Claudia on the Financial Measures Act - Bill No. 419

CLAUDIA CHENDER « » : I rise to speak to the Financial Measures Act. With a bill of this magnitude that exists in theory to enact the spending in the budget, it's important that we understand the context that gives rise to it. We spend most of our time here talking about the government's agenda and how well or how poorly they are doing at making progress. Health care, housing, cost of living, protecting ourselves and our province from the changing climate - these are the things that Nova Scotians ask us about, that they care about, and that we, in turn, try to solve in this Chamber.

We can talk about bills and numbers and percentages, but our work is really about Nova Scotians, and ensuring that they can thrive: to live a fulfilling life, to provide for their families, and to be optimistic about their future. The year 2023 was a year where Nova Scotians shined, sometimes against all odds. It has been a challenging time. We had fires, we had floods, and we have seen the necessities of life become harder and harder to afford. As always, when faced with a challenge, Nova Scotians have shown their true colours: from local bakeries and restaurants feeding first responders to Legions stepping up, volunteer fire departments, countless community organizations, search and rescue, families and volunteers showing up and taking care of each other. In that way, 2023 showed us again who we are as Nova Scotians. We are a province of people who do what needs to be done. We don't swagger, we don't care about out mojo, we care about each other - quietly, steadily, loyally. We don't talk about it, we do it, and we need a government that does the same.

We need a government that cares about us the way we care about each other: always and without reservation. This is what we look for in the budget and in the Financial Measures Act. These are our metrics. A school food program points to this, which is why we have fought for this for so long.

As food costs rise and more and more children in Nova Scotia are food-insecure, a school food program is imperative in our province and in our country as a whole. The reality is, despite the great work of organizations like Nourish Nova Scotia, many children in this province today don't have enough to eat. They don't eat lunch, and breakfast may be a granola bar.

The minister and I had a disagreement about this earlier in the year and the minister assured us repeatedly that every student in this province had access to healthy and nutritious food in school. They didn't and they don't, but hopefully, with the help of federal funding, they soon will.

Diabetes care also points to this and in a province and country with socialized medicine - that's right, health care is free and accessible to all and socialized. This is a necessary step, but there is so much more to what should be a straightforward bill. There are entire bills in this bill. There was a provision enabling career firefighters to volunteer, something on which the Halifax firefighters were clear that they were not consulted and which, wisely, the government amended before the bill came for debate in Committee. Now we have the Nova Scotia Guard. Is this an end-around? It's too early to tell, but we know that search and rescue organizations, volunteer fire, and other professional organizations whose job it is to respond in emergencies were not consulted and that, yet again, government is acting without proper advice or consultation from those who know best.

This isn't in the FMA. It isn't in the budget, and so is it even going to happen? I guess we will have to wait and see. What is here is an extension of the Executive Panel on Housing in Halifax Regional Municipality for another two years, when the existing process has gone anything but smoothly. This panel makes closed-door decisions and circumvents municipal jurisdiction.

In Southdale-Mount Hope in my district, after serious concerns about the treatment of the wetland on part of the site, we recently learned through FOIPOP that 300 affordable - they were never going to be affordable, they were attainable - housing units planned and partially financed by a $22 million forgivable loan to the developer, have been quietly scrapped with no consequence. Not only was this not announced, but when I asked department staff about it, they denied it.

This confirms what we have said all along, which is that this government is going to have to get much more serious about financing attainable and affordable housing in order for it to get built. Not only will it not trickle down, it will - for the most part - not get built at all by the private sector, even with incentives, unless there are good partnerships and clear contracting, and we have not seen that.

Even setting aside affordable housing - which, it goes without saying, we are woefully underfunding in this bill, notwithstanding the someday investment in 200 units of public housing that represents a fraction of the need - the task force is not leveraging their powers to achieve important public goods. They are not requiring units to be built to the latest building codes. They are not requiring heating and cooling systems to meet our climate commitments. Shockingly, they are not even requiring egress for entire communities being built adjacent to neighbourhoods ravaged by fires, where residents fear they would not be able to escape in time with only one way out.

These special planning areas are yet another giveaway; giving away land, giving away expedited development permits, and giving away our wild spaces, and what do we get? Some housing - yes, at the very high end of the market. We need homes for families, for tradespeople, for health care workers, for educational assistants and restaurant workers and tourism operators - for the people who make our economy run. But we are not building housing for them - certainly not in the areas approved by this task force. We are expediting housing for the people who can afford to buy it and build it themselves already. That housing will get built, with or without government intervention, because the market will see to it, but what about everyone else? That question is not answered in this Act.

That brings me to the poison pill of this legislation, buried at Clause 110, not heralded in any press release or triumphant announcement: an unprecedented intrusion in the privacy of all Nova Scotians. When this bill passes, conversations between Nova Scotians and their primary care providers will, no matter what the minister says, no longer be confidential.

I would like, for the record, to read Clause 110 of this Act, because it is very important that we understand not what the intention is, not what the idea is, not what the program is, but what the legislation says, and the legislation says the following:

Subsection 110(1) of Chapter 41 of the Acts of 2010, the Personal Health Information Act, as amended by Chapter 31 of the Acts 2012 and Chapter 22 of the Acts of 2022, is further amended by adding immediately after clause (n) the following clause:

(na) requiring custodians and classes of custodians to disclose personal health information to the Minister or a person acting on behalf of the Minister for the purposes of planning and management of the health system, resource allocation and creating or maintaining electronic health record programs and services.

The provision is quite clear. The minister or her designate may have access to all medical records of patients - all records. Let that sink in. A conversation about fertility, about substance use, about gender reassignment, about anything, visible directly to the minister. Why? Health care planning. We have the information we need. It comes through MSI billing. We've been told that in previous sittings by the minister herself. This is how they triage the list. This is how they understand how to allocate primary care resources. They have the information they need.

What else? For resource allocation - well, that's terrifying. Why would the assigned personal information of Nova Scotians be needed for resource allocation? Well, you could say, like, who's busy or who's not, but you could also say, What are our priorities in terms of health care? Well, we know that it's probably not women's health right now. We haven't seen an increase in access to the endometriosis clinic, which we've talked a lot about. We haven't seen free birth control in this bill, which we've talked a lot about. There are lots of ways in which women and gender-diverse folks continue to be disadvantaged in health care. That's not a priority.

What is a priority? My colleague, the member for Bedford Basin, has talked about what's happening in the U.S., and I think was accused of fearmongering. That is real. We have jurisdictions around the world that are making health care decisions based on ideological opposition to what kind of health care people should receive, and this provision opens the door to that possibility. Do I think that's going to happen this year or next year? No, I don't. I don't think that's the government's intention, but it's possible. They have been told that over and over again, and they refuse to amend this legislation.

The question is: What problem is the minister trying to solve? We have asked that question, and we have not gotten an answer. The minister has been clear that she doesn't want to see our personal information, but she's also said that she might just need to peek at it or lightly touch it in order to manage the system. Which is it? Because those who know - physicians and regulators - have been clear: The department has access to the disaggregated information it needs. It's not accurate to say that this is needed for health management.

Another explanation has been that Nova Scotians can have access to their own data. That's what this is for. It's for the app, and it says that here: ". . . maintaining electronic health record programs and services." The legislation doesn't mention an app. So, if that's what the minister has decided that this is for, then she should amend the legislation, so it says that; but before she does, we should be really, really nervous, all of us, if that is what this is for.

Should we have access to our own medical records? Absolutely. Should we have to pay to access them from third party storage providers which, as we lose more and more family doctors, Nova Scotians are needing to do? No, we shouldn't, but this government says they are doing that through the app. I can't make the point strongly enough that this is a massive overreach, and one of many. It's a solution to a problem that doesn't exist.

If it's for us, then that probably means that, although the government hasn't said so, it's for the app. She's not talking about us all getting a copy of our electronic medical record to us, and that's not what the legislation says. So the huge privacy breach hidden in this bill is to give us access to the information. But is it? Because who built this app? Who has access?

Well, I'll tell you. It was built by a company called Think Research Corporation, chosen directly through an alternative procurement process - which the Auditor General has formally frowned upon - which has signed a $50 million contract with the government of Nova Scotia, in part to build this app. FOIPOPs show that it's likely that that alternative procurement was settled upon because Jenni Byrne + Associates - you might recognize that name, Jenni Byrne, chief adviser to the hopeful next leader of the country, Pierre Poilievre - hopefully not, I would say, on this side of the aisle - who also represents Loblaws and other companies who have a direct interest in monetizing people's medical data.

So, Jenni Byrne's company shows up in the Premier's Office and says: Hey, have I got a deal for you. Sign this alternative procurement with Think Research, pay them $50 million, they're going to build you a crackerjack app, you're good to go. This raises red flags, and we have continued to raise them as the Premier has quadrupled down on his alternative procurements and bad decisions. Why no procurement, why this company, why this app? Those questions remain.

Back to the minister's new power: This makes us deeply concerned, but not as concerned as when we learned that Think Research has gone out of business. Think Research has gone out of business and been acquired by its lender, a business called Beedie Capital.

Nova Scotians, when you release your information to the minister, maybe it's going to a hedge fund. Maybe it's going to Beedie Capital. Maybe they're figuring out how to monetize it. We have no idea. We have no idea, because this government has not been transparent in the procurement, has not been transparent in questions about this matter, and is not being transparent about what this provision is going to be used for.

Alarm bells should be ringing. Will Beedie Capital have access to our health information? Are they a designate of the minister? Well, we don't know, but we should be concerned about it, and we have not gotten the answers that we need.

The minister continues to say that they are following the highest privacy safeguards, but we know - well, we don't really know, but because she won't answer the question, we think - that the Office of the Information and Privacy Commissioner for Nova Scotia was not consulted on this. What we hear is that the minister and presumably her staff believe that they are complying with privacy, but this government has a bad track record on that. We have no third-party verification of that. In fact, the only external and feedback we've been given, including from the most prominent privacy lawyer in our province, is that this is extremely dangerous, and that this provision should at the very least be amended if not removed from the legislation.

There are some things in this Chamber that never penetrate public conversation. They're too technical; they're too boring; they're too complicated. We make a big deal about it in here, and it never gets out there. This is not one of them. This provision is an overreach just in the language, right on the face of it. In dozens of conversations over the phone, via email, and around kitchen tables over the long weekend, people have asked me about it repeatedly. We have done our best to amend it, raising the voices of health regulators, doctors, assault survivors and others who are concerned over and over again. The government has refused to listen - maybe because there is not a specific seat that they fear losing when it passes. But make no mistake: This provision is a poison pill. It does nothing to fix health care and everything to shake our confidence further in its management.

As Dr. Gus Grant eloquently said at the Law Amendments Committee - and I have tabled this - there are already people who don't trust the system for very good reasons, and this confirms their fears.

Last, I want to speak for a moment about the suggestion of a Child and Youth Commission, which appears as a schedule at the back of this bill. Again, in the context of the year that was and where we find ourselves at this moment, I'd like to talk about the Child and Youth Commission that is created - except that it isn't. This was an election platform promise - one of many, but also one of the most important. Why are we here if not for the next generation and for the generations to come? With the rising cost of living, with the challenges in health care and housing come children and families who suffer, an independent child and youth commission is critical to ensuring that we are living up to the responsibilities to the next generation, especially to young Nova Scotians who are excluded from or marginalized by the systems that this government oversees.

We are so glad to see the mention of this in the FMA, but in a cruel twist, for a bill literally titled the Financial Measures Act, it comes with no budget, no staff and no timeline - just a promise. Almost three years into this government's mandate, a promise is not enough. My colleague the member for Halifax Citadel-Sable Island attempted to amend this bill with, I think I can say, the support of the entire Opposition, adding what was needed to make this bill real. But it isn't real. We hope it will be, and we will fight until it is.

Speaker, I want to conclude where I began, by taking a moment to recognize and honour the strength, resilience, innovation and excellence of Nova Scotians this year and every year. In this budget, in this bill, we were looking for something that honoured that, that supported it, and that reflected the care that Nova Scotians have for each other. Sadly, we did not find it.