November 2, 2022 HOUSE OF ASSEMBLY PROCEEDINGS Vol. L No. 12
The House met at 10 a.m.
SPEAKER (Bennett): Order, please!
Admit strangers.
Government Business
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
Speaker, I call from the Order Paper, Motion 1.
That notwithstanding Standing Order 63, this House shall not proceed to Private Members' Day today, Wednesday, November 2, 2022, but shall instead meet at 2 p.m. today for Routine Proceedings of government business and that, if not earlier adjourned, the Speaker shall adjourn at midnight.
SPEAKER: Is it the pleasure of the House to adopt the motion?
All those in favour, 'aye.'
SOME HON. MEMBERS: Aye.
SPEAKER: All those against, 'nay.'
Motion carried.
The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
Speaker, I call from the Order Paper, Motion 2.
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Speaker, I move, seconded by the Minister of Education, that in accordance with Standing Order 8(8) the spring sitting of 2023 of the House of Assembly shall commence on March 13, 2023, but all other aspects of the Parliamentary Calendar for 2023 shall remain unchanged.
SPEAKER: Is it the pleasure of the House to adopt the motion?
All those in favour, 'aye.'
SOME HON. MEMBERS: Aye.
SPEAKER: All those against, 'nay.'
Motion carried.
The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
I call from the Order Paper third reading of Bill 19.
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
I move, seconded by the Minister of Labour, third reading of Bill 19, An Act to Amend the Fishing Industry Collective Bargaining Act.
SPEAKER: It is moved and seconded that the said bill be now read a third time.
Is it the pleasure of the House to adopt the motion?
All those in favour, 'aye.'
SOME HON. MEMBERS: Aye.
SPEAKER: All those against, 'nay.'
Motion carried.
CLERK (Barnes): A bill, An Act to Amend the Fishing Industry Collective Bargaining Act. (Bill 19)
SPEAKER: This bill has now been read a third time and it is ordered that the bill do pass and its title be as on the Order Paper.
On motion, a bill, “An Act to Amend the Fishing Industry Collective Bargaining Act,” read a third time, ordered passed and its title be as on the Order Paper. (Bill 19)
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
I call from the Order Paper second reading of Bill 20.
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Thank you, Mr. Speaker.
I move, seconded by the Minister of Finance and President of Treasury Board, Bill 20.
SPEAKER: It is moved and seconded that Bill 20, An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority, be now read a second time.
Motion, second reading of a bill, “An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority.” (Bill 20)
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Thank you, Mr. Speaker.
I'm pleased today to introduce Bill 20, An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority. The bill is being introduced to fulfill commitments made to the people of the province during Budget 2022 and to realize one of the recommendations of the Health Accord NL final report, the creation of a single Provincial Health Authority.
Mr. Speaker, Budget 2022 announced the creation of one Provincial Health Authority to ensure consistency and collaboration across the province. The Premier and the Minister of Health and Community Services established a Task Force, Health Accord NL, to reimagine health and health care in the province in November of 2020.
The Task Force oversaw six strategy committees and four working groups. The final report identified that in the reimagined health system there is a need for a governance structure operating at a provincial and regional level and for the two levels of governance to be connected. Health Accord NL calls for the creation of a Provincial Health Authority to provide province-wide planning, integration and oversight of the health system and to deliver province-wide programs. It also calls for regional health councils to be established to inform the delivery of quality health care at a regional level.
In fiscal years 2004-2005, transitional teams were established to ensure a smooth and seamless change in governance from the previous regional board structure to new regional integrated health authorities. The regional integrated authorities order under the Hospitals Act created the four regional health authorities in 2005, which order was continued by section 28 of the Regional Health Authorities Act. Since the integrated health authorities order was issued in 2005, the four regional health authorities have delivered health and community services in the province.
Bill 20 proposes to repeal the Regional Health Authorities Act and replace it with a new statute that will crease a single, province-wide health authority.
Budget 2022 also indicated a review of the Newfoundland and Labrador Centre for Health Information to ensure it is well positioned to meet the needs of the provincial health system and pursue the tremendous opportunities of digital technology in health care.
NLCHI currently operates under the Centre for Health Information Act, 2018. Bill 20 proposes to repeal the Centre for Health Information Act, 2018 and tasks the new Provincial Health Authority with the responsibilities and duties of NLCHI. This will align the priorities of the Provincial Health Authority and the digital technology opportunities in the province.
The core functions related to the delivery of high quality health care for the people of the province will not change. Rather, the proposed amendments will help strengthen and improve the delivery of consistent care across all regions of the province, care which will also be sensitive to regional differences and local needs.
A single Provincial Health Authority will permit the province to, among other things, develop and maintain standards for provincial programs of care delivery and increase province-wide efficiencies within the health system by ensuring the sharing of resources through a clear division of responsibilities, improved communication and enhance collaboration.
The bill is substantially similar to the Regional Health Authorities Act. While it is necessary to create a new statute to achieve a single health authority, the Regional Health Authorities Act functioned well to ensure the appropriate balance between operational delivery of health and community services and transparency and accountability to the minister by the regional health authorities.
The bill proposes to create a board of trustees for the Provincial Health Authority with representation from all regions of the province. Government's best practices recommend the use of competency-based boards.
Mr. Speaker, the minister will be responsible for establishing the objectives and priorities for the provision of health and community services and information systems in the province. The minister will continue to have the power to determine which health and community services are to be delivered by the Provincial Health Authority and the standards for the provision of health and community services.
The Provincial Health Authority will be required to comply with the minister's determinations of which and to what standards health and community services shall be provided.
As currently exists, the minister will further have the ability to issue directions on any matter for the Provincial Health Authority, with which directions to the Provincial Health Authority shall be compelled to comply.
One of the substantive changes in Bill 20 is with respect to the responsibilities that will be given to the Provincial Health Authority. Coming out of the recommendations of the Health Accord NL final report –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
The minister is right next to me and it's still hard to hear him.
The hon. the Minister of Health and Community Services.
T. OSBORNE: I could hardly hear myself, Mr. Speaker.
Coming out of the recommendations of Health Accord NL's final report, the Provincial Health Authority will, in addition to the responsibilities of the regional health authorities, be responsible for developing and maintaining standards of care for provincial programs of delivery; overseeing accountability for health outcomes through the monitoring and reporting on quality, safety and performance; in conjunction with the minister, developing a framework for connecting the social determinants of health with the health system at the provincial framework; in conjunction with the minister, ensuring a provincial strategy for recruitment and retention of health professionals; and complying with the direction for the delivery of administration of health and community services set by the minister.
In addition, with the repeal of the Centre for Health Information Act, 2018, the Provincial Health Authority will also be required to assist and support itself, individuals, communities and other health service providers and policy makers at federal, provincial and regional levels to enhance the health and well-being of persons in the province through the planning and delivery of the health and community services by: developing, operating and managing a comprehensive and aligned information system that fully integrates and uses data and health information from all components of the health and community services system for the delivery of health care and health system planning; developing data and technical standards and keeping them up to date; managing provincial health data and information assets; preparing health reports and conducting applied health research and evaluation; and providing health analytics and decision support services.
To protect the privacy of individuals whose personal information or personal health information is collected, used, disclosed, stored or disposed of by the Provincial Health Authority in accordance with the Access to Information and Protection of Privacy Act, 2015 and the Personal Health Information Act and to carry out other responsibilities prescribed by regulations.
Mr. Speaker, Bill 20 will also require that the information system referred to shall protect the confidentiality and security of personal information and personal health information that is collected, used, disclosed, stored or disposed of by the Provincial Health Authority; provide accurate and current information; be efficient and cost-effective; and be flexible and responsive to the changing requirements of the system.
Another change from the current Regional Health Authorities Act is that the Provincial Health Authority will be able to engage in innovation and activities related to economic development with the approval of the minister. Under the current system, the ability to engage in these activities is not clear.
Speaker, as I mentioned, the bill also provides for the creation of regional health councils that will be responsible for advising the Provincial Health Authority on nuances and the particular needs of various areas of the province to deliver health care at the regional level.
The Lieutenant-Governor in Council will be given the authority to, by regulation, establish one or more regional health councils in the province. The regulations will set out the name of the regional health council, describe its boundaries and specify the organization and composition of the regional health council.
The minister, using the merit-based process through the Public Service Commission, will appoint members of the regional health councils. This will help ensure that community voices are heard and local differences are at the forefront of the delivery of health and community services.
One member from each regional health council will be appointed to the board of trustees of the Provincial Health Authority. Regional health councils will develop annual plans at the regional level to provide advice and recommendations to the Provincial Health Authority on the delivery of health and community services in its health region.
The regional health councils shall implement formal and informal structures for working with Indigenous governments and organizations in its health region and to engage with regional, social and health networks to influence health and health outcomes.
Finally, the bill will create a quality council. The quality council will established by the Lieutenant-Governor in Council to provide oversight to the Provincial Health Authority on matters of quality and performance. The quality council will be required to provide written reports to the minister regarding the quality and performance of health systems and other reports requested by the minister; develop and execute an evaluation plan for the authority; provide leadership on the learning health systems; develop standards for the collection, storage, processing and disposal of data by the authority; and carry out duties that may be prescribed in the regulations.
Speaker, the minister will be required to release any report related to the quality and performance of health systems to the public. The Provincial Health Authority will be required to notify the minister when it receives reports, advice or recommendation from the quality council.
This transition will require significant work, and I'd like to thank David Diamond and the entire transition team and subcommittees for engaging in this work. The bill contains necessary transitional provisions to help ensure a smooth process to create a single health authority. These include, among other things, transferring assets and liabilities of the regional health authorities and NLCHI to the Provincial Health Authority; transferring all employees of all regional health authorities and NLCHI to the Provincial Health Authority and ensuring the continuity of employment is not broken; and substituting the Provincial Health Authority in respect of any agreement in which the regional health authority or NLCHI is a party.
Speaker, we know that the transition to a single health authority, with that, there will be questions, and most particularly by employees. As we have communicated in the past, the goal of this transition is to create more consistency in health care throughout Newfoundland and Labrador, as well as avoid duplication in associated corporate services such as human resources, payroll and finance. For our valued health care workers in the province, employment impacts will be managed primarily through attrition and other efficiencies. It is anticipated that employees will be offered meaningful, comparable, alternative employment in the new regional health authority.
In conclusion, Bill 20 will support the transition to a single Provincial Health Authority and fulfill the mandate of providing consistent quality health care to all residents of the province, regardless of where they live.
Mr. Speaker, officials in my department are working closely with the members of the transition team to ensure that the proposed amendments meet the provinces needs and we look forward to continuing this positive working relationship.
Mr. Speaker, this is an important bill. We do look forward to debate here by all Members of the Legislature.
With respect to current employees, the new bill provides assurances that current employees will become employees of the new Provincial Health Authority and that collective agreements will continue as they are. The bill states that the rights, duties and obligations of the employer and employee continue until changed by collective agreements or contract of employment.
Mr. Speaker, we've taken measures here to ensure that there is no disruption to our unionized employees, that collective agreements are respected as they are and that employees – if a position in payroll, for example, is impacted, that we will find alternate employment for those employees within the system.
I ask all Members of the House to join me in supporting this bill, Mr. Speaker. It's an important commitment of the Health Accord and it's important that we ensure consistency of health and community services to all people, regardless of where they live in Newfoundland and Labrador.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Topsail - Paradise.
P. DINN: Thank you, Speaker.
I want to thank the staff of the minister's department for providing us with an overview of this report. However, I think they were put in a very difficult position because the briefing was without any documentation. It's very difficult to go through a briefing and have some dialogue and to ask some questions if you're not provided with the documents.
I'm not shooting the messenger because I think the staff did the best they could with what they had. But in future, that's not the appropriate way to do this, especially as the minister stated this is a very, very important bill. This is an extremely important bill for this province, for the residents of this province, for anyone who is struggling with health care issues.
I will question whether this is exactly fulfilling what the Health Accord asked for. There are, certainly, and we'll talk about this later – it's not right on with what the Health Accord asked for because they were looking at more of an arm's-length organization here, but when I read down through the notes and, again, it was only yesterday we got a briefing without documentation and there's a lot to this bill even though you're carrying over other acts, there are big changes here. This is very important to the people of the province.
I'll go through some of the things that the minister has mentioned, but I go specifically to clause 19, which talks to the responsibilities of this authority. It talks directly to the responsibility of this authority and it's section 2(a): “… the authority shall (a) promote and protect the health and well-being of persons in the province and develop and implement measures for the prevention of disease and injury and the advancement of health and well-being.” I would hazard to say that is core – core to what we are doing here in terms of health care.
We sat in this House and we asked many questions on the Health Accord. We asked many questions and continue to ask many questions about the health and welfare of residents of this province and, of course, most of the answers have been: wait for the Health Accord. We're waiting for the Health Accord to come out. That's going to give us a plan, give us some direction. Of course, we've seen some things come out ahead of the Health Accord that are not even in the Health Accord.
But if you're really looking at the investment we made in the Health Accord, because it's a lot of work gone into that report and we all heralded it as a great report. We may not always agree with what was in that report, but the reason for this bill today is supposedly coming out of that report. It may, in some respects, be coming out of that report.
When I look at some of the issues we've gone through, Newfoundlanders and Labradorians dealing with their health issues and that, we've heard the stories. We've heard the stories. The minister has – I think I quoted him, he can correct me later if I'm wrong, but he talked about the high quality of health care in this province will not change.
I won't dispute that our health care workers, our health care professionals do their very best. They do their very best with what they have. Those who can access health care in a timely manner get that quality care.
When we talk about the high quality care, there's no argument. But the biggest issue here in this province, when you talk about the Health Accord and social determinants of health, a lot of it comes down to access to health care.
I still continue to hear the stories. I hear stories of patients who are struggling with mental health challenges and they can't access a psychologist or a psychiatrist or long-term care for mental health and they're on a wait-list for two years. Certainly that's access, that's access to this care. I'm sure if and when they get that, it's quality care.
When I hear stories of elderly people in the hallways of hospitals who are in there for dementia, which they can't be put into an acute-care bed, and the gentleman falls out of the bed and they're told by the staff there too bad you didn't break a bone, you would've had a bed. This is what we need to be talking about.
This individual did not get access to the care. I'm sure if he had got in there he would get quality care. The reason he can't get an acute-care bed is because acute-care beds are taken up by individuals waiting to get into long-term care facilities. Again, access. I'm sure, as the minister said, it'll continue to have the high-quality health care, it will continue. But it's access. It's access to the care.
So when we talk about promoting and protecting the health and well-being in the province, and talk about implementing measures for the prevention of disease and injury and the advancement of health and well-being, I rose in this House just yesterday and I spoke about continuous glucose monitoring devices that clearly prevent disease and injury. Again, high-quality care will not change. But it has to change in terms of access. That's what the Health Accord was about.
The Health Accord was about access for those who the social determinants of health have prevented them from getting. So we've got to work on access. I know it all costs money, and I believe in this document it speaks to – and just give me one second to find it here – these health – I don't want to misquote myself.
It talks to a section 21(5): “The authority may, with the approval of the minister, engage in health innovation and economic development.” We're at a point where we're still struggling to provide the proper health care services to everyone, to have access for everyone. I talk about the glucose monitoring devices helping save health care $60 million to $80 million. That's money that can be reinvested. I don't know what they're defining as economic development; that's money that can really be reinvested.
So when I see that the Health Authority can engage in innovation and economic development, I wonder are we expanding what they have to do too much right now when, clearly, we're still focused on access to health care. People are struggling to get that access.
I'm also not quite sure about how much consultation has gone on with this. We've certainly seen a trend in this sitting in terms of legislation and briefings happening either the same day or just before the legislation is offered in the House. It's unfortunate because sometimes if you have a proper briefing with proper timelines, you eliminate a lot of the questions. We become more efficient in this House. When we talk about, again – and I agree with the minister, this is a very important bill. This deserves more than a paperless briefing –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
I know Members are conducting district business and that in the House but the level of conversation is getting a little bit loud so if you want to take meetings, I ask that you take them outside so that we can hear the speakers.
The hon. the Member for Topsail - Paradise.
P. DINN: I appreciate that, Speaker; I am disappointed that they are not all ears on this, but I will move on.
When you look at this, just think about they talk about bringing the information system in under the one department. I don't know how this falls with what the Premier announced earlier the year because the Premier announced something different for the information system than we're seeing here, but I guess you thought something different here.
Only the other day, we had the first-year anniversary of the cyberattack. So I would suspect any time you mention information and private information and bringing it together under one umbrella, I'm sure the little red flags go up – especially in those that were impacted by the cyberattack but also by everyone else. How do you do this?
I think it was back in 2004, when they amalgamated some more of the health authorities, it went from eight to four at that time; I believe it took almost five years to figure out the information sharing for that. I'm not disputing that it is not something that we need; we certainly need that. Because, as a government, if we're moving towards virtual care and we want to be able to share information from all parts of the province on a system that we are sure is secure or we have done the most and the best we can to ensure that it is secure, then that is a good thing.
There are many things that can be cleaned up here. When you have a blood test out in Corner Brook and they send you in here and you come in here to the Health Sciences and you have to do another blood test because you can't share the information, that's something we need to address. There's no doubt about it; that's something we need to address.
So there are things in this paper, or this bill, that aren't going to happen overnight – they're not going to happen overnight.
I read again the description of electronic health record, and this is what we're moving towards. I don't disagree with it, but how we're going to get there and the need for more consultation and look at this, is what we need. Electronic health record means a province-wide record of a patient's health care history that is available electronically. That is a goal you work towards.
In fact in this day in age, I think to myself, how are we not there now? How are we not there now that doctors from – in fact, doctors around the world should be able to share information on a secure site on patients, especially now when some of our patients, some of our residents, have to travel. Have to travel either within the province or have to travel out of the province, or maybe even out of the country to get some specialized help or, in some cases, I'll say everyday help that's just overburdened here in the province.
AN HON. MEMBER: IVF.
P. DINN: Yeah, I mentioned IVF the other day. That's something that we should be looking at.
The minister already touched on this, but when you talk about the different labour groups, the different unions that represent health care workers in this province, again we know when the last reduction in regions happened. There are health workers working under one union, and others under another. So there's a bit of work to do there.
I'm sure all parties to that will work in concert to try and make sure that moves as smoothly as can possibly be done. But it is a hurdle. It is a hurdle that you have to get over, and I'm not sure how easy that hurdle will be to jump over.
Again, talking about continuity of employment in this bill – and I know you hear that a lot: Don't worry, your job is safe. I'm not fear mongering here at all. I'm just saying. We have to ensure that our valuable health care workers – we can't afford to lose one, not one. So I'm really hopeful that this bill will ensure that nobody's job is in jeopardy.
Some of these questions may come up in Committee, but when I'm talking about looking at the board of trustees in this bill and it talks about appointed by the Lieutenant-Governor in Council and then it says trustees appointed by the minister from the regional health councils which, of course, the regional health councils are appointed by Lieutenant-Governor in Council and it goes on and talks to this. I may have missed it, but I don't see staggering of appointments here. When people are being appointed to these committees, especially when you start, there are three, three-year appointments. I would hope that there would be some staggering.
Now, I understand there's an extension clause here, but to ensure some continuity, you certainly want to ensure that there's some staggering to the board, how they're put in there.
I'm looking at the authority here: responsibility of the health authorities. So one of their responsibilities will be to “collect and analyze health and community services information for use in the development and implementation of health and community services policies and programs for the province ….”
So when I look at that clause, I then go back to the security. The privacy of information is a big concern there. But one of the pluses there – that's a good plus if we're doing what's happening here. That's the collection and analyzation of health and community services data. I think in our briefing there was lots said about ensuring private information like that would not be shared, and that's a given. So we'll hold you to that on that one that privacy and individual information will not be shared.
But it does bring to light the need to have decisions that are made for the public health and welfare of Newfoundlanders and Labradorians to ensure that it is based on information and data that's available. That enables us, in government and us collectively, to make decisions on real issues; real health care issues that affect people in this province.
Further down in that section, it talks to “develop and maintain standards of care for the delivery of provincial programs ….”
As the minister mentioned, we have quality health care here, when you have access to it. I think we do have a high standard of care. We've had some pieces of legislation in here, changes to the Medical Act and the like, and the issue there – or sorry, not an issue, not a concern, but a prime point there has been to ensure that it does not affect the standard of care in this province that people receive. So it's good to see that.
We voted yes on that past bill, that we need to come up with better ways, more efficient ways to have new residents of this province who are come from away, they're RNs or doctors from away, to ensure that they can practice to their scope in our province. That goes to: while maintaining a standard of care.
So we have to keep moving in that direction, I don't disagree with that. Is there more that can be done? Is there more that can be immediate? There sure is and we will argue or maybe have a discussion that there's not enough being done. You're going to hear that. I hear it everyday from individuals who are in hospital beds or trying to get into hospital beds, who are not getting the access to that quality of care. We hear that on a regular basis.
As this is coming out of the Health Accord, I mean that's what the Health Accord is focused on. The Health Accord is focused on outcomes for Newfoundlanders and Labradorians out there who need help. Every region of this province, every district of this province has people who need help. They need help to deal with life-changing matters, life-and-death matters.
Again, I go back to the minister, this is an important bill. I agree, I agree 110 per cent. This is a very important bill. It's a bill that I would hope everyone speaks to. But I still go back to my issue about consultation and ensuring – like the Medical Act, as an example, again. We heard from the Medical Association who felt they should have been consulted ahead of that. I tend to agree with them.
When we're dealing with anything in health care in this province, anything that deals with everyday life and death and issues for our residents, we need to ensure – and the term gets used in this House a lot, we hear it: no stone unturned. Sometimes we're throwing the stones here, but it's no stone unturned. When it comes to health care, we should be – and I don't have an indication yet on this, but we should ensure that there's been full discussion and consultation on this bill. This bill is going to have far-reaching effects on this province and how we do health care better. Again, not debating the quality of health care when you receive it, but this is far reaching.
Some of the questions coming out of this are going to be: How does this – and not from me, but from people we have out in the districts – address my father-in-law who's waiting to get heart surgery and has been waiting for months and months and months? Those are going to be some of the questions on this. How does that address that?
I, quite frankly, wouldn't have the answer. I mean this is not a quick fix, this piece here, nor should it be really. It's what came out of the Health Accord, in some respects – we'll chat about that later.
It's an important piece that we have to work together on to make sure that all the pieces of this puzzle fit so that when we're changing the makeup, we're changing the horizon on health care in this province and we're looking at developing a Provincial Health Authority Act, that's a big piece. That is something that we really need to ensure our i's are dotted, our t's are crossed multiple times.
There are so many pieces in this puzzle. I look at section 19. That, to me, is one of they key sections of the act because it talks directly to the responsibilities of the authority regarding health and community services. I'm in that section and I'm looking over just before you get to section 20. I wonder, on some of these clauses, whether they're better placed or they appear to be more operational than legislative. I can't help but look at this as the trend we've seen where there seems to be more power being put in the respective minister's hands. That's how it appears there.
Just for the record here, that is section 19 – they almost have the whole alphabet in there but we come to section (m): “… in conjunction with the minister, develop a framework for connecting the social determinants of health with the health system at the provincial level; (n) in conjunction with the minister, implement a provincial strategy for recruitment and retention of health professionals; (o) comply with the direction for the delivery and administration of health and community services set by the minister ….”
To me, those are very operational pieces. When I look at “implement a provincial strategy for recruitment and retention of health professionals,” isn't that what the current recruitment and retention office is supposed to be doing?
I'm not sure if they're fully staffed, but they may be. It was close. A couple of weeks ago, they were working on the last pieces. But isn't that what we already have in place? We have a recruitment and retention office all in place.
It talks about a provincial strategy. Now, we heard from the previous minister of Health and it quoted as saying they have a strategy very similar to Nova Scotia. So I am kind of lost on the retention and recruitment. We hear that government is focused on it – I'm not sure but someone said laser focused on it – yet we're hearing and seeing very different pieces here. I'm not arguing against any of those; I'm just saying which it is. Where is the clarity there?
If I look at section 20 – I was just giving you a chance to change seats; I wouldn't want you to miss any of this. So I am moving along to section 20. It talks about “developing, operating and managing a comprehensive and aligned information system that fully integrates and uses data and health information from all components of the health and community services system for the delivery of health care and health system planning ….”
There is a lot in that clause – a lot – as I have previously mentioned speaking to another clause, about a province-wide information system. I alluded to the last amalgamation of some regions and how long it took. I think it was five years to get their system in place for Eastern Health at the time.
So there is a lot to that because – and we know the cost of the cyberattack on us. What is the cost of this? What will be the cost of this? What will be the timelines for this? Because now we're looking at province wide; again, not arguing it. I am just amazed – and this is not on anyone here in this House; this is just a general comment that in this day and age, with technology, it's amazing we can't do that.
When you see kids on the street six and seven years old and they're doing unreal stuff with their cellphone. So we've got to move there, but what's the cost? What are the timelines for this? This is going to take some time, especially to ensure that confidentiality and all the security walls are in place to protect the information as best as they can. That's what we're looking at there.
Within this document, it comes down to what's the plan because there are bits and pieces of this bill that, in and of themselves, they have huge pieces of work to be done to get to where they want to go. Questions get raised, and they've been raised in the public. We've heard the stories.
I had one just recently when the hours at the Mundy Pond collaborative care clinic were extended. It went from 8 to 8. I had an individual call me. She lined up there early in the morning to get in. She didn't get in the door. She got to the door around 9:30 to be told sorry, we're booked up. She ended up going to a private clinic and paying for her services that she needed. I think it was $70 she said, and $70 is a lot for someone, especially in a province, in a country where we have great health care and very professional, very expert staff that can give you that health care. Again, once you've got access to it.
We do get questions being asked: Are you going to privatize health care, or are you going to do this? Those are questions that people ask. Or are we headed towards a two-tier system? Those are questions that get asked.
So when I look at section 21, the Authority's power, and I go there to (d) and I go to Roman numeral (i) under that, it says “unless prohibited by the regulations,” – the authority may – “charge fees (i) for health and community services directly to the person who received the services ….” Isn't that something we're trying to ensure people get services without having to pay?
We have residents, as I just alluded to in an example, who went into a collaborative care clinic looking for a service, and that service could be anything. But you know when you're running out for health care; they're going because they need it. So what happens to the individual who goes to the collaborative care clinic and doesn't have the $70? Then, in this we have a clause that says they can charge directly to the individual who receives those services.
Now, we'll probably find out more as we go along, but, again, I'm flying on a paperless briefing, so understand that, I'm flying on a paperless briefing here.
These are questions, again, like I said, we could have asked, could have clarified had we had this document ahead of time, which we didn't.
So what's entailed in that? What is the thought process for that? What is the scope of that? Is it extremely specialized services that you can't get here in the province? I would suspect if you have some specialized service that's not available in the province, I would suspect it would be the other way around that government would assist you in getting it, but again I don't know. I don't know what it is there.
That's key to a lot of people in this province. That's a big decision for them. You think about when Eastern Health came out, the Health Science came out and said do not come to our emergency rooms. Do not come to our emergency rooms unless it's an emergency. But what's an emergency to me and what's an emergency to my neighbour or someone up the road are very different things.
So they went out to a community centre, they can't get in so where are they going next? They're going to an emergency room. They're sitting in a chair there. They could be sitting next to someone who has a bad cough and someone with a broken leg or someone having a mental breakdown. That's what's happening in our emergency rooms, and those who can't get an acute-care bed who need it.
I spoke to the nurses. Our front-line health care workers, my heart goes out to them on what they go through on a daily basis. Our paramedics who are not sure that when they pick up someone where they can take them and if they're going to make it.
The nurses, God love them for what they do – broken but not beyond repair. When they're telling you, telling me – I get a lot of calls simply because I'm the shadow minister for Health, but I do get district calls as well. But when I hear of individuals lined up on gurneys in hospitals – one nurse telling me they're out there on a two-inch mattress being toileted and medicated in a hallway. That's what we have to be looking at.
J. WALL: It's reality.
P. DINN: That's reality, that's the outcome.
Now, as I alluded to earlier, they tell them if you fell off the bed and broke your leg we'd get you in. That's a true story. That's a true story for an elderly gentleman who fell and they took X-rays. It was almost the reverse: bad news, he didn't break anything. Think about it.
I look at this and I wonder are we creating more red tape? Are we creating more bureaucracy here? When you look at all the reports: annual reports and the reports that the minister can ask for and who can have access to those reports. Yes, you need annual reports; yes, you need reports that can give you benchmarks and give you success ratings or where you need to focus, yes. But sometimes I think we're overridden – overridden with reports.
We're operating now with four health authorities. It's all going to come in under one provincial authority, but you'll continue to have regional health councils. I do not disagree with that at all because regions are different. Labrador is very much different than the rest of the province in the health care they have access to and the health care they need. They had very specific issues that need to be addressed, especially around medical transportation and access. So we need to look at that.
So regional health care councils, I totally agree. In fact, I would almost argue that maybe they need more authority under this umbrella. But, again, I don't have the details. We didn't have the details when we were briefed on this.
So under Part II, regional health council: “The Lieutenant-Governor in Council shall, in accordance to the regulations ….” Now, I'm not going near the regulations because we have a hard time seeing regulations. We always say the proof is in the regulations.
But it goes on: “The Lieutenant-Governor in Council shall, in accordance to the regulations, establish (a) health regions in the province; and (b) a regional health council for each health region.”
Now, I'm only speaking and assuming – I'm only assuming that there are going to be four health councils like there are health authorities now, but it really doesn't have it defined. The regions are not defined, the boundaries are not defined and, actually, the makeup of these health councils are not defined.
That's critical; that's a critical piece of this legislation. Especially, as I said, when you're talking about the Labrador district region. I don't know, I'll just toss this out; maybe they need multiple regions in Labrador. I don't know. But the point is, each region is not created equal and we need to address, through this, how do we balance that? How do we ensure that if you're living up in Nain or down in Flatrock, you have access to the same quality health care that we all deserve? But, again, the devil is in the details.
I'm looking at clause 38(b): “The authority shall … set a process, in accordance with the regulations, for reviewing reports, advice and recommendations received from the quality council for the purpose of reducing or mitigating risks identified by the quality council.”
They are important reports, as I stated earlier. Having the data, having the information to make these decisions is very important. I don't know here if this is going to be released to the public, these reports. Again, protecting private information and the like, I'm sure there is a way to release these reports and ensure that there is openness, transparency and accountability, that people can realize that these health and well-being decisions are really based on clear evidence, clear data, clear information.
I raise that because we have seen many reports done by this government and we've requested access and there has always been, you know, Cabinet confidentiality; or, no, it's detrimental to fair play out there in the world. I just want to make sure that when we're talking about health care, that affects everyone, and I guarantee you that until you have to access the health care system in this province, you have no understanding of what a dire need we're in.
I still go back to when you get in those hospital doors and you have a nurse, a paramedic, a radiologist, whatever and they are there at the end of a 20-hour shift and they're still smiling the best they can to help you, I don't know how they do it.
SOME HON. MEMBERS: Hear, hear!
P. DINN: But we depend on that; we depend on them so much. For anyone who was down to the rally that the Nurses' Union held last week, I've got to say and I went around – I go around and I talk to the people. I talk to them. There was a registered nurse and a nurse practitioner that spoke up and talked about the situation health care is in. I'm just amazed.
Actually last night, I was out to a pumpkin stroll, I guess, going around looking at pumpkins, and a young girl came up to me and she said: Thank you, Mr. Dinn, for what you're doing. I didn't know who she was. I never met her. I said: What are you talking about? She said: I am a paramedic. I said: Really? She graduated in May.
She said: Thanks for keeping it real and talking about the issues. I asked her: How is it with you? And she said: Oh no, I'm fine. I am only just started but she said some of her colleagues that she works with, they're really, really, really struggling. She alluded to me about some of the situations she's been to, accidents or going to homes and seeing the trauma and seeing the look of despair on family members, it's crazy. It's really crazy. There are solutions, and many of the groups I've talked to have brought forward solutions.
So when you talk about doing studies and providing reports and speaking to a process, you really have to consult with the people that have lived experiences. Those are the ones who see that day to day. I can't even imagine.
I think about the elderly couple that spoke to me. Her husband was rushed to hospital just a couple of weeks ago, into the Health Sciences. She followed. She got in her car and went on in. She went into the hospital. Her husband wasn't there to be seen. She went up to the wicket to talk to the triage nurse and asked: How's my husband doing? Where's my husband? To be told, oh, we're looking after him.
Several times she went up because he's diabetic. She got up another time, after being there for an hour, hour and a half, and said: Look, I really want to make sure my husband is getting something to eat. Yes, we're looking after him.
Anyway, two hours in, she goes up and there's a different gentleman there, nurse, and he said: What's your husband's name? She gave him the name. He said: He's not here. He wasn't there. Now, I'm not faulting the nurses there because they are juggling people out in the hallways – they're just overrun, overburdened. Do you know where her husband was? Still out in the ambulance.
So that's some of the real stories we deal with. When you talk about the Health Accord and all that's in it – it's a pretty in-depth document, and you try to take out a piece of work, some solutions, and make our health care better for this province and for the people in this province, that's a good thing but you have to do it properly. You have to make sure.
There are solutions for the some immediate needs. We've heard them. We've all heard them. We've seen what other provinces are doing. We try to be on par, but we want to be better than on par. We are competing for health care workers. I don't disagree with that and I don't disagree with this development of a Provincial Health Authority. I really don't have the information. I don't know what it entails. I don't know what kind of consultation or work has been done behind this – don't know it.
As my late father would say, you don't know if it's fit to eat. It could very well be, I don't know. But it's too much of an important bill – and I'm only going by the trend that we've seen – to rush through without having a really fulsome briefing on it which, due to whatever technical reason, couldn't happen. But I would just like to see that this gets the proper attention. I'm not saying it's not, but I'm saying it gets the fulsome – which is a word we've heard in this House many times – attention that it needs and talk to the people who may not even be on the consultation list, talk to those people. Ask them: Is this fit to eat? Are there changes or what should be done? Are there problems that are not identified? Are there problems there that we've missed?
I've just gone through in the little time I've had to talk about some that are unseen. Now, maybe when I turn over that rock, oh, that's what's happening, good. Or maybe I turn over that rock and I roll it back over.
I just think for something like this, when you're talking about an overreaching authority for health care – again, I use recruitment and retention. Well, which is it? There are still some pieces that are flip-flopping a bit. The information system, that's a big piece in itself. The piece around reports and who gets them and who can release them and who sees what, is a big piece of this. The how exactly the regional health councils are going – what their makeup is going to be, how many are going to be on it. That's a real piece for questions.
If you're going to address health care in this province, you have to do it right. Again, I'm not saying this isn't right. What I'm saying is what has gone on behind this to ensure that this is doing it right, because it's come out of the Health Accord, but it's not directly out of the Health Accord. The Health Accord talked to an arm's-length approach. This is not arm's length. These are issues that we have to talk to.
With that in mind, seconded by the Member for Harbour Main, I want to propose an amendment. The amendment reads: That the motion be amended by deleting all the words after the word “that” and substituting the following therefore “that Bill 20, An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority, be not read a second time but that the Order be discharged, the bill withdrawn and the subject matter thereof referred to the Social Services Committee of the House for further study and consultation.”
SPEAKER (Warr): Order, please!
We will recess the House and take a look at the proposed amendment.
Thank you.
Recess
SPEAKER Are the House Leaders ready?
Order, please!
After careful consideration and discussion, the proposed amendment is deemed to be in order.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Topsail - Paradise.
We are now debating the amendment.
P. DINN: Thank you.
I'm pleased, very pleased that it's in order. As I've gone on with my earlier talk about the bill – I've said it in my debate earlier – I'm not against the concept and that of this bill. It's a very important piece that really will set the pathway for future health care in this province. I just want to be sure on that. I want to make sure and I'm sure everyone in this House wants to do the same thing. You want to be sure that when we're looking at something as substantial as this, you want to make sure that it's going to have the intended outcomes that, we and all our Newfoundlanders and Labradorians, deserve when it comes to health care.
There was a huge piece of work done, a very good piece of work done with the Health Accord. It was quite an extensive piece of work. It had lots of consultations through that process. It had lots of options. Dr. Parfrey and Elizabeth Davis, they did a wonderful job looking at health care in this province and envisioning areas where it should go and putting forward in documents outlining what would happen in year one, what could happen in, I think, it's year two to three and it goes on to talk about four and five, of course, longer-term solutions.
We applaud that piece of work. We all have. We waited in earnest for it to arrive and for us to start looking at that and devising and developing a plan forward for health care. We all understand it's medium to long term. We understand that. We were told that. This bill, certainly, doesn't take away from the focus on immediate health care issues that work is being done and there's more that can be done and we can get solutions and recommendations from other provinces, from other jurisdictions. No doubt about it. We have to do a little better. We have to be above par.
You know, it's been referred to sometimes as band-aid solutions and sometimes you have got to put a Band-Aid on it. But this piece of legislation that we're talking about here today, this bill that we're talking about here today is going to have long-term, real long-term ramifications, and I don't say that in a negative manner, for health care in this province.
Some will say, well, didn't the consultations occur during the Health Accord? Yes, there were consultations that took place through the Health Accord and they set the high-level areas that we should address. Now, were talking about a piece of legislation that becomes more specific, more prescriptive in what is going to be done to address the short-, medium- and long-term solutions in this province.
As I said earlier, the Health Accord did suggest a Provincial Health Authority, but they envisioned – and again I stand to be corrected – that this would be at arm's length. This would be something more independent, yet we see it going the other way. We actually see it not even close to arm's length and moving in under a government department with greater authority vested to the minister.
Again, that's no disrespect to the minister or anyone who sits in that seat. I, and our caucus here, want to be assured that decisions that are made on our health care, and especially the future and long term of our health care, are made in the most independent and objective manner, supported by data; data that we can all see, that's transparent and accountable, again, maintaining the privacy of individual data. We want to see that. We want to be aware of that.
Despite the consultations for the Health Accord, I would think and I would argue that when pieces of this – people realize what's in this, people will have questions. They will have more questions, like I asked about the regional health councils. I asked about the regional health councils because the details are not there.
I'm assuming the four regional health authorities now will become the councils, I don't know. Is this an opportunity for these other regions to address more pressing issues in the area and say – I use Labrador as an example, which is very unique in terms of access to and availability of health care. Maybe there's opportunity there – and again, I'm just tossing it out there. I could be totally off the wall on this. But maybe they need a different approach. Maybe they need an authority or council or multiple councils, I don't know. Maybe their representation needs to be a little different to address their issues, I don't know. As I said, what someone wants up in Nain and someone gets down in Flatrock are different things, different levels.
So this is an opportunity for that. This is an opportunity to have those more in-depth discussions. To have that consultation, talk with people with lived experiences and say this is how it's going to work, or no, maybe you should do this. Because right now we have the Health Accord, which has laid out quite a few recommendations there. It didn't dive down into the weeds or get into the details. In some instances, especially when you're dealing with creating a Provincial Health Authority, maybe we need to be in the weeds on this.
Again, I alluded to the many particular instances and different situations that people have found themselves in when it comes to accessing health care in this province. Some of them are very different, and that's what we need to be addressing. The Health Accord was focused on health care outcomes. We can't lose sight of that. I spoke to it. It's in the bill here. Again, like I said, it's all important. I know the work that goes into putting together legislation. It doesn't happen overnight. A lot of staff put long hours in researching and putting together this legislation; they do that.
When I focus on this piece – I just focus on section 19. Section 19 is the core piece of this because it talks to the responsibilities of the authority regarding health and community services. That's a key piece. I go back to 19: “(1) The authority is responsible for the delivery and administration of health and community services in the province in accordance with this Act and the regulations. (2) In carrying out its responsibilities, the authority shall (a) promote and protect the health and well-being of persons in the province and develop and implement measures for the prevention of disease and injury and the advancement of health and well-being ….”
When you go to school and you read a novel and you have to do a book report, and you flip through all those pages and someone says, what's the core message in Tom Sawyer and Huckleberry Finn – that doesn't change when you look at legislation. What are we trying to do with this legislation? What's the ultimate goal in this legislation? Is it put together with the bits and pieces and the expertise that results in the desired outcome? I mean, that's the crux here.
This may result in the desired outcome, but again there are a lot of questions. Where we've moved, where we've invested so much, government has invested so much, a number of people have invested so much time and effort into putting together the Health Accord, and the Health Accord came out with a whole list of recommendations – it's a good piece of work. Do we agree with all the recommendations? I'm sure there are bits and pieces that people don't agree with. I'm sure there are bits and pieces that people totally agree with. But the point here is we're moving into a bit more specific legislation.
What the public and people who spoke out and had discussions and consultations and did surveys during the whole Health Accord process, maybe with this they're looking at this and saying I'm a little clearer on where it's going and I have questions. Maybe they're looking at it and saying, hang on now; I perceive there could be issues here. Maybe people when you talk about the regional health councils are saying hey, this is an opportunity to make changes there that would be more effective. Maybe this is an opportunity to have people and representation from unique regions involved here.
If we're looking at working together and really, truly invested in people with lived experiences and really focused on health outcomes and the social determinants of health, we have to make sure that's in there. It's more than adding the definition of social determinants of health. It's more than that.
That's why we went with this amendment. It's something that needs, in my mind, greater attention to this, now that we have a document in hand. It requires more attention. Essentially, that's all that's being asked here in this amendment, is that we lay this to the side right now. We can continue to be focused on the short-term issues of health care. We can continue to be focused on recruitment or retention of doctors, nurses, paramedics, looking at the scope of nurse practitioners. That's stuff we can continue to focus on, is stuff that is affecting people right now.
Take some additional time to make sure and look at this and ensure that it's headed in the right direction; speak with the representatives of the Health Accord. They were looking at this as a more arm's length.
So maybe ask: Why? Why did you think this was probably better arm's length? I don't know. Or ask them: Is this not the right way to go? I don't know. Again, we invested a lot of time and people invested a lot of time into the Health Accord. I know people, they'll say, well, the Health Accord was really given as recommendations. It wasn't the plan.
That's fine. You can say that, but you cannot ignore the effort that was put into that document. You can't ignore it. So you have to ask those questions. You have to find out is this what you envisioned? Is this better than what you envisioned? I don't know. Is it worse than what you envisioned? I don't know. Are there individuals out there who are saying, hang on now, I went to all the consultations, I wasn't expecting this because there are some good things but there are also some bad things.
This is why we're asking for some more time on this to look at it. This important bill deserves far more than a paperless briefing and the next day debating it. That's all we're saying. That's all we're saying here.
SOME HON. MEMBERS: Hear, hear!
P. DINN: I really don't see the harm in that. I really don't see – you know, if we can continue to focus on the short-term, right-away issues of recruitment, retention, getting more here, if we can continue to focus on that, what is the damage in laying this aside for, I don't know, two, three, four months, whatever it takes to have a better understanding of it and hear from people on it? What is the negative in that?
Because this is going to be far-reaching. This is changing, although you say the acts are, basically, moved over in some respects, but it is changing the horizon and the makeup of us moving forward – us moving forward to come up with a system that works, to come up with a system that promotes and protects the health and well-being of Newfoundlanders and Labradorians. That's the goal. I can tell you that's the goal we all agree on. We all agree on that goal, no debate. To be honest with you, I'm not debating whether this is good or bad.
All I'm saying is in a realistic world, with something that is going to be as far-reaching as this, let's lay it aside. I'm not saying years, no. Let's lay it and have someone else look at it. Let's look at it and make sure all the i's are dotted and our t's are crossed and that it is – because we all want it, we want to make sure this is the best piece of legislation that is going to make sure our residents, Newfoundlanders and Labradorians from all parts of this province, have the health and well-being they deserve. That's what we want.
With that, I'm going to sit down and hopefully hear from more.
SOME HON. MEMBERS: Hear, hear!
SPEAKER (Bennett): The hon. the Member for Lake Melville.
P. TRIMPER: Thank you, Speaker.
It's an interesting situation that's just developed here in the House of Assembly. In my seven years of being around here, I've not encountered what's called a dilatory amendment. Essentially, what this is doing is, it's a delaying tactic. It's very rarely used in this Assembly and, I guess, it is some years. Without revealing all the confidences of the opportunities I have in this House of Assembly, this is something that hasn't be used in a long time
I wanted to back up now for a second and just talk about – I was going to speak to the bill and the importance of it. I wanted to talk about health care. Just a little show of hands as I look around the room, I bet every one of us could raise their hand if I asked the following question: What is the dominant issue in your constituency office? If you didn't say health care, I'd say you're asleep at the wheel because it dominates everything we do. It's all about getting our constituents the health care that they need. I can tell you sitting in Labrador this is magnified so many more times.
This morning I did an interview with The Telegram talking about the cost of living. My number one theme in that interview this morning was getting people to health care. It is such a cumbersome hurdle and, frankly, I know people who have, unfortunately, even with the Medical Transportation Assistance Program and all the challenges we have around that, people still can't even afford those differentials. They are foregoing health care.
Folks, we've just spent the last two years overhauling, evaluating and studying through the Health Accord. Two brilliant minds, Dr. Pat Parfrey and Sister Elizabeth Davis, who just went through a monumental exercise looking at all aspects of our health care, what's right with it, what's wrong with it and put together this multi-volume Health Accord.
I say to my colleagues right now as I look at this amendment that's on the floor: Folks, we can't afford to delay. If we're upset that we didn't have an opportunity to have – if we had a paperless briefing, I get it. It's frustrating for everybody, but we're all in the same camp. Sitting here as a backbencher, I'm just seeing this as well myself today.
However, we certainly know what our constituents have been dealing with. We know what's been going on in the Health Accord. I can tell you that over the last two years I took full advantage of sitting and dealing with those co-chairs. They were readily available; we worked through so many issues. I'm quite excited about what I see in the Health Accord.
I believe there's a future there and I would propose that we take our time in Committee and going through the clauses. Right now, we're still in second reading and to really get at some of the aspects of what may be of concern to all of us, by the way, whether you're in government or Opposition, we all want to make sure we get this right. But when we get into the meat of it, that's when we'll do it. And if we need to take a lot of time to do it, I say we take it. But to move into a delay tactic and say we need more time.
Again, I would say – and I keep track each day – if you're watching me during Oral Questions, I track each one of the questions by MHA and the themes. I can tell you that every single day, health care dominates, as it should. But what I hear there is urgency – emergency. Why are you doing this when we need to be doing that? We've got clinics closing and so on. I can tell you, folks, I feel this every single day myself.
So I would ask everyone to think about it. Instead of trying to find ways to delay and further put off an opportunity to support our constituents, the people of this province, I say let's get on with the debate, let's conclude and then let's get into the meat of it in Committee. Maybe that's something to think about.
I wanted to also just talk a little bit about some of the issues that we're dealing with, again, in Labrador, where I feel it's just so much more magnified. When people are making a choice whether or not to go to specialized or additional health care and deciding that they can't afford to do that, we really have a system that needs our urgent attention.
Speaker, I think that's a simple point I put out there that for those people and everyone else who's looking for a new world, a new way to deliver health care in our province, I say let's get on with it.
Thank you very much, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Stephenville - Port au Port.
T. WAKEHAM: Thank you, Speaker.
I would suggest to the Member opposite that we don't need to change legislation to get on with it. That's the whole problem we have in health care right now. We haven't gotten on with it when we should have gotten on with it.
SOME HON. MEMBERS: Hear, hear!
T. WAKEHAM: Speaker, I've spent most of my working career in health care and, like some other colleagues in the room, we've seen many reiterations of changes in governing bodies in health care, whether it was 28 to eight to four, and now we're talking about going to one.
That's not the issue. The real issue in health care in this province today is accessibility, it's affordability and it's how do the people of Newfoundland and Labrador get the services they deserve. When the minister talks about diversion, how emergency departments, people are being diverted – to the people that live in those communities, to the people in Whitbourne, their clinic is not on diversion. Their emergency room is closed. To the people in Bonavista, their emergency department is not on diversion; it's closed. When they can't access it, it's closed. That's what happens. It's not diversion; it's closure.
One of the things that this bill talks about today, for me, clearly highlights the lack of action by this Liberal government in the last seven years. Because I have a difficulty going through this clause by clause and understanding why we need to change things to do what's recommended in here. How are the changes in here going to impact the people in our province today?
We can have all of the board structures we want, we can have all of the technology we want, but at the end of the day health care comes down to a basic principle of people helping people. Right now, we do not have enough people helping people in this province. Our health care system is in a crisis. The current Minister of Health has inherited a mess, a total mess. Because, for the last seven years, our health care system has been allowed to completely deteriorate. Many of the things that the current minister talks about with other provinces, yes, are real in this province too, but they could have been different. They were caused by a lack of action. Because it wasn't like they didn't know.
Go back to the former Nurses' Union president who talked about the need for more nurses in our province. You could go back seven years to the discussions on a need for a review of staffing levels in long-term care, of a need for a review of nursing positions in the health care sector. You can go back and talk about all of those things and how they were not acted upon. They were simply ignored. The NLMA took four years to reach an agreement with the NLMA. Those are the things that have resulted and contributed to where we find ourselves in health care today – a complete lack of attention to detail. That is what has happened and that is what continues to happen.
I look at this particular thing in here. One of the clauses simply says the new health authority is going to turn around and provide information to the residents of the province respecting how they gain access to those services.
Surely God, the people of the province right now would like to understand how they gain access to services. Why isn't that happening now? Why isn't that type of action happening now? It's highlighted in here, but where is it? There's another section in here that talks about information management – wonderful, that's exactly what this province needs is a new information management system but that recommendation was made to this government in 2016 and it was never acted upon. A recent report at the AGM of the Newfoundland and Labrador Centre for Health Information said that government was warned two or three years ago about the potential cyberattack but did nothing about it.
So, right now, we're talking about a new health information system – absolutely necessary, because the last time that the health authorities were merged from eight to four, it took Eastern Health five years to consolidate their health information systems under one. Now we're talking about one health information system for the province but when I read in the news that an RFP had been issued for a new health information system for the new Corner Brook hospital, the second line talked about it could be used for the province. I would argue – I hope that article reported that wrong because right now what we need is we need an RFP for a health information system, not just simply for Corner Brook hospital, the new hospital, but for the entire province.
Corner Brook hospital may be the one that it gets rolled out to first, but I hope that the article in the paper was wrong and that we're actually going to do that, because that's something that was talked about and recommended seven years ago. The current Minister of Health has talked about the back-office functions and the consolidation of back-office functions. Those were recommended in the Greene report as well.
Again, seven years ago, a report was given to the former minister of Health that outlined exactly how to do that, how it could be done after consultations with all of the unions and how it would consolidate all of the back-office functions from payroll to HR, to finance to supply chain, all of that. The report is there. It's somewhere in the Department of Health. If that report had to be acted upon, maybe we would have had those efficiencies in place already.
So this is not simply about going from four health authorities to one; it's about how do we improve outcomes for the people of Newfoundland and Labrador. The Member for Lake Melville talked about the issues in Labrador – and he's absolutely right, but I'll tell you and I'm sure he will agree that one of the biggest issues in Labrador for health care is the medical transportation system or lack of it. The extreme cost for those of us who live in the territories, as the former minister of Health likes to call us – anything outside the Avalon; apparently we're living in the territories.
For those of us that live outside, the medical transportation – the cost of getting to see a specialist at a tertiary care centre in St. John's is extremely high. For the people of Labrador, it's even worse. Will he stand up and say we should have 100 per cent coverage of medical transportation? That should be a basic right for the people of Newfoundland and Labrador. We understand that we cannot have a tertiary care system or a tertiary care facility in every part of this province; there are only 500,000 of us. But whether I live on St. Clare Avenue, five miles away from the tertiary care centre, or 500 miles away, the last thing I should have to worry about when I need service is if I can afford to travel to get there. But it's happening everyday.
I have a lady in my district right now who has an autistic son who cannot speak and he needs dental services. He cannot get them in Stephenville. This lady is on income support and the Medical Transportation Assistance Program is refusing to pay for her to take her son to see a specialist here in St. John's. There's something wrong with our system when people are left behind. That's what's happening.
Will this change fix that? If I thought it would, I'd vote immediately for it, but I do not see that happening.
To the senior in my district and other people's districts who are actually paying to see a nurse practitioner, actually have to pay a $300 fee in order to become a client and then for every visit pay $35 more. So every visit that senior makes now to get basic health care services, they pay a fee. When we've questioned the former minister of Health in this House of Assembly on numerous occasions the bottom line was they haven't figured it out yet. They haven't figured out yet how to reimburse nurse practitioners who want to set up private practice.
With all due respect, go figure out how to stop people from having to pay for it. That's what we should be doing, but we're not doing that. Will this today fix that? No, it won't.
There's a section in here that talks about charging fees. I just hope that we're not going down the road of now suggesting that the fees that we're going to be charging or allowing a health authority to charge includes charging fees for people for basic primary care services, because that is not what MCP is all about.
So those are things that need to be fixed now. They can be done without consolidating health authorities. They should've been done. All of the things that I have talked about should have and could have been done without this legislation but they are not done. They are left behind and people are left behind. That is the fundamental principle that we should be talking about.
When we talk about debating health care, it's not about the structure or how many boards or how many health councils or what it's going to look like. It should be about how do we ensure that people get the service when they need it. And service, Speaker, shouldn't just be a word; it should be an action. That's what the people of this province are demanding. They want to see action; they want to know that when they are in need that there will be a bed available. That when their loved one needs to go to long-term care, that there are beds available. Unfortunately, right now, there are beds available but we have no staff. We have no staff.
I understand, yes, we've started to add more seats to the nursing programs and more seats for LPN programs for the colleges, but think about if we had to do that seven years ago. Think about that, if they acted when it was brought to their attention seven years ago. If they had to start then, perhaps we wouldn't be as bad as we are today. I'm not suggesting that we would be perfect, but I would certainly think that we would be in a much better position.
But we didn't do that, we chose not to. They chose to ignore it and for the last seven years, as a result of inaction, we find ourselves in a health system in crisis. Today, we are here talking about a very detailed piece of legislation, 36 pages or so to it, a lot of changes. Will this help people get access to health care? That is the big fundamental question I have. Or will it take the eye off the ball. Will the health care system now be so wrapped up again in trying to come up with how they're going to reimagine themselves? All of these discussions will be around, how do I fit into this new health organization? How do we staff it up? Who is going to be in charge? What's it going to look like?
Because I have seen that happen in the past. I have seen with both sides of government, both PCs and Liberals, I'm not taking sides on this because I have been through many different variations of reductions in health authorities. I know from experience what usually happens is it takes the eye off the ball and you start focusing on the structure as opposed to the people.
In some cases, a lot of times all this was done in the name of efficiency and we're going to eliminate all the management positions and all of that. So the name on a door changes from a CEO to a COO, from a chief executive officer to a chief operating officer. But again, I find that what we're doing is not focusing our attention on where it needs to be. Our attention needs to be on helping the people of Newfoundland and Labrador right now.
So moving this to a Committee to really examine it, to really let people have a look at what this involves and what it would mean is a good thing. I don't see that as a bad thing. I think the fact that we want to have more input, that we want to get it done right and that we have lots of challenges to do this, simply trying to debate this in two days or a one day or whatever it turns out to be, that doesn't do it justice. It doesn't do the people of Newfoundland and Labrador justice. This is our health care system we're talking about. It's about the 500,000-plus Newfoundlanders and Labradorians who are counting on us to get it right because it's time we start to do this.
Unfortunately, as I have said, the last seven years it was ignored. All of those signs were ignored. We find ourselves now with all those types of people out there who are falling through the cracks, who can't afford to travel for health care, who can't get an appointment to see a specialist, who can't get an appointment to see a psychologist, who can't get in to see a doctor – 125,000 and counting is the number. Then the people who have to pay for primary health care services in our province because we can't figure out a solution to allowing nurse practitioners to work privately.
Let's talk about pharmacists for a second. Why aren't we talking about introducing legislation that would allow pharmacists who meet the qualifications to order blood work and then fill prescriptions? Imagine how much load that would take off of emergency room departments where people are going, simply, to get a prescription refilled. Imagine if they could fill them for more than just 30 days. Imagine if they could have basic blood work privileges to order blood work so they could monitor the patients.
Who best to know the reactions of drugs than the pharmacists themselves, clinical pharmacists in this province who have the training and the knowledge and the ability to do it? That's part of the expanding scope that we hear so much talked about. Those are the priorities for health care in this province. They should be the things that we should be talking about and debating, legislation that allows that to happen so that we free people up from having to go to emergency departments. There are things that we can be doing.
Again, sending this to a Committee to take the time to go through this and let's do it right. If this is the route the province is going down, then let's go down that road in a way that is fully informed, that the people of the province have an opportunity to understand it and that there is a clear direction. That, at the present time, we focus our attention not on the administrative structure, but on the health care of Newfoundlanders and Labradorians so that seniors don't have to pay to see a nurse practitioner, so that individual from Labrador doesn't have to travel to and pay over a thousand dollars. Will it improve coordination of health care services? Perhaps it will, but I would suggest that those are things that should be fixed now.
I'll tell you a quick story about my time as CEO of Labrador-Grenfell when an individual came into my office and said they had an appointment to see a specialist in St. John's. That person went to St. John's and spent a thousand dollars; saw the specialist who said you need this particular test done. The test was only available in St. John's. So they walked down the corridor to make an appointment to get the test done, only to be told come back in two weeks. Fly back home, back down two weeks later, another thousand dollars plus to have the test done. The test could be read and within 48 hours they go see the specialist to talk about making an appointment to get the results. Sorry, can't give you an appointment for another two months. Back up again, back down again.
These are the inefficiencies that we need to be getting at. These are the things that need to be happening, and I don't see that one single health authority will fix that. Maybe I'm missing it, but right now it's not there.
What I want us to do is focus on the people of Newfoundland and Labrador.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
Mr. Speaker, I move that this House do now recess until 2 p.m.
SPEAKER: This House do stand recessed until 2 this afternoon.
Recess
The House resumed at 1:30 p.m.
SPEAKER (Bennett): Order, please!
Before we begin, I would like to welcome in the Speaker's gallery a former Member from the beautiful District of Cape St. Francis, Mr. Kevin Parsons.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: In the public gallery today, I would like to welcome Jay Walters, Krista Keating and Jason Walters. They are joining us this afternoon for a Member's statement.
Welcome.
SOME HON. MEMBERS: Hear, hear!
Statements by Members
SPEAKER: Today, we will hear statements from the hon. Members for the District of Conception Bay South, Exploits, Torngat Mountains, Grand Fall-Windsor - Buchans and Placenta West - Bellevue.
The hon. the Member for Conception Bay South.
B. PETTEN: Thank you, Speaker.
MusicNL kicked off the 2022 Music Celebration Week recently in Corner Brook from October 25 to 29. The awards gala capped off a week of events that included workshops, performances, networking with peers and showcasing Newfoundland and Labrador talent.
The music awards were held on October 29 and I would like to give a special shout out and congratulations to the awards winners from Conception Bay South. Our very own Justin Fancy for Entertainer of the Year; Quote the Raven, folk duo Kristen Rodden-Clarke and Jordan Coaker, won Group of the Year; Rosemary Lawton took home two awards, Celtic/Traditional Artist of the Year and Music Video of the Year for “Little Fires”; Matthew Hender, a member of the Kubasonics, won Folk/Roots Artist of the Year.
A couple of honourable mentions: Darcy Scott took the stage on MusicNL's Stars of Tomorrow and participated in the Export Program; Mallory Johnson, our successful singer/songwriter residing now in Nashville hosted MusicNL's Songwriters Circle. Mallory had a very exciting week with the release of her new song “Surprise Party” which was published in the October 28 edition of People magazine.
Conception Bay South is extremely proud of these talented individuals and their accomplishments. These local musicians have a very bright future.
Congratulations to everyone and I wish them all continued success.
Thank you very much.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Exploits.
P. FORSEY: Thank you, Speaker.
On October 20, the Exploits Chamber of Commerce hosted their 22nd Annual Business Excellence Awards and Hall of Fame induction into which a businesswoman, at 31-years old, Ms. Megan Hoskins of Hoskins Funeral Homes and Crematorium received the Businesswoman of the Year award.
Speaker, Megan received her Bachelor of Arts degree in business administration in 2014. She went on to further her education and received her funeral directors and embalmer's licence in 2018. In 2019, she received her Life Licence Qualification Program and in 2020 she became a certified funeral celebrant and has been working at the funeral home since leaving university.
Hoskins Funeral Homes and Crematorium has been owned and operated by her parents, Paul and Debbie Hoskins, for 40 years. Megan followed their career path.
Megan is also Henry's handler, who is training to become the province's first certified funeral home therapy dog.
Speaker, I ask all Members of the House of Assembly to join me in congratulating Megan Hoskins of Hoskins Funeral Homes on receiving the Businesswoman of the Year award.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Torngat Mountains.
L. EVANS: Thank you, Speaker.
November 1 is a very special day for Bob Piwas of Natuashish and all of Labrador. In Natuashish, the very first home dialysis treatment in all of Labrador was completed by Bob Piwas supported by his daughter. We are very proud of them.
Hemodialysis is offered at three Labrador hospital sites: St. Anthony, Happy Valley-Goose Bay and Labrador West. People have to travel to these centres for dialysis. For people in Northern Labrador, it means moving to one of those centres because we are not connected to the provincial highway system, moving away from their communities, their families and their support systems.
So I want to recognize the tremendous life-changing options becoming available to all the Labradorians. Thank you to Labrador-Grenfell Health personnel for all their hard work in making this possible.
Labrador-Grenfell Health has worked with the Indigenous partners: Mushuau Innu First Nation and Sheshatshiu Innu First Nation, the Rotary International and the International Grenfell Association to purchase equipment to pilot home-based dialysis in two Indigenous communities. The program will be offered next in Sheshatshiu.
Following this successful pilot, home dialysis is anticipated to be offered across the Labrador-Grenfell Health region for patients who meet eligibility.
Sorry, it's very emotional because this means so much to the people on the North Coast, Speaker, I apologize.
SOME HON. MEMBERS: Hear, hear!
L. EVANS: And for those who opt to have their treatment in this manner.
I ask you to join with me, basically, and celebrating with me.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Grand Falls-Windsor - Buchans.
C. TIBBS: Thank you, Speaker.
It is my pleasure to rise today in this hon. House to pay tribute to an honourable man. Then rookie Dave Byrne joined the fire department in 1972 at the age of 17. He served as a firefighter with the Windsor Fire Department for 19 years until Windsor and Grand Falls amalgamated in 1991, which then formed the Grand Falls-Windsor Fire Department.
On August 1, 2003, Dave Byrne became assistant chief and is still a very active member today after serving 50 years as a firefighter.
SOME HON. MEMBERS: Hear, hear!
C. TIBBS: Assistant Chief Byrne joins a very short list of firefighters to serve half a century keeping his community safe.
Over that time, he has seen more than his share of tragedy and disaster but always answered the page when it went out. As an active member, firefighting is just one aspect of the job. There is so much work to be done inside the community and Assistant Chief Byrne continues to make this a priority. Whether it be training and advice or his quick wit, Dave continues to earn the admiration and respect from every firefighter he has ever served with.
As MHA and fellow firefighter, I speak for all residents of Grand Falls-Windsor to say thank you, Assistant Chief Dave Byrne for 50 years of service. God bless you, Sir.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Placentia West - Bellevue.
J. DWYER: Thank you, Speaker.
I recognize a dedicated constituent in our beautiful District of Placentia West - Bellevue, nine-year-old Jay Walters of Boat Harbour, who is joining us in the gallery today.
SOME HON. MEMBERS: Hear, hear!
J. DWYER: When Jay was in Kindergarten, the Baine Harbour Volunteer Fire Department visited his school. He was so excited to rush home and tell his mother, Krista, all about it. One item he received was a cardboard cut-out of a money bank. He proceeded to tell his mom that it costs a lot of money to put gas in the fire trucks and he wanted to help.
For the next couple of months Jay saved all his change in the cardboard bank. He saved $100 and made the donation in his late grandfather Tom Keating's memory, who also served on the Volunteer Fire Department in Baine Harbour. As a thank you, Chief Christopher Keating gave Jay his grandfather's bunker jacket from years ago.
Jay wanted to continue to help the fire department with a goal of $1,000. With COVID-19, his fundraising efforts were put on hold, but that didn't discourage him. From January 2019 to May 2022, Jay has donated a total of $3,900.
SOME HON. MEMBERS: Hear, hear!
J. DWYER: Speaker, I ask all hon. Members to join me in recognizing Jay Walters on his accomplishments to date and for being such an integral part of our beautiful District of Placentia West - Bellevue.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Statements by Ministers.
Statements by Ministers
SPEAKER: The hon. the Minister of Tourism, Culture, Arts and Recreation.
S. CROCKER: Thank you, Mr. Speaker.
It is my pleasure to rise in this hon. House today to share some exciting news. As everyone, I'm sure, is well aware, the City of St. John's is hosting the 2025 Canada Summer Games.
SOME HON. MEMBERS: Hear, hear!
S. CROCKER: It will be an excellent event for not only the capital city, but for all of Newfoundland and Labrador.
I am pleased to share with my colleagues today that we will be building a brand new, state-of-the-art track and field facility. This facility will support the 2025 Games, giving athletes and coaches top-notch facilities from which to train and perform.
This project will be cost shared between the federal, provincial and municipal governments. The City of St. John's will be issuing a request of proposals for that facility today.
The proposed facility will not only create a quality athletic facility in the metro St. John's region that meets the Canada Games technical standards, but will add a significant piece of sports infrastructure that will benefit youth and people of all ages.
The proposed facility will also see active, healthy living opportunities for residents in the region, long after the games have ended. This facility has the potential to be widely utilized by community members of all ages.
It will also enable Newfoundland and Labrador to attract more large-scale sporting events in the years to come, bringing athletes, coaches and their families to our province, benefiting our tourism industry.
Thank you, Mr. Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Placentia West - Bellevue.
J. DWYER: Thank you, Speaker, and I thank the minister for an advance copy of his statement.
It's exciting to have the 2025 Canada Summer Games coming to our province for the third time in our history. It's great to see the co-operation between all levels of government in the construction of this badly needed facility that will enhance the training and performance of our athletes. Our coaches will benefit as well by having this state-of-the-art track and field facility to practise.
Today is a good day for athletics in our province with the announcement of a brand new athletics facility for the city and the province. This will be the legacy piece for our 2025 Canada Summer Games and most certainly help attract new athletes to the sport and bring other national and international events in the future.
The facility can and should have a positive impact on the health of the residents long after the games have ended.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Labrador West.
J. BROWN: Thank you, Speaker.
I thank the minister for an advance copy of his statement. Sports and extracurricular activities instill confidence, time management skills and good mental health, especially at a community level.
We encourage this government to properly fund sport and other fitness programming at a community recreation level, to give the youth a foundation to go on to use elite facilities like the one being built in 2025. Sports excellence starts at the community level.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Further statements by ministers?
The hon. the Minister Responsible for Labrador Affairs.
L. DEMPSTER: Thank you, Speaker.
I rise in this hon. House to recognize the Labrador veterans who served with the Newfoundland Regiment in World War I.
More than 100 years ago, these brave men left their traplines and fishing boats to fight in battles half a world away. Some of them were too young to enlist, but they were driven by a duty to serve.
Historians have studied military records to piece together the stories of their courageous service, and I am happy to say we know quite a bit about who they were.
They were Blakes, Barneys, Curls, Flowers, Fords, Greens, Martins, Pardys, Pottles, Shiwaks, Traceys and Browns. They came from places like Battle Harbour, Henley Harbour, Carrolls Cove, Pinware, L'Anse au Loup, Sandwich Bay, Nain, Spotted Island, Hopedale, North West River, West St. Modeste, Grand Village, Red Bay and Rigolet.
Tragically, not all of these brave men returned home. Like others, they paid the ultimate sacrifice. Sadly, the men who returned to Labrador would never be the same.
As we prepare to observe Remembrance Day next Friday and mark Indigenous Veterans Day on November 8, it is fitting that we remember the Labradorians who volunteered in the First and Second World Wars, the Korean War and, most recently, the Gulf War and Afghanistan. They fought to preserve the freedoms and liberties that we take for granted today.
Please join with me in saluting the men and women from the Big Land who served in the Armed Forces and on peacekeeping missions. We also praise the Labradorians who have answered the call of duty and today proudly wear the uniform of their country.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Harbour Main.
H. CONWAY OTTENHEIMER: I thank the minister for an advance copy of her statement.
I, too, join with the minister in acknowledging and recognizing Labrador veterans who served with the Newfoundland Regiment in World War I. Many of these brave, young men were never able to return home. We owe many of our freedoms and liberties to their ultimate sacrifice. It is important we recognize this sacrifice as we approach Indigenous Veterans Day, as so many Labradorians that volunteered out of a sense of duty were Indigenous peoples.
On both Indigenous Veterans Day and Remembrance Day, the Official Opposition encourages everyone in our province to pause, reflect and honour the memory of our veterans.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Torngat Mountains.
L. EVANS: Thank you, Speaker.
I thank the minister for an advance copy of her statement.
We always remember the sacrifices of war and the harm it causes. Along with the courageous men honoured by the minister, we acknowledge the strong Labrador women who stayed home to support their families and the generations since, who still feel the impacts of their sacrifice. We honour them all.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Are there any further statements by ministers?
Oral Questions.
Oral Questions
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Thank you, Speaker.
Speaker, the people of the province want to see the receipts.
I ask the Premier once again: Can you table the receipts of your fishing vacation with Mr. John Risley?
SPEAKER: The hon. the Premier.
A. FUREY: Thank you, Mr. Speaker.
As I've said before and will continue to say, I've always followed the rules and will continue to follow the rules. In this case, I went beyond the rules, which are not legislated, there's no obligation to do so and set up an ethical wall so that I have no control over the process involved. In fact, the process was set up by Minister Parsons and is a robust one that's open and transparent for all to see, Mr. Speaker. Every proponent, 31 of them, in this exciting new generational opportunity will go through the same robust and open process.
Sorry, I mentioned him by name, Minister of Industry, Energy and Technology.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Thank you, Speaker.
Once again the ethical wall is the Premier's word. It's nowhere wrote down in legislation, that's his own term, so he wants us to trust him.
The answer is no, it's a flat no, and he's telling the people he's not going to provide it. So you have it loud and clear.
Premier, the people of the province are finding it hard to believe the Premier paid for the trip himself. It's astonishing we had to ask this so many times in the House.
I ask the Premier: Who paid for the trip, Mr. Risley or was there someone else who we're unaware of?
SPEAKER: The hon. the Premier.
A. FUREY: Mr. Speaker, as I've said, my time, my dime, full stop.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: It's comments like that, Mr. Speaker, that have a lot of people shaking their heads, us included.
Another classic Liberal deflection at its finest. As soon as we, the Opposition, turned up the heat on the Premier's fishing trip, another announcement. This time to replace St. Clare's hospital.
I ask the Premier: Was this announcement pulled out of thin air or to deflect from your fishing trip?
SPEAKER: The hon. the Premier.
A. FUREY: Thank you, Mr. Speaker.
I can understand why the Member opposite is confused about announcements of hospitals, because they announced one four or five times. It took a Liberal government to complete that hospital.
SOME HON. MEMBERS: Hear, hear!
A. FUREY: What we announced yesterday, Mr. Speaker, was the intent towards a new hospital.
SOME HON. MEMBERS: Oh, oh!
A. FUREY: I'm happy to respond if you'd like.
SOME HON. MEMBERS: Oh, oh!
A. FUREY: I'm happy to answer. Am I allowed to answer?
So the announcement of a new hospital in metro, Mr. Speaker, is in response to a changing dynamic within the metro region, which I think we can all recognize. It's time for a new St. Clare's; the data supports it. The population of the metro region has increased by 25 per cent and we have an aging population that is going to require more acute-care beds.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Thank you, Speaker.
The difference with the Corner Brook hospital is it was long talked about, there was a lot of planning that went into it. It just wasn't decided one day when the Premier of the day woke up –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
B. PETTEN: – and decided to announce a hospital. He came back from the weekend and decided –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
The hon. the Acting Leader of the Official Opposition.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
B. PETTEN: He came back from his weekend away and decided he's going to announce a hospital. So here we go. That's the way this government operates.
Yesterday, the Minister of Transportation and Infrastructure admitted there is no time frame, no budget and no feasibility study on the plan to replace St. Clare's hospital. Today, lo and behold, there's a briefing to explain this away.
Why wasn't this briefing carried out Monday or maybe last week?
SPEAKER: The hon. the Minister for Transportation and Infrastructure.
E. LOVELESS: Thank you, Mr. Speaker.
The interim, interim Leader of the Opposition likes to be selective with his words, right? Yesterday, if he listened closely in terms of – it was a budgetary process and the minister sitting in front of me appreciates all this as well. It's a lengthy process. I can say it's a 12-month process.
In terms of the St. Clare's hospital being replaced, like other infrastructure that was replaced, it has been discussed for months and months on end. No doubt about it.
But what the Member is losing focus of – and there are lots of people that patted him on the back for that announcement. He hasn't. We know why he hasn't, because it's for a political purposes only. But the hospital is needed and the minister can give you other reasons why it should be replaced.
SPEAKER: The minister's time has expired.
The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Speaker, I might be interim, interim, but after I listened to what he said on VOCM yesterday the minister might be on parole. Let's summarize. True words, he should listen to it.
The Premier was –
AN HON. MEMBER: (Inaudible.)
B. PETTEN: It's public knowledge. It's the radio station. Go talk to VOCM.
The Premier was caught on a luxury fishing trip with his billionaire buddy so the Liberals decided to announce a new hospital to distract from the Premier's problems. Yesterday, the minister admitted that the decision to build a hospital came out of nowhere. No homework was done on it.
Is today's briefing more damage control, Minister?
SPEAKER: The hon. the Premier.
A. FUREY: Thank you, Mr. Speaker.
Again, I'll finish my answer from the last time because I didn't have a full chance to articulate the data involved in the decision to drive this, Mr. Speaker. It's a 100-year-old hospital, Mr. Speaker. The population of the metro region has increased by 25 per cent. In 2000, when we took a hospital away from the metro region and didn't replace it with the full-bed capacity, the population has increased 25 per cent.
Since that time, the number of people over the age of 65 has increased from 18,000 to over 30,000. The number of hip fractures alone, Mr. Speaker, is gone from 250 a year to 450 a year this year to almost 650 a year projected in 2027. Where are we going to put all those people, Mr. Speaker? The approach from this government is to handle both the infrastructure and the human resource capacity at the same time and parallel.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Keep going, we're going to put them in a brand new empty building with no staff with all the broken hips and no one to look after them. That's what we're doing here.
Speaker, the Premier likes to say that we've never seen – I was doing Estimates for years in this Department of TI. There's never been any talk of St. Clare's hospital and he knows that like the rest of us do.
Speaker, yesterday, the Premier said replacing St. Clare's is – quote – addressing all issues of the Health Accord.
So I ask the Premier: Can you tell us what page of the Health Accord highlights the replacement of St. Clare's?
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Thank you, Mr. Speaker.
As the Premier said earlier, it won't take eight years and eight announcement for us to get this hospital built.
SOME HON. MEMBERS: Hear, hear!
T. OSBORNE: This summer, Mr. Speaker, a large piece of steel fell off of St. Clare's, landing on the walkway where people use as the entrance to get in to St. Clare's. The building needs to be replaced.
Mr. Speaker, we need infrastructure. The Opposition has said that many times before. We need people. We understand that. We're working on both. We need a modern facility. Some of the folks we're looking to recruit want a modern, state-of-the-art facility to come here, too. That is one of the things that we hear from folks. We are working on both very aggressively.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Speaker, that's infrastructure damage. We need doctors and we need nurses. That's what people need. And we need an emergency room where you can get care.
SOME HON. MEMBERS: Hear, hear!
B. PETTEN: Not this nonsense of coming out with announcements, making announcements and you don't even have a clue where the money is coming from. It's unbelievable, Mr. Speaker.
Speaker, long-term care beds sit empty across the province and staff are being forced to work mandatory overtime.
I ask the Premier: How can you commit to building a new hospital if you can't staff the current ones?
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Mr. Speaker, I will address the preamble of the question. The reality is we do need folks to work in our health care facilities. This health care facility that we're talking about is bursting at the seams. Anybody will tell you that the emergency room down there is non-functional, it's not laid out very well, Mr. Speaker.
St. Clare's hospital needs to be replaced. It is a priority of this government, but so is getting individuals working in this province. We've got a number of initiatives in place to hire people in this province, Mr. Speaker. We're reaching out worldwide to hire health professionals in this province, and we're doing much better than some of the other locations across Canada.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Speaker, it astounds me. It's not a bricks and mortar issue; it's a human resource issue. We need people on the ground to look after them. Who cares if you look after them at the Empire State Building or Mile One, we need people to look after them.
They're building a building to deflect. It makes no sense. Everyone is saying it. We're asking those questions, which we're supposed to do.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
This is the warning. If it keeps up, Members are going to lose their speaking privileges again today.
The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Thank you very much, Mr. Speaker, for that.
A year ago, in response to questions about the long-term care homes in Central Health, the minister said – quote – those facilities are fully staffed. But yesterday we learned that only half of the beds are open in Grand Falls-Windsor.
So I ask the Premier: If the facility was fully staffed a year ago, what happened?
SPEAKER: The hon. the Premier.
A. FUREY: Mr. Speaker, I'll again address the preamble with respect to St. Clare's. I'd ask the Member opposite, does he expect 200 extra hip fracture patients, who can't be treated at home, to live in Mile One? Mr. Speaker, I don't think that is prudent; I don't think that is responsible. We're trying to plan for the future. I would say to the Members opposite –
AN HON. MEMBER: (Inaudible.)
A. FUREY: I am not riled up again.
I can say, with respect to the where – you have to understand that this is a complex system that can't be treated in a linear fashion. You need to do two things at once, Mr. Speaker; you need to grow the human resources and you need to provide the infrastructure.
It is quite clear from the numbers involved right now, Mr. Speaker, and the population that the current facilities will not allow for acute care for the patients of the metro region.
SPEAKER: The Member's time has expired.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Repetitive, Mr. Speaker.
I'll ask again, a year ago, in response to a question about long-term care homes in Central Health, the minister said: “Those facilities are fully staffed.” But yesterday we learned that only half of the beds were open in Grand Falls-Windsor.
I ask the Premier, again: If the facility was fully staffed a year ago, what happened?
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Mr. Speaker, I had indicated here yesterday and I'll indicate again today, we are doing a review of the services and requirements in personal care homes and long-term care homes with an aim to better utilize the individuals getting into these facilities so that we can get them out of acute-care beds.
We also need staff, and, more directly to the Member's question, we are recruiting staff not only within Canada, but internationally. The Member is obviously aware of the Medical Act that we put in place to recruit physicians from outside of Canada, from other countries. He will hear in the very near future about a nursing initiative, Mr. Speaker, to recruit from outside of the country and he will hear shortly, again, after that another initiative to recruit –
SPEAKER: The minister's time has expired.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Stephenville - Port au Port.
T. WAKEHAM: Thank you, Speaker.
It is interesting to hear the Members opposite talk about the importance of the rebuilding of St. Clare's hospital, yet at the same time the very people who did their Health Accord had no recommendations on replacing St. Clare's hospital in it and, at the same time, I don't recall anything in the fiscal forecast talking about the replacement of St. Clare's hospital.
So if it is such a priority, why isn't it in those buildings? But I also know that there is nothing in the Health Accord about the sugar tax.
So I ask the Premier: Will you finally admit that it is nothing more than a tax grab?
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Premier.
A. FUREY: Thank you, Mr. Speaker.
I tell you what is not recommended in the Health Accord: taking nurses out of the system, as was recommended by the Member opposite, Mr. Speaker.
SOME HON. MEMBERS: Hear, hear!
A. FUREY: We are trying to provide modern facilities for the people of the metro region. It is unfortunate that the Members opposite don't recognize that value. I think that we have made a good case for this, Mr. Speaker, in terms of the changing demographics, the changing population of the metro region. In fact, this hospital will continue to serve not only the metro region but the entire province, Mr. Speaker.
With respect to the sugar-sweetened beverage tax, I've already made my case on that, and I think the public understands it.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Stephenville - Port au Port.
T. WAKEHAM: Speaker, I remind the Premier, in case he doesn't know, that taking nurses out of the health care system in 2016 was at the direction of his former minister of Health and his deputy minister of Health, both who are sitting on that side of the House –
SOME HON. MEMBERS: Hear, hear!
T. WAKEHAM: – right now, and, of course, you weren't allowed to tell the caucus Members of what their direction was. Maybe he should talk to some of them about it.
Speaker, yesterday the Premier said that people should just drink water. Well, the people in my district, in many communities, do not have access to clean drinking water.
So again I ask the Premier: Show some leadership and axe the tax.
SPEAKER: The hon. the Minister Responsible for Labrador Affairs.
L. DEMPSTER: Speaker, I'd like to respond to the preamble and shed a little light. When the Member says he did it at the direction of this government, when we formed government in late '15 and we thought we were facing a billion-dollar deficit and it turned out to be over $2 billion from the Muskrat Falls fiasco, there was tough decisions to be made.
However, when this government asked the Labrador-Grenfell Health, which he was CEO at the time, to find savings to the tune of 30 per cent, he honed in on the most vulnerable population, a small isolated community in Labrador and said we'll take the nurse out of Black Tickle. The reason the nurse there was getting so much salary was from mismanagement from the health authority under his leadership at the time. That's what happened.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Stephenville - Port au Port.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
T. WAKEHAM: If only half of that was true. What the minister just failed to realize is we were given a directive to take $500 million out of the system and that minister, her Minister of Health, told us not to tell her, not to communicate with anybody in the communities. We were not allowed to tell the communities what was being proposed. We were not even allowed to tell our own MHAs.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
The hon. the Minister of Industry, Energy and Technology will lose his speaking privileges this afternoon.
The hon. the Member for Stephenville - Port au Port.
T. WAKEHAM: At the end of the day, Minister, it was the Minister of Health who said yea or nay to any recommendations that come in. So if she wants to blame someone for taking the nurse out of Black Tickle, blame the former minister of Health.
Now I'd like –
SPEAKER: The Member's time has expired.
SOME HON. MEMBERS: Oh, oh!
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Minister Responsible for Labrador Affairs.
L. DEMPSTER: The point I'm making when you're in a leadership role and you're asked to make decisions, you look generally in the back room and you look for places to find efficiencies. You do not reach in to the most vulnerable.
So I have to wonder if this Member across the way is seeking a leadership role, I would ask the people of the province is he going to reach in to the most vulnerable. Because I can tell you that's what happened in that situation –
SOME HON. MEMBERS: Hear, hear!
L. DEMPSTER: – and when he called me and said we're taking the nurse and we're going to serve it with paramedics, I said it will not happen and it did not happen.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Stephenville - Port au Port.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
T. WAKEHAM: Speaker, what I will not do is fail to communicate with the people who are being impacted. I will not turn around and say do not communicate with the communities that you're talking about. I will not turn around and not allow MHAs to have a say in what's happening in their own districts, which this government did, which that minister refused to do. Those are the facts, Mr. Speaker. Those are the facts in this particular case.
SOME HON. MEMBERS: Hear, hear!
T. WAKEHAM: I go on to say, at the end of the day, if this government had not wanted to axe $500 million out of the system, none of that would've happened. So let's go back to the question at hand.
SPEAKER: The Member's time is expired.
The hon. the Minister of Education.
J. HAGGIE: Thank you very much, Speaker.
I feel obliged to address a comment in the preamble. Perhaps the Member opposite would like to explain why he wanted to shut the St. Lewis clinic, the St. Mary's clinic at a time when there were no roads paved – which we have achieved – and those roads were essentially impassible in spring and the fall and now –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order!
The Member for Stephenville - Port au Port will lose privilege this afternoon also.
J. HAGGIE: – he tries to deflect the blame.
Thank you, Mr. Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Ferryland.
L. O'DRISCOLL: Great deflection going on here today, great deflection, I have to say.
Speaker, it's been four years since government finally opened the first phase of the Team Gushue Highway. The Liberals have indicated they don't have the money and need federal support. Incredibly, 65 per cent of the provincial share of the Investing in Canada program, a federal program, remains unallocated.
Minister, what is the holdup?
SPEAKER: The hon. the Minister of Transportation and Infrastructure.
E. LOVELESS: The holdup is because we're doing things responsibly. This government is doing things responsibly. As I said, we need support from the federal government and we've gotten support from the federal government under Trudeau.
We go back to Harper when there were all kinds of cuts. But we will do it right when we get the funding arrangement in place. I say to the Member opposite, stay tuned.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Ferryland.
L. O'DRISCOLL: You won't have to worry about doing the road; you need to worry about cutting the trees over there by the time it's done.
Speaker, unlike the new hospital, the plans are in place for the infrastructure program. According to the Canadian Construction Association, our province is the worst in the country at getting money out the door. Ontario, on the other hand, has spent their share.
Again, why can't the minister get the project moving?
SPEAKER: The hon. the Minister of Tourism, Culture, Arts and Recreation.
S. CROCKER: Thank you very much, Mr. Speaker.
I had to take this question just to point out to the Member opposite that it was only less than, I don't know, 35 minutes ago I stood up here and announced a federal-provincial partnership with the City of St. John's to build a new track and field facility here in this province.
It's ironic, Mr. Speaker, they stand here and talk like – where's the infrastructure? Where's the infrastructure? Then preceding that was why are you building a new hospital?
Well, to the Members opposite, a hospital is infrastructure.
AN HON. MEMBER: (Inaudible.)
SPEAKER: Order, please!
Member for Ferryland, you can lose your privileges for this afternoon, too.
S. CROCKER: Mr. Speaker, this is a hospital; it's infrastructure. The new Canada Games facility – and I can tell you, I was fortunate enough to spend three years in this minister's responsibility and let me tell you, the Team Gushue completion was always something that was on the table. I think as the minister said, stay tuned.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Terra Nova.
SOME HON. MEMBERS: Hear, hear!
L. PARROTT: The Team Gushue Highway is like their plan – a road from nowhere to nowhere.
Speaker, municipal leaders across the province will be gathering this weekend in Gander at the annual MNL Conference and they're wondering: Is there a cost analysis completed for the Premier's regionalization plan?
SPEAKER: The hon. the Minister of Municipal and Provincial Affairs.
K. HOWELL: Thank you, Speaker.
It is an opportunity that I've been waiting for a few days to be able to stand and speak to the regionalization plan.
We've received our report from the joint working group on regionalization, which has undergone extensive analysis. As I've said before, when I stood in this House, it's certainly not my intention to come out and make decisions that are rash and unappropriated and not approximated.
So when I come forward with a plan for regionalization it will be a solid plan that has evidence base behind it so that the people of this province will get the best bang for their buck out of any particular regionalization plan.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Terra Nova.
L. PARROTT: Thank you, Speaker.
We're looking for a cost analysis. That's the question.
Anyhow, we're hearing from towns and LSDs who are concerned about regionalization and, according to the emails obtained by my office, there are more questions than there are answers.
I ask the minister: Is the regionalization plan on hold or is it cancelled altogether?
SPEAKER: The hon. the Minister of Municipal and Provincial Affairs.
K. HOWELL: Thank you, Speaker.
As I've said previously, the report that came from the joint working group is still being analyzed. We want to make sure that all the numbers are right and that things make sense for the people of this province. We don't want undue burdens to be placed on people in LSDs or unincorporated areas but we want everybody to have reasonable and equitable pay for the services that are provided.
Given that, we do consider that these are new costs that could be associated and we want to make sure that when we bring it forward it's fair, it's equal and it's done right to provide equitable services to create sustainable communities where people will want to come, work, live and continue to grow this province.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Exploits.
P. FORSEY: Mr. Speaker, one in 10 residents in our province are currently under a boil-water advisory, yet the government has been unable to allocate some 65 per cent of provincial share of the investments on the Canada plan.
Speaker, why is the minister allowing people to get sick when federal dollars remain unspent?
SPEAKER: The hon. the Minister of Environment and Climate Change.
B. DAVIS: Thank you, Mr. Speaker.
I thank the hon. Member for the question. It's a very important question. We have a number of communities, as we know, that have boil-water advisories. Any opportunity we can – I know the previous minister responsible for this area has put a lot of pressure on the municipalities and the LSDs to come forward with proposals to do the favourable regime for waste water and water.
Drinking water is an important piece. It's a priority for us. We're going to work with our federal government through the Minister of TI as well to get those projects started and get them moving, but it starts with the municipality coming forward to us. We want it done. We want them to come forward for this and we want to support it.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Exploits.
P. FORSEY: Speaker, we have 160 communities with boil-water advisories and impending federal waste water regulations. According to the Canadian Construction Association, our province has the worst performance in the country in getting the money out the door.
Communities are ready; contractors are ready.
Why won't the minister move and give residents clean, safe drinking water?
SPEAKER: The hon. the Minister of Transportation and Infrastructure.
E. LOVELESS: Thank you, Mr. Speaker.
It is an important question. I've had conversations with the associations that represent the industry. But just, I guess, for factual information, the department has provided more than $100 million and that's represented 300 water projects over three years. We're calling for more applications and, especially this year, we're focusing as well, we always remind towns that, listen, we're interested in water projects. We've done that in the past and we'll continue.
We have a commitment to the communities in this province that if they can't financially afford to do it, we'll be there to support them.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Topsail - Paradise.
P. DINN: Thank you, Speaker.
Speaker, during the last election, the Premier promised IVF services here in the province. He said – quote – we will be working with stakeholders including obstetricians and gynecologist here who firmly believe that a clinic here is possible.
Today, we find out that two of our doctors trained in IVF here in the province have been completed ignored.
I ask the Premier: Were these just more empty promises?
SPEAKER: The hon. the Minister of Health and Community Services.
T. OSBORNE: Mr. Speaker, the election was about 18 months ago. Since that time, we've put in the $5,000 fund to allow people up to three trips outside the province for IVF services. We've also announced, within the last couple of days, that we're doing an RFP to look at what fertilization services are available in the province, whether or not they need to be expanded, the number of people on the waiting list and how we should provide fertility services in the province.
Mr. Speaker, this an important issue. It's an important issue to the individuals who require the service and we are focused on addressing it. I will be communicating with and consulting with stakeholders on this issue.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Leader of the Third Party.
J. DINN: Speaker, the cost-of-living crisis has hit post-secondary students particularly hard. Many have seen their tuition quadruple since they started their program.
I ask the Premier: Will his government support and invest in post-secondary students, freeze tuition and expand the needs-based grants.
SPEAKER: The hon. the Minister of Education.
J. HAGGIE: Thank you very much, Speaker.
Tuition at MUN remains a valued proposition, whether you're an undergraduate student or post-graduate or international. We are very competitive. Even with the tuition freeze gone – which MUN lifted – and in response to that, we took the tuition freeze money and gave it directly to the students in an offset. We have committed significant funds, and along with the federal government, we are providing more funding this year than last year.
In terms of the valued proposition, MUN is an excellent facility and is one of the cheapest both for domestic and international students.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Leader of the Third Party.
J. DINN: It may be competitive but it's definitely not accessible.
Speaker, post-secondary students were on the steps of this building pleading for supports this morning. While this government announces new hospitals to benefit their political supporters, the future workers being trained to address the health care crisis had to rely on food banks, to the point where those food banks closed.
I ask the Premier: Which part of the population growth strategy outlines youth and student poverty as a goal?
SPEAKER: The hon. the Minister of Education.
J. HAGGIE: Thank you very much, Speaker.
Just to clarify some things in the preamble. MUN is an autonomous body and sets its own tuition rate. This they did and they announced this to us. In view of the fact they were not freezing tuition, as we had understood, and we funded them to make up for that. We decided to repatriate that money, take it back into government and redistribute it to students in need across this province. This we have done. We have significantly improved the individual grants, we've raised the weekly limits and we have improved provincial funding by almost half, compared with this time last year.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Leader of the Third Party.
J. DINN: Speaker, students once came to this province because our post-secondary institutions offered an accessible, quality education and the experience of living in our great province. This Liberal government has cut funding to students and failed to invest in infrastructure.
I ask the Premier: Is this what he meant when he said Memorial had to figure out what it wanted to be when it grew up? A place where buildings leak, food bank shelves go empty and students face homelessness.
SPEAKER: The hon. the Minister of Education.
J. HAGGIE: Thank you very much, Speaker.
I think for accuracy, again, I need to repeat the answer to the previous two questions. We have increased funding to students in the province at post-secondary education. We have done this by a factor of 50 per cent on average. We have taken the tuition money that we gave to MUN on the understanding that they would freeze tuition, and we have given it directly to the students to directly offset their course cost increases. That is nothing but an increase.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Humber - Bay of Islands.
E. JOYCE: Mr. Speaker, John Risley stated publicly: “The province asked us to do this in phases.” He said the original idea was to submit all proposed sites for the hydrogen project. Not only did government advise GH2 on how to proceed, the Minister of Environment and Climate Change accepted Phase I only.
The Premier stated that he did not discuss the wind project with Mr. Risley on his fishing trip.
To ensure fairness, equal opportunity to all proponents, I'm asking the Attorney General to refer this matter to the Auditor General under section 22, to conduct an investigation on who in government is advising GH2 on how to proceed and circumvent the environmental assessment and giving GH2 an unfair advantage.
SPEAKER: The hon. the Minister of Environment and Climate Change.
B. DAVIS: Thank you, Mr. Speaker.
I would just like to thank the hon. Member for the question, but there is no one in government who has ever said to the proponent – I think the proponent actually clarified that in a media interview right after that, maybe a day or two later.
It is just that facts matter in a case like this. It is a legislatively governed process. The environmental assessment is legislatively governed. Every proponent in every facet there that meets the requirements to go to environmental assessment goes through that environmental assessment.
This proponent did so; they're going through, as of August 5, the environmental impact statement, of which I encourage the public to reach out – they have two more opportunities for public consultation. The next one closes off on November 8 and then there will be another one that will open (inaudible) –
SPEAKER: Order, please!
The minister's time has expired.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Humber - Bay of Islands.
E. JOYCE: Mr. Speaker, just to be clear, Mr. Risley stated later that he is the one that wanted to put in all three phases and government advised him not to. They are the facts, Minister. If the government wants an open and transparent process, ask the Auditor General who advised them how to do it. Here is an opportunity to prove the Premier correct.
Mr. Speaker, Phase II of the GH2 project would include Lewis Hills and Serpentine valley areas. A major portion of the area is classified as sensitive, where Crown Lands can't even accept an application for a cabin. It's also a portion of the Appalachian Trails, potentially a geopark and UNESCO destination.
I ask the minister: Due to the sustainability of this area, why is GH2 advised not to submit three phases of this project to be included?
SPEAKER: The Member's time is expired.
The hon. the Minister of Environment and Climate Change.
B. DAVIS: Thank you, Mr. Speaker.
I can't be any clearer than I was already. There was no one in the department or in government, to my knowledge, that has ever told a proponent. A proponent clarified that in the very next interview that he did.
Facts do matter. That's what was out there in the public domain. We've looked at it too and I encourage the Member to look at it as well.
All I can say is that it's a legislatively governed process that we're following for every proponent that goes through. This proponent, no different than any other proponent. As we heard in this House earlier this week, there are 31 other proponents potentially coming forward. That's great for this province. They're all going to have to go through this process.
I hope that this process, at the end of this process, will have many environmentally sound projects that they're going to be having to employ people in this province.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The time for Question Period has expired.
The hon. the Government House Leader.
S. CROCKER: Point of order, Mr. Speaker.
Earlier on in Question Period, under Standing Order 34, the Opposition House Leader referred to comments about the Minister of Transportation and Infrastructure about being on parole, Mr. Speaker. I think that would be a –
AN HON. MEMBER: Uncalled for.
S. CROCKER: Well, yes, totally uncalled for, Mr. Speaker. That would be unparliamentary and it would suggest that the Member opposite would have some reason to be on parole.
Thank you, Mr. Speaker.
SPEAKER: I'll take the point of order under advisement and review some of the audio then.
Presenting Reports by Standing and Select Committees.
Tabling of Documents.
Notices of Motion.
Answers to Questions for which Notice has been Given.
Petitions.
Petitions
SPEAKER: The hon. the Leader of the Third Party.
J. DINN: Thank you, Speaker.
This petition is signed by about 140 to 150 people and it's regarding just transition legislation. These are the reasons for the petition:
The effects of climate change are already harming people of this province, according to the final report of the Health Accord, through more frequent and destructive weather events, disappearing sea ice in Labrador or through toxic pollution.
The science unmistakeably tells us that we need a 45 per cent reduction in greenhouse gas emissions by 2030 and a 90 per cent reduction by 2050 in order to avoid ruinous climate change.
Former Bank of Canada Governor Mark Carney stated in the fall of 2021 that the green transition is the greatest commercial opportunity of our age.
Newfoundland and Labrador stands to gain by entering early into the green technology sector, with some of the strongest renewable energy resources in North America, a rapidly growing technology sector and world-class education and research facilities.
The major economic transformations of the past were carried out without consideration for workers in phased-out industries. Our workers in the oil and gas sector already have the skills and know-how needed to build the new green industries and are, therefore, well placed to take advantage of this unique opportunity.
Therefore, we petition the hon. House of Assembly as follows: We, the undersigned, call upon the House of Assembly to urge the Government of Newfoundland and Labrador to introduce just transition legislation, ensuring high-quality union jobs, guaranteeing workers the supports they need to join the new green workforce and ensuring local communities are the primary beneficiaries of the green transformation.
Speaker, I can't help but think that if we had just transition legislation, this whole discussion around a fishing trip would be moot because we would have a framework in place that would at least make the whole process transparent. Part of what we called for in our own just transition legislation was an officer of climate accountability who would report to this House.
We know quite clearly from the disaster that hit Port aux Basques that –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
The hon. the Leader of the Third Party.
J. DINN: Thank you, Speaker.
We know –
B. PETTEN: (Inaudible.)
SPEAKER: Would you get up after he finishes? He has 30 seconds left, if you don't mind.
The hon. the Leader of the Third Party.
J. DINN: In the end, Speaker, what these petitions are looking for is an overall plan to address this issue, that's well planned out, well thought out and that is transparent. That's what they're calling up, and let's get on with that.
Thank you.
SPEAKER: The hon. Acting Leader of the Official Opposition.
B. PETTEN: Mr. Speaker, during the Member for St. John's Centre's petition, the Member for Corner Brook took liberty to go up and speak to you on something pertaining to me, which I couldn't overhear, but it was about giving you advice on something that was a point of order, which I find offensive. Then he took it upon himself, when he walked back, to start blowing kisses our way. I'm not sure who he done it to, but this is below the bar. You're going below the bar.
We can say a wrong word here or there, but to try to get up and turn one missed word – maybe one might not be an issue. But to try to get up and through a bullying and intimidation process go up there and try to intimidate me – because he isn't intimidating me. The Member for Corner Brook is not going to intimidate me in this House and I don't think he's intimidating anyone on this side.
I've let a lot of things go in this House; believe you me, a lot. But I will not sit here, as Opposition House Leader, as Member for Conception Bay South, as the person I am and let that man walk back and start blowing kisses our way – our way. I don't care who he's directing it at, it's diminishing, it's demeaning and it's not what this House is intended for.
He thinks he owns this House; he don't. The people of the province owns this House and I think it's wrong.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Corner Brook.
G. BYRNE: Thank you very much, Mr. Speaker.
This House must retain its integrity and its decorum, its very dignity.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
G. BYRNE: And by the very fact that there are cat calls now –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
I heard the speaker, so I'd like to hear this one, please.
G. BYRNE: Thank you very much, Mr. Speaker.
So what the hon. Member, the interim Leader, the House Leader of the Opposition Party, may have inadvertently neglected to provide during his discourse to the House and to you, Mr. Speaker, was that – and you may have picked this up on audio and it may be captured in Hansard but I'm not sure. But as I walked back to my seat he said: It's time for you to get a new career; it's time for you to step down. That's what the House Leader of the Opposition stated.
So while, Mr. Speaker, I certainly do take aghast to that particular expression, I don't think it's warranted. One could argue that was meant to intimidate me. If there was any offence taken by any particular hand gestures, in reply to the clear statement from this supposed interim Leader of the Opposition – or I'm sorry, the House Leader? What's his position again?
AN HON. MEMBER: Interim.
G. BYRNE: Interim Leader of the Opposition. I apologize for not giving his title correct; he deserves his title. If there's any implication or any concern that was taken by any kind of hand gesture that may have been misinterpreted by him, I certainly do apologize.
But I'd ask for the hon. Member as well, in the spirit of decency, of mutual respect and the dignity of this House, to acknowledge that to present to another hon. Member that it's time for you to leave – your time has come; it's time for you to get a new career – that's an offence to the House as well.
So I apologize unequivocally and I ask the hon. Member to do exactly the same thing.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Acting Leader of the Official Opposition.
B. PETTEN: Thank you very much, Mr. Speaker.
If my comments offended the Member for Corner Brook, I do unequivocally apologize as well. But I think the lesson here is the start of what started all this – and I am apologizing. But to go up there and to be talking about me to you that I could almost hear – not quite; I know my colleague for Terra Nova could hear – that's the crux of this problem, Mr. Speaker. It's a form of bullying.
I will remain offended to that. If my comments offended the Member for Corner Brook, I will apologize on that. But I still have an issue with the commentary up there that could be almost overheard by some Members on this side. That is bullying and intimidation and I do take offence.
Thank you very much.
SPEAKER: The hon. the Member for Corner Brook.
G. BYRNE: Mr. Speaker, if you'll take an opportunity to review Hansard, if required – but I think you heard it very clearly yourself – he did not apologize. In fact, all he did is take the opportunity to repeat the previous accusation or the previous slight.
Mr. Speaker, the other thing that you will be of clear mind to be able to judge, without review from a copy of Hansard, is what the topic of the conversation was. When I repeat it to you, it was simply a matter of precedent that applies to the entire House, which had no reference whatsoever to the hon. Member in question.
You are first-hand; you are first party to the conversation that I conducted with you. The hon. Member has made a reference, a second slight, to suggest that I was speaking to you to make reference to the hon. Member in question, which you know to be false.
With that said, I address the question of whether or not there was a precedent that had been established by the Speaker of the House, potentially under advice of their Clerk, and whether or not that should be appropriate to apply to this particular situation. There was no discussion whatsoever about the hon. Member, the interim Leader of the Official Opposition. You know that to be true because you were first party to the conversation.
With that said, Mr. Speaker, the hon. Member has not unequivocally apologized. He's not apologized. He used the reference. He stood on his feet to repeat the allegation or the slur in question and then tried to basically obfuscate the situation by referring to a second issue. Then, he went on to indicate that our conversation was very different than what it was.
This is a second offence to the House and a second breach of privilege.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Order, please!
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
I know everybody's getting a bit heated and everything else. Both Members did apologize. I will take the additional comments under advisement and report back to the House.
The hon. the Member for Humber - Bay of Islands.
We are in petitions.
E. JOYCE: Thank you.
It's great to get back to government business, I must say.
WHEREAS our environment must be protected and an environment assessment be followed to ensure the safety of our environment for future generations; and
WHEREAS the World Energy GH2 has submitted a plan to the Government of Newfoundland and Labrador to build wind turbines in Western Newfoundland; and
WHEREAS the company director has stated publicly that the government told the company to register only Phase I of the project; and
WHEREAS the company director stated they need the three phases to make the project viable;
THEREFORE we petition the hon. House of Assembly as follows: We, the undersigned, call upon the hon. House of Assembly to urge the Government of Newfoundland and Labrador to reject Phase I of the World Energy GH2 project and complete an environmental impact study on the World Energy GH2 project as one to ensure the complete project is evaluated and the environmental study is not circumvented.
I'm going to speak today on what the minister said earlier; he said to his knowledge. I ask the minister, when I stood up and asked to be referred to the Auditor General, you're saying to your knowledge. Can you stand in this House and confirm that no other person, even on that fishing trip, never spoke to John Risley about this? If you can't confirm that, Minister, this is why we need this referred to the Auditor General.
This is serious. This is taking a friend, giving them inside information John Risley said himself, and not making it fair for the rest of the proponents. You can't have that.
Another thing the minister just said. He said that John Risley went out and clarified this later. John Risley just recently said that we're hoping to get the three projects done. So John Risley is out saying we want the three projects done. We're hoping to get the three of them done. We got to have three of them done.
For the minister to stand up and say – and I challenge the minister to show me this information where John Risley said, oh, that was a misunderstanding. John Risley is publicly now saying that we need the three of them done by next year to make this project viable.
Minister, because I gave the government an opportunity, right now, to get the Auditor General to say, no, that's not true – John Risley, his statements were not true – I'm going to keep saying that it was on the fishing trip. I'm going to keep it because no one can confirm that it didn't. They refused to look at it to say what was said where and who. But when you've got inside information and someone is telling you, here's the best way to go about it because Phase II, Lewis Hills, is too sensitive, you can't touch the Lewis Hills, don't go there. Just do Phase I and once you get your buildings, we have to give you the other ones.
I'm going to say that there is someone in government who's feeding this information and we should get to the bottom of it.
SPEAKER: Order, please!
The Member's time is expired.
E. JOYCE: Thank you, Mr. Speaker.
SPEAKER: The hon. the Member for Torngat Mountains.
L. EVANS: Speaker, my petition is about the return of the marine shipping service between the Island portion of the province and our Northern Labrador communities.
We, the undersigned, are concerned citizens of Newfoundland and Labrador who urge our leaders to return the marine shipping service between the Island portion of our province and our Northern Labrador communities of Rigolet, Makkovik, Postville, Hopedale, Natuashish and Nain.
Our Northern Labrador communities are totally isolated with no road access and marine transportation services are limited to just five months, on average. With the cancellation of the direct marine freight service from the Island portion of our province to our communities, residents are witnessing exorbitant price increases of basic needs impacting overall quality of life.
Therefore we, the undersigned, call upon the House of Assembly to urge the Government of Newfoundland and Labrador to reinstate the marine shipping service between the Island portion of the province and our Northern Labrador communities.
Now, Speaker, I know people are saying when she dies on her headstone is going to be a call for the return of the marine shipping from the Island. In actual fact, if I were to die today, that would be one of my wishes. Because every resident in my Northern coastal communities is impacted. They're impacted because the cost of food has gone up. Not only with the increased cost of fuel for the trucking because of this war in Ukraine, but in actual fact, the prices have gone up because of the additional trucking alone.
Not only that, in April and May of 2019, when I was campaigning to get elected into this hon. House, the teachers in Nain told me that the removal of this freight boat starting in June 2019, they said teachers were going to leave. They said, Lela, within three years you're going to see a significant difference. In actual fact, that's true now. It's three years later and in Nain they had a huge retention issue. I had parents talking about 12 teachers leaving in one year. That's a lack of retention. You can't fill the vacancies; it's basically a lack of being able to recruit.
Looking at food insecurity, the cost of building materials, the cost of having a house, maintaining a house, household goods, all of that has increased directly. What's happening now is people can't afford quality of life, most people. When the cost of living goes up and you're struggling to buy food and obtain shelter and actually be able to have quality of life for your elders, for yourself and for your children, it's causing a lot of difficulties.
In this Health Accord it talks about the social determinants of health and when you look at that, the ability to feed yourself, to be able to have safe shelter –
SPEAKER: Order, please!
The Member's time has expired.
The hon. the Member for Bonavista.
C. PARDY: Thank you, Speaker.
Health care on the Bonavista Peninsula is currently, and has been for a significant period of time, not resourced adequately to provide quality health care for the residents in the District of Bonavista but particularly in the Bonavista area.
A large portion of the district is without a family physician and the local area has no representation in the recruitment and retention process. Without adequate resourcing, the District of Bonavista is grossly substandard in providing appropriate care.
We, the undersigned, call upon the House of Assembly to urge the Government of Newfoundland and Labrador, in addressing the human resourcing of physicians in the District of Bonavista, to include local representation in the recruitment and retention process to further enhance the opportunities of attracting prospective physicians to our historic area.
Minister, we're debating now Bill 20 and in Bill 20 we have a component which looks at the retention and the recruitment and we're asking the provincial authority to be able to look at and have a process. Through this petition that has been signed by members from Bonavista, I would ask that we don't lose in that process, representation from the local area.
And I would say that if we're trying to recruit local physicians or family physicians to the area, it's important that we have local representation in order to be able to fully disclose to them what the offer or what the area can provide for them. That's the gist of the petition.
I would say that if we had a local group that were involved within the recruitment process that can show them what this district has to offer in a scale from the locals, even to have an opportunity to show what can be brought forward, locally, in the area, I think it increases our opportunity that we may be able to attract some health personnel to our area and that's the gist of the petition.
So just to repeat: local representation. If someone said that we already have local representation, I want to reflect back upon a session we had at the Garrick Theatre where the hall was full. Eastern Health had representation there and one question was asked by a gentleman, Mr. Reg Durdle: Does anybody have any involvement or know of anybody in the area that's involved in the retention and recruitment? There were three hands, I think, went up in the auditorium – three out of a full house.
So the thing I said, one thing is to have it, another thing is that we will be comforted to know we have it.
Thank you, Mr. Speaker.
SPEAKER: The hon. the Member for Topsail - Paradise.
P. DINN: Thank you, Speaker.
So the content of this petition:
WHEREAS there are many hopeful mothers and couples in this province dealing with infertility issues and require medical assistance to conceive; and
WHEREAS the costs associated with out-of-province fertility treatments, specifically in vitro fertilization, is extremely cost-prohibitive; and
WHEREAS there are doctors in this province trained in in vitro fertilization and have the desire to set up an IVF clinic in the province; and
WHEREAS the province is dealing with an aging population and serious population growth challenges;
THEREFORE, we petition the House of Assembly as follows: We, the undersigned, call up the House of Assembly to urge the Government of Newfoundland and Labrador to establish a fertility clinic in the province providing full fertility services including IVF for hopeful mothers and families. And in the interim provide financial assistance to access out-of-province fertility treatment and services.
Speaker, I've presented this petition many times in this House. In fact, I broached one question today in Question Period on this where this was promised in the last election, 21 months ago, almost two years ago, and the doctors in question here had provided a proposal four years ago with the government on setting this.
As we know, we have severe population challenges here, and this is truly grow your own, when you can help families out there conceive and have children and start a family. The stats will tell you it'll vary between one in four and one in six families have issues or troubles with trying to conceive.
Partially in response to these petitions, government came in with a subsidy, $5,000, I think, for three times. But we've also found out from many that's not enough. Because we know that going out of province to access IVF treatments is very costly when you take into account the travel, the accommodations and the time away from work. You even pay for embryo storage. These are things that people don't realize, the added costs that it takes to do this. If we have doctors who are willing and able to set up here in the province – now, will they have the level of expertise someone up in Calgary has? Maybe not, but they start somewhere and you give the residents of this province an option. They can select that.
So I really hope that government will follow through on their commitment and establish an IVF clinic here in the province.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Orders of the Day.
Orders of the Day
SPEAKER: The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
Mr. Speaker, I call from the Order Paper, second reading of Bill 20.
SPEAKER: The hon. the Member for Terra Nova.
L. PARROTT: Thank you, Mr. Speaker.
Mr. Speaker, we are tired of explaining to patients and their relatives why they can't get a timely appointment when they need one. Most of all, we are exhausted by the effort to get government to listen and to act.
Think about those words: We are tired of explaining to patients and their relatives why they can't get a timely appointment when they need one. But, most of all, we're exhausted by efforts to get government to listen and act. Not my words, not the words of a constituent, the words of the former president of the NLMA, current Minister of Education and previous minister of Health – his words. Think about that.
We are here today debating a bill that there was lots of time to enact and to work on. The motion we put forward isn't about delaying a bill. I'll quote what the Member for Lake Melville said: We can't afford the delay. I don't disagree that we can't afford the delay, but there is one other thing that we can't afford and that is we cannot afford to get this wrong – we cannot afford to get this wrong.
People in this province are hurting in ways when it comes to our health care that we have overlooked for a long time. We all know that there are efforts going on. I'm not going to stand here and say that this government isn't trying to recruit doctors and nurses, not trying to retain, haven't tried to put in a new initiatives; but the reality of it is that they haven't all worked. Some of them haven't had the time to come to fruition and work. We're not stunned to all of that, and we know that some of it is going to take time. But what I will say is that this isn't an issue that happened in the last three months; this is an issue that has been growing for years and it is probably been growing in the previous administration.
But there has been a seven-year period where we have watched this grow exponentially and I really don't care what anybody else in this building thinks; I'm here to represent the people of this province and certainly my constituents in my riding. What is happening in PEI or British Columbia, Quebec or anywhere else doesn't concern me. While I know it probably has some effect on this, with the drain and other provinces trying to recruit our health care providers, we're on equal footing and we should be looking at that. Right now we have a system that – to quote the nurses – is broken but it's not beyond repair.
So the Premier said this morning as an example when he was talking about building a new hospital, we have a changing dynamic in the metro area so we need a new hospital. I don't disagree. We have a changing dynamic right across this province. But when we have health care centres right across the province closing down because of staffing, we need to realize that there are other areas that we need to focus on.
Let's look at it in this way. We're looking at recruitment, retention and now we're looking at building new infrastructure, we're looking at bringing in new programs, all for health care, and we're looking at eliminating health care boards. There's nobody in this place or in health care that's going to tell you that the elimination of health care boards isn't going to cause a short-term strain on health care.
The individuals that are working in the backrooms, the people that are managing anything from procurement up to front-line health care are going to be concerned about their jobs. It's going to add extra strain and pressure on them that we are not taking into consideration.
We need to find a way to streamline health care. Nobody is arguing that. I believe there are many people in this House who've worked in health care. I have not; I profess that. What I will tell you is I probably spent a lot more time on the other end of a scalpel than most people here have and I've seen the strains that nurses and doctors face. Just last week I was at St. Clare's and I had an appointment with an orthopaedic surgeon. So I said: How's it going? Are you busy? The first thing out of his mouth: The quietest we've been. I said: Why is that? We don't have the nurses to perform surgeries. We cannot do and provide the services we need to provide.
Next question – not to this particular doctor but another doctor who's a friend of mine who happens to be an orthopaedic surgeon – was with regard to hip surgery. He almost laughed, and I kind of sat back and I remembered a doctor I talked to when I had a surgery in London, Ontario and he put it very clear to me about the hip surgeries. He said: Lloyd, hip surgeries, this whole idea of bringing people in and out the same day, there are a whole lot of things that people aren't considering. Now, a lot of people in this room will understand the first thing is it's not a lot of young people who have hip surgeries. Not at all. It's not a lot of skinny people who have hip surgeries. It's not a lot of people who don't have – but it's to do with obesity, age, bone degeneration, people with sleep apnea. All these underlying issues do not allow you to go in and out of the hospital the same day, but our solution to backed-up surgeries is to bring people who need hip surgeries in and out the same day.
Now, if you were to talk to all the orthopaedic surgeons and ask them if they think that's going to expedite the process, they will tell you that the people that live within the metro area, who are very close to the hospital, who are fairly healthy, yes, they can probably do that for them; but the bulk of the patients who require hip replacements, it's not going to happen. And that's not my words. That's coming from doctors.
We need hard, fast solutions and part of that is the recruitment of health care professionals. Again, I'll say we know that they're doing that. Last week I attended a rally with the nurses and the nurses were very clear – 600, that's how many nurses they're short. Think of that. I think the amount of overtime equates to 192 full-time positions. So now you take the 600 they're short plus another 192, that's astronomical.
Listen, we all know that there's going to be troubles to get these people; there's no question. But that should be the focus. The focus should be right now on primary health care. To be very frank, if we talk about the Health Accord and we understand everything that that was trying to say, it specifically speaks about long-term needs. There's no question that the amalgamation of the health care boards is a long-term need. But we also need to be able to communicate.
I can remember my days when I was on the board of directors of Hebron and we had money to give back to charities, one of the initiatives we looked at was a neonatal plan with the Janeway. $1.6 million they were asking for and they were going to get it. They didn't get it because the health boards couldn't communicate with one another. In order for the plan to work, they had to have the technology to communicate to each other.
So now we're going to amalgamate four health care boards and we still don't have the ability to communicate across the province. Nobody is talking about those things. Labrador – I listened to the Member for Lake Melville talk and certainly the Member for Labrador West. Labrador West is my home. My mom lives there. I listen to her all the time. I listen to her talk about health care. And it's not just Labrador, the Northern Peninsula, West Coast, the services are not available, the cost of health care, how do we get people to go to places, how do we get doctors to go to those places – they're big issues.
I can tell you right now a new hospital in St. John's, I agree, will probably bring young doctors who want to come operate in this province, but the amalgamation of four health care boards in amongst all of this, in amongst trying to build a new hospital, in amongst trying to get doctors and nurses and physiotherapists, occupational therapists, while we're trying to get pharmacists to practise within their scope of practice, while we're trying to get occupational therapists and physiotherapists to do the same and nurses, while we're looking at ways to get LPNs more effective, we're going to amalgamate the four health care boards. We've got all the time in the world to do all of that, but I can tell you it's going to create a whole lot of issues. We need to make sure we do it right.
So yesterday when there was a paperless briefing given and the bill was put forward – it's 36 pages, I believe – there's lots on information in there but I don't think there's anybody in this House who can look at that bill and say they think every bit of it's going to work. It's okay to say we're going to go to Committee or, as the Member for Lake Melville said, I agree, we need to go and we've got lots of questions. But why not present the bill the right way? Why not make sure that it's the right bill? Why not not put the fear into the people that are working in health care?
I believe there are a lot of people in this province who believe it's necessary. A lot of those people work inside of health care and a lot of them are inside of government; a lot of them are in this House. But the bill should be a bill that's presented that we know it's going to work, that isn't going to put extra strain on the health care system right now as we're trying to put it through. Because our system right now cannot handle the extra strains.
There is the problem. Every single one of us know – every single one of the people in this House gets a phone call, I'm willing to bet you daily, probably multiple daily, from someone who's had an issue with an appointment, with an ER, who can't get a blood test, who can't get a mammogram, who can't get – and do you know what? Some of us in this House as Members have experienced that, no doubt.
We're moving forward with an administrative function that may or may not help things. If somebody could stand up and say how this is going to change health care – we know what the goal is and we need to do it, there's no question. But we need to do it right and we need to do it during the right time. I don't think anybody on this side of the House is arguing the fact that we need to look at how we can better streamline and manage our health care system. There's no question.
When you look at these boards and their functions, I think if you read through the bill you'll find out that there are still many, many boards and councils and stuff that are going to be involved in how it's all managed. Hopefully, that all works. But the reality of it is we have to have a health care system that's functioning before we look at the administrative processes and how to change them. Because the administrative processes are not the front-line workers that need our help right now.
That is what we need to focus on. We need to focus on our cancer patients and our orthopaedic patients and our diabetic patients and all the people that need to get access to the hospital for immediate care, acute care and long-term care. All the words that we hear all the time about the problems in our health care system.
We can have all the beds in the world; we don't have the nurses to be able to bring people in. We have people lining stretchers in halls in emergency rooms. We've just seen with the mammogram scare. That's not a function of someone doing something wrong, it's people working with what they have. Those are the tools they were given to do the work with. So now here we are backed up on that again.
We need to support our front-line workers in health care before we start worrying about getting rid of four health care boards. I think that there's not one person who works on a front line who would say they don't agree with that.
At the end of the day, management is probably an issue. We have too many layers to manage with regards to health care. There's no question. But at the end of the day, it doesn't matter how much management we have if we don't have the staff to manage.
When you get sick and you have to go to the hospital and you're sitting out in an ER for 12, 14, 16 hours, you're wondering if you're going to get seen; not when you're going to get seen, if you're going to get seen. And it's the same issue everywhere.
Somebody mentioned earlier that diversions are just another word for closures. Well, I don't know if they're another word for closures, but I will say this, the reality of it is when there's a diversion in Bonavista it puts a strain on the hospital in Clarenville that the people in Clarenville can't sustain. It's no different in Grand Falls or Corner Brook or in St. John's. When there are diversions from emergency rooms, the next closest geographic area or larger emergency room with the staff to handle it are the ones that bear the brunt of the pressure. If you go talk to those front-line workers they will tell you that load is getting too heavy for them to carry.
When you have a nurse who works 24 hours and 22 or 20 hours into her schedule there's a serious highway accident and they're bringing patients in and those individuals are left to make decisions that could affect not only the patient's life, but the nurse's life. It's pretty serious, right?
I can tell you, right now, if there's a nurse in an operating room after 20 or 22 hours and they make a bad decision due to fatigue, there's nobody coming to their rescue. There's nobody coming to their rescue. They're going to be left for the rest of their life inside their own minds questioning why they made that decision and how come they were put in that position to start with. I'll tell you why. It's because we're failing them. It's because we haven't got the staff. It's because we've got no choice but to ask them to work 24 hours. It's because we're not listening. It's because we think we've got the best ideas. Sometimes the best ideas come from the people on the ground who know what exactly it is they're dealing with.
The Premier likes to use the word parallel and I agree, not just with health care, with most of the things we do. We need to do them in parallel in order to get the most success, but at a time, right now – again I'll go back – when health care is in shambles, when people can't get in to see a family practitioner, a specialist, can't get an X-ray, can't get blood work.
When you think of it, blood work is the greatest example. I mean, it was not that long ago if you needed blood work you could walk in in the morning and get your blood work within a half hour, 45 minutes. Now, the same process takes three weeks and nobody can explain why. Now, you've got to have an appointment that you may wait two or three weeks to get done.
Those are the things we should be trying to fix. We should be trying to streamline how health care is working, not how the administrative process is worked. It just simply should not be the hugest priority right now.
Again, I'll go back, I know and we all know that government has made efforts but those efforts are not working to the level they need to work. So we need to find greater ways to invest in health care in order to make that work. If something is broken, we need to fix what's broken. It's pretty simple. If you've got a broken window, you replace the window, you don't build a new house and that's exactly what we're trying to do with the health care system. We're not replacing the window. We're not trying to find a way to give people the tools they need in order to succeed.
If it's about money, which I would suggest that a part of this is, then we ought to just say that. If it's about saving money or finding ways to do things more efficiently from a cost standpoint, then we should say we need to do this because of. But nobody's using those words. At the end of the day, instead of putting strains on an already broken system, we should be trying to fix the system and then we can go back and try and fix the strains that are on the system.
We had eight health care authorities not that long ago and we went to four. Now we're going to go to one. I would argue that if you look at the health care authorities in this province, the difference between what happens in Eastern Health, Central Health, Western Health and Labrador-Grenfell are not all similar. I would also say, and I'm not sure – if someone can correct me on this, feel free to go – I believe I'm the only MHA in the province who straddles two different districts. So in my district –
AN HON. MEMBER: (Inaudible.)
L. PARROTT: Okay, the hon. Member for St. Barbe - L'Anse aux Meadows also.
For me, I have Central and Eastern. I'll tell you, it's shocking for me when I call Eastern Health, how – I won't say little help, but the difference in how hard it is to get the responses and the help, than when I call Central Health. It's two entirely different systems.
I could say that would be an argument as to why we should amalgamate, but we should also understand why those systems are so different before we decide to amalgamate. We should understand how the four systems work through consultations. We should look at the Health Accord and understand some of the things they recommended.
I'm looking at the whole idea of the board system. We have health care boards where members don't get paid, but our garbage boards get paid. Think about that. Waste disposal members of our ABCs get paid; the people who sit on our health care boards don't get paid. It makes no sense, makes no sense whatsoever.
Several months ago, we presented a PMR in the House. I remember it very clearly because the hon. Member for St. John's East - Quidi Vidi, the Minister of Children, Seniors and Social Development, stood and he actually presented an amendment to eliminate the word “crisis” from our PMR when we said health care was in crisis. Make no mistake about it, three months ago, four months ago, six months ago, 12 months ago, our health care was in crisis. Now it's probably beyond that point.
The reality is we should be focusing on that crisis and what's causing that crisis. I'll say it again: If somebody can stand in this House and tell me that the four regional health care authorities are the reason that this health care in Newfoundland and Labrador is in crisis, I'd love for someone to stand up and explain that. I don't think they can.
The first quote I said from the current Minister of Education, I said it for a reason. There was a seven-year period where he was the minister of Health. We stood in this House several times and we asked about nursing levels, staffing levels, doctors and family physicians. We heard all the time we've got just about 600 family physicians, there's no nursing shortage and mental health is the best in the country. We heard those words time and time again. We heard it in Question Period, we heard it in PMRs and we heard it every time we've stood and spoke on health care. But now, all of a sudden, we're in a crisis and none of that stuff rings true.
It is so true today that we have nurses leaving en masse. The ones that aren't leaving are asking to go and work from satellite positions – or I guess the correct terminology isn't fly-in, fly out, but they're working for contractors to do work. We've got nurses that don't want to work full-time; they're going into part-time positions. It's because they don't have a work-life balance. That's a big part of it. That's also a big part, as we all know, of why we're having troubles getting doctors.
We need to find a way to fix health care. The biggest way for us to fix health care, again I'll say, is not the combination of the health care boards; it's to find the staff we need in the hospitals, in the family medicine clinics and in smaller clinics in order to make them operate the way they're supposed to operate. Nurses don't want to go to work in ERs because there are no doctors; doctors don't want to go to work in hospitals because there are no nurses. It's just a vicious cycle of the same over and over and over again.
Listen, I've always been a proponent to say metro Newfoundland – urban Newfoundland and rural Newfoundland are two different creatures. Until we recognize the problems we have with geography and our ability to bring people into those areas, and we utilize those areas in order to recruit health care people, we'll never succeed. We can do that.
I remember as a young man I worked as a recruiting officer recruiting doctors into the military – doctors, nurses and pharmacists. We had no troubles getting them because it was solid contracts, schooling was paid for and they knew what they had to do and when it was done. At the end of the day, if we could do that here, perhaps some of them would stick around. Once they're established in a community, most of them won't want to leave.
Anyhow, Mr. Speaker, I'll take my seat. I think there's lots more debate to happen on this bill.
SPEAKER (Warr): Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Mount Pearl - Southlands.
P. LANE: Thank you, Mr. Speaker.
I'm happy to have my first opportunity to speak to Bill 20. Of course, this really comes down to taking all of the existing health care authorities and placing it under one provincial authority. I will say, Mr. Speaker, that unlike yesterday's bill – I think it was 19, if I'm not mistaken – where we, basically, scrapped the English School District and brought it under the Department of Education, I feel better about this one in the sense that the bill we were talking about yesterday, we were basing this decision, or government, I should say – not even all of the government, the Cabinet were basing the decision on some hidden report that none of us could see what the rationale was.
I would say at least with this bill – and that's why I take more comfort, I guess, in potentially supporting this bill, is that this is identified by Health Accord NL. It is a recommendation. I do have respect for Dr. Parfrey and Sister Elizabeth. Nobody could ever argue, I don't think, that they did not consult with stakeholders; they did not consult with the general public. I heard some people even sort of suggested: My God, how much consulting are they going to do? Because I believe they consulted and then they came out with their findings and then they took those findings, they went forward and had more consultations all around the province and consulted on the findings of their first consultation so they could get it right.
They came up with a very comprehensive report and, I would suggest, an unbiased report based on the information, based on their expertise and with complete consultation with all the stakeholders, including the people of Newfoundland and Labrador. Through that process, they have recommended that we should make this move.
So that alone puts me in a much better mind frame, if you will, to support this bill, unlike the bill I didn't support yesterday on the schools because it was based on some secret report that we couldn't even see, even though we paid for it.
I think we all recognize the need to streamline. Obviously what's happening now is not working. When you think about it, you know, you could take the entire population of Newfoundland and Labrador, that's not even a big city on the grander scheme of things, really – a half a million people, it's very small. To have the number of health care authorities that we have, I think one could argue it's probably a top-heavy system, a lot of unnecessary duplication and so on.
That has nothing to do with the front-line services. That's a separate issue in itself, which I'll certainly speak to and my colleague from Terra Nova spoke eloquently to a number of those issues around the front-line services. But certainly from a managerial point of view, I would say, from a systems point of view, and in terms of having consistency throughout the province – because it's supposed to be a universal system, and under a universal system, really, health care in the St. John's metro area should be really no different than the West Coast or Central Newfoundland or Labrador.
Now, we all understand there are going to be geographic challenges, and that's why it's important to have advisors, if you will. I'm not sure if that's the exact term that's used in the legislation here, but to have individuals and advice and management throughout the province that would deal with the unique issues for those areas. While, at the same time, having things under the singular umbrella so that we have consistency right across the board.
Certainly, the concept here where it talked about the IT functions as an example, that makes a whole lot of sense. It really should be one system. How can you operate effectively if you have one system in St. John's, a different system in Central, another system up in Labrador-Grenfell, and perhaps the systems are not even compatible with each other? It just doesn't make sense. Streamlining that and bringing that under the health care authority, again, it makes sense certainly to me to do that.
I think we're a little disappointed, if you will, on this side of the House at least, of the way that this sort of came about and how it seems to be you have it today and you're debating it tomorrow and it's a very comprehensive document and it's certainly something that's going to have potentially a huge impact on the province, the health care of the people in this province.
I think that's why my colleagues in the Official Opposition – I'm certainly not going to speak for them. They're more than capable of speaking for themselves, but I think that's sort of a concern that they have is that there's a feeling that this is kind of being rammed through the House of Assembly as opposed to really having that thorough consultation amongst Members here in the House so that we can all understand the intricacies around, not just this bill, but government's vision of what the system is going to look like and we can all have a better understanding and perhaps even, heaven forbid, some input into that process to make things better.
One of the themes that I have certainly seen during this sitting and perhaps the last sitting as well coming from the Opposition side of the House, I think we've all been fairly united on the fact that what we would really like is to have more consultation, more input. I think that's what the people of Newfoundland and Labrador would like to see, more actual consultation and input as opposed to Cabinet getting together, making all these decisions, drafting legislation and ramming it on through and then you're kind of expected to rubber stamp, to some degree, what they've decided on.
Sometimes I think it's felt over here that you can't give justice to a bill, especially one of this magnitude, by simply saying, okay, we'll go to second reading, a couple of people will speak to this now and then we'll all just vote on it. It'll all go through and you can ask a few questions during Committee and way to go. Something that's going to have such a huge impact on the province.
That doesn't mean we're against it in principle because I'm in favour of it in principle. I think we have to modernize the system and streamline it. Because what's happening right now is just not working.
Now, I would say, Mr. Speaker, I do have a concern around the timing of it, in the sense that, if our current health care system were not in crisis – and I'm not just throwing that word out – crisis – from a political point of view. I'm really not, but I think all Members, regardless of what side of the House you're on, whether you want to call it crisis, we're in trouble, serious deficiencies, concerns, you can call it whatever word, you can use whatever word, you can use whatever adjective you want, but the bottom line is that things are not all well in health care. We all understand that. It is what it is.
For me at least, this is not about a blame game. This didn't happen overnight. I recognize certainly that this is happening across the country, across the world, there are challenges that we are having to compete with. I think some of the decisions, if you were to ask some people – I've spoken to some nurses, for example, and one of the things they said to me was we saw this coming when the government decided to shut down the nursing schools.
Now, I'm not up on all these issues, to be honest, but that's what a few nurses said to me. When we shut down the nursing schools and that, we started limiting the people that would get involved in nursing and the numbers started to go down and down and down. We saw this coming. We knew this was going to happen. We knew it would discourage some people from being nurses, when they shut down the nursing schools and they just went with MUN only.
AN HON. MEMBER: (Inaudible.)
P. LANE: Whether that's the fact or not – and the minister will have his opportunity to speak as well, he says it's not correct. I'm just saying what some nurses have said to me. That, in their view when the nursing studies programs got shut down, the different nursing schools at the General and St. Clare's and whatever, they felt it was going to have a negative impact on nursing and the number of people who would go to nursing schools.
Perhaps it's because it was only a two- to three-year program and now it's at MUN, it's a degree that you have to go for four or five years, whatever it is. Maybe it's more costly, whatever, or took longer to do. So it was something that perhaps was more accessible for people to enter before, now we just went with the MUN system and it may have dissuaded some people from becoming nurses. I don't know, but this is what I was told.
Certainly, we know recruitment of doctors has been an issue. I'm not sure how long it goes back, I'm really not. Although, I've had it brought it to my attention the last two or three years for sure. I will say that I find it very disturbing to hear – and I've told this story before in the House and I've heard from others as well. I had a young fellow, for those who might not have heard it, or maybe, God forbid, you weren't listening, probably not either. A young fellow in Southlands graduated from MUN med school, contacted me from Nova Scotia only a couple months back and said: Mr. Lane, I just wanted to share this with you. I went through MUN medical school, as you know – because I know his family – and over the last two years in MUN med school, I was constantly bombarded, we were constantly lobbied by recruiters from Prince Edward Island, New Brunswick, Nova Scotia and Quebec, in particular, about coming to work when I graduated. He said: Do you know how many people contacted me from Newfoundland, from Eastern Health, Western Health? Zero. Nobody contacted me. Not a soul.
He said: I even took it upon myself a couple of months ago just before I graduated; I called Eastern Health. I called them. I told them who I was, told them I was graduating, told them I was from Newfoundland and told them I wanted to stay in Newfoundland: Do you have any jobs?
Nobody returned my call. I called a second time and said: Listen, I called here and – oh, is that right, nobody called. Okay, I'll get someone to call you. Nobody returned the call the second time.
He told me that his best friend who was in medical school with him – she was a young lady – same thing. She did the same. He said: I can't speak for the other ones. I can tell you that myself, personally, and my best friend, we both made the calls ourselves to the health authorities. Nobody would return our call. We called a second time and nobody would return our call. I picked up the phone, I call the recruiter in Nova Scotia and with 48 hours I was on a plane, put up in a hotel while they're finding me a house and all kinds of incentives and bonuses.
Now, we're only talking about this last group that went through, to which I would say and I have said and I will say again, whoever is or was, because I know you have a new person in place now, but whoever was responsible for recruitment, if that's what was going on, they should be replaced. They weren't doing their job. I don't know who they are, but I'm telling you, there's a big problem there. That's very disturbing when you hear these things.
We have to do better. The point I was trying to make is that if we were in a place where I wasn't getting called on the regular, and all other Members, about the fact that we don't have a family doctor, what am I going to do. 811 is useless, people tell me. I cannot get in a collaborative clinic; been trying for a month to get in a collaborative clinic and no luck there. Go to the walk-in clinic and you have to show up an hour before it opens to stand in line and hope that you're one of the first 15 or 20 people in line. Because if you're not, after standing in line for an hour, you get in and they say I'm sorry, all the appointments are taken up for the day; try again tomorrow. Try telling that to some senior citizen, probably having to stand up in the rain and everything else, so there are issues.
If we didn't have all those issues, if I didn't have people contacting me constantly about having to wait hours and hours and hours on end in an emergency room, whether it be St. Clare's or the Health Sciences, if I wasn't hearing from ambulance drivers – I'm sure we've all heard from them as well – talking about the fact that there's no ambulance on the road – do you know why there's no ambulance on the road, Paul? No, tell me why there's no ambulance on the road. Because when I pick up a patient and I bring them down to the Health Sciences, I can't leave until the nurse or whoever at the emergency, I have to hand that patient over.
I could be stood up there in the hallway for two or three or four hours until a nurse is available – I'm saying a nurse – to hand that patient over to. So here we are now, I'm stood up here next to a stretcher for three or four hours, my buddy is sitting in the ambulance in the parking garage listening to Open Line or whatever I suppose, waiting for me, and there is no ambulance on the road. That's where we get these red alerts.
I know I'm not saying anything here that every Member doesn't know. I realize the Minister of Health knows – he knows that and I have to give him credit. I do have to give him credit. I've done it before; I'll do it again. I will give the man credit. He's trying. I really believe he's trying. He's only been in the portfolio a short time, but I will give credit where credit is due on the initiatives that he's announced, initiative after initiative after initiative. He is listening. I've talked to him personally on some stuff. He has returned my calls and I know he's followed up on stuff, and I do appreciate it. So I'm not dumping on him. I'm not. That's not my intent.
I am not dumping on anybody, really, but the fact of the matter is that the system right now is in a mess. So my bigger concern about this move is not the fact that we're going to do it, because again Health Accord NL is advising us we should do it, but from a timing point of view I wonder if the disruption that this may cause, during a time of crisis, is just going to make things even worse. That is my fear.
Now, maybe we can do this and, at the same time, we can try to address the nursing issue, address the ambulance issue, address all those things and build new hospitals and we can do it all at the same time. Maybe we can. I'm not saying we can't, but I am just saying that is my concern, that's all. My concern is, on top of everything else that we're trying to do, now we're going to start tearing apart the regional health authorities and start bringing this all under one authority. We're going to start shutting down hospital boards; we're going to start restructuring and reorganizing.
And we're doing all that at a time when we don't have primary health care, when we have people that are waiting for months on end for diagnostic and surgical procedures. At a time when the emergency rooms are overflowing and we got hospitals on diversion, we have clinics shut down and we have doctors shutting down their private clinics to work at a collaborative care clinic where they used to be seeing 25 or 30 patients in a day and now they only have to see 15 or 16 under their new contract and people are not getting the care they need.
For me, it is more of a concern about timing than actually doing it. With that said, my time is up but I will be speaking again.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Thank you.
The hon. the Member for Torngat Mountains.
L. EVANS: Thank you, Speaker.
I am really pleased to stand here today to speak on the amendment to Bill 20.
What I really support is “the Bill withdrawn and subject-matter thereof being referred to the Social Services Committee of the House for further study and consultation.” The reason why I am reading that out is because a lot of people in the general public don't really know much about this bill, this act and also what this amendment means.
I was listening earlier to the Member for Lake Melville and he called this amendment a delay tactic. I tell you that was offensive to me and I think it was offensive to the Official Opposition that submitted this amendment as well. Because what a lot of people don't realize is that we actually didn't have much time to review this bill. If it is a delay tactic, it's only allowing to give us time to look at these major changes that are going to be coming about. In actual fact, this legislation is so rushed that this amendment is about giving us time to review it.
Also, the Member for Lake Melville talked about a paperless briefing. But the general public should know that we had a technical briefing on this very, very, very important legislation, where the actual people who were briefing us didn't have the act in front of them. There was no slide deck so we asked was this bill actually ready, was it available, was it finished – we asked that when we were being briefed on it.
Do you know something? The people, the experts that were briefing it, were working off little pieces of paper. They said yes, this bill is ready, it's available, but it was not available to us. There's a technical issue. A delay tactic – this amendment was called a delay tactic by a Member from Labrador.
We all know about Labrador. Everybody in this House on this side that wants a better health care system talks about the vulnerability of Labrador, the difficulty in Labrador, the different regions, the culture, the ethnicity, the geography, the transportation. So, to me, it was really even hard to speak about.
AN HON. MEMBER: (Inaudible.)
L. EVANS: Exactly, a delay tactic.
The general population should know that your elected Members of this House of Assembly didn't even have time to really read through the act, let alone digest it, let alone be able to actually question some of the decisions, these changes that are going to impact the health care system.
We look at the health care system. We look at all the poor nurses out there that are doing their best to keep people alive, to make sure that people are safe and taken care of. Looking at the poor doctors that are working overtime. There's a mass exodus from the health care system because of chronic burnout, yet they don't have the common decency to even brief us properly.
So I say, you know something, I stand with the Official Opposition on this – I stand with you. This is actually something that will give us time to look at it, because something this major – and I have to tell you I was there and I was saying we're going to write stuff down because I'm so upset that I'm going to forget the important things that I want to say.
What I want to say is that, in actual fact, this legislation is so rushed; we got the bill yesterday afternoon. So why I support this amendment – because I'm questioning myself now, the briefing, the fact that we got the bill yesterday. Was that a lack of preparation on this government's part to deliver this bill? Was it a lack of preparation? We just got to look at the gender pay equity legislation: no consultation, rushed in the act, no bones to it. Oh, don't worry about that. We're going to consult after the legislation has actually passed and then we're going to put it in the regulations. But the regulations don't come to the House of Assembly. We, as Members, don't get a chance to question it, you know, and the thing is there's so much bias. There's so much influence that can happen that actually could derail everything.
So was it a lack of preparation, it was so rushed that we didn't get a chance to really look at it or was it a meant to shut us out? And I tell you this actual amendment is helping us keep from being shut out because we want a good piece of legislation because our doctors and our nurses and our health care providers deserve that.
When I actually heard about our vulnerable people in the nursing homes being ridiculed, shamelessly ridiculed by professional people in our health care system, the first thing I thought of was burnout. Burnout so that people would actually think it's okay to make fun of our vulnerable people. People are trapped in their own bodies that can't look after themselves. One of those people is younger than most of the people I play hockey with. I play hockey with the men and they were older than that person that was suffering from a chronic disease and he couldn't actually defend himself. His wife, who was so upset that these pictures were taken, said she wasn't sure if he actually knew what was going on. In the back of her mind she was hoping that he didn't.
That's what happens when you burn out your medical staff, when you burn out your supports. And this is so important. I don't know if I can actually use a quantifier here that's accepted in the House of Assembly, but this legislation is supposed to actually help us. An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority, that's going to, basically, determine the outcomes of our health care system.
So I've got to say, I'm supporting this amendment, talking about relevance. So where are we? So where are we now? We need time to read this bill, because we were elected to represent our districts. We were elected to serve on behalf of, actually, the overall province to make sure that the changes are positive.
I'm supporting this amendment, Speaker, because I want to figure out is this about the Health Accord and the recommendations or is this about the Greene report, which is about cutting and saving money. We don't know who's going to benefit from saving the money out of the Greene report.
Where are we? The Greene report versus the Health Accord. One of the things I'm always careful about is making sure they're not cherry-picking from the Health Accord to satisfy the recommendations out of the Greene report, because in actual fact we're going to be in a bigger mess than we already are. That's why I support this amendment.
Another thing I want to bring up while I'm speaking on this amendment, the pressure on us over here. Because in actual fact, the general population don't realize there's pressure on us not to speak out. We have to be really careful. I've been told we have to be really careful when we're speaking about the Health Accord because there are positive things in here. There are things that look at the overall systems that impact our health. So we have to be careful.
So if we want to be careful and make sure that the intent of the Health Accord is met, then we would like to be able to digest this act that's going to actually impact our health care.
There are a lot of people, like in my district; people don't even really know how to protest. That's one thing I realized. Because it's not in our culture to be doing such behaviours. But at the end of the day, our people need help. Our people need help basically because our people are dying. People are dying from cancer that could've been saved if they were diagnosed earlier. People are dying from cancer – if they got the proper treatment when they were supposed to get the treatment.
In actual fact, I learned after the fact that in Nain there was a lady who was actually diagnosed with cancer and she was doing her treatment and she got bumped off the plane. The schedevac, we call it, she got bumped off the schedevac twice going to Goose Bay. Can you imagine the impacts on that?
I'm supporting this amendment, I really am. I'm going to take my time here because I have another 10 minutes. I'm going to use it.
It's very, very important for us not to criticize without knowing. Because we're told that if you criticize something and later it's found out there are more details there, that in actual fact it was a positive, that's the only thing they're going to focus on. They're not going to focus on the 99 things that are actually derailing our health care system, the inefficiencies.
Also, I'd just like to mention again about the Member for Topsail, when he was talking about the legislation dealing with the schools, bringing the English school board into government. He said that he fell victim to wanting more, expecting more. I'm going to be quoting him all the time on that now, because in actual fact, we want more, we expect more of this legislation. You know, the people in this province deserve more.
So we're all very concerned about the state of our health care. We're not standing up here against positive changes to the health care, but the problem is we don't know if these are positive. We don't know if this is going to be improvements or actually make it worse, because there's a lack of trust. When legislation comes forward and they're saying, oh, don't worry about that, we're going to put that in the regulations. We didn't have time to consult. We threw this together. That's actually happened, I know that, we seen it, we witnessed it. Like I said, it's smoke and mirrors.
Everybody who talks about the health care systems know about Labrador. In Labrador, we don't actually even have our own health authority. We never ever had our own health authority. We actually shares the health authority with the Northern Peninsula. Our ICU for Labrador is on the Northern Peninsula of the Island.
The only problem I ever had with this Health Accord, that I really took exception to, was one provincial health authority. I actually wanted Labrador to have its own authority so we could actually stop having our people die of diseases that could have been treated if they were properly diagnosed and actually properly looked after. To me, it's very, very important for us to be able to look at this legislation.
Actually, there are probably about four regions in Labrador that are very, very unique. We have Western Labrador. We have the North Coast, totally isolated. We have Central Labrador, which is a mixture. Then we have the South Coast. I have to tell you, every time that air ambulance for Labrador is not flying, there are people that are very vulnerable that suffer. Sometimes people die. That's why we'd like to have our own health authority.
One thing I always talk about is, when I go into the hospital in Happy Valley-Goose Bay and I go in through emerg, I look at all the signs. There's a sign there that says ICU. I follow the coloured tape down to the ICU and I look on the wall there and it says ICU. But during COVID it became very, very clear to people in the province and especially people in Labrador that there's no real official ICU unit in Labrador, anywhere in Labrador – no official ICU unit.
So, for me, I want Labrador to have its own health authority. I want there to be a Western, a Central and Eastern, because, at the end of the day, no one is going to stand up for Labrador. This legislation that I can see actually does not ensure that Labrador is going to have a voice, that there's going to be effective advocacy to make sure that our people are not dying, that our cancer patients can actually get to their treatment.
This is not a criticism of the nurses and doctors, or even the administrative staff in Labrador-Grenfell Health. There's been a lot of times when I had to call them and they try and work with me, but you work within your limitations.
Speaker, there's a lack of time for us to digest it. On the amendment here, the paper that I was given, I wrote here: Do the right thing. Send it back to Committee so we can have a proper look at it, so there can be proper consultations, so when we're discussing this bill we will know if this will improve or hinder our health care system. Will this help our overworked nurses? Will this help with the doctor shortages? Will it help with all our patients who are stuck in the hallways waiting for a bed, on a gurney waiting to be seen? For us, this is not right.
I'm going to clue up. I was talking to my fellow MHA here for Labrador West and one of the things we talked about was all the vacancies in Labrador-Grenfell Health. There are 237 vacancies in Labrador-Grenfell Health right now. For me, we are probably at the bottom of the list to fill those vacancies. We are having tremendous hardships, but, at the end of the day, we got to make sure our people are safe and we got to make sure that the health care system is improved on. So I fully support this amendment.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Bonavista.
C. PARDY: Thank you for your kind words, Mr. Speaker.
SPEAKER: Yes, you're kindly welcome.
SOME HON. MEMBERS: Hear, hear!
C. PARDY: Thank you.
It's always a pleasure to stand and to talk today on such an important bill, it being the health bill. Just a few words on that.
We have watching in Elliston today – and I know I've done this a few times now, but I know that we have 64-year-old Scott Martin and Pam Fleming who are watching from Elliston. He's a retired fisherman and he watched the fishery discussion that we had yesterday on the fishery panel. I must say we had a conversation this morning, when we had talked and he was going to be watching the House today.
Today was a different day then what it was yesterday and I'm sure we probably have something more to talk about at that time. But I'm sure Scott Martin and Pam Fleming are going to be wondering what this bill will do for them? That's a good starting point. What does the bill do for them?
I think my hon. Member for Torngat Mountains had stated that the feeling was that it was not enough time being given to make sure we thoroughly debate and digest what the bill contains in the number of pages that it does. The number of pages, I think, is probably 36, if my memory is correct. I know that this is a foundation document consolidating four boards into one, but it's very important that we do get that correct.
How important is health care to Bonavista? Another watching now is a friend to the Speaker's and that's Eliza Swyers in Bonavista. Eliza has been an advocate for health care for some time in the Bonavista area. I want to tell you something that's unique, and the minister is well aware of it, I think he has corresponded to a group in Bonavista, who between 12 o'clock and 1 o'clock every day of the week, seven days of the week, they line up on both sides of the road, on Hospital Road, and they are there as a rally in support of quality health care in the District of Bonavista. It is not a protest, but they are there to support health care and to make sure that the system that we have in Bonavista and area, supports the residents of the area.
Just a couple of points. I think the group acknowledges that it's not easy. I think everyone here would acknowledge that this is not easy; it's not an easy task. The only thing we would know is that we'd like to critique a plan. What would the plan be for the District of Bonavista? Today, we're looking at what would the plan be for the province?
This bill that we have before us is providing the foundation for our system, one provincial authority and the powers that they will have and who, ultimately, holds the power.
So this group in Bonavista, which would be about 20 people who line the roads each day, they would like to have more information as to where we're headed in health care, not only the province, but, in particular, the District of Bonavista. About 10 people on each side of the road. They hold signs in support of health care. Cars pass between them and they blow their horn – very supportive because everyone has a vested interest in health care.
Sometimes in a group we'll hear that we know that government departments and different departments need to make sure that they communicate with each other. We need to make sure that we're all as one. So when this health authority – and we're moving four, which other speakers have said that the four different authorities didn't really communicate with each other and they operated in their own silos. So now we're going to bring them all together and we'll bring them together in one. But when we bring them together and the parameters that we bring them together, we've got to make sure that this is the right foundation for the system. That's why the Member for Torngat has said we don't want to rush this. We want to make sure that we're doing it right.
In Question Period today, the Minister of Municipal and Provincial Affairs, she had answered a question and when she was asked about regionalization, which regionalization is going to affect a lot of people, but her answer was we want to make sure it's – I think she referenced that we want to make sure that the plan is right, unappropriated and non-estimated, I think she had used those words, but before it was rolled out wanted to make sure that it was going to meet the desired goals of which it was intended for.
Who can take exception to that? We've got a lot of LSDs in the District of Bonavista, but who can take exception to that. There comes a point in time, if we're looking at it in '25 and she's still doing it, that's an issue, but we're doing it. We're talking about it right now in '22. So I would commend that joint working group, the work they're done, and it's still being analyzed because maybe the minister and her team doesn't have full confidence in what it is and they want to roll it out to be the right decision. Kudos.
So I would do that and say that when we look at this legislation that we've got here, Bill 20, I would say nothing wrong with pausing, make sure we've got it done, done right, but done as best we could to build a foundation on that the Health Accord speaks to.
Does it now? I'm not sure if it does. That's what the importance of the debate is. Does it do it? If we take things hastily, sometimes we don't get the product that we do. Again, I just celebrated the minister in doing that.
When Scott Martin and Pam Fleming – look, they're going to want to know and I think they'd be comforted to know that get it right. That doesn't mean that we can't change the system and do some short-term changes, which I think the minister has been credited to doing some good initiatives. Great, go ahead and do some good initiatives, but make sure that building block that we're going to build on is correct and is the right one.
There are a couple of systems – we look at a system now that we've got collaborative clinics. Bonavista is destined for a collaborative clinic. Nobody in Bonavista has any problem, to my knowledge, with a collaborative clinic. I would think that when we look at Bonavista, it probably would be a priority area.
If the government now is creating collaborative clinics but they are only in rural areas, then I would beg to ask: Why not put one in a rural area? If you're not going to pilot one right now or roll one out in a rural area, why not? If there's a reason why you're not going to roll out a collaborative clinic because you may not be able to obtain doctors to go in that, then we've got some missing ingredients in parts of that foundation that we need to work on. I know that within Bill 20 we're talking about a provincial recruitment and retention plan, so we know that work is ongoing, but there's your plan.
I mentioned in this House on two previous occasions, and I mentioned it on the Health Accord, some sessions that we've had with Dr. Parfrey and Sister Davis. We turn out 60 medical practitioners from a world-class medical school at MUN. I don't use world class loosely, because I really do think it's world class that we send them out.
My suggestion on two times when I stood in this House, and on some speaking engagements that I've had in my district, I would like to see some agreement where we have some family medical students that would move out, but would move into some of these rural areas for a family practice, maybe for a period of two years. With good debate some might say five years, four years or three. I would say two would be respectful of them within that short time frame coming out of school that they would have to serve. Maybe we would get collaborative clinics if we had three ones going out incentivized to do so, but part of their agreement and service duty would be that they would serve in rural Newfoundland for two years.
I know that may create a revolving door to start, but I would think that you're going to have 5 to 10 per cent of them or even more, once they discover an area which they're practising in they're going to opt to say I want to remain. Now we have some building blocks in place where we can build on into the future.
I don't where that's gone, I don't know if it's being considered, but I would think we're going to have to put in something into a system to make sure that we have the quality of care in our rural areas. Even in our urban areas at this time here.
We've also mentioned there's nowhere spelled out in Bill 20 which talks about daycare facilities within our institutions. I presented a petition for Bonavista that if we have space in our health care facility, with a lot of currently young personnel within the health system who struggle to get daycare, why couldn't we be creative right now to put in a daycare facility within one of the buildings and structures that we have currently in Bonavista.
It was mentioned now with the new St. Clare's that would be built that the vision would be that we're going to have a daycare centre. Kudos, I think it's good. I think schools that have space ought to have them now. Schools in the future, large schools, ought to have them as part of new builds. It should happen. But why now can't we take the initiative to put a daycare in an existing facility like in Bonavista hospital?
There are also conversations that we'd have on our line on Hospital Road that would talk about the blood services that are being offered. We have people who are trying to get blood services and access that know that prepandemic, they could get blood work in 20 minutes. Now you have to make an appointment and you'd be lucky to get it within two weeks. Now, you may be slightly below two weeks.
So one could ask, when we look at operationalizing a system that we're struggling with to serve the residents of Newfoundland and Labrador, why such a difference between 20 minutes before a pandemic to currently you are lucky if you get an appointment within two weeks? That's a fair question – operationalizing the system.
A couple of other points to make. In the bill, one question I'm sure many people would ask is that when we have trustees, the number of trustees that they would have – again, the trustees will be appointed by Cabinet; three-year term with a possibility of another three-year term. One thing I've always wondered is that I know that if you appoint a committee, in my experiences in education, it was the committee that selected the chair. But I notice that in the Schools Act, and in this act, it is not the committee that selects the chair; it is the minister or the Cabinet.
I would say, if you look at the research and the most productive chair that would be for a group, research would tell you that it is from the membership of the committee that they would select the one that will chair the proceedings. Well, I think that's research but, more often than not, we'll have the chair selected by the minister or the Cabinet.
When we met with the Health Accord – and we met with them four or five times, I would think, in the session and they did, again, commendable work. But one thing I had mentioned – and I often quoted data from the Quality of Care NL. I think that's Dr. Parfrey's – I think that was his baby. That is what he championed. Because he had said: How do you know exactly where you're going to go and how are you going to get there if you haven't got good directions or good data in how to find your way there?
If you're going to change the system, it's going to be through good data that you change the system. I think he's a hundred per cent correct. You need to know what you need to adjust. You might say sometimes it's obvious, but good data will influence change. I think that when you address issues you'll know which ones need to be addressed because of good data.
You can correct me if I'm wrong in this but I know that in the Health Accord he had stated that he thought that the Quality of Care NL ought to be at arm's length from government. He thought that's how important the data was. Don't fudge the data, don't do anything with the data that might be misleading or might be a little bit not as forward as what it should be. I don't know what Dr. Parfrey would say about Bill 20, because I don't see that in Bill 20 where he would say that it's at arm's length. It is not at arm's length, it is fully under Cabinet and the minister.
He also stated that when you do report, you report to the House of Assembly. I don't see that in this bill either. Why present to the House of Assembly? Well, I would think we ought to have meaningful debates. If we had time to prepare for something and we had good topics that were presented, we ought, on behalf of our districts, to have good debates on bills that are presented in this House.
So I would say Dr. Parfrey and his Health Accord envisioned it being independent and arm's length from politics and government – and that doesn't mean Liberal, it doesn't mean PC, it doesn't mean NDP; arm's length from government to make sure the data is correct and is unstained. I would agree with that. That would have been my vote if I was asked to vote at the briefings that we had. I concur wholeheartedly, but Bill 20 doesn't have that.
Maybe at some point in time someone can speak to that. It would be great to hear from Dr. Parfrey because I think he'd champion that. I know the minister in his preamble thanked David Diamond for his input, and I'm sure he's thankful of Sister Davis and Dr. Parfrey, but it'd be nice for the minister at some point in time to address that issue, why it didn't make it from the Accord and why it didn't make it to Bill 20. Why didn't that make it to Bill 20?
If we took a vote in the House of Assembly and say if you want good, accurate data, unbiased and you had an independent or if you had it presented by government, that sometimes you couldn't see it, because it's not going to come to the House of Assembly according to Bill 20, even though it was stated in the Health Accord that you would. I would say most people would say, let's have it transparent. Let's have it come to the House of Assembly and let's make sure it's at arm's length of any political group that we've got.
Ageism was another one that Sister Davis had talked about and do you know what? I even spoke to it when they were there and when we had the briefing. If we, in this province, walk through the Miller Centre and you walk through the Janeway hospital and you look at those two domains, you'll find that there are very stark, distinct differences between the Miller Centre and the Janeway.
The Janeway is what we would aspire to have. I would say the care that we've got for those that are most senior at the Miller Centre is brutally substandard. I think that under that umbrella of ageism, some people could use that as an example.
Speaker, I know my time is getting short. I appreciate the opportunity and I look forward to another opportunity.
Thank you.
SPEAKER: The hon. the Member for Humber - Bay of Islands.
E. JOYCE: Thank you, Mr. Speaker.
I am going to stand and have a few words on this Bill 20 because it's going to affect everybody in the Province of Newfoundland and Labrador. Every constituent that we're elected for will be affected by this bill.
I'm going to start out and say at the briefing this wasn't even available. So when you want to have a comprehensive discussion at a briefing and not have information available, it's tough. More so tough, how can you say that you want input into the bill when you can't have a discussion and ask the proper questions on it? It's a situation which you wonder why – why are we rushing this through? It's very sad. I'm just going to read through one part of this, Mr. Speaker.
We're all elected in this House – and I just want to let the people of Newfoundland and Labrador know, I'm just going to read one part of this bill, it's “The Lieutenant Governor may make regulations,” which we haven't seen. I'm just going to read out some of the regulations that they're going to make after this bill is approved. I'm just going to read some out: “(a) defining 'health and community services' for the purpose of paragraph 2(f); (b) defining 'health service provider' for the purpose of paragraph 2(g); (c) respecting the appointment of trustees to the board;” – these are all the regulations – “(d) prescribing the number of trustees to be appointed ….”
We don't even know how many trustees are going to be appointed. This here is all part of the regulations. “(e) respecting the manner in which health and community services are provided by the authority; (f) prescribing other responsibilities for the purpose of paragraph 20(1)(e); (g) prohibiting the charging of fees for the purposes of paragraph 21(1)(d) ….”
We don't even know what the fee is, but it's all going to be put in regulations. Later on, we'll find out later on. This is the bill that's going to affect every person in this Province of Newfoundland and Labrador and we're asked now to stand up and talk about this.
I'll just keep going “(j) respecting accounts and other financial records …; (k) establish health regions ….” Here's the one “(n) prescribing other duties of the quality council for the purpose of paragraph 36(1)(f) ….”
You go back, I know it's cumbersome but I think people will get the idea when I'm finished: 36(1) “The quality council shall (a) provide written reports to the minister regarding the quality and performance of the health system ….” That's 36(1)(a).
When you go to 38(1) “… (a) provide information to the quality council, when requested, to allow the quality council to carry out its duties and responsibilities ….” Here's the problem with all that, when you look at the regulations in the next one: “(p) prescribing the form and manner of a report for the purpose of paragraph” 38(1) and 38(1) as I just said “… provide information to the quality council ….”
In the regulations it's going to say the minister will tell you how to prescribe that report. That struck me. When I went through this bill, that struck me, do you know why? Cataract surgeries. There's a wait-list one out in Corner Brook right now that the Department of Health and the minister won't accept. There now they're putting in a bill, we're going to tell you how to give us the report. They're going to tell you how to give us the report. We're going to prescribe to you how to put the report in.
Fool me once, Mr. Speaker, but now there's a report that I know the minister is well aware of now. I'm confident the Minister of Health and Community Services is well aware that there's a report in Corner Brook, over 800 people on that wait-list and they still refuse to accept that report. You want me to stand up and to go through this bill and let the minister tell them how they want the report given to them instead of the facts. That is proof to me that they want something coming in, everything rosy and flowery and everything all good. Just that alone in the regulations that we have no input into.
And I ask the minister and I'll give the minister the opportunity – he has it confirmed that there is a wait-list of 800 people and still not being done. In St. John's, when there was 3,000 given, one thing he is forgetting to tell people and – then it was to get rid of the wait-list, but not for Western Newfoundland. The minister went publicly and said, oh, we needed to balance it out because one health care private clinic has this many and St. John's only got this many.
The minor detail that the minister forgot to put in there – and this is so disturbing for the people of Western Newfoundland and this is why it is hard to support this – is that there are five surgeons doing cataract surgery – four or five, I think it is five – in the hospital in St. John's. It is not even included.
So when he stands up and goes out publicly and says I just want to balance it out, there are three surgeons in one clinic in Corner Brook; there are two clinics now in St. John's and there are four or five other surgeons doing cataract surgeries at the hospitals in St. John's that he is not even including. And I have to support this? It is hard.
The other thing I said to the minister on this cataract surgery thing: Where is the wait-list? Show us the wait-list. They never even took up the province on getting the funds to put an intake officer to establish a wait-list. You don't even know if there is a wait-list. Yet, you get 3,000 surgeries while a lot of seniors – and I heard the Member for Bonavista talking about people watching from his district. I can tell you there are 800 or 900 from Western Newfoundland who would love to be able to watch, but they can't see it. It is sad. It is absolutely sad. Now we're going to take this bill and give more authority to the minister in St. John's.
I can go through it, how many people – and, Mr. Speaker, you know about the cataracts. I don't meant to put you on the spot but there are people calling me from your district. They're calling me from L'Anse au Clair, down that way. They're calling me from the Straits. They're calling me from the Member's district down in St. Anthony. People are calling and can't get their surgery done. Calling from the Premier's district. Calling from the Member for Corner Brook's district, the Member for St. George's - Humber's district. You can't get it done.
Yet, St. John's, boom, strike of the pen. Because the former minister of Health and Community Services was saying, oh no, we have to go through the Newfoundland and Labrador Medical Association; we can't do that. All of a sudden, 'snappo,' 3,000 to get rid of the wait-list in St. John's, if there is a wait-list, because there are at least seven, eight surgeons in St. John's doing that, if there isn't a wait-list. And then now all of a sudden Corner Brook, West Coast – not just Corner Brook, West Coast. No, that's fine. Don't worry about that. You want me now to accept this bill where I know there's a report there that will show that's there are at least 800 people not even on the wait-list that go within the 112 days.
It's very easy to get the information. I did a lot of research on this. I say to the minister, straighten this out. For the minister to go public and say there are 96 per cent of the people in Western Newfoundland who had their consult within the 112 days, it's just – I have to put it on the record – absolutely categorically false. It's just false, and the minister knows it's false.
I remember years ago when someone made a false statement, it was a big deal. But now you make a false statement and you get all the information showing it's wrong, you should correct it. I'm asking the minister to correct it.
I just want it explained, because I did a lot of research on this for these people. If I'm wrong, the minister can stand and I'll sit down and let the minister take my time and explain if I'm wrong. When the minister went public and said, for the 112 days, 96 per cent were within the 112 days. That's what he said, the national average, 112 days, the benchmark.
What they took, what the Department of Health got information – I don't know where they got it from, what they did, there were surgeries. They were doing surgeries for two months. He said, okay, within that two months, 96 per cent were done within that two months, the people. That's true, but he's forgetting about the people who were in the consult before and never got done after. That's just like saying, Mr. Speaker, there are 50 people in that House of Assembly here. Right now, this minute, there are 40 people in this House. Now we confirmed there are 40 in the House all day. Half of us might be gone out for meetings or other things; that don't mean there are 40 in the House the whole day.
So if you want to take one little snippet of time and say they're all within that wait-list, you may be right. But when you go from the referral to the consult, it's absolutely false. When I went through that and knew what regulations we are going to put through, and seeing it there, the minister can prescribe how to get the report and what's in the report – and I already know there's one report that they won't even look at because they're seniors.
I heard the Member for Torngat Mountains talking about how people up in her district, it's not in their nature to protest. How they won't come together and protest, it's not their nature. I ask anybody in this House, try to get seniors with cataract surgery needed, get them out on the street – try it. They're the silent, suffering majority. I absolutely refuse to let false information get out and make those people suffer more.
It may never be done, but I'll guarantee you I'll hold the elected politicians accountable. I'll do whatever I can to raise the issue, whenever I can.
I give the opportunity again – the minister is sitting in his seat, the Minister of Health and Community Services. Anything that I said here now – I have eight minutes left; I'll sit down and let you correct it. That's how confident I am. Every bit of information I brought about this 800, 900 people is 100 per cent correct. I even offered the minister the number to phone to get the information, which he has. I even offered to give him the number in St. John's for the information, which he can get, which I got.
I could offer him the number of how many surgeries are being done. He has it; he doesn't need it. So this is why I have a problem with Bill 20. I look at the hospital in Corner Brook. People are talking about the hospital in Corner Brook. I know the group, through access to information, I know back – when was it – in 2018, 2019, the PET scanner was always supposed to be included. It was taken out and no one knew. The PET scanner is gone. What is it, $2 million now put in a trust fund? Laundry services – all was supposed to in; it is taken out.
During the election in 2021, oh no, it's in there. It's all taken care of. The laundry services are in there; it's not taken out. I can show you documentation where the government said it's not taken out; it's in there. It was gone, a year and a half before that, gone, out, done.
So this idea of saying trust me. Here's a bill here right now and you're going to turn around and say trust me on the regulations, when I know how many people are out there suffering right now.
Another thing to the minister that I brought up on a regular basis, and hopefully he's going to make a decision on it soon, is the nurse practitioners. I got an email from someone today who had to pay $50 and wants to know how he can get reimbursed, a senior. A senior wants to know how he can get reimbursed for going to see a nurse practitioner. So simple to do. It's easy to do, but we're not doing it.
For some reason it's easy to go out and say we're going to build a building. I'm not talking about – lots of time to talk about that, but I can tell you when a senior can't see a doctor, he has an appointment for a nurse practitioner and all of a sudden he gets dinged with a $50, $75 bill and we're saying there's nothing we can do, when there is something we can do. There is definitely something that we can do.
That's the kind of thing that we can do immediately to help out people in the province; help out the emergency rooms in Newfoundland and Labrador. These aren't hard. I don't mean to be picking – I look at some places like Whitbourne, prime example. I don't mean to be picking on Whitbourne, but if they could find a nurse practitioner to help out in Whitbourne, that's going to take the pressure off. Then have the nurse practitioners be able to go ahead and bill MCP. That would take the pressure off that area.
That's a great opportunity. That's the kind of things we should be doing. This is a bill that's going to bring in all the health authorities, put the control right under the minister, 100 per cent under the minister. Yet, there's nothing in this bill that's going to help anybody – any resident of Newfoundland and Labrador in the short term.
When you turn around and say oh trust me on this, this is what we have to do. If you go through the bill there are all the different issues that hasn't been resolved. If you want to talk about a bill that's being rushed through, the most important thing in the Province of Newfoundland and Labrador right now is health care, and we're rushing this through. We're rushing it through.
This here is something that we should take our time and this is what this amendment is about, Mr. Speaker. This amendment is saying why don't we slow it down, put it through a Committee. I know the former minister said that it's going to take a nice while to get this done. I know the former minister said it's going to – so why not send it out to a Committee so we can go out and have some hearings on it? This is so important for that.
I know –
P. LANE: I'd like to know what Dr. Parfrey has to say about it.
E. JOYCE: The Member for Southlands wants to know what Dr. Parfrey got to say about it.
I think we all met with Sister Davis and Dr. Parfrey and had a great discussion and offered some input into it. There are a lot of issues here that we can hash through, but if we rush through it, we're going to make mistakes. If we don't get the proper information, we're going to make mistakes.
What if we make a mistake in here, 40 of us make a mistake and we say, my God, we missed that. Who's going to suffer? It's the people who need the services.
I've been fortunate, I've been healthy, but I see a lot of people who go to emergency, older people, who have to wait hours upon hours upon hours. I see a lot of people who try to get a nurse practitioner; you have to wait two, three, four weeks. I see people with cataracts who could get cataract surgery started this year to get done, just not done for whatever reason.
I go back to cataracts because when I read this bill, more and more it says to me the minister is going to take control. More and more, when I go back – and I know a lot of those people, especially in Curling, Corner Brook, Bay of Islands; the Corner Brook area I know a lot also and in the Curling area there's cataract surgery; a lot from the Premier's own district. He won't even meet with them – the Premier wouldn't even meet with them.
So when I look at this – and I revert to the cataract surgery, which is a passion of mine to try to get resolved – I've yet to find a reasonable excuse why it can't be done.
I heard the Minister of Finance the other day out talking about the great surplus. That's fine, that's great, but I'll ask the Minister of Finance – and this has nothing to do with her, but only as a Minister of the Crown – you think people who need cataract surgery are jumping in their seat because there's a surplus when we can make a stroke of the pen, which the Minister of Health did here for St. John's; 3,000 new cases for two private clinics in St. John's. When he can make a stroke of a pen, get it done but won't do it for Western Newfoundland, for some reason just won't do it and this is all Western Newfoundland.
This is why I say to the government there are a lot of things that you can do to help out people, there are a lot of things that you're not doing to help out people and this here happens to be one. When you want to consolidate – and I'll look at the group that's out in Corner Brook now and I'll give you a good example. I hope that it won't be gone when the boards come together. I'll give you a good example.
For years in Western Newfoundland you couldn't get a recruitment set up – couldn't get, they were never even contacted. I know two, never contacted for four years. Couldn't get a call returned. But I can tell you right now there are two new people, one in particular, in Western Newfoundland right now doing recruitment and they're doing a good job. They're finding out their locals from Newfoundland and Labrador. They're finding out the locals that are in the medical school from Western Newfoundland and they're in contact.
If the boards come together, are they going to stay in place or is it going to be one central board here in St. John's and then they'll decide where the recruitment office goes? Because I can tell you, in the last little while the recruitment for Western Newfoundland, I have to give those people credit, give the management credit in Western Newfoundland; they are out hunting for people. They're courting people, asking them what they want to try to get them to stay. They are doing a great job. If this goes through will that be diminished?
My time is up and I thank you very much.
SPEAKER (Trimper): Thank you.
I next recognize the Member for St. John's Centre.
J. DINN: Thank you, Speaker.
Speaker, I'll start by saying that I take the Health Accord NL seriously and I think that this legislation and it are intertwined. I take it seriously because we know the system is not working for people in this province the way it should be.
We know that what the Health Accord proposes, Speaker, is this is a long-term fix. This legislation is about that step, about making a decision that's going to affect really generations to come, which is important that we get it right. I do support this amendment to basically suspend the debate and send it to the Social Services Committee for further review.
In effect, there are two reports out there and for this reason. There are two reports out there that recommend some sort of a centralization or an amalgamation of the health authorities: the Health Accord and PERT. They're two visions. The question I have to ask then with regards to this piece of legislation is: Which vision is being put forward that's going to guide this health care system for the next five to 10 years as it undergoes its transformation, hopefully, for generations to come for my children, for my grandchildren, that there's going to be a health care system here that will meet their needs? So, to me, it's a significant piece of legislation.
Because on one hand, you've got the PERT which basically looks at that amalgamation from the point of view of cost efficiency and finding efficiencies, and the Health Accord which basically looks at we've got to make a health care system that's more responsive, that's better for people. One is about budget; one is about people, I would argue.
So will delaying this bill negatively impact the health care system? Will sending it to a committee basically delay the process, making –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
J. DINN: Thank you.
Will it make it better? I don't think so, probably not. But will it make for better legislation, Speaker? Definitely. Let's not act in haste.
I would argue then, not only that, let's take it back to the Health Accord, let's take it back and do what the Health Accord did, which is basically do the consultation, come up with a report and go back to the people and find out did we get it right. I think, in many ways, that's what we need to be doing with this legislation: Did we get it right?
My colleague from Torngat Mountains has already referenced the technical briefing. That has to be one of the worst when the people who were present did not have the legislation or the notes in front of them, a day before – less than 24 hours before.
I do believe that, for any legislation to be effective, you have to be informed on both sides and certainly be able to make informed comments where you can. I don't think it's helpful then that we have this the day before and then not the full amount, and it's only after we complained that we get the legislation itself – unacceptable. I don't know what the reason is. If it s a lack of personnel to do the writing, I'm not sure, but somehow that's got to be addressed. Especially for a piece of legislation that has many moving parts, it's technical and it's not as simple as it looks.
It can't be that simplistic because, in the end, we're going to affect the people of this province for generations to come, we may not fix the health care system the way we want it to be fixed and we're going to impact the lives of the people who are working in that system. The other question I would ask and why I think delaying it makes sense, the question I have got to ask is: Do we need it? Do we need to have this legislation in place, passed today or this week, to put the other pieces in effect? Because the Health Accord, in particular, identified other priorities that were the key pieces and I think that these are the priorities, Speaker, that we can work on.
It spoke about the need for, if anything else, the big money items, if we need to fix it, are the ambulance system, the data management system, virtual emergency centres, community teams, the centres for excellence for senior care in Central, Western and to update it in St. John's and the care to children who are at risk. These are all things, Speaker, that can be done while we're trying to look at the governance structure of the health care system that can be sent back; we can deal with these.
If I may – maybe we are putting the cart before the horse a little here. But it is an interesting statistic, Speaker. As of August 15, there were over 23,000 people who had applied for or registered for a collaborative team clinic. From what we have here, the total patients who are attached to a collaborative team clinics, as of August 15, is somewhere around 2,876. My point is this, let's get our priorities straight, let's focus on the aspects of the Health Accord that are essential to, in the short term, making this system work, let's pause this debate on the governance structure on the health authority and let's make sure we get it right.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
It is just a little noisy in the room. If we could just have a little more quiet.
Thank you.
J. DINN: Otherwise, we're not going to –
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
J. DINN: Otherwise, we're not going to fix the system, it's going to cost us more and people are going to be disadvantaged again.
With that, I will support this amendment. I think it's prudent. If anything else, a sober second thought. Let's do it right. I would hope, though, that if it goes back, Speaker, that it's not a simple case of formality of where we send it back to the committee and we come back with the same legislation.
Prove me wrong as a cynic, please.
Thank you.
SPEAKER: Thank you.
The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
Mr. Speaker, I move that the House do now recess until 6 p.m.
SPEAKER: This is not a debatable motion. This House stands in recess until 6 p.m., 1800 hours.
The House resumed at 6 p.m.
SPEAKER (Bennett): Order, please!
Are the House Leaders ready?
The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
I call from the Order Paper second reading of Bill 20.
SPEAKER: Again, I remind Members we’re speaking to the amendment.
The hon. the Member for Labrador West.
J. BROWN: Thank you, Mr. Speaker.
In light of the email letter I just received, and the House Leaders just received, from the Office of the Privacy Commissioner, an Officer of this House, given the light that this is actually in violation of ATIPPA, potentially in violation of ATIPPA, I ask that this House suspend debate on this and review what has been sent by the Privacy Commissioner, because this is not good.
ATIPPA was controversial stuff in itself; just ask the Member for Mount Pearl - Southlands about that debate and all the people who actually fought for the ability to find access and information and stuff like this. So why are we considering to debate this and now we have this from the Privacy Commissioner. It’s telling us that we’re in violation of this and that we shouldn’t actually – so why don’t we just take this, suspend this, and find out what is correct and actually properly take this back to a Committee, bring in the Privacy Commissioner who seems to be slighted by the government?
Why don’t we just take this, end debate now, vote on an amendment to take this back to a Committee and do this. Like I said, Speaker, you were informed of this. We were all informed of this, prior to this now and we’re still here debating this.
So clearly there’s something wrong. There’s something that needs to be corrected. Why aren’t we correcting it? Because this isn’t right. This is something that’s going to change the entire fabric of health care. And I’m not saying I’m opposed to the idea that we have to move and change and all that stuff, but there was no consultation. We had no consultation. We had little to no briefing on this and now we’re expected to just push this through.
Unfortunately, I have a lot of questions about this and I think a lot of people in Labrador have a lot of questions on this, because we’ve been burned many times before, especially in the centralization of services. Just look at the English School District, if anyone got burned in the amalgamation of the school boards, I think Labrador got burned the most. We lost Labrador-based programs. We lost support and we lost a lot of our identity when it comes to education when they amalgamated the school boards.
I don’t want Labrador to get burned again when it comes to the amalgamation of health boards, because even in the system we have now, it’s a struggle. The last thing we want is Labradorians’ voices to get muffled out even more than it currently is right now with government.
I have 261 vacancies in Labrador-Grenfell Health when it comes to health care professionals, support staff, everything like that. That’s a small town in Labrador of vacancies. They’re expecting that if we amalgamate the boards together, we go from having an actual entire system that actually is based to serve Labrador and the Northern Peninsula to being muffled into a larger system.
Yes, they’re going to talk about their health committees, the regional health committees, but even the wording in this it’s just an advisory committee. That’s only as good as it’s written on paper. Because that’s all it is, is you’re going to advise. It doesn’t mean they’re going to take your advice. They have no obligation to take the advice. Once again, who’s going to get burned? Labradorians. That’s what actually happened.
This is why we’re very cautious when it comes to these changes. I’ve seen it time and time and time again where my people are an afterthought. Just look at the Medical Transportation Assistance Program. That is the most convoluted thing to ever exist. I have not seen anything else in government where you require such an amount of resources for one individual, a sick individual, and all the hoops they have to jump through just to get a thousand bucks.
What it actually does is it is costing people more to seek medical help after they’ve applied for MTAP. It’s the most convoluted and, another thing is, discriminatory thing that government’s ever come up with when it comes to health care.
Then they expect me to quietly go oh, yeah, this is great. No, I’m going to question it and I want to question it, but I should have, as a Member of this House, privilege to actually be given enough time to go through this before it’s brought to the floor, to actually have a fulsome technical briefing on what is actually being asked of us.
We’re going to make some huge changes and I’m just expected to accept it. But do you know what? After hearing from Michael Harvey and after hearing from what’s going on, this is clearly a massive mistake that needs to be pulled back and try to do something actually positive. We talk about collaboration and we talk about this. Make it the actual meaning of collaboration. Make it meaningful. Make it actually come across and say, we hear your concerns. We hear your things, because you should.
Anyone that actually wants meaningful change in this province, especially when it comes to health care, should understand where we’re coming from. As a person that has seen what I think is some of the worst of what health care is like right now, indulge me. Do this. Do the right thing.
Only a week ago, I had a constituent who reached out to me, after waiting two weeks in a hospital bed after a massive heart attack to even get medevaced to St. John’s – and he did eventually but when he got there, the cardiologist found more trouble and told the gentleman he’s lucky to be alive. And now he’s on his way to Ottawa for massive heart surgery.
When it comes to Labrador health care, it’s delicate. There has to be i’s dotted, t’s crossed and make sure you’re implementing the correct thing because we’re expecting better. The hopes of Labradorians, after a lot of these consultations and stuff with the Health Accord, they were expecting better. They’re expecting something that actually was fulsome. They would actually have a voice. They would actually have some actual input into the delivery into a unique place.
It’s not like delivering health care anywhere else in this province, other than when it comes to Labrador-Grenfell. It’s a unique place with a different culture, with a different way of doing things, with a different opinion, a different thing. It’s a very unique place. The idea that we can’t actually have a say, have an actual review of what’s actually going on, that myself and my colleague from Torngat Mountains, we actually don’t have the ability to be properly consulted on what’s going to change – it’s not just like a small change. It’s not just a temporary change. This is the entirety of the delivery of health care and then you take on the challenges of Labrador-Grenfell.
At the end of the day, what is really important is, why do we have to be treated this way? Why can’t we have a fulsome explanation of what this meant? What was the thought process on such a delivery system? Aren’t we all in this together? Aren’t we supposed to be doing a collective good? But to have such a very lacking consultation process of a huge bill – a massive piece of legislation – and this is how we’re there. Because this is, in my opinion, very disrespectful to the people of Labrador.
Like I said, I have 261 vacant positions, as a small Labrador town. One was over 100 days to see a psychiatrist. Here’s a good example. I had to bring my daughter down with me for an allergy test, something that normally was done in Labrador. It’s such a routine test, and I had to bring my daughter to St. John’s because it’s the only way I can get it done for her – basic services.
For the first time apparently, I’m told, in a long time in Labrador West, we have lost both our respiratory therapists. We do not have a respiratory therapist in Labrador West. I’m told there’s actually not one in Happy Valley-Goose Bay at this time either. They just quit. So what does that have to say about everything that’s going on? Even though there is some glimmer of hope in the future of health care in the province, they’re still quitting. They’re just packing their bags and moving on.
So, in the whole theory of it, why was this done the way it was? Why was there no thought on a wholesome explanation? A wholesome, thoughtful approach of cross-floor collaboration on this is what we’re doing.
Those are my thoughts in a nutshell on what this. I think it is time to call it what it is, pull this debate, listen to the Privacy Commissioner, listen to all the other things, regroup, try this again and actually listen to us and the other people that actually have expert opinions on this. Maybe we can actually deliver the true spirit of the Health Accord and what those people wanted and thought was right, because there are some good stuff in there, and actually deliver on what we all want to deliver on, which is proper health care for the people of this province. That includes everybody. Not just metro, not just Central, but all the regions of this province and the diversity of this province. It is not a one-size-fits-all solution.
There has to be some differences and some actual input from different regions, and not just advice but true wholesome, meaningful input from different regions of this province. Just having one Labradorian sit on the board doesn’t make it inclusive. It doesn’t make it right, just having that one figurehead. It needs to be actually meaningful; it actually has to be with purpose and with compassion. Because this is it. We want the best for everybody, but we also have to make it meaningful and actually do what it is supposed to do.
Without any of that compassion, we’re just destined for failure again and that is the long and the short of it. If you don’t put the resources in, you’re not going to get what you want on the other end.
Thank you, Speaker.
SPEAKER: Seeing no other speakers, all those in favour of the amendment?
SOME HON. MEMBERS: Aye.
SPEAKER: All those against the amendment?
SOME HON. MEMBERS: Nay.
SPEAKER: The amendment is defeated.
We will go back to the main motion.
AN HON. MEMBER: Division.
SPEAKER: Sorry, Division has been called.
Call in the Members, please.
Division
SPEAKER: Are the House Leaders ready?
S. CROCKER: Yes.
SPEAKER: All those in favour of the motion, please rise.
CLERK (Hawley George): Barry Petten, Helen Conway Ottenheimer, Paul Dinn, Lloyd Parrott, Tony Wakeham, Jeff Dwyer, Pleaman Forsey, Loyola O’Driscoll, Craig Pardy, Chris Tibbs, James Dinn, Jordan Brown, Lela Evans, Paul Lane.
SPEAKER: All those against the amendment, please rise.
CLERK: Steve Crocker, Lisa Dempster, John Haggie, Gerry Byrne, Bernard Davis, Tom Osborne, Siobhan Coady, Pam Parsons, Elvis Loveless, Krista Lynn Howell, Andrew Parsons, Sarah Stoodley, Derrick Bragg, John Abbott, Brian Warr, Perry Trimper, Paul Pike, Sherry Gambin-Walsh, Scott Reid, Lucy Stoyles.
Speaker, the ayes: 14; the nays: 20.
SPEAKER: Thank you.
I declare the amendment defeated.
On motion, amendment defeated.
SPEAKER: Back to the main motion.
The hon. the Member for Mount Pearl - Southlands.
P. LANE: Thank you, Mr. Speaker.
I’m glad to have the opportunity to rise in this House of Assembly and speak to this very important piece of legislation again. Obviously, it is of critical importance to the people of Newfoundland and Labrador. As I said the last time I spoke, as other Members have said I think on both sides of the House, we’ve been bombarded with phone calls, emails, messages, you name it, from people who have serious concerns about our health care system; people who do not have a family doctor; people who are waiting for hours on end in emergencies; people who have hospitals and clinics in their area that are shutdown or on diversion on a regular basis; people on the West Coast who do have a nurse practitioner, but are not covered by MCP; people who are waiting on ambulances and the list goes on and on and on.
This is a very, very serious matter. I would say this is the most serious matter facing our province right now. This is number one. I’ve had a number of constituents who have reached out to me and said, Paul, b’y, I want to say first of all that I thank you for raising a number of issues in the House of Assembly and in the media and so on, important issues to people and we really appreciate it, but, please, the number one focus now has to be health care. And I absolutely couldn’t agree more.
That’s why this piece of legislation is critical because it’s going to, in many ways, change the direction of health care. Now, many people would argue the direction needs to be changed and we’ve heard it talked about before, the concept of bringing health care under one roof, under one health care authority. This was recommended, as I said earlier, by the Health Accord NL, Dr. Parfrey and Sister Elizabeth, after doing significant consultation and reaching out to all the stakeholders. Even after they did the consultation, they came back with a: this is what we heard, did we get it right?
So I do have confidence in the fact, as I said earlier, that they feel that this move to bring everything under one health care authority is the right move. I’m supportive of that. I’m supportive of it. Again, I’m not going to speak for my colleagues over here because they’re more than able to speak for themselves, I can assure you, but I’ve got a feeling that they’re not against that concept either. I don’t think they’re against that concept.
But what we have concerns about, and what I’ve heard here all night, is the concerns around the process by which this legislation has come before the House of Assembly, in terms of not having enough notice, not having proper briefing with the legislation.
Now, I’m listening to my learned colleague here from Bonavista and he raised a very good point. He raised a lot of good points, but he raised a good point there tonight about this legislation. There was a number of things that he raised that triggered more questions in my mind, perhaps that I didn’t have until he raised them.
Because it’s not until you go down through this legislation line by line that you really start to realize that there are a number of concerns and there are a number of grey areas that exist. The big one that my colleague from Bonavista raised was this whole concept that Sister Elizabeth and Dr. Parfrey said about having an arm’s-length group that would be advising, that would be preparing the data, if you will, and supplying the data so that the best decisions could be made. In their consultations, that’s what they recommended. But this is going to put it right back to the minister and the Cabinet.
So that’s a major one to me. Not something I picked up on right away, because, again, there’s so much in this bill, but that’s a big one. There are many other concerns.
Now, that was bad enough. But just before we closed down for supper, I happened to check my phone – what's this here? I see an email from our Privacy Commissioner, Michael Harvey. What’s this all about? It's addressed to myself, the Government House Leader, the Opposition House Leader, Third Party House Leader and the Member for Humber - Bay of Islands. This is coming from our Privacy Commissioner and I am saying, what could be in this letter that we’re getting here now, because it was addressing this bill tonight.
For Members who don’t know, maybe Members particularly in the backbench – I don’t know if this has been shared with you or not, but this is a letter and I opened this up at 4:45 this evening. This is a bill before this House of Assembly, right now, that's going to dictate the direction that we go with health care for years into the future, that's going to impact the health of Newfoundlanders and Labradorians for years to come and, at the 19th hour here, I’m getting an email from the Privacy Commissioner.
So I open it up. What does it say? I am going to tell you, Mr. Speaker. Our Privacy Commissioner says, Today, November 2, I wrote to Minister of Health and Community Services, copied to the Speaker, the Clerk of the House of Assembly, the clerk of Executive Council, and the deputy minister of Health and Community Services to express my concern – this is not Paul Lane's concern; this is our Privacy Commissioner here now – that the introduction of this bill in the House of Assembly has resulted in – get this – a violation of section 112(1) of ATIPPA, 2015.
Our Privacy Commissioner is telling us, right now, that the introduction of this bill, right here tonight, is a violation of legislation. We are actually violating legislation right now. That's what he's telling us. An independent Officer of the House – I’m not making it up; I can provide copies to every Member.
Why are we in violation? Because he says, “… as no meaningful consultation occurred prior to notice being given to introduce this Bill into the House, a Bill which does indeed contain implications for the protection of privacy in this Province.”
And everybody will agree that when it comes to health care matters, your private medical information, there are significant implications when it comes to access to information and protection of privacy. I would say nowhere in any other jurisdiction of government and any other legislation and any other aspect of government would people have, perhaps, more concern about their privacy than when it comes to their personal health and that's what he points out here.
He says: “Indeed a copy of the Bill was never forwarded to this Office ….” So here we are with this bill that’s going to have major implications on our health care system into the future for years to come, major implications on privacy, and you never even bothered to share it with the Privacy Commissioner. He hasn’t seen it – he hasn’t seen it. We’re here debating it and he’s emailing me and telling me he hasn’t seen it and obviously he is concerned.
He doesn’t just say, not only was it not forwarded to this office, he said, it “was never forwarded to this Office, despite our requests for same.” So he actually asked for the legislation. It’s not like it was an oversight. He asked for it, and nobody gave him a copy of the bill to look at.
“The only consultation that occurred was a brief, high-level verbal overview, which happened well after notice of the Bill was given to the House. In response to our requests to receive the Bill, we received only further offers of verbal discussion, which was meaningless if we did not have access to the Bill’s specific provisions, and under no circumstances would we say that we have been consulted on a Bill that we haven’t seen.” Now, that sounds familiar. That sounds like the bill yesterday, the education one and the report that informed that decision, another major decision. A report that we never even seen but vote for it anyway.
Now we’re going to change our health care system, permanently, in a major way, implications for privacy and we know we’ve had privacy issues within the Department of Health, that is for sure and certain. The Privacy Commissioner, not only did you not share the bill with him, but he asked for it and you didn’t give it to him. Yet, we’re here debating it, apparently, illegally, according to the Privacy Commissioner, against the legislation.
He goes on to say: “Having been denied the opportunity for informed dialogue with the Minister’s officials on the contents of this Bill prior to it being made public today, the purpose of my letter to you, further to my legislative mandate as a statutory officer of the House and in accordance with section 112(3) of ATIPPA 2015,is to directly provide you with our comments. These comments are preliminary in nature, and to some degree are questions which may or may not have been able to be addressed by the Department had we had the usual and statutorily mandated” – that’s an important point: usual and statutorily mandated – “opportunity to consult on the Bill. Normally the considerations we raise would have been provided directly to the Minister’s officials, who would then consider them and decide whether to amend the draft accordingly in order to mitigate any potential negative impacts of a draft bill on access to information or protection of privacy. If there were significant matters relating to access or privacy that we deemed to be still unaddressed through that consultation, this Office has the right, under section 112(3), to comment publicly once the Bill has been made public. Under the circumstances, I felt it was important to provide you with these comments in order to inform debate and public discourse on this Bill.
“The requirement for consultation under section 112 has been a productive process that I address each year in my Annual Report, and it has resulted in a number of improvements to draft bills over the years. It has been an opportunity for cooperative dialogue between my Office and Government that has served the people of this province well since ATIPPA, 2015 came into force. This is the first time in seven years that a Bill with obvious access or privacy implications has been introduced at second reading without a draft having been provided to this Office for consultation.” First time in seven years, Mr. Speaker. You wonder why there was an amendment, if there was a need for an amendment. They didn’t even know it at the time; none of us did. We know it now.
“I am particularly dismayed about that given the significance of the Bill before the House.” He ought to be dismayed, because this is probably the most significant piece of legislation that we will debate during this term of office, I would suggest.
“Based on our limited opportunity for review, there are three primary areas where we feel there may be cause for questions and concern, and potentially some opportunity for improvement in the Bill:
“1) The term ‘learning health system,’ how it is used in the Bill, and its implications: 2(j) ‘learning health system’ means the health system where science, education, informatics, incentives, and culture are applied for continuous improvement, innovation and equity.’ All we know is that under section 19 the Authority has to ‘(l) establish a learning health system’ and under section 36(1) the Quality Council shall ‘(d) provide leadership for the learning health system.’”
Then it goes on to say: “But what is a learning health system? The definition is so broad, it could be almost anything. It’s not clear what this provision actually enables. Does the term ‘learning’ imply integration with the education system, or does it mean something else? Does it involve new collection, use and disclosure of information? Who will have access to such data, and for what purposes? This provision is wide open as it stands right now, and it is virtually impossible to discern the meaning or intent behind it from the limited definition of it in the statute. Furthermore, while the Minister’s regulation-making authorities in the Bill are quite broad, this concept is not included among the many topics identified.”
So there’s one. He then talks about social determinants of health: “under section 2(s) ‘social determinants of health means the conditions in which people are born, grow, live, work and age.’ We know that in accordance with section 19(2)(m) the Authority shall ‘in conjunction with the minister, develop a framework for connecting the social determinants of health with the health system at the provincial level.’ Furthermore, we know that under section 32(1)(c) ‘A regional health council shall engage with social and health networks in its health region that are established to influence health and health outcomes.’ Again, this is extremely broad. Operationally, it could mean … every aspect of our citizens’ interaction with government, education, health and other public bodies from birth to death. We have no idea what this information will be used for, who will have access to it, etc. Will teachers in the school system be able to access student health records? If so, for what purpose, and with what limitations? Will they be able to access sensitive health information that has no bearing on a student’s learning? We simply don’t know. Furthermore, there are once again no specific provisions for regulations that could more specifically set out the intent and the guard rails around this provision.”
His third point that he makes without even seeing the legislation: “The roles, governance and appointment of the regional health councils and the quality council: Are these intended to be separate public bodies subject to ATIPPA, 2015? Are they intended to be custodians of personal health information subject to the Personal Health Information Act? Given the way that these boards are appointed, will their decision-making process regarding the collection, use or disclosure of personal information or personal health information be sufficiently independent from political influence? We think these are important considerations.”
He goes on to say that: “The organizational restructuring of our health care system is one of the most significant public policy considerations of our time. Even though the Health Accord discussed and made recommendations around some of these issues, it was unknown until now whether these particular aspects would be made law, and most importantly, how they would be made law. The specific provisions of this Bill do not, unfortunately tell us very much about what is intended here” – now here is an important one – “and unless there are significant amendments, it is my view that the Bill is far too vague about those intentions, to the point that this Bill could result in significant negative impacts on the privacy of citizens of this Province.” Let me repeat, “… it is my view that the Bill is far too vague about those intentions, to the point that this Bill could result in significant negative impacts on the privacy of citizens of this Province.
“By rushing this process at the last, most crucial stage, which is legislative drafting, privacy consultations, and debate in the House, Government runs the risk of taking good intentions and implementing them in such a way that could cause unnecessary harm to the public.
“Under the circumstances, we have had no opportunity to do a detailed comparison between this Bill and existing provincial statutes, and no opportunity to do a jurisdictional comparison to see if similar provisions exist in other provinces or territories. We have only had the bill for a few hours, in fact, at the time of writing of this letter. We therefore hope that these comments are of some value to you as members of the legislature as you carry out your duties on behalf of the Province in debating the provisions of this Bill.”
Really. I can assure the Privacy Commissioner, as one Member of this House of Assembly, that these comments are of great value to me and they are of great concern to me. I am sure they are of great concern to all my colleagues on this side of the House and I would hope that they should be of great concern to all Members on both sides of the House.
This process is flawed. When we came here today, we knew this was a flawed process. We knew it and that is why the Official Opposition put in the amendment that they did and that is why we all support it over here because we knew it was a flawed process.
Do we agree with the premise of one health care authority? Again, I’ll speak for myself, I do and I do trust the judgment of Sister Elizabeth and Dr. Parfrey and the work they have done and the consultation they have done; I think it probably is a good idea. But do I support this piece of legislation, as written, given the comments I’ve heard here tonight, given some of the significant concerns my colleague from Bonavista raised and now, on top of that, given the concerns raised by the Privacy Commissioner that we’re actually in breach of the act and he has serious concerns for the privacy of people of Newfoundland and Labrador on an ongoing basis?
I can tell the Members opposite that based on that, here is one Member, unfortunately, while I may agree with the premise, once again, I will not be supporting this bill.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Grand Falls-Windsor - Buchans
C. TIBBS: Thank you very much, Mr. Speaker.
I’ll take a couple of minutes to speak to this as well. The first thing I want to say is a big thank you to, of course, all the health care workers who work in the province, especially out my way in Grand Falls-Windsor – Buchans, but also across the province.
SOME HON. MEMBERS: Hear, hear!
C. TIBBS: Whether it be nurses, RTs, doctors, support staff, paramedics, I mean they put it on the line every single day and we’re so lucky to have them. We want to create an environment for them which is comfortable once again, because the days of health care workers working to the bone is gone and it should be. It should be. That balance in lifestyle needs to be implemented and needs to be constantly thought about whenever we do any sort of legislation or whenever we try to fix the health care crisis that we see today. That needs to be kept in mind. That’ll show the respect and the admiration that we have for our health care workers to let them know that we recognize your life balance is important to you, it’s important to us and I think that we need to carry that forward with us.
This afternoon we had a Member stand up and say that what we were doing was a stall tactic and do you know what? We took offence to it at the time because what one Member would see as a stall tactic, we see as due diligence. That is exactly what we are doing here today, tomorrow, however long it takes, is due diligence to ensure, like the Member for Mount Pearl - Southlands said, the most important piece of legislation that we are putting forward is done right – it’s done right.
The same Member, of course, said that – and by the way, I respect the Member, I do – but he said, you know, it’s important that we don’t stall it, we don’t hang it up sort of thing, but it’s important we get it right. The Member for Terra Nova said it earlier on as well. We can’t wait, but I would sooner wait and get it right than anything at all.
Speaker, as I grew up as a boy, and I teach it to my two sons now, if you’re wrong, if you make a mistake, you are courageous for standing on your feet and saying, I was wrong. I made a mistake. Let’s regroup. Let’s revisit.
I think that’s something that government needs to do after today and there’s nothing wrong with it. You know what, maybe we did rush it and maybe it wasn’t given the proper due diligence. We know now it wasn’t. I mean let’s be honest, we know now that it truly wasn’t.
So instead of ramming it through – and I get it, they want the best for the province too, they truly do, but you need to take a step back sometimes and say, whoa, let’s regroup and ensure that this is done right. We know now that it was rushed. An hour and a half ago, you could say that it was subjective, but right now we know that it was rushed by what we just heard from the Member for Mount Pearl - Southlands there.
The Member for Bonavista talked about meaningful debate. When I got elected in 2019 I was somewhat naïve, just like every person that comes in here for the first time, about politics. I truly believed in the greater good and I still believe in the greater good. I truly believe that 40 Members can come in here and we can have a meaningful debate. Instead of standing your ground, I would have absolute admiration for somebody to stand up – and I pray it’s me one day, I do. I may see government one day and I would be honoured to stand up and say, you know what? I made a mistake. I’d like to take a second look at this, talk to some Members, talk to people in the community and revisit it once again.
As I thank the professional health care workers throughout our community, I also need to thank and recognize the Minister of Health and Community Services. When he took on his new role, I believe a couple of days afterwards he got an email from me or a phone call actually. He called me back within an hour as a request to meet with him in his new role to talk about the things in my district. He said whenever you’re ready and I thought that was pretty fantastic at the time. We sat down; we had a 20-minute chat, so I want to thank him for that. I do believe in him.
SOME HON. MEMBERS: Hear, hear!
C. TIBBS: I do.
I believe that minister has been around long enough where he has the gumption and he has the courage to also say, you know what, let’s take this and take a step back once again and see what we’re looking at. Because we want the best for all of our families. I want the best for my sons. I want the best for my grandkids one day. This piece of legislation is going to be in stone for quite some time and I mean at 36, 37 pages in one bill.
We’ve sat here with one bill and one page and debated it for three days. The helmets on Side By Sides; we were days and days and days. Helmets on Side by Sides; we debated that amongst each other. It was a great debate, it truly was. We’re expected to swallow this in one afternoon? It can’t happen, it’s not due diligence and we’d be doing a disservice to the stakeholders of this province.
We have two stakeholder groups that are the most important when it comes to this bill: patients and health care workers. I applaud the bureaucracy, I applaud the backroom managers, but at the end of the day the two stakeholders that we need to respect and keep in our minds whenever we are debating these bills and debating the possibility of putting them forward or revisiting them again – the two stakeholders are the patients throughout the province, which are the citizens and the health care workers. We owe it to them.
This might be the greatest thing that we are putting forward. I hope it is. I truly hope it is. I’m not here to oppose for the sake of opposing. You know what; I’ve heard it quite a bit. I have.
In my opinion, I would have liked to have seen this come out – and, again, you can call it being new to politics, but I would have liked to see this come out so I can take this back to my district and sit down with the health care workers there and go through some of it and see what inputs they may have. That would’ve been the process for me. Let us have a couple of weeks to bring it back to my district, talk to those stakeholders which I just talked about, the citizens, the patients, the health care workers. Go through it with them. That’s my job as an MHA; go through it with them so that they can have input. That doesn’t look that great. Can we get some more clarification about this? Then come back and debate it. Then we would have a fulsome debate with the experts that know because those experts are on the ground. There’s not an expert in this House of Assembly right now, I guarantee you.
Over the summer, Speaker, I conducted my own consultations with a lot of my health care workers throughout months and months and months. Myself, my CA and a couple of other people got together and we did our own little report. I will present that to government one day – I will. I will table that. That’s what I heard from doctors, nurses and RTs out my way. It was a good debate; it was good meetings I had. I learned a lot and I was very thankful that they could come over and talk to me about it.
The other thing I would’ve liked to have seen is for this to be sent back to the Health Accord that we put so much faith into and so we should. For Dr. Pat Parfrey and Sister Elizabeth Davis to give up so much of their time and put together a package and a report to put us on the right path for a better tomorrow when it comes to health care. I would’ve liked to have gotten their take on it. We put so much confidence in their opinions and their expertise, which we absolutely should. We owe them a debt of gratitude. I would have liked to have seen what they had said to that.
But it’s mind-blowing and absolutely ridiculous to think that this can be pushed through in one afternoon, two afternoons, a week. It’s not feasible. It just isn’t. This is not a slight against government by no means. It’s just not feasible. I wouldn’t be able to do it. In all good conscience, I wouldn’t be able to vote for something that I don’t know what I’m voting for. I think that’s the biggest thing here.
We’re not knocking this bill by no means. I’m not, because I don’t know everything in it. I think there’s a lot there that needs to be dissected. We look forward to dissecting it and I hope that we can. Again, without having the proper time, I can’t do it.
But you know what I would like to see in a bill someday, and this is one thing that I’d heard this summer. I would like to see somewhere in a bill like this a section where health care workers can speak with impunity, can speak their minds. You wouldn’t believe how many health care workers I sat down with this summer who felt as though they couldn’t speak their minds because they were afraid of repercussion or punishment. That’s not right. The health care workers are the ones we need to hear from, whether it be good, bad or ugly. We need to hear from our health care workers because those are the workers on the ground and we need to ensure that we create the environment, once again, for them.
We talk about being arm’s-length from government. I lost track of how many times I’ve seen the word “minister” throughout this bill. Upon the minister’s implementation – what else do we have here? The minister shall, in conjunction. If we’re going at arm’s length from government, which is what’s been called for through the Health Accord, then again, it’s something that should be in the bill and it’s something that I would like to see in that bill as well.
Part 2, when we talk about this bill, it appears to create or provide regional representation to delivery of health care; however, the terms of reference will be defined in regulations. I don’t know how many times we’ve heard that. Again, maybe that’s the way it has been done for some time now, but when we hear that, we have to be a little bit skeptical. We do because it almost seems like to me – and I could be wrong – it’s a bit of an out. It will be determined in regulations. Well, let’s sit down and figure that out now. Let’s sit down and figure out what is going to be determined in regulations.
We have heard it, same thing once again with the helmets on the Side By Sides, in regulations. Unfortunately, it’s not something that we can buy. It’s not something that I can go along with without reading deeper into the bill.
In Grand Falls-Windsor, the diversions – and I have heard it a couple times from a couple of people – the diversion is what is absolutely stressing the Grand Falls-Windsor hospital right now.
Over the summer, I made a visit more than once to the emergency room in Grand Falls-Windsor. I went down and I talked with the staff that were down there. I wanted to see for myself, and I encourage everybody to do the same. I’m sure most of you probably have, but I wanted to see for myself exactly what they were talking about on the ground, how it looked, as practical as it was. You hear about it over and over again, you hear the doctors, you hear the nurses, but I wanted to see it for myself. It was absolutely shocking to see. They were completely overrun.
We had diversions, you know, of course, from Baie Verte and I know it is something that needs to be done because we want the best health care for everybody across the province. But, unfortunately, what’s happening in Grand Falls-Windsor is people are showing up to the ER, they see the lineup, they see the wait, they see how many people are in the hallways on stretchers and they leave. Some of these people could have diagnoses that need to be brought to light as soon as possible or sooner rather than later.
People have to be getting misdiagnosed or undiagnosed; it has to be happening. Unfortunately, they get turned away or most recently I have heard from people who say I can’t get a doctor, obviously, 811 doesn’t work for them. I’ll tell them myself, well, do you know what? If all else fails, the emergency room is the backup and that is what everybody is being told. They immediately say, no, I’m not going to the emergency room because I don’t have 12 hours to sit down and wait. So they’re not even going down anymore to take a look at the emergency rooms; it’s a default now, I’m not going there because I don’t want to sit down and wait.
Again, what is in here that addresses that problem and the other problems that I have talked about in particular? I don’t know. We are unsure. You know, 24 hours or whatever it was is not enough time to dissect 37 pages of a bill. It’s just not enough.
So it may not be fair to us and that’s a fact, and to the Opposition Members, but it is especially not fair to those two stakeholders: the patients and the health care workers throughout our province. They depend on us in here to make those right decisions, Again, I know I have said it 10 times throughout this last 15 minutes, this might be it. This might be the saving grace for Newfoundland and Labrador health care and I hope to God it is. I hope to God it’s a good start to get us to where we need to be, a better tomorrow, where, if you have cancer here in Newfoundland and Labrador, you know that the supports are going to be there to take care of you. But, unfortunately, we don’t know.
So how can we, in good conscience, vote on a bill? I can’t imagine that everybody on the other side have had a chance to dissect it, go through it thoroughly. How can anybody whether you’re here, over there, or here, how can anybody vote in good conscience on this bill, either way, if you don’t know what it involves? I think that’s exactly what we were getting at. I think that’s what the amendment was for, to take it back.
Can we afford to wait another year? Heck no, of course, we can’t. Can we afford to wait 12 weeks, eight weeks, four weeks to really go through this? I don’t think we have any other choice.
I think that’s our biggest point that we’ve been debating now since 10 o’clock this morning, is that we need a little bit more time. I applaud the government for trying to do their best to ensure that health care is put in the right direction. I know a lot of people have the heart that they want to put into it for their own constituents. You guys hear it over there, just as we do over here. But without due diligence, without the proper consultations and without really diving into this and dissecting it, there’s not one person here in good conscience can vote in favour of this bill right now the way it is.
I’m not kidding, I’ll say this, if there’s more time and we can sit down and dissect it, go through it in our districts possibly, bring it back then have a fulsome debate, a real debate of back and forth. Yes, that looks good, maybe we can change that, maybe we can change this sort of thing, by God I’d be the first one to vote for it. I really would. If we can find some common ground here and we know that it’s going to help the people of the province tomorrow, it’s going to help my two sons, 15 and 17 years old, I want to keep them here. I do, I want to keep my two boys here with me.
If they move away, I don’t know what I’d do. I really want to keep them here. But in order to keep them here, we need the proper infrastructure and health care that they need, that they’re going to need as they get older, as we get older. I want to ensure that that’s there.
So when we hold up this bill and we take a look at it, we got it yesterday and the proper time was not given, again I can’t imagine voting for this bill. It’s not because I don’t want to because I do. I truly do. It’s the biggest problem right now in Newfoundland and Labrador, it is. It’s on everybody’s mind.
So, again, I applaud the work that was put into it, but we need more work put into it. We need the due diligence to ensure that it’s going to work for Newfoundland and Labrador.
We cannot afford to make a mistake right now when it comes to this. Because what’s going to happen is the bill is going to go forward, it’s going to get worked on and it’s going to be talked about for years. Well, we passed that back in 2022, back on November 2, 2022, how much more can we add to it? How much more could we possibly take away from it? How much more could we amend to ensure that it works for Newfoundlanders and Labradorians moving forward?
That’s who I look out for. That’s why I got into politics, was for my two sons and so many people like them who I want to keep right here, and I know you do, too. I would love to see this province at 600,000 people one day between immigration and birth rates. It would make my day. But in order to do that we need to ensure that the proper bills are in place to pass to ensure our health care is better for tomorrow.
So I’m going to take the time to look over this. Whether this passes today, tomorrow, next week, I’m still going to take the time to look over this. I’m going to take it back to my district, because I have doctors and nurses who are watching this right now, and health care workers who are watching this right now, who would love to sit down with me. Who are the experts, who would love to sit down with me and add something to this, or possibly go through it, and see what can be added, see what can be taken away or see what can be changed.
AN HON. MEMBER: The regulations.
C. TIBBS: The regulations, that’s right. The regulations don’t work. It just doesn’t work for me.
So we need to ensure we give it proper debate. When it comes to debate, I’ll just say this before I sit down, Speaker, I truly believed when I came into this House of Assembly in 2019, that debate would have been more productive. Sometimes I’m so disappointed. I have to be honest, I’m so disappointed that the debate is not as productive as I thought it would be, because for us to dig in our heels and the government to dig in their heels and we just spin and spin and spin. Why are we here? What’s the sense in being here? If it’s carte blanche, why are we here?
So I think that we really need to see what’s best for the province. If somebody else has a good idea, acknowledge it and let’s do what we can for the future of Newfoundland and Labrador.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Opposition House Leader.
B. PETTEN: Thank you, Speaker.
It’s a pleasure to get up and speak on this bill today. I always qualify every time I stand in this House that the pleasure and the responsibility, Speaker, that comes with all of us in this House. I like to say that pretty often, too, because I’ll always say sometimes we forget, because this is a pretty tumultuous environment. It’s a pretty hectic pace. There’s a lot of back and forth. There’s a lot of good debate. There’s a lot of bad debate. But it’s debate.
When I speak in the House and whether I’m talking on the legislation or I’m talking on a question or I’m talking on anything, petitions, ultimately, you’re speaking for your district but you speak for the people of the province. Sometimes it’s a juggle in that role, too. We kind of blur the lines a lot of times because you’re caught up in bigger issues, sometimes, than own district. Ultimately, you’re doing something to help one of your constituents, 100 of them or 1,000 of them. It all multiplies up to 520,000 we have here in the province. We all, ultimately, speak for those people.
So when you look at this Bill 20 – and I’m not going to belabour much the letter that was sent today. The Member for Mount Pearl - Southlands spoke about it and I think the Member for Labrador West. Not that it’s not important; I think it’s not a good show. That’s something government has to deal with. We’re not government. We’re the Opposition. Our role here is to question government, ask questions, debate and bring in amendments or, ultimately, it’s about making legislation better.
It’s not about we’re one up on you, or we’ve got you this way or we got you that way. Ultimately, we’ve got a role to play here. I’m the Member for Conception South and I’m proud to be the Member for Conception Bay South, as every Member in this House is proud for their own district, because it’s my hometown. I’m sure most everyone here represents their hometown.
But when I see stuff like this, it comes back to the question – this is a huge piece of legislation but underneath this legislation, it’s our health. It’s dealing with our health, delivery of health in the province. This is a big bill. On the surface of it people would say, oh, you’re getting rid of the health authorities; putting it under one roof. In the budget it was kind of simplified to a degree and, for the most part, everyone in the province kind of saw the merits in that. There was some to and fro. Overall, I think the majority of the province is like, okay, that makes some sense.
We hear in the news issue with Central Health. The CEO didn’t live in the province. You would hear issues with Western Health probably and you would hear issues with Eastern Health. There was a duplication of services. That was something I think was said by the minister today: There is a lot of duplication of services.
So on the surface of things, amalgamating them together or bringing them all under one board and setting up these regional health councils and what have you, there’s a lot of merit in doing that. That’s not lost on anyone on our side the House either. I mean, everyone got their own views. There might be some here on my side that might not agree with that. But missing an important step like we see in this letter – and that’s a misstep and that’s something that, again, we’re not government; the minister and his officials can deal with that issue. I guess my question would be: Why the rush? Why does everything have to be rushed?
There was a time in this House you could come in and debate all the legislation in the world. You’d have Address in Reply some days. You’d have that opportunity to catch your breath. I understand debates in the Legislature can go on and it can go many different ways, but why do we always feel rushed? I feel like everything is rushed. I spoke to the Government House Leader about this; we speak about this often. I understand – it’s more than being critical; I’m just stating the facts. It’s difficult.
So you’re getting this legislation a day in advance, and I question that – and I know that they’ll say when you were in government, the PCs they were worse than that, and they probably were. I wasn’t part of that government. I wasn’t an elected official of the day, but maybe they were. That doesn’t make it right. I always say that. Two wrongs don’t make a right.
But you’re left with a piece of legislation and when you start reading it, there’s a lot to it. The media asked a question today and I said it’s a lot to it. More to it than we realized. We couldn’t speak on it Monday. We knew it was coming. That could be a one pager. We’re like, okay, very good, some of them can go within an hour and you’re done. We knew it would be more than one page.
When we got the piece of legislation, I mean it’s a fair bit to it. I have it here; it’s a fairly substantive piece of legislation. When you read closely into it, this is something – I’d like to talk about some of the health issues in the province and in my own district, but one issue in general, if you have a quality council, that’s like a quality assurance. That should be standalone. That needs to be almost like the AG. If you’re really going to have an oversight over your health care – it is quality; that is what is called, a quality council. If you’re only going to do on recommendation of the minister and you’re going to be in consultation with the minister, are you really doing quality assurance or are you doing the quality council and the assurances that the minister wants or government wants or asks for? Are you really doing any benefit or is this another layer of a bureaucracy that doesn’t give any comfort to people?
That’s stuff that, as you’re reading this legislation, you realize there’s more to this piece of legislation than what you’re seeing. That’s just one example of many. Again, that was something actually I said when I was asked questions of the media today, as an example. Do we agree with that? No. There are lots of parts of the legislation and I can go down through some of those parts. Keep in mind – I’m putting together something – when you go and you say that and I say about being rushed and then you see this come out this evening, there’s no doubt we’re rushed. There’s no doubt in my mind.
We brought that amendment in because it was like, give us an opportunity so we can go back and get staff and get our own heads around stuff and have a proper debate. Because ultimately, that’s what’s required. That’s what we get criticized for, because there are people out there that follow the Legislature, follow our debates and actually call us out for it, rightly or wrongly. A lot of times, unfortunately, they’re right. They call us out for some of the legislation we put through, some of the bills we put through, some of the debates we have or we don’t have, and it’s not a good look for any side of this House.
But on our side, we can only exhaust avenues you have. You have second reading, you have amendment options and you have Committee and even third reading. Ultimately, if government don’t respond, you run the clock and when the clock runs out, you’re done. It can be very frustrating. So this is not a good look. There’s no way this is a good look for government. But it’s not only on this bill, Speaker, and that letter tonight, I mean, again I’m not going back to that. There will be enough about that.
But I see this as a trend with a lot of legislation, and I get that government have an obligation. They’ve got legislation to get through, they’re running the province and they need these bills. I get that, but we have a job to do too. As painful as it is a lot of the time for government to listen to us, we have a job to do. We ask questions, and I know they don’t like our questions – I know they don’t like our questions. I repeat: I know they don’t like our questions.
But whoever wants to listen, and I don’t know if the Premier’s close by, we have a tough job to do. Government has a tough job to do. Our job is no lesser, and there are Members on that side of the House sat on this side of the House – they sat here. The Minister of Health sat over here; the Government House Leader sat over here. They know what it is about. The Member for Stephenville and St. George’s I believe sat over here. I’m doing my math there, I’m going across and I think I’m getting most all of them.
But my point being said, they know what it’s like. The Member for Humber - Bay of Islands sat over here and the Member for Mount Pearl - Southlands sat over here. It’s not an easy place to be. This is not an easy place to be. You’re on the receiving end of a lot of flack. You get it from government, obviously. You get it from government-hyper partisans out there – both sides get that. But we have a job to do. We have to ask tough questions. We have to get up every day and ask the ministers of the Crown, the Premier of the province, we’ve got to ask those questions.
T. WAKEHAM: We won’t be here long.
B. PETTEN: My colleague from Stephenville - Port au Port says it won’t be long. It won’t be long now. There was a former premier and that was his slogan: It won’t be long now.
But the point I’m trying to make, Speaker, to get to the point of Bill 20, is this argument is a very valid argument. What is the rush? What’s so wrong with us being Opposition? Why do you see frustration around Members? Why do you see the Mount Pearl - Southlands Member get up tonight and he’s frustrated? Humber - Bay of Islands, they’re independent, they can speak of their own free will. Some of the points they may say, and we may not always agree with everything they say, either. I’m probably the biggest critic, I’ll call them out sometimes in the House myself when I think they’ve gone off course. But they’re not always wrong. We’re not always wrong about pointing out stuff.
We’ve spent – we were here 10 o’clock this morning; we’re here now, I don’t know how many hours we’ve been here now: two, whatever, seven, five, six or seven hours and it’s going to be longer debating this bill. Partway through the debate we were finding out that there was a step on the way missed. Fair enough. Again, that’s the red herring, that’s a bigger issue. But that’s not my point.
My point is we have emergency rooms full. We have 125,000 people without a family doctor. We have people who are dying, literally dying, in waiting rooms, in the hallways: horror stories. We all hear it. Every Member of this House gets emails pretty regularly. It is the number one issue in this province right now: the health care crisis.
Cost of living is very important, but you go now and you talk to some who’s sick and they’ll tell you – what will they tell you? If you don’t have your health, you have nothing. Think about that. Someone really close to me tells me that a lot of times. I’ll leave it at that. My mother (inaudible), I don’t like getting emotional and I’m not going to stay there very long, Mr. Speaker. That’s true words. I spent a big part of this year in the hospital, I know, I’ve seen it first-hand. That means nothing. Her health is what she needs.
Think about that for a second for everyone in this House. When you’re rushing this stuff through, think about that. There’s a bigger piece to be had, there’s a bigger conversation to be had. That’s our job; it’s what we try to do on a daily basis. Sometimes to the peril of being called out for being fear mongers, of being critical for the sake of being critical, to delay it for the sake of delaying it. That’s not where we want to be. We have big misses on legislation. We miss stuff.
I remember several years back there was a piece of legislation that went through here and when it went through I voted – that was earlier years and I was a bit greener, but I voted and someone said after do you realize what you just voted on? When I went back and I said you’re right. It was one of those moments. I said that can never happen. That was ridiculous. It wasn’t earth shattering but it was to the point, I actually voted on something that I really did not have my full thought process around.
That’s a lesson I learned then and since then, even on complicated bills, we all have our way of getting our heads around stuff. Some of these bills can get pretty dry and they get pretty complicated, but I’ll always be aware of what I’m voting for.
We also have to get an opportunity to get our own heads around it, to get the proper debate. Because, ultimately, we’ll get here, the minister will get up in Committee and whenever Committee comes on this legislation, whenever that is, whenever they get through it, this hurdle that they face now, we’ll ask the minister a lot of questions. Committee is for that and I’m sure the minister will stand up and answer as best he can. I’m not saying nothing about that.
But that is our responsibility and we can’t ask too many questions, nor should you be ridiculed for asking those questions, nor should you be ridiculed for bringing in a motion to lift this. We’ve seen that this was a bigger bill than government were thinking it was. We wanted this lifted for that reason. We didn’t say cancel it. As I started off saying, there’s a part of me and a part of us here that feel like there’s merit in this bill, but it has to be done right; make sure it’s done right.
If you’re dealing with controversy, if something has to be done, do it right. But don’t just do it for the sake of doing it. Because when you’re doing it, at the end of that, there is someone that’s sitting in their house that just wants their health. That’s all they want. Think about that.
I’ll say it again; I’ll repeat it: That’s where sometimes everyone misses the ship. I can stand up here, you know, and I’ve had to fill in for my good friend, hopefully he’s getting close to return, and people say, you need to talk about cost of living, you need to talk about health, you need to talk about this or fishing trips, whatever. If you don’t have your health, you have nothing – you have nothing.
I can talk about cost of living all day long, but when I’m reading the cost of living of someone who is struggling, that’s hard. I get it, that’s hard. That’s hard to hear. We read those stories daily and we have all these programs, you’re trying to help people, but then when I read a story of a man out in the hospital who is calling me crying, his wife is pleading with me, his wound is infected. He’s in the bed. He don’t know if he can make it. He’s being discharged. He’s being sent home. The public health nurse says no, you belong in the hospital; the hospital says no, you belong home.
There’s a big quagmire going in. They’re pleading with me; I’m trying to deal with everything else with the House and the session. I’m hearing some of the debate that goes on. We come in here and we ask questions every day and some of it is mocked back at you.
Ultimately, I think back to not just my mother, I think back to that man and we all have them, I mean, I can open my phone now and list off a load. You try not to go down that road because everyone has their own personal issues and you don’t want to be naming, I don’t anyway. It is the issue that is out there, but give it the honest attention that it needs.
I’m trying to loop this together to make some sense because, ultimately, if you have an agenda full of items and this bill is one of many and it’s get it done, get it done, get it done and get out of here. Along the way, it is this bill here that will affect people; this will have an impact on the delivery of health, no doubt about it. You’re getting rid of all your regional health authorities, and that may be a good thing. It’s not about that, it is the principle of what is involved in the bill.
It is not the proper length; it has not even gone through the proper channels within government. I won’t talk about that because the average person at home don’t really get where we are coming from when we get into that. That is where we lose our point. But they understand when they got someone sick; they understand when they are in an emergency rooms; they understand when they are sent home from hospital and they don’t want to go home and they’re being told they shouldn’t be home. That’s where it hits the road, that’s where the connection happens and that is the problem we have, Mr. Speaker. That is the problem we have with this legislation and rushing stuff through.
So we need to give this a lot more serious look. Whatever steps we do along the way, you know, I still believe that it is not a bad idea to go to a Committee and get the proper look at this bill. We did this with the real estate bill; I was on the Committee actually, we done it on the real estate bill as a test drive. Yes, it slows things down. Government is not going to be happy to – they like to say after every closing that they had X number of pieces of legislation through in a very productive session of the House.
But, you know, you have a lot of legislation go through and some of it is changing a word or is pretty agreeable, you’re updating legislation. Most of the time we’re here, we’ll put one person up for five minutes and they sit down and we’ll go to Committee because there is no debate required. It is like, okay, let’s move on. Why waste our time here on something that we all agree with, move on.
But then when you get into the meatier bills and the ones that have more debate to them, one being like we went through the Future Fund. We were having a good strong debate on it, but it’s almost like you’re mocked, it’s like, how dare you? It’s almost like you are offending them. How dare you ask us questions?
I mean, it astounds me, you think about it, often I go home and I sit down and I wonder, I probably think too much because I try to make sense of it. That’s the biggest mistake I have ever made is going home and trying to make sense of some of the days in here because it don’t make no sense.
But the thing that I remember and the thing that I’ll say and I’ll stick to it, it’s near and dear to me, if you don’t have your health – it all comes back to that, Mr. Speaker. But I think government missed the ball on a couple of things here.
Because we’re dealing with an ongoing crisis and you can build a hospital, you can give $500 cheques, you can have all the announcements you want, ultimately, we still have the same issue facing us. You can bring in Bill 20. You’ve still got the same issues.
This is not dealing with today’s issues. This is not dealing with our problem. This has probably created another problem, but it’s not going to solve our problem. In my last minute, I was just going to touch on something. This was Dr. Connors, head of cardiac surgery, and he took exception to a comment I made in the House. I’m sure someone along the way must have fed it to him because I can’t see him listening to the House but, anyway, maybe he does. I said: We, as government, celebrate failures.
I never once intended to say that sending patients to Ottawa was a failure. We have a backlog. You do what you have to do. To get cardiac surgeries completed, it’s very important and it’s life-saving; we’re all for that. I criticized government for having a big celebration in the lobby for having an announcement to do that on the backs of people dying, waiting to get surgeries. I believe that surgery should happen in this province.
SOME HON. MEMBERS: Hear, hear!
B. PETTEN: That’s the failure, not getting the Ottawa Heart Institute involved. That’s your failure. We should not be sending patients to Ottawa. If you’re a Newfoundlander and Labradorian, you should be getting your heart surgery done here in Newfoundland and Labrador, not in Ottawa. That’s what I wanted clarified.
Thank you once again for your time, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Harbour Main.
H. CONWAY OTTENHEIMER: Thank you, Speaker.
It is an honour to speak today on this very important bill, Bill 20, in regard to the Provincial Health Authority Act. Speaker, first of all, I think I am going to start off and talk a little bit about what my colleague from Conception Bay South left off with. He was talking about health and he was talking about the fact that if we do not have our health we, basically, have really nothing.
The health of the population, the health of the people and the fiscal health of the province really go together. When we look at where we are today with this legislation, I think it’s important for us, and to share with people who are watching, really the impetus for this legislation comes from the Health Accord. The Health Accord was a document that involved extensive research by co-chairs Sister Elizabeth Davis and Dr. Parfrey.
I can say, as a Member of the Opposition, we had many presentations by both of the co-chairs of this Health Accord to help us better understand, so that they could consult with us and confer with us about how to improve this important document, which really is a foundational piece. It’s a transformational document to help guide government in terms of our health care system in Newfoundland and Labrador.
So one of the things that were quoted in the Health Accord, Michael Marmot had said: “Evidence from around the world shows that health is a good measure of social and economic progress. When a society is flourishing, health tends to flourish. When a society has large social and economic inequalities, there are large inequalities in health.”
Speaker, I think that’s a really important and significant observation that was made and that was brought to our attention in the Health Accord. It just shows us today where we are in the Province of Newfoundland. We look at whether health is a good measure of social and economic progress. We see our performance, the health performance outcomes in the province, and we see how inadequate they are today.
When we look at some of the indicators or some of the measurements of our performance in the province in terms of our health outcomes, Newfoundland and Labrador has the worst health system performance in Canada. In all of the provinces, Newfoundland and Labrador has the worst outcome. The health system performance, according to Sister Elizabeth, when she presented to us on numerous occasions, she said that is key. She said that health system performance is key.
I think that’s really important to note because when we look at our performance in our province, Newfoundland and Labrador, again, has the worst health system performance in Canada. We have a health crisis; there’s no question or no doubt about that. People in Newfoundland and Labrador are more likely to die from heart disease, they have the highest rates of cancer, the worst cancer mortality in the country and there are more seniors in Newfoundland and Labrador who are living with chronic illnesses. These are some of the indicators, Speaker.
I think it’s important to note that, because we need to put this in the proper context. We have a broken system, and we’ve heard it over and over again. We don’t have enough doctors; we don’t have enough nurses. That is the reality. It’s not of the reality to think that we have enough doctors and nurses that are working in our health care system. Doctors and nurses, the vacancies are incredible. When we look at the nurses, for example, they’re pleading for relief. We’ve seen this already, just as recent as last week. We’ve seen that they are asking for help. They are saying that there are nurses who are leaving our province, many nursing positions are vacant, not only in long-term care facilities, but in hospitals.
We even heard from the president of the Registered Nurses’ Union. She said that things could get even worse, Speaker, with up to 40 per cent of nurses saying that they will leave this profession if things do not improve.
So why am I talking about that now? It’s about quality care. If we don’t have the health care professionals to work in our hospitals, then we’re not going to be able to provide quality care. How can patients expect that type of quality care if we’re allowing and if government is allowing such an exodus of health care professionals in our province? I have to say that because we need to look at the fact that so many nurses are leaving. There are so many vacancies. There are so many nursing positions vacant in our facilities.
But again, why am I talking about that? I’m talking about the fact that there has to be change. Yes, I do agree that the Health Accord provided some guidelines; it was a very transformational 10-year plan. Now, getting to this piece of legislation here, this piece of legislation is a piece of legislation that I think the intention is good. I think that government’s intention, for example, to have the transformation and have the consolidation or amalgamation of one Provincial Health Authority that, in principle, is good. I think that most people feel that, for the reasons stated by the minister – he did indicate that it should increase province-wide communications. He talked about strengthening and improving delivery of consistent health care so there are good objectives that exist in this legislation. No one is disputing that.
What we’re concerned about, Speaker, is how this has come about. I attended the technical briefing and was extremely disappointed. This 36-page document, which is the act, the legislation which has many clauses and four parts to it, was not even provided at the time of the briefing. That is not good enough. No one would disagree that we need to have the actual bill to be able to really meaningfully understand any kind of technical briefing that was going to be given. That did not happen.
When we asked for even further information, that was not available at the time of the briefing. That is a concern. What does that suggest to us? It suggests that there’s a rush on here and that brings me to the Office of the Information and Privacy Commissioner. Fortunately, we have an Office of the Information and Privacy Commissioner, because today we received an email, a letter from the Commissioner.
Why is that important? First of all, just for the benefit of context there are seven statutory offices that report to the House of Assembly, that are established by statute and report to this hon. House of Assembly through the Speaker. It’s an independent office. It’s independent of the Executive Branch of government. It’s not directed by Cabinet, it’s not directed by ministers.
What does it do? It performs an oversight function. Speaker, we see that oversight function in action today. We have to be thankful that occurred because it allowed us an opportunity to look at some of the problems that exist here with this legislation.
Now, we knew about these problems, because as the Official Opposition we put forth an amendment earlier basically asking that the bill be withdrawn, that the subject matter be referred to a Committee, another Committee, a Social Services Committee of the House, so that we could have further study and consultation.
So that’s what we were hoping to have but that did not happen. Then, lo and behold we have the email that we received later in the day from the Office of the Information and Privacy Commissioner. The Member for Mount Pearl - Southlands read this letter in it’s entirety into the record and I think there were a couple of key points that we need to emphasize in this letter. Really, it’s about the fact that there was no meaningful consultation.
Why is that important? Because the significance of this piece of legislation cannot be overstated. In fact, the Commissioner indicated the organizational structuring of our health care system is one of the most significant public policy considerations of our time. This reorganization, this restructuring, this amalgamation of four boards into one has significant implications for our health care system in the province. As the Commissioner stated, it’s one of the most significant public policy considerations of our time.
We have to be thankful that the Commissioner gave us and submitted that to us. His intent was to execute his duties in his statutory office. He indicated it’s to inform debate and public discourse on the bill. That was the intent. He said, in fact, part of his mandate, which has been working very well for many years; it’s a requirement for consultation under section 112 of ATIPPA, of the legislation.
He said it’s been so positive; it’s resulted in improvements to draft bills over the years. It’s an opportunity for co-operative dialogue between government and the office. But, sadly, it was the first time in seven years that a bill with obvious access or privacy implication has been introduced at second reading without a draft being produced or provided to the office for consultation. We can understand the dismay that was indicated by the Commissioner, given the significance of this bill before the House.
Why do I bring this up? It’s not about blame. That’s not what this is about. It’s about learning from this experience. It’s about understanding that we have, fortunately, mechanisms in place like this statutory office that provides that oversight to government and to government decisions. That is exactly what the intent of the Office of the Information and Privacy Commissioner is, to provide that oversight of government’s actions and decisions.
So I must say that I was very pleased when I saw this because it just shows that in our democracy that we have here and in the House of Assembly, that it is working effectively, that we have this oversight independent body that basically checked in here and said okay, hold off here, we need to look at this again. We need to ensure that the proper consultation takes place. That’s really what we in the Opposition, what our intent was by submitting that amendment, so that there would be that consideration, that government would look at referring it to a Social Services Committee for further study and consultation.
I must say I am very pleased that we have the support of – all of us in the House of Assembly – this statutory office and that it came into play so effectively. Because, really, when we look at the Health Accord and all the work that was done, Speaker, there were a number of key elements that Sister Elizabeth and Dr. Parfrey looked at, and the many other people that conferred on this important work that was done. They looked at three of the key elements in having a transformation of our health care system.
But you know what the most important element was? It was to listen to the voices of the people. It said in the Health Accord, the Health Accord’s “fundamental belief is that, to change the health of the people of the province, it is essential to engage with the people of the province.” I’m going to repeat that; it bears repeating: “… it is essential to engage with the people of the province.” What better place to engage with the people of the province is through this hon. House of Assembly, where we are representatives of the people of the province.
Speaker, on that note, I just want to say that I am concerned that we are at this stage now. I’m thankful that the Office of the Information and Privacy Commissioner intervened at this point today. I am very thankful, as I think all of the Members of the House of Assembly are. We look forward to further consultation and further debate in order to have the best possible legislation that can be made and can be created. Because I think that the people, in view of the circumstances that the people of our province are facing, in terms of the people that are suffering and that are in fact dying because of our poor health outcomes and our performance, we have to ensure that we get this legislation as close to perfection as we can. That will only happen if there is proper consultation and involvement of people.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Leader of the Third Party.
J. DINN: Thank you, Speaker.
The question that is top of mind: Why are we debating this at this point, considering the letter from the Privacy Commissioner and, more importantly, how do we get here? How do we get to this place where we have a letter from the Privacy Commissioner? If I am reading into the letter or reading it correctly, before this letter appeared to the Members mentioned, there were requests for legislation, there was a brief, high level of consultation which was insufficient and that there was, today, a letter sent to five people.
Before we get to this letter that came to us, there are one, two, three steps before this. At any point, I guess, this could have been stopped or prevented. It could have stopped with the request for the legislation, because even yesterday when we asked for this – the question I had asked was if this legislation is prepared. Oh yes, it’s prepared. We got it half an hour after.
But the Privacy Commissioner asked for this legislation numerous times and did not get it. If he had, I am assuming that he and his office could have done the due diligence that they needed and we could have gone ahead. That there was a brief, high-level consultation which did not – well, after notice of the bill was been given in the House, by the way, almost as an afterthought, then the letter to the five people mentioned in the letter here in the first paragraph. That is one, two, three steps and then this letter landed in our mailboxes.
There were multiple opportunities along the way to rectify the problem and we didn’t – or government didn’t. Interestingly enough, the Privacy Commissioner raises similar issues or almost identical issues that were raised here by the Opposition and the Third Party. The question is – I’m assuming now that government will go and consult with the Privacy Commissioner. I would assume. As I understand it, that’s probably going to be the process. So we’re putting the cart first, the horse coming a distant second. But nevertheless, that’s a start.
Now, what I’ve got to ask is, well, if that’s going to happen, then what are we doing? Are we looking for a patchwork solution then in terms of if the Privacy Commissioner identifies some major problems, what are we going to do? Try to fix this in a very extended session of the Committee? Because even in Committee, when we try to put amendments through and usually the bill, we would’ve assumed, has gone through the process, we would assume that it’s more tightly written, it’s been vetted, it’s gone through the various checks and balances and, for the most part, is complete.
So who else was not consulted? We did get from at least one union today that didn’t have members in the health care system. Nope, no consultation, nothing, nada, niet, zilch. That’s the problem. So the question is, in addition to the Privacy Commissioner, are we now going to sit down with the unions that represent our health care workers, the people who are going to be dependent on them to make this system work, whether it’s through CUPE, the nurses, the NLMA, NAPE, and have them and allied health care professional and figure out okay, what did we miss? Because really, that’s what it’s going to take.
There was plenty of time to be briefed and do the briefing with Mr. Harvey, and that was not done. But I do want to point out, it has been said a few times – section 7 has been read here already in the House but it’s got to be driven home, Speaker. Because I am reminded in many ways of – this is not the first time we’ve raised concerns here about other pieces of legislation with similar problems: pay equity, education. This is the same issue: the lack of transparency, the lack of consultation, the lack of preparedness for major pieces of legislation.
What I look at, in the second paragraph, of having been denied informed dialogue. Informed dialogue of having basically the information to make an informed decision, of being denied the opportunity to directly provide the government with the comments from the Privacy Commissioner. The word “normally” is used. “Normally the considerations we raise would have been provided directly to the Minister’s officials ….” Yet, this was not done and we deemed that many of them were still unaddressed.
In the third paragraph, it starts with the requirements for consultation. So if I’m understanding it correctly, this is not a may, but this is a shall. There’s a requirement here for consultation. I have said here in this House more than once about the whole notion of what consultation means. Is it checking a box or is it actually sitting down and having co-operative dialogue as the Privacy Commissioner speaks about? And how co-operative dialogue would have severed the people of this province very well since ATIPPA, 2015 came into force.
The first time in seven years, this has not been done, especially for a bill with obvious access or privacy implications. Now, think about this. It was only a short while ago, we’re still dealing with the fallout of the cyberattack. We’re still dealing with that. If we’ve learned anything, it’s the need for due diligence on that. We’ve seen the fallout. I know people who actually have had their identities stolen. It’s caused tremendous anxiety, yet here we have a bill, according to the Privacy Commissioner, has obvious implications for access to privacy and he has not been consulted. I’m assuming now we’re going to go back and try to fix that up. That really should have been done long before that.
If you look at the three recommendation he’s giving that are on the blind, some of the key words that come out – broad, the legislation is broad, “it could be almost anything. It’s not clear what this provision actually enables.” And this has to do with the learning health system and how it’s used in the bill. For example, could the system be used for selling people’s personalized information and genetic data? We don’t know.
Number 2, the social determinants of health. Again, extremely broad, unanswered questions; many unanswered questions.
“The roles, governance and appointment of the regional health councils and the quality council: Are these intended to be separate public bodies …?” I guess here, one thing that I have heard echoed, I’ve said it, I know my colleagues on this side of the House have said it, this is one of the most significant public policy considerations of our time. It’s not about simply changing the language to be gender neutral, as important as that is, it’s not about that. It’s not going to change the effect of the bill. But here we are passing legislation that will have impacts on the health and the health care of our citizens.
But it’s the second last paragraph that stands out: “By rushing this process at the last, most crucial stage, which is legislative drafting, privacy consultations, and debate in the House, Government runs the risk of taking good intentions and implementing them in such a way that could cause unnecessary harm to the public.” And that’s what we’ve been saying in this House. Slow down, it’s not coming into effect immediately, we’ve got time to do it right.
We know why the Health Accord was struck, because of major systemic problems in the health care system. It was a system that was designed for a time in the past when we had a greater population of younger people. We’ve heard the misery that health care professionals have relayed to us and we’ve heard the misery of the people who are depending on health care people and cannot get them. We cannot just simply rush this through haphazard, slapdash and hope that it’s going to fix it. We, the people of this province, deserve better, Speaker.
If nothing else, the Privacy Commissioner talks about without this proper consultation, there’s “no opportunity to do a jurisdictional comparison to see if similar provisions exist in other provinces or territories.” To be honest with you, I don’t know if we did that either, I didn’t hear that.
But just a few things, a few other comments here. The Centre for Health Information: the centre appears to be abolished and its functions are taken over by the Provincial Health Authority. But it is necessary for the contracting out of services. The government cannot easily hand over health information management to private corporations to develop and manage if this centre exists.
This change does nothing to improve the collection of information or to ensure its public and non-political use for the study of health outcomes and the performance of the system. The new Provincial Health Authority has an interest in collecting information in a way to show it is doing great work. The current centre does not have this impetus. Also, one employer and therefore a discussion about who represents the health care workers.
Now, you might remember that I brought this same concern up when we were talking about the Schools Act. We couldn’t answer that, but here we seem, in this act, to have answered who’s going to be the employer. But we couldn’t answer it in the Schools Act.
The last thing health care workers need right now is a divisive and exhausting battle about representation and the government’s actions not only will not help with improving health care in this area but will add conflict and distraction among health care workers at the worst possible time.
The bottom line then is it comes to why is government doing this now? If it’s to be seen as doing something that’s going to help contracting out centralized authority to easily make more cuts. Those are fears of, I would say, the people who work in the system. I don’t think the fears would be there if there had been proper consultation first.
If we’re going to the Information and Privacy Commissioner, then you cannot stop there. You must go and you must speak to the unions that represent the workers who work in the health care system and who will be most impacted. Because impacting them, if this is not improving their lives, you are not improving the care of the patients or the people who depend on it, who use the services of the health care authorities, of the hospitals, and you’re certainly not going to improve the health outcomes.
The quality council is an example that was in the Health Accord. The Health Accord wanted it to report to the public; otherwise it wouldn’t achieve what is needed. The Health Accord asked that the quality council report to the House of Assembly to make certain that this happened. Yet, if you look at it, it reports to the minister, not to the House of Assembly.
What has been a common theme, certainly from the Third Party and from the Official Opposition –
P. LANE: And the fourth party.
J. DINN: And the fourth party, the fifth column – is the need for transparency and openness and that’s so key. There is a concern there that that’s not going to be the case.
The Health Accord also asked for great authority for the regional councils. In the legislation, their authority seems limited to providing advice and recommendations to the Provincial Health Authority, collaborate with Indigenous communities and with other health social networks.
It’s going to be interesting how that works. The Health Accord had hoped that they would be more directly involved in health care delivery in their regions and giving great voice and influence to the people of the region. So you’re seeing here an increased centralization and not this – what I remember from the Health Accord is that there’s this balance of centralization with regional health authorities to satisfy the regional needs.
I can only say that the comparison to the education system, Speaker, is when you centralize you risk – and it happened – losing the voices of the regions and you’re not as responsive to their needs. That’s not good for education nor the health system.
Section 40 says, “The minister shall release a report received under paragraph 36(1)(a) to the public.” It does say “shall” not “may” which seems positive. However, it doesn’t stipulate how often this is done. Hopefully, it will be annually, but there is no indication as to how often this should be done.
So there is concern here about the actual role of the regional health councils. Are they merely advisory or are they going to take a more positive and direct role? How much influence will they have on behalf of the regions? That’s the key thing about having a system that’s responsive to the region.
You can centralize it in St. John’s, you can centralize it out of the minister’s office, wherever you want, but the fact is that the needs in Torngat Mountains, the needs on the Bonavista Peninsula, the needs in Labrador West, are vastly different. The needs on the Northern Peninsula definitely. I’ve had the opportunity to travel there. The needs for the school system are different. It’s got to have the same needs for the health care.
Why wouldn’t, for example, Labrador be its own region separate from the province? Maybe that’s what it needs. Not St. Anthony but the Big Land itself have its own region. As well, and I’ll end with this, that there’s no reference to virtual care in the section on information systems. So is that part of it? Is it implied? Is it going I happen? Who knows?
So I think it was fortunate that the Privacy Commissioner sent this letter when he did. It is unfortunate that he had to, Speaker. It’s unfortunate that he had to point out to this Legislature that, indeed, according to section 112(1) of the ATIPPA 2015, the introduction of this bill is in violation of that section. This is not a novice government on the other side; it’s been here in one form or another for seven years. By now they should know better.
I was asked today, by the media, about what was behind the delay. I really don’t know. I understand we have one legislative writer up there. If this comes down to – and I’ve got to say this – a lack of human resources in these positions, and we have sat in Estimates here a number of times and seen the vacancies, then for God’s sake we’ve got to start filling those vacancies so that the government can do the work of the day.
Passing legislation is not about passing legislation, it’s about serving the needs of the people who elected us. Well, not only who elected us, but whether they elected us or not we’ve got to serve their needs.
So let’s make sure we do a good job, Speaker, put the people in place. But this is amateurish, truly. It should not have happened.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER (Trimper): Thank you.
The Speaker recognizes the hon. the Member for Exploits.
P. FORSEY: Thank you, Speaker.
Being the Member for Exploits in the Central region, it’s great to speak on this bill because I’ve heard a lot about health care in the Central region; I’ve talked a lot about health care in the Central region. It’s something that’s very dear to the people of my district and the Central region. Actually, Central Health alone takes in six districts. I hear from all those districts every day and I’m sure other Members do too.
In this bill we’re looking at taking one health authority – really, how is that going to look, one health authority? We still have Central Health; you still have Western, Labrador-Grenfell. How will it look? Are we just losing our CEOs? Are we losing more management positions? What does this actually look like, to do one health authority? Where is the directive coming from? Where would main base be?
I’m thinking the main base would probably be Eastern Health. That’s probably the main base. But how does the directive, how does the management get out to Central? How does the directive get to the West Coast? How does it get to Labrador to figure out what we really need in those areas and to provide the best primary care that we can to those types of areas?
So we still need some sort of management teams, some communications teams out there. What do we lose, just one CEO? We lose a CEO of each health authority and we’re just down to one CEO? Is that how it works? We’ll still have, basically, four health authorities; it is just how do we streamline it to make it fit all the needs of the people in the Central districts, in the Western and Labrador-Grenfell.
I know in Central Health alone we face a number of challenges; we face a number of shortages. That goes from doctors, nurses, long-term care, personal care, emergency units, emergency paramedics, right down through the system. So if we take out some of the management positions or CEO positions, how is that still correct and getting those positions filled, having resources to fill those positions.
We’re taking away some positions, so now the directive is coming from one area, one base, yet we’re still short doctors, we’re still short nurses, we’re still short long-term care, we’re still short emergency units. We hear it every day in Central Newfoundland. The Fogo Island hospital is on diversion; Baie Verte hospital is on diversion; Harbour Breton hospital is on diversion, Buchans on diversion. It’s terrible.
All those units then, people in that geographic area – all those geographic areas – end up congregating on either Central East or Central West, the James Paton or the Central Newfoundland Regional Health Centre. That congregates all those people. The areas and the wait times there are getting to be tremendous. It’s terrible, actually. I’ve heard 12, 14 hours of wait times, probably longer, in those hospitals; people in hallways.
Those are stories that are related to me. I’ve got a number of stories like that and I hear it every day because of the shortages of the health care – of the physicians and of the nurses in those positions. So we need to fix what we have there first before we can move on – anything like moving one health authority. Even though Central Health, Central West, they all had – and you have one health authority and you have one ADM for recruitment.
One ADM for recruitment – the health authorities always had recruitment teams. They always did. I know Central Health always had a recruitment team. They even had community advisory committees. The community advisory committees would relay to the recruitment teams in Central Health and then they’d go out and team up. They would look for physicians, they would look for what was needed and fit the communities that needed it. So now we’re going to take all that away and we’re going to do that through one health authority.
I’m not saying it can’t work, but this bill being pushed through like this, that’s where we’re losing. Are we doing the best? Is this the best reason to be doing this? Is this the best result that’s going to happen to the citizens of Newfoundland and Labrador? Is this the result that we’re going to give them?
If four health authorities couldn’t do it – we’re in shambles now, the health care is; I don’t know why – so now we’re going to do it through one. When all the recruitment teams, all the community advisory committees couldn’t do it, now we expect one to do it. Maybe. I’m not saying it can’t work. I’m not saying that this is a bad decision. We all know that health care needs to be streamlined. But when you look at those things happening in Central Newfoundland alone, how does it work? What are we losing? What are the people of our province losing? Primary health care is not there now, how are we putting it back? We can’t fix what we have there now, so we need to sit down with all the stakeholders and be doing this.
We’re hearing of doctor shortages all the time. I know back in April month my hometown, Bishop’s Falls, we lost our doctor. There are 3,000 people in the community. We had the clinic there and 3,000 gone. What happened? Those 3,000 people are basically left without a doctor. I think it was 1,500 files that that doctor had, so that was half the community that did go to that clinic. Where do those people go? They either had to go to Botwood hospital or Grand Falls-Windsor hospital to the emergencies. That’s probably just to get prescriptions filled most of the time.
That, alone, was overloading our emergency services. That’s where we need to sit down and really fundamentally think, is this the right decision we’re making? How will that community alone get a doctor when, right now, you already have the recruitment team there, you have a community advisory committee there and now you’re going to take all that away – it all depends because I don’t know what’s in the regulations, I really don’t know. But I’m just asking, is that the way it’s going to work, and if it does, if the hands-on people there can’t get it done, we’re going to expect somebody from a different area to get those positions filled to help out with our priorities, with their priorities.
That’s the kind of thing where we need to sit down and not push this through. We’d like to see more happening in here and be detailed with it before this bill actually goes through to have the costs and everything and people’s livelihoods and especially their needs being taken care of.
We’re out there now – it’s only yesterday I asked a question to the minister about beds in the long-term care in Central Newfoundland. We know they’re only half capacity. We know it’s only half capacity, the beds are already there. Why? Resources – we’re not talking resources from doctors; we’re talking resources from LPNs, basically, nurses. That’s what we’re talking for resources there. We’re not filling those positions. It wasn’t filled.
Now, I know the minister has taken some initiatives to have those in place, but you’re talking a year ago. The ribbon cutting was done on the long-term care unit a year ago. According to the previous minister, it was going to be full. It’s still not happening; we’re short 30 patients, 30 residents, that brand new long-term care unit. I know the minister now is taking initiatives but seven years to get this done, to streamline some health care when our acute beds now are being taken up in Grand Falls-Windsor, the acute beds are being taken up by beds that could be in long-term care. We’re not fixing the problem here. We’re certainly not fixing problems. We’re creating problems because the communication probably be won’t there if we don’t do it right. We’re going to miss that communication.
So if we’re missing 30 beds out of the long-term care right now, and like I say the beds being taken up at the Central Newfoundland Regional Health Care Centre, this shouldn’t be. Our doctors are the top professionals but when we get into the LPNs, PCAs, that kind of stuff, we should be doing more of this in our province and we should have our staff, especially in long-term care units.
So if we can’t get that done in long-term care units right now to staff those and keep those residents in those buildings and when we’re looking at doctors and nurses, then we have a bigger battle on our hands.
Without having physicians and that kind of stuff in Central Newfoundland, travel costs, to see a doctor outside Corner Brook or St. John’s, is massive. I’ve heard stories. They leave St. John’s in the morning, some of them do, to save costs, so they try to balance it out so that they don’t have to get hotel rooms. They are trying it as best they can so they don’t have to stop at restaurants. The cost of living has gone way out of wack; we all know that. To force those people to come out here, they try to make an appointment for, say, 1 or 11 in the day, so those people try to get out here, try to get their appointment, say it’s 1 in the day, and then try to rush back home out of it. Most of the time these are seniors that just don’t want to do this. Now you have this time of year, so they have to. They’re forced to stay in hotel rooms. I’ve heard that when they get here, there are no beds. We can’t do your procedure today. We have no bed. You’ve got to go home.
We’re not fixing any problems. That’s the thing with this. Pushing this down the road, we’re not going to fix those problems. We’re just not going to fix them. All we’re doing is kicking the can down the road. Later on somebody else is going to have to deal with more problems in the health care system that should have been started to fix seven years ago, anyway, but it’s not there yet.
We know the system is broken and it’s really broken. We need to fix that. We need to get priorities done, especially in the doctors, nurses and those situations. I’ve heard stories where people are leaving Harbour Breton in the nighttime to drive up over a road that’s just pathetic. It is wintertime, nighttime, to force those people up over the road. There are a lot of moose on that road. You know, you’re putting those people’s lived in danger just by forcing them to come up over that road to get to the Central Newfoundland Regional Health Care Centre. That’s a long, long drive. It’s a dangerous drive. It’s stress on the patients. It’s stress on the individuals. It’s stress on the entire system.
What’s happening then you got the entire system at the emergency units in Central Newfoundland, you’ve got everyone congregated there and you’ve got people in hallways. The doctors and nurses, they’re trying their best; they’re doing their best. They’re trying to get them assessed so that they treat them and get them on their way as best as possible in the manner that they know how to do best. But you’re causing more stress in those areas because the doctors, the nurses and the health care teams are not there. They’re just not there to help out with the patients that need the treatment at the time. Doctors and nurses feel this too, the ones that are there. They really do. They feel this, and they try to do their job as best as possible.
So in order to fix the problem, we need to fix the problems at hand first, not the problem of the streamline, as far as government goes, what the cost to government is, because that’s what one health authority is just going to do. One health authority is just going to streamline government’s costs, which is a good thing, but how is that going to affect the services to other patients in Newfoundland and Labrador? That’s what we have to look at. That’s what it really comes down to.
How do we deliver? How do we make it the best for all the residents in Newfoundland and Labrador without losing their primary care services? Every Newfoundlander and Labradorian, especially our seniors who paved the way for us and done a lot for us, and probably built our hospitals, and not get those treatments, only to be left – go on to St. John’s somewhere b’ys, go on to Corner Brook. If you get there, hopefully you can get your procedure done. If not, well, come on back home again, go again another day. Is that how we treat some of the people who built our hospitals? I don’t think so. I don’t think that’s the way it works. So we really need to sit down with all the stakeholders at hand, make sure that we are giving the most direct care and the way to promote the health care the best way we can to the people of our province.
I know the Health Accord spent a full year on suggestions to government of what to do, how to address the health care system. They were only suggestions, it’s up to government then to implement or change some of those suggestions that the Health Accord put forth. I know in some of the things, the Health Accord made some good proposals. There are some there that they can adopt and some there that you can’t adopt.
I’d like to thank the Health Accord for the year of what they’ve done to help government make those decisions, but I don’t think they meant for government to make hasty decisions of moving everything down the road quickly, just to say we’ve got it done. I don’t think they meant it that way. I think they meant for government to sit down and look at that Health Accord: Now what are we going to implement? Let’s do it this way, let’s do it that way, let’s all take a look at it and see where we go from here.
Thanks again to the Health Accord, but government needs to sit down, put more emphasis on what they’re doing and not rush this through. We need to sit down and make it the best for every Newfoundlander and Labradorian in our province that they receive the best primary care that we can give them.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: Thank you.
The hon. the Member for Humber - Bay of Islands.
E. JOYCE: Thank you, Mr. Speaker.
I’m going to stand and just have a few words on this. I’m going to speak, I guess, from a bit of experience on some of it.
Yesterday, we were talking about changes to the school board act. Can you remember when I said the six backbenchers never seen the report? Do you see why it’s so important to have the information today? Do you see why it’s so important now? Yesterday, some people thought I was just trotting and just bringing up issues, but do you see why now?
We voted yesterday for something that we never fully seen. We couldn’t make a proper decision. I was serious when I was saying that yesterday. And we’re here today, Mr. Speaker, about a bill that’s going to affect all of our health care. I’m just going to go at it from a little slight different angle for a second.
The process for something to be brought to this House of Assembly is that there is a proposal made to usually whichever department. In this case, the Minister of Health. The Minister of Health then takes it to the Committee of the Cabinet – SPC in this case. So when SPC gets this referral, this piece of legislation, they dissect it. They go through it, they ask questions, they bring in people and they get the answers.
Once the SPC says, okay, we’re comfortable with this; you bring it to Cabinet. Then you get the whole Cabinet going through this whole piece of legislation, dissecting this piece of legislation. Can you see why now the next time someone from government looks at anybody over on this side and says what are you wasting your time for asking questions, do you see why now? Just with the process that this should have went through, that it did go through, and we’re here today with the Privacy Commissioner that no one even spoke to. No one spoke to the Privacy Commissioner and gave him full details. He never even seen the bill.
AN HON. MEMBER: He even asked for the bill.
E. JOYCE: He even asked for it. This went through the SPC and some people – like, I can’t get into the Cabinet stuff, but we know sometimes when you bring something up from SPC, if you never did your homework, sometimes you may get hauled over the carpet.
So the question I have to ask: What is the vetting process for government? If this didn’t come out today – just for the record, I brought this up today also. You’ll hear in my speech, the part of the legislation that I brought in about the regulation, this was concerning this. No one paid attention on the opposite side. No one paid attention.
I should say, that’s not true, the Member for Baie Verte - Green Bay did because he asked me some questions after. I have to say that he did ask me some questions after.
AN HON. MEMBER: (Inaudible.)
E. JOYCE: That’s true. He did, no, I’m sorry about that.
AN HON. MEMBER: (Inaudible.)
E. JOYCE: Anyway, when I was bringing that up today, I was dead serious because once you bring this in this will change our health care all across the Province of Newfoundland and Labrador. So now we know that the vetting process wasn’t done properly, now we know that it went through the Committee stage, now we know it went through Cabinet, Cabinet went down, sat and could have called anybody that they wanted to come in and speak to Cabinet to say we have to talk to you. They could have taken their time, could have taken a month or two months to do it. Sometimes you bring this back three or four times in Cabinet.
So when that never happened and we end up with a piece of legislation now that is going to be pulled. There is no doubt in my mind what is going to happen here. I’ll tell you what is going to happen. We’re going to go until 9 o’clock tonight and he’s going to pull it. It won’t come up to Committee. He will not call Committee tomorrow on this here; he won’t call Committee. Who wants to bet with me? He won’t call a Committee because before you’re going to call Committee, you have to go and meet with the Privacy Commissioner and let him vet through the Privacy Commissioner. That’s what’s going to happen.
AN HON. MEMBER: (Inaudible.)
E. JOYCE: Oh, no, I’m just saying –
AN HON. MEMBER: (Inaudible.)
E. JOYCE: No, no, but you take the Privacy Commissioner, I remember standing here, Mr. Speaker, going four or five days fighting over Bill 29. Do you remember that? And the Minister of Industry, he could stand up and confirm that if he wants to. I’ll give you leave to stand up and confirm that if you want to. You can stand up and confirm that.
But we were here for five days fighting for Bill 29 – five days. Just for the fun part of it, just for the fun part of Bill 29: Do you know how they got Bill 29 through? They invoked closure on access to information. They invoked closure on a Saturday afternoon, right over there. That’s when they decided they were going to invoke closure.
So this is serious. This is very serious. This is why you need an Opposition. This is why you need people in government to ask questions also. This will affect every person in Newfoundland and Labrador because of their health, this piece of legislation here. And it almost got just pushed on through because, for some reason, government said we have to get it done, we said we’re going to get it done, let’s rush it and let’s get it through. They didn’t go through the proper vetting process, didn’t go through Cabinet properly and now the Privacy Commissioner steps in.
I just want to read from the letter. I think my colleague, the Member for Mount Pearl - Southlands already read the letter. You know the funny part? I’ve seen ministers here today asking for a copy of this here. Didn’t even know that this was an issue. I’ve seen Pages bringing the ministers copies, didn’t even know that this was an issue. It is serious.
I just made a few notes of it here, Mr. Speaker: “… as no meaningful consultation occurred prior to notice being given to introduce this Bill to the House, a Bill which does indeed contain implications for the protection of privacy in this Province. Indeed a copy of the Bill was never forwarded to this Office, despite our requests for the same. The only consultation that occurred was a brief, high-level verbal overview, which happened well after the notice of the Bill was given to the House.” That’s the Privacy Commissioner.
How many of us here in this House and the Minister of Digital – how many times did we hear about privacy breaches? Here’s the person who is supposed to help with privacy breaches, where our most important thing is, our health, and this guy, this Officer of the House.
The other thing now, I mean Michael Harvey – sometimes I put in stuff that I tried to get. I never got it. Sometimes I say, jeepers, he’s pretty stubborn and I couldn’t get it. I thought I could and I never. That’s the way it goes. But for Michael Harvey to have the courage to come out now in the middle of this bill, an Officer who is answerable to this House, an Officer who the Executive Council can appoint again – had the courage to come out and say: Hold it now, this is a major problem. You have to give him credit.
SOME HON. MEMBERS: Hear, hear!
E. JOYCE: You have to give him credit.
Now, there are times I spoke to Michael Harvey and I didn’t agree.
AN HON. MEMBER: Integrity.
E. JOYCE: Pardon me?
AN HON. MEMBER: He has integrity.
E. JOYCE: Integrity. Yeah, it’s called integrity.
There were times I spoke to him in his office and sometimes I said I disagree. Well, go on and do what you have to do, that’s fine. But when you get someone who is going to stand up to this here in the middle of a debate that the government just brought through, the same Executive Council that was supposed to – Cabinet – who was supposed to have vet this and he goes out in the middle of it while the legislation is being discussed and say, I have a major concern, that’s integrity. That is integrity.
When you notice and you see integrity, you have to recognize it. This is what makes this province so good is that we have people like Michael Harvey in that place. Now, I may argue when it’s something else down the road, that’s fine. The sad part about it, when I do argue with Michael Harvey on issues, he’s usually always right anyway, but it’s just me couldn’t get my own way.
But I’m going to read something else that he has here: “Having been denied the opportunity for informed dialogue with the Minister’s officials on the contents of this Bill prior to it being made public today, the purpose of my letter to you, further to my legislative mandate as a statutory officer of the House and in accordance with section 112(3) of ATIPPA, 2015, is to directly provide you with our comments.” Here it is now in the middle of a debate to change the all-around structure of the health care in this province and here’s a person coming out, I have to give you my comments because I never had an opportunity before.
People on the government side would say, well, we’re just over here talking. We’re just over here, what are you wasting time for? This is a prime example of what I said yesterday on Education when we never had the same opportunity because we never did see the report. Well, Michael Harvey stood up today and said this bill never was vetted properly. That’s what we’re facing.
What’s going to happen here, I feel, it’s going to end at 9 o’clock, maybe ten after 9. Tomorrow this will not be called to Committee because the government right now has to say, uh oh, this is going to be in the media tomorrow. This is going to be in the media, government’s going to haul it back, go through the structure that you’re supposed to, vet it properly and then bring it back to the House after. You can’t vet this in two or three days. Not now. It can’t be done.
You cannot now say, okay, we need this done over the weekend. Mr. Commissioner, we need this done over the weekend. Can’t be done. Not going to be done. That’s my opinion. Because if it does come back in the House, say, next Tuesday or Wednesday, it will never have the opportunity to be vetted properly.
What we’re going to be doing then – and I’ll say to the government now and I especially say it to the backbenchers who never saw that Education report who turned around and voted for it anyway – the next time that you vote for this, if this comes up Tuesday or Wednesday and you vote for it, the next time that the emergency is shut down in your home, remember this vote too. Remember this vote.
SOME HON. MEMBERS: Hear, hear!
E. JOYCE: I’m telling you remember this vote. That’s what I’m saying because what’s going to happen, if this here goes through next week without the proper vetting, there are going to be implications to all of our Members here, especially rural Newfoundland and Labrador. Trust me on that. Trust me.
Then, if we’re going to allow this to go through without doing the proper vetting through the process – which never worked. The Commissioner, which is now saying that we’ve got a problem – if we don’t do the proper vetting in this House ourselves as Members, not just the Opposition, not just the Third Party, not just the independents, but collectively, as a whole, we’re going to put implications on our constituents, on patients we don’t even know. In two, three or four years down the road that’s going to cause problems if we don’t do it right.
P. LANE: I’d like to know what Dr. Parfrey would have to say about it.
E. JOYCE: My colleague from Mount Pearl - Southlands, he’d like to know what Dr. Parfrey got to say on it. I don’t know if Dr. Parfrey was brought in the Cabinet or not. He had the opportunity to be brought into Cabinet to ask. I don’t know if he was. That’s something some of the ministers could say if he was or wasn’t. I don’t know but it’d be great to know. It would be a great thing to know because as I said yesterday on the education, the ones who are going to fall through the cracks when this went through yesterday – boom, gone through.
The ones who fell through the cracks are the ones on the borderline; the ones with special needs now have to go to St. John’s to get approval for something. They’re the ones. Who’s going to fall through the cracks here? It’s going to be a lot of people who are waiting in the long lines now of emergency rooms. They’re going to be waiting. If there are needs for attention, if something is done in the – bring from one area to another, decisions made in St. John’s, that’s what’s going to happen. I’m preaching now. I’m telling people, now this is what’s going to happen.
So I am definitely not going to be knocking anybody or be hard on anybody, but what I’m going to say – and I’ll give the most experienced voice that I have – is that if we don’t do this here properly, we’re going to hurt people in the long-run. What we swore an oath to do is to help our constituents to the best of our ability. We should take this now, put this aside I say to the Government House Leader. Take this, put this aside and go with the motion that was made today, to put it out and have some consultations on it so that we can bring back the best bill.
I heard you too, Mr. Speaker, talk about the issues in Labrador for health care. We need to get it right. We need to get it right. Labrador does have issues. They do. So if we just take this now and we just say – and especially after we know. Mr. Speaker, I don’t mean to put you on the spot. I definitely don’t mean to put you on the spot. You were in Cabinet. You know the vetting process and you know if something like this ever went through Cabinet and ended up back here, the vetting wasn’t carried out. You know the vetting wasn’t carried out. Once you know that the vetting wasn’t carried out and now we’re going to just take it and just put it in anyway, we’re not representing the people that elected us. I can guarantee you that we will see the implications of this here on the people down the road.
We’ve all got to, as I’ve said before on several occasions, take a bit of water, put it in their wine and let’s all come together to try to get this right. This is too important, and I tell you, five, 10 years down the road when most of us will be gone, except for myself and the Member for Mount Pearl - Southlands – but in the next five or six years when some of us are moved on, we’re going to see the implications of this if you don’t do it right.
Someone like me will be sitting home in a rocking chair and saying: Why didn’t I speak up about that? Why didn’t I bring that up? Why didn’t I stay stronger on this here? Because if we go around this province, bar none – I don’t know if there’s a Member in this House of Assembly who would disagree with me – the number one issue in this province is health care. The number one problem is access to health care. I brought up something today – I won’t bring it up now, but that’s the number one issue that I hear out in Corner Brook, Humber - Bay of Islands. I think that every Member here would agree that it’s health care.
If we’re going to say the number one issue that’s being raised by the constituents that elected all of us is health care, should we rush this through? Should we rush a bill that’s so important to the people of this province – health care – should we rush it through because government made a commitment that they’re going to change the health care boards? Are we just going to rush it through because the government made a commitment that they’re going to consolidate the boards and now they’ve got to rush it through to get it brought back to the House?
Just think about this, Mr. Speaker. Here we are now with a piece of legislation that’s before us, that the Privacy Commissioner hasn’t vetted, which he has major concerns with – he don’t even know if he got major concerns, and we’re going to try to push it through in three or four days because the government made a commitment to have the health care boards start the process, to get them consolidated. So now we have to rush this through when, obviously, it wasn’t done properly.
I say to the Minister of Health and Community Services, with all due respect, let’s take our time on this. Let’s find a way that we can get this done properly. I can assure you – and I said the same thing yesterday about the education one. I’ll say the same thing about the health care. If we don’t do it right, by the time that is going to be back in this House of Assembly to make major changes to it, it will be 10 or 15 years down the road, and I don’t know if any of us will even be here. But the implications and the issues that arise from not doing it right is going to affect the people that we elected, and it is going to affect the most vulnerable in this province, the people who have health care needs.
So I’m pleading with everybody in this House right now, especially the government side, let’s just take this off the table. Let’s get it done right so that when we can vote on it – even if the government overrides all the Opposition and the independents and the Third Party, even if they do, at least we can say that we got the best bill possible for the people of Newfoundland and Labrador. I can assure you when you see Ministers of the Crown asking Pages for a copy from the Privacy Commissioner because that was never ever vetted in Cabinet –
P. LANE: And they knew nothing about it.
E. JOYCE: And they knew nothing about it, we have a major problem with this bill and we have a major problem with the health care if this goes through.
I’ll take my seat, Mr. Speaker, and I call upon the conscience of the people in government to take our time. If we all make a gentleman’s agreement that we’ll haul this bill off the table, let’s get it right, let’s shake hands and let’s work together to get it done, I’ll be the first one to shake their hand.
Thank you.
SOME HON. MEMBERS: Hear, hear!
SPEAKER (Bennett): The hon. the Member for Placentia West - Bellevue
J. DWYER: Thank you, Speaker.
It’s always an honour to stand in this hon. Chamber to represent the beautiful District of Placentia West - Bellevue. I honestly thank the residents of the district for the opportunity to represent them here in this hon. House with integrity and respect.
We are here to debate Bill 20, An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority. One of the most comprehensive, I guess, to date of what we’ve seen recently is the Health Accord. It wasn’t done overnight. There were a lot of proponents that were brought in to consult on it. It was a very comprehensive piece of work, and I thank Sister Elizabeth Davis and Dr. Pat Parfrey for binging it forward and having the initiative to meet with proponents in the province.
The main point that I have gotten out of the Health Accord was to improve health outcomes for the people of our province. Earlier we brought in an amendment, trying to utilize the Social Services Committee as a check and balance because then we have many views and many different perspectives, and it is necessary to get the best solutions and recommendations to move forward to produce the best health outcomes in the shortest period of time.
We currently have a bit of a crisis in our province in providing the human resource side. We do have good facilities; we just don’t have them manned at the right amount right now. If this is going to create more bureaucracy, then this will not produce better health outcomes. But with recommendations, as we thought, from the Social Services Committee, we may cut a lot of the bureaucracy and get better outcomes quicker for our patients. But that opportunity was defeated, unfortunately.
At the end of the day, Speaker, we should be proactive to the needs of our people and they deserve the very best care that can be provided in a timely manner. That sounds like a good health care system to me, but we’re not going about it the right way. Our nurses, our doctors and our health care providers also deserve to work in a safe environment. Hopefully, with checks and balances in place, it will also provide this safe environment.
This is such and important piece of legislation. I agree, it shouldn’t be rushed through and all proponents should be consulted when coming to such an important piece of legislation that would strengthen our health care system. It is incumbent on us all in the House of Assembly to get this one right so we can provide better health care for the people of our province. Because if we don’t get it right, we will not reach our goal in improving health outcomes for the people of the province that put us here to represent them. It is our collective duty to get this right.
Our District of Placentia West - Bellevue, Speaker, is in a very unique situation, as there are no hospitals physically in our district. Our residents rely on the Burin Peninsula Health Care Centre in Salt Pond, Burin; the U.S. Memorial hospital in St. Lawrence; the Grand Bank hospital; the G. B. Cross in Clarenville; the Placentia Health Centre; as well as the clinic in Whitbourne, Wm H. Newhook Community Health Centre.
We are very reliant on making sure that this is done right for the simple fact that we have to go outside of our own district to get these services, but notwithstanding that, the residents of my district also provide services at these facilities as health care professionals and everyone relies on these hospitals and clinics to get better – so closures at these facilities are affecting the residents of my district daily.
Change to any system, Speaker, needs to be for the better and let our patients experience better health care outcomes because that is initially what we are here to do. That seems to be the driving force behind these proposed changes, but let’s get it right because that is really what the people of our province deserve. It is our responsibility to get it right by providing a health care system that is beneficial to all that utilize these services.
We are currently in the fourth year of trying to replace a doctor in the Arnold’s Cove area that has given 50-plus years in the region. This gentleman certainly deserves to retire. He’s putting in all the effort, but we’ve even gotten to the point where we’ve asked for a nurse practitioner and we still don’t have that in place.
So the thing is that, while I welcome the new Minister of Health. We’ve had a couple of discussions. He’s been very forthright in how we’re going to approach this and I appreciate that forthrightness, to be quite honest. Since we came in here as rookies, this is somebody from the other side that has certainly provided fulsome direction and I guess setting us all up for success as opposed to being against each other.
So in conclusion to what I’m going to say, I’m not going to go the full 20 minutes because I know that we’ve all had enough to say about this and I don’t want to rehash everything. But what I am saying and the bottom line to me is that it is our responsibility to get this right because the people that put us here are the people that we’re here to represent. It is not about us individuals. While we are residents of the province and we get the benefit of a good health care system as well, it’s our seniors, it’s our children, it’s our people with disabilities and it’s our residents that deserve to have a better health care system.
So there’s no need to rush it because it hasn’t been rushed for a long time. What we need to do is do a very full approach on making sure that we are getting better health care outcomes for the people of Newfoundland and Labrador.
Thank you, Speaker.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Member for Torngat Mountains.
L. EVANS: Thank you, Speaker.
Just speaking on this bill now, I can’t actually believe I’m standing here still debating this bill after what we all read in the letter. It’s been referenced many times here. The Member for St. John’s Centre actually questioned why we’re actually here discussing a bill, when the Information and Privacy Commissioner actually stated that it’s “a violation of section 112(1) of ATIPPA, 2015 ….”
Now, we’ve heard that quite a bit tonight, and I might get called on relevance for duplication, but the thing is, we have to ask why? So why would the Information and Privacy Commissioner say that? Why would he say that this bill is actually a violation of ATIPPA, “… as no meaningful consultation occurred prior to notice being given to introduce this Bill ….”
So that goes back to a theme, a theme with bills being brought forward to this Assembly that we’re supposed to debate. The theme is a lack of consultation. We’re all getting emails from stakeholders talking about this lack of consultation.
Looking at the bill, this letter from the Information and Privacy Commissioner says “a Bill which does indeed contain implications for the protection of privacy in this Province.” That’s the second thing. So his office requested but didn’t actually see the bill. Now that’s a common theme, as well, because when we were being briefed, we asked if we could see the bill. They said no. There was a technical difficulty in getting us the bill, but the bill was there, so why couldn’t we see it?
We were kind of – I don’t know if it was offended or upset that we didn’t get to see this bill before the technical briefing and we only got to see the bill the day before. But, in actual fact, it pales in comparison to actually having the Information and Privacy Commissioner request to see the bill. So he never got it and we never got it.
He also said in this letter, it says here: despite our requests. It’s written right there. “In response to our requests to receive the Bill, we received only further offers of verbal discussion, which was meaningless ….” That’s not my word. That’s a description of being told, oh, we can verbally discuss but you can’t see the letters on the paper. You can’t actually read the bill.
I’m laughing again, but it’s only because I feel like I’m falling through the rabbit hole. I didn’t realize when I was growing up and my mom used to encourage us to read, especially me and my brother, we were avid readers. Even as children, Alice in Wonderland, you think that’s some sort of fantasy. But, in actual fact, we have to question when you walk through the doors have you fallen through the rabbit hole. I have to say, who’s the mad hatter in this scenario, really, honestly?
It’s sad that it’s so foolish that we have to laugh at it.
Now, the request to see the bill. Do you know something? This is not a bill about moose meat. This is not a bill about wearing helmets in Side By Sides. This is about life and death. We have doctors leaving in droves; we have nurses being burnt out. We have shenanigans going on that really, really is offensive to anyone that has loved ones in nursing homes.
Was there some reference to a ship, righting the ship? Remember that? Well, do you know something? This is no way to right that ship. I tell you, if he was on board with my dad, my dad would throw him overboard. I have to tell you, one of the problems with throwing somebody overboard is what will happen to the water.
I’m gauging myself now, I have to be really careful because I’m going to get kicked out of this House of Assembly, I tell you.
Do you know something? When I got ready to speak on this bill, I had a whole different list of things to talk about. But I actually realized that, in actual fact, this bill is a violation of ATIPPA, 2015. Really, do we have legal right to be here? Do you know what I mean? In all honesty, they’re going to avoid Committee because, of course, we can’t do that.
The rest of the letter is concerning, too. Now, I’m not sure if anyone else has read this out, but I tell you something, even if I’m going to read it out again to duplicate it, I think it’s worth saying a second time: “Having been denied the opportunity for informed dialogue with the Minister’s officials on the contents of this Bill prior to it being made public today, the purpose of my letter to you, further to my legislative mandate as a statutory officer of the House and in accordance with section 112(3) of ATIPPA, 2015, is to directly provide you with our comments.”
Now, this letter that’s addressed to many people here is not the first letter. Today, November 2, I wrote to the Minister of Health, copied to the Speaker, the Clerk of the House of Assembly, the clerk of Executive Council and the deputy minister of Health to express my concern that this bill being introduced to the House of Assembly has resulted in a violation of ATIPPA.
I tell you, this is rabbit-hole stuff. You got to wonder, is this reality? We’re here in the House of Assembly and people talk about our health care being in crisis. We talk about righting the ship. Looking at this bill, one of my biggest concerns has always been what was in the Greene report because the Greene report was a lot about cutting, cost savings. Privatization was a concern with that Greene report, and then we look at the lovely Health Accord that’s come out, that most of these things in here we can support.
So with me, my concern is, basically, where’s the balance? Is this Greene report recommendations dressed up – cherry-picked from the Health Accord to make us actually think it’s a good document? We don’t really know because we haven’t really had a chance to thoroughly investigate it. One of the key recommendations from the Greene report was to merge the four regional health authorities into one Provincial Health Authority. That’s actually here in this legislation.
But that motivation, which I strongly disagree with – there are not very many things I disagree with coming out of the Health Accord, but with the Greene report, I strongly disagreed with it. It was motivated by a perception that many of the services were being duplicated as a result of the division of authority resulting in higher operation costs. Now, in actual fact, there is a division of authority. The regional health authorities had authority over their areas, which this legislation actually wipes away. That’s one of the biggest problems I have with what I’ve seen so far in this legislation, taking the four health authorities into one.
Sure, there are duplications, but it delivers on a regional level. I go back to what the Member for Bonavista said yesterday, when you talked about regional advocacy. You have to have regional representation. My concern is that it can be lost, the ability to deliver services in unique regions, with unique cultures, with unique geographical locations.
Comparing the Greene report to the Health Accord, the Health Accord was tasked with devising a new governance and management approach to health care in the province. One of the recommendations, of course, was to create a Provincial Health Authority. But that was to address the parts of the system that needed the province-wide integration and oversight.
Now, there was a counterbalance that was mentioned in this Health Accord. That’s the difference. In the Health Accord, it actually talked about counterbalance in centralization so they could also propose the creation of regional health councils. In the Health Accord, the proposal of the regional health councils was that they would report to the Provincial Health Authority, but these would have the authority to address the delivery of health care at the regional level – the authority. But there’s no authority actually in this legislation for the regions.
They would also listen and respond to the voices of the people in their regions and be sensitive to regional differences, needs and challenges. That’s actually what’s lost with the formation of the regional health councils because there is no authority, and that’s one of the biggest problems I have with this legislation.
So I’m just going to go to Part II of this legislation, what we were looking at, the part that creates the regional health councils versus the existing health authorities. It was talked about the main objectives of the regional health councils and it was basically read out: to develop an annual plan, to provide advice to the provincial health authorities, engage with Indigenous governments and organizations in their health regions. That’s empty words. That’s really empty words: engage with Indigenous governments. I don’t know how many times the First Minister of Nunatsiavut said a minister hadn’t even returned his email addressing any concerns. Didn’t even acknowledge his email. So I don’t know how much engagement there will be.
What’s the use of the regional health councils? The regional health councils’ roles and powers are very limited.
SOME HON. MEMBERS: Oh, oh!
SPEAKER: Order, please!
L. EVANS: Some protection, Speaker.
SPEAKER: I can’t hear the Member.
The hon. the Member for Torngat Mountains.
L. EVANS: Thank you, Speaker.
What’s the use of the regional health councils? The regional health councils’ roles and powers are very, very limited, and the legislation expressly notes that the role is to simply provide advice and recommendation.
In the legislation here, in section 43: “The Lieutenant-Governor in Council may make regulations” … “(l) establishing regional health councils including the appointment of members, terms of office, composition, terms of reference and other matters relating to regional health councils ….”
When you look at that, the government gives itself power to overrule and change any of the elements laid out in Part II of the regional health councils. That’s our interpretation of it when you look at it, and it’s hidden – it’s hidden there. It’s erosion of autonomy. It’s erosion of advocacy on a regional level. It’s erosion of authority and voice. What’s going to happen again, just like with the school boards, when they actually took them all down and put them into one is that regional differences and needs are not going to be looked after.
Like in my district, we’re going to end up with the Grade 12s all around one computer, with the slow Internet, trying to do their core academic courses so they can keep their dreams of going into post-secondary alive. Trying not to get forced down into general, and also the parents there trying to help their kids not become so discouraged they switch it down to the general program. That’s social marginalization. That’s what we face every year, every decade.
So looking at the regional health councils, we know their role is very limited, as compared to the regional health authorities that exist right now. So looking at the council’s role, it’s very limited. The ability to truly advocate or intervene in any positive way for its residents is nonexistent. You might as well call it what it is. Even this limited role of reporting can be changed or limited at any time through a Cabinet decision.
Now, throughout this act, that’s actually in place, Cabinet can just change anything it wants in the interpretation or delivery of the act. We all should be very, very concerned about that because, like I said, this is not about community freezers. This is not about what we’re going to do with the moose meat from roadkill. This is about the health of our children, ourselves and our seniors. This is about the health care for our most vulnerable.
How many times do we talk about people on gurneys out in the hallway? You want to talk about bad experiences, can you imagine now going in and being exposed to somebody there on the floor who’s crashed and they’re trying to do CPR on them? That’s a fact. That’s happening today in our hospitals. That’s happening today.
Now, in my region, we don’t even have a regional health authority. We don’t even have an ICU, all of Labrador. You talk about the Big Land. Well, I tell you, the Big Land is actually – I’m going to stop there because I was going to say something that would probably get myself kicked out of this honourable House.
To me it’s very, very troubling. This whole thing is troubling. I’m not going to stop. I still have three minutes.
So what about consultation? Was the Newfoundland and Labrador Federation of Labour consulted? Was NAPE consulted? Was CUPE consulted or other unions involved in our health care? Were they consulted on this legislation?
So there are a lot of different things. Just getting back to the regional health councils, I’m very, very disappointed with that. To me, it’s erosion of autonomy, it’s erosion of advocacy and what’s going to happen is everybody that’s outside of Eastern Health is going to fall through the cracks again. I don’t mind saying that, because in my district people are dying that really shouldn’t die. People that could be saved if they lived anywhere else.
I’ll tell you now, when I was going to university, because I was here in St. John’s is the only reason why I’m standing here alive today. Because I was in St. John’s, I was early diagnosed with cancer and I had treatment. I tell you right now, I would not be here; I would not be here alive today. I had the most aggressive form of skin cancer, I had a malignant melanoma and it had already had ulcerated. I had to have surgery and treatment. I tell you something right now, if I was home at the time, I would have died.
So it’s really, really upsetting for me, because right now in my district, in Northern Labrador, six Indigenous communities, and one day a year will be acknowledged when people put on the orange shirts. I tell you in my district, we put on those orange T-shirts and we march. My mother, 80 years old, with a hip replacement, she puts on her orange T-shirt and she goes out and marches because she’s a residential school survivor. I have to tell you, it’s very, very concerning when we hear about people who died.
I’ve had people in my family who was diagnosed too late to be saved. I had people in my family who were actually diagnosed and, in actual fact, the chemo treatments and the actual treatment wasn’t arranged. She had fallen through the cracks. When she went out for her treatment, it was when they medevaced her out, because she was too sick to stand up. That’s one of the cracks we talk about.
I have to tell you something else now, Speaker. I’m just going to talk a little about what was said against the Member for Stephenville - Port au Port. I have to tell you what I heard across the floor was inaccurate. I think something should be done about that because, in actual fact, the fellow Member for Stephenville - Port au Port was accused of making the cuts. I’ll tell you something right now –
AN HON. MEMBER: (Inaudible.)
L. EVANS: Yes, it was –
SPEAKER: Order, please!
L. EVANS: I’ll tell you something right now, when you’re forced to actually give options to a minister and a minister makes decisions, it shouldn’t be blamed on somebody else.
SPEAKER: Order, please!
The Member’s time has expired.
SOME HON. MEMBERS: Hear, hear!
SPEAKER: The hon. the Minister Responsible for Labrador Affairs.
L. DEMPSTER: I take exception to the Member’s comments across the way, when she’s saying that there was comments made that were inaccurate. She was not even an MHA in this hon. House.
SPEAKER: Order, please!
Are you making a point of order?
L. DEMPSTER: Yes, I am; section 49.
You weren’t even in the House. I don’t where you were up in Voisey’s Bay somewhere. Don’t speak to what you don’t know.
SPEAKER: Order, please!
L. DEMPSTER: Do not speak to what you don’t know.
SPEAKER: Address the Chair, please.
There’s no point of order here, it’s just difference of opinions.
Are there any further speakers?
The hon. the Government House Leader.
S. CROCKER: Thank you very much, Mr. Speaker.
I’m just going to take a minute or so to thank everybody for the debate today and realize that there is more debate to come on this. I’ll take my seat and we’re good.
Thank you very much, Mr. Speaker.
I move, seconded by the Deputy Government House Leader, that this House do now adjourn.
SPEAKER: It is moved and seconded that this House do now adjourn.
Is it the pleasure of the House to adopt the motion?
All those in favour, ‘aye.’
SOME HON. MEMBERS: Aye.
SPEAKER: All those against, ‘nay.’
Motion carried.
This House do stand adjourned until 1:30 p.m. tomorrow.
On motion, the House at its rising adjourned until tomorrow, Thursday, at 1:30 p.m.