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November 2, 2022 HOUSE OF ASSEMBLY PROCEEDINGS Vol. L No. 12

The House met at 10 a.m.

SPEAKER (Bennett): Order, please!

Admit strangers.

Government Business

SPEAKER: The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

Speaker, I call from the Order Paper, Motion 1.

That notwithstanding Standing Order 63, this House shall not proceed to Private Members' Day today, Wednesday, November 2, 2022, but shall instead meet at 2 p.m. today for Routine Proceedings of government business and that, if not earlier adjourned, the Speaker shall adjourn at midnight.

SPEAKER: Is it the pleasure of the House to adopt the motion?

All those in favour, 'aye.'

SOME HON. MEMBERS: Aye.

SPEAKER: All those against, 'nay.'

Motion carried.

The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

Speaker, I call from the Order Paper, Motion 2.

SPEAKER: The hon. the Government House Leader.

S. CROCKER: Speaker, I move, seconded by the Minister of Education, that in accordance with Standing Order 8(8) the spring sitting of 2023 of the House of Assembly shall commence on March 13, 2023, but all other aspects of the Parliamentary Calendar for 2023 shall remain unchanged.

SPEAKER: Is it the pleasure of the House to adopt the motion?

All those in favour, 'aye.'

SOME HON. MEMBERS: Aye.

SPEAKER: All those against, 'nay.'

Motion carried.

The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

I call from the Order Paper third reading of Bill 19.

SPEAKER: The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

I move, seconded by the Minister of Labour, third reading of Bill 19,

An Act to Amend the Fishing Industry Collective Bargaining Act.

SPEAKER: It is moved and seconded that the said bill be now read a third time.

Is it the pleasure of the House to adopt the motion?

All those in favour, 'aye.'

SOME HON. MEMBERS: Aye.

SPEAKER: All those against, 'nay.'

Motion carried.

CLERK (Barnes): A bill,

An Act to Amend the Fishing Industry Collective Bargaining Act. (Bill 19)

SPEAKER: This bill has now been read a third time and it is ordered that the bill do pass and its title be as on the Order Paper.

On motion, a bill, “An Act to Amend the Fishing Industry Collective Bargaining Act,” read a third time, ordered passed and its title be as on the Order Paper. (Bill 19)

SPEAKER: The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

I call from the Order Paper second reading of Bill 20.

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

T. OSBORNE: Thank you, Mr. Speaker.

I move, seconded by the Minister of Finance and President of Treasury Board, Bill 20.

SPEAKER: It is moved and seconded that Bill 20,

An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority, be now read a second time.

Motion, second reading of a bill, “An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority.” (Bill 20)

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

T. OSBORNE: Thank you, Mr. Speaker.

I'm pleased today to introduce Bill 20,

An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority. The bill is being introduced to fulfill commitments made to the people of the province during Budget 2022 and to realize one of the recommendations of the Health Accord NL final report, the creation of a single Provincial Health Authority.

Mr. Speaker, Budget 2022 announced the creation of one Provincial Health Authority to ensure consistency and collaboration across the province. The Premier and the Minister of Health and Community Services established a Task Force, Health Accord NL, to reimagine health and health care in the province in November of 2020.

The Task Force oversaw six strategy committees and four working groups. The final report identified that in the reimagined health system there is a need for a governance structure operating at a provincial and regional level and for the two levels of governance to be connected. Health Accord NL calls for the creation of a Provincial Health Authority to provide province-wide planning, integration and oversight of the health system and to deliver province-wide programs. It also calls for regional health councils to be established to inform the delivery of quality health care at a regional level.

In fiscal years 2004-2005, transitional teams were established to ensure a smooth and seamless change in governance from the previous regional board structure to new regional integrated health authorities. The regional integrated authorities order under the Hospitals Act created the four regional health authorities in 2005, which order was continued by

section 28 of the Regional Health Authorities Act . Since the integrated health authorities order was issued in 2005, the four regional health authorities have delivered health and community services in the province.

Bill 20 proposes to repeal the Regional Health Authorities Act and replace it with a new statute that will crease a single, province-wide health authority.

Budget 2022 also indicated a review of the Newfoundland and Labrador Centre for Health Information to ensure it is well positioned to meet the needs of the provincial health system and pursue the tremendous opportunities of digital technology in health care.

NLCHI currently operates under the Centre for Health Information Act, 2018 . Bill 20 proposes to repeal the Centre for Health Information Act, 2018 and tasks the new Provincial Health Authority with the responsibilities and duties of NLCHI. This will align the priorities of the Provincial Health Authority and the digital technology opportunities in the province.

The core functions related to the delivery of high quality health care for the people of the province will not change. Rather, the proposed amendments will help strengthen and improve the delivery of consistent care across all regions of the province, care which will also be sensitive to regional differences and local needs.

A single Provincial Health Authority will permit the province to, among other things, develop and maintain standards for provincial programs of care delivery and increase province-wide efficiencies within the health system by ensuring the sharing of resources through a clear division of responsibilities, improved communication and enhance collaboration.

The bill is substantially similar to the Regional Health Authorities Act . While it is necessary to create a new statute to achieve a single health authority, the Regional Health Authorities Act functioned well to ensure the appropriate balance between operational delivery of health and community services and transparency and accountability to the minister by the regional health authorities.

The bill proposes to create a board of trustees for the Provincial Health Authority with representation from all regions of the province. Government's best practices recommend the use of competency-based boards.

Mr. Speaker, the minister will be responsible for establishing the objectives and priorities for the provision of health and community services and information systems in the province. The minister will continue to have the power to determine which health and community services are to be delivered by the Provincial Health Authority and the standards for the provision of health and community services.

The Provincial Health Authority will be required to comply with the minister's determinations of which and to what standards health and community services shall be provided.

As currently exists, the minister will further have the ability to issue directions on any matter for the Provincial Health Authority, with which directions to the Provincial Health Authority shall be compelled to comply.

One of the substantive changes in Bill 20 is with respect to the responsibilities that will be given to the Provincial Health Authority. Coming out of the recommendations of the Health Accord NL final report –

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

The minister is right next to me and it's still hard to hear him.

The hon. the Minister of Health and Community Services.

T. OSBORNE: I could hardly hear myself, Mr. Speaker.

Coming out of the recommendations of Health Accord NL's final report, the Provincial Health Authority will, in addition to the responsibilities of the regional health authorities, be responsible for developing and maintaining standards of care for provincial programs of delivery; overseeing accountability for health outcomes through the monitoring and reporting on quality, safety and performance; in conjunction with the minister, developing a framework for connecting the social determinants of health with the health system at the provincial framework; in conjunction with the minister, ensuring a provincial strategy for recruitment and retention of health professionals; and complying with the direction for the delivery of administration of health and community services set by the minister.

In addition, with the repeal of the Centre for Health Information Act, 2018 , the Provincial Health Authority will also be required to assist and support itself, individuals, communities and other health service providers and policy makers at federal, provincial and regional levels to enhance the health and well-being of persons in the province through the planning and delivery of the health and community services by: developing, operating and managing a comprehensive and aligned information system that fully integrates and uses data and health information from all components of the health and community services system for the delivery of health care and health system planning; developing data and technical standards and keeping them up to date; managing provincial health data and information assets; preparing health reports and conducting applied health research and evaluation; and providing health analytics and decision support services.

To protect the privacy of individuals whose personal information or personal health information is collected, used, disclosed, stored or disposed of by the Provincial Health Authority in accordance with the Access to Information and Protection of Privacy Act, 2015 and the Personal Health Information Act and to carry out other responsibilities prescribed by regulations.

Mr. Speaker, Bill 20 will also require that the information system referred to shall protect the confidentiality and security of personal information and personal health information that is collected, used, disclosed, stored or disposed of by the Provincial Health Authority; provide accurate and current information; be efficient and cost-effective; and be flexible and responsive to the changing requirements of the system.

Another change from the current Regional Health Authorities Act is that the Provincial Health Authority will be able to engage in innovation and activities related to economic development with the approval of the minister. Under the current system, the ability to engage in these activities is not clear.

Speaker, as I mentioned, the bill also provides for the creation of regional health councils that will be responsible for advising the Provincial Health Authority on nuances and the particular needs of various areas of the province to deliver health care at the regional level.

The Lieutenant-Governor in Council will be given the authority to, by regulation, establish one or more regional health councils in the province. The regulations will set out the name of the regional health council, describe its boundaries and specify the organization and composition of the regional health council.

The minister, using the merit-based process through the Public Service Commission, will appoint members of the regional health councils. This will help ensure that community voices are heard and local differences are at the forefront of the delivery of health and community services.

One member from each regional health council will be appointed to the board of trustees of the Provincial Health Authority. Regional health councils will develop annual plans at the regional level to provide advice and recommendations to the Provincial Health Authority on the delivery of health and community services in its health region.

The regional health councils shall implement formal and informal structures for working with Indigenous governments and organizations in its health region and to engage with regional, social and health networks to influence health and health outcomes.

Finally, the bill will create a quality council. The quality council will established by the Lieutenant-Governor in Council to provide oversight to the Provincial Health Authority on matters of quality and performance. The quality council will be required to provide written reports to the minister regarding the quality and performance of health systems and other reports requested by the minister; develop and execute an evaluation plan for the authority; provide leadership on the learning health systems; develop standards for the collection, storage, processing and disposal of data by the authority; and carry out duties that may be prescribed in the regulations.

Speaker, the minister will be required to release any report related to the quality and performance of health systems to the public. The Provincial Health Authority will be required to notify the minister when it receives reports, advice or recommendation from the quality council.

This transition will require significant work, and I'd like to thank David Diamond a nd the entire transition team and subcommittees for engaging in this work. The bill contains necessary transitional provisions to help ensure a smooth process to create a single health authority.

These include, among other things, transferring assets and liabilities of the regional health authorities and NLCHI to the Provincial Health Authority; transferring all employees of all regional health authorities and NLCHI to the Provincial Health Authority and ensuring the continuity of employment is not broken; and substituting the Provincial Health Authority in respect of any agreement in which the regional health authority or NLCHI is a party.

Speaker, we know that the transition to a single health authority, with that, there will be questions, and most particularly by employees. As we have communicated in the past, the goal of this transition is to create more consistency in health care throughout Newfoundland and Labrador, as well as avoid duplication in associated corporate services such as human resources, payroll and finance. For our valued health care workers in the province, employment impacts will be managed primarily through attrition and other efficiencies. It is anticipated that employees will be offered meaningful, comparable, alternative employment in the new regional health authority.

In conclusion, Bill 20 will support the transition to a single Provincial Health Authority and fulfill the mandate of providing consistent quality health care to all residents of the province, regardless of where they live.

Mr. Speaker, officials in my department are working closely with the members of the transition team to ensure that the proposed amendments meet the provinces needs and we look forward to continuing this positive working relationship.

Mr. Speaker, this is an important bill. We do look forward to debate here by all Members of the Legislature.

With respect to current employees, the new bill provides assurances that current employees will become employees of the new Provincial Health Authority and that collective agreements will continue as they are. The bill states that the rights, duties and obligations of the employer and employee continue until changed by collective agreements or contract of employment.

Mr. Speaker, we've taken measures here to ensure that there is no disruption to our unionized employees, that collective agreements are respected as they are and that employees – if a position in payroll, for example, is impacted, that we will find alternate employment for those employees within the system.

I ask all Members of the House to join me in supporting this bill, Mr. Speaker. It's an important commitment of the Health Accord and it's important that we ensure consistency of health and community services to all people, regardless of where they live in Newfoundland and Labrador.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Topsail - Paradise.

P. DINN: Thank you, Speaker.

I want to thank the staff of the minister's department for providing us with an overview of this report. However, I think they were put in a very difficult position because the briefing was without any documentation. It's very difficult to go through a briefing and have some dialogue and to ask some questions if you're not provided with the documents.

I'm not shooting the messenger because I think the staff did the best they could with what they had. But in future, that's not the appropriate way to do this, especially as the minister stated this is a very, very important bill. This is an extremely important bill for this province, for the residents of this province, for anyone who is struggling with health care issues.

I will question whether this is exactly fulfilling what the Health Accord asked for. There are, certainly, and we'll talk about this later – it's not right on with what the Health Accord asked for because they were looking at more of an arm's-length organization here, but when I read down through the notes and, again, it was only yesterday we got a briefing without documentation and there's a lot to this bill even though you're carrying over other acts, there are big changes here. This is very important to the people of the province.

I'll go through some of the things that the minister has mentioned, but I go specifically to clause 19, which talks to the responsibilities of this authority. It talks directly to the responsibility of this authority and it's

section 2(a): “… the authority shall (

a) promote and protect the health and well-being of persons in the province and develop and implement measures for the prevention of disease and injury and the advancement of health and well-being.” I would hazard to say that is core – core to what we are doing here in terms of health care.

We sat in this House and we asked many questions on the Health Accord. We asked many questions and continue to ask many questions about the health and welfare of residents of this province and, of course, most of the answers have been: wait for the Health Accord. We're waiting for the Health Accord to come out. That's going to give us a plan, give us some direction. Of course, we've seen some things come out ahead of the Health Accord that are not even in the Health Accord.

But if you're really looking at the investment we made in the Health Accord, because it's a lot of work gone into that report and we all heralded it as a great report. We may not always agree with what was in that report, but the reason for this bill today is supposedly coming out of that report. It may, in some respects, be coming out of that report.

When I look at some of the issues we've gone through, Newfoundlanders and Labradorians dealing with their health issues and that, we've heard the stories. We've heard the stories. The minister has – I think I quoted him, he can correct me later if I'm wrong, but he talked about the high quality of health care in this province will not change.

I won't dispute that our health care workers, our health care professionals do their very best. They do their very best with what they have. Those who can access health care in a timely manner get that quality care.

When we talk about the high quality care, there's no argument. But the biggest issue here in this province, when you talk about the Health Accord and social determinants of health, a lot of it comes down to access to health care.

I still continue to hear the stories. I hear stories of patients who are struggling with mental health challenges and they can't access a psychologist or a psychiatrist or long-term care for mental health and they're on a wait-list for two years. Certainly that's access, that's access to this care. I'm sure if and when they get that, it's quality care.

When I hear stories of elderly people in the hallways of hospitals who are in there for dementia, which they can't be put into an acute-care bed, and the gentleman falls out of the bed and they're told by the staff there too bad you didn't break a bone, you would've had a bed. This is what we need to be talking about.

This individual did not get access to the care. I'm sure if he had got in there he would get quality care. The reason he can't get an acute-care bed is because acute-care beds are taken up by individuals waiting to get into long-term care facilities. Again, access. I'm sure, as the minister said, it'll continue to have the high-quality health care, it will continue. But it's access. It's access to the care.

So when we talk about promoting and protecting the health and well-being in the province, and talk about implementing measures for the prevention of disease and injury and the advancement of health and well-being, I rose in this House just yesterday and I spoke about continuous glucose monitoring devices that clearly prevent disease and injury. Again, high-quality care will not change. But it has to change in terms of access. That's what the Health Accord was about.

The Health Accord was about access for those who the social determinants of health have prevented them from getting. So we've got to work on access. I know it all costs money, and I believe in this document it speaks to – and just give me one second to find it here – these health – I don't want to misquote myself.

It talks to a

section 21(5): “The authority may, with the approval of the minister, engage in health innovation and economic development.” We're at a point where we're still struggling to provide the proper health care services to everyone, to have access for everyone. I talk about the glucose monitoring devices helping save health care $60 million to $80 million. That's money that can be reinvested. I don't know what they're defining as economic development; that's money that can really be reinvested.

So when I see that the Health Authority can engage in innovation and economic development, I wonder are we expanding what they have to do too much right now when, clearly, we're still focused on access to health care. People are struggling to get that access.

I'm also not quite sure about how much consultation has gone on with this. We've certainly seen a trend in this sitting in terms of legislation and briefings happening either the same day or just before the legislation is offered in the House. It's unfortunate because sometimes if you have a proper briefing with proper timelines, you eliminate a lot of the questions. We become more efficient in this House. When we talk about, again – and I agree with the minister, this is a very important bill. This deserves more than a paperless briefing –

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

I know Members are conducting district business and that in the House but the level of conversation is getting a little bit loud so if you want to take meetings, I ask that you take them outside so that we can hear the speakers.

The hon. the Member for Topsail - Paradise.

P. DINN: I appreciate that, Speaker; I am disappointed that they are not all ears on this, but I will move on.

When you look at this, just think about they talk about bringing the information system in under the one department. I don't know how this falls with what the Premier announced earlier the year because the Premier announced something different for the information system than we're seeing here, but I guess you thought something different here.

Only the other day, we had the first-year anniversary of the cyberattack. So I would suspect any time you mention information and private information and bringing it together under one umbrella, I'm sure the little red flags go up – especially in those that were impacted by the cyberattack but also by everyone else. How do you do this?

I think it was back in 2004, when they amalgamated some more of the health authorities, it went from eight to four at that time; I believe it took almost five years to figure out the information sharing for that. I'm not disputing that it is not something that we need; we certainly need that. Because, as a government, if we're moving towards virtual care and we want to be able to share information from all parts of the province on a system that we are sure is secure or we have done the most and the best we can to ensure that it is secure, then that is a good thing.

There are many things that can be cleaned up here. When you have a blood test out in Corner Brook and they send you in here and you come in here to the Health Sciences and you have to do another blood test because you can't share the information, that's something we need to address. There's no doubt about it; that's something we need to address.

So there are things in this paper, or this bill, that aren't going to happen overnight – they're not going to happen overnight.

I read again the description of electronic health record, and this is what we're moving towards. I don't disagree with it, but how we're going to get there and the need for more consultation and look at this, is what we need. Electronic health record means a province-wide record of a patient's health care history that is available electronically. That is a goal you work towards.

In fact in this day in age, I think to myself, how are we not there now? How are we not there now that doctors from – in fact, doctors around the world should be able to share information on a secure site on patients, especially now when some of our patients, some of our residents, have to travel. Have to travel either within the province or have to travel out of the province, or maybe even out of the country to get some specialized help or, in some cases, I'll say everyday help that's just overburdened here in the province.

AN HON. MEMBER: IVF.

P. DINN: Yeah, I mentioned IVF the other day. That's something that we should be looking at.

The minister already touched on this, but when you talk about the different labour groups, the different unions that represent health care workers in this province, again we know when the last reduction in regions happened. There are health workers working under one union, and others under another. So there's a bit of work to do there.

I'm sure all parties to that will work in concert to try and make sure that moves as smoothly as can possibly be done. But it is a hurdle. It is a hurdle that you have to get over, and I'm not sure how easy that hurdle will be to jump over.

Again, talking about continuity of employment in this bill – and I know you hear that a lot: Don't worry, your job is safe. I'm not fear mongering here at all. I'm just saying. We have to ensure that our valuable health care workers – we can't afford to lose one, not one. So I'm really hopeful that this bill will ensure that nobody's job is in jeopardy.

Some of these questions may come up in Committee, but when I'm talking about looking at the board of trustees in this bill and it talks about appointed by the Lieutenant-Governor in Council and then it says trustees appointed by the minister from the regional health councils which, of course, the regional health councils are appointed by Lieutenant-Governor in Council and it goes on and talks to this. I may have missed it, but I don't see staggering of appointments here. When people are being appointed to these committees, especially when you start, there are three, three-year appointments. I would hope that there would be some staggering.

Now, I understand there's an extension clause here, but to ensure some continuity, you certainly want to ensure that there's some staggering to the board, how they're put in there.

I'm looking at the authority here: responsibility of the health authorities. So one of their responsibilities will be to “collect and analyze health and community services information for use in the development and implementation of health and community services policies and programs for the province ….”

So when I look at that clause, I then go back to the security. The privacy of information is a big concern there. But one of the pluses there – that's a good plus if we're doing what's happening here. That's the collection and analyzation of health and community services data. I think in our briefing there was lots said about ensuring private information like that would not be shared, and that's a given. So we'll hold you to that on that one that privacy and individual information will not be shared.

But it does bring to light the need to have decisions that are made for the public health and welfare of Newfoundlanders and Labradorians to ensure that it is based on information and data that's available. That enables us, in government and us collectively, to make decisions on real issues; real health care issues that affect people in this province.

Further down in that section, it talks to “develop and maintain standards of care for the delivery of provincial programs ….”

As the minister mentioned, we have quality health care here, when you have access to it. I think we do have a high standard of care. We've had some pieces of legislation in here, changes to the Medical Act and the like, and the issue there – or sorry, not an issue, not a concern, but a prime point there has been to ensure that it does not affect the standard of care in this province that people receive. So it's good to see that.

We voted yes on that past bill, that we need to come up with better ways, more efficient ways to have new residents of this province who are come from away, they're RNs or doctors from away, to ensure that they can practice to their scope in our province. That goes to: while maintaining a standard of care.

So we have to keep moving in that direction, I don't disagree with that. Is there more that can be done? Is there more that can be immediate? There sure is and we will argue or maybe have a discussion that there's not enough being done. You're going to hear that. I hear it everyday from individuals who are in hospital beds or trying to get into hospital beds, who are not getting the access to that quality of care. We hear that on a regular basis.

As this is coming out of the Health Accord, I mean that's what the Health Accord is focused on. The Health Accord is focused on outcomes for Newfoundlanders and Labradorians out there who need help. Every region of this province, every district of this province has people who need help. They need help to deal with life-changing matters, life-and-death matters.

Again, I go back to the minister, this is an important bill. I agree, I agree 110 per cent. This is a very important bill. It's a bill that I would hope everyone speaks to. But I still go back to my issue about consultation and ensuring – like the Medical Act, as an example, again. We heard from the Medical Association who felt they should have been consulted ahead of that. I tend to agree with them.

When we're dealing with anything in health care in this province, anything that deals with everyday life and death and issues for our residents, we need to ensure – and the term gets used in this House a lot, we hear it: no stone unturned. Sometimes we're throwing the stones here, but it's no stone unturned. When it comes to health care, we should be – and I don't have an indication yet on this, but we should ensure that there's been full discussion and consultation on this bill. This bill is going to have far-reaching effects on this province and how we do health care better. Again, not debating the quality of health care when you receive it, but this is far reaching.

Some of the questions coming out of this are going to be: How does this – and not from me, but from people we have out in the districts – address my father-in-law who's waiting to get heart surgery and has been waiting for months and months and months? Those are going to be some of the questions on this. How does that address that?

I, quite frankly, wouldn't have the answer. I mean this is not a quick fix, this piece here, nor should it be really. It's what came out of the Health Accord, in some respects – we'll chat about that later.

It's an important piece that we have to work together on to make sure that all the pieces of this puzzle fit so that when we're changing the makeup, we're changing the horizon on health care in this province and we're looking at developing a Provincial Health Authority Act , that's a big piece. That is something that we really need to ensure our i's are dotted, our t's are crossed multiple times.

There are so many pieces in this puzzle. I look at

section 19. That, to me, is one of they key sections of the act because it talks directly to the responsibilities of the authority regarding health and community services. I'm in that

section and I'm looking over just before you get to

section 20. I wonder, on some of these clauses, whether they're better placed or they appear to be more operational than legislative. I can't help but look at this as the trend we've seen where there seems to be more power being put in the respective minister's hands. That's how it appears there.

Just for the record here, that is

section 19 – they almost have the whole alphabet in there but we come to

section (m): “… in conjunction with the minister, develop a framework for connecting the social determinants of health with the health system at the provincial level; (

n) in conjunction with the minister, implement a provincial strategy for recruitment and retention of health professionals; (

o) comply with the direction for the delivery and administration of health and community services set by the minister ….”

To me, those are very operational pieces. When I look at “implement a provincial strategy for recruitment and retention of health professionals,” isn't that what the current recruitment and retention office is supposed to be doing?

I'm not sure if they're fully staffed, but they may be. It was close. A couple of weeks ago, they were working on the last pieces. But isn't that what we already have in place? We have a recruitment and retention office all in place.

It talks about a provincial strategy. Now, we heard from the previous minister of Health and it quoted as saying they have a strategy very similar to Nova Scotia. So I am kind of lost on the retention and recruitment. We hear that government is focused on it – I'm not sure but someone said laser focused on it – yet we're hearing and seeing very different pieces here. I'm not arguing against any of those; I'm just saying which it is. Where is the clarity there?

If I look at

section 20 – I was just giving you a chance to change seats; I wouldn't want you to miss any of this. So I am moving along to

section 20. It talks about “developing, operating and managing a comprehensive and aligned information system that fully integrates and uses data and health information from all components of the health and community services system for the delivery of health care and health system planning ….”

There is a lot in that clause – a lot – as I have previously mentioned speaking to another clause, about a province-wide information system. I alluded to the last amalgamation of some regions and how long it took. I think it was five years to get their system in place for Eastern Health at the time.

So there is a lot to that because – and we know the cost of the cyberattack on us. What is the cost of this? What will be the cost of this? What will be the timelines for this? Because now we're looking at province wide; again, not arguing it. I am just amazed – and this is not on anyone here in this House; this is just a general comment that in this day and age, with technology, it's amazing we can't do that.

When you see kids on the street six and seven years old and they're doing unreal stuff with their cellphone. So we've got to move there, but what's the cost? What are the timelines for this? This is going to take some time, especially to ensure that confidentiality and all the security walls are in place to protect the information as best as they can. That's what we're looking at there.

Within this document, it comes down to what's the plan because there are bits and pieces of this bill that, in and of themselves, they have huge pieces of work to be done to get to where they want to go. Questions get raised, and they've been raised in the public. We've heard the stories.

I had one just recently when the hours at the Mundy Pond collaborative care clinic were extended. It went from 8 to 8. I had an individual call me. She lined up there early in the morning to get in. She didn't get in the door. She got to the door around 9:30 to be told sorry, we're booked up. She ended up going to a private clinic and paying for her services that she needed. I think it was $70 she said, and $70 is a lot for someone, especially in a province, in a country where we have great health care and very professional, very expert staff that can give you that health care. Again, once you've got access to it.

We do get questions being asked: Are you going to privatize health care, or are you going to do this? Those are questions that people ask. Or are we headed towards a two-tier system? Those are questions that get asked.

So when I look at

section 21, the Authority's power, and I go there to (

d) and I go to Roman numeral (

i) under that, it says “unless prohibited by the regulations,” – the authority may – “charge fees (

i) for health and community services directly to the person who received the services ….” Isn't that something we're trying to ensure people get services without having to pay?

We have residents, as I just alluded to in an example, who went into a collaborative care clinic looking for a service, and that service could be anything. But you know when you're running out for health care; they're going because they need it. So what happens to the individual who goes to the collaborative care clinic and doesn't have the $70? Then, in this we have a clause that says they can charge directly to the individual who receives those services.

Now, we'll probably find out more as we go along, but, again, I'm flying on a paperless briefing, so understand that, I'm flying on a paperless briefing here.

These are questions, again, like I said, we could have asked, could have clarified had we had this document ahead of time, which we didn't.

So what's entailed in that? What is the thought process for that? What is the scope of that? Is it extremely specialized services that you can't get here in the province? I would suspect if you have some specialized service that's not available in the province, I would suspect it would be the other way around that government would assist you in getting it, but again I don't know. I don't know what it is there.

That's key to a lot of people in this province. That's a big decision for them. You think about when Eastern Health came out, the Health Science came out and said do not come to our emergency rooms. Do not come to our emergency rooms unless it's an emergency. But what's an emergency to me and what's an emergency to my neighbour or someone up the road are very different things.

So they went out to a community centre, they can't get in so where are they going next? They're going to an emergency room. They're sitting in a chair there. They could be sitting next to someone who has a bad cough and someone with a broken leg or someone having a mental breakdown. That's what's happening in our emergency rooms, and those who can't get an acute-care bed who need it.

I spoke to the nurses. Our front-line health care workers, my heart goes out to them on what they go through on a daily basis. Our paramedics who are not sure that when they pick up someone where they can take them and if they're going to make it.

The nurses, God love them for what they do – broken but not beyond repair. When they're telling you, telling me – I get a lot of calls simply because I'm the shadow minister for Health, but I do get district calls as well. But when I hear of individuals lined up on gurneys in hospitals – one nurse telling me they're out there on a two-inch mattress being toileted and medicated in a hallway. That's what we have to be looking at.

J. WALL: It's reality.

P. DINN: That's reality, that's the outcome.

Now, as I alluded to earlier, they tell them if you fell off the bed and broke your leg we'd get you in. That's a true story. That's a true story for an elderly gentleman who fell and they took X-rays. It was almost the reverse: bad news, he didn't break anything. Think about it.

I look at this and I wonder are we creating more red tape? Are we creating more bureaucracy here? When you look at all the reports: annual reports and the reports that the minister can ask for and who can have access to those reports. Yes, you need annual reports; yes, you need reports that can give you benchmarks and give you success ratings or where you need to focus, yes. But sometimes I think we're overridden – overridden with reports.

We're operating now with four health authorities. It's all going to come in under one provincial authority, but you'll continue to have regional health councils. I do not disagree with that at all because regions are different. Labrador is very much different than the rest of the province in the health care they have access to and the health care they need. They had very specific issues that need to be addressed, especially around medical transportation and access. So we need to look at that.

So regional health care councils, I totally agree. In fact, I would almost argue that maybe they need more authority under this umbrella. But, again, I don't have the details. We didn't have the details when we were briefed on this.

So under

Part II, regional health council: “The Lieutenant-Governor in Council shall, in accordance to the regulations ….” Now, I'm not going near the regulations because we have a hard time seeing regulations. We always say the proof is in the regulations.

But it goes on: “The Lieutenant-Governor in Council shall, in accordance to the regulations, establish (

a) health regions in the province; and (

b) a regional health council for each health region.”

Now, I'm only speaking and assuming – I'm only assuming that there are going to be four health councils like there are health authorities now, but it really doesn't have it defined. The regions are not defined, the boundaries are not defined and, actually, the makeup of these health councils are not defined.

That's critical; that's a critical piece of this legislation. Especially, as I said, when you're talking about the Labrador district region. I don't know, I'll just toss this out; maybe they need multiple regions in Labrador. I don't know. But the point is, each region is not created equal and we need to address, through this, how do we balance that? How do we ensure that if you're living up in Nain or down in Flatrock, you have access to the same quality health care that we all deserve? But, again, the devil is in the details.

I'm looking at clause 38(b): “The authority shall … set a process, in accordance with the regulations, for reviewing reports, advice and recommendations received from the quality council for the purpose of reducing or mitigating risks identified by the quality council.”

They are important reports, as I stated earlier. Having the data, having the information to make these decisions is very important. I don't know here if this is going to be released to the public, these reports. Again, protecting private information and the like, I'm sure there is a way to release these reports and ensure that there is openness, transparency and accountability, that people can realize that these health and well-being decisions are really based on clear evidence, clear data, clear information.

I raise that because we have seen many reports done by this government and we've requested access and there has always been, you know, Cabinet confidentiality; or, no, it's detrimental to fair play out there in the world. I just want to make sure that when we're talking about health care, that affects everyone, and I guarantee you that until you have to access the health care system in this province, you have no understanding of what a dire need we're in.

I still go back to when you get in those hospital doors and you have a nurse, a paramedic, a radiologist, whatever and they are there at the end of a 20-hour shift and they're still smiling the best they can to help you, I don't know how they do it.

SOME HON. MEMBERS: Hear, hear!

P. DINN: But we depend on that; we depend on them so much. For anyone who was down to the rally that the Nurses' Union held last week, I've got to say and I went around – I go around and I talk to the people. I talk to them. There was a registered nurse and a nurse practitioner that spoke up and talked about the situation health care is in. I'm just amazed.

Actually last night, I was out to a pumpkin stroll, I guess, going around looking at pumpkins, and a young girl came up to me and she said: Thank you, Mr. Dinn, for what you're doing. I didn't know who she was. I never met her. I said: What are you talking about? She said: I am a paramedic. I said: Really? She graduated in May.

She said: Thanks for keeping it real and talking about the issues. I asked her: How is it with you? And she said: Oh no, I'm fine. I am only just started but she said some of her colleagues that she works with, they're really, really, really struggling. She alluded to me about some of the situations she's been to, accidents or going to homes and seeing the trauma and seeing the look of despair on family members, it's crazy. It's really crazy. There are solutions, and many of the groups I've talked to have brought forward solutions.

So when you talk about doing studies and providing reports and speaking to a process, you really have to consult with the people that have lived experiences. Those are the ones who see that day to day. I can't even imagine.

I think about the elderly couple that spoke to me. Her husband was rushed to hospital just a couple of weeks ago, into the Health Sciences. She followed. She got in her car and went on in. She went into the hospital. Her husband wasn't there to be seen. She went up to the wicket to talk to the triage nurse and asked: How's my husband doing? Where's my husband? To be told, oh, we're looking after him.

Several times she went up because he's diabetic. She got up another time, after being there for an hour, hour and a half, and said: Look, I really want to make sure my husband is getting something to eat. Yes, we're looking after him.

Anyway, two hours in, she goes up and there's a different gentleman there, nurse, and he said: What's your husband's name? She gave him the name. He said: He's not here. He wasn't there. Now, I'm not faulting the nurses there because they are juggling people out in the hallways – they're just overrun, overburdened. Do you know where her husband was? Still out in the ambulance.

So that's some of the real stories we deal with. When you talk about the Health Accord and all that's in it – it's a pretty in-depth document, and you try to take out a piece of work, some solutions, and make our health care better for this province and for the people in this province, that's a good thing but you have to do it properly. You have to make sure.

There are solutions for the some immediate needs. We've heard them. We've all heard them. We've seen what other provinces are doing. We try to be on par, but we want to be better than on par. We are competing for health care workers. I don't disagree with that and I don't disagree with this development of a Provincial Health Authority. I really don't have the information. I don't know what it entails. I don't know what kind of consultation or work has been done behind this – don't know it.

As my late father would say, you don't know if it's fit to eat. It could very well be, I don't know. But it's too much of an important bill – and I'm only going by the trend that we've seen – to rush through without having a really fulsome briefing on it which, due to whatever technical reason, couldn't happen. But I would just like to see that this gets the proper attention. I'm not saying it's not, but I'm saying it gets the fulsome – which is a word we've heard in this House many times – attention that it needs and talk to the people who may not even be on the consultation list, talk to those people.

Ask them: Is this fit to eat? Are there changes or what should be done? Are there problems that are not identified? Are there problems there that we've missed?

I've just gone through in the little time I've had to talk about some that are unseen. Now, maybe when I turn over that rock, oh, that's what's happening, good. Or maybe I turn over that rock and I roll it back over.

I just think for something like this, when you're talking about an overreaching authority for health care – again, I use recruitment and retention. Well, which is it? There are still some pieces that are flip-flopping a bit. The information system, that's a big piece in itself. The piece around reports and who gets them and who can release them and who sees what, is a big piece of this. The how exactly the regional health councils are going – what their makeup is going to be, how many are going to be on it. That's a real piece for questions.

If you're going to address health care in this province, you have to do it right. Again, I'm not saying this isn't right. What I'm saying is what has gone on behind this to ensure that this is doing it right, because it's come out of the Health Accord, but it's not directly out of the Health Accord. The Health Accord talked to an arm's-length approach. This is not arm's length. These are issues that we have to talk to.

With that in mind, seconded by the Member for Harbour Main, I want to propose an amendment. The amendment reads: That the motion be amended by deleting all the words after the word “that” and substituting the following therefore “that Bill 20,

An Act Respecting the Delivery of Health and Community Services and the Establishment of a Provincial Health Authority, be not read a second time but that the Order be discharged, the bill withdrawn and the subject matter thereof referred to the Social Services Committee of the House for further study and consultation.”

SPEAKER (Warr): Order, please!

We will recess the House and take a look at the proposed amendment.

Thank you.

Recess

SPEAKER Are the House Leaders ready?

Order, please!

After careful consideration and discussion, the proposed amendment is deemed to be in order.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Topsail - Paradise.

We are now debating the amendment.

P. DINN: Thank you.

I'm pleased, very pleased that it's in order. As I've gone on with my earlier talk about the bill – I've said it in my debate earlier – I'm not against the concept and that of this bill. It's a very important piece that really will set the pathway for future health care in this province. I just want to be sure on that. I want to make sure and I'm sure everyone in this House wants to do the same thing. You want to be sure that when we're looking at something as substantial as this, you want to make sure that it's going to have the intended outcomes that, we and all our Newfoundlanders and Labradorians, deserve when it comes to health care.

There was a huge piece of work done, a very good piece of work done with the Health Accord. It was quite an extensive piece of work. It had lots of consultations through that process. It had lots of options. Dr. Parfrey and Elizabeth Davis, they did a wonderful job looking at health care in this province and envisioning areas where it should go and putting forward in documents outlining what would happen in year one, what could happen in, I think, it's year two to three and it goes on to talk about four and five, of course, longer-term solutions.

We applaud that piece of work. We all have. We waited in earnest for it to arrive and for us to start looking at that and devising and developing a plan forward for health care. We all understand it's medium to long term. We understand that. We were told that. This bill, certainly, doesn't take away from the focus on immediate health care issues that work is being done and there's more that can be done and we can get solutions and recommendations from other provinces, from other jurisdictions. No doubt about it. We have to do a little better. We have to be above par.

You know, it's been referred to sometimes as band-aid solutions and sometimes you have got to put a Band-Aid on it. But this piece of legislation that we're talking about here today, this bill that we're talking about here today is going to have long-term, real long-term ramifications, and I don't say that in a negative manner, for health care in this province.

Some will say, well, didn't the consultations occur during the Health Accord? Yes, there were consultations that took place through the Health Accord and they set the high-level areas that we should address. Now, were talking about a piece of legislation that becomes more specific, more prescriptive in what is going to be done to address the short-, medium- and long-term solutions in this province.

As I said earlier, the Health Accord did suggest a Provincial Health Authority, but they envisioned – and again I stand to be corrected – that this would be at arm's length. This would be something more independent, yet we see it going the other way. We actually see it not even close to arm's length and moving in under a government department with greater authority vested to the minister.

Again, that's no disrespect to the minister or anyone who sits in that seat. I, and our caucus here, want to be assured that decisions that are made on our health care, and especially the future and long term of our health care, are made in the most independent and objective manner, supported by data; data that we can all see, that's transparent and accountable, again, maintaining the privacy of individual data. We want to see that. We want to be aware of that.

Despite the consultations for the Health Accord, I would think and I would argue that when pieces of this – people realize what's in this, people will have questions. They will have more questions, like I asked about the regional health councils. I asked about the regional health councils because the details are not there.

I'm assuming the four regional health authorities now will become the councils, I don't know. Is this an opportunity for these other regions to address more pressing issues in the area and say – I use Labrador as an example, which is very unique in terms of access to and availability of health care. Maybe there's opportunity there – and again, I'm just tossing it out there. I could be totally off the wall on this. But maybe they need a different approach. Maybe they need an authority or council or multiple councils, I don't know.

Maybe their representation needs to be a little different to address their issues, I don't know. As I said, what someone wants up in Nain and someone gets down in Flatrock are different things, different levels.

So this is an opportunity for that. This is an opportunity to have those more in-depth discussions. To have that consultation, talk with people with lived experiences and say this is how it's going to work, or no, maybe you should do this. Because right now we have the Health Accord, which has laid out quite a few recommendations there. It didn't dive down into the weeds or get into the details. In some instances, especially when you're dealing with creating a Provincial Health Authority, maybe we need to be in the weeds on this.

Again, I alluded to the many particular instances and different situations that people have found themselves in when it comes to accessing health care in this province. Some of them are very different, and that's what we need to be addressing. The Health Accord was focused on health care outcomes. We can't lose sight of that. I spoke to it. It's in the bill here. Again, like I said, it's all important. I know the work that goes into putting together legislation. It doesn't happen overnight. A lot of staff put long hours in researching and putting together this legislation; they do that.

When I focus on this piece – I just focus on

section

Section 19 is the core piece of this because it talks to the responsibilities of the authority regarding health and community services. That's a key piece. I go back to 19: “

(1) The authority is responsible for the delivery and administration of health and community services in the province in accordance with this Act and the regulations.

(2) In carrying out its responsibilities, the authority shall (

a) promote and protect the health and well-being of persons in the province and develop and implement measures for the prevention of disease and injury and the advancement of health and well-being ….”

When you go to school and you read a novel and you have to do a book report, and you flip through all those pages and someone says, what's the core message in Tom Sawyer and Huckleberry Finn – that doesn't change when you look at legislation. What are we trying to do with this legislation? What's the ultimate goal in this legislation? Is it put together with the bits and pieces and the expertise that results in the desired outcome? I mean, that's the crux here.

This may result in the desired outcome, but again there are a lot of questions. Where we've moved, where we've invested so much, government has invested so much, a number of people have invested so much time and effort into putting together the Health Accord, and the Health Accord came out with a whole list of recommendations – it 's a good piece of work. Do we agree with all the recommendations? I'm sure there are bits and pieces that people don't agree with. I'm sure there are bits and pieces that people totally agree with. But the point here is we're moving into a bit more specific legislation.

What the public and people who spoke out and had discussions and consultations and did surveys during the whole Health Accord process, maybe with this they're looking at this and saying I'm a little clearer on where it's going and I have questions. Maybe they're looking at it and saying, hang on now; I perceive there could be issues here. Maybe people when you talk about the regional health councils are saying hey, this is an opportunity to make changes there that would be more effective. Maybe this is an opportunity to have people and representation from unique regions involved here.

If we're looking at working together and really, truly invested in people with lived experiences and really focused on health outcomes and the social determinants of health, we have to make sure that's in there. It's more than adding the definition of social determinants of health. It's more than that.

That's why we went with this amendment. It's something that needs, in my mind, greater attention to this, now that we have a document in hand. It requires more attention. Essentially, that's all that's being asked here in this amendment, is that we lay this to the side right now. We can continue to be focused on the short-term issues of health care. We can continue to be focused on recruitment or retention of doctors, nurses, paramedics, looking at the scope of nurse practitioners. That's stuff we can continue to focus on, is stuff that is affecting people right now.

Take some additional time to make sure and look at this and ensure that it's headed in the right direction; speak with the representatives of the Health Accord. They were looking at this as a more arm's length.

So maybe ask: Why? Why did you think this was probably better arm's length? I don't know. Or ask them: Is this not the right way to go? I don't know. Again, we invested a lot of time and people invested a lot of time into the Health Accord. I know people, they'll say, well, the Health Accord was really given as recommendations. It wasn't the plan.

That's fine. You can say that, but you cannot ignore the effort that was put into that document. You can't ignore it. So you have to ask those questions. You have to find out is this what you envisioned? Is this better than what you envisioned? I don't know. Is it worse than what you envisioned? I don't know. Are there individuals out there who are saying, hang on now, I went to all the consultations, I wasn't expecting this because there are some good things but there are also some bad things.

This is why we're asking for some more time on this to look at it. This important bill deserves far more than a paperless briefing and the next day debating it. That's all we're saying. That's all we're saying here.

SOME HON. MEMBERS: Hear, hear!

P. DINN: I really don't see the harm in that. I really don't see – you know, if we can continue to focus on the short-term, right-away issues of recruitment, retention, getting more here, if we can continue to focus on that, what is the damage in laying this aside for, I don't know, two, three, four months, whatever it takes to have a better understanding of it and hear from people on it? What is the negative in that?

Because this is going to be far-reaching. This is changing, although you say the acts are, basically, moved over in some respects, but it is changing the horizon and the makeup of us moving forward – us moving forward to come up with a system that works, to come up with a system that promotes and protects the health and well-being of Newfoundlanders and Labradorians. That's the goal. I can tell you that's the goal we all agree on. We all agree on that goal, no debate. To be honest with you, I'm not debating whether this is good or bad.

All I'm saying is in a realistic world, with something that is going to be as far-reaching as this, let's lay it aside. I'm not saying years, no. Let's lay it and have someone else look at it. Let's look at it and make sure all the i's are dotted and our t's are crossed and that it is – because we all want it, we want to make sure this is the best piece of legislation that is going to make sure our residents, Newfoundlanders and Labradorians from all parts of this province, have the health and well-being they deserve. That's what we want.

With that, I'm going to sit down and hopefully hear from more.

SOME HON. MEMBERS: Hear, hear!

SPEAKER (Bennett): The hon. the Member for Lake Melville.

P. TRIMPER: Thank you, Speaker.

It's an interesting situation that's just developed here in the House of Assembly. In my seven years of being around here, I've not encountered what's called a dilatory amendment. Essentially, what this is doing is, it's a delaying tactic. It's very rarely used in this Assembly and, I guess, it is some years. Without revealing all the confidences of the opportunities I have in this House of Assembly, this is something that hasn't be used in a long time

I wanted to back up now for a second and just talk about – I was going to speak to the bill and the importance of it. I wanted to talk about health care. Just a little show of hands as I look around the room, I bet every one of us could raise their hand if I asked the following question: What is the dominant issue in your constituency office? If you didn't say health care, I'd say you're asleep at the wheel because it dominates everything we do. It's all about getting our constituents the health care that they need. I can tell you sitting in Labrador this is magnified so many more times.

This morning I did an interview with The Telegram talking about the cost of living. My number one theme in that interview this morning was getting people to health care. It is such a cumbersome hurdle and, frankly, I know people who have, unfortunately, even with the Medical Transportation Assistance Program and all the challenges we have around that, people still can't even afford those differentials. They are foregoing health care.

Folks, we've just spent the last two years overhauling, evaluating and studying through the Health Accord. Two brilliant minds, Dr. Pat Parfrey and Sister Elizabeth Davis, who just went through a monumental exercise looking at all aspects of our health care, what's right with it, what's wrong with it and put together this multi-volume Health Accord.

I say to my colleagues right now as I look at this amendment that's on the floor: Folks, we can't afford to delay. If we're upset that we didn't have an opportunity to have – if we had a paperless briefing, I get it. It's frustrating for everybody, but we're all in the same camp. Sitting here as a backbencher, I'm just seeing this as well myself today.

However, we certainly know what our constituents have been dealing with. We know what's been going on in the Health Accord. I can tell you that over the last two years I took full advantage of sitting and dealing with those co-chairs. They were readily available; we worked through so many issues. I'm quite excited about what I see in the Health Accord.

I believe there's a future there and I would propose that we take our time in Committee and going through the clauses. Right now, we're still in second reading and to really get at some of the aspects of what may be of concern to all of us, by the way, whether you're in government or Opposition, we all want to make sure we get this right. But when we get into the meat of it, that's when we'll do it. And if we need to take a lot of time to do it, I say we take it. But to move into a delay tactic and say we need more time.

Again, I would say – and I keep track each day – if you're watching me during Oral Questions, I track each one of the questions by MHA and the themes. I can tell you that every single day, health care dominates, as it should. But what I hear there is urgency – emergency. Why are you doing this when we need to be doing that? We've got clinics closing and so on. I can tell you, folks, I feel this every single day myself.

So I would ask everyone to think about it. Instead of trying to find ways to delay and further put off an opportunity to support our constituents, the people of this province, I say let's get on with the debate, let's conclude and then let's get into the meat of it in Committee. Maybe that's something to think about.

I wanted to also just talk a little bit about some of the issues that we're dealing with, again, in Labrador, where I feel it's just so much more magnified. When people are making a choice whether or not to go to specialized or additional health care and deciding that they can't afford to do that, we really have a system that needs our urgent attention.

Speaker, I think that's a simple point I put out there that for those people and everyone else who's looking for a new world, a new way to deliver health care in our province, I say let's get on with it.

Thank you very much, Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Stephenville - Port au Port.

T. WAKEHAM: Thank you, Speaker.

I would suggest to the Member opposite that we don't need to change legislation to get on with it. That's the whole problem we have in health care right now. We haven't gotten on with it when we should have gotten on with it.

SOME HON. MEMBERS: Hear, hear!

T. WAKEHAM: Speaker, I've spent most of my working career in health care and, like some other colleagues in the room, we've seen many reiterations of changes in governing bodies in health care, whether it was 28 to eight to four, and now we're talking about going to one.

One of the things that this bill talks about today, for me, clearly highlights the lack of action by this Liberal government in the last seven years. Because I have a difficulty going through this clause by clause and understanding why we need to change things to do what's recommended in here. How are the changes in here going to impact the people in our province today?

We can have all of the board structures we want, we can have all of the technology we want, but at the end of the day health care comes down to a basic principle of people helping people. Right now, we do not have enough people helping people in this province. Our health care system is in a crisis. The current Minister of Health has inherited a mess, a total mess. Because, for the last seven years, our health care system has been allowed to completely deteriorate. Many of the things that the current minister talks about with other provinces, yes, are real in this province too, but they could have been different. They were caused by a lack of action. Because it wasn't like they didn't know.

Go back to the former Nurses' Union president who talked about the need for more nurses in our province. You could go back seven years to the discussions on a need for a review of staffing levels in long-term care, of a need for a review of nursing positions in the health care sector. You can go back and talk about all of those things and how they were not acted upon. They were simply ignored. The NLMA took four years to reach an agreement with the NLMA. Those are the things that have resulted and contributed to where we find ourselves in health care today – a complete lack of attention to detail. That is what has happened and that is what continues to happen.

I look at this particular thing in here. One of the clauses simply says the new health authority is going to turn around and provide information to the residents of the province respecting how they gain access to those services.

Surely God, the people of the province right now would like to understand how they gain access to services. Why isn't that happening now? Why isn't that type of action happening now? It's highlighted in here, but where is it? There's another

section in here that talks about information management – wonderful, that's exactly what this province needs is a new information management system but that recommendation was made to this government in 2016 and it was never acted upon. A recent report at the AGM of the Newfoundland and Labrador Centre for Health Information said that government was warned two or three years ago about the potential cyberattack but did nothing about it.

So, right now, we're talking about a new health information system – absolutely necessary, because the last time that the health authorities were merged from eight to four, it took Eastern Health five years to consolidate their health information systems under one. Now we're talking about one health information system for the province but when I read in the news that an RFP had been issued for a new health information system for the new Corner Brook hospital, the second line talked about it could be used for the province. I would argue – I hope that

article reported that wrong because right now what we need is we need an RFP for a health information system, not just simply for Corner Brook hospital, the new hospital, but for the entire province.

Corner Brook hospital may be the one that it gets rolled out to first, but I hope that the

article in the paper was wrong and that we're actually going to do that, because that's something that was talked about and recommended seven years ago. The current Minister of Health has talked about the back-office functions and the consolidation of back-office functions. Those were recommended in the Greene report as well.

Again, seven years ago, a report was given to the former minister of Health that outlined exactly how to do that, how it could be done after consultations with all of the unions and how it would consolidate all of the back-office functions from payroll to HR, to finance to supply chain, all of that. The report is there. It's somewhere in the Department of Health. If that report had to be acted upon, maybe we would have had those efficiencies in place already.

So this is not simply about going from four health authorities to one; it's about how do we improve outcomes for the people of Newfoundland and Labrador. The Member for Lake Melville talked about the issues in Labrador – and he's absolutely right, but I'll tell you and I'm sure he will agree that one of the biggest issues in Labrador for health care is the medical transportation system or lack of it. The extreme cost for those of us who live in the territories, as the former minister of Health likes to call us – anything outside the Avalon; apparently we're living in the territories.

For those of us that live outside, the medical transportation – the cost of getting to see a specialist at a tertiary care centre in St. John's is extremely high. For the people of Labrador, it's even worse. Will he stand up and say we should have 100 per cent coverage of medical transportation? That should be a basic right for the people of Newfoundland and Labrador. We understand that we cannot have a tertiary care system or a tertiary care facility in every part of this province; there are only 500,000 of us. But whether I live on St.

Clare Avenue, five miles away from the tertiary care centre, or 500 miles away, the last thing I should have to worry about when I need service is if I can afford to travel to get there. But it's happening everyday.

I have a lady in my district right now who has an autistic son who cannot speak and he needs dental services. He cannot get them in Stephenville. This lady is on income support and the Medical Transportation Assistance Program is refusing to pay for her to take her son to see a specialist here in St. John's. There's something wrong with our system when people are left behind. That's what's happening.

Will this change fix that? If I thought it would, I'd vote immediately for it, but I do not see that happening.

To the senior in my district and other people's districts who are actually paying to see a nurse practitioner, actually have to pay a $300 fee in order to become a client and then for every visit pay $35 more. So every visit that senior makes now to get basic health care services, they pay a fee. When we've questioned the former minister of Health in this House of Assembly on numerous occasions the bottom line was they haven't figured it out yet. They haven't figured out yet how to reimburse nurse practitioners who want to set up private practice.

With all due respect, go figure out how to stop people from having to pay for it. That's what we should be doing, but we're not doing that. Will this today fix that? No, it won't.

There's a

section in here that talks about charging fees. I just hope that we're not going down the road of now suggesting that the fees that we're going to be charging or allowing a health authority to charge includes charging fees for people for basic primary care services, because that is not what MCP is all about.

So those are things that need to be fixed now. They can be done without consolidating health authorities. They should've been done. All of the things that I have talked about should have and could have been done without this legislation but they are not done. They are left behind and people are left behind. That is the fundamental principle that we should be talking about.

When we talk about debating health care, it's not about the structure or how many boards or how many health councils or what it's going to look like. It should be about how do we ensure that people get the service when they need it. And service, Speaker, shouldn't just be a word; it should be an action. That's what the people of this province are demanding. They want to see action; they want to know that when they are in need that there will be a bed available. That when their loved one needs to go to long-term care, that there are beds available. Unfortunately, right now, there are beds available but we have no staff. We have no staff.

I understand, yes, we've started to add more seats to the nursing programs and more seats for LPN programs for the colleges, but think about if we had to do that seven years ago. Think about that, if they acted when it was brought to their attention seven years ago. If they had to start then, perhaps we wouldn't be as bad as we are today. I'm not suggesting that we would be perfect, but I would certainly think that we would be in a much better position.

But we didn't do that, we chose not to. They chose to ignore it and for the last seven years, as a result of inaction, we find ourselves in a health system in crisis. Today, we are here talking about a very detailed piece of legislation, 36 pages or so to it, a lot of changes. Will this help people get access to health care? That is the big fundamental question I have. Or will it take the eye off the ball. Will the health care system now be so wrapped up again in trying to come up with how they're going to reimagine themselves?

All of these discussions will be around, how do I fit into this new health organization? How do we staff it up? Who is going to be in charge? What's it going to look like?

Because I have seen that happen in the past. I have seen with both sides of government, both PCs and Liberals, I'm not taking sides on this because I have been through many different variations of reductions in health authorities. I know from experience what usually happens is it takes the eye off the ball and you start focusing on the structure as opposed to the people.

In some cases, a lot of times all this was done in the name of efficiency and we're going to eliminate all the management positions and all of that. So the name on a door changes from a CEO to a COO, from a chief executive officer to a chief operating officer. But again, I find that what we're doing is not focusing our attention on where it needs to be. Our attention needs to be on helping the people of Newfoundland and Labrador right now.

So moving this to a Committee to really examine it, to really let people have a look at what this involves and what it would mean is a good thing. I don't see that as a bad thing. I think the fact that we want to have more input, that we want to get it done right and that we have lots of challenges to do this, simply trying to debate this in two days or a one day or whatever it turns out to be, that doesn't do it justice. It doesn't do the people of Newfoundland and Labrador justice. This is our health care system we're talking about. It's about the 500,000-plus Newfoundlanders and Labradorians who are counting on us to get it right because it's time we start to do this.

Unfortunately, as I have said, the last seven years it was ignored. All of those signs were ignored. We find ourselves now with all those types of people out there who are falling through the cracks, who can't afford to travel for health care, who can't get an appointment to see a specialist, who can't get an appointment to see a psychologist, who can't get in to see a doctor – 125,000 and counting is the number. Then the people who have to pay for primary health care services in our province because we can't figure out a solution to allowing nurse practitioners to work privately.

Let's talk about pharmacists for a second. Why aren't we talking about introducing legislation that would allow pharmacists who meet the qualifications to order blood work and then fill prescriptions? Imagine how much load that would take off of emergency room departments where people are going, simply, to get a prescription refilled. Imagine if they could fill them for more than just 30 days. Imagine if they could have basic blood work privileges to order blood work so they could monitor the patients.

Who best to know the reactions of drugs than the pharmacists themselves, clinical pharmacists in this province who have the training and the knowledge and the ability to do it? That's part of the expanding scope that we hear so much talked about. Those are the priorities for health care in this province. They should be the things that we should be talking about and debating, legislation that allows that to happen so that we free people up from having to go to emergency departments. There are things that we can be doing.

Again, sending this to a Committee to take the time to go through this and let's do it right. If this is the route the province is going down, then let's go down that road in a way that is fully informed, that the people of the province have an opportunity to understand it and that there is a clear direction. That, at the present time, we focus our attention not on the administrative structure, but on the health care of Newfoundlanders and Labradorians so that seniors don't have to pay to see a nurse practitioner, so that individual from Labrador doesn't have to travel to and pay over a thousand dollars.

Will it improve coordination of health care services? Perhaps it will, but I would suggest that those are things that should be fixed now.

I'll tell you a quick story about my time as CEO of Labrador-Grenfell when an individual came into my office and said they had an appointment to see a specialist in St. John's. That person went to St. John's and spent a thousand dollars; saw the specialist who said you need this particular test done. The test was only available in St. John's. So they walked down the corridor to make an appointment to get the test done, only to be told come back in two weeks. Fly back home, back down two weeks later, another thousand dollars plus to have the test done.

The test could be read and within 48 hours they go see the specialist to talk about making an appointment to get the results. Sorry, can't give you an appointment for another two months. Back up again, back down again.

These are the inefficiencies that we need to be getting at. These are the things that need to be happening, and I don't see that one single health authority will fix that. Maybe I'm missing it, but right now it's not there.

What I want us to do is focus on the people of Newfoundland and Labrador.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Government House Leader.

S. CROCKER: Thank you very much, Mr. Speaker.

Mr. Speaker, I move that this House do now recess until 2 p.m.

SPEAKER: This House do stand recessed until 2 this afternoon.

Recess

The House resumed at 1:30 p.m.

SPEAKER (Bennett): Order, please!

Before we begin, I would like to welcome in the Speaker's gallery a former Member from the beautiful District of Cape St. Francis, Mr. Kevin Parsons.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: In the public gallery today, I would like to welcome Jay Walters, Krista Keating and Jason Walters. They are joining us this afternoon for a Member's statement.

Welcome.

SOME HON. MEMBERS: Hear, hear!

Statements by Members

SPEAKER: Today, we will hear statements from the hon. Members for the District of Conception Bay South, Exploits, Torngat Mountains, Grand Fall-Windsor - Buchans and Placenta West - Bellevue.

The hon. the Member for Conception Bay South.

B. PETTEN: Thank you, Speaker.

MusicNL kicked off the 2022 Music Celebration Week recently in Corner Brook from October 25 to 29. The awards gala capped off a week of events that included workshops, performances, networking with peers and showcasing Newfoundland and Labrador talent.

The music awards were held on October 29 and I would like to give a special shout out and congratulations to the awards winners from Conception Bay South. Our very own Justin Fancy for Entertainer of the Year; Quote the Raven, folk duo Kristen Rodden-Clarke and Jordan Coaker, won Group of the Year; Rosemary Lawton took home two awards, Celtic/Traditional Artist of the Year and Music Video of the Year for “Little Fires”; Matthew Hender, a member of the Kubasonics, won Folk/Roots Artist of the Year.

A couple of honourable mentions: Darcy Scott took the stage on MusicNL's Stars of Tomorrow and participated in the Export Program; Mallory Johnson, our successful singer/songwriter residing now in Nashville hosted MusicNL's Songwriters Circle. Mallory had a very exciting week with the release of her new song “Surprise Party” which was published in the October 28 edition of People magazine.

Conception Bay South is extremely proud of these talented individuals and their accomplishments. These local musicians have a very bright future.

Congratulations to everyone and I wish them all continued success.

Thank you very much.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Exploits.

P. FORSEY: Thank you, Speaker.

On October 20, the Exploits Chamber of Commerce hosted their 22nd Annual Business Excellence Awards and Hall of Fame induction into which a businesswoman, at 31-years old, Ms. Megan Hoskins of Hoskins Funeral Homes and Crematorium received the Businesswoman of the Year award.

Speaker, Megan received her Bachelor of Arts degree in business administration in 2014. She went on to further her education and received her funeral directors and embalmer's licence in 2018. In 2019, she received her Life Licence Qualification Program and in 2020 she became a certified funeral celebrant and has been working at the funeral home since leaving university.

Hoskins Funeral Homes and Crematorium has been owned and operated by her parents, Paul and Debbie Hoskins, for 40 years. Megan followed their career path.

Megan is also Henry's handler, who is training to become the province's first certified funeral home therapy dog.

Speaker, I ask all Members of the House of Assembly to join me in congratulating Megan Hoskins of Hoskins Funeral Homes on receiving the Businesswoman of the Year award.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Torngat Mountains.

L. EVANS: Thank you, Speaker.

November 1 is a very special day for Bob Piwas of Natuashish and all of Labrador. In Natuashish, the very first home dialysis treatment in all of Labrador was completed by Bob Piwas supported by his daughter. We are very proud of them.

Hemodialysis is offered at three Labrador hospital sites: St. Anthony, Happy Valley-Goose Bay and Labrador West. People have to travel to these centres for dialysis. For people in Northern Labrador, it means moving to one of those centres because we are not connected to the provincial highway system, moving away from their communities, their families and their support systems.

So I want to recognize the tremendous life-changing options becoming available to all the Labradorians. Thank you to Labrador-Grenfell Health personnel for all their hard work in making this possible.

Labrador-Grenfell Health has worked with the Indigenous partners: Mushuau Innu First Nation and Sheshatshiu Innu First Nation, the Rotary International and the International Grenfell Association to purchase equipment to pilot home-based dialysis in two Indigenous communities. The program will be offered next in Sheshatshiu.

Following this successful pilot, home dialysis is anticipated to be offered across the Labrador-Grenfell Health region for patients who meet eligibility.

Sorry, it's very emotional because this means so much to the people on the North Coast, Speaker, I apologize.

SOME HON. MEMBERS: Hear, hear!

L. EVANS: And for those who opt to have their treatment in this manner.

I ask you to join with me, basically, and celebrating with me.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Grand Falls-Windsor - Buchans.

C. TIBBS: Thank you, Speaker.

It is my pleasure to rise today in this hon. House to pay tribute to an honourable man. Then rookie Dave Byrne joined the fire department in 1972 at the age of 17. He served as a firefighter with the Windsor Fire Department for 19 years until Windsor and Grand Falls amalgamated in 1991, which then formed the Grand Falls-Windsor Fire Department.

On August 1, 2003, Dave Byrne became assistant chief and is still a very active member today after serving 50 years as a firefighter.

SOME HON. MEMBERS: Hear, hear!

C. TIBBS: Assistant Chief Byrne joins a very short list of firefighters to serve half a century keeping his community safe.

Over that time, he has seen more than his share of tragedy and disaster but always answered the page when it went out. As an active member, firefighting is just one aspect of the job. There is so much work to be done inside the community and Assistant Chief Byrne continues to make this a priority. Whether it be training and advice or his quick wit, Dave continues to earn the admiration and respect from every firefighter he has ever served with.

As MHA and fellow firefighter, I speak for all residents of Grand Falls-Windsor to say thank you, Assistant Chief Dave Byrne for 50 years of service. God bless you, Sir.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Placentia West - Bellevue.

J. DWYER: Thank you, Speaker.

I recognize a dedicated constituent in our beautiful District of Placentia West - Bellevue, nine-year-old Jay Walters of Boat Harbour, who is joining us in the gallery today.

SOME HON. MEMBERS: Hear, hear!

J. DWYER: When Jay was in Kindergarten, the Baine Harbour Volunteer Fire Department visited his school. He was so excited to rush home and tell his mother, Krista, all about it. One item he received was a cardboard cut-out of a money bank. He proceeded to tell his mom that it costs a lot of money to put gas in the fire trucks and he wanted to help.

For the next couple of months Jay saved all his change in the cardboard bank. He saved $100 and made the donation in his late grandfather Tom Keating's memory, who also served on the Volunteer Fire Department in Baine Harbour. As a thank you, Chief Christopher Keating gave Jay his grandfather's bunker jacket from years ago.

Jay wanted to continue to help the fire department with a goal of $1,000. With COVID-19, his fundraising efforts were put on hold, but that didn't discourage him. From January 2019 to May 2022, Jay has donated a total of $3,900.

SOME HON. MEMBERS: Hear, hear!

J. DWYER: Speaker, I ask all hon. Members to join me in recognizing Jay Walters on his accomplishments to date and for being such an integral part of our beautiful District of Placentia West - Bellevue.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: Statements by Ministers.

Statements by Ministers

SPEAKER: The hon. the Minister of Tourism, Culture, Arts and Recreation.

S. CROCKER: Thank you, Mr. Speaker.

It is my pleasure to rise in this hon. House today to share some exciting news. As everyone, I'm sure, is well aware, the City of St. John's is hosting the 2025 Canada Summer Games.

SOME HON. MEMBERS: Hear, hear!

S. CROCKER: It will be an excellent event for not only the capital city, but for all of Newfoundland and Labrador.

I am pleased to share with my colleagues today that we will be building a brand new, state-of-the-art track and field facility. This facility will support the 2025 Games, giving athletes and coaches top-notch facilities from which to train and perform.

This project will be cost shared between the federal, provincial and municipal governments. The City of St. John's will be issuing a request of proposals for that facility today.

The proposed facility will not only create a quality athletic facility in the metro St. John's region that meets the Canada Games technical standards, but will add a significant piece of sports infrastructure that will benefit youth and people of all ages.

The proposed facility will also see active, healthy living opportunities for residents in the region, long after the games have ended. This facility has the potential to be widely utilized by community members of all ages.

It will also enable Newfoundland and Labrador to attract more large-scale sporting events in the years to come, bringing athletes, coaches and their families to our province, benefiting our tourism industry.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Placentia West - Bellevue.

J. DWYER: Thank you, Speaker, and I thank the minister for an advance copy of his statement.

It's exciting to have the 2025 Canada Summer Games coming to our province for the third time in our history. It's great to see the co-operation between all levels of government in the construction of this badly needed facility that will enhance the training and performance of our athletes. Our coaches will benefit as well by having this state-of-the-art track and field facility to practise.

Today is a good day for athletics in our province with the announcement of a brand new athletics facility for the city and the province. This will be the legacy piece for our 2025 Canada Summer Games and most certainly help attract new athletes to the sport and bring other national and international events in the future.

The facility can and should have a positive impact on the health of the residents long after the games have ended.

Thank you, Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Labrador West.

J. BROWN: Thank you, Speaker.

I thank the minister for an advance copy of his statement. Sports and extracurricular activities instill confidence, time management skills and good mental health, especially at a community level.

We encourage this government to properly fund sport and other fitness programming at a community recreation level, to give the youth a foundation to go on to use elite facilities like the one being built in 2025. Sports excellence starts at the community level.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: Further statements by ministers?

The hon. the Minister Responsible for Labrador Affairs.

L. DEMPSTER: Thank you, Speaker.

I rise in this hon. House to recognize the Labrador veterans who served with the Newfoundland Regiment in World War I.

More than 100 years ago, these brave men left their traplines and fishing boats to fight in battles half a world away. Some of them were too young to enlist, but they were driven by a duty to serve.

Historians have studied military records to piece together the stories of their courageous service, and I am happy to say we know quite a bit about who they were.

They were Blakes, Barneys, Curls, Flowers, Fords, Greens, Martins, Pardys, Pottles, Shiwaks, Traceys and Browns. They came from places like Battle Harbour, Henley Harbour, Carrolls Cove, Pinware, L'Anse au Loup, Sandwich Bay, Nain, Spotted Island, Hopedale, North West River, West St. Modeste, Grand Village, Red Bay and Rigolet.

Tragically, not all of these brave men returned home. Like others, they paid the ultimate sacrifice. Sadly, the men who returned to Labrador would never be the same.

As we prepare to observe Remembrance Day next Friday and mark Indigenous Veterans Day on November 8, it is fitting that we remember the Labradorians who volunteered in the First and Second World Wars, the Korean War and, most recently, the Gulf War and Afghanistan. They fought to preserve the freedoms and liberties that we take for granted today.

Please join with me in saluting the men and women from the Big Land who served in the Armed Forces and on peacekeeping missions. We also praise the Labradorians who have answered the call of duty and today proudly wear the uniform of their country.

Thank you, Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Harbour Main.

H. CONWAY OTTENHEIMER: I thank the minister for an advance copy of her statement.

I, too, join with the minister in acknowledging and recognizing Labrador veterans who served with the Newfoundland Regiment in World War I. Many of these brave, young men were never able to return home. We owe many of our freedoms and liberties to their ultimate sacrifice. It is important we recognize this sacrifice as we approach Indigenous Veterans Day, as so many Labradorians that volunteered out of a sense of duty were Indigenous peoples.

On both Indigenous Veterans Day and Remembrance Day, the Official Opposition encourages everyone in our province to pause, reflect and honour the memory of our veterans.

Thank you.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Torngat Mountains.

L. EVANS: Thank you, Speaker.

I thank the minister for an advance copy of her statement.

We always remember the sacrifices of war and the harm it causes. Along with the courageous men honoured by the minister, we acknowledge the strong Labrador women who stayed home to support their families and the generations since, who still feel the impacts of their sacrifice. We honour them all.

Thank you, Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: Are there any further statements by ministers?

Oral Questions.

Oral Questions

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Thank you, Speaker.

Speaker, the people of the province want to see the receipts.

I ask the Premier once again: Can you table the receipts of your fishing vacation with Mr. John Risley?

SPEAKER: The hon. the Premier.

A. FUREY: Thank you, Mr. Speaker.

As I've said before and will continue to say, I've always followed the rules and will continue to follow the rules. In this case, I went beyond the rules, which are not legislated, there's no obligation to do so and set up an ethical wall so that I have no control over the process involved. In fact, the process was set up by Minister Parsons and is a robust one that's open and transparent for all to see, Mr. Speaker. Every proponent, 31 of them, in this exciting new generational opportunity will go through the same robust and open process.

Sorry, I mentioned him by name, Minister of Industry, Energy and Technology.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Thank you, Speaker.

Once again the ethical wall is the Premier's word. It's nowhere wrote down in legislation, that's his own term, so he wants us to trust him.

The answer is no, it's a flat no, and he's telling the people he's not going to provide it. So you have it loud and clear.

Premier, the people of the province are finding it hard to believe the Premier paid for the trip himself. It's astonishing we had to ask this so many times in the House.

I ask the Premier: Who paid for the trip, Mr. Risley or was there someone else who we're unaware of?

SPEAKER: The hon. the Premier.

A. FUREY: Mr. Speaker, as I've said, my time, my dime, full stop.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: It's comments like that, Mr. Speaker, that have a lot of people shaking their heads, us included.

Another classic Liberal deflection at its finest. As soon as we, the Opposition, turned up the heat on the Premier's fishing trip, another announcement. This time to replace St. Clare's hospital.

I ask the Premier: Was this announcement pulled out of thin air or to deflect from your fishing trip?

SPEAKER: The hon. the Premier.

A. FUREY: Thank you, Mr. Speaker.

I can understand why the Member opposite is confused about announcements of hospitals, because they announced one four or five times. It took a Liberal government to complete that hospital.

SOME HON. MEMBERS: Hear, hear!

A. FUREY: What we announced yesterday, Mr. Speaker, was the intent towards a new hospital.

SOME HON. MEMBERS: Oh, oh!

A. FUREY: I'm happy to respond if you'd like.

SOME HON. MEMBERS: Oh, oh!

A. FUREY: I'm happy to answer. Am I allowed to answer?

So the announcement of a new hospital in metro, Mr. Speaker, is in response to a changing dynamic within the metro region, which I think we can all recognize. It's time for a new St. Clare's; the data supports it. The population of the metro region has increased by 25 per cent and we have an aging population that is going to require more acute-care beds.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Thank you, Speaker.

The difference with the Corner Brook hospital is it was long talked about, there was a lot of planning that went into it. It just wasn't decided one day when the Premier of the day woke up –

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

B. PETTEN: – and decided to announce a hospital. He came back from the weekend and decided –

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

The hon. the Acting Leader of the Official Opposition.

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

B. PETTEN: He came back from his weekend away and decided he's going to announce a hospital. So here we go. That's the way this government operates.

Yesterday, the Minister of Transportation and Infrastructure admitted there is no time frame, no budget and no feasibility study on the plan to replace St. Clare's hospital. Today, lo and behold, there's a briefing to explain this away.

Why wasn't this briefing carried out Monday or maybe last week?

SPEAKER: The hon. the Minister for Transportation and Infrastructure.

E. LOVELESS: Thank you, Mr. Speaker.

The interim, interim Leader of the Opposition likes to be selective with his words, right? Yesterday, if he listened closely in terms of – it was a budgetary process and the minister sitting in front of me appreciates all this as well. It's a lengthy process. I can say it's a 12-month process.

In terms of the St. Clare's hospital being replaced, like other infrastructure that was replaced, it has been discussed for months and months on end. No doubt about it.

But what the Member is losing focus of – and there are lots of people that patted him on the back for that announcement. He hasn't. We know why he hasn't, because it's for a political purposes only. But the hospital is needed and the minister can give you other reasons why it should be replaced.

SPEAKER: The minister's time has expired.

The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Speaker, I might be interim, interim, but after I listened to what he said on VOCM yesterday the minister might be on parole. Let's summarize. True words, he should listen to it.

The Premier was –

AN HON. MEMBER: (Inaudible.)

B. PETTEN: It's public knowledge. It's the radio station. Go talk to VOCM.

The Premier was caught on a luxury fishing trip with his billionaire buddy so the Liberals decided to announce a new hospital to distract from the Premier's problems. Yesterday, the minister admitted that the decision to build a hospital came out of nowhere. No homework was done on it.

Is today's briefing more damage control, Minister?

SPEAKER: The hon. the Premier.

A. FUREY: Thank you, Mr. Speaker.

Again, I'll finish my answer from the last time because I didn't have a full chance to articulate the data involved in the decision to drive this, Mr. Speaker. It's a 100-year-old hospital, Mr. Speaker. The population of the metro region has increased by 25 per cent. In 2000, when we took a hospital away from the metro region and didn't replace it with the full-bed capacity, the population has increased 25 per cent.

Since that time, the number of people over the age of 65 has increased from 18,000 to over 30,000. The number of hip fractures alone, Mr. Speaker, is gone from 250 a year to 450 a year this year to almost 650 a year projected in 2027. Where are we going to put all those people, Mr. Speaker? The approach from this government is to handle both the infrastructure and the human resource capacity at the same time and parallel.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Keep going, we're going to put them in a brand new empty building with no staff with all the broken hips and no one to look after them. That's what we're doing here.

Speaker, the Premier likes to say that we've never seen – I was doing Estimates for years in this Department of TI. There's never been any talk of St. Clare's hospital and he knows that like the rest of us do.

Speaker, yesterday, the Premier said replacing St. Clare's is – quote – addressing all issues of the Health Accord.

So I ask the Premier: Can you tell us what page of the Health Accord highlights the replacement of St. Clare's?

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

T. OSBORNE: Thank you, Mr. Speaker.

As the Premier said earlier, it won't take eight years and eight announcement for us to get this hospital built.

SOME HON. MEMBERS: Hear, hear!

T. OSBORNE: This summer, Mr. Speaker, a large piece of steel fell off of St. Clare's, landing on the walkway where people use as the entrance to get in to St. Clare's. The building needs to be replaced.

Mr. Speaker, we need infrastructure. The Opposition has said that many times before. We need people. We understand that. We're working on both. We need a modern facility. Some of the folks we're looking to recruit want a modern, state-of-the-art facility to come here, too. That is one of the things that we hear from folks. We are working on both very aggressively.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Speaker, that's infrastructure damage. We need doctors and we need nurses. That's what people need. And we need an emergency room where you can get care.

SOME HON. MEMBERS: Hear, hear!

B. PETTEN: Not this nonsense of coming out with announcements, making announcements and you don't even have a clue where the money is coming from. It's unbelievable, Mr. Speaker.

Speaker, long-term care beds sit empty across the province and staff are being forced to work mandatory overtime.

I ask the Premier: How can you commit to building a new hospital if you can't staff the current ones?

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

T. OSBORNE: Mr. Speaker, I will address the

preamble of the question. The reality is we do need folks to work in our health care facilities. This health care facility that we're talking about is bursting at the seams. Anybody will tell you that the emergency room down there is non-functional, it's not laid out very well, Mr. Speaker.

St. Clare's hospital needs to be replaced. It is a priority of this government, but so is getting individuals working in this province. We've got a number of initiatives in place to hire people in this province, Mr. Speaker. We're reaching out worldwide to hire health professionals in this province, and we're doing much better than some of the other locations across Canada.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Speaker, it astounds me. It's not a bricks and mortar issue; it's a human resource issue. We need people on the ground to look after them. Who cares if you look after them at the Empire State Building or Mile One, we need people to look after them.

They're building a building to deflect. It makes no sense. Everyone is saying it. We're asking those questions, which we're supposed to do.

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

This is the warning. If it keeps up, Members are going to lose their speaking privileges again today.

The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Thank you very much, Mr. Speaker, for that.

A year ago, in response to questions about the long-term care homes in Central Health, the minister said – quote – those facilities are fully staffed. But yesterday we learned that only half of the beds are open in Grand Falls-Windsor.

So I ask the Premier: If the facility was fully staffed a year ago, what happened?

SPEAKER: The hon. the Premier.

A. FUREY: Mr. Speaker, I'll again address the

preamble with respect to St. Clare's. I'd ask the Member opposite, does he expect 200 extra hip fracture patients, who can't be treated at home, to live in Mile One? Mr. Speaker, I don't think that is prudent; I don't think that is responsible. We're trying to plan for the future. I would say to the Members opposite –

AN HON. MEMBER: (Inaudible.)

A. FUREY: I am not riled up again.

I can say, with respect to the where – you have to understand that this is a complex system that can't be treated in a linear fashion. You need to do two things at once, Mr. Speaker; you need to grow the human resources and you need to provide the infrastructure.

It is quite clear from the numbers involved right now, Mr. Speaker, and the population that the current facilities will not allow for acute care for the patients of the metro region.

SPEAKER: The Member's time has expired.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Acting Leader of the Official Opposition.

B. PETTEN: Repetitive, Mr. Speaker.

I'll ask again, a year ago, in response to a question about long-term care homes in Central Health, the minister said: “Those facilities are fully staffed.” But yesterday we learned that only half of the beds were open in Grand Falls-Windsor.

I ask the Premier, again: If the facility was fully staffed a year ago, what happened?

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

T. OSBORNE: Mr. Speaker, I had indicated here yesterday and I'll indicate again today, we are doing a review of the services and requirements in personal care homes and long-term care homes with an aim to better utilize the individuals getting into these facilities so that we can get them out of acute-care beds.

We also need staff, and, more directly to the Member's question, we are recruiting staff not only within Canada, but internationally. The Member is obviously aware of the Medical Act that we put in place to recruit physicians from outside of Canada, from other countries. He will hear in the very near future about a nursing initiative, Mr. Speaker, to recruit from outside of the country and he will hear shortly, again, after that another initiative to recruit –

SPEAKER: The minister's time has expired.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Stephenville - Port au Port.

T. WAKEHAM: Thank you, Speaker.

It is interesting to hear the Members opposite talk about the importance of the rebuilding of St. Clare's hospital, yet at the same time the very people who did their Health Accord had no recommendations on replacing St. Clare's hospital in it and, at the same time, I don't recall anything in the fiscal forecast talking about the replacement of St. Clare's hospital.

So if it is such a priority, why isn't it in those buildings? But I also know that there is nothing in the Health Accord about the sugar tax.

So I ask the Premier: Will you finally admit that it is nothing more than a tax grab?

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Premier.

A. FUREY: Thank you, Mr. Speaker.

I tell you what is not recommended in the Health Accord: taking nurses out of the system, as was recommended by the Member opposite, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

A. FUREY: We are trying to provide modern facilities for the people of the metro region. It is unfortunate that the Members opposite don't recognize that value. I think that we have made a good case for this, Mr. Speaker, in terms of the changing demographics, the changing population of the metro region. In fact, this hospital will continue to serve not only the metro region but the entire province, Mr. Speaker.

With respect to the sugar-sweetened beverage tax, I've already made my case on that, and I think the public understands it.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Stephenville - Port au Port.

T. WAKEHAM: Speaker, I remind the Premier, in case he doesn't know, that taking nurses out of the health care system in 2016 was at the direction of his former minister of Health and his deputy minister of Health, both who are sitting on that side of the House –

SOME HON. MEMBERS: Hear, hear!

T. WAKEHAM: – right now, and, of course, you weren't allowed to tell the caucus Members of what their direction was. Maybe he should talk to some of them about it.

Speaker, yesterday the Premier said that people should just drink water. Well, the people in my district, in many communities, do not have access to clean drinking water.

So again I ask the Premier: Show some leadership and axe the tax.

SPEAKER: The hon. the Minister Responsible for Labrador Affairs.

L. DEMPSTER: Speaker, I'd like to respond to the

preamble and shed a little light. When the Member says he did it at the direction of this government, when we formed government in late '15 and we thought we were facing a billion-dollar deficit and it turned out to be over $2 billion from the Muskrat Falls fiasco, there was tough decisions to be made.

However, when this government asked the Labrador-Grenfell Health, which he was CEO at the time, to find savings to the tune of 30 per cent, he honed in on the most vulnerable population, a small isolated community in Labrador and said we'll take the nurse out of Black Tickle. The reason the nurse there was getting so much salary was from mismanagement from the health authority under his leadership at the time. That's what happened.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Stephenville - Port au Port.

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

T. WAKEHAM: If only half of that was true. What the minister just failed to realize is we were given a directive to take $500 million out of the system and that minister, her Minister of Health, told us not to tell her, not to communicate with anybody in the communities. We were not allowed to tell the communities what was being proposed. We were not even allowed to tell our own MHAs.

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

The hon. the Minister of Industry, Energy and Technology will lose his speaking privileges this afternoon.

The hon. the Member for Stephenville - Port au Port.

T. WAKEHAM: At the end of the day, Minister, it was the Minister of Health who said yea or nay to any recommendations that come in. So if she wants to blame someone for taking the nurse out of Black Tickle, blame the former minister of Health.

Now I'd like –

SPEAKER: The Member's time has expired.

SOME HON. MEMBERS: Oh, oh!

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Minister Responsible for Labrador Affairs.

L. DEMPSTER: The point I'm making when you're in a leadership role and you're asked to make decisions, you look generally in the back room and you look for places to find efficiencies. You do not reach in to the most vulnerable.

So I have to wonder if this Member across the way is seeking a leadership role, I would ask the people of the province is he going to reach in to the most vulnerable. Because I can tell you that's what happened in that situation –

SOME HON. MEMBERS: Hear, hear!

L. DEMPSTER: – and when he called me and said we're taking the nurse and we're going to serve it with paramedics, I said it will not happen and it did not happen.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Stephenville - Port au Port.

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order, please!

T. WAKEHAM: Speaker, what I will not do is fail to communicate with the people who are being impacted. I will not turn around and say do not communicate with the communities that you're talking about. I will not turn around and not allow MHAs to have a say in what's happening in their own districts, which this government did, which that minister refused to do. Those are the facts, Mr. Speaker. Those are the facts in this particular case.

SOME HON. MEMBERS: Hear, hear!

T. WAKEHAM: I go on to say, at the end of the day, if this government had not wanted to axe $500 million out of the system, none of that would've happened. So let's go back to the question at hand.

SPEAKER: The Member's time is expired.

The hon. the Minister of Education.

J. HAGGIE: Thank you very much, Speaker.

I feel obliged to address a comment in the

preamble. Perhaps the Member opposite would like to explain why he wanted to shut the St. Lewis clinic, the St. Mary's clinic at a time when there were no roads paved – which we have achieved – and those roads were essentially impassible in spring and the fall and now –

SOME HON. MEMBERS: Oh, oh!

SPEAKER: Order!

The Member for Stephenville - Port au Port will lose privilege this afternoon also.

J. HAGGIE: – he tries to deflect the blame.

Thank you, Mr. Speaker.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Ferryland.

L. O'DRISCOLL: Great deflection going on here today, great deflection, I have to say.

Speaker, it's been four years since government finally opened the first phase of the Team Gushue Highway. The Liberals have indicated they don't have the money and need federal support. Incredibly, 65 per cent of the provincial share of the Investing in Canada program, a federal program, remains unallocated.

Minister, what is the holdup?

SPEAKER: The hon. the Minister of Transportation and Infrastructure.

E. LOVELESS: The holdup is because we're doing things responsibly. This government is doing things responsibly. As I said, we need support from the federal government and we've gotten support from the federal government under Trudeau.

We go back to Harper when there were all kinds of cuts. But we will do it right when we get the funding arrangement in place. I say to the Member opposite, stay tuned.

SOME HON. MEMBERS: Hear, hear!

SPEAKER: The hon. the Member for Ferryland.

L. O'DRISCOLL: You won't have to worry about doing the road; you need to worry about cutting the trees over there by the time it's done.

Speaker, unlike the new hospital, the plans are in place for the infrastructure program. According to the Canadian Construction Association, our province is the worst in the country at getting money out the door. Ontario, on the other hand, has spent their share.

Again, why can't the minister get the project moving?

SPEAKER: The hon. the Minister of Tourism, Culture, Arts and Recreation.

S. CROCKER: Thank you very much, Mr. Speaker.

I had to take this question just to point out to the Member opposite that it was only less than, I don't know, 35 minutes ago I stood up here and announced a federal-provincial partnership with the City of St. John's to build a new track and field facility here in this province.

It's ironic, Mr. Speaker, they stand here and talk like – where's the infrastructure? Where's the infrastructure? Then preceding that was why are you building a new hospital?

Well, to the Members opposite, a hospital is infrastructure.

AN HON. MEMBER: (Inaudible.)

SPEAKER: Order, please!

Member for Ferryland, you can lose your privileges for this afternoon, too.

S. CROCKER: Mr. Speaker, this is a hospital; it's infrastructure. The new Canada Games facility – and I can tell you, I was fortunate enough to spend three years in this minister's responsibility and let me tell you, the Team Gushue completion was always something that was on the table. I think as the minister said, stay tun