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Not enough for health care in provincial budget, critics say


HALIFAX — Nova Scotians have been spared tax and service fee hikes but the 2019-20 budget is not likely to help much in navigating a beleaguered health-care system.

“With this budget we continue to deliver on our plan to strengthen the financial health of the province so that we can strengthen supports and services that are important to Nova Scotians,” Finance Minister Karen Casey said of the fourth consecutive balanced Liberal budget that was presented Tuesday at Province House.

“We are focusing this budget on four key areas — improving access to health care, investing in education and preparing youth for the workforce, creating conditions for economic growth and supporting our people and our communities.”

Health care priorities

Residents, front-line health-care workers, caregivers, clinicians and opposition parties have been ringing alarm bells for months about health-care woes that envelop the province. It is no surprise that health spending tops the ho-hum Liberal budget, accounting for $4.64 billion of the projected $10.98 billion in spending as government struggles to stem the bleeding in what many refer to as a health-care crisis.

That amount includes $10 million to further develop collaborative-care teams intended to make it easier for Nova Scotians to see a doctor or other clinicians. The government has allotted just $200,000 to support doctor recruitment.

“Health care is the No. 1 priority for Nova Scotians as it is for our government,” Casey said.

The 2019-20 projection for health-care spending includes a $191.5-million increase from last year’s $4.45-billion budgeted amount.

“Health care is in crisis in this province,” said Tim Houston, leader of the provincial Progressive Conservative party. “People are worried that they won’t be able to access the care that they need when they need it. I don’t think government acknowledged the crisis with the budget. If you look at EHS (Emergency Health Services), where paramedics have been screaming for help, Nova Scotians are seeing incredibly high response times, sometimes 40 minutes, sometimes an hour. The budget for EHS as compared to what was spent last year hasn’t gone up. The government is just saying ‘there’s enough there, we’re not listening to you.’ The same thing with long-term care beds.”

A significant infusion of money to build new long-term care facilities was conspicuously absent in the budget, although $2.8 million has been allotted to implement the findings of the expert panel on long-term care. That $2.8 million is tabbed to cover wound care, service co-ordination and staffing. No budget funds will go to the construction of new long-term facilities but new beds will open in Cape Breton Regional Municipality and a replacement for facilities for the Clare and Mahone Bay communities are in the long-term plans.

“It looks like a dumpster of disappointment,” NDP Leader Gary Burrill said.

“Here we have ERs all over the province in chaotic, jammed-up, overcrowded circumstances. Doctors and nurses all say the same thing about this. It’s because they can’t discharge those (ER) patients to the hospitals because the hospitals are plugged, jammed full of people who are waiting to get into long-term care, people who aren’t even hospital patients, so plainly a big part of the solution to the crisis is to open new long-term care beds.”

The majority Liberal government has budgeted $156.9 million to support health-care redevelopment projects at the Halifax Infirmary site and the community outpatient centre in Bayers Lake, along with the recently announced expansion at the Cape Breton Regional Hospital in Sydney that will double the capacity of the emergency room, critical care and cancer centre spaces.

A bilateral funding agreement will have the federal government provide mental health funding of $16.8 million for home care and $11.7 million for mental health support, part of a five-year $295.5-million expenditure.

“I’m happy that the government is acknowledging the need and the situation there,” Houston said. “There will be now $295 million invested in mental health, that would be the seventh largest department if it was on its own and I think it should be out on its own. I think they missed an opportunity to really send a message to Nova Scotians that they are serious about addressing the mental health needs of the province.”

The government has budgeted $57.2 million for the Nova Scotia Health Authority to cover rising demand for health-care services and committed $2.9 million to open 15 new residency spaces for specialty medical positions at Dalhousie University Medical School.

Pharmacare programs will get an injection of $8.4 million while $4.6 million will be allotted for Emergency Health Services.

The balance sheet

The government forecasts $11.01 billion in revenue for 2019-20 and expenses of $10.98 billion. The forecast surplus after government expenditures for this year is estimated to be $33.6 million, following the $28.4-million surplus from last year.

Nearly $6 billion of that revenue will come from taxes collected, including a projected $2.8 billion in income tax, $1.9 billion in harmonized sales tax and $605 million in corporate income tax. The haul from cannabis sale taxes collected by the federal government and distributed to the province is forecast to be $7.8 million, about 25 per cent less than originally estimated.

The overall projected tax revenue increase is 1.8 per cent from last year.

The government will spend $1.43 billion on education and early childhood development. The regulated provincial child-care sector will eat up $67 million of that total, but that includes an $11-million federal contribution. The province will spend $10.2 million to expand pre-primary classes in an effort to reach its goal of providing access to free, pre-primary learning opportunities for every four-year-old in the province by September 2020.

The Liberal majority government has budgeted $15 million as part of its two-year $30-million commitment to implement the recommendations from the Commission on Exclusive Education.

“Since 2014, our government has increased the education budget by nearly 30 per cent,” Casey said. “We are investing in students, improving classroom conditions and preparing young people for the workforce. This budget invests in expanding pre-primary classes, provides increased funding for inclusive education and reinstates the reading recovery program across the province.”

Government reports that the province’s population has reached an all-time high of 965,382 people as of January. The province will spend an additional $14.2 million on programs to support adults and children with disabilities, $5.6 million to increase income assistance payments and $5 million on poverty-reduction programming.

The budget contains $3 million to prevent domestic violence and $470,000 for work to curb sexual violence on university and community college campuses.

The government has earmarked $7.2 million more to make improvements to public housing and $3 million to support a three-year plan to add 1,500 new rent supplements in an effort to reduce waiting lists.

“There isn’t anything here building affordable housing,” said Christine Saulnier, the Nova Scotia director of the Canadian Centre for Policy Alternatives. “There are some rent supps but that’s not enough. We need to actually build affordable housing. We need actual supports for housing. We need to ensure that we don’t have people who are homeless. We need to ensure that those with children actually have support.

“We don’t have a plan here. People are definitely in crisis. I really want to see them address poverty and help people to actually afford the basics.”

The government will spend $15 million on roads, including highway twinning projects, and bridges. Budgeted initiatives to foster economic growth include $15 million to expand and create tax credits to encourage investment in new and growing businesses, $2 million to revitalize tourism icons, another $2 million to fund projects that support competitiveness and productivity in various sectors, $1.7 million to encourage the move to ecological forestry and $850,000 more for export development programming.

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