Proceedings of the Special Senate Committee on Aging
Issue 8 - Evidence, May 12, 2008 - Afternoon meeting
HALIFAX, NOVA SCOTIA, Monday, May 12, 2008
The Special Senate Committee on Aging met this day at 1:09 p.m. to examine and report upon the implications of an aging society in Canada.
Senator Sharon Carstairs (Chair) in the chair.
[English]
The Chair: Honourable senators, members of the public, welcome to the Special Senate Committee on Aging. We will spend the next bit of time inviting people from the audience to come forward. There are only three of you, so I will invite you all to the table at the same time because you are interested in the same field. So, David Ward, Trudy Ward and Linda MacDonald, if you would all come to the table, we will give you some time to put your ideas forward and then have a little dialogue with you because we have time before the minister comes. Which one is beginning, Ms. Ward or Mr. Ward?
David Ward, Member, Acadia Lifelong Learning, as an individual: I used to produce radio programs in Prince Edward Island and a friend of mine said I am the only fellow he knew that could broadcast without a microphone.
I did not plan to say anything today until I read some of your second interim report. I read as far as page 12 and was taken by the phrase of individuals who loved ``to learn for learning's sake,'' and the mental health benefits of continuing learning and, further down the page, comments on educational tax credits for those pursuing accredited courses.
I am fortunate in my time to have two degrees and I have nine credits I could apply to another degree, were I so inclined. I am now 72 years old and not particularly interested in obtaining any more degrees. However, we live near Wolfville. We live north of Kentville overlooking the Annapolis Valley on what we call North Mountain. Acadia University has a magnificent adult education program called Acadia Lifelong Learning for older adults. I think you have to be 55. Be that as it may, it cost all of $20 to join ``ALL,'' as we call it and for the $20, we have access to any number of seminars on topics of great depth or frivolous topics for some. We are able to audit any course taught at Acadia University, with the permission of the professor and we have full use of Acadia library. ALL offers four-to-six week courses on topics as diverse as studentship issues of the Bay of Fundy or learning to play bridge. These courses carry a fee of around $100; fees vary from $75, $85 to $100, which, strangely enough, is too much for some.
We know people who join ALL to participate in the seminars, but do not have the extra money to take the courses. Both my wife and I take courses and the expense is not that bad, but I take a course today and drive 20 minutes to get there. Trudy takes a course tomorrow and drives to it. We can tolerate that expense, but I think it would be great if there were a tax exemption or a portion of registration fees to be tax exempt for seniors. To that extent, I suppose the question mark is here: Should measures be expanded for seniors to include a broader definition of ``eligible courses''? I say yes, and will leave it up to people more learned than I to define what institution should provide those courses.
While I was thinking of making that comment relative to perhaps a tax break for mental health learning, it caused me to realize that I used to do our own income tax returns, somewhat aware of the ins and outs and what was eligible and what was not. These last few years, I have hired an accountant to do the work for both my wife and me, but I have come to realize and, please, I am not sure that I am absolutely correct on this, that medical expenses are a percentage of either earned or taxable income. I have no earned income anymore. Now, I have a pension income. Unfortunately, my medical expenses have gone up somewhat, yet the percentage is the same. I hope that some consideration might be given to those who, on the one hand, are able to look after themselves with their savings or whatever, but my, it is an onerous exercise at times to realize that the eligible percentage is less because my income is less. I wish Senator Cools were here because she and I have something in common. I was born at home, as were my three siblings, in the beautiful Depression years when I thought everyone had a barrel of shad fish in the basement or a barrel of salt cod and picked blueberries, and we bought lobsters by the potato sack full because they were poor man's food.
It has been a wonderful opportunity to hear everyone this morning. Those three doctors sure got us all thinking. Thank you for the opportunity.
Linda MacDonald, Elder Learners, Saint Mary's University: Good afternoon. Thank you very much for the opportunity to speak to you today on behalf of Elder Learners. For the past four years, on behalf of Saint Mary's University, I have been associated with this voluntary group of seniors from metro Halifax and nearby communities in Nova Scotia.
I would like to tell you briefly about Elder Learners. It is a third-age learning opportunity and has been offering challenging academic lectures since 1988 with the objectives to encourage continued participation in lifelong learning; to further the concept of the university of the third age; to become more aware of the heritage and traditions of our people, our province and our country; and to promote greater friendship, cooperation and communication among lifelong learners.
As an example of the last objective, last summer our Elder Learners hosted a soiree, I guess I could call it, with a group of seniors from Japan. They spent several afternoons together and exchanged a variety of cultural experiences. It was great fun.
Initially begun in 1987 as a co-sponsored consortium by the metro universities, Dalhousie University, Mount Saint Vincent University and Saint Mary's, since 1989, Elder Learners has been sponsored as a joint venture with Saint Mary's University alone. Since that time, more than 120 lectures have been offered to approximately 12,000 seniors across the province predominantly here in metro.
The programs and the organization are planned, organized, delivered by a committee of Elder Learners, and Saint Mary's offers only logistical support. I will mention that Carmen Moir is the President of Elder Learners because some of you who are from the local area and from Manitoba will recognize the name. I believe he has been very active —
The Chair: I was born and raised here.
Ms. MacDonald: Oh, that is right. I was reminded of that by my husband.
Anyway, we have lectures on Saturday mornings with three topics each fall and each winter, and then short courses that are four to six sessions either on Saturday afternoon or Sunday afternoon.
Membership is currently about $165 with most of those members attending the lectures and about 20 per cent taking part in the more intensive short courses. This year will mark the twentieth anniversary of the partnership between Elder Learners and Saint Mary's University. So that is my background.
There is a limited amount of research in Canada, maybe a little bit more from the United States, on the scope, the extent of learning, the motivators for learning and the barriers to learning amongst older adults, seniors, and especially with reference to the Atlantic Region. So, in 2006, with the support of Elder Learners and with funding from the Adult Learning Knowledge Centre, I undertook a survey of their members. I brought you a summary of the survey. I will leave it with your researcher.
Elder Learners is open to people who are 55-plus, and the age of the survey respondents ranged from 50 to 80-plus, but the majority of the respondents were 70 to 79. The findings of the survey, briefly, were that the strongest motivations for learning were for intellectual stimulation and the joy of learning for its own sake. That is what they said and I think that is shown in the kinds of programs that they organize and present.
These seniors have a traditional concept of what learning is about and so the lecture was their primary approach to participation and to organizing learning. They are most interested in topics having to do with literature, art, music appreciation and history.
Interestingly, this particular group identified no barriers, no limitations to their learning except for one possibility, which was time. They are so busy doing all kinds of other things, they do not always have enough time to do all the learning they would like to do. So I think we are fortunate in this particular group. In fact, I describe them as an elite group of millennial seniors. I think they are exceptional. They are not run of the mill, but I think they point the way to issues that are worthy of consideration for the next oncoming group of seniors, the baby boomers.
They prefer cultural settings such as art galleries, museums and universities. They prefer formal learning and, for about half the group, they participate in formal learning at least once a month.
The other interesting thing was that they did not always recognize their activities and their engagement in informal learning. It happened so connected to the context and to their focus and their purpose that they did not always see the activity as learning. They have this traditional form of presentation.
When the respondents were asked in the interview component to identify a recent occurrence of learning, every reply described an example of informal learning undertaken to address a specific goal such as to extend their knowledge of local history, to learn to import and export, to learn procedures for publishing a book, to learn informally from a new context and experiences, and to read and reflect on other cultures and beliefs. These goals were a blend of serendipity and curiosity. They were described with great personal satisfaction for both the learning process itself and the outcomes. So I think there is a great deal of informal learning happening amongst Canadian seniors, but they do not always recognize it for what it is; that it is learning.
The question is, how does learning contribute to the quality of life? I think that is an important aspect for our consideration. As a source of intellectual stimulation and friendship, Elder Learners provides an opportunity for learning about issues locally and globally, and for travel and new experience.
The observation has been made that social factors play a critical role in how we age. Those who have been surrounded by family and friends, and who stress the cultivation of the intellect, have a clear advantage over those who lack such experiences.
Furthermore, recent indicators suggest that those who remain active learners in later life enjoy better physical and mental health and express stronger life satisfaction than those who do not.
It is vital to recognize the connections amongst various factors such as previous education, life circumstances, particularly financial security, and the participation in learning.
A more recent study in which I collected information about the same age cohort, but with different life circumstances, does not depict the same level of engagement, satisfaction in learning or even a motivation to learn. This group lacks higher education and they lack financial well-being. Previous learning has not been rewarding, it has not been satisfying, and it has not been advantageous. In aging, this learning, or forms of learning, have been thrust upon them in response to changes in diet, lifestyle and behaviours. They lack resources to engage in learning for pleasure, and are more likely to express dissatisfaction with their quality of life. Notably, they have much more frequent contact with social and health services than do Elder Learners.
Various proposals are being put forward these days to allow those with weak or non-existent employer-sponsored pension plans to make additional contributions to the Canada Pension Plan. I think that this concept, approach or policy is well worth serious consideration because the financial security of this growing group of seniors will be important for their integration into society, for their well-being and for the well-being of our Canadian society.
A significant finding among both these groups is the low participation of men. McGivney, a British researcher, asked the question, ``Why is it that whenever opportunities for adult learners are provided, it is mostly women who take advantage of them?'' She identifies various reasons including a perception that learning is formal and irrelevant, a lack of awareness of learning opportunities and a lack of confidence.
Only 12 per cent of the Elder Learners membership is made up of men. One person who belongs to Elder Learners explained, ``Men are not inclined to be joiners and do not have the same social environment as women.'' This was a woman speaking.
While the feminization of the aging population of Canada is borne out by the demographics, special efforts must be made to engage men in both formal and informal learning. One successful example is the Men's Sheds project in Australia. I do not know if anybody has heard of that project here. A researcher from Australia who was here in Halifax last June, spoke about these sheds, which are more like our idea of community centres.
They are informal learning environments where men can go to get away from the wife who is saying, ``Why are you not repairing that garage door?'' or whatever it may be. These sheds are sites of informal learning, camaraderie and a contribution to well-being. They are structured around woodworking and metalworking activities. They provide opportunities for schmoozing, for applying or developing shop skills and for social good. One thing they do is gather up old bicycles and wheelchairs, and they rehabilitate them and donate them to persons in their community who would not otherwise be able to afford them. This approach is proving to be significant to engaging men in learning in Australia. I think we could learn a few lessons from them.
Canada needs to enable men at their local level to express and engage in various learning opportunities that offer social and learning stimulation, and that can enhance life satisfaction.
Because Elder Learners represents the kind of active and engaged learning we would wish for all Canadian seniors, I felt it was important to tell you about the survey and about this particular group. The intellectual stimulation, the active engagement, the planning and direction for themselves are characteristics that may provide insight into trends for the future and the retirement of the baby boomer generation. That is my generation and I am interested in what is available.
The implications for those responsible for programs for seniors cannot be generalized necessarily from this single study. With their overall increased educational level and sense of entitlement, boomers will expect to be active partners in decisions about their continued learning, just as Elder Learners now plan and implement their lecture series and short courses.
For boomers, having been focused on formal education and training for the workplace during their work lives, boomers in retirement may well embark on extended programs of learning about the arts, culture, literature and philosophy. With many more resources at their fingertips including the Internet, boomers may neither want nor need the information transmission mode preferred by their parents. Learning is one important aspect of a satisfying and successful stage of old age. Its benefits and contributions to healthy aging depend upon life circumstances and financial well-being. The challenge for those who work with seniors will be to find ways of attracting and retaining men as active participants in all categories of learning.
Another challenge that I was reminded of is the tendency over the past 10 years for Canadian universities to remove their tuition-free provision of learning to persons who are 65 and over. This change has happened in response to the funding regime coming from the federal government, then to the provincial granting councils and onto the universities. My university is one that has removed that particular funding, and I think that was in response to the expectation of more seniors wanting to take advantage of it.
The Chair: Thank you all for making this meeting interesting with respect to aging. Ms. Ward, I am sorry we missed you. I asked who would speak, Mr. Ward or Ms. Ward.
G. A. Trudy Ward, Member, Acadia Lifelong Learning: Senator Carstairs and your committee, thanks on behalf of all Canadians for dealing with the multiple issues of our aging population.
I was unable to download the 84 options from our computer, so this morning when we arrived from the Valley, we had an opportunity to look through them with great interest. I will add briefly to what my husband has already said about the Acadia Lifelong Learning program and I brought a calendar if your researchers would like to take a look at it for general information and the website.
The program has been in existence for about 10 years, and we have almost 400 members from Windsor to Digby, up and down the Valley. We realize that with the population taking courses right now, not all of them have computers, access to computers or the savvy to navigate them. One thing we implemented this year was called ``ALL on Call'' where the onus is put on the people who do not have computers to call into a number, and on a daily basis, that message is updated with any new seminars that are offered, any changes of rooms or any cancellations. We are trying hard to address all the membership, which has various levels of computer literacy.
If you do not mind, I will speak a little bit more about a passion of mine. I retired as a nurse consultant with Veterans Affairs Canada, so I was more than interested to see in your report that you have obviously spent a fair bit of time consulting with Veterans Affairs Canada and the multitude of programs that they have perfected or worked on for many years, dealing with the geriatric population.
I am pleased to see that with many of the options, you are talking about best practice. We have talked about that forever, so I am pleased to see, at least in words, that we are looking at best practice. With health care being the domain of the provinces, it is difficult to deal with a lot of issues, but a lot of provinces have implemented excellent things that should be looked at that will work with some modification in other areas.
I encourage you, as Dr. Rockwood mentioned this morning, to look beyond the Canadian borders if you have not looked at the Swedish model, which has been in existence for some time, but is absolutely stellar in how they deal with their aging population. Everything from housing — it is a marvel and I hope you will take a good look at that.
As a nurse consultant with Veterans Affairs Canada and dealing primarily with the veteran population and the spouses who ended up being caregivers to this aging population, my passions were looking for solutions to elder abuse, end-of-life concerns including palliative care, and caregiver issues.
In the early 1990s, Veterans Affairs Canada had a six-week pilot project developed by Mount Saint Vincent University, so I was more than interested, not knowing who was speaking today, that Pamela Fancey brought up many of the things that they have developed in their centre for aging.
I spoke briefly to Pamela after she spoke here at the hearings and she said that this pilot project still exists on their website and is being used. If, in your consultation with Veterans Affairs Canada, that pilot project on Care for the Caregiver did not come up, there were about four sites across the country and I worked out of the Edmonton office. I was one of two nurse consultants for the entire province and the Northwest Territories. Edmonton was chosen as one of the pilot sites for that Care for the Caregiver six-week project. Although it was close to 15 years ago now that I was involved with that project, it was highly successful. I urge you to take a look at that project and consider it.
The Chair: Thank you very much.
It is interesting. I have a 75-year-old spouse who, when I was appointed to the Senate, came to Ottawa deciding that we would spend the majority of our time there, so he needed to find something to keep himself busy. He started taking courses at the University of Ottawa. It ended up that he switched to Carleton University and most recently, earned a master's degree in political science to add to the other three degrees he already had. I have now banned him from doing anything but auditing courses because I was tired of editing. That is what would happen after the papers were prepared. As the former teacher in the family, I landed the job, but I refused to do any more editing, so he now only audits the courses. I have experienced adult learning first-hand from that perspective and it truly is a valuable way to engage the mind. In fact, there are often little notes when I arrive home saying, ``I know you do not have time to read the whole book, but read chapter 6,'' or other such little notations. Obviously, he does not think I receive enough mental stimulation in the Senate. He had to provide me with a little bit more. Do you have any questions, senators, for our guests?
Senator Cordy: I am interested in your Elder Learners. I had the opportunity last year at a conference to meet members from Elder Hostel who filled me in on the extensive programming they do. Are you related in any way to Elder Hostel? Do you deal with them or are you totally independent?
Ms. MacDonald: They are completely different organizations. Saint Mary's University has had a program of Elder Hostel, but felt that perhaps we would provide more opportunities for learning by working with the local communities and by providing learning opportunities for visitors who would be here only for a week. However, Elder Hostel is an exciting program.
Senator Cordy: Yes, it is, but I was curious whether there was a tie because of the name similarities. There is a cost to join Elder Learners, $165?
Ms. MacDonald: Yes.
Senator Cordy: Can you claim that on income tax? I know if you attend university, you can always write off the courses you are taking on income taxes. Is there any provision?
Mr. Ward, you mentioned courses you have taken at Acadia. If you are a part-time student, you can claim the cost of tuition for your courses, but can you claim it as an elder student?
Ms. MacDonald: At Saint Mary's, there are provisions for non-institutional learning and non-formal learning institutions. For example, I took Greek for a number of years. I could not claim that tuition — I spent $400 a year — because it was an individual initiative by someone who was not in an accredited learning institution. I took that course for pure intellectual stimulation and social learning.
So there are differences. Because Elder Learners is sponsored by an accredited formal learning institution, if people take part in all the learning programs, they probably have that ceiling of $100 in tuition, but if they take part in only one or two of the activities, they are not able to claim it.
Senator Cordy: What about at Acadia University?
Mr. Ward: This is the point I was trying to make, though perhaps I was not as articulate as I should have been. There are educational tax credits for those pursuing accredited courses. The courses that are available for the ALL program, many of which, by the way, are taught by active or retired professors, are not accredited courses regarding credit to a degree or a certificate. My wife and I, and many others who belong to ALL, take the courses really for those that have ``an inquiring mind.'' The folks who I would like to see more involved are those who have an inquiring mind but do not have the $100, $75 or $85 tuition fee.
Senator Cordy: That is something we should look at.
Mr. Ward: I hope so, yes.
Senator Cordy: Another thing you talked about, Mr. Ward, was the percentage of medical expenses you can claim against income taxes. When you fill our your income tax, as it stands now — I have not done my own for a few years — I think it used to be whatever is over and above 3 per cent of your income.
Mr. Ward: It is something like that.
Senator Cordy: Do you suggest that the percentage be higher if you are over the age of 60, 65 or whatever number?
Mr. Ward: I would go further than that. I wrote down and chose not to mention my thoughts on the income tax moratorium for people who have paid income tax for over X number of years. Would that not be nice?
Senator Mercer: Every sixty-fifth year free?
Senator Cordy: Yes, every sixty-fifth year free. That would be good.
Mr. Ward: I think I prefaced my remarks by saying I am not certain of the income tax regulations regarding medical expenses. It happened that I was looking at old income tax returns and ran across a number of receipts from my accountant of the day saying something like ``not eligible'' or ``over the eligible amount.'' It only hit me this morning, quite honestly. My heavens, my income is down, but my medical expenses are up. I am not getting as fair a shake as I did when I had more money.
The Chair: Actually, it is in the reverse.
Senator Cordy: Yes.
The Chair: It would have been 3 per cent if you had earned $100,000; it is 3 per cent of $100,000. If you earn only $40,000, it is 3 per cent of $40,000, so you would be able to deduct much quicker because if your expenditure is 3 per cent or more of $40,000, you can claim those expenditures. As your income goes down, the 3 per cent figure goes down, putting you into the area where you should be able to deduct the medical expenses.
Mr. Ward: I hope so, because I still pay income tax and I do not make over —
The Chair: The other thing that is now included in the income tax is the $1,000 age tax credit, and that was supposed to have taken care of some of the anomaly.
The other issue that you may not have had the chance to look at in our report is the fact that one of our options was to institute a national prescription program, which means that drugs essentially are free.
Mr. Ward: That is in this report?
The Chair: Yes, and of course that is where most of the cost occurs to the senior. It is not in the medical services per se because an MRI, CAT scan or that kind of thing is covered, but what is not available in many, many provinces is some kind of prescription coverage.
Mr. Ward: As a matter of interest — and it is the last comment I will make — obviously we have seen only the second report. Presumably, there was a first report. Going quickly through the table of contents, I was not aware of any mention of the words ``income tax.'' Words like ``financial'' and ``seniors'' are mentioned, but this income tax issue impacts a lot of people who could best use that money to pay for the next hip they need, for example.
Senator Mercer: First, thank you very much for being here. I remember as a student at Saint Mary's back in the late 1960s, there was a gentleman who was constantly in my political science class, an older gentleman. I got to know him. His name was Zatzman, the brother of Joe Zatzman, a former Mayor of the City of Dartmouth. I cannot remember his first name, so that is why I mentioned his brother's name. He was always in my class and I asked him, What are you doing? He said, I am retired and I cannot stand sitting at home. He was working on his fourth degree and this time he was taking a degree in political science. When he finished that degree, he would take a degree in English literature or something, I do not know. Even if we did not invent it, there were people around who were trying to invent it.
We heard a couple of weeks ago about a program at the University of Prince Edward Island. We have heard about Saint Mary's University. We have heard about Acadia University. I wonder whether the other schools in Nova Scotia — Université Sainte-Anne Collège, Dalhousie University, Mount Saint Vincent University, St. Francis Xavier University and University of Cape Breton — all have similar complimentary programs?
Ms. MacDonald: I can tell you that Cape Breton University has a seniors' college that is about three years old. I am not aware of Université Sainte-Anne having anything. Dalhousie started a seniors' college this past summer.
Senator Mercer: Always, always late, that group.
Ms. MacDonald: Saint Mary's led the way. We are 20 years old.
Senator Mercer: As always.
Ms. MacDonald: There is no competition amongst the universities.
Senator Mercer: No, not at all.
The Chair: Some of us are Dalhousie grads and some of us are Saint Mary's grads.
Senator Cordy: Some of us are Mount Saint Vincent grads.
Ms. MacDonald: I can claim all three. I know that St. Francis Xavier has been looking at something, but, to the best of my knowledge, there is not a program specifically in place at this time. McGill University has a creative institute for retirement and there is a national organization called Catalyst.
Senator Mercer: Maybe in our report we need to talk about coordinating the dissemination of information to people about the various programs across the country because I think continuous, lifelong learning is absolutely terrific.
Mr. Ward, you talked about the program at Acadia and it costs $20 to join. Is that fee only for the free lectures?
Mr. Ward: Yes, that is correct. The $20 allows someone to attend any of the seminars that are mentioned in the program that comes out each year, to audit any course and they have free access to the university library. If they want to take ``a course,'' six to eight weeks long, of so many hours and on such and such a topic, there is a fee that varies from course to course.
Senator Mercer: If it was a credited course, do they pay the same as an undergraduate student?
Mr. Ward: No.
Senator Mercer: No?
Mr. Ward: No.
Senator Mercer: Is it free?
Mr. Ward: Any of the advertised courses carry a fee. I can audit a course that is taught within the university itself simply by paying the $20 registration fee. If I am a member of ALL, I pay no fee to audit a course within the halls of the university. If a university professor, a bio-water-engineering guy, puts on a course on wildlife biology in the Lower Annapolis Basin and it is advertised in ALL, I might pay $75 to take that course.
Senator Mercer: If I went to Acadia's calendar and chose a course that I might take as an undergraduate —
Mr. Ward: You must be at least 50 to be a member of ALL. As a member of ALL, you may audit a course. That would be non-credit. You would simply audit that course because you are interested in that topic. You receive no degree, qualification or whatever.
Senator Mercer: Okay.
The Chair: As opposed to my husband who spends $800 to take a course, which he audits, but Carleton does not have that kind of a program. Carleton used to, and it was for free, as you indicated that Saint Mary's used to be, but my daughters told him that since they were paying for university courses they were taking, he should be able to pay for his too.
Senator Mercer: As far as I can gather, Senator Carstairs, the only thing that has changed here is he is still paying the fee and still taking the courses. You are the only one who has benefited so far. You do not have to proofread his work. As long as we all understand that.
I think the coordination thing would work well, particularly in a market as tight as the Atlantic Provinces and even tighter if you talk only about Nova Scotia because there is an established university organization where the universities talk to each other on a regular basis and work together. I suggest that it might not be a bad forum for them to add seniors' education and lifelong learning as a topic for their discussion.
Ms. MacDonald: Last August, the University of Prince Edward Island hosted a national consultation on the concept of seniors colleges and seniors learning for exactly the reasons you indicated: to share information, to look at trends and to consider policy.
Ms. Ward: As a point of interest, the University of New Brunswick has a similar course. It is interesting to look at the boards that make up these different adult learning situations across the country. For some, all the board members must be alumni of that university. Both my husband and I are graduates of McGill, and so at Acadia, there is a broad spectrum which is nice.
Senator Cools: Thanks for holding up the fort for other universities. I am a graduate of McGill University too. So far, Nova Scotia universities have dominated, but it is lovely to be in Nova Scotia.
I listened to all of you and I understand many individuals who have a quest to learn, especially in areas perhaps that they have not mastered before or in which they have been curious all of their lives. It suddenly occurred to me, in terms of the people that you are talking about that I was interested in the demographics. We are in Nova Scotia and, for a lot of years, mining was a part of the life of Nova Scotia. Somewhere out there, there must be many retired miners because mining is now a thing of the past in Nova Scotia. What do retired miners and retired labourers do in their retirement? How many of these people do you see? In other words, are there social stratification elements to this learning? In other words, is it university-type people who seek these courses in later life, or is it the individual who always wanted to go to university, but could not go because, for example, they had to help their father in the roofing business? I am curious; who are these people?
Ms. Ward: It is a broad spectrum and we have done surveys as well. An artist created this cover for our program and we used that sort of thing. We realize that there is a certain amount of intimidation for people who have never gone to university to come onto campus to take courses. So we try hard to offer some programs off campus. For instance, this past year we instigated a brown bag lunch program and participants do not even have to pay their $20 to belong to ALL. They can show up and have their brown bag lunch; there may be a speaker, or maybe not.
So people can take many things where they do not require any formal education in any way, or any history of formal education. I appreciate what you are saying; that there is often a large group of people that we are not reaching because they have never had the privilege or the opportunity to take education beyond perhaps high school or, perhaps, not even high school. So we always need to be aware of access.
Ms. MacDonald: Coming from a university, I always quote the research. Research seems to indicate that people resume learning at the level at which they left off, which addresses part of your concern.
However, I can speak briefly about the Cape Breton University's Seniors College because there are not many miners in Halifax, but there are a fair number of them in Cape Breton. I have some contacts with the people there and their seniors college. They have been cognizant of that particular concern and have made special efforts to reach out to people who do not have a university background, but to draw upon their strengths, expertise and experiences and to use them as a focus to draw people in. There is a culture of the mine and organizers have drawn upon that both to create learning resources for elementary school children as well as to bring people into a learning community of seniors.
The Chair: The other thing is, of course, that there is great talk about mining starting up again in Nova Scotia and so we will be interested to see what happens.
Senator Cools: Also, to learn from this experience too, maybe we should be more mindful to social stratification in our debates and discussions, because you quoted a woman's statement about men not being disposed to learning or something. My mother taught me when I was young to be respectful of the people who work on your land, who come to work for you on your property. If I have someone in to cut or trim my trees, I make sure I give them cold water, cold drinks and so on. It is easy for us sometimes to overlook the fact that the majority of people in this country are labourers.
Most men are carpenters, plumbers, welders or mechanics. Most women are not sitting here around the Senate table. Most women are cashiers, sales ladies, hair dressers and so on. I like to think of myself as a sensitive person, but I realized I have not been thinking about these people in retirement and maybe we should include this aspect because I have discovered that a lot of men do not have a natural inclination to make personal demands for themselves and their needs. A lot of men have done only brutish labour all their lives. I will give an example. If someone is working for you and cuts his finger, it is the hardest thing in the world to persuade him to stop work, to lose that two hours pay, to go to a doctor. Other people, especially who are on a different payroll, want two days off work, sick leave or something. In a way, you evoked this issue in my mind. Why is it then that so many people who do not have a history of personal self-development are reluctant to seek it?
One of the earlier witnesses talked about the churches providing social cohesion because many of those individuals still go to church. This is something that just came to me and perhaps you can comment.
Ms. MacDonald: I mentioned briefly, because I have not completed the analysis part, that I am engaged in a follow- up study with seniors who are the same age cohort as Elder Learners, but who do not have the same educational background and the same financial resources. In that context, this group includes both men and women. There are more men in this particular group, but there is not an interest in formal learning, and I think the critical word is ``formal.'' I think they are learning, but the idea of sitting still, of listening passively to someone else who is an expert and who does not connect to their areas of expertise is something that is of no interest to them. It is not relevant to where they are in their lives. I think it is a matter of finding, and I do not think it is difficult to find, and promoting appropriate kinds of learning and the men will be there. Organizers for the Australian Men's Sheds asked themselves, what can we do to make learning a more positive experience for everybody; we have these men who are sitting around being nuisances at home, being drunk in public and being totally engaged in antisocial kinds of behaviours. Community centre sheds have been an important response.
The Chair: Thank you all for participating in this session.
Senators, our next witness is the Honourable Michael Baker, Minister of Finance for the Government of Nova Scotia. With him is his assistant deputy minister, Elizabeth Cody.
You know Senator Mercer and Senator Cordy because they are Nova Scotia senators, and Senator Cools, who is from Ontario, introduced herself to you.
When I was sworn into the Senate in 1994, I was told that I was the senator via Nova Scotia and Alberta because I was born and raised in Nova Scotia. My father is a former premier and a former senator from the province. Then, of course, I graduated from university here and then, went west, young lady, go west. That is what happened to me so you are in good company, Mr. Minister. We welcome you and look forward to your presentation.
Hon. Michael G. Baker, M.L.A, Minister of Finance, Government of Nova Scotia: I appreciate the opportunity to be here this afternoon, and it is nice to see that so many have Nova Scotian ties. I am sure those ties will help you appreciate some parts of our position that I will detail.
With me is Elizabeth Cody from the Department of Finance of the Province of Nova Scotia. I have some, I will not call them short, remarks, but they are not tremendously long remarks and then afterwards I will be glad to attempt to answer any questions the committee might have.
I am pleased to speak to the Special Senate Committee on Aging today. I commend your thorough approach to exploring this topic and I welcome the opportunity to comment on your excellent report, Issues and Options for an Aging Population.
The work you are doing has important implications for all of Canada and particularly for provinces like Nova Scotia. We are already seeing the effects of an aging population and over time, these effects will only become more profound.
It is incumbent on all of us to develop public policy that will respond to these changes appropriately as they occur and I believe this exercise can help guide us in that complex process.
Your work complements Nova Scotia's extensive research for our Strategy for Positive Aging in Nova Scotia, which I table with you today. We are well-versed in the issue and options you have outlined in the report.
I regret that there is not sufficient time today to respond to most of them. However, we will file a paper in due course that will provide you with more specific comments.
As Minister of Finance for Nova Scotia, I want to focus specifically on the importance of fiscal policy solutions to address the consequences of aging in our society, which forms the last section of your document. I expect that many of us here today are part of the baby boom generation, born in the post-war years.
Most senior managers in Nova Scotia's public service were around to remember when John F. Kennedy was shot, and I believe the federal government is similar. Indeed, sadly, I remember that day as well.
In a way, we baby boomers are all experts on our demographic history, as we have had a front-row seat to observe all the phases. The outline of my own baby boomer story is typical. When I was growing up in Lunenburg County, every house on the street had kids, most of the moms were at home when the kids arrived after school and the dads generally worked full-time. In my home town, the work was usually something related to fishing or processing it when it reached the wharf.
Your report describes categories of the ``young old,'' ``middle old'' and the ``frail old,'' rightly pointing out that aging is not much about chronological age. These concepts did not exist back then. There were not as many older people and people did not live as long.
By contrast, in the town of Mahone Bay near my hometown of Lunenburg, a full one quarter of the population today is over 65. It is only natural that infrastructure and services focus much more on their needs.
For the young old who still have disposable incomes, there are now fine-dining restaurants and luxury condominiums popping up where the old buildings used to be. These people are often doing well, yet by the time they reach middle old, problems may creep in. Mobility is one. It is hard to move around a rural Nova Scotia county if they do not drive. One of the reasons we introduced a program in my budget this year is to help municipalities set up more shuttle services.
Then, there is the issue of frail old. We now offer more seniors' facilities, but as you pointed out, most people prefer to stay in the homes they have lived in all their lives. How do you convert a 120-year-old classic home in Mahone Bay, which has only one bathroom upstairs, into a safe place for your mom who has had a few falls or your father? Who will make sure she is okay when she takes a tumble while you are at work? Is it not all so familiar?
It is important to note that there are both good and bad elements to these demographic changes. We are all enriched by the presence of older friends, relatives and indeed work colleagues in our community. It is great that people are living long and, in many cases, living well. I do not think much in life can compare to taking in the view of Mahone Bay over morning coffee. It is one of the reasons people choose to retire to Nova Scotia's South Shore, but it is a fact that many people across our province will need more support from us in future to live well and in good health in their senior years, perhaps as long as 30 years or more for some. That is true not only for smaller communities like Mahone Bay, but for larger urban centres like Halifax.
However, it will be a challenge for all of us to make sure the supports they need are there. It is not only that baby boomers are aging and living longer. A number of other factors combine to make this issue more acute for us here in Nova Scotia and I will note a few examples. We see considerable out-migration of young people who form our potential tax base. The birth rate has now dipped below the death rate. We have a higher population of people with disabilities who have more complex care needs. We have a relatively high proportion with age-related illnesses such as cardiovascular disease and diabetes. We have relatively lower incomes per capita particularly among older women.
Factors like these suggest that the effects of the aging population will be more pronounced in Atlantic Canada, a concept that you have also outlined in your report. We are already working on the problem here in Nova Scotia. For example, our Department of Seniors, created last year from our longstanding Seniors' Secretariat, received a significant increase in its budget this year to pursue the goals identified in the Strategy for Positive Aging in Nova Scotia. We continue to invest in additional continuing care beds, including financing the construction of new facilities this year. We are focusing on helping older people live healthier lives through programs such as the framework for Preventing Fall-Related Injuries Among Older Nova Scotians.
Of course, a significant portion of major programs such as health care and social services are focussed on serving older Nova Scotians. Age-related issues touch almost every aspect of our government operations and policy, from long-term care and health promotion to accessible transportation and community development. I believe that we still may be the only province in Canada that has a separate Department of Health Promotion and Protection. Much of their work emphasizes protection of the elderly and promotion of health among the elderly.
Costs are already considerable and we know they will increase as the population ages. As mentioned, this concern is not only a Nova Scotia one. It is, or will be, an issue for all of Canada. It is clear that new and sustained funding will be required to address the changes on the horizon.
If there is one thing we do not agree with in your report, it is the idea that that this problem, which will take some 35 years to cycle through, is temporary. This issue is as permanent as most of the major public policy issues we see. I make this point because the federal government, in particular, has a tradition of providing temporary finding for long-term problems like this one.
Short-term funding propositions, like health wait-time money for three years, leaves the provinces on the hook for major programs when the money expires. My favourite example is Legal Aid — you will forgive me, I am a former Minister of Justice for Nova Scotia as well as a lawyer by profession — where the 50-cent dollars first promised by the federal government have dwindled away and people complain that the province is not doing enough.
Federal infrastructure money is now available, but only if we have the 50-cent dollars to match funding. Federal trust funds for things like education and the environment are designed to empty out even though the needs remain.
The aging population is an issue of profound significance, a matter of generational change, and it is not going away. We need a sustained and consistent approach to this issue for many years to come. That approach includes the appropriate financial resources. We think that the Senate committee's options should be thoroughly considered by the federal government and all provinces.
As you say, it may be time for Canada to consider amending our federal fiscal transfer system to address the aging problem. Serious consideration should be given to adjusting transfer payments to reflect differences in age-based expenditure needs across the country. Nova Scotia's preferred option is to amend the Canada Health Transfer to compensate provinces with disproportionately large senior populations.
This compensation would at least offset somewhat the planned move to an equal per capita cash transfer in 2014-15. This move will base the health transfer only on the number of citizens in each province and not on what they need in relative terms.
We are not convinced, however, that other transfers would lend themselves to adjustment related to aging. We feel equalization is already complex enough without the additional overlay of an aging factor. While Nova Scotia has noted a number of flaws in the current structure of the Canada Social Transfer for other reasons, we do not see it as the appropriate vehicle for tackling the aging problem.
Your committee has referenced the option of a supplementary program to compensate provinces for uneven aging. We think this option is something worth looking at. In fact, a separate and distinct payment might be the simplest and most straightforward way to help provinces with the costs associated with populations that are aging more rapidly.
However, the bottom line must be that any transfer funding program designed to offset the cost of aging should not suddenly expire when things become really tough; in other words, when most of the baby boomers are old.
Of course, the tendency for governments, both federal and provincial, is to do nothing. It is possible to pretend the problem does not exist or, perhaps, to wait until things reach a crisis mode. You clearly do not recommend this choice and, once again, we very much agree with that.
Here in Nova Scotia we know something must be done. The population, our population, is aging and the earlier we prepare for the change, the better off we will all be. The nation's seniors should be empowered, have choices and live their lives in dignity. We do not believe seniors in some provinces should have more and better services than their counterparts in other provinces.
We all want to enjoy the last days of our baby boom years no matter where we live in Canada.
Once again, I thank you for the opportunity to speak here today and wish you all the best as you tour the country on this important topic. I would be glad to take any questions.
The Chair: Thank you, Mr. Minister. We are delighted that you addressed the big issue that we think impacts specifically on the provinces, which is this fact that we have recognized that certain parts of the country are aging much more rapidly than others. We are seeing some differentiation because Saskatchewan was aging more rapidly than anyone and now has started to do the reverse because of the oil and gas income that has accrued and, of course, the high price for potash. The combination of those two things is drawing people back into the province now.
The same kind of changes are happening in Newfoundland and that is one reason why I think the committee has been looking carefully at Professor Joe Ruggeri's suggestion of a supplemental initiative, but he also makes clear that the initiative must be a minimum of 35 years, that it could not be less than that if we start with a supplemental payment.
Yes, it can fluctuate from province to province. If the offshore activity in Nova Scotia becomes as wonderfully pervasive as we want to see, Nova Scotia could have the same kind of boom of younger citizens. The movement of citizens in this province is not new. I remember being interviewed in 1962, when I graduated from Dalhousie University, about why so many of us were leaving the province. We used to pride ourselves on the fact that Nova Scotia's finest export was our brains.
Can you also address, very briefly, the whole idea around national prescription coverage for Canadians because, as you know, this area of high cost for seniors is becoming higher and higher. Some provinces like Ontario deal with it on the basis of everybody over 65 pays a small base and then they receive the rest of their prescriptions free.
Manitoba deals with prescription coverage entirely differently. In Manitoba, it is based entirely on income. What are your thoughts with respect to a national prescription program? Is it a long overdue concept?
Mr. Baker: We certainly support it. I should perhaps tell you a bit about Nova Scotia's program. Nova Scotia has a program where a senior pays $400 for coverage. It is universal in the sense that anyone over 65 is eligible for the program. There are those who do not take advantage of the program, but, by and large, they are people who have lifelong coverage as a result of perhaps working for the Government of Canada where, in many cases, they have prescription coverage for their lifetime. Therefore, the issue is not so important. By and large, I would say almost all our seniors would take advantage of that program and the cost of that program. There are co-pays, obviously, in the program. Those co-pays are capped. There are a number of details to the program, but one of the most significant is that we have made a commitment as a government that 75 per cent of the cost of the program will be paid for by government. This leaves 25 per cent of the cost of the program to be borne by seniors on an ongoing basis. The program is generous from the point of view of the amount of governmental contribution.
Also, groups of people are exempted, obviously, from paying any premiums at all. My recollection is that, and it is always a danger is to go by memory, people receiving the guaranteed income supplement, for example, are exempted from paying any premiums at all.
The program is income tested in that way, but it is a flat premium, reduced or eliminated by your income. Income does not need to be very low before they are covered under the program.
As you can appreciate, our average income in Nova Scotia is lower than other parts of the country, which is something that, as Minister of Finance, I am well aware of because it means that more of our citizens fall into lower marginal tax brackets than other parts of this country, and that situation affects our revenue stream, of course.
I think the program has great merit. One thing we have also implemented in Nova Scotia this past March is the Family Pharmacare program. That program is based largely on income, as opposed to the seniors program. It is designed to provide coverage.
As an anecdote, by the way, we believe that a national Pharmacare program period both for seniors and for younger Canadians would be well in order. We believe that as many as 180,000 Nova Scotians will be covered under our new Pharmacare program that did not have coverage previously either through the seniors programs, employer-provided programs and the like.
The Chair: The other advantage, of course, is having a national formulary. We all know the stresses on an individual province when one province grants a drug under their formulary. Every other province, no matter how effective or how costly this drug may be, has immediate pressures laid on them to recognize that drug as a drug of choice for citizens. A national formulary would take some of the pressure off individual provinces to accept or not accept these drugs.
Mr. Baker: I think that is again a good idea. I think we are in the same boat as other provinces, in that regard. When one province approves a drug, it puts tremendous pressure on us to approve that drug as well and those drug approvals may or may not be the most effective way of treating a particular illness.
I think a national formulary would take at least part of that pressure off provincial governments. One drug in Nova Scotia for catastrophic illness is a $250,000-a-year-per-person medication and we happen to have in Nova Scotia the highest number of people with the illness, certainly per capita, but I think in absolute terms. It is a particular genetic illness. I believe it is called Fabry's disease, technically speaking, but in Lunenburg Country, growing up, it was known as Tancook Disease. Medications are expensive medications for this illness.
By way of anecdote, the particular genetic illness in question started with a lady whose last name was Baker, and she would be at least a relative of my own. Fortunately, in my particular family we do not have that ailment, but it goes to prove that any particular province can be susceptible to these kinds of drugs and drug pressures. A national formulary would be a great way of at least bringing some management to the question. A number of provinces cover the medications for this drug and many more do not.
Again, while it is most common in Nova Scotia, it is not by any means an illness that is not known in other parts of the country. Apparently, it is a genetic illness that is connected to people of central European extraction.
Senator Mercer: Mr. Minister, welcome and it is good to see you again. A couple of items have been covered throughout our study, as we have held hearings in Ottawa and as we started across the country. We have had an ongoing discussion about guaranteed annual income. Some people support it, and some people do not. Senator Segal, who is a Conservative senator from Ontario, says that if we have a guaranteed annual income, we will be able to remove a whole bunch of other social programs that we currently have in place. I am interested in whether you have an opinion on guaranteed annual income, or whether the Government of Nova Scotia has formulated an opinion on it?
Mr. Baker: No, we do not have any formal policy position on that issue, one way or the other. I am obviously familiar with the concept. It has been one around for a number of years. I have heard some of the advocates for and against, and candidly, our government has not formulated an opinion. I do not think I will express an opinion, except to say it is an interesting concept, and it is one mechanism to deal with some problems, particularly social problems. The concern that I have heard expressed, of course, is that it may have the effect, in some cases, of discouraging people from entering the workforce and that kind of thing. That problem becomes another source of concern because, as you can appreciate, we have the same problem in Nova Scotia that many parts of this country have, which is that jobs in many parts of our province are not being taken up. That is one reason why our seniors are important because they represent a source of labour for our businesses that we cannot afford to ignore because people have learned skills over a lifetime and we want to make sure that those skills are available for people so that they will continue to provide them as long as they are able to, and want to, of course.
Senator Mercer: This situation is a problem across the country. The shortage of labour has become a problem and, God knows, I never thought I would hear the day in Nova Scotia when we were starving for people to go to work. However, that news is good news, but we still must fix it.
The other argument that we have heard is with respect to transportation for seniors. Many seniors are not able to afford transportation. We need to separate our discussion into rural and urban because for people, other than the people who live in the King's corridor to Weymouth, there is no rural public transit. By the way, that transit system is probably an exception in the country and one that we should all be proud of.
Some thoughts have been presented in the last few days that perhaps we should give anyone who receives a guaranteed income supplement a free transit pass, whether or not it is public transit, or maybe anybody over the age of 65 should be given free access to pubic transit, without having a means test. Obviously, some adjustment will be required in these situations with rural Canadians or rural Nova Scotians. Have you given any thought to that issue? Have you examined that end? Of course, as Minister of Finance, your ultimate concern would also be the cost.
Mr. Baker: People in metro Halifax, the urban part of Halifax Regional Municipality, have a reasonable transit system. Obviously, we would all like to see it further enhanced, but there is a transit system. The difficulty, of course, is that outside of that transit system there is none, with the exception of the King's transit in the corridor that goes from Hants County through to Weymouth, there really is no other significant transit corridor in our province.
If there is some kind of transit allotment for a senior, then I believe it needs to be adjusted in some way to deal with the realities of rural folks. Because, candidly, taxis or paying a neighbour to drive people are pretty much the only public transit options that are available to rural Nova Scotians. There are a few exceptions. Cape Breton Regional Municipality has a transit service as well, of course, but with those exceptions, there is not much. This is why our government has implemented in the budget a mirroring of the federal transit credit, which has been implemented in this year's budget. People who live in an area such as metro Halifax, the Annapolis Valley or Cape Breton where there is access to public transit, will be able to take advantage of a provincial transit credit mirrored, basically, on the federal one to increase the amount of accessibility. We also felt we needed to assist municipalities that want to look into at least limited shuttle services because a number of municipalities are looking at shuttle services. I know of one, in particular, in Lunenburg County that is looking at a shuttle service to shuttle people to work potentially from one part of that municipality, and also to doctor's appointments and the like because transit is a big concern for people of all income levels and all ages. We are trying to address that concern by assisting municipalities in a modest way to create these programs. However, the need is much larger than the funding, candidly, and as a member who represents a rural riding, I talk to a lot of older people who either cannot drive, no longer drive or, in a more classical situation, where women, in particular, did not learn to drive — there are still a surprisingly large number of those people, particularly in rural settings. They are then at the point that perhaps, when their spouse passes away, they do not have any means of conveyance anymore. Buying groceries, going to the doctor and even going to family get-togethers or friends' houses becomes a real burden in these situations. We would support anything that increases the mobility of our seniors.
Senator Mercer: Mr. Minister, I will try to ask these last two questions quickly because I do not want to take too much more of your time so my colleagues can ask questions.
Under the heading of ``Long-term Care,'' we made a recommendation and encouraged provinces and territories to make reciprocal agreements to eliminate waiting periods for residents from other provinces. We think this waiting period is a big disadvantage not only in Nova Scotia, but in other provinces because many seniors want to move to Nova Scotia. It is a great place to live, we know that, but many of them are also moving to Nova Scotia to be closer to adult children who are their support network. What is your opinion on that recommendation?
My second question, which I will give you as well, relates to recommendation number 60 in our report, which talks about the introduction of a national home care program. I had a personal health issue last year where I became ill in Ontario. I needed to access the Ontario health care system and, because of the reciprocal agreement with Medicare in Nova Scotia, I was fine. Everything was taken care of there, but when I left the hospital and needed home care, of course, there is no reciprocal agreement between Nova Scotia and Ontario, and I have a good drug plan through my employer. I kept saying every time a bill came in, what do people do who do not have this benefit? It seems to me that we need to look at either coming up with a national home care program or at least coming up with a reciprocal program that allows for cases where people find themselves ill in a jurisdiction other than their home.
Mr. Baker: I think there are many advantages to a national program, as opposed to only reciprocal ones. One challenge is that people move to Nova Scotia, and a lot of our population coming in are people who come to Nova Scotia to retire. Some of them are Nova Scotians that have moved away and, Senator Carstairs, it would be a wonderful thing to move back to Nova Scotia.
Nevertheless, we find that in many cases those people have spent their entire working lives paying taxes and contributing in other parts of Canada and they come back to Nova Scotia at the time in their lives when their need for public services, in particular, health care, is at its zenith. A national program — in fact, making it part of an insured service like, for example, home care — would be a great benefit. It would make the program eligible for funding, which would be a huge asset and would also ensure more consistent national standards for care. I understand the standards vary widely across this country, and that is a challenge for provinces for their own budgetary reasons, and I am well aware of the kind of reasons that exist because they exist in my budget. When we do not have those kinds of national standards with a federal contribution, a reciprocal agreement can expose the provinces that can least afford it to an influx of people with the highest need. That is a problem from a financial point of view. With a national program, we can have modest moves towards consistent standards, plus, of course, as an insured service, it is eligible for more funding from the Government of Canada. I think that approach obviously would offer us a better way of dealing with the problem.
Senator Cordy: Thank you, minister, for once again coming before a Senate committee. This is becoming a good habit. A friend of mine in Nova Scotia was once Minister of Finance and he said every time that he thought everything was under control, the Minister of Health would come knocking on his door.
Mr. Baker: Yes, I think that is one of the eternal truths of being Minister of Finance in Nova Scotia. Forty-two per cent of our budget goes to health care and it grows, as is consistent across the country, far in excess of our revenues. It is truly the issue that makes living within our financial means most difficult. The acronym we have in Nova Scotia besides health, education and community service is ROG, meaning ``rest of government,'' and ROG is everything that grows the economy. That kind of program that is so important tends to take a back seat sometimes when we are talking about the tremendous costs of health care, education and, of course, community services. Although with community services, some of the income support programs have been a little more sustainable; they have improved a bit, but it is a big problem.
Senator Cordy: I was planning to ask you about national Pharmacare and national homecare, but those things have been touched upon. I was on the Kirby committee and we talked about the fact that our health care system in Canada is definitely doctor and hospital. Things have changed so much and people are not in hospitals for long and yet, as soon as they walk out the door, we leave them alone. The idea of the Canada Health Act talking about portability does not hold true so much in the year 2008, as Senator Mercer would say, unless one has private coverage.
I will now go to the whole issue of volunteerism. We have heard from people in Ottawa and people as we have travelled across the country about the challenges of finding volunteers to work in the area of seniors because a lot of volunteers are seniors themselves. Also, we heard about the sandwich generation that look after children or grandchildren and aging parents. Those of us who are baby boomers can understand some of that issue.
Mr. Baker: I am very familiar with that.
Senator Cordy: Yes, as my husband used to say when I volunteered for something, ``How much will this cost us?'' There is a definite cost to being a volunteer. We heard from a number of people that we should have a tax credit; we will call it a federal tax credit for your benefit.
Mr. Baker: Thank you.
Senator Cordy: Maybe you can address it more objectively from that perspective. Then, if they have a receipt saying they worked 900 volunteer hours last year, they would receive a tax credit. We heard that suggestion, on the one hand.
On the other hand, we heard that a tax credit is great, but a tax credit is for the people who are likely able to afford to volunteer anyway because they pay taxes; they make a reasonable income. What about those who do not make enough money to pay taxes so the tax benefit will not be as beneficial? What do you think about a tax credit?
Another thing we heard was, at least reimburse volunteers for out-of-pocket expenses like gas. However, sometimes we, in government, can make things so cumbersome that it is hard to give somebody $20 for gas because a form must be filled out in triplicate and, you know the whole story. Do you know any way that we could help volunteers be volunteers?
Mr. Baker: In Nova Scotia we have had for the second year in a row a Volunteer Firefighters Tax Credit. It is $258 for this tax year past. This year, for the returns filed next March and April, it grows to $375, and then to $500 the following year.
We extended the credit in this year's budget to include Ground Search and Rescue personnel and the tax credit is refundable. It is not based on income. Volunteers do not need taxable income to take advantage of the credit. We have people who volunteer in Ground Search and Rescue or fire departments, for example, who do not have any taxable income, but nevertheless they are entitled to that credit. It is a way of addressing a huge problem in rural Nova Scotia.
Nothing will pay for the time those people contribute, but it is a modest way by the government of trying to say to those people that their time and effort is valued, and to deal with some of the out-of-pocket cost problems. For example, some of these firefighters live a considerable distance from the fire department. They must drive not only to the fires themselves, or in emergency, they are first responders, but they must come to innumerable practices and meetings. They are out-of-pocket for a tremendous amount and we felt that, at some point, to have a viable first responder system in Nova Scotia, we need to do that. We have pursued that model in Nova Scotia. Obviously, we would like to do more. Fiscal realities prevent us, at the moment, from doing more than that with respect to that group of volunteers.
The Chair: Mr. Minister, how does the credit work if they do not pay tax?
Mr. Baker: The tax credit is refundable tax so they receive a cheque regardless. For example, they file their return and the government sends them a cheque. It is that simple.
Senator Cools: It is like party donations.
Mr. Baker: Yes.
Senator Cordy: One thing we came up with was, how do you determine whether somebody is a volunteer? If somebody volunteers two hours a year and somebody else volunteers 300 hours a year, what do you do? Is there a certificate?
Mr. Baker: We set minimum standards by regulation that sets out the number for firefighters. This approach works for firefighters. Obviously, it would be adjusted for general volunteers, but we set out requirements that are rigorous, but not so rigorous that they are unreachable. Those criteria were worked out, in this case, in conjunction with the volunteer fire chiefs, and they are verified by the fire chiefs. Once the regulations are established by government, then the true person who is in charge of that volunteer organization certifies that volunteers have met the standard. Once we receive certification from the fire chief that volunteers have met the standard or, in this case, volunteers for Ground Search and Rescue have met the test, we send them a cheque. So I guess that is our suggestion.
Senator Cordy: That sounds reasonable.
Senator Cools: Senator Mercer will remember this well. I think it was 1974 when the Elections Expenses Act was passed around party donations. Mr. Trudeau was the Prime Minister at the time and I knew some of the individuals that were involved at the time of bringing about that act. It might be useful for us to make some inquiries, but I know at the time they were keen not to go into the kitty that the charities want. They did not want to have tax deductions, which are related to the amount of taxable income, so they chose the tax credit system. I do not know who would remember, or who would know now how that was done, how it was approached and the principles it was based upon, but we should look into the principles.
The Chair: As I recall, you and I are about the same age, they could only use it if they paid taxes.
Senator Cools: I thought it was once they filed a return. We should find that out.
The Chair: Yes, they deduct it from their tax whereas with this credit, I understand, they are paid whether they have a taxable amount payable or not.
Senator Cools: That is so with party donations. They are not a deduction, they are a tax credit.
The Chair: Yes.
Senator Cools: What he has proposed, what his government has in Nova Scotia —
The Chair: They have gone a step further.
Senator Cools: Oh, they went further?
The Chair: If there is no tax payable, they still send them a cheque.
Mr. Baker: They can have zero income. They fill out the form. One thing I have found as the Minister of Finance is that the tax system is flexible in the sense. We always think of it as a revenue collection mechanism, but, in this situation, it also works as a low administrative cost program because cost is a factor with programs. Particularly for provinces, we are concerned about programs that create huge administrative costs. For this program, the infrastructure is already in place, of course, through the tax system so that if they file a Nova Scotia tax return and they have this form signed by a volunteer fire chief where they are a member, then the government sends them a check for $250 this year. That amount rises to $500 over the next couple of years.
Senator Cools: It is a use of the tax system for redistribution of income, and there is a whole vast body of principles that we would have to look at there. However, you raise a critical question in the instance of the firefighters and I would suppose maybe the Search and Rescue people because there are massive amounts of volunteers involved in those activities. The real question at the end of the day is, who has the credentials or the authority to give anybody the necessary receipt to be able to file for the tax credit? I know that was an issue of contention back in 1974 and, as you know, in the interest of political parties, not everybody can issue that receipt. It is well-controlled. We would need to look at that issue because there are a few things to consider. One is the practical application of the program, and also, the principle of redistribution of income, which is what you are doing. You are taking other dollars that have been collected from other taxpayers and you are giving them to another set of people. It is a body of principles and I think we should examine it before we put forward a recommendation.
Senator Cordy: My next issue is that in Nova Scotia, we have had high profile cases involving young people and we have had high profile cases involving seniors. One case was the alleged abduction of a senior from Nova Scotia to England. We also had a senior woman who was involved in the court system, and throughout her whole life had never been involved, but was suffering, I believe, from dementia or some form of mental illness. One challenge that became apparent was the lack of government departments working together: justice, community services, finance, health, housing, transportation; all of them. Then, of course, we have different levels of government — municipal, provincial and federal — all of whom had some little tab, but yet everybody tended to say; not my problem, you handle it. We have people, and I will deal with seniors because we are the committee dealing with aging, falling between the cracks because there is nothing for them. I asked this question this morning of the three doctors who were panellists — whether these high profile incidents had created a momentum within government to make changes to work together — and they said they did not see it. They said government was being reactive and not proactive. Can you comment on the silo effect and the need for everybody to work together so that seniors do not fall between the cracks? I assume you will say it is working, but can you give your perspective on it?
Mr. Baker: I think there is always an element or level of reactivity because sometimes things occur for all governments that point out a deficiency in the system and governments try to react to that deficiency. I can say that, for example, part of that experience and other experiences are leading toward establishing a mental health court in Nova Scotia to deal with the individuals who have mental health problems which, in many cases, go across Community Services, Health of course, and Justice. That case highlighted why it might be a good idea here in Nova Scotia to have a mental health court, and that was part of that response.
I can also say that part of the response is a bill that is in front of the House at the moment that deals with consents and medical consents in situations where people cannot consent themselves. We are trying to respond on a number of fronts to those kinds of issues, and you can call it reactive or call it responding to a perceived need, but I think a real effort is being made to do that. Particularly with the Department of Seniors, which is newly created here in Nova Scotia, there is an effort to try to coordinate our service response for seniors more. We are in the early stages. I do not want to suggest other than that.
We have had the Nunn commission in Nova Scotia, with an unprecedented amount of funding. I have heard members on the bench comment that while a terrible tragedy led to Theresa McEvoy's death, there is good coming of it because it has changed the system in how to respond to young people. Sometimes good things come of terrible things.
Senator Cordy: The Nunn report is excellent. I think we would all agree provincially and federally that it was an excellent report, and a mental health court would be excellent. I have heard from people in Toronto who work within the mental health court in Toronto, and it saves a lot of heartache and headache for a lot of people.
The Department of Seniors does not have ministers, necessarily, but —
Mr. Baker: They have a minister, but the minister is not solely responsible for that department.
Senator Cordy: I understand, yes, but does this department arrange meetings between various departments to ensure that cooperation is taking place, not necessarily at the ministerial level, but within the bureau?
Mr. Baker: My understanding is yes. A deputy minister, for example, is responsible for seniors and part of the responsibility of the deputy minister is to make sure that the concerns and needs of seniors are addressed by government and across the bureaucracy, not only at the ministerial level.
I do not want to suggest it is a panacea because we are in our early stages in Nova Scotia, but we can see, obviously, the demographic realities of Nova Scotia and we are trying to address them.
The Chair: When I was first elected to the Manitoba Legislature in 1986, we spent 34 per cent of our budget on health and 19 per cent of our budget on education. When I last looked at the budget line in Manitoba, they were spending 41 per cent on health and 17 per cent on education. What are the realities of Nova Scotia with a 42-per-cent expenditure on health, in terms of the other departments?
Mr. Baker: It limits our abilities to fund initiatives in the rest of government plus even education and community services that we might be able to fund otherwise because not only do we have the growth in the budget, but I think all provinces are working hard to try to control that growth with greater or lesser degrees of success.
The difficulty is that there is so much unmet need in health care. We have spent only a little while this afternoon talking about things such as home care, long-term care, continuing care and all those unmet needs. I will be honest, chair; it creates a huge difficulty in offering the rest of the programming that is so important to so many other members of our society. The growth in health care is truly jamming us. As the Minister of Finance, one thing I would like to do is to have a more competitive tax environment in Nova Scotia. We are phasing in almost every program we offer in Nova Scotia, and the reason we are phasing in is not because we have not identified the need for the program at the time it is created, but because we must phase in, to sustain that program because of the growth of health care. It creates huge problems at budget time.
The Chair: My other question relates to an ethical question, and it only recently came to my attention. As you may know, I have done a lot of work in the field of palliative care. I was also on the Senate's special study on euthanasia and assisted suicide. I have long been a strong believer in advanced directive legislation and in getting one's house in order, if you will. Nursing homes are now, in some cases, demanding the signature of a ``Do Not Resuscitate'' order upon the admission of a long-term resident, and I bring that matter to your attention. I do not expect a response from you, but I hope you take it to your health colleague because I think this issue is a critical ethical one. Yes, somebody should sign a do-not-resuscitate order if that is what the individual wants, if the individual is not capable of making that decision and if that is what their families want, but it should not, in any way, be related to their admission to that particular facility.
Mr. Baker: I was not aware of that practice and I will pass that information onto the minister.
The Chair: It may not be in Nova Scotia.
Mr. Baker: No, it may not be, but sometimes it may be.
Senator Cools: I wish you would say what province that is taking place in.
The Chair: It is taking place in some nursing homes in Ontario that I am aware of.
Senator Cools: Ontario, okay.
Mr. Minister, I have two questions. One is smaller than the other. One is large. Maybe I will give you the smaller one first, or the lesser one.
This morning we heard reference to The Newfoundland Ladies. That was what they said, The Newfoundland Ladies. Do you have any knowledge of them?
Mr. Baker: I do not even know what the phrase would mean.
Senator Cools: I am trying to find out. They tell me it is a local thing.
Mr. Baker: I have no idea whether it is positive or negative.
The Chair: It is positive.
Mr. Baker: Oh, good.
The Chair: But, we will find out more about it.
Senator Cools: I gather some women from Newfoundland are coming to Nova Scotia to provide services in people's homes for the ill or the elderly; that sort of thing. Anyway, it was not all that clear, but somebody made a reference to The Newfoundland Ladies. You cannot tell me what it is, so you, of course, have no attitude. That is okay, thank you.
My next question relates to your statement. I believe you said that the birth rates are now lower than the death rates.
Mr. Baker: Yes.
Senator Cools: What does that mean for Nova Scotia and for Nova Scotians? If we look down the road a few years, will the government look at this?
Mr. Baker: Oh, absolutely.
Senator Cools: Can you share some of that with us, please.
Mr. Baker: It is obviously a statistic that is of great concern to us. It points out a number of things to us as a government. One, of course, is the importance of immigration. We need to attract more immigrants to Nova Scotia, and that is a demographic reality.
We also have a number of initiatives designed to attract Nova Scotians who have moved away to return to Nova Scotia to live, both people who are working age and people who are retired.
Some of the short-term and not so short-term concerns are that our population decline lowers our transfers, and it lowers the number of taxpayers to support the social programs that we all depend on. Smaller populations, particularly populations concentrated in rural parts of our province, are a huge problem. We have municipalities in this province where the population today in those municipalities is half of what it was in the 1920s, and that is long before the baby boom. I use that statistic only because we all know there were large populations and many young people not only in Nova Scotia, but across this country in the 1940s, 1950s and 1960s. This change has had a huge impact because that municipality, in the period from 1920 to the present, 80 years, has halved. That is not to mention the effect that decline will have on those municipalities in the not-too-distant future.
For example, we have many fewer hospitals in this province that offer any kind of obstetric care. The reason fewer hospitals offer obstetric care is because not enough babies are being born to justify maintaining obstetric care. The physicians who provide that kind of care are the first to say they need a minimum number of deliveries to keep on their toes, as they say; to maintain the quality of care that their patients quite correctly demand. Once deliveries dip below those numbers, then it is in everyone's interest to concentrate the obstetric cases in a larger centre. It may not be more convenient for the mom and the family, but it is to make sure that the quality of care is maintained so that the mom and the infant are properly taken care of. As that number accelerates and there were are fewer and fewer children born in Nova Scotia, there will be fewer and fewer obstetric facilities with farther distances between them because the physicians who provide that kind of care still need to deliver a certain minimum number of children to keep their skills. That is only a small example, but a real one of where the birth rate affects the kind of care that is available throughout rural Nova Scotia.
I was born in the hospital in my hometown, Lunenburg. That hospital is still there, but no longer has an obstetrics service. Unless there is an accident, there will be no one with their birth certificate that reads ``Lunenburg'' on it as their birthplace. Both my children were born in Halifax.
Equally, Queens County — again it is on the South Shore, which is why I am familiar with it; there are other places in Nova Scotia — no longer offers an obstetrics service because, to provide the quality of care to everyone involved, it was in everyone's interest to have the obstetrics service in Bridgewater.
Senator Cools: Maybe I am uninformed, but this is dismal. What you are saying is dismal. It does not take long for a group, whether it is a race of people or a community, to die out. It is something that can happen quickly, in two generations or so, and maybe it is like this and it is because you have put it in such a stark way. It had an impact on me, but I assume that this issue must become a major public policy question with the best minds beginning to figure out how we can support couples and people having families and having children. Maybe I am a little startled, but that does not mean anything. All that means is that I was in the dark, I did not know, but are there other possibilities? There must be. There must be motivations for people to have children and to raise them. There must be somebody to work on some of those issues because a lot of young people tell me again and again that if things were more conducive, they would have another child, or something like that.
The Chair: Senator Cools, I think that adds to the whole dilemma. If a province like this one spends 42 per cent of its budget on health care, it has less and less money for social services. It has less and less money for child care arrangements, which means we cannot fill those spaces which is what we probably need above and beyond to encourage young people to have children.
I will put it in another perspective by taking a look at the other end. If we provide 25 per cent of dying Canadians with palliative care services — and that is a stretch, it is probably somewhere between 15 per cent and 25 per cent, but let us be generous and say 25 per cent — then right now we have 207,500 Canadians who cannot access the service.
In 2030, we will have 400,000 deaths. That means 300,000 Canadians cannot access the service. What happens is that we deliver fewer services, not more services. Fewer services are delivered at the beginning and at the end in terms of what a provincial government like Nova Scotia can deliver unless, as I suggest, there is more engagement of the federal government.
Mr. Baker: I think that is exactly it. We have tried to create more and more portable child care in our province, but the ability to do so is limited, as you can appreciate, by virtue of the huge pressure that is placed on our budget by health care.
My wife and I, and you must remember that our youngest child is now 14 years old, were lucky. We literally lived across the street from a good daycare and my wife is a nurse, but was working in a hospital nursing setting at that time. It was a great asset for us as a family to have child care that accessible. For us, it was more accessibility than affordability. We could afford to pay for child care, although many people cannot do that easily. I point out that it is a real problem and it is a real problem, again, more pronounced in rural Nova Scotia than in urban Nova Scotia. That is not to say that it is easy to find child care in urban Nova Scotia, but in rural settings, it is even more challenging because they must have more flexible arrangements where the concentration of children is, as you can expect, much lower.
It also means that we are building schools in Nova Scotia as school populations decline. The reason we are building schools at an astounding rate in Nova Scotia is because our younger people who, obviously, are the people who have families, are relocating disproportionately to urban centres.
We are in a situation of declining school enrolment, but having to build schools using a huge amount of our capital budget. The second largest amount of our capital budget, after roads, is building schools. Notwithstanding rapidly declining school enrolments, what we would expect with a declining birthrate, we are still building schools because, as you can equally appreciate, the children are being born where the schools are not. That situation puts a huge budgetary pressure on our province, and it is hard to think about having more than two children, if there is no adequate child care. To replace yourself and your spouse, you need to have more than two. It is hard to think about having any children if you do not have adequate child care, let alone having more than two children.
It creates a huge problem. Also, the chair referred to palliative care and the fact that it means 300,000 Canadians do not have it. That assumes that you can even increase the budget maintaining a quarter of Canadians who need it because dollars are available in actual dollar amounts; they do not proportionately increase. A program that provides 25 per cent funding, I speak as the Minister of Finance in that regard, may not grow. Say that the number of people requiring palliative care grows at 5 per cent a year, for example. If you cannot sustain growth at 5 per cent a year, you may grow the program, but you may grow that program at much less than 5 per cent a year.
In theory, the number of people the program might be available for might decline in percentage terms even if the program increases in absolute terms. When I prepare budgets, I am required to budget in dollars and not in percentages. It is not being glib because it is a challenge. We see so many programs where they reach a certain level of demand and it becomes difficult to sustain that level of demand as that demand grows because revenues are not growing at that rate.
Senator Cordy: Some of the things we have heard as we have spoken to so many people since we have started the report relate to transportation and communication. We think in 2008, everything is great because of the inroads that we have made and that you have spoken about. You are well aware of the transportation needs in Nova Scotia and you are working toward solving the problems. We cannot have perfect solutions overnight, but at least to know that the government is in that mindset is helpful.
I will talk about communication. One thing that we have heard is that seniors are not necessarily aware of programs that they are entitled to. We have a Department of Health Promotion and Protection in Nova Scotia. Is the provincial Department of Health Promotion and Protection doing something that we should be doing at the federal level? We can talk about communications in terms of computers and that is great for one segment of the seniors' population, or we can talk about finding information at a seniors' drop-in centre and that might be good for another segment of our senior population, but a number of seniors are isolated. We have had a dialogue about seniors living in rural areas, but seniors do not need to be in a rural area to be isolated. They can live in downtown Halifax and be isolated if they do not have somebody who will drop in and talk with them.
Does the provincial Department of Health Promotion and Protection have any programs for seniors that are working specifically to catch the pocket that we might not catch? This group is a challenge because, when I look at Canadians who are not aware that they are entitled to receive CPP, it blows me away. If they do not realize they are eligible for CPP, what else are they not aware of?
Mr. Baker: The challenge is huge. I do not think we have a particular recipe in Nova Scotia. I will give you an example. We had a program that has been reinstated recently, formerly known as Keep the Heat and now is another acronym. That program used to reach 50 per cent, maybe 55 per cent of the eligible low income people that it was designed to help, many of whom were seniors. This program was designed to provide assistance to low income Nova Scotians of all ages with their home heating costs.
We reinstated the program because we saw the difficulties that last winter, in particular, posed for many people, and particularly for seniors. We learned some things and one of the things we are doing, for example, is we are sending out the application form to everybody who populated the previous program rather than to reinvent the wheel. We automatically send out the form to everyone receiving the guaranteed income supplement, for example, because we have identified a group of people who, by definition, are low income and obviously seniors as well. However, how do you find people who need the program because it is not lack of determination on the part of the government to help everyone who is low income and is struggling with heating costs? The difficulty is to make them aware of this program because many people clearly qualify for the program and are struggling, I am sure, with their heating costs. It becomes a real challenge and we try to reach them through the media, but many people do not receive newspapers. We try newspapers, TV, the typical brochure mail-outs that governments put out, but unfortunately, many people see government mail-outs and they throw them out and do no read them. Sometimes, we are not asking them to do something. Sometimes is not bad news, it is good news. Sometimes the government is here to help, and all levels of government are here to help. We have programs in Nova Scotia such as a program that we are doubling this year to help seniors with their property taxes. We will provide property tax rebate relief to this group of people that we want to assist in staying in their homes. The idea is keeping people in their own homes. The difficulty is that many people who are eligible for this program will never apply for it.
The challenge is huge because all levels of government create the programs in a sincere effort to help people and then so many people, sometimes the ones that are least advantaged — that is my experience — are the ones least able to know about a program. These programs would provide them with $200 towards their oil tank refill or would provide them with $800 towards their property taxes, both of which I would think would be a great deal of assistance to people who want to stay in their own home. Those programs are only two I can think of. I am sure there are others.
Senator Mercer: I will make a comment about Senator Cordy's question. It seems to me at this time that if any senior Nova Scotian is not applying for the program, or does not know that they qualify for the Canada Pension Plan and other federal plans, it is worth our while to reach out to them as the Province of Quebec has done. That province claims they have almost 100-per-cent take-up because they have gone out and talked to people. I talked to a relative this morning — it was $900 to fill her oil tank today. That is a lot of money.
Please do not misinterpret this next question. I planned to ask it no matter what happened last Friday or last week with my provincial friends.
Mr. Baker: I was happy with what happened last week.
Senator Mercer: I am sure you are, but I was not planning on taking any credit for it. It is with respect to the number of seats at Dalhousie Medical School. I commend the government for agreeing to the deal to add some extra seats. I also want to relate that what we have learned as this committee has travelled across the country is how few of these seats in medical school will produce geriatric specialists and people who will deal with geriatrics. We heard from extremely well-spoken members of the medical community this morning about the same problem. They said that even when one specialist is produced, there may not be a residency opportunity for someone here in Nova Scotia and we might lose somebody that we trained. I recognize you are the Minister of Finance, not the Minister of Health.
Mr. Baker: I happily recognize that too.
Senator Mercer: I am sure you do. Is there any thought from the government as they increase the funding to Dalhousie Medical School to give some direction as to the shortage of specialists we currently have? I mentioned only geriatrics. I am not aware of all the statistics on what else we are short of.
Mr. Baker: Well, I am not Minister of Health and I cannot comment other than to say, because it was in the budget, that besides the 10 seats this year and then 10 seats next year that will be provided for Dalhousie Medical School, the budget also provided for nine residency seats in Nova Scotia.
I am not sure how and what specialties those are in, but it is all part of our effort to not only train the doctors here in Nova Scotia, but to retain the doctors here in Nova Scotia. I can only hope that those seats will be in those kind of specialties that are in highest demand in the province.
There is an effort, I can tell you, because it was in the budget to attempt to identify not only medical school seats, but residency seats as well.
The Chair: Thank you, Mr. Minister. This discussion has been fascinating, and we are delighted we were able to do some manoeuvring and come this afternoon.
Mr. Baker: I appreciate all the effort that was made to adjust to my schedule as well. Thank you.
The committee adjourned.