive throughout this time and I think it is not our intention to delay the estimates of the minister for much longer, but there are a couple of wrap-up initiatives mainly in the area of administration, I guess initially.
Could the minister - I am looking at Page 15.4, I think it is the Supplementary Detail. I have torn my pages out and I have mixed them up now, but I think it is Page 15.4 - yes. I have it, the Supplementary Detail, Page 15.4, Chief Information Office. Could the minister please account for the increase in Administration in the Chief Information Office, it has increased by $57,800.
MR. MUIR: In the Chief Information Office, Mr. Chairman, we have added a Secretary III, a web administrator on a part-time basis and we transferred a person from long- term care into the Chief Information Office and there is also some increase in CIHI contracted services.
DR. SMITH: I am sure the minister did not mean that, but it is not a retirement office, I would gather, because he is transferring people in from long-term care, but he meant people who work in long-term care, I would imagine. I am sure some of that great staff he has there in Information Technology were not recruited from long-term care facilities, I would not think.
There is an increase on Page 15.4 and also in the Communications budget of $219,000 over that amount. What changes are being made? He mentioned some of them and I gather it would be personnel and maybe he has just answered the question, so I will tag on another. The Freedom of Information category on Page 15.4, there is no longer an amount associated with that position. Would the minister indicate where this position has been incorporated in the budget or whether the position has been eliminated and if not, where is it?
MR. MUIR: The Freedom of Information position has been transferred to Health Systems Development.
DR. SMITH: Mr. Chairman, I am not going to ask him about his motor vehicle and those things. There was a time when a lot of time was spent on that in the House on estimates. It got to be kind of humorous at times, but important, however. You have changes with EAs. What is the status now with your EA and are there people working with you that are paid through Priorities and Planning? I know I shouldn't ask about another budget, but just with your EA, if you have one or two or one and a half, how is that being funded?
MR. MUIR: I have one EA, Mr. Chairman, and that is Lewis Bedford and he is funded from the Department of Health. The former EA is now with the Treasury and Policy Board. A certain portion of his responsibility is still within the Department of Health. But his salary is now coming out of the Treasury and Policy Board.
DR. SMITH: Am I to understand that part of that salary is assigned to Health or the one EA is assigned to Health and the other is totally assigned to the Treasury and Policy Board now? That is correct. I know it is another budget and I could be ruled out of order here, but I didn't get on Priorities and Planning, the minister who is responsible there, but St. Paul's Hospital in Vancouver had $5,000. Would the minister know what that would have been for Priorities and Planning to have paid for at the St. Paul's Hospital? To me it would be health, maybe a person with AIDS or something like that. I know the hospital's specialty there, but also your deputy has been associated with that hospital. Was there anything relative to your deputy or others that was paid to St. Paul's that would have gone through what was called Priorities and Planning?
MR. MUIR: Mr. Chairman, I can't answer the question. I do know that when deputy ministers are hired, they are basically not hired by the individual departments. They come out of then P&P and the Premier's Office. I guess the only way is if the honourable member would raise that question with the minister responsible for P&P.
DR. SMITH: That minister just smiles knowing that I have lost track of when that would be. It is not a big item. I was just going over some administrative changes. I would just like to briefly though move into the in-home support. It has been an area that I know our caucus has brought before our meetings. I just want to ask, I think one of the things that is evolving with in-home support and some of the matters relative to long-term care, that between the Department of Health and the Department of Community Services there seems to be different criteria, different lengths of time relative to eligibility of certain matters, disposal of assets, those types of initiatives. So we see a three year in one group and a two year in another, I think, in home care.
I think it is normal that you go through a transition period. But I think the in-home support matter has really gone on now for quite some time. I would just ask the minister, through you, Mr. Chairman, what is the status of the review that started, I believe, in March 2000 on in-home supports? Are there any changes or proposed changes relative to paying family members for in-home support and the understanding of the minister as to the waiting
times? We have some areas, I am thinking, maybe, Richmond County and other areas, the people are being told that there are 40 or 50 people on the waiting list for in-home support. They are being referred there from home care into the in-home support saying that that would be appropriate and then they are being told, well, it is frozen. That is my question relative to the status of in-home support. Is there in fact freezing, what is the status of the review and are family members going to be eligible? Are there any proposed changes?
MR. MUIR: The issue of the in-home support has been an item in which the department has expended considerable energy, Mr. Chairman. As the honourable member would know very well, there was a tremendous amount of inconsistency in the in-home support that was delivered around the province. Indeed, there were, I am told, about 30 different programs existing in the province. We have been working this past year to try to bring some order out of it. I guess, if we were looking at 30 different programs in one small province, it would bring some order out of chaos. As we did that, we had to slow down the intake.
What we have done now, we basically completed our deliberations, the review of that, Mr. Chairman, and there are a series of recommendations that will be presented to senior management. The new policies that we will have in place will enable us to treat some new clients. One of the things that did happen is that, basically, those that were in the program were grandfathered so there was no radical change for those that were receiving assistance.
DR. SMITH: The minister is saying that, in some areas, at least, there is a freezing, there is no one being taken into that program at this juncture. What about the family members being paid?
MR. MUIR: Indeed, Mr. Chairman, after we took over that particular program from Community Services, admissions were basically frozen. With the new policies, we will be able to bring some new people in. I said one of the really difficult challenges that the department faced was the vast distinction among the programs that were available in the province. We had to bring some consistency to that.
DR. SMITH: Is there any consideration regarding changing the payment to family members in the in-home support, because that was a change that came in a few years ago and was a real issue where family members were giving care, and some people actually would give up their job or move from another area? Is there any active consideration taking place within the department with the minister regarding discontinuing that payment to family members?
MR. MUIR: Mr. Chairman, we do provide that support now for some individuals. To dramatically increase the amount that was given to the caregivers, would mean an increase in our budget, which we did not get this year.
DR. SMITH: I was more concerned, Mr. Chairman, about the minister addressing the concerns that are out there, being that that would be discontinued to family members, in fact, or new people coming in, the family members will not be allowed to receive payment for offering their care in the in-home support. That would be it.
Mr. Chairman, I don't have a lot more questions. There are always issues relative to health and I am sure will come back another day. As far as the estimates go, I am not going to make any long wrap-up speech either relative to the initiatives, money, that is still going into health, lots of changes taking place, obviously, but also whether, in fact, the priorities are in the right areas.
Speaking of home care and in-home support and the continuum of care in other areas is the area of long-term care. The minister announced last year a long-term care advisory group, under the chairmanship of Brian MacLeod, the owner of several nursing homes in the province. Could the minister please update us as to the status of this group and what, if any, recommendations have been made to government from the long-term care advisory group?
MR. MUIR: Yes, indeed, Mr. Chairman, the MacLeod report had four major recommendations and we are in the process of implementing these things. One of the things - I won't say slowed us down, because they had a very good working group - as members of the House may know that Mr. MacLeod was taken ill and I would just like to take this opportunity to say, the last information I had is that he is coming along pretty well and that is very good news.
DR. SMITH: I notice that tomorrow the two ministers, the Ministers of Health and Community Services, will be announcing a plan, the process that will lead to the blending of child and youth mental health services in Nova Scotia. I usually spend quite a bit of time on mental health services, particularly with children, adolescents and youth and I think now were we are getting the blending of these services, probably I am going to get the same kind of answers. So I will probably just save the committee the misery of going through some of these initiatives other than to compliment both ministers that those are the initiatives that have been difficult, a long time coming and been planned for a long time. I just want to compliment them because I see certainly an increased budget going on there and I don't want to get into the specifics of that. We will see what the ministers have to say tomorrow. We will be following and monitoring that.
I think, Mr. Chairman, that I will pass my comments over to another member, if they are ready but I did want to get a clarification. Last week we were discussing quite a bit to do with hepatitis C and the federal monies coming in. I just will end on that, that we are getting information and various concerns of those involved in the compensation of hepatitis C victims and whether there are specific programs, now that we have had a chance to review that, that will be - and I say specific for those persons outside what is commonly called the window. There are allegations that this money is going directly into general revenue, if not
of the province, at least of the Department of Health, and the fact that one is being told that it is going in for testing and various other programs like that that are already available aren't satisfying those persons who are making these claims. Would the minister be able to clarify for the committee the status of the outside-the-window hepatitis C victims within Nova Scotia with the federal monies that are coming in?
MR. MUIR: Mr. Chairman, I guess probably one thing I should say first of all is that earlier today I did affix my signature to an agreement which would see us receive some money from the federal government, actually the money to which the honourable member refers. The amount of money that Nova Scotia is going to receive is really pretty small.
Just to go back a little bit in history, and the honourable member would know this, that Nova Scotia was one of the very first provinces in Canada to provide support for people with hepatitis C who were infected outside the window. The way that they did that, Mr. Chairman, was that Nova Scotia wrote something like more than 3,000 letters to people who had received blood transfusions in the province advising them that they may wish to consult additional medical advice to find out, given the things that had happened with the transfusions. As a result of that, the province did identify some people, unfortunately, with hepatitis C who had contracted it perhaps outside the window. We were one of the first provinces in Canada to get into that business. So therefore, our province did set up programs earlier than a lot of other jurisdictions, specifically intended to help people with hepatitis C.
Also, as part of an ongoing commitment with the federal government, our province did contribute and perhaps when the honourable member for Dartmouth East was minister, I don't know, a sum of about $6 million to that hepatitis C fund. What the money will be used for, the agreement is pretty clear. It is to provide support to people who have hepatitis C. The money will be used to provide support to people who have hepatitis C. One of the things that we are required to do under the terms of that agreement is to provide an accounting of how that money has been spent to the federal government and that is reasonable, indeed.
[5:00 p.m.]
There is really not enough money there to start many new programs although the honourable member mentioned last week the issue of genotyping and I have asked my staff to work with people at the QE II to see that the genotyping program is established. To be quite frank, and I don't take any great joy in announcing this, I thought the program had been established and I may have indicated that in one of my responses to the honourable member last week. I know we expected it to go ahead last year and anyway, we have done that.
So the money, about $300,000 a year, is intended to provide support for people who have hepatitis C and obviously for reasonable access to health care and services to anybody who has hepatitis C. I think if you wanted to look at it, the money is how you actually view it. If you understand that this is part of a care-not-cash program, Mr. Chairman, and the money is basically given to the government to support programs that serve people who have hepatitis C and in recognition of those who were infected outside the window and did not get the financial settlement those infected inside the window did.
MR. CHAIRMAN: The honourable member for Cape Breton West.
MR. RUSSELL MACKINNON: Mr. Chairman, my first question is with regard to the STARS air ambulance service that was provided here in the province. I understand that STARS is no longer providing that service and that the provincial government - i.e., the Department of Health - has taken over that service. Would the minister be kind enough to apprise members of the committee as to how much he anticipates it will save as a result of this takeover?
MR. MUIR: I should begin my answer, Mr. Chairman, by saying that we did not make that decision, that relationship was not terminated because of financial reasons but in specific answer to your question, it is likely that the saving, because the Department of Health is now running that service, is going to be between $120,000 and $200,000.
MR. MACKINNON: Mr. Chairman, does that take into account the number of helicopter pads and sites that have been donated from across the province by private individuals and does it also take into account private financial contributions by various individuals and corporations?
MR. MUIR: The amounts I spoke of, Mr. Chairman, had to do with the operational dollars. Some of the helipads that are around the province have been built by hospital foundations or district heath authorities and then regional health boards have taken the money out of their capital allocation or their operating budgets. So the business of the helipads, these are operated by the health authorities or by an institution and we don't basically provide specific dollars for helipads.
MR. MACKINNON: Mr. Chairman, it is my understanding that somewhere in the vicinity - and I do stand to be corrected - of $2 million was collected by STARS to assist in the operation of this particular service and in particular the capital cost of building some of these pads where the land sites were donated by private individuals. What is the status of this foundation or this list of contributors that had contributed either in the past or had contemplated contributing in the future? What is the status of this pool of money?
MR. MUIR: I will have to take that question under advisement, Mr. Chairman. The honourable member has raised a point and one of the reasons that the province and STARS parted company - amicably by the way - was the basic approach to fundraising and operations. The province's model was that if there was to be fundraising, the same model of any health care institution here in the province that your foundation is arm's length from the operation of the hospital. Under the STARS model, the fundraising and the operations are integrated. They felt that was the only model under which they could operate and it was a decision of government that we didn't want to operate under that model.
MR. MACKINNON: Mr. Chairman, I was quite pleased to hear the minister say that the department would be saving between $120,000 and $200,000 which is a little better than was quoted by one of the officials in your department, which I believe, if my memory serves me correctly, was more like $60,000. I will be interested to see how the calculations will fare off once these donations dry up, as I am led to believe.
That having been said, what is the status of the New Waterford General Hospital? Does the Department of Health have any plans for changing the status of that particular hospital as it is in the system? Are there any plans to downsize or even closure?
MR. MUIR: Mr. Chairman, the New Waterford General Hospital is part of the Cape Breton Health Care Complex and of course the Cape Breton Health Care Complex is part of District Health Authority 8. The role of each or all or any of the particular health care facilities or services is under the management of a district health authority now. Does the Department of Health have any plans to change what is happening in New Waterford? The answer to that is no.
MR. MACKINNON: Mr. Chairman, does the Minister of Health, or anybody within his department, have any knowledge as to what the powers to be within district 8 have in terms of future plans for the New Waterford General Hospital in this fiscal year?
MR. MUIR: Mr. Chairman, we received only a preliminary business plan. It didn't indicate any change in the role and the final business plan is not in yet. No, we don't have any knowledge.
MR. MACKINNON: Mr. Chairman, when does the minister expect the final business plan to be submitted?
MR. MUIR: We are optimistic that they will be here by the end of this month, at least certainly for district 8, Mr. Chairman.
MR. MACKINNON: Mr. Chairman, would the minister be prepared to table or make that report available once the final one is submitted?
MR. MUIR: Mr. Chairman, the approved business plans are required to be tabled.
MR. MACKINNON: Does the preliminary or the tentative plan that has been submitted make any recommendation with regard to the New Waterford General Hospital?
MR. MUIR: Mr. Chairman, I had been asked this question the other day and I am reluctant to answer, not to try to keep information away from the honourable member or any other honourable member who has an interest in that. The fact is that these plans were preliminary. They were based on an amount of money which was the first budgeted amount last year and basically what we did during the process, we went to these authorities and we said, given this amount of money, what does it mean for you? So, as you know the amount of money that did go into the Health budget was a little bit more - actually considerably more - than initially budgeted last year. If I answer that in detail, then he might ask me some other detail and I am reluctant to get into the details.
MR. MACKINNON: Well, perhaps the reason I would, Mr. Chairman, is because it is always a delight to ask the honourable minister some questions on his department because they are quite insightful.
Mr. Chairman, with regard to the Glace Bay General Hospital, I would suspect we are on the same playing field. Mum's the word on all questions regarding that. I would focus perhaps on the issue of in and about the Glace Bay General Hospital, the possibility of a need for a bone densitometer. I think that is the right terminology, not being a medical mind, expert. I understand that in terms of the population, the requirement on a population demand or per capita demand, whatever the terminology would be, is there a need, based on population figures for a bone densitometer and if so, is there any plan to provide one in the near future?
MR. MUIR: Mr. Chairman, if one accepts the premise that bone densitometers are an integral diagnostic tool, and obviously the province sees that they have a role, and I don't say that really lightly, but obviously we only had one in the province that was operational. There has been another one. The answer to that would be yes, there is likely a need for a bone densitometer in the industrial Cape Breton area because of the population.
MR. MACKINNON: Mr. Chairman, I am pleased to hear that because as the minister perhaps knows, Glace Bay General Hospital covers not just the Town of Glace Bay but the catchment areas - Donkin, Port Morien, Birch Grove and the outer reaches of the Mira district in my constituency - as well as (Interruption) Sure. It will certainly fill into the entire big picture.
Another question I have is with regard to smoking at the regional hospital and the mental health division down there. Apparently that appears to be quite an issue of concern for in-patients, in terms of them going out into the courtyard. Apparently there is some
difficulty there and both staff and patients have raised that. Is the minister aware of this particular issue? I know of his lack of affection for smoking but certainly given the fact that it is an illness on top of an illness, obviously, that we are dealing with here, is there any indication that perhaps the Department of Health could work with the local hospital board to address this particular impasse?
MR. MUIR: I think it would be, Mr. Chairman, and that is a real issue that the honourable member has raised. As a matter of fact, I can say that I have a relatively strongly worded letter from a mental health consumer group when the price of tobacco went up. I would think that probably the mental health professionals would work with the hospital board to come to some resolution, whatever is in the best interest of the patients. I guess a further extension of that was raised, not trying to flag the issue, but will it come up again with regard to the new CorFor facility which is currently under construction in Dartmouth as to whether the people who are on the forensic part of that would be allowed to smoke, because the Minister of Justice has made it clear that there is a smoking ban in prisons.
MR. MACKINNON: Mr. Chairman, is the minister saying he is going to ban smoking in that section of the hospital?
MR. MUIR: No, I said that that obviously is something that is going to have to be addressed because that is a combined institution having to do with both a mental health unit as well as a penal unit.
MR. MACKINNON: On that issue, with regard to the correctional services, has the Minister of Health had any input into that decision by the Minister of Justice to ban smoking in the penal institutions, particularly the low-risk penal institutions? What input has the Minister of Health had into that decision? I realize it comes under the purview of the Department of Justice but, given the fact that it is a health issue, obviously certain factors would have been considered on that decision that affect the Department of Health.
MR. MUIR: Mr. Chairman, I guess, indirectly, yes, because our department has gone on at considerable length about what we feel are the deleterious effects of smoking on just about everybody. Did I specifically sit down with the Minister of Justice and discuss the smoking ban in the penal institutions? No.
MR. MACKINNON: Mr. Chairman, did anybody from the Department of Health sit down with representatives from the Department of Justice and discuss this?
MR. MUIR: We are represented on the CorFor committee, Mr. Chairman, and whether that committee had input into that decision, I don't know.
MR. MACKINNON: Mr. Chairman, I find this a little concerning that the Minister of Health has indicated he had no input into a policy decision by the Minister of Justice on a smoking ban, because it appears that the Minister of Justice has taken on the role of the Minister of Health. Obviously one would have concluded that there would have been some collaboration or discussions between both departments and some consultation that would have generated at least a report, or some analysis as to what the benefits of such a decision would be. From a layman's point of view, and being a non-smoker, it would be easy for me to come to a conclusion as to what I would see would be the benefits, but it is far more complex than that and I realize that. So is the minister saying that the policy decision made by the Minister of Justice was a decision that was made independent of the Department of Health?
MR. MUIR: Mr. Chairman, I think that question would be better addressed to the Minister of Justice because I don't know exactly who was consulted by him.
MR. MACKINNON: Mr. Chairman, I am absolutely astounded that the Minister of Health didn't have any input into a public policy decision on smoking in our penal institutions that are the responsibility of the province. One can only conclude that was a political decision to curry favour for some political reason. I will leave it on that particular note because I don't want to beat a dead horse, but it's quite disappointing. (Interruption) Well, they are certainly smoking them out of the penal institutions, that's for sure. It is quite concerning that there's no report, there's no analysis, there's no cost-effective benefit analysis. The minister who is responsible for Health in the province hasn't been consulted and, yet, the inmates in these penal institutions are being persecuted even more because the Minister of Justice took it upon himself to initiate a ban, which really comes under the purview of the Department of Health, and the Minister of Health is saying he had no input into this decision. So we will leave that for the time being.
One final question is with regard to nursing homes. I realize we have nursing homes that are owned by municipalities and there are privately-run nursing homes. I can take this question on notice. How many private nursing homes do we have in the province, how many beds does that represent and are there any plans to increase the total number of private nursing beds in the province in the upcoming fiscal year?
MR. MUIR: I am going to have to take that question under advisement. We do have that breakdown in the department. I don't have it in my notes. The total is more than 5,800 long-term care beds that are licensed in the province, and probably about one-third of those beds would fall into the private category.
MR. MACKINNON: Mr. Chairman, I will take this on notice, the fact that he will give an indication as to whether there will be an increase of the total number of private beds and if I could get those numbers, that will be fine.
One final question is with regard to user fees within the Department of Health. Would the Minister of Health be kind enough to indicate what user fees are presently being utilized, or being charged, whatever the terminology would be? What user fees do we have that will realize an increase as a result of this budget? What present user fees do we have that will realize an increase, and what new user fees does the Department of Health contemplate for the upcoming fiscal year? I can take those on notice as well.
MR. MUIR: Well, I can try to answer some of those questions, Mr. Chairman. I guess, obviously, one of the things that we ask people to participate in as they are able, is long-term care. We also require people with regard to Seniors' Pharmacare, there was a co-pay on that and there was also premium for those people who could afford to pay the premium. Of course, the premium slides; those who can't afford to pay the premium or GIS, it is all paid for, and then there was a sliding scale.
We also would have some user participation with respect to ambulances, the ground ambulance service. We also would have some user participation, occasionally, with some dental features. Part of this, Mr. Chairman, why it is awkward to answer that, we do have some cases in the health care system where, if you have insurance, then the insurance picks it up. Now you pay an insurance premium to get that picked up, so I guess if you wish to count an insurance premium in that particular category, then a lot of us, including everybody sitting in this House, would have that, to be quite frank.
Another fee, if you call it a user fee - I don't know what you would call it - would be if you go into an acute care facility and some of them have semi-private rooms as well as private rooms, you would pay something for that. Quite often, people who do that have insurance that covers it. Similarly, if you were in an acute care institution, from these long-term care and care institutions, things for television, these go back, not to the Department of Health - there are certain things the facilities or the health authorities do charge, such as parking and things like this which contributes revenue either to the operation of the facility or to a foundation which then goes on to buy capital equipment.
Mr. Chairman, as well, if you were to extend this, the hospital foundations or auxiliaries quite often make contributions to capital equipment or something like that, and they would do that. I don't think you would call that a user fee, but that is money from outside the regular channels that does flow into it. There are a number of things like that: physiotherapy, although we don't charge for physiotherapy, some people opt for private physiotherapy; private psychologists; there are a variety of things.
MR. CHAIRMAN: The honourable member for Dartmouth North.
MR. JERRY PYE: Mr. Chairman, I had an opportunity to speak on the Health budget approximately 50 minutes now. I want to thank the members from the Liberal Party with respect to allowing me some time to ask this one particular question. There seems to be a
constant occurrence and a frequency with the number of calls that I am receiving in my constituency office with respect to home care services. I do know that over the weekend there was a very important issue, there was a 96 year old woman, I believe, who was requesting home care services, who had spent some time in the hospital. Apparently, there is a policy or there is the need for the Department of Health to deliver the kind of services that it now finds itself delivering as a result of its contractual agreements with the four home care providers. The kind of services I am talking about is the delivery of home care services.
I will go back to the 96 year old lady, who got out of the hospital after three days in the hospital. There appears to be, after three days or more in the hospital or without the services of a home care worker, that automatically the service is dropped. As a result of that, you are again put back on a waiting list. The waiting list can be up to a period of three weeks. You are then prioritized with respect to the particular needs. The very reason for that, as I understand, is because the services that the capital health region has contracted to deliver home care services, the four companies in this particular case, have a shortage of staff, or are unable to provide the staff that is needed to deliver home care.
I guess that is because of the competing marketplace, as well, from what I understand, and because of the wages earned by the home care workers. More people are opting out of becoming home care workers simply because of the salary level that is provided. They can get a better job working in a call centre - I should say earn a better income working at a call centre and other places than what they can by being home care support workers.
[5:30 p.m.]
My question to the minister is, this, apparently, within the last few months, has become a very serious issue, and I am wondering if the minister is attempting to address this very serious issue, or what obligations are there by the contract providers to provide that kind of service? If there are no obligations by the contract provider to deliver home care workers to those people who are in need, how is his department addressing that issue? How is his department addressing issues where people who are 70 years-plus, who are coming out of institutions and need that home care service immediately after coming out of institutions, it is prescribed by their specialist, by their doctors and so on - there are a number of questions here, but through that number of questions, I am wondering if the minister can add some clarity with the delivery of home care services in the Province of Nova Scotia as it now stands?
MR. MUIR: Mr. Chairman, let me begin by stating that we have increased the home care budget by more than 20 per cent this coming year; we are up to about $88 million, which I think is an increase of about $15 million over last year. The honourable member is correct, sometimes the number of home care workers that are needed does not match the number that is available. If that is the case, and I think this is what the honourable member is leading to, if a person needs the home care to survive and can't get along without the home care then,
obviously, they have to be placed or remain where they are until such time - this may be where the honourable member was going - we do recognize that.
Mr. Chairman, clearly, we are doing everything we can to increase the number of home care workers and, of course, we contract for the services of the care providers. The other thing is that in some cases where home care workers are needed to accompany someone who is being discharged from an acute care facility, if a worker is not available at that particular time and will not be, they do consult with family members to see if there is any way the family can deliver that service until such time as a home care worker does become available. Nova Scotia being Nova Scotia, in many cases family members are able to provide that service until a paid home care worker is able to participate.
MR. PYE: Mr. Chairman, this is my final question, and once again I thank the Liberal Party for giving me the opportunity. I believe it is a matter of wage as well, and I don't know how you speak to the contracted services you have with respect to improving benefits and wages to encourage more people to become actively involved in and employed within the home care services field. I guess that's the most important question, does the minister have any influence, does the minister have any opportunity to communicate with those contractual services about enhancing the benefits and the pay scales so that more people will be encouraged to be employed within the home care delivery service field?
MR. MUIR: Mr. Chairman, Home Care Nova Scotia contracts for a lot of services from private agencies, some for-profit and some not-for-profit agencies. In general, the matter of how these people are compensated is between their employer and them. Our stand has been for those workers, as with any others, we want people to be fairly compensated; we say that for any of our health care professionals. On the other hand, we also have to recognize that fairness has to be tempered sometimes with the ability of the resources, because we do want sustainability. In answer to the honourable member's question, clearly, the matter of negotiation is between the employer and the employees.
One of the things that has happened, as I understand, there have been some issues of parity, which have been straightened out in this past year. One of the things we have been wrestling with, and I have mentioned on a number of occasions, I think the honourable member and, indeed, all honourable members recognize, there was so much diversity around the province, and part of our effort as a Health Department has been trying to bring some consistency to practices and the delivery of health and health care across the province.
MR. CHAIRMAN: The honourable member for Cape Breton The Lakes.
MR. BRIAN BOUDREAU: Mr. Chairman, my first question, I am going to follow up on my colleague, the member for Cape Breton West, in asking how many new fees have been added to your department, and how much money does this generate?
MR. MUIR: Mr. Chairman, the Department of Health hasn't incorporated any additional user fees in its budget this year. I think the honourable member may be referring to the ALC fee, which he asked questions about the other day. That particular revenue accrues to the district health authorities, not the Department of Health.
MR. BOUDREAU: Mr. Chairman, I am going to change the topic here, I want to talk about food. I would like to know how much food is purchased by your department from outside the Province of Nova Scotia?
MR. MUIR: We can tell the honourable member how much we spend on food, but how much is purchased outside of the province, I don't know. One of the things that we are bound by - I never really think of food falling under this - the Atlantic Provinces Procurement Agreement. There may be some case where something might be shipped from Sackville, New Brunswick, if you bought it from Atlantic Wholesalers or something like that, I don't know, but it would be under the terms of the procurement agreements that are in place.
MR. BOUDREAU: Mr. Chairman, I am wondering, is the minister aware that his department is purchasing food from Quebec?
MR. MUIR: Mr. Chairman, I don't know, in terms of the actual Department of Health, most of the food services are obviously delivered by other agencies through district health authorities or the IWK-Grace Health Centre. About the only one I can really think of, where I suppose you might have seen it, would be the Nova Scotia Hospital, because that really sort of operated as a direct arm of the Department of Health. Again, if food is being purchased from Quebec, I would have to find that out, but my suspicion is that it is purchased locally and shipped from Quebec because of the distribution system. One of the things I learned last year, for example, somebody told me that one of the major grocery stores here in the province, if you go buy a loaf of bread that has its name on it, it was baked in Ontario yet landed down here on the shelves the next morning.
MR. BOUDREAU: Mr. Chairman, I will get a clear answer yet, I am sure. Mr. Minister, I am sure I am going to get an answer from you. I want to talk a little bit about the Northside General Hospital. Of course, we are all familiar with where that is and know the minister has been visiting there on a regular basis in the last two months. I asked and ran out of time the other day, but I am wondering if the minister recalls the commitments he has made to the residents of the Northside pertaining to the Northside General Hospital.
MR. MUIR: Mr. Chairman, I think the honourable member knows I met with members of the foundation of the Northside General Hospital and talked about certain items with them. One of the things they were concerned about during our conversation was that if they went ahead and did certain things or purchased certain pieces of equipment for the hospital, because they are part of the Cape Breton Health Care Complex - an integral part of
it - for example, if they purchase something for the specific use of the Northside General Hospital, that somebody wouldn't look at it and say, well, that piece of equipment could be better used if it was in the Glace Bay Health Care Complex or the Glace Bay Hospital in New Waterford, or something like that. Basically, my commitment was, as you say, I certainly didn't think that if a piece of equipment was purchased for the Northside General Hospital that it would be removed without the permission of those people there.
MR. BOUDREAU: Mr. Chairman, I appreciate the minister's response, particularly when the hospital foundation does a lot of fundraising, of course, and puts a strong effort into purchasing many pieces of equipment for that hospital, and assisting in any way, shape or form that they may need to, in whatever role that may be. In any event, I am interested in the services, Mr. Minister, the services. Do you recall the commitment you made to the community in regard to services at Northside General Hospital?
MR. MUIR: Mr. Chairman, in terms of making specific commitments about services, as the honourable member knows, the Northside General Hospital is part of the District Health Authority 8. It is an integral part of the Cape Breton Health Care Complex. We did talk about - I believe it may be about the third busiest general visits unit in the province. We did talk about that and the function that it does provide there, not only to the Northside by coming down from Victoria County, Upper Victoria County as well. In terms of specific commitment, because I don't administer that hospital, it's under somebody else, the type of commitment I could make would be rather limited.
MR. BOUDREAU: Mr. Chairman, it is obvious that the minister has a short memory. However, that is fine, Mr. Minister, because I don't. I know the residents I represent and the people of the Northside don't have short memories. Those commitments you made pertaining to that hospital were very well documented, and I would suggest that the minister will hear loud and clear not only from this member but from the community at large if those commitments are not completed.
Mr. Chairman, through you, of course, I would like to ask the minister about the switchboard at that particular location and the commitment he made in respect to the switchboard operation at the Northside General Hospital.
MR. MUIR: Mr. Chairman, as I remember, the switchboard at the Northside General Hospital, during the period from, perhaps, 12:00 o'clock at night until 8:00 o'clock in the morning, or perhaps it was 2:00 a.m. to 6:00 a.m. or some period of time, was going to be forwarded, they had a person there, there were not many calls that came in, so they had a part-time person, effectively a part-time position that was going to be removed there. It was my understanding that those calls were being forwarded and answered in Sydney or Glace Bay or New Waterford, or someplace.
MR. BOUDREAU: Mr. Minister, you certainly do have a short memory. (Interruptions) I know that after 4:00 p.m., we have to call Truro. When we call 911, of course, it comes through Truro, there is no local answering. That system doesn't work very well. There are many documented situations, particularly on the Northside, with wrong addresses or whatever, they always blame it on the 911 system. I just want to acknowledge to the minister that those commitments you made in that community are very well documented, not only by myself but by the community, and we will be watching very closely over the next couple of years, in fact, that that facility is not tampered with. I believe those were the exact words the minister indicated.
In any event, I want to move on to the seniors' drug plan and the penalties that are imposed against late applications. It is my understanding, Mr. Minister, that if a senior doesn't apply by a certain date then they are penalized forever, not only this year or the year they are making application, but in following years the penalty remains the same and is in place. I would like to ask the minister if he has any plans to review this policy to change the policy to what I would suggest is an unfair penalty clause against seniors in this province.
MR. MUIR: Mr. Chairman, the Pharmacare Program we have for the seniors helps seniors pays for their drugs. I guess it's seen as an insurance plan. Even if it isn't, obviously we have to have policies in place to ensure its sustainability. One of the policies that is in place is that there is a premium if seniors enrol late or leave the program and wish to join again. It's open to Nova Scotians 65 and older, and about three months in advance of turning 65 people are sent information on the program and the instructions on what they should do, whether they want to join or would want to join. Of course, there is an 800 number if they need any help.
On the other hand, there are people who will opt in and out of the plan. For example, let's say I make the decision that I don't want to join the plan and all of a sudden I get sick and then I want to join the plan. I believe that is the situation the honourable member has pointed out saying, well, he is acknowledging that the premium differential is a good thing. It is like any insurance plan. I can get along just fine, all of a sudden I get sick and I need a high-priced drug that is on the formulary, therefore, I am willing to join. If the program is going to work and be sustainable, then those who are eligible should join it, and they should join it and be a participant in it. It is for everybody.
MR. BOUDREAU: Mr. Chairman, again, on these fees, many people in the province feel they are unfair and that they really put pressure on seniors. In many cases, the situation you have just explained does not exist. In fact, for many reasons, for instance many of our seniors, as you are aware, Mr. Minister, throughout the province who are 65 years old, some can't read or write. They obtain this documentation in the mail and they don't understand it, they don't even know what it is about. In that regard, it is basically an unfair penalty that is being imposed on some situations in the province. My question, again, to the minister is, will
he agree to review this policy and, hopefully, eliminate the handicap that is being imposed for many of the seniors in our province?
MR. MUIR: The Pharmacare Program is reviewed every year and, obviously, the policies that are associated with it are reviewed too, as well as the premiums, the co-pays and things like that. I can tell the honourable member that that particular policy has been in place since 1995. The reason for it is to ensure that those who are eligible, do participate. The program, like most programs, is set up - one of the parameters, one of the guidelines in having that program operational is that there would be a certain critical mass of people who would be there who are needed to make it operate.
What the honourable member in some ways is saying is that it's like automobile insurance, you take that out because someday you might need it. If I follow the argument of the honourable member, he is saying, well, I am going to take out the automobile insurance after I have an accident and then I am going to make a claim. That really doesn't work.
MR. BOUDREAU: I am trying to identify here, it is a little difficult with this minister. How can the minister stand here and justify any senior in this province being penalized year after year because they made a simple mistake when they applied for Pharmacare. It's a revolving penalty and one that should be not imposed, in my opinion, particularly if you are being penalized for the first year, that's fine, most seniors can accept that, but to be penalized year in and year out is an unfair practice. Will you review this program and this policy and, hopefully, change the program so all our seniors can be treated as fair and equal Nova Scotians?
MR. MUIR: The Pharmacare Program is reviewed every year and the policies associated with it, that policy among them. I would tell the honourable member for Cape Breton The Lakes that if he knows people who are having difficulty with that particular policy that they should phone the 800 number and discuss it with the appropriate officials.
MR. BOUDREAU: Mr. Chairman, the minister is kind to provide that advice to me, but I have already done that, and it's the same old story, the policy stands and seniors in the province are penalized year in and year out. It's really unfair and it's not a universal plan, as that minister indicated.
I want to ask a question about your new fee that doesn't exist, the 911 fee that is imposed on telephone bills. (Interruptions) As far as I am aware, it's a new fee. The minister indicates it's not a new fee, however, it's a new fee, it's obvious, it's added on the phone bills. I want to ask the minister, is HST collected on this fee?
MR. MUIR: Mr. Chairman, two answers to the question. First of all, you could ask that question to me as Minister responsible for the Emergency Measures Act because it was under that portfolio where this decision was made. Secondly, yes, HST will be added to that fee.
MR. BOUDREAU: Would the minister please provide the total amount that individuals will pay for 911 service via their telephone bills?
MR. MUIR: Mr. Chairman, I can't do that. First of all, it is before the CRTC at the time, but I can tell you what our projection is for the Emergency Measures' portion of it. If you add in taxes and everything else and the collection fee that is proposed by the carriers - and, again, it is proposed because that is what is being considered right now at the CRTC - the portion of that that would be attributable to the improvement of 911 services in the province would be about 49 cents per month.
MR. BOUDREAU: So, 49 cents plus tax for a fee?
MR. MUIR: No, that includes tax.
MR. BOUDREAU: Oh, that includes tax. What a deal, 49 cents, that is a steal of a deal.
MR. MUIR: An excellent deal. Think of the last . . .
MR. BOUDREAU: It is an excellent deal, yes, Mr. Minister, it is an excellent deal, but it is not a fee or a tax. I don't know what we call these.
In his comments regarding tobacco tax increases just last week, he indicated publicly that he would have preferred the taxes to be doubled what he imposed; I believe it was approximately 50 cents a pack. If the minister agrees that the tax should have been doubled, then I would like to ask the minister why he did not double the amount that he imposed on tobacco products.
MR. MUIR: Mr. Chairman, indeed I was asked for a comment, and the people who study the relationship between the price of tobacco and health diseases, and what we are trying to do is cut down the use of tobacco and indeed get people to stop or discourage people from starting, they told me - and I think this is pretty well universal - an increase of about $8.00 a carton would have been the desirable thing. However, this was an increase that came from the federal government and, although I tried to give my opinion, Mr. Martin did not solicit my advice in making that decision.
MR. BOUDREAU: Mr. Chairman, it is my understanding that the Atlantic Provinces, the ministers, had direct input and agreed to the increases by Mr. Martin. Is that true, Mr. Minister?
MR. MUIR: As the honourable member may know, this is a tax matter and the tax matters for the province are under the jurisdiction of my colleague, the Minister of Finance. The Minister of Health doesn't impose taxes or collect them.
MR. BOUDREAU: Mr. Chairman, actually that concludes my questioning. I would just like to thank the minister on behalf of my caucus for providing direct answers. I guess for the time being we will believe the minister. We will check some of the information you have provided of course. I want to also congratulate the minister's staff, of course they have proven that they are second to nobody in this province and in the country, particularly when they even make the honourable minister look good. So with that, thank you.
MR. CHAIRMAN: I would like to thank the member for Cape Breton The Lakes. Mr. Minister, it is the norm for you to stand and read your resolutions, but we only have a number of seconds, so I would ask you to do it quickly, sir.
MR. MUIR: I will and just prior to reading that resolution, Mr. Chairman, I would also like to thank my staff: Byron Rafuse, Chief Financial Officer, and Cheryl Doiron, the Associate Deputy Minister, who have been here the entire time; and up in the balcony, although we didn't have to really get them, we have Allan Horsburgh and Gary Glessing who . . .
MR. CHAIRMAN: Mr. Minister, I am going to have to . . .
MR. MUIR: The resolution, Mr. Chairman.
Resolution E13 - Resolved, that a sum not exceeding $631,000 be granted to the Lieutenant Governor to defray expenses in respect of the Emergency Measures Organization of Nova Scotia, pursuant to the Estimate.
MR. CHAIRMAN: Shall Resolution E13 stand?
Resolution E13 stands.
This moment is the moment of interruption and the committee will be back at 6:30 p.m., and at that time we will do the estimates of the Department of Community Services.
[6:00 p.m. The committee recessed.]
[6:30 p.m. The committee reconvened.]
MR. CHAIRMAN: The honourable Government House Leader.
HON. RONALD RUSSELL: Mr. Chairman, would you please call the estimates of the Minister of Community Services.
Resolution E2 - Resolved, that a sum not exceeding $626,508,000 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. PETER CHRISTIE: Mr. Chairman, I would like to open with a few remarks and my staff will be join be joining me in a moment.
I am pleased today to introduce the budget for the Department of Community Services for the fiscal year 2001-02. I urge the members to take time to read the department's business plan and see how we are planning for the long term, not just this fiscal year.
The department has a budget for the fiscal year of over $626 million to support programs and services in four major areas: Community Supports for Adults, Family and Children's Services, Housing Services, and Income and Employment Support Services. Each year about 165,000 Nova Scotians are served by the department and its partners. Our primary role is to provide a social safety net, but our approach is changing. We are now focusing on developing a framework which will enable us to be more responsive to the changing needs of the people we serve. Traditional methods have been reactive. This hasn't been effective. We are going to be proactive, flexible and preventative. Our strategic goals support this department's vision for the future and its commitment to economic prosperity and social well-being. Our mission statement reflects the vision with a commitment to promote the independence, self-reliance, security and well-being of the people we serve.
Mr. Chairman, joining me today are Assistant Deputy Minister Robert Fowler and our Director of Budget and Results, Clem Henneberry. We are a new Department of Community Services. Since the last budget was introduced, we have welcomed the addition of Housing Services to our department. Housing Services is responsible for provincial housing initiatives, including grant and loan program delivery, social housing operations, and residential land development. Services are provided through four regional offices and seven housing authorities across the province. We believe this is a logical addition to Community Services, and staff are now looking at ways in which the programs and services of Housing Services can be supportive and coordinated with the programs and services of our other divisions.
Mr. Chairman, I would like to take a few moments to talk about our continuing and increasing commitment to children, and to bring you up to date on our Social Assistance Redesign project. This government will continue to invest in the future of our children. The research is clear, the critical years for children are the early years, and we know that many parents need a helping hand. Within the department, our Early Childhood Development Services section is dedicated to offering programs that support the family unit. One of the main goals of this section is to promote the healthy development of children between the ages of birth and six years.
They do this in a number of ways: by licensing and monitoring child care programs; by developing policies and standards for child care centres and programs; by approving education and training programs for early childhood; by promoting awareness among parents and community members of quality child care choices; and by conducting audits on selected child care programs to ensure quality. This section also supports parents who need child care while they work or attend school or training. We provide subsidized spaces for their children enrolled in child care centres or in family daycare. We now subsidize over 2,500 spaces across the province, including 95 subsidized spaces that are attached to the child, not the centre. These new portable spaces have expanded the choice for child care. Parents can take the portable subsidized spaces to any licensed daycare in Nova Scotia that has a signed funding agreement with the department, and for the first time this includes commercial child care centres.
We are carefully evaluating this new system and are still in the pilot stage of portable child care. So far we have been able to determine that half the portable spaces are used by parents who had been receiving social assistance. These parents are now able to work, look for work, or take part in training programs. Some of these spaces are also being used by families who have children with special needs. We are confident that portable child care spaces provide an additional option for parents who need this type of flexible help to make the transition from assistance to self-reliance a little easier.
Mr. Chairman, early intervention programs help children up to five years old who have development disabilities. These programs allow workers to directly help children and families in their homes. There are now 16 early intervention programs across the province that help more than 450 children. For parents on social assistance who are able to work, employment case plans will be based on each person's situation. The assessment will consider the availability of resources, including child care. For parents on social assistance, funding for child care has been increased from $300 a month to $400. We know that for a number of reasons child care spaces can sometimes be difficult to get. We are not going to punish families who can't access child care when they are trying to get back into the workforce; instead, there will be more flexibility.
Under our new Social Assistance Program, family members other than parents can now be paid for child care. Our staff continues to work to identify other methods of increasing the availability of quality, affordable child care. Community Services and the child care sector have invested in many studies and have identified the long-standing need to improve funding and how we deliver that funding for licensed child care programs. The Child Care Funding Review started last year will address these funding issues.
With a number of portable child care spaces now in place, Phase 1 of this review is well underway. As I mentioned, these portable spaces are attached to the child and can follow the family if they move within Nova Scotia. Phase 2 will see recommendations for improving how we fund child care. Consultations have taken place with members of the child care community and other stakeholders. Experts have conducted research and analyzed the data on child care in Nova Scotia. They are in the process of finalizing their report. This, in turn, will assist us in determining the best use of our Early Childhood Development funding.
New infant child care regulations came into effect this month. These regulations have been under development since 1994. They are the result of consultations with the child care community and the Nova Scotia Round Table on Child Care. Since 1994, infant guidelines have been standard practice for most infant programs. Regulations for the youngest children in care keep Nova Scotia in pace with other provinces by ensuring quality care. Although these new regulations are now in effect, it has always been our intention to allow a period of time for centres to make the necessary physical adjustments. Our staff is more than willing to work with centres that need extra time. There are 52 centres in Nova Scotia that are licensed for infants and the majority of these are already in compliance with the new regulations.
Mr. Chairman, Community Services continues to make every effort to provide adequate child care for our troubled children and youth. Some of these children require highly specialized care and have been placed outside of Nova Scotia, but we will soon see most of these children cared for in their home province. We plan to have a tender call in May or June for our new Secure Treatment Centre in Truro and we are aiming to have it open next winter. Once operational, the secure treatment program will employ about 30 full-time, highly-trained staff including youth care workers, social workers, nurses, teachers and other clinical treatment staff.
I would like to take this opportunity to thank the people of Truro and their town council who have expressed interest and support for this new treatment centre. Department staff have held three public meetings in Truro and have been impressed by the quality of the questions and appreciate the effort to stay informed. We are confident this program will make a difference to some of our children and youth who need this type of special care. Secure treatment is an intensive, temporary intervention and is part of a larger system of youth in care residential services. This system includes secure treatment, foster homes, group
homes, residential treatment centres, and parent counsellor programs. Our goal, shared by all of our partners, is to keep children and youth as close to home as possible.
Mr. Chairman, under the National Child Tax Benefit initiative, we are about to reach a major milestone in addressing child poverty in Nova Scotia. Starting this July, we will restructure and substantially increase our Nova Scotia Child Benefit Program. When it is combined with the National Child Tax Benefit supplement, a standard benefit of $1,700 will be established for every child of a family with an income under $16,000 a year. Just as important, the new standard benefit will remove the need for children's allowances in the welfare program so that, for the first time, income security for children will be equal and fair for every family.
The amount of increase this July will depend on the number of children in a family. Families with income between $16,000 and $32,000 will receive partial benefits based on their income level. By providing benefits for children, whether their parents receive social assistance or are in the workforce, we have reduced the need for low-income working families to turn to welfare programs for help. At the same time, we have made it easier for families dependent on welfare to make the transition to work, because joining the workforce no longer means losing children's benefits. This means that children's personal allowances will be removed from social assistance budgets beginning this August. The department will make sure there is plenty of advance notice about these changes.
We have created a better system of children's benefits in Nova Scotia by standardizing the benefits for all low-income families and providing, under this program, one of the leading benefit structures of this type in Canada. These are encouraging signs that a combination of a healthy economy and the National Child Tax Benefit are having an impact. The most recent statistics from Statistics Canada for 1997-98 indicate the child poverty rate in Nova Scotia dropped from 22.4 per cent to just below the national average of 18.8 per cent, but there is a lot more to do as we work towards the addressing and elimination of child poverty.
Mr. Chairman, our new Social Assistance Program will take effect this August. We are on schedule with the legislation and regulations now in place. This is an exciting and significant change in the province's system of social assistance. It will also be a time of transition that will include huge challenges. These challenges include resources and information technology. Our dedicated staff are determined to make this transition as smooth as possible. Going to a single-tier system is a key achievement. It is not about workfare or work for welfare because benefits will not be time-limited. No one will lose benefits for not finding work within a set period of time.
Our Social Assistance Redesign project is about creating a framework that will help people be the best they can. It is about providing the supports people need to become self-sufficient. It is about working with families on assistance, to enable them to enter the
workforce and stay employed. It is about improving employment skills, searching for work, and actually finding work. The new regulations outline enhanced employment supports and allow us to lower the welfare wall. These changes include increased transportation, child care and training allowances. We will support people working towards becoming self-reliant by providing up to a year of transitional Pharmacare coverage for those entering the workforce, along with improved wage incentives.
The new system will also provide Pharmacare coverage for the recipient's spouse and dependent children. The new Act and regulations will create a single system with standard rates and policies. The focus will be to help people overcome barriers to self-reliance, but it will also recognize that some people will continue to rely on social assistance for longer periods of time. While people with disabilities will want to participate to the extent they are able, we will also ensure realistic long-term support for those who cannot reasonably be expected to find work.
Mr. Chairman, once again Community Services will provide help to people on social assistance who have children in school. The school supplies supplement will be provided to everyone on social assistance with dependent children attending elementary, junior high or senior high school. The supplement provides $50 for children between the ages of 5 and 12 and $100 for children between the ages of 13 to 18. The supplement will be provided this September.
Mr. Chairman, our new Housing Services division continues to provide public housing and rental supplements to a number of families in Nova Scotia. This includes assistance to over 10,500 families in the form of home repair loans and grants, and housing subsidies for rental and ownership. Housing Services has a budget this fiscal year of $13.5 million. However, it is important to note that the total amount spent on housing is approximately $120 million. This includes $60 million from the federal government, $6 million from municipalities and another $45 million in rents collected from tenants. Housing Services works closely with other provinces and the federal government to develop and participate in national housing programs and services. Staff from Housing Services is also participating with other governments and community partners involved with the federal homelessness project.
We have work to do in the Housing Services area. Nova Scotia has one of the oldest housing stock in the country. In 1996, 73 per cent of all the dwellings in the province were over 16 years old. Older dwellings require more ongoing maintenance and often low-income homeowners cannot afford essential home repairs. Every year demand always exceeds available funds and, as a result, we have long waiting lists for grant and loan programs. Staff have improved the waiting list protocol to better address the timeliness of our response. Our goal is to serve low-income homeowners who need urgent repairs within four to six months.
Mr. Chairman, earlier this year, we released an independent report on our Community Based Options program. The report was prepared by Dr. Michael Kendrick, an international consultant specializing in mental health and disability. This independent review points out many of the strengths of our small options system and supports the direction government has been taking with the Community Supports for Adults sector. It provides suggestions on how we can keep improving the system in the future.
We have known about the issues presented in this review and have been continuing to make improvements in the system, including interim standards for the operation of community-based homes, and minimum training standards for those who work in the Community Supports for Adults sector. We recognize there is much more to do and the review points out that many of the suggestions are long term, from 5 to 10 years. Community Services will continue to work with the Department of Health to bring improvements to the long-term care sector in this province.
Our focus has been on the needs of those who are cared for in the Community Supports for Adults sector, who are our most vulnerable citizens. Under the division's funding framework, we are committed to increasing salaries paid to individuals working in the continuing care sector. We also commit to achieving equity within the sector for direct care and support staff. We are pleased that, effective this month, this has been achieved. For direct care staff who meet the department's training standard, their salary now reflects that of their colleagues in other parts of this province working in this sector.
We are very proud and appreciative of the work with our partners at the Nova Scotia Community College in the development and implementation of the curriculum for those who want to work in the continuing care sector under the mandate of this department. The introduction of training standards for direct care staff in this sector has been viewed by other jurisdictions as being in the forefront in the area of service provision for persons with disabilities.
Mr. Chairman, thank you for allowing me the opportunity to provide members of the House an outline of some of our important budget initiatives that we have underway and planned. We look forward to debate on this budget.
MR. CHAIRMAN: Mr. Minister, we thank you for your comments, and now I would like to recognize the member for Dartmouth North.
MR. JERRY PYE: Mr. Chairman, I must say that I listened intently to the speech from the Minister of Community Services with respect to the new initiatives that the government is taking with respect to Community Services. The minister is very much aware, as he has already stated, there are some 165,000 Nova Scotians who rely upon a social safety net and rely upon his Department of Community Services to deliver programs.
The minister is very much aware as well that they have introduced something new, which is a single-tier income assistance and support program services this year with respect to Bill No. 62. The minister is very much aware as well that those regulations are relatively new. There are a lot of community organizations and agencies you are left yet to digest what particular impact those regulations will have. The minister himself knows that only time will tell with respect to the kind of program that he is unfolding with respect to his Department of Community Services with income assistance support programs.
The minister also talks about proactive flexibility and being in a preventative state. As well, the minister talks about - and I am going to be brief on this particular issue because I do want to get into the area of questions, and since we only have a short period of time to question the minister with respect to his estimates, I want to make sure that we have covered sufficient ground - the secure treatment centre for children with severe difficulties. The minister is also aware that that secure treatment centre is a year behind schedule. That secure treatment centre was supposed to be up and running in year two of this government's mandate, and he is now looking to the fall or the winter to provide those secure treatment centres.
There are some 25 Nova Scotians who are placed in secure treatment facilities outside the province as we speak on this particular budget this day. The minister knows that it is important to have them home and close to their families. The minister also talked about the early childhood intervention initiatives, and much of that money has come from the federal government. I will question the minister on where that money is going to be put forward. All in all, if I can, I would like to go directly to some of the questions.
The first question I have is, in his budget and in the pocket budget brochure, there shows about a 7.3 per cent increase in your budget for the year 2001-02. I believe - and the minister can offer me clarity on this - that includes the $11 million of service exchange which is something the government has committed to and I don't know if that is the final instalment of the service exchange or not; I believe there is one more year left on the service exchange. There is also the $9 million of federal monies to the national child agenda that is counted in that 7.3 per cent, and also an addition to the budget of the Minister of Community Services is now - because it comes under his umbrella - the $13.5 million for the Department of Housing.
I am wondering, can the minister tell me just exactly what does that leave as an increase from the Nova Scotia taxpayers to this budget? Is that a 4 per cent increase? A 3.5 per cent increase? What sort of an increase might that be?
MR. CHRISTIE: As the honourable member indicated, our estimates increased from $583.748 million to $626.508 million this year - $13 million was Department of Housing; so the actual increase from year to year for Community Services was $29.3 million. The member indicated that part of that was the $11 million memorandum agreement with
municipalities. Last year in our estimates, we had $8 million included, so $3 million would be an additional increase. We did have in the estimates for this year, we did have the $9 million for the early childhood development as you have mentioned. We have an additional $5.9 million increase for children and we have a $12 million increase, the balance is in community supports for adults. So, our increase is approximately in the 4.7 per cent range after you remove the Department of Housing.
MR. PYE: That increase is consistent I believe with the previous year?
MR. CHRISTIE: It would be not quite consistent, but you recall last year, when we had the debate on the estimates, the Department of Health had moved seniors from our budget over to the Department of Health, so that is what made our numbers not comparable with the previous year, which would be the year 1999.
MR. PYE: I want to ask the minister again. He did say some 4.3 per cent increase in his budget over 1999-2000, for the year 2001-02 year, he did briefly touch upon where that money is going, but can you specifically tell me where these new dollars are designated in the budget once again? I didn't catch just exactly where you had indicated those new dollars are going.
MR. CHRISTIE: We have - removing the Department of Housing - we are talking about base to base now and, taking those out, I indicated to you that the significant changes were in the Family and Children's Services, the $9 million of the new program from the federal government. There is $3.8 million in transfers of lease payments from the Department of Public Works. We did have an additional $5.9 million increase in the maintenance of children. Part of that would be the cost of the implementation of secure treatment this year. The balance, we had an additional $3 million increase in Pharmacare costs this year and that would be under the income support section and the balance would be in the Community Supports for Adults sector.
MR. PYE: Your Minister of Finance boasted about putting $1.5 million into adult education. The Voluntary Planning Committee pegged about 50 per cent of Nova Scotians have a high school education or less, and many of those are the 36,000 adults who are on social assistance and would fall into that category. Many of those people will need retraining and educational programs to make sure that they are able to be employed within the workforce. In your opinion, how many clients will be able to benefit from those dollars?
MR. CHRISTIE: The question was, of the $1.5 million put in by the Minister of Finance, how many would be able to take benefit of that? What I could indicate to the member is that as we indicated in our return-to-work initiatives, we have increased that by $2 million. We hope a great number of people will take part in that. As I indicated before, we will be doing an assessment of all of the people on social assistance and determining their eligibility for training programs. We hope a great number will take advantage of that. At this
point in time we are making those programs available, and we will have to see how many people take advantage of it.
MR. PYE: The minister is unaware - and I agree - would be unable to make an accurate calculation, but he would be able to make some sort of an estimate of the number of people who would be able to take part in that program simply because of the age levels of the individuals, adults, who may be on social assistance. So he would know an estimate of how many people would be able to benefit from that.
Now because of the one-tier income assistance, Community Services will not be providing those on welfare the opportunity to obtain a university education. You are going to be exempting those who are grandfathered prior to August 1, 2001. The minister knows that many clients on assistance are single mothers. He also is aware that the higher the education, the greater the income, and a chance for individuals to become independent and self-reliant. I am wondering why, because people are poor, must you further penalize them from obtaining a higher education, and how do you justify such a decision?
MR. CHRISTIE: I want to correct something that we were talking about with the honourable member before. The indication of the $1.5 million that you were talking about, a training program, is in the Department of Education budget. I referred to the $2 million increase that we were putting in our back-to-work initiative to cover those. So it is a combination of those two programs that we were talking about.
[7:00 p.m.]
Now your other question was university education. The honourable member indicated in his remarks that he is aware of the number of people on community assistance rolls and assistance that do not have a Grade 12 high school education. That is the reason we have to focus in on that area, because we have to help those people achieve a level so that they can be prepared to go back to work, they can be prepared to take the training and take advantage of the programs that we have.
MR. PYE: Well, the minister is also aware that certain regions of this province are hit more so than other regions of this province. I am just wondering where the minister would be able to find jobs or train individuals, particularly with the consistently high unemployment rate in rural areas where there are no jobs to enter and also Cape Breton, where the unofficial unemployment rate is somewhere around 18 per cent and that does not include persons on social assistance. So what is the game plan for the Minister of Community Services in providing people the opportunity to become self-reliant and independent through employment opportunities in those regions?
MR. CHRISTIE: Mr. Chairman, the member raises a very good point and it is one of the challenges that we have in putting in programs and helping people. What we have indicated is that a number of things have to happen. People will have their assessment. They will be able to take training programs and, if work is available, they will be able to go to work. If there are areas where the unemployment is high and where there are no jobs available, then they simply won't be able to go to work. But that doesn't suggest to us, in our logic, that we shouldn't give them the opportunity to take the training. They might take training in one area where there is unemployment and then move to another one. But we want them to have the opportunity. If there is no job there, then they won't be able to leave assistance and go to the workforce.
MR. PYE: Mr. Chairman, I guess someone in the department is going to oversee this program. I am wondering who and what department is going to be overseeing this return to education program, as well as who does the evaluation and who does the assessment and what expertise do these individuals have with respect to providing that sort of service?
MR. CHRISTIE: Mr. Chairman, the honourable member's question was, who is going to do this assessment? Well, this will be done by our caseworkers. Our income support people will be working with people to indicate to them and evaluate where they are and what programs are available to them and that will be done by our income support people, to provide that assistance. They have been doing that. We are giving them more money. We are giving them new computer systems so they can work at it more diligently and they will be able to take care of that process.
MR. PYE: Well, I think it is obvious that the minister knows that the new system must provide employment incentives. Part of that employment incentive is education. I am just wondering, through you, Mr. Chairman, to the minister, let's take a hypothetical case of a single mother using a new system of working full-time, 11 hours. She would still need money to feed her family by staying on the system because of the child care costs. We have talked about some of those child care costs.
You talk about this welfare wall and how you want to move people away from that welfare wall. You also talk about a system that will prepare those individuals for tomorrow. If in fact you have a system that is going to prepare those individuals for tomorrow and if in fact education is the singular most important component - because we do believe that that is the only way that people are going to significantly move off the welfare roll into employment - I am wondering, Mr. Minister, what types of jobs are you going to be providing training for or offering training services to individuals who are on social assistance? It is important to offer educational programs.
I do know that you said you were involved with the community colleges in providing health care workers programs through the community colleges to people who want to take those health care working programs. Surely that is not the only program that is going to be
offered by community colleges. I am wondering what kinds of educational programs, other than that program that the minister is preparing to have his department be involved in so that when people do walk off the welfare roll, they have a secure income, an income that is adequate, an income that they know full well will feed their family, where there is no embarrassment, there is no need to be supplemented by the Department of Community Services.
I am wondering if you can look at that in light of, again, the voluntary report that says over 50 per cent of Nova Scotians, once again, earn an income of less than $20,000 a year. If that is the point, then I want to know, through you, Mr. Minister, what kinds of educational programs are you actually looking at that are going to provide people employment opportunities in Nova Scotia?
MR. CHRISTIE: Mr. Chairman, to the honourable member, programs that will be available to people to work are any programs that are offered at the community college. Those programs, as the honourable member knows, are wide and varied. The Department of Education has indicated that we will be having a school for adults to help them get their Grade 12 and to work towards that. But, after that, they will be working towards those things which make them job-ready, which will be all the programs and services offered by the community college.
MR. PYE: So the minister is prepared to provide support up to two years to complete a degree at a community college. I am wondering what happens to an individual who would require probably an upgrading educational program, plus a two year program services? Is the minister prepared to lump that into the two years or is the minister and his department prepared to provide the upgrading programs that are necessary so that when the individual enters the community college or an institute of higher learning, that they do have those skills that are available?
MR. CHRISTIE: Mr. Chairman, to the honourable member, the program that we are talking about will be bringing people, in discussion with their caseworker, from the situation that they have now if they need to have additional work at school to complete their Grade 12. We are not for a moment suggesting that if somebody comes in it is just two years. It is programs that will get people job-ready. That might require, for certain individuals, to finish high school and then go to community college. Some people might have completed high school and then they will go on to community college. We are talking about getting people from where they are after their assessment to getting them job-ready. That will require, in some cases, more than the two years. This program isn't a defined two years, it is the definition of getting people job-ready.
MR. PYE: Mr. Minister, in order for a unemployed single parent to even consider meaningful skills training and employment opportunities, there must be sufficient child care spaces available and quality programs offered. Nova Scotia has 2,480 subsidized child care
spaces, a far cry from the estimated 5,000 child care spaces that were needed in 1993. The minister wasn't here and that was going to be part of the National Child Care Policy, as it was going to be adopted by the federal government and be supported by the other provinces.
The total number of low-income children under the age of seven in Nova Scotia is over 17,500. Once again to the minister, the total number of children under the age of seven in Nova Scotia is 17,500. If we are to move people from welfare to work, how many child care spaces are you budgeting for this year?
MR. CHRISTIE: Mr. Chairman, in our budget this year our numbers under daycare are for the 2,500 spaces plus the portable spaces. As we indicated in the Throne Speech and I indicated in my comments, what we will be doing with the National Child Tax Benefit monies that are coming this way, our intent is to work with that program in the child care sector. The honourable member will recall that both he and I had an opportunity to attend a meeting of daycare workers in Dartmouth, as you will recall, and the question at that time was salary subsidization and how we were going to move forward.
The program that we are working on, to complete with the federal government in the very near future and have that framework ready to announce to everybody in the next few weeks, will include those supports for commercial and non-profit daycare centres plus, as we have indicated, we will be giving grants for non-profit to open additional child care spaces. If you ask me what will be the take-up in that, how many spaces, I don't know that yet, but we have had indications from the non-profit sector that they see that as a very positive go-forward plan and that that will initiate a number of additional spaces in the province.
MR. PYE: Once again I do apologize, Mr. Chairman, but I didn't hear the number of daycare spaces that were going to be available this year along with the portable spaces. I didn't hear the minister say. I think that he said they were still working on those numbers and the numbers had not been finalized?
MR. CHRISTIE: Yes, that is a fair assessment. What I did indicate to the honourable member was as we finalize this program and work with the non-profit sector, we anticipate a number of - what we have indicated to them is that there will be grants available to develop non-profit daycare spaces throughout this province. What the take-up will be, we don't know, but we feel that that will be a very positive initiative into opening up daycare centres in areas where there aren't so many centres at this point in time.
MR. PYE: Mr. Chairman, I am going to move to the portable daycare spaces later, but in the Speech from the Throne on Page 4 it states that your government will commit ". . . additional resources to existing licensed child-care centres." Can you explain the resource your government is talking about?
MR. CHRISTIE: Mr. Chairman, the member raises the very question I was just speaking about a second ago. What I indicated, under the framework agreement with the federal government, we are in the final stages of just completing that and that funding arrangement will be announced in the next couple of weeks when we finalize that, but as we indicated in the Throne Speech, a large portion of that will be going to supplement salaries and to help with salary stabilization in that sector, both the non-profit and the commercial sector, but the side that we would be offering grants and expansion for would be in the non-profit sector.
MR. PYE: Mr. Chairman, the minister anticipated my next question because last year we did meet with a number of directors and employees of early childhood educators. They were all concerned about the lack of funding for the centres and the low wages. Many came with high student debts and worked with the most cherished children for wages less than that paid to an auto mechanic.
You made a commitment to improve their wages and benefits on that day, Mr. Minister, and I know that we had talked with many of them and they had expressed the kind of concerns around what kind of benefits, what improved conditions there would be, what sort of salary wages they could be looking at with respect to early childhood educators. Many of them come with high debts as well, we do know that, from university and many of them said that they were quite concerned that they could no longer afford to be employed within the child care profession, simply because the salary ranges were not consistent with the kind of education they had achieved.
So my question to the Minister of Community Services, and I know you said that you are working on this particular program, you are finalizing and you are doing the details. Have you spoken with any of the stakeholders with respect to wages, the types of benefits, and the kind of improved working conditions one might expect?
MR. CHRISTIE: Mr. Chairman, the answer to the question is yes, we have spoken with both sectors in the child care, both the non-profit and the commercial. As the honourable member is aware, the federal program is very specific. It talks about the availability, affordability, and the other part of that is the accountability sector that all provinces that are involved in this have to do. We have spoken to them. The final details of that program have not been signed off by all of the partners and so I am not able to announce the full details of that program as yet, but we have indicated to the sector that we will be looking at training opportunities for people in daycare, both commercial and non-commercial.
We will be looking at salary adjustments so that people will be able to afford in non-profit centres to achieve levels of salary that are comparable to other areas and, as I indicated, the other area of this will be that grants that we will be offering for people to open new centres, particularly in areas that are under-centred right now, and we will be offering that.
The final details we will be working on as quickly as possible with our federal counterparts so we can get that completed and make that announcement, but we have been working with the sectors and they are aware of the direction that we are going.
MR. PYE: Mr. Chairman, there are a number of private daycare centres as well and at that meeting we had met with a number of private daycare services as well. They were looking towards the government requiring some support and funding for their facilities, for their staff and benefits for their staff as well. This, in my opinion, requires an unusual step because now government is stepping into the private sector, which is providing the same level of service as not-for-profit daycare centres, and yet the government is trying to enhance the wages, the benefits, the working conditions for people who are in the not-for-profit sector.
Now, I am wondering how the government rationalizes its position with respect to providing benefits for the private sector, as those benefits are provided for the not-for-profit sector, as well as is there going to be a transition period or will there be an opportunity for the private sector businesses to buy into being a not-for-profit organization whereby it will receive the same benefits from government? There is this quasi position, I believe, that is hanging out there, that I am totally unaware of how government is going to move in that direction.
We know the government has committed. It has spoken with stakeholders and I would assume that those stakeholders are primarily in the not-for-profit sector of the early childhood care development programs that are offered. I don't know how much conversation the government has had with those who provide early child care intervention programs who are in the private sector, but I do know that I may be in a unique position - and maybe not - because there are a number of not-for-profit organizations in the constituency that I represent as well as a number of private-for-profit organizations that are in the constituency that I represent, both delivering early childhood care programs and services to those people who require the service. I guess if the minister can enlighten me as to how he goes about delivering this to the private sector and what commitments are there on the private sector to live up to certain standards, agreements, and/or policies that may be introduced by your department?
MR. CHRISTIE: Mr. Chairman, to the honourable member, as I indicated in my remarks, subsidized spaces are available now. We have some of those subsidized spaces which are portable spaces which are being used in the commercial sector. We know that we have a resource, as the honourable member indicated, the resource of the children. We have to be concerned with all of those. We regulate those and they have to meet our regulatory standards.
The part that we haven't completed as yet, with the federal government, is just exactly the issue you raised: how are we going to deal with both sectors? That is what we are trying to work on. What we do know is that our go-forward plan from here on, as we talk about developing new centres, will be in the non-profit. The issue of how we are going to complete those people who are in the sector now, is something that we have to sign off with the federal government. That is not completed as yet.
MR. PYE: I thank the minister for that comment, but I think that if, in fact, we are going to enhance the early childhood intervention programs and we are going to make sure that all Nova Scotians benefit from such a program, and that the private sector which, in fact, has now obviously spoken with the minister and has now, unlike before, attended meetings with respect to the benefits and programs and services that they want to enhance within their private centres, I think it is important to know where your government stands with respect to this position.
I haven't heard it clearly where you stand with respect to this position and how you, as the Minister of Community Services, see that. I don't think that you indicated if you are open and receptive to a transition period whereby the private-for-profit daycare centres will have an opportunity through that transition period to be able to move into non-profit facilities or not-for-profit organizations so that they can reap the benefits - I shouldn't say reap the benefits, but they can get the enhanced benefits - that the department would be offering.
MR. CHRISTIE: I think what the honourable member's question is, the distinction, is there going to be a distinction between commercial and not for profit, I can indicate to the honourable member that we have centres now that are commercial centres that make application and move to non-profit status. As we look at going forward, I indicated our development and our plan for the future will be with the non-profit sector. Obviously, it will be an opportunity for people to make that transition. Our goal, of course, is to provide, as we talked about earlier, the number of spaces for people and having them all across the province. That will be our goal to develop and the profit centres will be able to look at that.
In terms of the wage issue and how we are going to do that, that is the area that we are not able to announce yet because, yes, we have met with them, we have heard their concerns. We have also met with the federal government people and that is the thing we have to put the final touches on before we can announce that.
MR. PYE: I know that earlier the minister implied that his government did keep one of the blue book promises with respect to portability of daycare subsidies. Actually the portability goes with the child and not with the particular daycare, as I understand it. I do know that may be beneficial, particularly because in rural areas there may not be the sufficient daycare spaces or child care spaces that are available to people in rural communities. And not even necessarily in rural communities, but in parts of Nova Scotia that certainly may or may not be available.
I am just wondering though when your government has committed itself to portable daycare spaces, other than a direct family member, the parent, you are able to possibly have members of the family such as aunts, uncles, and so on and so forth, who may be prepared to be child care workers in the true sense because they will be looking after the child while the parent is out in the employment field, or for whatever other needs the parent may need a child care centre for.
I am wondering if that is considered by his department a good move in light of the kind of programs that are offered by early childhood daycare spaces. It is one thing to be a babysitter, it is another thing to be a child care worker. Many of the child care workers come with degrees, expertise in the field of understanding early childhood development, of knowing how to get the child off on the right foot, putting the child on the right ground so that the Minister of Community Services knows that at the end of the day, this child will not be a client on the social services rolls.
There is this whole factor of quality child care while the child is in the custody or the care of someone for that period of time. First of all, I have some difficulty with respect to what kind of quality care might that child receive, particularly since the government is funding this sort of portable program. Number two, are there any specific qualifications for individuals to be daycare workers? What is happening here, and the picture that I received, some of them have now become glorified babysitters, if you don't mind my using that term. I don't mean to use that term in a derogatory way, but that is the way portable daycare happens to fall. It happens to fall for those people who might very well need the daycare and might have an aunt or an uncle or a sister or a brother or someone who is going to look after that child who may not have the qualifications or the expertise to do that, simply because it is portable and it gives the parent the right to select who their child care provider might be.
I think there is a serious problem with respect to wanting two things here. One, that you make sure that early childhood development - particularly when you are putting the kind of taxpayers' dollars into the program that you are putting in. One is that you want to see that child - and that child is usually from the ages of 0 to 6, as the minister has said in his statement in budget estimates. This is a significant growth period for the child. This is a significant development period for the child and there need to be people with expertise in the field so that those children don't get waylaid, that, in fact, there is an opportunity at the end of the day for them not to be grown adults who will be one day on the social services rolls.
So, I am wondering if the minister has looked into that whole portability issue, if in fact the portability issue has been brought up to him by people who are experts in early childhood intervention. If they have brought those issues up, what are the kind of problems that they may have envisaged as being part of the portable spaces available?
MR. CHRISTIE: I want to clear up one thing. The portability spaces that we have - the 100 portable spaces - must go to licensed daycares. They can be profit or non-profit. We just want to make sure that is understood. The next issue that the honourable member raised was, have you looked at a number of these issues. The answer is yes and the honourable member might know a child care expert by the name of Jane Beach. We have had Jane Beach working with us on this initiative, working at the framework, looking at all of these issues. As I indicated to the honourable member, part of the issue around the federal government program was it had to be accessible, affordable and there had to be accountability. She has brought that part to bear.
[7:30 p.m.]
We know that that report from the Nova Scotia Child Care Funding Review, which is the one I am indicating to the honourable member, is in the final stages of sign-off with the federal government and Ms. Beach has been working on the different areas. She has taken the opportunity, along with Mr. John Jozsa, to talk to both sectors, to interview stakeholders, along with meetings at the department, to look at just those issues that the honourable member is raising. So that is all part of this transition through to the framework report that I am talking about that we hope we have to be