May

18, 2011 HOUSE OF ASSEMBLY PROCEEDINGS

Vol. XLVI No. 27

The House met at 2:00 p.m.

MR. SPEAKER (Fitzgerald): Order, please!

Admit strangers.

Statements by Members

MR. SPEAKER: Today, the Chair welcomes the following private members'

statements: the hon. Member for the District of Burgeo & La Poile; the hon.

Member for the District of Ferryland; the hon. Member for the District of

Cartwright-L'Anse au Clair; the hon. Member for the District of Humber Valley;

and the hon. Member for the District of Baie Verte-Springdale.

The hon. the Member for the District of Burgeo & La Poile.

MR. KELVIN PARSONS: Thank you, Mr. Speaker.

I rise today to recognize and pay tribute to Elizabeth Harvey of Isle aux

Morts in the District of Burgeo & La Poile who was instrumental in driving the

income tax issue for fishers throughout this Province and in the Province of

Quebec.

Due to her determination and persistence, this issue was not permitted to

die. Whether it be politicians, Cabinet ministers, unions, and ultimately the

courts, she fought to have an injustice corrected and needs to be recognized.

For years she has been an advocate for this income tax issue and deserves, along

with their lawyer, Mr. Eli Baker, recognition and accolades.

Yesterday, the Federal Court ordered Canada Revenue Agency to reassess the

income tax paid by fishers on buyouts of their fishing licences in the 1990s.

The amazing thing is Ms Harvey approached these issues quietly but with such a

level-headed, persistent, and determined manner. She was also one of the persons

in this Province to petition the House of Assembly to remove the HST from home

heating bills and the driving force behind the petitions for dialysis at Port

aux Basques and other centres. In all of these issues, Mr. Speaker, she achieved

success.

Mr. Speaker, I ask all members of this House to join with me in paying

tribute to Ms Elizabeth Harvey. All the best to Elizabeth, her husband, Doug,

her four children and eight grandchildren.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. Member for the District of Ferryland.

SOME HON. MEMBERS: Hear, hear!

MR. HUTCHINGS: Thank you, Mr. Speaker.

Mr. Speaker, I rise in this hon. House today to recognize and congratulate

two youth from my district, Aprille Whelan and Molly Houlihan, on being selected

to attend Motivate Canada's seventh Annual ACTIVATE National Youth Leadership

Forum at Carlton University in Ottawa held from May 11 to May 15.

ACTIVATE is a five-day forum about empowering youth to create positive

changes in their communities. It is all about youth leadership and using sport,

physical activity and recreation as a tool for personal community development.

ACTIVATE is driven by enthusiasm and builds on shared positive experiences.

The participants experience interactive leadership and team building

workshops, learn to set and achieve goals, create action plans to lead physical

activity initiatives in their community.

Aprille is a third year MUN student and Molly a Level III student at Mobile

Central High. Both of these young ladies are actively involved with the Bay

Bulls to Bauline Athletic Association. In 2010, Aprille was chair and Molly a

member of the Youth Committee which completely organized and promoted the fourth

Annual Regional Games in the Bay Bulls to Bauline area held in September 2010.

It is very encouraging, Mr. Speaker, to see our youth giving back to their

community and taking on such leadership roles. I am confident that Aprille and

Molly will bring back the knowledge gained from this forum to enhance their

skills to further build their communities with their volunteer involvement.

Mr. Speaker, Aprille and Molly are tremendous youth ambassadors and no doubt

have very bright futures ahead of them. They are an inspiration for all our

youth to get involved in building and being part of what our future communities

will look like.

I ask all hon. members to join me in congratulating Aprille and Molly and to

commend them on being so actively involved in their communities.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Cartwright-L'Anse au

Clair.

MS JONES: Thank you, Mr. Speaker.

I rise in the House today to recognize two Junior Canadian Ranger Patrols

from my district and one individual Junior Canadian Ranger who recently won

awards at the Junior Canadian Ranger National Marksmanship competition.

Mr. Speaker, this competition features teams comprised of the top five or ten

shooters from each province. In our Province the selection is based on the top

two regional teams and not necessarily the top shooters. You would think that

this would put us at a competitive disadvantage, but I am proud to say that the

two regional teams, both from the District of Cartwright-L'Anse au Clair, who

represented our Province, placed first and second in the whole country. They

were the Mary's Harbour Patrol and the Port Hope Simpson Patrol. This was an

outstanding performance by these young people aged twelve to eighteen years old

who represented Newfoundland and Labrador.

I would also like to recognize the members from the Mary's Harbour Patrol:

Sergeant Daniel Johnson, Master Corporals Paula Russell, Cassandra Pye, Evan

Pye, Hillary Roberts, and their coach, Larry Rumbolt, for finishing in first

place. Very special congratulations to Sergeant Daniel Johnson for winning the

top shooter in the Country Award.

Mr. Speaker, I would also like to recognize the members from the Port Hope

Simpson Patrol on their second place finish. The members were Master Corporal

Shauna Burdon, Daniel Sampson, Regan Burdon, Darren Ward, Bobby Marie Clarke,

and Coach Bradley Penney.

I ask all members of the House to join with me in extending congratulations

to the Junior Canadian Ranger Patrols for their superb performance on behalf of

the Province of Newfoundland and Labrador.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Humber Valley.

SOME HON. MEMBERS: Hear, hear!

MR. KELLY: Mr. Speaker, I rise in this hon. House today to congratulate

the organizers of Deer Lake Winterfest 2011.

The Winterfest was a huge success this year. The ten - day event kicked off on

March 4, and took place at various locations throughout Deer Lake. I would like

to extend my congratulations and special thanks to the Winterfest committee

members : Samantha Caines, Sarah Bursey, David Fever, Crystal Major, Junior

Pinksen, Julie Pinksen, Patty Regular, and Danielle Young. They did an outstanding job, and

their goal to have a successful event was certainly accomplished. I would also

like to thank all the sponsors and volunteers, as well as the Town of Deer Lake,

for contributing to the festival's success.

Mr. Speaker, Winterfest revived the atmosphere of the former Deer Lake Winter

Carnival, which had seen interest wane in recent years. So, the young parents

who made up the committee had a goal this year to return the festival to how

they remembered it when they were children. Mr. Speaker, Winterfest 2011

included a balance of activities for all age groups.

I was so pleased to have attended many of the events. Xavier Junior High

hosted an "Are you Smarter than a Sixth Grader?" kind of contest. It was kind of

embarrassing for me to admit to all those present, that I was not smarter than a

sixth grader. Also, I attended March Hare, an Atlantic Canadian arts festival.

They set up a venue which saw performances by the Dunn Hill Singers and The

Once.

Mr. Speaker, I ask all members of this House to join me in congratulating the

Winterfest committee and the Town of Deer Lake in hosting a tremendous winter

festival. It certainly was a wonderful ten days of events for the community, our

region, and indeed, our Province.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Baie

Verte-Springdale.

SOME HON. MEMBERS: Hear, hear!

MR. POLLARD: Thank you, Mr. Speaker.

I rise in this hon. House today to acknowledge the Indian River High School

Female Ball Hockey team.

Mr. Speaker, at the eight-team School Sports Provincial Tournament, host

school, Indian River High defeated Glovertown in the championship game to

capture the 3A Provincial title.

Mr. Speaker, the fans were treated to lots of excitement, sheer perseverance,

and skill, as all teams pulled out all the stops to secure a victory. Indeed,

the school and the entire community are to be commended for hosting and

organizing a tournament of this magnitude.

Events such as this go a long way in fostering a positive, healthy learning

climate which enhances student achievement.

Members of the championship team are: Hannah Pollard, Katie Mckay, Shawna

Pelley, Demi Pelley, Rebecca Bouzanne, Julia Brewer, Lacee Budgell, Lashonda

Roberts, Kristie MacDonald, Katie MacDonald, Emily Edison, Chelsea-Hobbs

Regular, Kena Stuckless, Nikita Osbourne, and Morgan Whitt.

Mr. Speaker, I invite all hon. colleagues to join me in sending accolades to

the provincial 3A female high school ball hockey champs, the Indian River

Wildcats.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Statements by Ministers.

Statements by Ministers

MR. SPEAKER: The hon. the Minister of Health and Community Services.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Mr. Speaker, I rise in this hon. House today to provide an

update on the progress of our government's significant health care

infrastructure projects throughout the Province. Budget 2011, Standing

Strong: For Prosperity. For Our Future. For Newfoundland and Labrador.

furthered the provincial government's commitment of advancing health

infrastructure with investments of $200.6 million for new construction and

redevelopment projects, $50 million for new equipment and $21.6 million for

repairs and renovations.

Budget 2011, Mr. Speaker, includes new and significant health-related

infrastructure projects, including an investment of $4.5 million for the initial

planning of a new mental health facility to replace the Waterford Hospital. In

addition to new projects, we continue to fund existing projects, some of which

have reached or are about to reach significant milestones.

Mr. Speaker, I am particularly pleased to report that our continued

investment, $23.7 million in Budget 2011, has allowed the next phase of

construction to begin at the Labrador West Health Centre. Significant progress

has been made to date on this $90 million project. Site preparation was

completed in late 2008 and work was completed on the foundation and structural

steel this past fall. Construction for the main building is anticipated to begin

within the next two weeks and the facility is expected to be ready for occupancy

by 2014.

This past fall, Mr. Speaker, site preparation was completed for the new

Lewisporte Community Health Centre. The foundation for the facility has been

laid and construction of the structural steel frame is ongoing. The $29.9

million facility is expected to be ready for occupancy in 2013.

Mr. Speaker, I am also pleased to report that construction is about to begin

for the Strait of Belle Isle Health Care Clinic in Flower's Cove.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: A contract totalling over $7 million has been awarded, final

design drawings are now being reviewed and construction will begin in the coming

weeks.

Significant work also continues on the hospital being constructed in Corner

Brook in which we are investing $18.5 million in Budget 2011. Work also

continues on the $150 million new long-term care facility in St. John's, which

will replace the Hoyles-Escasoni home, and the $30 million redevelopment of the

Central Newfoundland Regional Health Centre in Grand Falls-Windsor.

Mr. Speaker, projects of this scale are complex and take a significant amount

of time to complete. We are pleased with the progress that has taken place to

date. We currently have twenty-five significant infrastructure projects ongoing,

fifteen of which are outside of St. John's.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Our dedication, Mr. Speaker, to these projects further

illustrates our commitment to providing quality health care infrastructure,

especially in rural Newfoundland and Labrador.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

I thank the minister for an advance copy of his statement. One thing I can

say for certain is that government is great on announcements because all of

these things we have seen announced and heard announced on many occasions. They

are a little slow on delivery, I say to the minister. When you look at things

like the youth addiction facility in Grand Falls-Windsor that has been on the

books for over two years and it is not started yet, you look at the facility for

youth with complex mental health needs that you committed to that is still not

started in the Province, you look at the addictions centre in Carbonear that is

still not started. Mr. Speaker, there is a whole list.

The minister likes to talk about all of these great announcements and the

fact that there is $200 million today. The reality is that $143 million of that

is being carried over year after year and we are not seeing these facilities

being completed.

When you look at places like Labrador West, they have waited years. They had

to have protests. They rallied in the street to get the government to move on

this infrastructure. When you look at Flower's Cove and Lewisporte, these were

facilities a few years ago the government wanted to take off the map, close down

X-ray services, and cut back their hours of operation. The people got up against

it and the people protested. Today, Mr. Speaker, they deserve the reward of

having proper facilities in their communities.

Mr. Speaker, the government is slow on delivery. We are hoping that we are

going to see these facilities built in a timely fashion in Newfoundland and

Labrador to meet the needs of our people. That is what is important. We also

want to see the government move on other things. We have asked them questions

around the cancer control strategy in the House of Assembly. We are learning

that the advisory committee for this is still not in place and there has been no

movement.

I say, Mr. Speaker, announcements are great but the real thing is seeing the

results at the end of the day.

MR. SPEAKER: The hon. Member for the District of Signal Hill-Quidi Vidi.

MS MICHAEL: Thank you very much, Mr. Speaker.

I, too, thank the minister for the advance copy of his statement. It is not a

new statement, a statement reminding people of the fact that commitments they

have made in at least some areas are moving ahead. Obviously, I am glad to know

that the Labrador West Health Centre is finally going into the final stages of

actually coming into existence. The people there have been waiting a long time

for it.

We, of course, are very pleased about what was announced in the Budget with

regard to the replacement for the Waterford Hospital. I hope the minister in the

department will direct the planners and architects to consult closely with the

mental health community in particular, so they can come up with a design that

will respond to the needs of patients and the potential for reintegration into

the community.

Infrastructure spending is important, Mr. Speaker, and it is essential, but I

wish this government would move its second foot and put money into preventative

health measures because that is where we are lacking badly in this Province;

yet, we have all kinds of indicators that our people are not in good health.

Preventative health measures are needed desperately. So let's move the second

foot, Mr. Speaker. Along with infrastructure, let's get into educational and

preventive health programs.

Thank you very much.

MR. SPEAKER: Further statements by ministers?

The hon. the Minister of Human Resources, Labour and Employment.

SOME HON. MEMBERS: Hear, hear!

MR. KING: Thank you, Mr. Speaker.

I rise today to inform members of the House of an exciting development in the

provincial government's commitment to help young people seize opportunities and

build better futures.

Mr. Speaker, since the launch of the Youth Retention and Attraction Strategy,

we have been communicating with our youth and helping them access the endless

opportunities that abound in Newfoundland and Labrador. One of the forty-one

initiatives contained in the strategy was a grant program to support businesses

that wish to implement innovative workplace skills development practices for

young people.

Mr. Speaker, through a commitment of $100,000, the grant program for

businesses to implement innovative workplace skills development practices will

assist businesses that have recruitment or retention challenges. It will also

provide an incentive for employers to encourage innovation in workplace

strategies and practices to increase their capacity to both recruit and retain

recent graduates and young workers.

Mr. Speaker, this exciting program offers grants of up to $5,000 for small

and medium-sized businesses in the Province. It will be administered by the

Newfoundland and Labrador Association of Community Business Development

Corporations, which is an organization which recognizes the critical role that

youth play in developing a strong business climate in our Province.

By empowering youth, we are laying the groundwork to ensure the growth and

sustainability of Newfoundland and Labrador. Today's announcement is an exciting

new development for post-secondary students, young workers, and businesses

operating throughout our Province. Youth have clearly stated that accessing

employment and gaining workplace experience is a priority for them, Mr. Speaker.

Through Budget 2011, Standing Strong: For Prosperity. For Our Future. For

Newfoundland and Labrador, the provincial government has allocated $3.7 million

for grants and subsidies in support of the Youth Retention and Attraction

Strategy. Mr. Speaker, by enhancing education, research and the labour market in

this Province with these kinds of investments, we are contributing to a stronger

and more prosperous future for everyone.

In closing, as the Minister Responsible for Youth Engagement in this

Province, I am looking forward to seeing the results of this program, as young

people and businesses work in partnership to realize their dreams and their

goals right here in Newfoundland and Labrador.

Thank you.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of The Straits & White

Bay North.

MR. DEAN: Thank you, Mr. Speaker.

I thank the minister for an advance copy of his statement. Certainly, all of

us look forward to seeing the results of this strategy and this particular part

of the strategy that has been launched. We all know that our young people are

undoubtedly the future of our Province. While we are pleased to hear about the

grant program, and the emphasis on networking and partnerships between youth and

business, Mr. Speaker, we cannot overlook the fact that there are serious

challenges that face our youth today.

When we look at the unemployment rate in Newfoundland and Labrador in our

youth, it is 24.8 per cent, basically double of the national average. We see too

many people still having to leave our Province to find work in other parts of

Canada; countless stories.

We all know of our young people who are leaving our neighbourhoods and our

families to further their careers across the country. Certainly, so much has to

be done. From the skilled trades' point of view as well, Mr. Speaker, so many of

them have to pack up and leave, particularly to Alberta. The Telegram

carried a story a short while ago that said Have trade, will travel , and

I just recall the stories of so many people leaving.

Mr. Speaker, it is good to see the initiative. It is great to see that grants

have been made available to businesses. I, too, would hope that the outcome will

be that we see more of our young people being able to stay in this Province,

develop their careers, and have a positive input into our society.

Thank you, Mr. Speaker.

MR. SPEAKER: The hon. the Member for the District of Signal Hill-Quidi

Vidi.

MS MICHAEL: Thank you very much, Mr. Speaker.

I, too, thank the minister for an advance copy of his statement. I do believe

and agree with government that they have a role to play in assisting small

businesses in their training needs and ensuring that youth get employment

opportunities. Skills training continues to be an extremely important need in

this Province, and it will go on for quite a while, I believe. We need to

continue to increase the number of interns that government hires in its own

departments, to ensure that youth get the crucial experience they need to become

more employable and remain in the Province, as the minister has stated.

With regard to this particular announcement today, Mr. Speaker, if the

maximum grant is given to all businesses who apply, it would help actually

twenty businesses. I would like to see a more extensive and permanent program to

offer regular training to small business employees, young people who are small

business employees, so they can continue to upgrade their skills to the benefit

of their company and enhance the economy.

Thank you very much, Mr. Speaker.

MR. SPEAKER: Further statements by ministers?

Oral Questions.

Oral Questions

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

Mr. Speaker, my questions are for the Minister of Intergovernmental Affairs.

The deadline to reach a settlement with the Canadian Union of Postal Workers is

just a week away. We understand that Newfoundland and Labrador opted out of the

agreement to have postal workers deliver pension and social assistance cheques

in our Province.

I ask the minister today: What is the plan to have those cheques delivered to

the people of the Province come Tuesday if these workers are on strike?

MR. SPEAKER: The hon. the Minister of Intergovernmental Affairs.

SOME HON. MEMBERS: Hear, hear!

MR. DENINE: Mr. Speaker, at any time when there is any type of a job

action or anything going to happen, there is always measures being taken to make

sure that any important mail or cheques or whatever are delivered on time. I am

sure that will be done this time, too.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

Maybe the minister could tell me why Newfoundland and Labrador opted out of

the program that other provinces signed on to for the delivery in the case of a

strike or a lockout and maybe he can tell me what the contingency plan is in

Newfoundland and Labrador if this should happen come Tuesday?

MR. SPEAKER: The hon. the Minister of Intergovernmental Affairs.

SOME HON. MEMBERS: Hear, hear!

MR. DENINE: Mr. Speaker, again, when there is a job action taken by any

union or anyone that affects anyone in the Province of Newfoundland and Labrador

and Canada, all the necessary steps are taken to make sure that whether it be

mail, whether it be cheques or any information gathered are disseminated

throughout the Province.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

It is quite obvious the minister knows nothing about this and obviously,

there is no plan in place or he would be telling the people of the Province

today.

Minister, AbitibiBowater reported this week that it earned a $30 million

profit in the first three months of this year. The company sales are up 8 per

cent. The company is still making paper, it is just not making paper in

Newfoundland and Labrador, I say to the government. That is a far cry, Mr.

Speaker, from what the Premier and Nalcor President, Ed Martin, said was going

to happen when they told us that we needed to expropriate the company's assets

two years ago. Mr. Speaker, the actions of the government obviously have chased

Abitibi out of our Province.

I ask the Premier today, Mr. Speaker

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: - because the company is still solvent, the company is still

earning a profit; the company is still making paper.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: I ask the Premier today, if she could update for us what the

government is doing with those assets at this time?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, AbitibiBowater pulled out of Newfoundland and Labrador despite

tremendous support by this government and support from the communities in

Central Newfoundland for over 100 years.

Mr. Speaker, the poor little lambs across the way, we provided all the

information to them and they joined unanimously with us as we expropriated those

assets; one of the finest moments in the Legislature of Newfoundland and

Labrador, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Now, Mr. Speaker, that they have been granted

protection under the laws of Quebec and have been able, because of the laws of

Quebec, to walk away from their environmental responsibilities in Newfoundland

and Labrador, like they walked away from the people of Central Newfoundland, she

wants us to do something.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

The problem is, Mr. Speaker, they have walked away. They walked away, they

are earning a profit, they are making paper, and they are creating jobs

somewhere else. What is happening in Newfoundland and Labrador? We are paying

the bills, we are paying the price for a mill that you expropriated, and we are

paying for all the security and clean up costs.

Mr. Speaker, I ask the government today: What is happening with the assets

that were left behind by Abitibi and what is the plan to deal with this?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, I will tell you one thing they are not doing, they are not

making money off the assets of Newfoundland and Labrador while they are not

providing work in this Province to the people of the Province.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Premier.

PREMIER DUNDERDALE: Now, Mr. Speaker, we have those assets here in the

Province. We have the generation coming off the Exploits River; we have the

biomass and an opportunity to do something with that to provide employment. Like

the people of Central Newfoundland said to us: Expropriate those assets. We may

not be able to earn a living from them but we want the ability of our children

and grandchildren to be able to do that. We stand by that decision, Mr. Speaker,

too bad you do not.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

Abitibi is not providing jobs in this Province today because your government

chased them out. They are not providing jobs today because they could not work

with the government opposite. Mr. Speaker, the Premier and the head of Nalcor

led all of us to believe, in this Province, that AbitibiBowater was going

bankrupt - that they were going bankrupt.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: Here they are today, a thriving company, earning $30 million in

profits in the last quarter, creating jobs and making paper.

I ask the Premier: It is nearly two-and-a-half years now, can you tell the

people of this Province how much we are paying, in total, for this bungled

expropriation, including the paper mill that she had for nine months and did not

realize she had?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, this company has been under bankruptcy protection in the

Province of Quebec since the expropriation. I do not know where you are, but the

rest of the country is well aware of that, Mr. Speaker.

Now, we laid out exactly what was going on, we listened to the advice of the

people of Central Newfoundland, we did what was right. Talk about an abrogation

of the responsibility. Every piece of information we had at that time, we

provided to the members of the Opposition, and they stood with us at the time,

proudly I recall, to expropriate those assets.

It just goes to show they do not know what they are talking about now, and

they did not know what they were talking about or doing then, either.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

At the time, we stood by because we were told by you, Premier, and Mr. Ed

Martin that this company was going into bankruptcy, everything would be lost;

and here we are seeing them earning a profit, creating jobs, making paper, while

we are left with what? With all of the environmental damages that will cost the

people of this Province.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: So, Mr. Speaker, we will not be taking the Premier's word and

Mr. Martin's word next time around.

Yesterday, Nalcor released its financial reports indicating it made $77.5

million last year. I ask the Premier: Nalcor is making vast amounts of money and

increasing their profits, so why have they made an application to the Public

Utilities Board to increase the electricity rates on the Island by nearly 7 per

cent?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, thanks to this government, Nalcor is now a very big, integrated

company, working on behalf of the people of Newfoundland and Labrador, earning

money for the people of Newfoundland and Labrador.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Mr. Speaker, we get good return through our royalties

from our oil and gas. We are going to also get a return from our equity, through

Nalcor, because of what we are doing in oil and gas, Mr. Speaker. Electricity is

a regulated activity in this Province, something we are well aware the members

of the Opposition do not understand, Mr. Speaker. Anybody who has been listening

to the debate on Muskrat Falls must be scratching their head in wonderment that

three members who are part of a government, two part of a Cabinet, do not

understand the regulation of electricity in this Province.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

We understand fully. I tell you what: I would even take it a step further to

say that they are not just a big, integrated corporation; they are a big,

integrated, secretive corporation, Premier, and you created them that way. They

are also the same corporation today that you are funnelling $348 million of

taxpayers' money into as I speak.

Mr. Speaker, why is it Nalcor is earning a profit this year of $77.5 million,

yet they are going out asking the people of Newfoundland and Labrador to pay 7

per cent more for their electricity? I think the people deserve an explanation,

Premier.

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, the people of the Province always get an explanation when they

ask questions of this government, unlike members opposite when they sat on this

side of the House.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Mr. Speaker, electricity generation is a regulated

activity in this Province. The cost of generation, except in exceptional

circumstances, is paid by the ratepayer, Mr. Speaker. That is the way the system

works. It is the way it worked when you were there; it is the way it works now.

We expect Nalcor to make money to make money for Newfoundlanders and

Labradorians, Mr. Speaker. We may decide at some point to increase our subsidies

to pay for electricity. We do that in a number of communities already in this

Province. We have just made a big commitment to the people of Newfoundland and

Labrador in our Budget with the 8 per cent rebate on home heating costs, Mr.

Speaker. We respond to Newfoundlanders and Labradorians.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

The Premier is prepared to do everything possible under the law to protect

Nalcor as a corporation, to ensure that it is secretive, to ensure that it is

exempt from the Auditor General, and to ensure that it is exempt from the Public

Utilities Board. Mr. Speaker, all of those particular things, but she is not

prepared to go out on a limb to protect the consumers in Newfoundland and

Labrador from another rate hike, Mr. Speaker. That is what she is not prepared

to do.

The Minister of Finance stated the other day in the House of Assembly that

Nalcor would make $500 million a year on Muskrat Falls power by collecting money

from Newfoundlanders and Labradorians. They currently make $77.5 million based

on a power price of 6.5 cents per kilowatt hour.

I ask you today, Premier: How much will Nalcor really have to charge to

Newfoundlanders and Labradorians for Muskrat Falls power to ensure they make

that $500 million a year?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Mr. Speaker, just let me remind the Leader of the

Opposition, when this government was establishing the Crown corporation of

Nalcor, we suspended the rules of this House for over a week, three days or a

week, so that they could be fully informed, the members of the Opposition. We

made all the advice we had available to us from the Department of Justice

available to them. We worked co-operatively together so that they would

understand the structure of this company and how it would work on behalf of the

people of the Province; suspended the rules of the House so they could

understand, Mr. Speaker. We moved ahead.

Mr. Speaker, Nalcor has an annual meeting where all of the people of the

Province can come and question directly the executives of Nalcor about the

business they perform on our behalf.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

Half the people in this Province cannot afford to get to a hospital, I say to

the Premier, in St. John's, along with a meeting with Nalcor at one of the

hotels downtown.

Mr. Speaker, for the past six months the Premier has been telling the House

of Assembly that Muskrat Falls will get a full assessment at the Public

Utilities Board. We learned yesterday, however, that she and the Chair, Andy

Wells, whom the government appointed to that board, are now negotiating just how

much of the project will go to the PUB for review.

I ask you today, Premier: Why are you limiting the ability of the Public

Utilities Board to examine this project?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, unlike members opposite, we are sending this project to the PUB

for review, more than they were going to do.

Mr. Speaker, it is astounding actually that former Premier Grimes' deal did

not go to the board of Newfoundland and Labrador Hydro. It did not go to the

PUB, was not going to the PUB. They had an order for an exemption from the PUB,

Mr. Speaker. It did not go to the people of Newfoundland and Labrador, and the

Leader of the Opposition, who was Justice Minister and Attorney General at the

time, talked yesterday about the fact that there was not an exemption. Mr.

Speaker, I do not even know how much of the Cabinet knew. Mr. Speaker, we are

bringing the PUB back in, something they should have done in 2000.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

This project is the work of the Premier and her government, Mr. Speaker. The

act says that she may, Mr. Speaker

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: - may order the Public Utilities Board to do a full review of

this project.

I ask you today, Premier: What is there to hide? What is it that you are

trying to keep from the public? Why are you not prepared to have the Public

Utilities Board do a full review of the Muskrat Falls Project?

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Thank you, Mr. Speaker.

Mr. Speaker, there is nothing to hide. This is a project that everybody on

this side of the House is so proud of, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: We are pleased to be associated with this project.

Mr. Speaker, not only is there nothing to hide and not only are we going to

the PUB to ask the fundamental question, the critical question that you have

been putting forward day and day. What is the critical question? Is Muskrat

Falls the lowest cost option for the people of Newfoundland and Labrador for

electricity generation? That is the question that is going to be put to the PUB.

When that question is answered from the PUB, all of the other answers to the

other questions will become absolutely clear.

Mr. Speaker, not only are we putting it to the PUB, Nalcor is putting it to

independent consultants; that report will be available, Mr. Speaker, by

midsummer.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

PREMIER DUNDERDALE: So, Mr. Speaker, Nalcor will put that question to

independent consultants to review. Mr. Speaker, the government will put it to

the PUB to review. The PUB will answer your most important

MR. SPEAKER: Order, please!

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

It is nothing to be proud of in this Province as an MHA to say that we are

going to support increasing and doubling electricity rates of Newfoundlanders

and Labradorians.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS JONES: I am so proud, Mr. Speaker, I am going to give away 29 per cent

of our transmission to a private corporation in Nova Scotia. That is something

to be proud of.

Mr. Speaker, the Premier says she is putting it to the PUB. The difference is

she is putting it to the Public Utilities Board under her terms, terms that she

will control the outcome of, and that is not fair. We are asking that there be a

full review of the Public Utilities Board, that there be public hearings, that

it be an open process. The time it takes to do it should be done because it is

the people's money that you are gambling with that Newfoundlanders and

Labradorians will have to pay for, for many years to come.

MR. SPEAKER: The hon. the Premier.

SOME HON. MEMBERS: Hear, hear!

PREMIER DUNDERDALE: Mr. Speaker, I will guarantee you one thing, I am not

putting it there under their terms which was not to have the PUB look at it at

all. Mr. Speaker, I am not taking that position.

Now, Mr. Speaker, you can say until you are black in the face that Muskrat

Falls is doubling electricity prices in this Province. You will be wrong. You

were wrong the first time you said it; you will be wrong the last time you say

it, Mr. Speaker.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

PREMIER DUNDERDALE: That is not so.

In the same way she constantly repeats that only 11 per cent of our

electricity comes from Holyrood, Mr. Speaker, when she has admitted in this

House that ranges from 11 per cent to 37 per cent given the hydrology.

AN HON. MEMBER: Oh, oh!

MR. SPEAKER: Order, please!

PREMIER DUNDERDALE: Nobody argues with you that it was 11 per cent last

year, but it was 37 per cent the year before.

AN HON. MEMBER: Oh, oh!

MR. SPEAKER: Order, please!

PREMIER DUNDERDALE: You see, Mr. Speaker, that is part of the problem.

She can only get part of the information. That is all she presents to the

public. She does not (inaudible).

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. Member for the District of The Straits & White Bay North.

MR. DEAN: Thank you, Mr. Speaker.

Mr. Speaker, the Minister of Environment and Conservation has decided to

celebrate Municipal Awareness Day by blaming municipal leaders for having boil

order advisories in their communities. The fact of the matter, Mr. Speaker, is

that of over 200 boil order advisories in this Province, 36 per cent are related

to the lack of chlorination because municipalities do not have the resources or

the financial ability to operate them.

I ask the minister: Why is your department, which is responsible for

addressing environmental concerns, allowing these situations to continue in

municipalities?

MR. SPEAKER: The hon. the Minister of Environment and Conservation.

SOME HON. MEMBERS: Hear, hear!

MR. WISEMAN: Thank you.

In recent years, our government has made some tremendous effort and great

strides in working co-operatively with municipalities throughout Newfoundland

and Labrador. In fact, we have established three mobile training units stationed

in Western Newfoundland, Central Newfoundland, and Eastern Newfoundland serving

the entire Island portion of the Province and Labrador to provide the technical

expertise and training to operators of our water systems around the Province.

We have introduced a certification program to ensure that people who operate

water systems around the Province have the appropriate training and

certification levels to operate these sometimes very complex systems, Mr.

Speaker. We have introduced new funding arrangements, my colleague the Minister

of Municipal Affairs, to allow smaller municipalities to access greater amounts

of money to make enhancements and improvements to their water systems, Mr.

Speaker.

We will continue. We made a commitment and we will continue to work with

municipalities to enhance the quality of water supplies throughout Newfoundland

and Labrador.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of The Straits & White

Bay North.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MR. DEAN: Mr. Speaker, thank you.

The number of boil order advisories remains extremely high in this Province,

despite this government's minimal efforts to address the issue. In fact, Mr.

Speaker, the best this government could offer to municipalities is the portable

water dispensing units. Very few municipalities have taken advantage of them

because they do not see them a viable solution and many of them cannot afford

them.

Mr. Speaker, I ask the Minister of Municipal Affairs: What plans does his

department have to address the 200-plus boil order advisories that are presently

in this Province?

MR. SPEAKER: The hon. the Minister of Municipal Affairs.

SOME HON. MEMBERS: Hear, hear!

MR. O'BRIEN: Mr. Speaker, I thank the hon. member for the question

because it gives me a chance to highlight the significant investment that we

have made with regard to municipal infrastructure particularly in the water

area. We have invested over the last six, seven years over $200 million in

regard to addressing the infrastructure needs in this Province.

SOME HON. MEMBERS: Hear, hear!

MR. O'BRIEN: As well I would like to point out, Mr. Speaker, that 60 per

cent of that is in rural Newfoundland and Labrador.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Opposition House Leader.

MR. KELVIN PARSONS: Thank you, Mr. Speaker.

Mr. Speaker, yesterday in this House I asked the Minister of Justice to

explain why he cut the staff that could deal with nuisance wildlife in this

Province, principally moose. He said that nothing had changed. I am not sure how

that is possible seeing that the permanent field staff has gone from 120 to 37,

contrary to the numbers that the minister gave us yesterday.

How can you say there are no changes to dealing with nuisance wildlife,

minister, when the field staff complement has been cut by 70 per cent?

MR. SPEAKER: The hon. the Minister of Justice and the Attorney General.

SOME HON. MEMBERS: Hear, hear!

MR. F. COLLINS: Mr. Speaker, I am still puzzled where the hon. member is

getting his figures. The thirty-seven positions, Mr. Speaker, he refers to were

thirty-seven positions moved from Natural Resources to Justice, in addition to

the approximately fifty positions we already had in Justice. We have, I think it

is eighty-eight positions under this new department, new division, Mr. Speaker,

all doing the work of conservation including the work of nuisance animals and

road kill and that sort of thing. From that point of view the same people are

working the same job; we have eighty-eight people doing the job not

thirty-seven. I do not know where you are getting those numbers.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Opposition House Leader.

MR. KELVIN PARSONS: Thank you, Mr. Speaker.

We hear about economics of one sort or another and mathematics is important

too. Mr. Minister you do not include secretaries, mechanics, ADMs, that is what

you have included in your eighty-eight. I am using the word field officers.

I say, minister, this is indeed an issue of public safety. If there is a

moose knocked down on one of our roads today, conservation officers are not

allowed to touch it, not allowed to do anything. They now have to wait for one

of the officers from Justice to show up and there are only thirty-seven of them.

For example, there were six wildlife officers in Labrador West previously who

could deal with this type of issue. That has been cut to one.

I ask you minister: Why are you jeopardizing public safety by not allowing

Conservation Officers to remove these nuisance carcasses from our highways?

MR. SPEAKER: Order, please!

The hon. the Minister of Justice and the Attorney General.

SOME HON. MEMBERS: Hear, hear!

MR. F. COLLINS: Mr. Speaker, this government is very proud of its natural

resources, its wildlife and fish stocks -

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MR. F. COLLINS: - and, Mr. Speaker, very determined to make sure that we

preserve and protect our wildlife resources in this Province. That was the

reason for this merger and bringing this division together. At the end of the

day, Mr. Speaker, this will all be combined under one division, under one roof;

we will do all the work that was necessary to wildlife and conservation

protection.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

Order, please!

MR. F. COLLINS: We will continue to do that and will do much better under

the new arrangement. There is a transition team in place, Mr. Speaker, making

sure this all goes seamlessly. At the end of the day, we hope to have a better

division as a result of it.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The hon. the Opposition House Leader.

MR. KELVIN PARSONS: Thank you, Mr. Speaker.

It is good to see that the minister has finally admitted there are not

eighty-eight because you do not include the secretarial staff and so on when it

comes to field officers. It is great to see that. We finally have an admission.

Mr. Speaker, there are five fish and wildlife officers on the Avalon

Peninsula. We have learned that on Monday all of them were in St. John's dealing

with nuisance moose. We have heard this is common throughout the Province and

takes up most of the officers' time.

I ask the minister: Who is doing fish and wildlife enforcement on our rivers

and in our forests when all the officers responsible for it are busy getting rid

of nuisance moose, yet you refuse to allow conservation officers to undertake

that task? What is the logic and rationale for doing such?

MR. SPEAKER: The hon. the Minister of Justice and the Attorney General.

SOME HON. MEMBERS: Hear, hear!

MR. F. COLLINS: Mr. Speaker, the comments of the Opposition House Leader

make absolutely no sense whatsoever. We have eighty-eight positions - and I do

not know the exact number of officers, the exact number of secretaries. We have

thirty-seven new positions that came over from Justice.

The Department of Justice and the Department of Natural Resources sat down

over a number of months and put the team together to put fish and wildlife

enforcement in place. It is designed to protect our wildlife stocks in a much

more expedient, expeditious and safe manner and that is the whole purpose behind

this division.

With regard to the nuisance animals, that will be done in the same spirit it

was done before, by most of the same people who did it before because these

officers are still in place.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Signal Hill-Quidi

Vidi.

MS MICHAEL: Thank you very much, Mr. Speaker.

Mr. Speaker, diabetes is a terrible disease which affects approximately

47,000 people in our Province.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS MICHAEL: In the report The Economic Burden of Diabetes in Newfoundland

and Labrador, the Canadian Diabetes Association

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

The Chair is having difficulty in hearing the hon. the Member for the

District of Signal Hill-Quidi Vidi with conversations back and forth across the

House.

The hon. the member.

MS MICHAEL: Thank you, Mr. Speaker.

The Canadian Diabetes Association estimates that the annual cost of diabetes

to government in 2010 was $254 million. This cost is expected to skyrocket by 27

per cent to a cost of $322 million by 2020.

Mr. Speaker, I ask the Minister of Health and Community Services if the

unfinished chronic disease prevention and management strategy will include

programs that will deal with healthy weights, populations at risk, and secondary

prevention.

MR. SPEAKER: The hon. the Minister of Health and Community Services.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Thank you, Mr. Speaker.

The hon. member opposite is aware, from Estimates last week, that the chronic

disease management strategy is in its final stages of being prepared. She is

aware of that. It will outline a plan, as does other strategies, to deal with

these situations.

Mr. Speaker, we are a government of action, and not only of plans. Let me

give you an example how our approach to diabetes has impacted on the lives of

individuals in this Province. In 2007, we brought in a $1.4 million investment

to fund insulin pumps for children in this Province, and it has affected

people's lives.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Mr. Speaker, Budget 2010 provides an additional $797,700 to

expand the coverage from eighteen to twenty-five year olds.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Mr. Speaker, we are not a government that talks, we are a

government that acts.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Signal Hill-Quidi

Vidi.

MS MICHAEL: Thank you very much, Mr. Speaker.

I thank the minister for pointing out the information about the insulin

pumps, which was good information, but the Canadian Diabetes Association, Mr.

Speaker

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS MICHAEL: has reported that diabetes itself is on the rise in the

whole country, but Newfoundland and Labrador's rate was significantly higher

than the Canadian rate.

So I ask the minister: Is government going to further expand its insulin pump

program to include all residents living with type 1 diabetes, where medically

prescribed, and cover the glucose testing strips under MCP?

MR. SPEAKER: The hon. the Minister of Health and Community Services.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Yes, Mr. Speaker, again I will quote the Opposition House

Leader earlier: The NDP seems to take the position that you pay for everything

and money falls off trees now, I am paraphrasing somewhat.

Mr. Speaker, let me give you another example of how we have dealt with

diabetes, the priorities and choices we have to make. Look at our investments in

dialysis. Talk to the members who have recently had the benefit, talk to the

Opposition House Leader, talk to the people on this side of the House, and the

investments we have made in dialysis, Mr. Speaker. What we have had to do is

make choices. We have made choices with dialysis. We have put it out throughout

this Province, and the impact it has on people's lives and improving their lives

is phenomenal. We have dealt with the insulin pumps, and look at the impact we

have had on people's lives. Talk to people, Mr. Speaker.

So, what we are doing, there is a limited budget, we make our decisions, we

look at the competing dictates, and we have to make decisions. We continue to

improve the health care system, and these are two great examples of how we have

improved people's lives.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The hon. the Member for the District of Signal Hill-Quidi

Vidi.

MS MICHAEL: Thank you, Mr. Speaker.

Mr. Speaker, the minister knows that people with diabetes are more

susceptible to many other illnesses. One of the leading causes of kidney failure

and ending up on dialysis is diabetes. The fact is our Province has the worst

record in the country of preventing the long-term complications from this

disease and the minister knows that. There is a desperate need for training and

education centres so they do not make it to a dialysis machine.

I ask the minister, Mr. Speaker: Why did the 2011 Budget not include more

provisions for diabetes nurses and treatment centres?

MR. SPEAKER: The hon. the Minister of Health and Community Services.

SOME HON. MEMBERS: Hear, hear!

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MR. KENNEDY: Thank you, Mr. Speaker.

This government has certainly placed emphasis and continues to place emphasis

on prevention, Mr. Speaker, because that is a key factor. Owning your own health

plays a key factor, Mr. Speaker, in maintaining the sustainability of the health

care system. Let me, Mr. Speaker, paraphrase again from the World Health

Organization report in 2003: 80 per cent of coronary heart disease, 90 per cent

of type 2 diabetes cases, and one-third of cancers can be avoided by changing to

a healthier diet, increasing physical activity, and stopping smoking, Mr.

Speaker.

We are attempting to get our message out, especially to school kids, Mr.

Speaker, and to all people of this Province. You have to own your own health and

there are things you can do to prevent illness.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: The time allotted for questions and answers has expired.

Presenting Reports by Standing and Select Committees.

Presenting Reports by Standing and Select Committees

MR. SPEAKER: The hon. the Member for the District of Lewisporte.

MR. VERGE: Thank you, Mr. Speaker.

The Resource Committee have considered the matters to them referred and have

directed me to report that they have passed without amendment the Estimates of

the following departments, offices, and agencies: the Department of Natural

Resources; the Department of Tourism, Culture and Recreation; the Department of

Fisheries and Aquaculture; the Department of Environment and Conservation; the

Department of Business; the Department of Innovation, Trade and Rural

Development; the Newfoundland and Labrador Research & Development Corporation;

the Rural Secretariat; the Women's Policy division; and the Office of French

Services.

I would like to thank the members of the Committee for their involvement: the

Member for Burgeo & La Poile, the Member for Labrador West, the Member for

Conception Bay East & Bell Island, the Member for Topsail, the Member for The

Straits & White Bay North, the Member for Grand Falls-Windsor-Green Bay South,

the Member for Cartwright-L'Anse au Clair, and the Member for Signal Hill-Quidi

Vidi.

Thank you, Mr. Speaker.

MR. SPEAKER: Further presentations of reports by standing and select

committees?

Tabling of Documents.

Notices of Motion.

Notices of Motion

MR. SPEAKER: The hon. the Government House Leader.

SOME HON. MEMBERS: Hear, hear!

MS BURKE: Mr. Speaker, I give notice that under Standing Order 11, I

shall move that this House not adjourn at 5:30 p.m. on Thursday, May 19, 2011.

Further, Mr. Speaker, I give notice under Standing Order 11, I shall move

that this House not adjourn at 10:00 p.m., Thursday, May 19, 2011.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Further notices of motion?

Answers to Questions for which Notice has been Given.

Petitions.

Petitions

MR. SPEAKER: The hon. the Leader of the Opposition.

MS JONES: Thank you, Mr. Speaker.

I stand today to present a petition on behalf of residents of Labrador with

regard to the Trans-Labrador Highway.

WHEREAS the Trans-Labrador Highway is a vital transportation lifeline for the

Labrador communities, providing access, generating economic activity, and

allowing residents to obtain health care and other public services; and

WHEREAS Route 510 and connecting branch roads of the Trans-Labrador Highway

are unpaved, in deplorable condition and are no longer suitable and safe for the

traffic volumes that travel this route; and

WHEREAS Labrador cannot afford to wait years or decades for upgrading and

paving of their essential transportation route;

WHEREUPON the petitioners call upon the House of Assembly to urge the

government to provide additional funding for much-needed improvements to Route

510 and connecting branch roads of the Trans-Labrador Highway.

Mr. Speaker, the people of Labrador have been petitioning the House of

Assembly for weeks now asking the government to address the need with the road

in the local area. Not only are they looking for an immediate response, Mr.

Speaker, to what are very bad sections of gravel road, but they are also looking

for a long-term commitment to pave this

section of road. They have not had any

response, Mr. Speaker, from the government and they are very frustrated.

In fact, Mr. Speaker, here we are now again about to head into a long

weekend. Another weekend where people all across Labrador, like the people all

over the Island portion of the Province, want to get in their vehicles and they

want to be able to drive out for the weekend. They want to be able to drive to

other areas of Labrador. They want to be able to drive out to the Island.

It is not fair that they have to put their vehicles on a road where there is

nothing, Mr. Speaker, only rocks protruding in many sections, where there is a

lot of loose gravel well not loose because it is actually gone, it has

disappeared now, it is on the sides of the road. What you have, Mr. Speaker, is

a lot of potholes and things like this. It is causing damage to their vehicles.

In fact, I told you yesterday about a reporter I talked to in Labrador on

another issue, and I just asked them if they had taken the road lately - in

conversation. They told me that they drove the road just a few weeks ago, and

from Blanc Sablon up to Goose Bay, which is normally a six to seven hour trip

for most people, they were fourteen hours trying to make the trip.

There have been so many stories. Almost everyday, Mr. Speaker, I am getting

calls in my office from people who have to use this road, almost every single

day. They are not just my constituents. They are constituents of everybody

else's in this Province, other members who sit in this House of Assembly who

have constituents who have to go into that area of the Province for work, for

travel, for other reasons. This is not just a Labrador problem. It is a problem

that is shared by everyone who wants to access that area and who wants to get

out of it.

Mr. Speaker, I think it is time to address it. Here it is, it is almost the

end of May. We are getting into the May 24 weekend. It is time now for

government to make a commitment in terms of what they are going to do to address

the immediate concerns on that particular road and that is what the people are

petitioning the House of Assembly for.

MR. SPEAKER: Further petitions?

The hon. the Opposition House Leader.

I ask the hon. Opposition House Leader if he would be mindful of the clock.

MR. KELVIN PARSONS: Thank you, Mr. Speaker.

WHEREAS the Department of Transportation and Works of the Government of

Newfoundland and Labrador is responsible for the funding and maintenance of

roads in the community of Cape Ray, in the Province of Newfoundland and

Labrador; and

WHEREAS the roads at Cape Ray are in a deplorable condition, including the

road leading from the community to the J.T. Cheeseman Provincial Park; and

WHEREAS the citizens of Cape Ray demand that the roads be upgraded;

WHEREUPON the undersigned, your petitioners, humbly pray and call upon the

House of Assembly to urge government to provide sufficient funding to complete

the necessary repairs to the roads at Cape Ray.

Mr. Speaker, this is the fourth or fifth time I have entered this petition on

behalf of those residents in Cape Ray and, indeed, all the users from that area

and tourists who visit our area.

The Department of Transportation and Works uses the road themselves, it is

adjoining a provincial park. It is in a deplorable condition and we would ask

the minister to please take it under consideration and hopefully, he can find a

few loads of sand even and a grader to get rid of the potholes that are there.

It is not a long stretch of road. Indeed, it is only about a kilometre or so

long and it could be repaired very quickly but somebody needs to give direction

to have it done. Without the direction from the department in here, they are not

prepared to do it on the ground out there, Mr. Speaker.

Thank you.

Orders of the Day

Private Members' Day

MR. SPEAKER: Order, please!

It being 3:00 o'clock in the afternoon, this being Private Members' Day, I

now call on the hon. Member for the District of Signal Hill-Quidi Vidi to

present her private member's resolution.

The hon. the Member for the District of Signal Hill-Quidi Vidi.

MS MICHAEL: Thank you very much, Mr. Speaker.

I am very pleased to move the following:

WHEREAS 47,000 people in Newfoundland and Labrador have a diabetes diagnosis

as of 2010, which is 9.3% of the population, the highest rate in Canada; and

WHEREAS the number of people with diabetes in the Province may double in the

next ten years without effective prevention; and

WHEREAS unless properly managed, diabetes leads to kidney and heart failure,

disability and early death; and

WHEREAS dialysis machines are in demand because more diabetes cases are

progressing to kidney failure, but if the disease is properly managed, people do

not end up on dialysis; and

WHEREAS diabetes costs our health care system about $41 million a year for

doctor visits, hospitalization, drugs, and medical supplies, a cost that could

double in ten years without better prevention and management; and

WHEREAS diabetes requires frequent daily glucose testing with expensive

testing strips, which is a hardship for most people who do not have private

insurance or government assistance; and

WHEREAS many people who need glucose testing strips are going without because

they cannot afford them, thus endangering their future health and placing an

added burden on our health care system;

THEREFORE

BE IT RESOLVED that this House urge the Government of Newfoundland

and Labrador to cover the cost of glucose testing strips for all diabetics in

the Province under MCP;

BE IT FURTHER RESOLVED that government place the highest possible priority on

releasing the chronic disease prevention and management strategy.

Seconded by the Member for Cartwright-L'Anse au Clair.

I am very pleased, Mr. Speaker, to take time now to speak to the motion I

the cost of managing their diabetes so they will not go on to develop serious

conditions such as kidney failure, heart disease, blindness, and disabilities

that cost our health care system millions every year.

We want government to ensure that all diabetics who need testing strips can

get them through MCP. These strips, Mr. Speaker, can cost up to $1,900 per year

if an individual with diabetes uses them for the maximum amount of time that one

can be called upon to use them. We know that not everybody uses them the same

amount, but if you really have a case of diabetes that requires it, you could be

required to use them up to six times a day.

There are 47,000 diagnosed diabetics in the Province, but not all of these

people would use the strips or test that much daily. Some experts are saying

testing strips are not needed if you are not taking insulin, while others are

saying every diabetic should use them.

The Canadian Diabetes Association takes the position that diabetes treatment

is something decided between the patient and the practitioner. Everybody's case

is different and they may use different types of treatment. That means that two

diabetics with the same diabetes might not require having to use the same number

of strips a day. Whether or not we are paying the $1,900 per person or not, will

depend on the condition of the person with diabetes.

Forty-seven thousand people with diabetes are 9.3 per cent of our population,

the highest rate in Canada. Government must do more to address this crisis

because it is a crisis and people in the Diabetes Association and people who are

dealing with diabetes call it a crisis.

Currently, the Government of Newfoundland and Labrador has not a finished

strategy, although I do know the minister is saying and has said that it is

coming, but at this point we still do not have the strategy in place to deal

with prevention and management of chronic diseases. I hope, Mr. Speaker, that

when we do get that strategy, and I am certainly expecting it sooner rather than

later, that this strategy will be a plan with specified goals and measurable

performance indicators.

Mr. Speaker, diabetes is a hidden public health threat. For every two people

diagnosed with diabetes there is one undiagnosed, and that is agreed upon inside

of the medical system. Nearly 18 per cent of our population are living with what

is called pre-diabetes, which is high blood glucose levels that leads to

diabetes or can lead to diabetes. If prevention does not become more effective

or if management of the condition does not become more effective, the number of

diabetics will double to 73,000 in 2020 that are here in our Province. At the

rate we are going, at the rate people are aging and at the rate diabetes is

being developed - I will repeat it - in 2020 we will have 73,000 people with

diabetes.

We do not even have in this Province adequate screen testing of people who

are a high risk for developing diabetes. This is really disturbing, Mr. Speaker,

because there are four tests that can be done of people who are at high risk,

people who can have no possibility probably of avoiding diabetes. The test that

can be done can indicate where they are with the disease. Yet, here in this

Province only 21 per cent of people at risk of diabetes can access all four

tests, Mr. Speaker. We have higher rates for one test than for another, but in

terms of all four tests that can be done, only 21 per cent of our people who are

at high risk for diabetes can access these screening tests. So, Mr. Speaker, we

are woefully deficient in trying to even prevent people getting into a dangerous

situation with diabetes.

Unless properly managed, as I have already mentioned, diabetes leads to

kidney and heart failure, disability, blindness, and early death. The mortality

rate for diabetes is quite high, Mr. Speaker. It is five times higher here in

Newfoundland than those without diabetes. So, people who have diabetes have five

times more of a chance to die than people who do not have diabetes.

The costs of diabetes, Mr. Speaker, they are high and they are a burden on

individuals. The direct costs of diabetes are estimated at $40 million a year

for doctor visits, hospitalization, drugs, and medical supplies. Indirect

mortality and disability costs are $214 million a year, so the total cost to our

system, of diabetes, is $254 million a year. The annual out-of-pocket costs are

close to $4,000 per person. That would include the testing strips and drugs. If

somebody gets an insulin pump, insulin pumps cost in the range of $6,000, and

according to Eastern Health persons with insulin pumps, while representing only

1 per cent of persons with diabetes, are consuming 50 per cent of resources

under its diabetes education program. Not everyone, Mr. Speaker, has private or

government insurance, so this is a heavy burden on people, I would present - a

major burden.

Prevalence of diabetes occurrence was only 5 per cent in the year 2000 that

is eleven years ago, Mr. Speaker but we have had, in the past eleven years, a

dramatic increase due to poor diet, obesity, and sedentary lifestyle. The

Auditor General's 2010 report deals in depth with diabetes and other chronic

illnesses. It indicates that we have some of the highest rates of obesity,

inactivity, and poor nutrition in the country, Mr. Speaker. The Auditor General

called for a better primary prevention strategy for pre-diabetics and for people

at risk. This is one of the preventative measures that I hope is going to be in

the strategy when it comes forward from the minister.

All of the health authorities, in response to the Auditor General, said their

services are not adequate to provide adequate care. Now, one of the anomalies

that we have happening

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER (T. Osborne): Order, please!

MS MICHAEL: - Mr. Speaker, in our Province right now is that with the

four

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MS MICHAEL: - regional authorities, four different things are happening

with regard to a prevention strategy. For example, Mr. Speaker, out in the

Western Regional Health Authority, they are actually in the process of

developing their own diabetes strategy. They have provincial funding for that,

Mr. Speaker. They are putting a program in place, software in place as they

develop their own strategy with provincial funding.

In Central Health, they are developing their own strategy for chronic disease

prevention and management. Their funding comes from the Public Health Agency of

Canada to complete projects focused on prevention of diabetes. Labrador Grenfell

has drafted a work plan with regard to diabetes prevention and management and

Eastern Health intends to align activities with the department's strategy which

we do not have yet.

Here we are, Mr. Speaker, we have four health authorities, each one doing

something different with regard to a prevention strategy and diabetes management

strategy. This is very, very disturbing, Mr. Speaker, that such is the case. Mr.

Speaker, this means that we do not even have right now in the Province a unified

standard going on even with regard to how strategies are being developed. This

is very disturbing and I hope that the minister finds it disturbing as well. I

find it very strange that, without a strategy, one health authority actually got

money to put something in place; another one went off and found money. All of

this happening under one Province, Mr. Speaker, it is not acceptable.

Even without a strategy we know we need more diabetes treatment and education

centres around the Province and more diabetes nurses. We have been told this by

the Canadian Diabetic Association; we have been told it by practitioners in the

Province who are involved in dealing with the people who have diabetes. Right

now it takes months to get into one of the education programs here in St. John's

and to see a diabetes nurse.

We have 47,000 people with diabetes but we have only eight education centres.

We have only eleven primary health care site practices and we have twenty-eight

collaborative practices but we have 47,000 people with the disease, Mr. Speaker.

I would like to point out that we used to have an office in the Department of

Health and Community Services that co-ordinated primary health care practices,

Mr. Speaker. There was federal money in that office keeping that office going.

When the federal money dried up in the year 2006, this government did not think

that it still had a responsibility to continue the co-ordination of primary

health care. This is really a shame, Mr. Speaker. It is a terrible shame.

We need so much education, Mr. Speaker. We need stronger school nutrition

programs. We need more physical education during school hours. We also need, Mr.

Speaker, better access for people who have diabetes to medications, devices, and

supplies.

Mr. Speaker, yesterday one of the radio stations in this city put a question

on-line with regard to this motion, asking how people felt about it. I do not

very often read the comments that happen when these kinds of polls are done, but

because the poll had to do with this motion I decided I would read the pages and

pages and pages of comments that people took the time to post. Mr. Speaker, I

can say that about 95 per cent of the comments that were on-line were people

with diabetes, people who had somebody in their family with diabetes, or

somebody in the health care system who knows diabetes who all said the same

thing: they totally, completely supported the motion I have brought forth here

today, Mr. Speaker.

We need to make sure that people who have diabetes can manage the diabetes.

One of the most important ways they can do that is through the use of glucose

testing strips, Mr. Speaker, which are a real burden for people who do not have

private insurance and a real burden for people who do not have government

assistance. So, Mr. Speaker, covering the cost of the glucose strips, while it

will be an expense upfront, it is going to take care of another expense at the

other end that will not happen. We will help keep people, Mr. Speaker, off

dialysis machines which would be a lot more expensive than providing people with

the glucose strips they need to manage their diabetes.

So, Mr. Speaker, this is of such an urgent nature with regard to the health

of our people in the Province. I really do urge all the members of this House,

Mr. Speaker, that we stand in solidarity together and pass this resolution so

that people know this whole House of Assembly does care for the health of the

people in this Province. This whole House of Assembly can stand together when it

comes to an issue that really does have to do with the welfare of our people and

the welfare of our communities.

So I thank you very much, Mr. Speaker, for the time to present the motion. I

look forward to the discussion that is going to follow here in the House.

MR. SPEAKER: The hon. the Minister of Health and Community Services.

SOME HON. MEMBERS: Hear, hear!

MR. KENNEDY: Yes, thank you, Mr. Speaker.

There are two aspects to this motion, and I will be speaking to that

throughout, but one deals with glucose, the second deals with the chronic

disease management strategy.

Mr. Speaker, there can be no question of the effect of chronic disease on our

society, and the future sustainability of our health care system. Chronic

disease is the biggest threat to the health of our population, and the

sustainability of the health care system. Chronic diseases have long durations,

they are generally slow to progress, they require ongoing management by

individuals, health care providers, and the communities. Some examples of

chronic disease and conditions include diabetes, heart disease, arthritis,

chronic pain, lung disease, kidney disease and there is, again, no question of

the significance of diabetes and the prevalence of diabetes in our society.

Mr. Speaker, contributing to the prevalence of chronic disease are the high

rates of risk factors, such as smoking, physical inactivity, unhealthy diets,

excessive alcohol use, and obesity. Chronic disease also is more common with

age, and in this Province, as we know, our population is rapidly aging. Other

factors include low income, poor social support, and unhealthy physical

environments. This all contributes, Mr. Speaker, to development of chronic

disease.

These factors then contribute to the decreased quality of life for

individuals, decreased productivity in the workplace, and increased costs to the

health care system. So there is no question, Mr. Speaker, on the significance

and importance of this issue to us as a government, or to any government. This

is not only a Newfoundland and Labrador issue, Mr. Speaker, this is an issue

that affects everyone in this country, because these same chronic diseases are

prevalent throughout the country, and in fact, contribute to burdens on the

health care systems throughout the world.

Last year, Mr. Speaker, I had the opportunity, as the co-chair of the

Federal/Provincial/Territorial health ministers to travel to Geneva and go to

the World Health Organization meetings, Mr. Speaker. I can tell you, not only

was it educational, but it was an eye opener, Mr. Speaker. Sometimes it is easy

to forget how good we have it in this country. That does not mean, Mr. Speaker,

that we cannot improve. It does not mean that we cannot continue to invest

wisely in health care. The reality is that the level of care offered in Canada

and in our Province, Mr. Speaker, is of the highest standard.

One of the things that jumped out at me I can remember the federal minister

of health saying to me, as we were listing to various countries it could have

been India, Brazil, various representatives we have to own our own health.

That is a message that we have to get out to each and every Newfoundlander and

Labradorian and each Canadian, Mr. Speaker. We have to own our own health.

Now, Mr. Speaker, what did she mean by that? Well I can tell you and I can

quote to you, Mr. Speaker, from the World Health Organization Global Strategy on

Diet, Physical Activity and Health which is 2003. They state that chronic

diseases are now the major cause of death and disability worldwide.

Noncommunicable conditions such as cardiovascular disease, diabetes, obesity,

cancer and respiratory diseases now account for 59 per cent of the 56.5 million

deaths annually and 45.9 per cent of the burden of disease. A relatively few

risk factors; high cholesterol, high blood pressure, obesity, smoking and

alcohol cause the majority of the chronic disease burden. A change in dietary

habits, physical activity and tobacco control has a major impact in reducing the

rates of these chronic diseases often in a relatively short time.

Mr. Speaker, the World Health Organization, made up of experts throughout the

world, state up to 80 per cent of coronary heart disease, 90 per cent of type 2

diabetes cases, and one-third of cancers can be avoided by changing to a

healthier diet, increasing physical activity and stopping smoking. Mr. Speaker,

you are going to hear one of my colleagues today talk about what this government

is doing in prevention and wellness.

By contributing to a healthier lifestyle, by each of us living a healthier

lifestyle, Mr. Speaker, we contribute to the health of the health care system.

Not only do we improve and manage our own health now, Mr. Speaker, I recognize

that there are numerous factors which affect all of this and it is not as simple

as simply saying go ahead and do all of these things. It takes cultural changes,

Mr. Speaker, in thinking. By that I mean that we have to look at what we do as

society.

Mr. Speaker, as all of us know, children are much more adaptable, their minds

are more malleable and they can accept ideas without question. There is an

example, Mr. Speaker, of a great project out in my District of Carbonear-Harbour

Grace whereby in the school that I went to, it seems like many years ago, they

for numerous years had a greenhouse attached to the school. Mr. Speaker, the

students run the greenhouse, the students eat the vegetables that they grow. Mr.

Speaker, they grow lettuce, they grow tomatoes, cucumbers, pumpkins and they eat

them. So, Mr. Speaker, what we are bringing home to them is the importance of a

healthy diet but they are doing it themselves, they are owning what is taking

place.

Mr. Speaker, another one of our colleagues is a great grower of vegetables.

At any given time, Mr. Speaker, he will grow the vegetables that all of us eat

on a daily basis. Mr. Speaker, what we have is that these vegetables again

contribute to your health.

Mr. Speaker, I agree with the member opposite, that prevention and awareness

is something that we have to focus on as a government. It is something that we

are doing. What will this chronic disease and management strategy be, Mr.

Speaker? What would it be? It is a document that lays the foundation for action

plans, evaluation plans to be developed separately over time.

Now, Mr. Speaker, a framework or a strategy by itself means nothing. It is

the action that counts. I can, after my short time in health - it seems like a

long time at times - know the kinds of things that should go into a strategy,

but what we have to do is not only a strategy. What are we going to do about it?

How are we going to increase awareness? What are we going to do? There is no

question, Mr. Speaker, and I do not have the exact numbers in last year's

Budget, but I know we had a number of diabetic educators in our Aboriginal

communities. Diabetes, again, is a very prevalent disease. Diabetes is certainly

a disease that we have to deal with. Mr. Speaker, the two types of diabetes that

we have is type 1 diabetes, which typically requires insulin and the age of

onset is generally younger; then we have type 2 diabetes, which is typically

managed by either diet alone or medication taken by mouth and the age of the

onset is usually later in life.

Mr. Speaker, we are working with various organizations. On April 14, 2011 we

provided $75,000 to the Canadian Diabetes Association for a variety of

prevention and management activities, including an awareness campaign focused on

type 2 diabetes. This funding will also help the Diabetes Association

participate in self-management initiatives. What we are doing, we are going to

the people who are living with this, the people who are the experts and saying,

how can we help you educate the people who need help? Not only all of us who are

at risk of developing diabetes, Mr. Speaker, but those who suffer from diabetes.

The numbers as outlined by the member opposite are certainly significant, but

the member opposite talks about in the motion the number of people in the

Province may double in the next ten years without effective prevention. Mr.

Speaker, the Canadian Diabetes Association estimates that the 47,000 in 2010 is

expected to increase to 73,000 in 2020, an increase of 65 per cent. It is not

going to 94,000. It is still a significant increase, Mr. Speaker, but not what

is outlined by the member opposite.

Mr. Speaker, now we come to the issue of the diabetic test strips. Mr.

Speaker, our Province is as good as or better than any other province or

Territory in Canada with the provision of these strips. There is no standard

approach across Canada. Diabetic test strips are in the top five drug costs in

the country's public drug programs. In this Province, blood glucose strips are

covered under the Newfoundland and Labrador Prescription Drug Program. So, Mr.

Speaker, if you are entitled to coverage under the drug program, the Access Plan

or the Assurance Plan, then they can also cover the strips.

The coverage, Mr. Speaker, "is restricted to: beneficiaries who have diabetes

and are taking insulin or oral hypoglycemic medications; beneficiaries who are

not on insulin or oral hypoglycemic medications but are being followed by a

Diabetes Nurse Educator, Dietician, or Family Physician, with a letter to

confirm same and have an approved special authorization."

Mr. Speaker, we are providing coverage for glucose strips. They will be paid

if the beneficiary has had a paid claim for diabetic medication within the past

year or has a special authorization in place. They are subject to a maximum of

2,500 test strips per year for all beneficiaries meeting the criteria. So, we do

provide coverage in this Province. There are private insurance plans, but we

also do it under our Newfoundland and Labrador Prescription Drug Program

Now, Mr. Speaker, the member opposite referred to evidence now questioning

the necessity of these glucose strips. Mr. Speaker, there has been a recent

report. It is a very lengthy report if anyone wishes to read it. It is in the

Optimal Therapy Report Systematic Review of Use of Blood Glucose Test Strips for

the Management of Diabetes Mellitus and it is the Canadian Agency for Drugs and

Technology Health.

This group, Mr. Speaker, referred to as CADTH, is an independent,

not-for-profit body funded by Canada's federal, provincial, and territorial

governments. For more than twenty years CADTH has been providing information and

advice on drugs and other health technologies based on the best available

research.

Mr. Speaker, the results of the clinical review are currently under

consideration. Basically, CADTH is of the opinion that in patients with type 2

diabetes who are managed either by diet alone or by medication by mouth does not

result in clinically significant improvement. Now, that is not going to change

at this point, the way anyone does business. As we talked about when we were

talking about the breast cancer screening policy, there is conflicting

literature.

What is happening here, I understand, Mr. Speaker, is the Canadian Diabetes

Association does not agree with the CADTH report. So we will explore this and we

will see what goes on. There is ongoing consultation with national experts.

Mr. Speaker, just to put it in perspective, in the Province in 2010-2011,

$5.5 million was spent on diabetic test strips involving 15,885 clients. Mr.

Speaker, we are going to examine all of this, we will look at it, and everything

will remain the same for now.

Mr. Speaker, in terms of considering what to do in the best interest of the

patients, we do that all the time. Anyone who has been involved in the budgetary

process knows that you have to sit down and you have lists and lists of

requests. We have to look at ranking those requests and how can we achieve the

best result with the money we have. Mr. Speaker, that is what we do with

dialysis, as another one of my colleagues will talk about today.

You talk about the effect of dialysis on the people down in Fortune Bay-Cape

la Hune; you talk to the MHA there at how pleased they are. Mr. Speaker, that is

a million dollar investment - $1.5 million with approximately $700,000 ongoing.

You talk to the people on the Burin Peninsula, the MHA for Burin or the MHA for

Grand Bank, and the effect on those people who had to drive back and forth to

either Clarenville or St. John's to obtain dialysis. You talk to the

improvements we have made in Stephenville, Port aux Basques, new dialysis in Lab

West. So, these are decisions that you have to make.

Then, we look at the insulin pumps and the investment in our youth and how it

has opened up a new lifestyle for a lot of our youth with the investments in our

insulin pumps $1.4 million in 2007, and $800,000 in Budget 2010 to expand from

eighteen to twenty-five. Mr. Speaker, in four years, look what we have done with

dialysis, look what we have done with insulin pumps. Yes, we will consider

whatever it is we have to do, but there has to be a process in terms of you

cannot have everything, what can we do each year, and you budget for that.

Now, Mr. Speaker, in terms of the resolution put forward, this is what I will

suggest. I would like to put forward the following amendment, that we delete

clauses 2 to 7 inclusive and replace with the following:

WHEREAS the number of people in the Province are expected to increase by

55% between 2010 and 2020 without effective prevention; and

WHEREAS diabetes can lead to kidney and heart failure, disability, and

shorten life expectancy; and

WHEREAS there are increasing demands for dialysis service for individuals

with diabetes and other chronic conditions which requires a focus on disease

prevention to reduce future demands for dialysis services; and

WHEREAS in 2010 diabetes cost our health care system $40 million for

doctor visits, hospitalization, drugs and medical supplies, a cost that could

increase by 65% without better prevention and management; and

WHEREAS some individuals with diabetes require frequent daily glucose

testing at a cost of approximately $1 a strip, which can pose a financial

hardship for individuals without sufficient financial means; and

WHEREAS the Newfoundland and Labrador Prescription Drug Program provides

support for people who need glucose testing strips but who have difficulty

affording them, thus seeking to prevent endangerment of their future health

contributing to an added cost to our health care system.

Mr. Speaker, when it comes to the resolutions, I would also put forth in the

first THEREFORE

BE IT RESOLVED clause the word cover be deleted and the

following inserted "give consideration in the next budgetary process to

covering". The clause reads:

THEREFORE

BE IT RESOLVED that this House urge the Government of Newfoundland

and Labrador to give consideration in the next budgetary process to covering the

cost of glucose testing strips for all diabetics in the Province under MCP.

Finally, Mr. Speaker, I put forth that the final THEREFORE

BE IT RESOLVED

clause be amended by deleting the words: place the highest possible priority on,

and insert the words: "continue to place priority on finalizing and". The clause

reads:

THEREFORE

BE IT RESOLVED that government continue to place priority on

finalizing and releasing the chronic disease prevention and management strategy.

Those would be the amendments suggested, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER: Order, please!

The Chair will take a brief recess to review the amendments as put forward by

the hon. the Minister of Health and Community Services and return with a ruling.

Recess

MR. SPEAKER: Order, please!

The Chair has reviewed the amendment as put forward by the hon. the Minister

of Health and Community Services and we deem that the amendment is in order.

The hon. the Member for the District of The Straits & White Bay North.

MR. DEAN: Thank you, Mr. Speaker.

It is an honour to be able to stand and speak to this private member's motion

today. A very important motion I believe covering a very important topic for all

of us in the Province of Newfoundland and Labrador. All of us are impacted in

one way or another, either personally or through family members and friends, by

a disease that really there seems to be no real cure for sure and control even

at best. The increases that we are seeing are very dramatic and concerning. I am

pleased that I can stand and speak to this private member's motion today for a

few moments.

I would say that the changes in terms of the amendment brought forward,

really we are taking it from placing the highest priority on this issue to

placing priority, so not a great shift, not really understanding totally perhaps

as to why it is necessary.

Mr. Speaker, in my research in preparation for speaking here this afternoon,

some of the numbers that we find are very glaring and very concerning in terms

of the numbers of people impacted by diabetes. When we look at it from a global

perspective we realize that indeed it is an epidemic of major proportions.

We see the numbers today tell us that there is an estimated 285 million

people or so throughout the world who are affected in some way or another by

diabetes. The statistics would suggest that within the next twenty years, taking

us to about 2030, the number will hit somewhere around 435 million to 440

million people with an increase each year of approximately 7 million people. So

certainly the numbers are staggering in terms of where this disease is going to

take the population not only of our Province but of the world.

Mr. Speaker, in Canada today we have somewhere around nine million people or

so who live with diabetes or are in what we would call a pre-diabetes state and

health condition and so on and it is very concerning.

Mr. Speaker, there are a lot of reasons for people being affected by diabetes

to the degree that they are. Population, of course, aging and as population

ages, Mr. Speaker, many of the chronic diseases in our society we obviously

experience them; diabetes is certainly one of those. Obesity rates, we know, are

on the increase. Mr. Speaker, it is a key contributor to diabetes. Then of

course there are just the lifestyles that we live; many of the things we do each

day are not necessarily good for us health-wise. We know that, we read about it

and we are informed of it from day to day but yet whether it is a lack of

physical activity or whether it is an unhealthy diet, high cholesterol, high

blood pressure, all of these things give us increasing chances of being affected

by diabetes.

Mr. Speaker, as well an interesting note is that as the demographics of

Canada change and as our population increases we realize that almost 80 per cent

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MR. DEAN: Thank you, Mr. Speaker.

I have a hard job trying to figure out what I want to say here right now

because I cannot hear myself speak.

Mr. Speaker, almost 80 per cent of new Canadians come from populations that

are considered to be at a higher risk for diabetes and these include Aboriginal,

Hispanic, whether they are from South Asian, African decent and many of the

other groups that really run a high risk for different reasons. Certainly, these

statistics and these demographics affect our Province as well as the country and

we know that it is a major issue that we are discussing here this afternoon. The

best and most efficient use of the taxpayers' dollars and being able to have the

services that are available to the people throughout our Province that have this

disease, Mr. Speaker, is very important.

Mr. Speaker, there are estimates in Newfoundland and Labrador in terms of our

provincial Budget that in 2010 there was approximately $250 million that was

spent on the treatment of diabetes. The estimates are that within the next ten

years, by 2020 that cost will increase some 27 per cent to take the total cost

of that particular piece of our health care to about $320 million. There is a

significant investment in terms of money in the administration of health care,

in the delivery of health care to people in the Province that have diabetes. It

is very important to us that we are able to meet that requirement, that we have

the tools in place, that we have the programs in place, that we educate our

people, that we make available to them medical treatments and resources and so

on throughout the Province; not only in one area, probably in the capital city,

or some of the larger centres of the Province, but it is very important that

people throughout our Province in the less densely populated areas of rural

Newfoundland and Labrador are afforded the same opportunity as well.

Mr. Speaker, the personal cost of diabetes, not only is it a financial piece,

but more importantly, it is the personal cost that is involved. When you have

this disease you are not able to participate, necessarily, in the same quality

of life that a person can before. It kind of reduces what you can do sometimes

in terms of activity. It gives you complications in health, in terms of whether

it is heart disease and stroke. It leads to blindness. We see where it goes when

it is out of control, eventually people losing limbs and so on and amputation.

So, the outcome and the cost of being stricken with this disease is very huge

and very great for sure.

Mr. Speaker, then there is the financial burden upon people who are inflicted

with this disease. They do not always have the types of medical insurance and so

on that many of us might be privileged to have, where there is no coverage for

certain types of insulin and certain types of treatments and so on. We realize

people who have diabetes incur medical costs per year that are astronomical

compared to what a healthy individual would have. For example, there can be

direct costs just from medications and supplies that can take you anywhere from

$1,000 to $15,000 or more a year. As we understand diabetes, as it affects

people with lower incomes and the aging populace of our community, then

obviously, there would be a lot of people in our community who would not be able

to afford $15,000 a year for medical treatment and medical supplies to

counteract their diabetes problem.

That in itself, Mr. Speaker, begs the question, are people really getting the

medical attention they need and that they should have? Are people slipping, if

you will, into this disease prematurely, or are they facing amputation

prematurely? Are they facing death prematurely, Mr. Speaker, because they do not

have the financial resources that are available to them to be able to really get

the medical attention they need and so on? I am sure that is the case and that

is very unfortunate, I would say.

Mr. Speaker, it is estimated that by 2020, it is just a staggering number,

but it is estimated diabetes will cost our health care system in Canada some $17

billion a year; $17 billion a year to treat one disease. So anything we can do

in terms of research, education, and pre-empting people being inflicted by this

disease, Mr. Speaker, obviously those things are very, very important.

Studies show us that 57 per cent of Canadians with diabetes do not comply

with their prescribed therapies because of the cost of medications, the cost of

devices, the cost of supplies, and so on. Over half the people who have that

disease we can equate that to our Province today. Over half the people in

Newfoundland and Labrador today, according to statistics, who have the disease,

do not comply with the prescribed therapies that the doctors have prescribed to

them, simply because they cannot afford the means of doing it. Of course, we

know failure to do that, Mr. Speaker, obviously, leads directly to more

significant complications, whether it is kidney disease, heart attacks, strokes,

blindness, or whatever the case may be. Obviously, ultimately the outcome is

that individuals are facing those kinds of illnesses simply because they cannot

afford to do anything about it.

Mr. Speaker, it is interesting to note the observations that the Auditor

General has made in his review of the diabetes health care issue in the

Province. He did an analysis on how the Province is doing. While we are doing a

lot of good things and I want to acknowledge that here this afternoon, Mr.

Speaker, that good things are being done in our health care system there are

also a lot of things that fall short of where we want them to be. The Auditor

General has taken time to note them and obviously things that the Auditor

General notes are important and significant for us.

One of the things he mentioned was a lack of accurate numbers in terms of

people in the Province who have diabetes. There is no chronic care registry, if

you will, and no diabetes registry within the Province.

SOME HON. MEMBERS: Oh, oh!

MR. SPEAKER: Order, please!

MR. DEAN: We really do not know where the numbers are, either from a

budgetary point of view or from the number of people who actually have the

disease and are being treated today, because there is no diabetic registry. The

failure to capture the patient information, whether it is personal information,

whether it is health information, whether it is risk factors, whether it is

diagnoses that have taken place of multiple diseases, whether it is the test

results and other things, Mr. Speaker, that would be important not only to the

patient but to really, I would think, understanding the disease and its

prevalence in the Province; really, we are missing out on that simply because we

do not have a Province-wide diabetes registry. I know that issue has been raised

in this House over time in recent sessions and I would encourage the government

and the Minister of Health in particular to really act upon those points of the

Auditor General to say this is something that we need, this is something that we

need to see and that we could expect, Mr. Speaker, in due order to see it

implemented.

Something else of importance that the Auditor General brought to our

attention, Mr. Speaker, in his report is that each of the regional health

centres indicated that the services available in their region are not sufficient

to offer the level of care needed to provide what they deemed as being optimal

care to diabetes patients. The level of care that they are able to offer is not

to the level that it needs to be if they are going to give optimal care to the

patients within their regional health authorities.

Mr. Speaker, that is concerning because we do not all live within a little

cluster in terms of geography, we are spread out. We know it is challenging and

it is very unfortunate I would say today that if one regional health authority

is able to offer an optimal service simply because of where you live, and yet

someone living in another part of the Province as they develop diabetes, as they

require treatments and medications and so on, Mr. Speaker, that they are not

able to get the same kind of service simply because of where they live. I would

hope that in due process and short order, that we can see changes to that where

we can see the Auditor General coming back and saying that great improvements

have been made and pleased to report that basically a proper and effective

treatment of diabetes and services is available across the Province.

Mr. Speaker, he also noted in his report that the Department of Health has

not implemented all of the recommendations contained in the 2008 primary health

care report and noted that as a result of that basically the Province of

Newfoundland and Labrador, "has not progressed to the level at which it should

be with regards to the management and control of chronic" diseases such as

diabetes.

It is one thing to do a report, it is one thing to do a strategy, it is one

thing to do an investigation, but behind that, Mr. Speaker, it is very important

that it is implemented. That is certainly of major importance, in terms of the

care of diabetes.

I am pleased today to be able to stand and to speak to this issue. It is an

important issue, I support the private member's motion as put forth by the

Leader of the NDP, and pleased that I can stand this afternoon and speak to it

for a few moments.

Thank you, Mr. Speaker.

MR. SPEAKER: The hon. the Member for the District of Ferryland.

SOME HON. MEMBERS: Hear, hear!

MR. HUTCHINGS: Thank you, Mr. Speaker.

Glad to rise today and speak to the motion put forward by the Member for

Signal Hill-Quidi, and as well, the amendment put forth by the Minister of

Health and Community Services.

Mr. Speaker, both speak to chronic disease prevention and the issue of

diabetes. I think for my speaking time today, I would like to speak to the

motion in general, but as well, to speak to the prevention component, and in

terms of health and well being, and certainly, the importance of prevention, and

being effective in all chronic disease, including diabetes and everything that

goes with that.

Mr. Speaker, our government continues to enhance the health and well being of

Newfoundlanders and Labradorians through record investment in health care in our

system. In particular, in Budget 2011 for the Province our government has

invested a record $2.9 billion in health care services to enhance health care

and services throughout the Province. Health care infrastructure throughout

Newfoundland and Labrador continues to be a huge priority of this government

with a total of $272 million in Budget 2011, Mr. Speaker. That includes a little

over $200 million for new and continuing construction and redevelopment, $50

million for new equipment, and almost $22 million for repairs and renovations.

So, the investments are certainly vast right across the Province, on the island

and in Labrador as well.

While investing in infrastructure is vital for enhancing our health care

system, I am pleased to say that the government is taking several approaches to

addressing health care for all our residents. As I have often said before,

health care is the full approach, it is the holistic approach. It is dealing

with acute care, dealing with things like long-term care, but dealing with

prevention as well, our full demographics, in terms of our very young right to

our seniors, in terms of living healthy lifestyles and certainly having access

to programming and services that promote that, education programming, all those

kinds of things that are so important for chronic disease and certainly for

diabetes as well. Promoting that wellness and prevention is an important aspect

of that commitment and we have made that commitment and continue to do so.

As Parliamentary Secretary for Health and Community Services I see first hand

how our investments are rolling out and the impact we are having on the ground

out in rural communities, all communities in Newfoundland and Labrador and the

efforts we are having.

Mr. Speaker, our government is committed to providing those supports and

encouraging everybody to adopt a healthy lifestyle. We do that by investing in

many of the programs, which I will touch on, and services that encourage our

residents to go healthy in the Province.

Mr. Speaker, some of those investments include $4.1 million annually in the

Provincial Wellness Plan. That focuses on several priorities, priorities like

healthy eating, physical activity overall, tobacco control, injury prevention,

mental health promotion, environmental health, child and youth development and

overall health protection.

Mr. Speaker, as part of our overall wellness plan our government launched the

Provincial Wellness Grants Program in 2005. Over that time we have awarded

approximately $3.5 million in funding to over 170 community-based projects

throughout Newfoundland and Labrador. I know in my area in particular I see it

first hand, Mr. Speaker, with the Bay Bulls-Bauline Athletic Association, a

total of $40,000 over two years to do a whole range of initiatives in terms of

healthy lifestyle, the promotion of healthy living with youth, as I said before,

right to seniors.

After-school programs in terms of our youth, statistics show that our youth,

the most inactive period of time is from three to five in the evening, so

after-school programs I know in St. Bernard's, Witless Bay, Baltimore and

Ferryland, I know them as well. They are involved in after-school programs,

keeping kids active in that period of time and providing support and services.

We do, through various programs, allow that to happen to introduce youth to that

healthy activity and healthy lifestyle. Learn that at a young age and they

continue down through their adult life which is all about prevention and is

about avoiding chronic disease and other diseases as they get older which is

extremely important.

Mr. Speaker, in addition we have over $700,000 in funds ranging from $5,000

to $40,000 to various types of different grants and that type of thing. I know

my colleague from Kilbride and I have been involved with the Gould's Daffodil

Club, another seniors group that is quite active. This year they had a

healthy-aging seniors grant approved of $10,000 to allow initiatives to get

started for them and to continue on the good work they are doing. The types of

things you need to do for prevention and a healthy lifestyle which are so

important.

All these grants were given to a wide range of community groups,

municipalities, community centres, youth centres, seniors groups, Aboriginal

groups, and athletic associations. It touches a broad spectrum of all the groups

out there on the ground that are doing a whole range of wonderful activities in

terms of healthy living. This funding allows government to reach out, put the

money on the ground, and allow these groups in the communities and regions who

know what they need to proceed to put the programs and services in place.

Mr. Speaker, forty-four community groups from across the Province were

receiving these funds and implementing programs, as I said, to address

priorities. These are tied to the Provincial Wellness Plan as I spoke of. That

is all about promoting prevention at a young age, instilling it in our youth in

terms of healthy living, and exposing them to the proper programs.

Mr. Speaker, the plan Go Healthy Achieving Health and Wellness in

Newfoundland and Labrador was released in 2006. The overall aim is certainly

improving the health of the provincial population and helping all

Newfoundlanders and Labradorians achieve their optimal state of wellness,

whatever that may be. The Wellness Plan reflects an increased focus on shared

responsibility for health and provides direction for promoting health,

preventing illness and injury, and increasing the capacity of individuals,

groups, communities, and sectors to take action for wellness.

The minister earlier spoke of taking ownership in terms of our health and

well-being. I think that is something we are coming to a realization of in terms

of prevention and healthy living. That is so important as well.

Mr. Speaker, this year, in addition to the Wellness Grants, our government

also provided twelve community groups with senior wellness grants ranging from

$7,000 to $25,000. A total of $200,000 was provided for a variety of projects

that focus on improving health and well-being and the overall health of seniors.

In the second year was also awarded a total of $200,000 in Age-Friendly

Newfoundland and Labrador Grants to ten municipalities and thirteen seniors

clubs.

Again, I can certainly relate to the area I represent, the District of

Ferryland, and the very active groups and initiatives and what they are doing:

the Trepassey 50 Plus Club, a $9,000 grant last year; the O'Connor 50 Plus Club

in Witless Bay, and I had an opportunity to attend their annual dinner and dance

last Saturday night, the work they are doing in the region; particularly from

Bay Bulls to Bauline, certainly working with the Bay Bulls-Bauline Athletic

Association collectively, a $10,000 grant, and they are certainly doing great

work as well; and the Captain William Jackman Social Club in Renews and the good

work they are doing in providing healthy activity for a whole range of people in

that area.

So these are all positive things that are reaching out, building healthy

lifestyles, and things like prevention which I spoke of. We certainly recognize

our responsibility in that and that is part of the holistic approach in terms of

health care and what we need to do. It is related to what we are talking about

here today in terms of chronic disease and certainly effective prevention.

There are other things we are doing, Mr. Speaker, in terms of investing,

$477,000 for the expansion of the Janeway Lifestyle Program that provides

services for children to achieve healthy weight and address other risk factors

for chronic disease. That is so important as they go through all of that, too.

It is about looking at the risk factors for chronic disease. Our prevention

programs focus on that, so we do not get there in regard to those chronic

diseases and all the implications that they would bring.

As well, Mr. Speaker, we are looking at things like $225,000 for a school

based tobacco prevention campaign and that is targeting our young people,

to focus on youth and young adults with smoking prevention and cessation

messages, and an increase in funding to the Newfoundland and Labrador Lung

Association for the operation of the Smokers Helpline. As well, talking about

directive towards prevention and awareness and providing that information so

people can make the right choices in terms of healthy lifestyles.

They all reflect the priorities we have set out in the Provincial Wellness

Plan, as I have indicated, and that is just one of the ways. Our government is

taking the necessary steps to address chronic disease. We have recently the

minister spoke of this as well - established a chronic disease control division

in the Department of Health and Community Services. The responsibility there and

the target is to look at a provincial chronic disease strategy, as we spoke of,

and include diabetes and other chronic diseases such as cancer, heart, stroke,

lung, arthritis and chronic pain. Once again, it is holistic in terms of

obviously chronic disease. We know this is so important to Newfoundlanders and

Labradorians and that is why we are addressing it now and moving forward with

it.

We have also made several investments to improve services to those with

chronic disease. In 2007, we invested $1.4 million to fund the insulin pump

therapy program which now provides insulin pumps to several hundred people

living with diabetes throughout the Province. One of the greatest things about

these pumps is that they help the very young children, our youths, who live with

type 1 diabetes. It reduces the number of injections that are required each and

every day and can be adjusted to match activity levels and needle times as well.

These pumps also reduce the risk of future complications of diabetes, so

certainly get to the prevention component of those who suffer from a chronic

disease.

Back a number of weeks ago I had the opportunity to attend the Junior

Diabetes kickoff for the Run for the Cure. Certainly there, the youth

ambassadors, some outstanding young boys and girls got up and talked about their

experience in terms of being diagnosed with type 1 diabetes and what they went

through. I heard first-hand from them in terms of the use of the insulin pump,

what it has meant for them. It certainly changes their lives and the activities

they do. I congratulate those three youths who got up and spoke so articulate,

strong leaders, strong youth. I think the ages were probably eleven and under.

It is just fantastic to hear these young people speak and give first hand their

experience in terms of dealing with type 1 diabetes, and the insulin pump and

what that has meant to them in their lives and how they are able to function.

Mr. Speaker, as well, I was pleased to see in Budget 2010 an additional

$800,000 to expand the coverage of insulin pumps for 2011, from ages eighteen to

twenty-five years of age. Again, to adults looking at that same, in terms of

moving that service to the older population - our youth, I guess you would say.

Other things we have done, in terms of chronic disease and looking at

assisting our population. We have increased the income threshold for its access

plan under the Newfoundland and Labrador Prescription Drug Program, making it

more accessible to residents and for new medications for diabetes as well, Mr.

Speaker.

Several groups, as well, just recently announced by Minister Kennedy,

$400,000 to address a number of issues related to chronic disease, diseases like

arthritis, diabetes, cancer control, tobacco use, and promotion of healthy

eating. Some of the groups that were targeted in this are groups that do

exceptional work out there. Once again, it is our government identifying those

who are out there on the ground doing fantastic work and providing the funding

and resources so they can do prevention programming and assistance to those who

need it. Some of those groups, for example, would be the Food Security Network

of Newfoundland and Labrador, Canadian Diabetes Association, Arthritis Society

of Newfoundland and Labrador, Buckmaster's Circle, and Stella Burry Community

Services. All of those, and others out there on the ground, we recognize and

respect the great work they do and the role they play.

Mr. Speaker, we believe the initiatives that we talk about here help improve

the lives of people with chronic disease, and as well, those with diabetes.

These initiatives demonstrate our understanding of what is happening out there,

how we are strategically moving to meet those challenges, and encouraging

healthy lifestyle choices and how we can prevent chronic disease.

Mr. Speaker, that commitment is evident in our investments over the past

number of years, through things like the Wellness Plan, and the Provincial

Wellness Grants Program. We certainly expect to continue to do that, and we

recognize that community programs and services contribute to successful

prevention and management of chronic disease. That is what we are talking about

here today, in terms of this overall motion and moving forward.

As I said earlier, in terms of the unprecedented investments we have made as

a government in health care, to make sure people receive the quality care as

close to home as they possibly can. We put the supports in place, Mr. Speaker,

to improve the overall health of our population in an effort to reduce the

demands on our health care system in the future; whether it is a number of

chronic disease types, including diabetes, that we deal with it when someone

unfortunately is diagnosed, but then prior to it in terms of prevention.

So, Mr. Speaker, I am glad to avail of the opportunity to speak to this

motion. I would ask the hon. members to further partake in the discussion. I

would certainly ask members as well to support the amendment put forward by the

Minister of Health and Community Services in terms of the private member's

motion.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

MR. SPEAKER (Kelly): The Chair recognizes the hon. the Leader of the

Opposition.

MS JONES: Thank you, Mr. Speaker.

I rise today to speak to the motion put forward by my colleague, the Member

for Signal Hill-Quidi Vidi and the Leader of the NDP. Mr. Speaker, it is a good

motion. It is a very good motion because it speaks to a real need that exists

out there in the Province for many patients today who suffer from diabetes in

particular and from chronic disease.

Mr. Speaker, let me just say from the offset, I was very disappointed that

the government chose today to make an amendment to the motion, an amendment

really that reflects very little in my opinion. Mr. Speaker,