QUESTION FOR MINISTER OF HEALTH RE: CRITICAL SUPPORT FOR PARAMEDICS

SUSAN LEBLANC: Mr. Speaker, my question is for the Minister of Health and Wellness. We are in critical need of support for and investment in our emergency response infrastructure. We are seeing paramedics having to work 12- to 14-hour shifts, and have seen response times in the Central Zone jump from eight or nine minutes just a few years ago to 27 minutes now. Today’s budget responds to this crisis with a move towards single-paramedic response units, an initiative that has faced criticism from paramedics for putting patient and paramedic safety at risk.

Can the minister explain why today’s budget is so disconnected from the emergency care crisis that Nova Scotia’s health system is facing?

HON. MICHELLE THOMPSON: I would like to say that the SPEAR unit is actually a very innovative way to support people who don’t need emergency care. We know that there are some people who call 911 for a variety of reasons - most certainly because they need assistance. But the physicians in medical comms working with paramedics in the field have actually been able to support four out of ten individuals in community to be diverted away from the emergency room for the appropriate care (Inaudible) community. We are investing in primary health care, emergency services, workforce strategy, surgical access, cancer care, and patient flow. I don’t think any of those are disconnected from the health care of Nova Scotians.

SUSAN LEBLANC: We all know the challenges facing our province’s paramedics, and we know our emergency care system is at a breaking point. Paramedics are feeling left behind, and they are looking to the government for support to be able to continue in their profession: serving Nova Scotians. This budget saw an expansion of the More Opportunities for Skilled Trades tax rebate to certain health care workers and emergency medical care, but excluded paramedics entirely. In a time when we are facing unprecedented emergency response times, paramedic resignations and vacancies, and unsustainable working conditions, why is the government refusing to support and recognize the importance of the paramedics?

MICHELLE THOMPSON: I want to assure the member that we continue to invest in paramedics in the EHS system. We have invested $3.5 million in equipment to prevent injury. We’ve implemented double overtime for paramedics in recognition that they need to stay sometimes after their shifts. We’ve covered a benefit that was a great cost to paramedics, resulting in $2,500 more per year in their pockets. We offered them a $5,000 bonus. We have a workforce planning group that meets on a monthly basis to support paramedics. EMCI has a strategic working group made up of paramedics. We are very committed to paramedics in this province. We have actually asked the union to go back to the table so that we can - at a table - talk about the things that are important to paramedics, and give them the work-life balance they want.

When will this government support paramedics in the ways that they need?

SUSAN LEBLANC: My question is for the Minister of Health and Wellness. I want to bring the House’s attention to a growing crisis among our province’s paramedics. Numbers from the Department of Health and Wellness show that 133 paramedics left the profession in 2022 for reasons other than retirement. I can table that. This is more than double the number from just a few years earlier. Paramedics have attributed most of these numbers to chronic undercompensation in the profession. Wages in other provinces are substantially higher than in Nova Scotia. Paramedics save lives every day and are as integral to the health system as nurses and doctors. My question is: When will this government support paramedics in the ways that they need?

HON. MICHELLE THOMPSON: I, too, am very concerned about our paramedics. I have worked with paramedics for 31 years, and I greatly appreciate the way in which they have supported patients throughout Nova Scotia. We have done a number of things. We have invested $3.5 million in equipment to support them because they are off, and we know that injuries have been an issue. Recently, we covered a short-term illness benefit for them in December and put more money in their pockets. We have offered a $5,000 bonus to them. We continue to look at their scope of practice. We have a variety of different practice settings for paramedics. We have introduced an $11,500 tuition rebate for paramedics to incentivize people. (Interruption) We’re very focused on the paramedic workforce, and we will continue to work with them to find the practice setting that they want.

SUSAN LEBLANC: Mr. Speaker, in spite of all that, in spite of all of those things, the growing number of paramedic vacancies is a cause for concern. We hear that every paramedic in this province, at this point, has an exit strategy. The 2022 total of 255 vacancies is significantly higher than previous years and the impact of this is becoming clear, and I can table that. We’re seeing more than four times the number of late responses to emergency calls than just two years ago, and I can table that. Nova Scotians need to know that there will be emergency care available when they need it, and paramedics need to be supported to stay in the province and in their profession. Retention and compensation is a clear issue among our province’s paramedics, and this government’s failure to meaningfully address this has put Nova Scotians’ health and safety at risk. Will the minister commit to raising paramedic wages to be competitive with the rest of the country?

MICHELLE THOMPSON: Certainly, there are a number of things that we are working with. We do have a committee that has been struck with the Department of Health and Wellness, Nova Scotia Health, EMCI, the paramedics union, and the college to support their practice environment and make sure they have adequate work-life balance. In fact, we have signalled to the paramedics union that we would like to get back to the table to address their compensation as well as work-life balance concerns because their contract is up at the end of October.

MSI for Migrant Workers

Mr. Speaker, on this Day for the Elimination of Racial Discrimination, I rise to draw attention to the unjust treatment of migrant workers - many of whom are racialized - in Nova Scotia.

In order to access our province’s public healthcare system migrant workers must have a one-year work permit. Unfortunately, contracts under the Seasonal Agricultural Workers Program, or SWAP, are (at the most) eight months per calendar year. This means that all workers under that program have to pay for their healthcare or rely on insurance packages negotiated by their employers.

I draw to the House’s attention Kerian Burnett, an agricultural worker from Jamaica diagnosed with cancer September of 2022 while working on a Nova Scotia strawberry farm. Ms. Burnett was fired after becoming ill and so doesn’t have access to the private health insurance that was tied to her employment. She is accumulating thousands of dollars in medical bills. No One Is Illegal Halifax/Kjipuktuk has created a Go Fund Me to help her.

I join No One is Illegal in calling on the government to extend MSI to all migrant workers.

High dose flu vaccine for seniors question

Yesterday I asked the Minister of Health why her government doesn't cover the cost of the high dose flu vaccine for seniors. View the video and read our exchange below!

“SUSAN LEBLANC: My question is for the Minister of Health and Wellness. Flu season has begun, and Public Health is urging everyone to get their flu shot, especially people over 65. The National Advisory Committee on Immunization says that seniors should get the high-dose flu vaccine, but many will not because of the cost, which can be $80 or more. My question for the minister is simple: Will her government cover the cost of the high-dose flu vaccine?

HON. MICHELLE THOMPSON: High-dose flu vaccination is available in congregate settings, high-risk settings, this year as it has been for the past number of years.

We do feel and know from science that the regular flu shot, which all of us get, is effective in the community, and we will continue to publicly fund that flu vaccine this year.

SUSAN LEBLANC: Mr. Speaker, seniors in Ontario, Manitoba, Saskatchewan, Alberta, New Brunswick, P.E.I., Yukon, and the Northwest Territories will have their highdose flu vaccine for free. The average cost of an influenza hospitalization in Canada is over $10,000 and in 2020, it killed almost 6,000 Canadians. Why does the minister believe that seniors in Nova Scotia don’t deserve as much access to the high-dose flu shot as seniors in the other provinces and territories?

MICHELLE THOMPSON: Again, the evidence would show that the regular flu season vaccination covers influenza well. We have also made it more available, actually, in communities this Fall by making sure that we partner with our pharmacy partners. You can now book and plan your immunization online. We continue to support seniors in this province, and we will offer high-dose flu shots in long-term care and other high-risk settings.”

Dartmouth North Mental Health Services statement

March 12, 2021

Nova Scotia Legislature

Mr. Speaker, Dartmouth North is a vibrant community that is home to many people facing systemic discrimination and marginalization, including a historical African Nova Scotian community. Our beautiful community has some of the lowest incomes and some of the highest levels of social deprivation, food insecurity, and rates of mental health and addiction disorders in the province. Dartmouth North also has no publicly funded mental health and addictions clinics. From people who access these services, they currently get themselves to downtown Dartmouth to one of the three locations there. Many people walk or use mobility aids to get to their appointments, some take transit and some drive. Later this Spring, Mental Health and Addictions will be closing all downtown Dartmouth locations and moving to a new building in Portland Hills - an increased distance of almost seven kilometres for people in Dartmouth North. This new location is difficult to access by foot, mobility aid, or public transit for people in my community and may mean the difference between getting and not getting mental health services. Mr. Speaker, I am calling on the government to support the call from members of my community and ensure stable and permanent satellite mental health services in accessible locations in Dartmouth North.

#CodeCritical Ambulance Crisis Speech

March 11, 2021

This speech can be read in the official record of the Nova Scotia Legislature, the Hansard, here.

SUSAN LEBLANC: I am glad to rise to speak to this critical issue, though of course saddened at the conditions which make it necessary and the fact that we even have to have this as an emergency debate. It’s not an exaggeration to say that paramedics have been sounding the alarm for years about this issue and so has our caucus.

First, it is important to put on the record some of the basics of the situation at hand. These are the things we know: paramedics are overworked and burning out. They spend hours waiting to offload patients at the hospital. They can work 16-hour shifts without eating. We have been hearing about the various tweaks that this government has been trying for years now, with little result.

The Code Critical issue is not just an ambulance or paramedic issue. It is a systemic, widespread health care system-wide problem that will not be solved by rearranging how our ambulance system works. We need widespread reinvestment in our entire provincial health network. Our system is taxed to the limit and the entire health care system and its backlogs are at the root of the #CodeCritical crisis and paramedics being unable to offload their patients at the hospitals.

Mr. Speaker, for years this government has refused to release a comprehensive report, paid for with $144,000 of public money, that analyzed the paramedic predicament. We know that this is called the Fitch Report. I will say off the bat that part of the campaign to have the Fitch report finally released by the government sent no fewer than 2,500 emails to me and to other members of this House to ask the government - to implore the government - to release the Fitch Report. The excuse that the government gave was that it could impact contract negotiations for our ambulance service provider, Emergency Medical Care Inc.

Finally, after those literally thousands of phone calls and emails from paramedics and their family members and average Nova Scotians who are concerned and, frankly, terrified at the state of our emergency health care system, the government finally decided to release the report years after it was completed.

Of course, upon its release we can see the real reason why it was hidden for so long. The report details the extreme conditions in our health care system that paramedics are faced with when they’re trying to do their job. The report states, “On average, EMC ambulances spend 1.5 hours offloading patients for Category 1 calls” or 3.25 hours measured at the 90th percentile. The International Union of Operating Engineers Local 727 president, Mike Nickerson, has said that he has heard of a paramedic waiting longer than 24 hours to offload a patient. Twenty-four hours to offload a patient. Let’s think for a moment about that patient and that paramedic. What an awful situation. When writing the report, Fitch found that nearly half of the paramedics’ time was spent driving people between different levels of hospital or nursing homes. Of those individuals being transferred between facilities, only two per cent required the skills of a paramedic or the equipment that is in one of the province’s 180 ambulances. Response times are routinely overshot in urban areas.

Fitch calculated the cost of offloading delays faced by paramedics but that important information was redacted. The public is not allowed to know, according to this government. The report also says that offload times appear to grow exponentially after 2018.

The government’s response to these challenges, which they have known about for years, was to issue a directive to the Nova Scotia Health Authority on offload times asking that they be limited to 30 minutes for emergency situations or 12 hours for transport. The former Minister of Health and Wellness tried the same thing in 2019. Offload times decreased for a period, but then increased after that again.

The government has said that it will be implementing 64 of the Fitch Report’s 68 recommendations, but it has not explained which four recommendations won’t be implemented. While I’m standing here, I would certainly urge the government not to implement the recommendation that suggests ambulance fees should be increased: “Review of patient transport fees which may lead to opportunities for increases, particularly as they apply to non-Canadian residents. Additionally, amounts unpaid by Canadian residents could be collected by other means, such as at the time of driver’s and other licence renewals.” I will remind the members of this House that ambulance fees can deter people from seeking medically necessary help.

I will also remind people about our caucus’s bill - which died on the Order Paper when the House was prorogued - to eliminate fees for medically necessary situations. That the government is leaving the door open to increased ambulance fees is, frankly, unacceptable.

No one has to search very far to find horrific stories of people who wait too long for an ambulance. People die while waiting for emergency help, as we tragically learned last month with the death of April George in Bass River. Even more people live in fear of what could happen to themselves, or a loved one, if an ambulance isn’t available to get to them. I know of a family member, for example, who when visiting the province to spend time here and decide whether they wanted to relocate back home here to Nova Scotia, were unfortunately in a car accident in Halifax. An ambulance took the passenger from the other vehicle to Emergency. Though she seemed fine, the paramedic on the scene said the daughter of the family should probably be seen, just in case, but there was not another ambulance to take her to the hospital. The family ended up deciding not to return to Nova Scotia. This experience was part of the decision.

As we find ourselves in a global health pandemic because of the COVID-19 virus, we know that paramedics are putting themselves and their families in harm’s way to take care of Nova Scotians during this pandemic. They will do so again should we experience another wave of the virus. Paramedics are still grappling with the same issues from before COVID-19 arrived, and some have intensified.

Like many things in our province - many systems in our government and in our province - COVID-19 has shed a light on the cracks and the chasms in those systems. This is definitely one of them. Paramedics are still working short and working extremely long shifts without breaks, being worn down, burnt out, and sometimes being assaulted at work. They now also have to contend with the risk of bringing COVID-19 home to their families. The stress is unimaginable, but IUOE 727’s request for temporary housing for paramedics during the pandemic, as was provided in Ontario, was not granted.

A scan of the #CodeCritical campaign shows dozens in the last few days in all corners of the province. Last month, after resuming the #CodeCritical campaign, paramedics reported more than 40 Code Criticals in five days across every health care zone in the province in which very few or no crews were available to respond to local emergencies.

We know the problems and we know the solutions. Frankly, our caucus has flooded this House with solutions to this very complex, multi-faceted health care crisis that is at the root of the Code Critical problem. We have introduced legislation that would build collaborative emergency care centres. We would keep community hospitals open in CBRM. We would allow physician assistants to work in the province and alleviate pressure in the system. We have introduced legislation that would require regular publishing on emergency room standards. We have committed to building a room for every resident and clearing the wait-list for long-term care that causes the extreme shortage of beds in our hospitals. We’re calling for emergency mental health response teams that would work to alleviate the burden placed on paramedics by mental health calls. We are waiting for these to be taken up by this government. We are proposing ideas, but Nova Scotians can’t wait much longer.

Mental Health Emergency Question for the Premier

March 11, 2021

View this exchange in the official record of province house here starting on page 80.

PREM.: MENTAL HEALTH SERVICES - COMMIT

SUSAN LEBLANC Mr. Speaker, my question is for the Premier. Police services have explained that they are not qualified to help people in acute mental health crisis. Both the Truro and Bridgewater police have said that they are not suited to the work. Bridgewater’s deputy chief has said, “We’re not full-time mental health caseworkers. We’re not in crisis management every day. We don’t have that experience from working full time . . . that’s not our profession.” I can table that.

Both chiefs say that much more needs to be done to help Nova Scotians in crisis, especially in rural areas. My question for the Premier is: Does the Premier agree with these police services, that when people call an emergency line in mental health crisis, they should not be met by the police?

THE PREMIER: I agree, we can do a lot more for mental health and addictions, especially what’s been shown throughout the pandemic. I am worried about those Nova Scotians who are experiencing mental health challenges and addictions. That’s why we created a new Office of Mental Health and Addictions within the Department of Health and Wellness. We’ll be hiring a clinician at the head of that office who will be working to ensure that we have more community supports - more capacity in communities - so that we do have more availability for mental health supports in Nova Scotia.

SUSAN LEBLANC: I’d like to thank the Premier for his answer. As an example, Mr. Speaker, last year alone 602 Nova Scotians in mental health crisis were met by the police after seeking help through the provincial crisis line; 7,390 more were referred out by police after someone called 911 searching for help. The police are interacting with people in mental health crisis in Nova Scotia every day. My question for the Premier is: Will the Premier commit, as part of his new initiative in mental health and addictions, to creating a province-wide mental health emergency response service?

THE PREMIER: As the member referenced in her first question, there is a crisis line that can be called and responded to immediately. There’s also another line, if it’s not of an urgent nature. We’re going to continue to bolster support for that and the Kids Help Phone and other supports we have. We’re going to make sure that we have more mental health supports in schools. We did increase the budget last time, but we’re going to look at this upcoming budget to make sure that we are supporting mental health in a more aggressive way.

Emergency Mental Health Response Service Speech

March 24, 2021

Bill No. 24 - Emergency “911” Act

Full debate here starting on page 440.

THE SPEAKER: The honourable member for Dartmouth North.

SUSAN LEBLANC: Mr. Speaker, I am honoured today to rise to speak to our Bill No. 24 - A Series of Amendments to the Emergency “911” Act that would create provincewide emergency mental health response teams. This bill requires the Minister of Municipal Affairs to ensure that 911 is able to dispatch geographically situated emergency mental health response teams across the province and to delineate the expertise, training requirements, and composition, and define the role of peace officers on the teams. Mr. Speaker, this is a service that would save lives. It is consistent with what mental health professionals, community organizations, anti-racist advocates, and police themselves have asked for.

The fact is that our mental health care system is bursting at the seams. It is simply not meeting the needs of Nova Scotians who have struggled with some of the highest rates of mental health challenges in the country, and who, since the COVID19 pandemic, are struggling doubly. We know what more people in this province have reported higher rates of anxiety than anywhere else in Canada since the COVID-19 pandemic began. Twenty-seven per cent of Nova Scotians describe their anxiety level as high, a 20 per cent jump from prepandemic levels. Sixteen per cent of Nova Scotians have reported high levels of depression since the pandemic, more than double the pre-pandemic number of seven per cent. People’s mental health landscapes are simply more complicated than ever before, and the pressures that are pushing people to the brink are more real than ever.

Mr. Speaker, when there is a fire in your home or there is a worry of fire in your home and you call 911, when you can hear the sirens coming in the distance, that is a sense of relief. When someone is having a medical emergency - a physical health medical emergency - and you need to call 911 and you hear the sirens coming, that is a sense of relief. But people who are in mental health crisis possibly do not feel a sense of relief when those sirens start - they can hear the sirens coming in the distance. People who are in mental health crisis should be allowed to feel absolutely safe when they call 911 and know that they will be met by professionals who are equipped and ready to help. Unfortunately, Mr. Speaker, this is not the case, and for too many people, the intersection of mental health crisis and policing can be deadly.

In the last 20 years, 460 Canadians have died in encounters with the police. A substantial majority of these people who were lost struggled with mental health issues or substance abuse or both, and often these issues prompted the call for help in the first place.

The situation is getting worse. According to a CBC investigation, the rate at which people die in interactions with police has nearly doubled in the last 20 years. The investigation also found that Black and Indigenous people were over-represented in these deaths, and I will table that. Tragically, we all know the names of too many of these Canadians. Only last year, Regis Korchinski-Paquet, a Black and Indigenous woman with ties to Nova Scotia, fell to her death from a Toronto balcony after police were called to her home to help. A week later, police in Edmundston, New Brunswick, fatally shot Chantel Moore, an Indigenous woman, after being asked to check on her well-being. In April, D’Andre Campbell, a Black man living with schizophrenia, was killed by police in Toronto after himself calling for mental health help. And, in June, Ejaz Ahmed Choudry, a Toronto man living with schizophrenia, was killed by Peel Region Police after being called to check on his wellbeing.

Closer to home, here in Halifax last year, a 28-year-old man died after police used a taser on him. They were called to the premises after reports that the man was inflicting self-harm. In 2014 in Halifax, Mohammed Eshaq, who lived with schizophrenia, died after he fell from his balcony in the South End while police were in his apartment. They were called there by a nurse after concerns about his mental health care. I could go on and on. Mr. Speaker, this deadly problem is acute for racialized people. We know that structural racism is baked into our justice and policing systems and it is not a surprising outcome that so many people are met by harm when what they desperately need is traumainformed professional help and de-escalation.

This incredible problem means, first, that racialized people are at a higher risk of being criminalized, harmed, or killed in encounters with the police when what they are seeking and what they need is help. We recently heard Emma Halpern, the executive director at the Elizabeth Fry Society of Mainland Nova Scotia, speak about this at a Standing Committee on Community Services. She said,

“Over the last few years in our work, we’ve seen some very concerning trends. We see high numbers of African Nova Scotian and Indigenous girls engaged in our programming around trafficking and exploitation. We see the criminalization of trauma and victimization, particularly for African Nova Scotian and Indigenous women and girls. When police arrive, for example, on scene when an issue has occurred, we see young women and girls being identified as part of the ‘problem’ - being criminalized for small things rather than recognized for what is actually going on, which is their tremendous victimization and trauma.”

I can table that. I believe Emma Halpern would agree that this trend of criminalizing people in crisis is fuelling the over-representation of Black and Indigenous women in the justice system. Second, it means that racialized people are less likely to seek help when they are in crisis if they know or suspect that police might be sent to the scene. It means that this government has a distinct responsibility to protect people seeking help in mental health crisis and to enable alternatives for the thousands of Nova Scotians every year who find themselves in this position.

People deserve better access to mental health care in this province, including, and possibly especially, when they are in crisis. That means making appropriate emergency help available to people, not necessarily the police. All of this, Mr. Speaker, is why a key demand for the Black Lives Matter movement is to defund the police. From Black Lives Matter Canada:

“Taxpayers spend over $41 million per day collectively on police services across the country. This does not include spending on the Canadian Security Intelligence Service, railway and military police, and government departments enforcing specific statutes in the areas of income tax, customs and excise, immigration, fisheries and wildlife. In engaging in these policing practices, police forces across the country routinely engage in surveillance against Black and Indigenous people, constrain our movements, harm and kill us. We believe that Black communities, and all communities, deserve better. The $41 million per day that is being spent on policing is not creating safer, more secure communities. This funding can be reallocated to create safer and more secure societies for all of us, and to rid Black and Indigenous communities of a serious threat to our safety.”

I will table that, Mr. Speaker. Allocating these resources and defunding the police means having systems set up that are safer and more appropriate. That is the spirit behind this bill, and I urge my government colleagues to support it. It is important to explain a little bit about what the movement to defund the police is about. It is about reallocating resources to community-based and other government organizations that are better equipped to deal with the roots of the non-violent issues that police are mostly called on to address, such as homelessness, mental health, and addictions. The police are the first to admit that they are increasingly called on to address everything, from potholes to cats stuck in trees. It’s simply about ensuring that the best, most appropriate help is deployed, which will work upstream to address the root of the problems people are experiencing. We will all know by now that police services across the country and here in Nova Scotia agree that they are not equipped to deal with the mental health crisis situations that they are asked to respond to. Chief Dave MacNeil of the Truro Police Service has said of mental health crisis response:

“This isn’t the type of work that we sign on to do, and it’s not the type of work that we’re actually trained well to do . . . We don’t call mental health clinicians to respond to break and enters, but unfortunately the police are kind of the agency of last resort . . .We’re the only 24/7 helping agency in most communities, and people call the police for all kinds of things.”

Bridgewater Deputy Police Chief Danny MacPhee says,

“We’re not full-time mental health case workers. We’re not in crisis management every day. We don’t have that experience from working full time . . . That’s not our profession. That’s not who we are.”

Both have asked for more crisis response resources in rural Nova Scotia.

Adrienne Peters, an assistant professor of sociology and a liaison and co-coordinator for police studies at Memorial University in Newfoundland, explains how this can go wrong.

“We do live in the society in which there is institutional racism. Police are simply an institution within this working system, mostly governed by the priorities and the mandate of government and what they’ve set forth for them.”

I will table that. This means that it is squarely in this government’s set of responsibilities to develop alternatives to the currently dangerous and mismatched arrangement that is the case today for so many Nova Scotians in mental health crisis.

I feel it’s important to comment on the cost of such an initiative, as I suspect this might be at the root of any opposition to the bill by the government members. Firstly, meeting the World Health Organization’s recommended minimum 10 per cent of health spending on mental health, as is committed to by the NDP’s Mental Health Bill of Rights, would help fund essential mental health services such as this.

Secondly, police are already doing the work of responding to people in mental health emergencies, though as I have described, many agree that they are not equipped to appropriately fill this role. The crucial point of defunding the police is about reallocating existing resources so that more compassionate, safe, and appropriate services can be enabled.

There are untold costs from the justice system that are rooted in criminalization of mental health issues, many of which could be avoided if we could get people suitable mental health support in crisis. Of course, the price we risk paying is in people’s safety if we fail to act. To summarize all of the comments about cost: it is more expensive not to put this program into place.

When people are in physical health crisis - when they are experiencing cardiac arrest, or stroke, or are in a life-threatening accident - as a society, we have committed that they should have emergency help available to them no matter where they are or what time of day or night they may need it. Mental health crisis can be lethal, and there is no reason why we should not make this same emergency help available to people in distress.

Question to Premier about Race Based Data March 23

We know from other jurisdictions that COVID-19 has hit racialized communities harder. In Toronto’s second wave of the virus, nearly 80 per cent of COVID-19 cases were among racialized groups. I can table that. It is a virtual certainty that this problem exists here in Nova Scotia, but we just don’t know for certain because this government has refused to collect race-based demographic data in health care, despite years of work and advocacy in the African Nova Scotian community to get this done. How does the Premier expect to address racism in this province if his government won’t collect basic data on the problem?