Pressing the Minister about accessing primary care

On April 4, 2024 I asked the Minister of Health and Wellness about people’s troubles accessing primary health care in Nova Scotia:

SUSAN LEBLANC: Our offices hear regularly from people who are struggling to have their needs met without attachment to primary care. One told us, “I live with some chronic ailments, and I have no support to properly manage them. My partner is in a similar position. I have three children, and there are many things I would like to have support with from a primary care provider.” Another person said, “Both of us have multiple disabilities. My spouse’s health needs constant monitoring. We have no continuity of care, and it is stressful.” My question to the Minister of Health and Wellness is: Can the minister assure these and all 160,000 Nova Scotians on the Need a Family Practice wait-list that they will have attachment to a primary caregiver?

HON. MICHELLE THOMPSON: I do want to assure folks who are on the Need a Family Practice Registry that one of the most important things and options available is to update their health information. Recently, as a result, people living with chronic conditions such as diabetes have actually been attached to a clinic to support their health care needs. Also, they’ve been scanning for people who have time-limited conditions such as pregnancy to make sure that people have access to the care they need. There are a number of ways in which people can access, and it also speaks to the necessary and important step of making sure that every individual in Nova Scotia has access to their health care records to ensure continuity of care.

SUSAN LEBLANC: Not sure how those two things line up, but let’s go on to the next question. Another person told us: “I can utilize services like Maple for refills, but no one is consistent. When my mental health is worse, I don’t have anyone to provide support and help change my meds if needed.” Another said: My 77-year-old father has been without a family doctor for several years now and has been waiting the whole time. He’s getting his prescriptions refilled by phone appointments but has had several health issues that need a primary care doctor as a main point of contact. He’s dealing with prostate cancer, high blood pressure, joint issues, and all the things that go hand in hand with getting old, all without a family doctor. Are these the people whom this government thinks are managing just fine with virtual care?

MICHELLE THOMPSON: Again, I go back to how important it is for individuals to work either through 811 or online in order to update their information. We know that there are people who do require complex care. In some cases, that can be handled through a pharmacy, as an example - cardiovascular health, there’s some diabetic care that can happen through there. There are a number of different avenues. We are looking at attaching people to a family practice. A family physician is very important, but there are other primary care providers who can support people in a healthhome environment. I would encourage people to make sure their information is updated on the Need a Family Practice Registry, and also to look at other avenues in which they can get support. We are scanning that Need a Family Practice Registry on a regular basis to look for people with chronic conditions and attach them to appropriate chronic care.

Asking the Minister of Health About Nova Scotians' Personal Health Information

SUSAN LEBLANC: Late last night, under the cover of darkness, government members discussed at length the mounting concerns about this government’s proposed new approach to the disclosure of personal health information, which physicians have warned will fundamentally change the nature of the patient-doctor relationship and potentially break people’s trust in their physicians by allowing unrestricted disclosure of deeply private information. Can the Minister of Health and Wellness explain: What is so important that requires this government to play with fire with our personal information?

HON. MICHELLE THOMPSON: As I said yesterday, there are already requirements in place for the Minister of Health and Wellness that that individual has to meet under the Personal Health Information Act already. This is about getting information in the hands of Nova Scotians so that they can have their record in their hands and they can navigate the health care system. We have seen this be hugely successful in other jurisdictions. We have a responsibility to manage the health care system. We receive aggregate data from our hospitals, from our clinics, from all over, but we don’t have aggregate data from our primary care. That’s what this is about: managing a system, managing it well, managing it appropriately, and giving people access to their patient records.

SUSAN LEBLANC: The government has indicated that these changes are needed to advance the work of the YourHealthNS app - has anyone heard of that app, by the way? - which in part is being run by an Ontario-based company that was awarded this work in an untendered $50 million five-year contract last year. It’s recently come to light that this company has been facing financial challenges and was recently acquired by an investment firm. Last week in Estimates, I asked the minister about the sale and was told by the minister that the contract would be assumed by the buyer. Can the minister confirm: Has anyone from the department been in contact with the new owner of people’s private health information, and what does all this mean for Nova Scotia’s health data?

MICHELLE THOMPSON: I want to assure Nova Scotians that we are absolutely in compliance with all of the privacy laws that are in place. We want people to have access to their health records. We want people to be able to be their advocates in the health care system. People are saying, as we hear all the time from the feedback on the app, We want more. We want to know where our records are. We want to know what our bloodwork says. We want to know about our diagnostic imaging. People are asking for this information. Through this legislation and through the work that is happening with the Nova Scotia Health Authority and the individuals who are responsible for privacy to support us in granting that request, there is nothing to fear for Nova Scotians.

Question Period: 156,000+ on the doctor waitlist. Why is gov dismissing them?

My exchange with Health Minister Michelle Thompson about the Need a Family Practice wait list:

Last week, the Premier said: “There are different reasons people are on the list. Some actually have a doctor, but they don’t like their doctor, or they’re worried the doctor might retire, but they have access to care.” I can table that. I find this puzzling. The government actually publicly reports people’s reasons for joining the Need a Family Practice wait-list, which I will table: 54,708 are on the list because they’re new to the area; 15,672 have not needed a provider until now; 39,060 say their provider closed their practice; 31,092 said their provider had retired; and 15,256 say their provider is retiring. None of these are what the Premier said. My question is: Why is this government trying to detract from the very real experience and anxiety of the thousands of Nova Scotians without attachment to primary care?

HON. MICHELLE THOMPSON: We do continue to use the Need a Family Practice registry as one of the indicators that is important, but it’s not the only one. We do have to look at the accessibility of health care. People languished on that list for a long time before we formed government, and there was no other access point for them, other than waiting at the emergency department. We have created 60,000 new appointments per month - that’s 720,000 per year - in order for people to access health care. We are working with the list. We understand who’s on that list. We are finding different pathways for individuals who have a variety of different concerns, and we will continue to attach and provide access to people in Nova Scotia.

SUSAN LEBLANC: Also last week, the Premier told us that only some Nova Scotians need a family doctor or nurse practitioner, and that for others, virtual is working just fine. I just tabled that. These certainly aren’t the people we speak to, who without attachment to care live in constant fear of getting sick: people with young children; people who need controlled medications prescribed or titrated; people with complex health needs. Can the minister tell the 156,000 people who are waiting which one of them doesn’t need a doctor?

MICHELLE THOMPSON: It is very important that if individuals are on that list, they do update their information. Recently, we’ve been able to attach 13,000 people. Some of those people were pregnant, for example. We know they have a time-sensitive condition that requires them to be attached to a primary care provider. We were able to attach a number of individuals directly to diabetic education centres. There are other people who can look after complex needs, like our pharmacists who can manage chronic disease, and we’re seeing that through the pilot that we have across the province. There are many ways to access care. We have also given over 10,000 patients access to their information, so that they can be better advocates for themselves in accessing and attaching for health care.

Kerian Burnett MSI Congratulations

I gave the following members statement in the Nova Scotia Legislature on March 22, 2024:

Speaker, Kerian Burnett, a migrant worker from Jamaica, got very good news recently. She finally got her MSI card in the mail. This was the result of a multi-year fight to get health coverage in the wake of her 2022 cervical cancer diagnosis. As a migrant worker in the strawberry fields, Kerian was not eligible for MSI, and her two surgeries cost $81,000. In 2023, Kerian was approved for the Interim Federal Health Program. In January of this year, she was granted a work permit through to July 2025. That work permit made her eligible for MSI. Though Kerian now has medical coverage, many migrant workers do not, as their work permits are not long enough to qualify. Kerian and No One is Illegal, Halifax/Kjipuktuk, which has supported her through her treatment and fight for coverage, are calling on the provincial government to immediately provide migrant workers with MSI coverage when they arrive in Nova Scotia. I congratulate Kerian on receiving her MSI card. I wish her good health, and I stand in solidarity with No One is Illegal and migrant workers, and their call for MSI for all.

Susan Leblanc Asks What will Goverment do to Ensure Measles Vaccine Supply

SUSAN LEBLANC: Speaker, Chief Medical Officer of Health Dr. Robert Strang recently urged Nova Scotians to check their immunization status, and for many to update their measles vaccination. Now we’re hearing that pharmacies and primary care providers are overwhelmed by demand. There are simply not enough doses of the vaccine. Kari Ellen Graham, a pharmacist in Halifax, has said, “The bottom line is you could try your pharmacy, although most pharmacies are out . . . a lot of doctor’s offices are now out.” How are Nova Scotians supposed to protect themselves and follow the advice of the Chief Medical Officer if there are no shots available?

HON. MICHELLE THOMPSON: First of all, I want to clarify and go on the record that there are shots available. There is MMR vaccine in this province. There is no shortage. Because of the demand, the orders that physicians and pharmacists have, they’ve gone through those orders more quickly. It’s simply reaching back out to the BioDepot, explaining that they are out of the vaccine, and ordering more.

SUSAN LEBLANC: It would be great if people could access the vaccine through mobile health units in cases where pharmacies and primary care providers are not a viable option, but according to Nova Scotia Health Authority’s website, many parts of Nova Scotia do not have mobile immunization clinics scheduled until April, and many are not even offering the measles vaccine. Measles cases across Canada are on the rise- we’ve heard this. Nova Scotians should not have to wait several more weeks to access the recommended vaccination. What is this government doing to ensure that all Nova Scotians have access to the vaccinations they need when they need them?

MICHELLE THOMPSON: Nova Scotians have a variety of different ways in which they can access vaccines. They can access them through the mobile clinics, they can access them through primary care providers, they can access them through pharmacists. There are a variety of different ways. There is no shortage. There is high demand, which has caused offices and folks to go through their supply, but there is no shortage of the vaccine. If individuals require more vaccine- whether they have a pharmacy or whether they have an office- they simply need to reach out to the BioDepot and increase their supply.

Susan Leblanc asks the Minister to address nursing burnout and add locums

SUSAN LEBLANC: Speaker, my question is for the Minister of Health and Wellness. This province spent $126 million last year on travel nurses who work for private agencies. I can table that. Despite this large sum, our nursing shortage is not going away. The Nova Scotia Health Authority continues to have over a thousand nursing vacancies. Too many of our nurses are having to work 24-hour shifts, while others have to work up to six days a week. This is leading to burnout and nurses leaving the line of work. The travel nurse program is making it worse. On top of burnout, local nurses are working next to travel nurses who are making much more money. Why is this government continuing to throw money at private nursing agencies when the perceived solution is clearly not working?

HON. MICHELLE THOMPSON: We know that there is a provincial and national nursing shortage. We have to use travel companies right now. There is no other alternative. It allows us to keep beds open. There has been an underinvestment in nursing education for a number of years, which has resulted in this nursing shortage. We are raising the number of seats. We are recruiting. Our Patient Access to Care Act is bringing people in from all over the country. If we were to walk away from travel nurses, we would have to close beds in this province, which we’re not willing to do. What I can tell the member is that we’re one of the first jurisdictions in Canada to actually limit the use of travel nurses, and we’re anxious to see what that will result in as the time moves on.

SUSAN LEBLANC: Janet Hazelton, the president of the Nova Scotia Nurses’ Union, has presented a clear solution to this government. She would like to see a nurse locum program in place of their reliance on agency nurses. In a committee earlier this week, she said, “It’s very doable. All it’s going to take is for the unions and the employer to sit down and negotiate this. We just have to do it.” I can table that. When asked about such a program, the department said talks have been limited. Will this government listen to what nurses are saying and implement a provincial nurse locum program?

MICHELLE THOMPSON: Moving the same number of people around in a different way in the province is not going to help our nursing shortage. We have done a number of things. We’ve increased the number of seats. PACA - which that member voted against - will bring nurses from all over this country to Nova Scotia, enabling them to work within five days. We are looking at immigration strategies. We have to raise the supply of nurses. We need to train them. We need them to come and move and live and work here. We have a competitive contract. We are an incredible environment to work in. There are a number of things that are happening through the new collective agreement and by the employers to improve conditions for nurses, and I am confident in our ability to address the nursing shortage.

Fixing Healthcare Fast Enough?

These are some of the statements I made recently about the state of Healthcare in Nova Scotia at the March 19, 2024 Health Committee meeting:

I have to say that the people who have been waiting for Primary Care who end up getting their Primary Care from a you know a doctor with a text message in Calgary or standing in line for 3 hours at a walking clinic or going to a mobile clinic and hoping to God that they're going to get there in time. It's not good enough and for a government that's been elected to fix healthcare to not be able to say by the next election this is going to be what we've done or this is where we want to be and then you can vote to tell us if you think we did a good job or not. I just find it, I find it unreal actually and I I just like it's not good enough. I know that everyone is working so hard but it feels like to the people who aren't attached or don't have like you know a a when someone feels sick that they make a choice not to contact, not to try to get an appointment because they know they're going to be waiting for hours and hours and hours or whatever. Oh we'll just see how I feel tomorrow. That's not a good state.

Couch of HOPE

I gave the following members statement in the Nova Scotia legislature on March 6, 2024:

Speaker, in the absence of a truly universal mental health care program in Nova Scotia, accessing timely and affordable or free mental health care is a significant challenge for Nova Scotians -a challenge that is being alleviated in part by a not-for-profit in Dartmouth, the Couch of HOPE. In 2020, when founding counsellor Michelle Labine and her colleagues noticed that their sliding-scale counselling spots were all full, it became clear that more radical action was required. At the same time, Michelle’s group practice was hearing from Master’s of Counselling students who needed clinical practicum hours, and that’s when Couch of HOPE was born. Clients dealing with stress, anxiety, depression, addiction, trauma, relationship issues, grief, life transitions, and more meet with a counselling therapist intern who is supported by a practicum supervisor and professor. In 2023, Michelle was named the United Way Invisible Champion for her work with Couch of HOPE. Recently, Couch of HOPE partnered with the North Grove to offer appointments to people there on site.

I ask the House to join me in expressing my deep gratitude to Michelle and the whole Couch of HOPE team for doing their part in making mental health care truly accessible in Nova Scotia.

Dense breast screening

On March 6, 2024 I spoke in the Nova Scotia Legislature about the need for follow up screening for people with dense breasts. Here’s what I said:

Mme Speaker, I rise today to call on the government to change the policy regarding follow up breast screening for people with dense breasts. Currently in Nova Scotia, people with breast density category C or D (that is, the densest breasts), are made aware of their breast density rating. That means, that when they get a regular mammogram, any signs of cancer or other issues could be obscured by the dense breast tissue. The problem is that in NS, if someone has dense breasts, they don’t have access to screening that could detect cancers accurately and prevent spread of the disease. I represent a women, and probably many women, in this situation. Women whose cancer was undetected because they couldn’t get access to follow up breast screening, and was in stage 4 before they were diagnosed. Cancer, if detected early, has a much better chance of being defeated. A person’s quality of life is generally going to be better with less treatment. Cancer is cheaper to treat if detected early. It only makes sense that we offer followup screening to all people with breast density C and D. I urge the government to change this policy as soon as possible.

IWK's Endometriosis and Chronic Pelvic Pain Clinic

SUSAN LEBLANC: I want to introduce a few people from the Endometriosis and Chronic Pelvic Pain Clinic at the IWK Health Centre who have joined us today. They’re over in the gallery opposite, and as I say their names, I’ll ask them to rise. Dr. Allanna Munro is an anaesthesiologist who specializes in chronic pelvic pain. Leah Pink is a nurse practitioner who works in the clinic. Linda MacEachern is a social worker who provides pain education and counselling at the clinic. Kathryn Hawkins is a pelvic floor physiotherapist who provides pain education and treatment in the clinic. Also working in the clinic but not present today are two gynecologists who specialize in endometriosis and chronic pelvic pain: Dr. Elizabeth Randle and Dr. Brigid Nee. Also, we would like to welcome today Maggie Archibald and Faith Lamoureux, who have shared their stories of accessing care for endometriosis in Nova Scotia. Of course, all of this is in light of the fact that today, March 1st, marks the beginning of the very first Endometriosis Awareness Month in Nova Scotia. I would like everyone to welcome our guests.

THE SPEAKER: Welcome, and thank you for being here and for all that you do. The honourable member for Dartmouth North. IWK CHRONIC PAIN CLINIC: IMPORTANT WORK -THANKS

SUSAN LEBLANC: Speaker, I rise today to recognize the work of the IWK Health Centre’s Endometriosis and Chronic Pelvic Pain Clinic. In 2021 the clinic opened, the first of its kind in Atlantic Canada, thanks to the hard work and advocacy of clinicians and the public. When it opened, nurse Leah Pink said: “Drawing on the expertise of multiple health care professionals and by using innovative strategies to provide care we will better meet the needs of this underserviced patient population.” This interdisciplinary care model is the gold standard. Endometriosis costs our medical system in ER visits and many often-unnecessary tests, due to a lack of understanding and the long delays people face in getting diagnosis and treatment. It also costs those who suffer from endometriosis in wages lost while unable to work, and time away from family and friends, and pain and money for physiotherapy, and other out-ofpocket expenses to manage chronic pain. Thanks to this clinic, more Nova Scotians have access to the treatment and support they need as well as qualified support. I ask the House to join me in thanking Dr. Allana Munro, Leah Pink, Linda MacEachern, Kathryn Hawkins, and their colleagues for their work in expanding badly needed endometriosis care in our province.

Government Must Fund More Midwives in Nova Scotia

SUSAN LEBLANC: Speaker, midwifery-led births account for only 5 per cent of total births in Nova Scotia, far below the national average of 14 per cent, and I can table that. This is a disservice for expectant mothers in Nova Scotia, given many positive health outcomes associated. Midwifery support leads to more natural births, a decrease in C-sections and surgical interventions, easier breastfeeding initiation, and it decreases the chance of having a pre-term birth. Not only does it take the stress off new moms, but it also takes stress off our hospitals. Does the Minister of Health and Wellness recognize the importance of midwifery care in our health care system?

HON. MICHELLE THOMPSON: I spoke about this yesterday in the Chamber. Certainly, midwives have a role to play in prenatal, obstetrical, and gynecological care. In fact, there are things that they can do around supporting women’s wellness. We have a couple of areas outside of the city. IWK has some midwives, and we do have some areas. It certainly is not easy to maintain the staffing complement in those areas. We’re also making sure that midwives are part of a team. We need to ensure that they have nurses who are around them. We need to make sure they have primary care physicians who do obstetrics. We need to make sure they have specialty services to support them. Yes, many deliveries are usual and regular, but we need to make sure that they have the infrastructure around them. We do continue to look at women’s health issues, and we’ll continue to assess the situation as we move forward.

SUSAN LEBLANC: As the minister’s response shows, it’s hard to ignore the benefits of midwives that they add to our health care system. Investment in midwives is simply a smart policy, yet there are only 16 funded positions and 3 practices in the province. Many communities across Nova Scotia, as the minister said, lack essential midwifery care. The budget yesterday was a missed opportunity for this government to address the critical shortage. Why is this government not investing in midwives? MICHELLE THOMPSON: Nova Scotians are not missing out on good, quality, excellent obstetrical and gynecological care in this province, and midwives are a part of that team, but they are not the only members on that team. We know that midwives play a role. We have 16 positions. To date, they have been very difficult to date to fill. We continue to work with Nova Scotia Health and IWK to better understand how to support them.

THE SPEAKER: Order. The time allotted for Oral Questions Put by Members to Ministers has expired.

Question to Minister: Why did gov pay developer’s tax bill on Hogan Court?

SUSAN LEBLANC: Speaker, my question is for the Minister of Health and Wellness. In the Auditor General’s report on the Hogan Court hotel deal, it was revealed that the highly unusual and concerning transaction was negotiated with a developer who didn’t even own the property and then included $500,000 to cover the developer’s deed transfer tax after they bought and flipped the hotel to the Province. My question is -and I think we would all like to know this -why is the government paying this developer’s tax bill?

HON. MICHELLE THOMPSON: We continually talk about Hogan Court, and I’m so pleased to be able to stand up and talk about that first-in-the-province transition-to-care facility. This is a monumental change. I can appreciate that they’ve . . . (interruption).

THE SPEAKER: Order. We’re all a little bit too loud in here today. We’re going to start again. The honourable Minister of Health and Wellness.

HON. MICHELLE THOMPSON: Thank you. I’d like to thank the members opposite for just helping me prompt my response there. I might have missed that opportunity if they hadn’t said something. We are really pleased with this development. There was a right of first refusal that informed how we proceeded with the project. We bought this facility so that we can get more care faster to Nova Scotians, particularly our seniors who are waiting in hospital. There are things we can absolutely learn from the Auditor General’s report. We have accepted them. Certainly the last Auditor General’s report had said that I was going too fast and doing too much, and I will take that any day over other . . .

SUSAN LEBLANC: Speaker, many may find it hard to believe, but despite spending a massive amount on this shell of a hotel, the government missed a pretty important part: the driveway. Shockingly, the government’s new overpriced hotel doesn’t even have road access. Instead, this government had to negotiate service and access agreements with the developer to make up for the omission. Why did the purchase of this hotel fail to include a driveway, and how much are we paying the developer for road access to our own building?

MICHELLE THOMPSON: If the only thing the member opposite can find wrong with Hogan Court is that it doesn’t have (interruption). The only thing we’re talking about today is a little driveway. I feel confident in our ability to put in an adequate driveway that will help families pick up their loved one and take them home after they receive excellent care in a transition-to-care facility.

Susan Leblanc Asks Government About Careless Spending on Hogan Court

SUSAN LEBLANC: Speaker, the government’s approach of “going like hell” -and I’ll table that -has proven to be high-risk but not high-reward. In fact, care seems to be missing entirely from the government’s approach to health care spending. Carelessly handing out untendered contracts has resulted in out-of-control costs, and a decrease in the promised number of additional health care beds. My question for the Minister of Health and Wellness is: When will the government take responsibility for its poor decision on the Hogan Court project?

HON. MICHELLE THOMPSON: There have been historic investments to date with a new budget coming. We have made incredible decisions. We have made incredible investments -60,000 more primary care appointments per month. We’ve invested in 60 new and strengthened primary care clinics across this province. We are finally using pharmacists to the fullness of their scope, resulting in 95,000. We are working with seniors in long-term care with the Nova Scotia Health Authority to transition seniors in this province in a respectful way to appropriate places for them to recondition and finally get home. We have a new Cape Breton Medical Campus. We have a surgical wait-list that has reduced by 27 per cent since April 1, 2022. I have about six more pages . . .

SUSAN LEBLANC: Money is tight these days. Nova Scotians go to the grocery store and compare costs before deciding what items to buy because they understand the importance of getting value for what they are spending. On the other hand, this government -as we have heard from the Auditor General bought a $35 million hotel without even a proper appraisal. While many Nova Scotians are scrounging to save a few cents, the government is recklessly throwing around millions of dollars. Will the government apologize to Nova Scotians for taking such a careless approach to health care spending?

MICHELLE THOMPSON: What I really want Nova Scotians to know is that this is a government that fully invests in their health, in their wellness, and in their ability to transition, based on the stage of their life, to an appropriate place where they can live. We did not buy a hotel; we bought a transition-to-community facility. When you have people who are world-class clinicians -like Dr. Christine Short and Dr. Rockwood excited about the prospect of the ability to care for our elders in this type of environment, it is more than value for money. Nova Scotians should be very proud that this government has their shoulders to the wheel, and that we show every day how we value them, because nobody on that side did for the last 12 years.

Susan Leblanc pushes government to commit to free birth control for all in N.S.

SUSAN LEBLANC: My question is for the Minister of Health and Wellness. For many Nova Scotians, the cost of birth control prevents them from accessing this basic form of health care. It’s estimated that one in three Nova Scotian workers do not have health benefits, and not all benefit plans offer equal coverage of the care. Insufficient access to birth control leads to worsened health, well-being, and socio-economic outcomes for patients, families, and communities. The minister has worked extensively as a health care provider. Does she find it acceptable that so many Nova Scotians can’t access this important medication?

HON. MICHELLE THOMPSON: Certainly, we’re looking at universal birth control over the last number of months. We know that there are a number of people, through Family Pharmacare, who can access birth control, providing that there is a medication component. I certainly know in the instance of IUDs, in order for those to be covered under Family Pharmacare, there does need to be a medicinal and hormonal component to that. We continue to look at ways to support Nova Scotians. We also know that through the Department of Community Services, as well, there’s free birth control available to those who meet the criteria. We are working all the time to cover things that are important to Nova Scotians, and we’ll continue to do that review.

SUSAN LEBLANC: The minister will know that there are gaps in providing contraception. Earlier this year, British Columbia became the first province to provide access to free prescription contraception.Nova Scotia needs to follow suit. It’s estimated that for every dollar spent on contraception access, there’s up to $90 in public savings. The Access Now Nova Scotia Coalition has called on government to urgently address this issue, supported by organizations like the Pharmacy Association of Nova Scotia, the Nova Scotia College of Family Physicians, the Dalhousie Department of Pediatrics, the Dalhousie Department of Obstetrics and Gynaecology, the North End Community Health Centre, and many others. I will table that list. Will the minister commit to ensuring that every Nova Scotian has access to no-cost contraception?

MICHELLE THOMPSON: Our Pharmacare Program is under incredible pressure, as we all know. Not only do we have advancing technologies and therapies, but we also know the costs of drugs are going up. As a department, we continue to look at what we’re best able to supply to Nova Scotians. We want to make sure we have things that are accessible to them and that are needed. There are always competing priorities, and we will continue to balance and look at those over the coming months. We will do what we can to support Nova Scotians.

Susan LeBlanc asks why government is hiding data about emergency care crisis

SUSAN LEBLANC: My question is for the Minister of Health and Wellness. Every day in this province, ambulances and patients are tied up, waiting dangerously long times, to be off-loaded at the hospital. On a recent Tuesday evening, I was told that 17 paramedics were at the QEII waiting to off-load patients. In her report on this issue, the Auditor General said, “We recommend the Department of Health and Wellness publicly report weekly ground ambulance response times by community and offload times by hospital.” I can table that. Presumably the minister has this information. Will she commit to reporting it weekly?

HON. MICHELLE THOMPSON: Certainly we are very committed to be a transparent government that reports on a variety of metrics, and I would point the member opposite to Action for Health. On a regular basis, not always weekly, but on a monthly or quarterly basis -sometimes annually, depending on the metric -we do post information there so that Nova Scotians can see how the system is performing. Not alwaysare those the best outcomes that we’d like, and those are the places where we focus the most, so I would say that we are very transparent. We are very committed to being transparent with Nova Scotians. We continue to work with the provider as well as the Nova Scotia Health Authority around off-load times as well as other metrics. I would point the member to the Action for Health website.

SUSAN LEBLANC: The current standard says that an ambulance that arrives at an emergency room should be able off-load the patient in 30 minutes or less. The government’s most recent public data show that for the week of October 1st, in the Western Zone, the average off-load time was 88 minutes. In the Northern Zone, it was 92 minutes. In the Central Zone, it was 139 minutes, and in the Eastern Zone, it was a 150-minute average -an average wait for thepatient to be off-loaded into the emergency department and the paramedic to get back on the road which is five times longer than the standard. But when it comes to what is happening at each individual hospital, people are left in the dark. So why is the government hiding this data?

MICHELLE THOMPSON: Certainly, there is no attempt to hide any information at all whatsoever. We’re not trying to hide it at all. In fact, we’re the first government that has an Action for Health website that actually shows the data for what’s happening in the health care system. What happened is we’re working very hard across this province. We have a number of places where the off-load times are meeting standards. We look at places like the Aberdeen Hospital, we look at St. Martha’s Regional Hospital, and we look at all ofthese hospitals and we take what’s happening there, and we scale it as best we can. There is nobody taking their foot off the gas in terms of response time. We are under-bedded in this province, in long-term care and in the hospitals, and have been for decades. We also need to increase staffing. So there’s a ton of work that’s happening around off-load times.

Susan Leblanc on ER closures leaving Nova Scotians without care they need

SUSAN LEBLANC: Speaker, my question is also for the Minister of Health and Wellness. This week alone, there have been announcements for emergency room closures at Fishermen’s Memorial Hospital, North Cumberland Memorial Hospital, All Saints Springhill Hospital, Queen’s General Hospital, Eastern Memorial Hospital, Digby General Hospital, Glace Bay Hospital, and Strait Richmond Hospital. Does the minister find it acceptable that Nova Scotians in these communities are regularly left without an open emergency room in their area?

HON. MICHELLE THOMPSON: I will say, as I said a few minutes earlier, the biggest challenges that we’re facing are our capacity in terms of beds, but also in terms of our health care workforce. We know particularly that there is a nursing shortage across this province. We have been working very, very hard. We have increased the number of seats. We’re working with the Collegeof Registered Nurses to bring in internationally educated nurses. We’re doing a very intentional program in order to train and bring nurses into our health care system so that they’re able to care for communities. We’re looking and working with people in the Department of Labour, Skills and Immigration to ensure that internationally educated nurses are settled and transitioned to communities in a very meaningful way. It is going to take time, but certainly we have seen an incredible amount of action and investment in health care since we’ve formed government.

SUSAN LEBLANC: ER closures cause crowding and long waits at regional hospitals as people travel further for care and cause massive stress and delays on paramedics. A FOIPOP filed by our caucus shows that the number of people leaving ERs without being seen continues to go up and up. It has increased again by 24 per cent this year. I can table that. This government promised to fix health care, but to the Nova Scotians facing emergency room closures and lengthy wait times, this just isn’t the case. Yes, it takes time, but Nova Scotians can’t wait any longer. When will the conditions in emergency rooms improve?

MICHELLE THOMPSON: Things are improving. I would draw attention to the Patient Access to Care Act, and the work that’s done with the college: 18,000 nurses have applied to come and live in Nova Scotia -a bill, I might add, that the NDP voted against when they were on the floor of this House. Here we are -we have just settled a new contract with nurses, and we have just settled a new contract with physicians. We are becoming a destination for health care workers around the world, as evidenced by the number of people who are coming here. They don’t want to look at the things that are going well. Ican assure you that we are investing. We are working our tails off to make sure that Nova Scotians have the health care they need and deserve, which was never a priority under the two previous governments.

Susan Leblanc asks why a government shelter has empty rooms in a housing crisis

SUSAN LEBLANC: My question is for the Minister of Health and Wellness. Last week, it was reported that three-quarters of the rooms on the health care floor of The Bridge shelter are sitting vacant. Meanwhile there are hundreds of people experiencing chronic homelessness in Halifax, many of them with serious health issues. We know there are staffing issues at The Bridge and across the whole health care system, but how is it possible that this government is allowing shelter beds to sit empty in the middle of a housing crisis?

HON MICHELLE THOMPSON: We are in a partnership with the Department of Community Services with The Bridge to support individuals experiencing homelessness and who may need health care. Our portion of The Bridge is to look at those folks who need a space to get community-based health care. We look at the ability to prescribe periods of time where people can be sheltered to get that care and make sure it’s safe for both the individual receiving care, as well as the person who is delivering care. We continue towork with our partners in HRM to make sure that those spots for people requiring health care at The Bridge are used appropriately.

SUSAN LEBLANC: That sounds excellent. That sounds great. That’s exactly what we thought that that part of The Bridge shelter was for, and yet three-quarters of it is sitting empty. Meanwhile, there are people on the streets with severe health problems -people who are being released from emergency departments out into homelessness again, instead of to that area. A spokesperson from the Nova Scotia Health Authority stated that on any given day, there are multiple homeless community members who are identified as people who would benefit from intake on this floor. I can table that. Despite this fact, there are already more names on the floor’s wait-list than there are rooms. People awaiting surgery, people using wheelchairs are living rough in this province. How does the minister plan for all these people to be safely and appropriately housed before Winter?

MICHELLE THOMPSON:As I said, we work across departments to find solutions for individuals based on their circumstances. The Bridge is used for people who require short-term care in community, who are experiencing homelessness. Unfortunately, it is not a long-term housing situation for them, but we do work with our allied health care professionals, such as social workers and other individuals in the health care system, to support transition to community for those who need additional support.

Question for Minister of Health - Another Clinic Closing

SUSAN LEBLANC: Mr. Speaker, my question is for the Minister of Health and Wellness. Another doctor is winding up their clinic in Halifax. Jason Haslam received a letter last week informing him and his partner that they no longer have a family doctor as of May 31st. They have spent numerous stints on the family doctor list, but he says, “My real concern is for my fellow patients. There could well be patients recently diagnosed with cancer, for example, who may also be waiting on another long list for specialist treatment, or elderly patients like my own mother, who not only need regular checkups but also a family doctor to advocate for them with specialists, insurance, and so on. I live in real fear of what happens if she loses her doctor too.” Jason and the people he’s concerned about need a family health team. When will the government stop the exodus of family doctors from the Central Zone?

THE SPEAKER: The honourable Minister of Health and Wellness.

HON. MICHELLE THOMPSON: Certainly, there have been a number of things undertaken in order to support physicians in Central Zone and throughout the province. Most recently, there was a letter that was sent to physicians explaining that if they were winding up their practice or felt that they need practice support, they could reach out to this 1-800 number, and that the local medical services team through NSHA and the Department of Health and Wellness would reach out to support them to ensure that they had the practice supports that they required.

SUSAN LEBLANC: Jason also said, “Ironically, in the same building as our now-former doctor, a private, for-profit clinic has opened. I guess our current Premier thinks only those who can afford to pay are allowed the luxury of health. It’s infuriating that others who may not be so lucky can simply be sentenced to the list for the crime of not having enough money.” I can table that letter. Does the minister think it’s fair that private clinics, where people have to pay to access primary care, are popping up at the same time as people are losing their family doctors?

MICHELLE THOMPSON: Certainly, our government has shown a strong commitment, 6.5 billion commitments, to make sure that our publicly funded health care system has the resources that it needs. We are working very hard in primary care. Attachment does not mean access. We are looking at a variety of modalities in which patients can access care as they wait for attachment, and I would encourage people, if they do need access, to get on the Need a Family Practice Registry. That allows them a variety of different ways to support their health care, and we are looking at ways of increasing primary care providers in the province.

Endometriosis Awareness Month - March 28, 2023 Members Statement

Mr. Speaker, as my honourable colleague has just said, March is Endometriosis Awareness Month. I rise today to call on this House to prioritize funding for reproductive health care and endometriosis care in Nova Scotia. Reproductive health care and health care specific to people with uteruses is often not taken as seriously as it should be. This is especially the case when it comes to menstruation and the pain that comes with it. In Canada, one million people - 1 in 10 women and an unknown number of transgender and gender nonconforming people - live with endometriosis. This is a gynecological condition where tissue grows outside the uterus. Endometriosis symptoms include severe menstrual pain, chronic pelvic pain, and infertility. Many spend years trying to get an accurate diagnosis so that they can get proper treatment. Sometimes these folks are told that this excruciating pain is normal, but it is anything but. Symptoms are managed using a combination of medical and surgical care. I call on this government to prioritize the health care for people with uteruses and ensure that we have the specialists and funding necessary to address endometriosis in our province. (Applause)

Need for Midwifery Investment

SUSAN LEBLANC: My question is for the Minister of Health and Wellness. Nova Scotians have been asking government for years to invest in more midwifery services across the province. There is still zero service in Cape Breton and the Valley. Midwives in the region have been working on establishing an education program, which is a key piece of the puzzle, and they have asked for a study on how to make it happen. FOIPOP documents from the minister’s department show the process was moving along nicely until it was squashed at the last minute from the very top decision-makers. I can table that. Can the minister explain why her government is so resistant to supporting midwives and new parents that they won’t even undertake a simple study asked for by midwives across the region?

HON. MICHELLE THOMPSON: Just to let the member know, we’re currently focusing on stabilizing our current midwifery services across the province. There are some issues around recruitment and retention. I also want to make note that we do have an unattached baby clinic. Certainly, the midwives in this province have been instrumental in supporting that. We are using midwives to the best of our scope, but currently, the focus is on stabilizing current midwifery services.

SUSAN LEBLANC: Perhaps we’ll have a chance to talk about retention in Estimates, but after this government tabled its budget last week, speaking of Estimates, our caucus heard from midwives and health advocates who were heartbroken that another budget has been tabled with no new investment in midwifery, including no new midwifery services in Cape Breton, where there was the highest rate of C-sections in low-risk pregnancies in the province between 2017 and 2020. C-sections are the most common kind of surgery, and midwives can help lower these rates and free up hospital resources, but we have to invest in them. If this government will spend whatever it takes to fix health care, why does it continue to refuse to implement the sensible and affordable suggestion to invest in primary care that will benefit pregnant people and free up other primary care providers in this system?

MICHELLE THOMPSON: Certainly, this has been a historic budget in terms of our investment in health care- More, Faster. We certainly are committed to improving primary care access, and again, we go back to the fact that we need to stabilize our current services before we spread ourselves too thin and make the program not available to anyone.