QUESTION PERIOD AT THE NEW BRUNSWICK LEGISLATURE! < WEDNESDAY >

ORAL QUESTIONS 4 QUESTIONS ORALES
December 14, 2005 Not finalized / Non finalisé le 14 décembre 2005
S:\HANSARD\HANSARD DAILIES - FASCICULES\2005-2006 55-3\06 2005-12-

Health Care Services

Mr. S. Graham: My question this morning is for the Premier. Members of the public have known about changes to integrate public health and mental health for three years, and this government has
waited until the 11th hour to manage the transition. Now, services have been transferred to the regional health authorities as of November 28.

Recently, it was reported in the Moncton Times & Transcript that Fonda Kazi, Vice-President of Community Health with the South-East Regional Health Authority, has raised some concerns,
stating that not only is the transition truly challenging, but offering services via the RHAs will prove equally tough, as they will have to do so with no additional funding or staffing.
The Liberal team has been emphasizing the need for a better process of interregional cooperation as one of our health care system priorities for the future.

In fact, it is evident in the investigation that the Minister of Health is undertaking right now that there are discrepancies in the system. This was highlighted by the recent problem in the Tracadie area, with the Thomas incident as an example.

My question to you this morning, Mr. Premier, is this: What is your government doing to coordinate and emphasize interregional cooperation among the regional health authorities, to prepare for public health and mental health services?

Hon. Mr. Lord: I welcome the question from the Leader of the Opposition. I must say from the outset that he is wrong in the premise of his question. It is really a trend that we see every day.

The government did not wait until the 11th hour. In fact, we have made it very clear from the time we set up the RHAs that they were a very different model from what was there before, and a better
model.

Since 1999, we have worked to implement a health system in New Brunswick—one health system for the province that would be community-based and focused on the patient. That is what
we have, and it is different from the eight very independent corporations that were set up by the previous Liberal government.

Because of the structure we have put in place, we have been able to give a community focus to our health care system, to deal with the needs of patients and their families far better than we could with
what was there before.

Mr. S. Graham: Maybe the Premier cannot answer the question because he does not understand the complexity of it. My question for the Premier today is very simple: Your government has recently received correspondence from the Nurses Association of New Brunswick. That
correspondence states that provincial Ministers of Health have agreed to make public health a top priority by improving public health infrastructure and by increasing provincial capacity. The
ministers also agreed that health human resources must be assured in order to strengthen capacity to respond to regional and national public health emergencies.

The association also said, in a letter to your government, that our public health system must be prepared to respond to emergencies in
a predictable and coordinated fashion where accountability and authority are clearly delineated.

Influenza

This is the document that the Manitoba government has on its Web site with regard to dealing with pandemic influenza. It is a comprehensive 24-page document dealing with interregional cooperation.

This is the document that our government has on its Web site today—a one-page document.

In fact, in its speech from the throne last week, the Manitoba government clearly indicated that legislative changes were going to be coming forward to strengthen preparations for a pandemic influenza outbreak.

Why are we not doing the same in New Brunswick?

Hon. Mr. Lord: I hope that, when I grow up, I can be as smart as the Leader of the Opposition. I am going to work very hard.

Hopefully, someday, I will be able to grasp the issues that he can grasp.

Hopefully, someday, I will be able to understand the things that he understands.

I will work very hard to be as smart, as bright, and as intelligent as the Leader of the Opposition.

Come on, give me a break. The arrogance coming from the Leader of the Opposition, trying to lecture us on how smart and how complexly he understands things, may come from his staff that he hired from Ontario, but it is not fooling anybody.

The fact is that when the Liberals left office in 1999, a lot of things were in disarray in this province. We put in place a health plan to deal with them.

Mr. S. Graham: I know that the Premier is worried that his throne speech did not mention the important issues of public health and, at the same time, did not deal with the challenges pertaining
to a pandemic influenza outbreak here in New Brunswick.

Other provincial jurisdictions are preparing for such an outbreak, because it is not a question of if, but when. Whether it is an avian
flu outbreak or some other influenza outbreak, New Brunswick must be prepared.

Today I am telling the Premier of New Brunswick that in a province such as Manitoba, they have coordinated a regional approach, coupled with businesses and community groups, to be prepared
for such an eventuality.

Here in our province, correspondence that your government has received clearly states that we are not doing enough.

My question to the Premier is this.

Coupled with the national medical association, which is saying
that provinces must be prepared, because it is a provincial responsibility, what legislation is your government bringing forward, similar to what they are doing in Manitoba, to make sure that we are best prepared for such an outbreak here in New Brunswick?

Hon. Mr. Lord: The Leader of the Opposition says that is not mentioned in the throne speech. I heard that from a few members yesterday. I would invite them to read the speech from the throne
again. It makes reference . . .

(Interjection.)

Hon. Mr. Lord: Well, go to bed earlier at night. Maybe that will help you.

The speech from the throne makes references to the provincial health plan. It makes references to the Quality Learning Agenda. It makes references to the Prosperity Plan, and there are a lot of
details in those government plans in terms of what the government is doing. Not everything needs to be written in the speech from the throne. In the provincial health plan, public health is front and
centre. The Department of Health and Wellness has been working with the officials in public health on strategies to protect the public from such outbreaks.

Mr. S. Graham: The Manitoba government has outlined it as a priority in its throne speech. It has also announced that it is bringing forward legislation to strengthen the plan to deal with a pandemic influenza outbreak in that province.

In New Brunswick today, we have a one-page document on the
government’s Web site versus a 24-page comprehensive document on the Manitoba government’s Web site.

My question to the Premier is this.

You have downloaded these responsibilities onto the regional
health authorities. Let’s take, for instance, the Moncton area, where we have two regional health authorities that will be coordinating a response to an outbreak in that region. What processes and protocols are put in place to make sure that there is no duplication of services, while at the same time making sure that the best level of attack on an outbreak is coordinated in that region of the province? Who is responsible?

Hon. E. Robichaud: As the Leader of the Opposition said, this is a very complex issue. I surely hope that the Leader of the Opposition was sincere when he said he understood the issue. When you
talk about a pandemic in New Brunswick or anywhere else, you would be talking about a strategy that would affect the whole country. We have a plan in New Brunswick, and our chief medical officer for public health is sitting on the national committee that is developing a strategy for the whole country.

I can assure you that if a pandemic were happening anywhere in New Brunswick, it would be dealt with not only by the region, but also by the chief public health officer of New Brunswick, and probably, there would be a Canadian team to help us out.

Mr. S. Graham: It is actually refreshing to get a straightforward response from the Minister of Health this morning, as opposed to the political answers from the Premier.

That is the point we are making today, Mr. Minister.

In Manitoba, they have produced a comprehensive, coordinated document to show the protocols and the level of authority of who is responsible for what. At the same time, they have also put legislation in place to deal with a pandemic outbreak to strengthen the protocol system, to make sure the system is there to protect the public.

What changes are going to be required here in New Brunswick? Health care is a provincial, as well as a federal, responsibility.

Hon. E. Robichaud: If there was a need to change any legislation in New Brunswick, we would definitely be doing that. As I have said, the chief public health officer for New Brunswick, Dr.
MacDonald, is sitting on a national task force. There are things that we already have in New Brunswick.

For instance, as Minister of Health, I could quarantine people. We already have an Act that permits this, whereas jurisdictions, Nova Scotia, for instance, were enacting the same thing last year.

It is already in place in New Brunswick. New Brunswickers can be assured that if there was to be a pandemic, New Brunswick would be as ready as any other jurisdiction in Canada.

Yes, we have a plan, and we would be dealing very efficiently, as we usually do, when we have any urgent situations with which to deal.

Mr. S. Graham: I am asking the minister today whether there is a plan that exists and whether he is willing to make it public, as the Manitoba government has done.

My second question to the minister is: What processes need to be brought forward to bring forward legislation to incorporate nonprofit community groups, as well as businesses, in the plan, as the province of Manitoba has done.

The SARS outbreak, such as the one we saw in Ontario, was a provincial responsibility. It comes down to having faith in the system. We recently saw a patient who was bounced from one regional
health authority to another. This government is now investigating that as an isolated case. We want to make sure that this does not repeat itself on a provincial scale. That is why we are asking the
government to make its plans public. It was not included in the throne speech. You stated that you have a plan. Will you table that plan today?

Hon. E. Robichaud: Evidently, I do not have the plan in my pocket. It is in the department. There is a plan. I would not have any problem sharing it with the public. The Leader of the Opposition has
to understand that this plan, and any plan in Canada, is being updated, lets say, on a weekly basis.

If, for instance, there are any changes, or any strategic directions being taken at the national level . . .
I am sure that the Leader of the Opposition also understands that we now have a public health institute in Canada, which was not the case before 2004. Our Premiers and our Prime Minister sat
together and made sure, after the SARS situation in Ontario, that we are better prepared to face those instances.

There is no problem. We have a plan, and I would be happy to make it public. If there was to be an outbreak, for instance, whatever the source, it would be the chief public health officer that would
be in charge of the situation, as has been traditional when there has been such a situation in the province.

Mr. S. Graham: What makes our province unique compared to other provinces is that we are experiencing a transition of authority, which occurred on November 28. Because of that, some of
the regional health authorities are saying that there are problems in the transition of authority.

If this government has a plan and if it is similar to the Manitoba health plan, then my question to the minister is as follows. We recently saw that an individual was bounced from one regional health
authority to another. Does that plan, then, clearly define inter-regional cooperation? That was one of the top priorities, stated by us on this side of the Chamber, to be included in the plan. That is why we are looking to you today to take the same leadership role taken by the Manitoba government.

I will read to you from their press release:

Emergency planning for a pandemic is a high priority for the Manitoba government. The recent throne speech announced that new legislation will be introduced to enhance the capacity to deal
with emergencies.

If you are saying that Manitoba’s priority list is the same as New Brunswick’s, then why was it not included in the throne speech, and why have you not brought legislation forward to strengthen it?
Hon. E. Robichaud: I will start with the last question, because there were three questions in the statement made by the Leader of the Opposition.

First of all, we did not need to put it in the throne speech, because we already have a plan. We do not need to create another plan. There is already a plan for New Brunswickers in the event of a
pandemic.

Regarding the question of how the regional health authorities would deal with those situations, first of all, it is the same staff. If the Leader of the Opposition was here in 2002, when I introduced the
Regional Health Authorities Act, he will understand that we are moving from a medical model to a more community-based approach.

The intent has always been to put public health and mental
health under regional health authorities, while the general direction of public health would stay at the department level. Therefore, we have the same staff everywhere in New Brunswick. There is no reason to be concerned, because it would be the same people dealing with those situations.

St. Anne-Nackawic

Mr. Targett: My questions are for the Minister of Training and Employment Development, based on her announcement of this morning. The first question I have is: Given the fact that she has stated
that these are private issues and that the redistribution and the pro rata approach to this will have to be dealt with on an individual basis, will the minister be going to Nackawic today? Has she already arranged to meet with these individuals, so that the facts get put in front of them immediately, as opposed to uncertainties and rumours about what might be taking place? If the minister is not going today, when will she be going to meet with these people?

Hon. Mrs. Blaney: I know that the member opposite is very well aware that my department has been in Nackawic, helping with the situation for quite some time. In fact, when the announcement
first came, we were there. My staff were there. We set up shop there, so that people could come in and get the information that they needed and so that families could get help. We will continue to do that. We are not saying today that we are going to leave lock, stock, and barrel.

Absolutely not.

We recognize that this has absolutely been a difficult time for people. However, all hope is not lost. This is a community that is seeing hope. We see a mill that is going to start up again, so it is not completely, one hundred percent bleak in Nackawic. However, are we going to abandon people there because we have made this announcement?

No, we are not. We are going to continue to be a presence there, and if we can continue to help mitigate any of these circumstances, we will do so, as we have been doing since the beginning. We will continue to do that.

Mr. Targett: The question was really simple, and maybe the minister could consider this as a question coming from the people who are affected today by this announcement. This is not a
question of abandonment.

I am not questioning what has been done. I am saying this very clearly:

Those people have now been told publicly that there is going to be a redistribution. These individuals who are affected, whether positively or negatively, need to have concrete, very specific
information given to them right away about what that means. The minister did not answer that question. Is she going to meet with those people, so that all of these questions can be answered in
an organized, formal, and professional setting, as opposed to allowing these people days, hours, or weeks to wonder how that is going to unfold?

My next question to the minister is this: In her
response to a question on December 16, 2004, with regard to the pension plan review, she stated: “I have undertaken to do a thorough review of the Pension Benefits Act”. At what stage is that
review?

Hon. Mrs. Blaney: The member opposite has definitely left an impression that my department and that this government do not care about the people of Nackawic, and that is absolutely, categorically,
not true. In fact, the announcement that we made today is, I believe, responsible and reasonable, and it is as fair a decision as can possibly be made. Morneau Sobeco is the administrator of the plan, and Morneau Sobeco will be, as it has been, in contact with the employees who have been impacted by the plan. It will be in contact with the employees, and my department will continue to be in contact with employees.

That dialogue will continue. It does not stop as of today. It has been going on all along, and it will continue.

Mr. Targett: I can tell you this: The people of our province expect more from ministers in charge of their departments than that answer.

The third question I have goes to a response that the minister gave us on December 17, 2004. I will read it. In response to whether there would be pension benefits reduction or redistribution, her
answer was this: “I would not mind at all reiterating that it is not our intention, and it has not been our intention since we started looking at this, to further deplete the pension plans of the people receiving pensions.

It is not our intent. I certainly do not mind stating that for the record again.”

How will the minister answer to the people to whom she has just announced today that she will be redistributing their pension funds?

Hon. Mrs. Blaney: First of all, I want to be absolutely clear. People will be informed of the status of their pension plan by Morneau Sobeco. I want to be absolutely clear about that. Morneau Sobeco is the plan administrator and will be in contact with the people who are involved in this plan.

When we went into the Legislature last spring to amend the Pension Benefits Act, it was at the express request of the people in Nackawic who have been impacted as the result of the bankruptcy
of this mill, so that we could work with them to see if there would be any option to keep the plan going.

You know that as well as I do. That is what we have been doing over the past number of months. We have been looking at options. We have been looking to see if there is any way that
either the company that has bought the mill would be able to take over that plan or the employees themselves would be able to continue on with that plan. That was the express purpose of going into the Legislature last year—to see if any of those options would be available.

Prescription Drugs

Mr. V. Boudreau: My questions today are for the Minister of Health and Wellness. I cannot help but come to the conclusion every time I sit at my desk and start looking at reports that the race to
the bottom continues for this government. I was reviewing the Common Drug Review report, which takes into account all drugs that have been reviewed by this committee from May 2004 to October 1,
2005. Once again, New Brunswick is tied for second last in terms of the number of drugs that have been approved by the province once they have been approved by this Common Drug Review.

The only province we are beating is Prince Edward Island, which ranks at 0%. We come in at 13%.

Could the minister explain why we are at the bottom of the list once again?

Hon. E. Robichaud: To start with, the Common Drug Review is a committee of experts—pharmacists and people who know about drugs. They make recommendations to me, and usually I accept all the recommendations that are made.

If the member for Shediac—Cap-Pelé is asking me, on my own judgment, to bypass a committee of experts, I am not ready to do that. I have to ensure that the safety of New Brunswickers is my first concern.

Mr. V. Boudreau: A supplementary. I find it odd that since May 2004, the Common Drug Review has approved 30 products. So far, this province has approved 4 of those 30, or 13%. Not only are
we at the bottom of the list in terms of the number of medications we approve, but it takes us the longest in the country to make a decision.

It took the province of New Brunswick 549 days to accept
these 4 products, compared to Nova Scotia, which has double our total and did it in half the time—258 days. Why is it that it takes . . . The minister just said himself that he is the one who does this.

It took him 549 days to approve 4 products. Can the minister explain why?

Hon. E. Robichaud: We have more than doubled the budget for prescription drugs in New Brunswick. I am sorry, but this is not a race or a contest between jurisdictions. I could not care less
if you showed me all the stats in the world. The first priority here is the safety of New Brunswickers.

The first concern of the Common Drug Review is to make sure that any drug we approve is safe for New Brunswickers. This is the way it will be done.

Mr. V. Boudreau: Last night, many of us were at a dinner organized by the Canadian Diabetes Association.

It pointed out very clearly that the cost savings in some of these drugs for New Brunswick would be incredible. From 2005 to 2016, our health care system could save over $60 million in direct costs
for treating diabetes. Yet, again, there is another list where New Brunswick is at the very bottom.
Of the 17 diabetes medications approved as safe and effective for Canadians, New Brunswick only has 6 on its list. It is tied for the bottom again. It is the worst province in the country. Why do we
continue to strive to be the worst in the country?

Hon. E. Robichaud: We have been adding millions and millions to the Prescription Drug Program.

I have in hand the report of the Canadian Diabetes Association. The first recommendation that it made was to create and appropriately fund a national catastrophic drug plan. It says that the creation
of a national catastrophic drug plan, with a national formulary, is the first of a number of critical steps. This is exactly what my Premier and other Canadian Premiers brought to Mr. Martin in 2004.
The federal government was not ready to step in and provide the proper funding to make sure that all Canadians, wherever they live, will have the same treatment.

If the member for Shediac—Cap-Pelé is honest, he will tell New Brunswickers that there are only four provinces . . . If you look at your stats, New Brunswick, Nova Scotia, Prince Edward Island,
and Newfoundland . . .

Mr. Speaker: Time, minister.

Home Care Workers

Mr. R. Boudreau: This summer, unionized home care workers ratified an agreement with the government of New Brunswick and the Red Cross after having had to take up strike action. My question to the Minister of Family and Community Services is as follows. Can you assure this Legislature that all home care workers, unionized or not, anywhere in the province, will receive the same salary and working conditions?

Hon. Mrs. M Alpine-Stiles: I am very pleased to answer the question of the member opposite. As ac he knows, we work very diligently, as a department, to ensure that the conditions that were required
and the changes that were needed were put in place. We continue to work with the home care support, because it is such an important entity in New Brunswick. Home care workers provide a
tremendous service to the clients of this province who require their assistance, and we are working with them. We will ensure that the raises that are in place are best used in the best locations in the province to ensure that those rates are maintained across New Brunswick. We have done that and will continue to work with those workers and with the union on this very important issue.
Mr. R. Boudreau: Part of the problem is the fact that the rates are different at the present time.

Some have very basic salaries and pitiful working conditions.
My second question is this. Our at-home elderly patients suffered during the strike, but so did the home care workers and the working conditions. Can the minister tell this Legislature whether a
strike contingency plan will be put in place in the event of any future work disruptions?

Hon. Mrs. M Alpine-Stiles: I would be happy to do that. There is a contingency plan in place. As ac I said before, we are working with the union and with the home support workers to ensure that the
needs of both the patients and workers are met. We will continue to do that. In fact, later this week, I will be meeting with members representing the union with regard to the steps that need to be taken to ensure that all of these options and problems are covered once and for all.