Dr. Swann in Question Period on Opioid Addiction Treatment and Death Reporting

Taken from the Alberta Hansard for Tuesday, December 13, 2016

Opioid Addiction Treatment and Death Reporting  

Dr. Swann: Bah. Humbug. Mr. Speaker, deaths from opiates are still increasing in year 4 of the most serious public health crisis in memory. Today I talked with a grieving mother who lost her daughter, presumably from a fentanyl overdose, in July. We still don’t know. Tragically, her daughter had been succeeding in a drug rehab facility right up until the point she was thrown out before her program was ended, allegedly because she also had bulimia, which the facility couldn’t accommodate. This girl, a college student without meaningful family input, was literally dropped off at a gas station to be picked up. Does the Premier feel that we are doing enough, that she is doing enough to create a sense of urgency . . .

The Speaker: Thank you, hon. member. The hon. Premier.

Ms Notley: Thank you, Mr. Speaker, and thank you to the member for the question. As we’ve often discussed – but let me reaffirm – the rise of elicit opiates, including fentanyl and the more powerful carfentanyl, has created a public health crisis here in Alberta and, quite frankly, across the country. Our hearts go out to the parents, the spouses, the brothers, the sisters, and the children who have lost loved ones. This government believes in harm reduction, and we believe in offering Alberta supports, not just stigma. So we are working carefully on a number of different avenues to improve the way that, as government, we can respond to this crisis, and our members will be . . .

The Speaker: Thank you, hon. Premier. First supplemental.

Dr. Swann: Thank you, Mr. Speaker. Given that opioid death rates in Alberta now exceed one per day – public health doctors estimate that we have approximately 40,000 to 50,000 addicts in Alberta – and given that together Calgary, Edmonton, and Cardston, the main Alberta Health Services clinics, manage only 2,500 patients a year and given that four- to six-week wait times are now the norm in our treatment centres and given that many of Alberta Health Services’ clinics close at 3 o’clock every day, does the Premier feel that the urgency of this matter is being addressed in Alberta?

The Speaker: The hon. Associate Minister of Health.

Ms Payne: Thank you, Mr. Speaker and to the member for the question. I have to say that I really do appreciate the member’s compassion and advocacy on this issue. Our government is working very diligently to expand access to opioid replacement therapies, which are known as best practice, in order to address opioid misuse disorders. He listed off the number of clinics that are being operated by AHS. We’re working with partners in the private clinics as well as working with doctors in the primary care setting so that stabilized patients in ODT centres can then be transferred back to the community for maintenance with their doctor.

The Speaker: Thank you, hon. minister. Second supplemental.

Dr. Swann: Thank you, Mr. Speaker. Well, given that B.C. is managing to report on opiate deaths, emergency room visits for opiate conditions, naloxone survivors, and wait times for therapy every month but given that Alberta reports every three to three and a half months, with some families not receiving reports on their dead loved one for eight to nine months, can the Premier tell us: is she going to direct the Justice minister and the Health minister to provide more timely information on these deaths?

The Speaker: The Associate Minister of Health.

Ms Payne: Thank you, Mr. Speaker and to the member for the question. Certainly, in B.C. they have a different set-up than we do here in Alberta. Here in Alberta we are having the information around emergency room visits reported to the chief medical officer of health, who is leading our government’s response to this very important crisis. Additionally, the reporting information that we’re getting from the Chief Medical Examiner is being reported back on a continual basis to the chief medical officer of health. They’re working quite closely. I look forward to talking more in depth with the member in our meeting later this week.

 


Dr. Swann in Question Period on Chronic Wasting Disease – 8 December 2016

Taken from the Alberta Hansard for Thursday, December 8, 2016

Chronic Wasting Disease

Dr. Swann: I’m shifting topics to the Alberta prion institute, that just received $11 million from Genome Canada to trace chronic wasting disease in deer, elk, and moose in Alberta. We need to act now to prevent a catastrophe not only in wildlife but in our agri-culture community. CWD is a fatal brain disease like mad cow disease. It’s spreading across western Canada since its introduction in game farms, and 15 years ago, the experts said that BSE, mad cow disease, would never cross species. Now, several hundred people have died from BSE.

The Speaker: Thank you, hon. member. [interjection] Your time is allocated, hon. member. Is there a minister who would like to announce . . . [interjection] Hon. member, your time is up. Please proceed, hon. minister.

Mr. Carlier: Thank you, Mr. Speaker and to the member for the very important question. You know, as a government we absolutely recognize the importance of keeping our livestock – our tame livestock, our domestic livestock, wild livestock – safe from any form of disease. It’s important for biosecurity reasons, for our markets, for everything. We’re continuing to work with the industry – the farming industry, the wildland farming industry, other livestock industries right across the province – on all our biosecurity issues and continue to be working with the member with the question as well on making sure we can do all we can. Thank you, Mr. Speaker.

Dr. Swann: It’s been a decade since I started raising these issues. When will you ban the movement of all potentially wasting-disease-infected carcasses, live animals, products, equipment, or other sources of infectious materials across this province?

The Speaker: The hon. minister.

Mr. Carlier: Thank you, Mr. Speaker and the member for the question. The odd time that, you know, those biosecurity issues do come up in the province, the department takes it very seriously and reacts very quickly. Those operations do happen not that often, but we do take action on it. Continuing to work with the member, we welcome the member’s input in going forward to do much more if we could.

Dr. Swann: No action. No action in 10 years. Given there’s now evidence that thousands of citizens are unknowingly consuming infected animals, including First Nations, will the minister mandate and implement now convenient, cost-free testing of all animals harvested in the CWD-affected areas?

The Speaker: The hon. minister.

Mr. Carlier: Thank you, Mr. Speaker and to the member for the question. The member I think does realize that there is testing going on. It is true that we have over the past few years, you know, picked up a couple of incidents when this has happened. It isn’t the doomsday scenario that he’s trying to make us believe. Incidents do happen. We have control of it. We continue with those controls. I have all the confidence in our public servants to do what they do best, and that is to make sure that we’re all safe. Thank you, Mr. Speaker.


Dr. Swann in Question Period on Tobacco Reduction Strategy – 29 November 2016

Taken from the Alberta Hansard for Tuesday, November 29, 2016

Tobacco Reduction Strategy

Dr. Swann: Thank you very much, Mr. Speaker. Yesterday’s second-quarter financial update contained very little good news for Albertans. A quarter-billion-dollar piece of that report was cost overruns in health care. Prevention, now approximately 3 per cent of our health budget, clearly must become a larger part of bending the curve in health care. The Premier has been quite vocal on a number of occasions regarding the health effects and costs of tobacco use to individuals, families, and the health care system. However, tobacco legislation passed in this House three years ago and supported by the Premier when in opposition remains to be proclaimed. To the Premier: what’s the delay?

The Speaker: The Minister of Health.

Ms Hoffman: Thank you very much, Mr. Speaker and to the member for the important question. We have been able to move forward on a number of those pieces, including the banning of flavoured tobaccos, including menthol, in Alberta. We’re very proud of that, and we are continuing to work with the chief medical officer of health and others in a public health way to make sure that we’re supporting Albertans and moving forward in a thoughtful way as we move forward with implementing additional pieces of the legislation.

Dr. Swann: Given that e-cigarette use is skyrocketing and given that youth are now almost as likely to try e-cigarettes containing addictive nicotine and given that Health Canada has now specifically recognized the danger e-cigarettes pose, will the minister commit to adding e-cigarettes to the tobaccolike products list and protect young Albertans by banning them in public establishments and workplaces?

The Speaker: The Minister of Health.

Ms Hoffman: Thank you very much, Mr. Speaker, and thank you to the member for a question that is clearly connected to govern-ment policy and something that I think we have heard and many of us advocated for in terms of an expansion and looking at an area for implementation. I’ve been working collaboratively with my federal counterpart, the Minister of Health for Canada, and they are looking at bringing forward a number of different precautions and safeguards in the area of e-cigarettes and vaporizers and other types of tobacco products. We’ll be looking at ways that we can have complemen-tary collaboration to provide the very best safety for Albertans.

The Speaker: Second supplemental.

Dr. Swann: Thanks, Mr. Speaker. Given that when in opposition the NDs made strong arguments against lobbyists from the tobacco industry having access to government ministers, in contravention of the framework convention on tobacco control, a global treaty of which Canada is a signatory, and given that there are still more than a dozen tobacco lobbyists currently operating in Alberta and on our lobbyist registry, will the minister commit today to ensuring that neither she nor her caucus members meet with tobacco lobbyists behind closed doors?

The Speaker: The hon. minister.

Ms Hoffman: Thank you very much, Mr. Speaker. That’s certainly my intention. I’m glad to have it on Hansard. That’s the way that we plan on moving forward, by making sure that we protect Alber-tans. They always deserve to be our number one stakeholder when it comes to making important decisions about their public health.


Dr. Swann in Question Period on Government Policy Development – 24 November 2016

Taken from the Alberta Hansard for Thursday, November 24, 2016

Government Policy Development

Dr. Swann: Thank you very much, Mr. Speaker. In 2016 this government brought in a host of new policies that are changing the very fabric of Alberta society, from energy and environmental transformation to large minimum wage hikes to dramatic investment decisions, in the midst of a profound recession. What is missing, of course, is a comprehensive analysis, details. Albertans and all of us are being asked to take a lot on faith. To the Premier: can you tell us why the government continues to announce massive policy change without tabling appropriate analysis, which the Legislature needs to properly inform debate?

The Speaker: The Deputy Premier.

Ms Hoffman: Thank you, Mr. Speaker and to the member for the question. We continue to address a number of problems that we’ve inherited, and I think the responsible thing for our government to do is: when you have a system that you’ve inherited, show leadership, step up, do what’s best, make determinations, work with the public service to gather the evidence, and move forward in a thoughtful way. With regard to specific items of interest, I’d be happy to respond to any of those. I think we’ve tried to do that as best we can as a government in an open way as we move forward while protecting the interests of all Albertans, Mr. Speaker. So we’re very proud of the work that we’re doing and the fact that our government is addressing a number of very serious issues.

Dr. Swann: My follow-up question is for the Energy minister. Given that the government has referred repeatedly in the media to the expected report of the oil sands advisory group and given that this group has been tasked with, quote, how government might implement the legislated 100-megatonne-per-year limit on oil sands emissions, end quote, and given that there’s no indication that the oil sands group will report while we debate the bill, what deliverables should this Legislature expect from the oil sands group?

The Speaker: The hon. Minister of Environment and Parks and climate change.

Ms Phillips: Thank you, Mr. Speaker, and thank you to the hon. member for the question. It’s a good question. The oil sands advisory group was tasked with providing the government with advice on how to give regulatory effect to the oil sands emissions limit. Of course, the oil sands advisory group is made up of folks who asked for the oil sands emissions limit. They asked for it because it provides investment certainty going forward as we act on climate change and provide an investment climate that signals to the world that, yes, we are a carbon-constrained jurisdiction but that, yes, we are also a responsible oil and gas producer.

Dr. Swann: It’s a bit confusing that they wouldn’t report to the Legislature while we’re debating the bill. That’s all I’m saying. To the Finance minister: given that on Tuesday this week both the Education minister and the Energy minister promised carbon tax funds, one to schools and one to backstop the electricity industry, and given that the agriculture minister has promised carbon funds to farmers and given that 60 per cent of Albertans have been promised a refund cheque, can the Finance minister show us the calculations for how this tax will cover the growing list of promises ministers are making?

Mr. Ceci: Thank you for the question. We have modelled the amount of money that’ll be coming forward with the carbon levy over five years. We know what the amount of money is, and we’ve portioned, basically, a third to rebates, a third to efficiencies, and a third to innovations over those five years. So we have to, going forward, keep within those monies, that we don’t have a bigger envelope than that, and I trust the ministers to come forward with requests that fit within that envelope.


Dr. Swann in Question Period on Fentanyl Overdoses – 21 November 2016

Taken from the Alberta Hansard for Monday, November 21, 2016

Fentanyl Overdoses

Dr. Swann: Thanks, Mr. Speaker. Despite frequent calls from public health experts and the opposition, the government has decided not to call a public health emergency in relation to the fentanyl crisis, stating that it’s able to effectively fight the emer-gency without such powers. Last week in a joint statement released from Ottawa, B.C., under a declared public health emergency, committed to release monthly data tracking, one, illicit drug overdose deaths, two, the proportion of deaths where fentanyl is detected, and, three, nonfatal overdoses requiring emergency response. Given that the associate minister has said that she already has such data, will she now tell us the number of opioid overdoses reversed through naloxone . . .

The Speaker: Thank you, hon. member. The Associate Minister of Health.

Ms Payne: Thank you, Mr. Speaker and to the member for the question. Certainly, the information that the hon. member has listed is now available online on Alberta Health’s website. We’ve com-mitted to releasing quarterly reporting on the opioid crisis and other substances of misuse, and we’re open and transparent with the public on the trend data. We feel it’s really important to make sure that that data is accurate so that we’re able to allocate our resources in the appropriate way because we cannot sacrifice the lives of Albertans for this PR exercise of more recently released numbers. We want those to be accurate numbers. Also, data . . .

The Speaker: Thank you, hon. minister.

Dr. Swann: To the associate minister again: are the number of naloxone reversals increasing or decreasing since the last report?

The Speaker: The hon. associate minister.

Ms Payne: Thank you, Mr. Speaker and to the member for the opportunity to answer the rest of the question. As of September 30 over 6,400 naloxone kits have been distributed to Albertans, and the reported number of usages is over 400. We know that that is an underinflated number, however, because not everyone is reporting the usage of the kits. In the time frame that the member is asking about, for the first half of 2016 there were 3,752 emergency room visits relating to opioid overdoses that have been reversed.

Dr. Swann: And that’s not an emergency? Overdoses, in reporting from emergency departments, have now reached approximately 25 per cent of all emergency visits for drug use. Can the minister tell us whether they’re increasing or decreasing?

The Speaker: The associate minister.

Ms Payne: Thank you, Mr. Speaker and to the member for the question. We have found that as this crisis is continuing, the number of visits is seeming to increase. We are continuing to keep tabs on those numbers, and we are working hard to ensure that treatment is making its way into the hands of people who need it. We are work-ing with our partners in the College of Physicians & Surgeons of Alberta to expand access to opioid dependency treatment, which is the best practice for treatment for people with opioid addictions. Additionally, we are working very diligently on the harm-reduction file, including supervised consumption services across our province.


Dr. Swann in Question Period on AISH Administration – 8 November 2016

Taken from the Alberta Hansard for Tuesday, November 8, 2016

AISH Administration  

Dr. Swann: Thank you very much, Mr. Speaker. My questions today are for the Human Services minister. For many years MLAs and constituency offices have been hearing about AISH: the application process, the delays, the inconsistency in appeals. It requires too much outside help and is inconsistent and unfair. We’ve heard now from the Auditor General that the times actually have increased between application and decision-making. How does the minister reconcile his statement that application times have decreased and the Auditor General saying that they have increased?

The Speaker: The hon. minister.

Mr. Sabir: Thank you, Mr. Speaker, and thank you, Member, for the question. I believe that Albertans deserve to receive the supports that they need when they need them in an accessible and timely manner. We have heard the concerns from Albertans, and we are working on a plan to reduce the wait times. We also accepted all of the recommendations that the Auditor General made, and we will make sure that they are implemented, wait times are reduced, and Albertans receive the supports that they need.

Dr. Swann: Well, perhaps, Mr. Speaker, the minister could outline what he’s done since he took office to improve the wait times, especially since the Auditor General said that they’ve actually increased.

The Speaker: The hon. minister.

Mr. Sabir: Thank you, Mr. Speaker. First, we have increased AISH funding by $29 million to make sure that Albertans receive the supports they need. Secondly, as of yesterday we have improved the website. The new website is online, with a focus on plain language and making it easier and accessible for Albertans. I’ve also directed my ministry to look into ways to streamline the application process.

Dr. Swann: It all sounds very good, but it isn’t improving the wait times, Mr. Speaker.

Given that the MLA salaries have kept up with the cost of living, when are we going to allow AISH people to keep up with the cost of living?

The Speaker: The hon. minister.

Mr. Sabir: Thank you, Member, for the question, and thank you, Mr. Speaker. We have increased funding for AISH, but due to our economic circumstances we can’t do everything that we wish to do. We are absolutely committed to making sure that AISH recipients receive the supports that they need. It’s not only the cash benefit. There are other benefits that are available with the AISH program, and we will make sure that we have stable funding to provide those benefits to all Albertans.


Dr. Swann in Question Period on Remand Centre Drug Overdoses – 3 November 2016

Taken from the Alberta Hansard for Thursday, November 3, 2016

Remand Centre Drug Overdoses  

Dr. Swann: Thank you very much, Mr. Speaker. My questions are for the Justice minister today. In the first nine months in Alberta there have been 23 near-fatal overdoses and three fatal overdoses in the Edmonton Remand Centre. In all of the year of 2014-15 in our federal correction services there were only six reported fatal overdose deaths, six in the entire federal prison system. This indicates a serious problem in the Edmonton Remand if not in the provincial remand system generally. Will the minister tell the House how many overdoses and overdose deaths have occurred in the other remand centres?

The Speaker: Thank you, hon. member. The hon. Minister of Justice.

Ms Ganley: Thank you very much, Mr. Speaker and to the member for the important question. Of course, the safety of our inmates and of our correctional facility staff is absolutely of top priority at all times. Unfortunately, it has been a long-standing challenge with correctional centres that sometimes drugs do get into them, and because of the recent wave of fentanyl coming into the province, that has had a really tragic impact on our correctional centres. We continue to work with our correctional staff to make sure that they are trained. They use drugs, they use searches, they use a number of methods to do their absolute level best to prevent those drugs from coming in.

Dr. Swann: My question was: will you table the number of overdoses and deaths in Alberta remand?

The Speaker: The hon. minister.

Ms Ganley: Thank you very much, Mr. Speaker. Sorry. That was rather shorter than usual.

I don’t have those numbers in front of me right now. We can certainly look into how those numbers are kept. Given that the hon. member has the numbers, I’m not really sure why he’s interested in my tabling them, but I will absolutely loop back with my officials.

Dr. Swann: Well, Mr. Speaker, my final question is: will the minister call a fatality review and find out what opportunities for prevention, where we’re falling down in protecting our children, our mothers, our fathers, our relatives who are charged but not yet convicted and staying in remand? I think we owe them a fatality review.

The Speaker: The hon. minister.

Ms Ganley: Thank you very much, Mr. Speaker and to the member for the question. As I’ve said, the safety of our inmates and of our correctional facility staff is absolutely top priority for us. Whenever there is a fatality within a correctional centre, there’s an automatic process that puts that before the Fatality Review Board, and ultimately that independent review board and not people at the political level makes the decisions on what ought to go to a fatality review. That being said, we do internal reviews of all overdoses and all deaths within corrections to make sure that we’re always taking steps to get a little bit better.