Election promises: Mental health, abortion and big budgets

Health care is by far the biggest expenditure for the P.E.I. government, taking up more than a third of the provincial budget.

It seems everyone on P.E.I. has ideas for better ways to spend that $600 million a year.

Health care is always a major focus for the parties during an election campaign. Here are some of the issues the parties are addressing with their commitments this year.

Mental health and addictions

Mental health and addictions has been a major concern in the province since the auditor general raised concerns about excessive wait times for treatment in his 2012 report.

The Liberal platform focuses on steps made by the previous government to address problems - including a new methadone clinic which opened recently in Charlottetown, a youth addictions recovery centre developed in Summerside,  and a new youth mental health unit announced by government but not yet developed.

There is a commitment in the platform to spend an extra $750,000 to expand detox and counselling services offered through community hospitals, making them more widely available across the Island.

The Progressive Conservatives and the Liberals both talk about a replacement for Hillsborough Hospital, but the timelines are either fuzzy or in the fairly distant future.

PC Leader Rob Lantz said the Tories would conduct a review and begin planning in their first year on a replacement for the facility, but there's no timeline for actual development and no commitment of money.

Liberal Leader Wade MacLauchlan says Hillsborough is beyond its service life but there's nothing else in the Liberal platform. The party is committing to "redevelop adult mental health in-patient and out-patient services."

In the long-range capital budget government tabled last fall there was $5 million meant to begin developing a replacement for Hillsborough, but the money doesn't kick in until 2019.

The Green Party talks about a 24-hour, emergency care service for those seeking support with mental health and addictions issues. A similar operation is already in place at the in Halifax. It was developed to ease some of the pressure mental health cases were putting on the emergency room.

The NDP has committed to increasing funding for mental health and addiction services.

The Progressive Conservatives have stated support for the idea of a wellness court, which would deal with addictions-related crimes. The court would take a therapeutic, rather than punitive, approach. It is, however, just a statement of support for the idea. There is no timeline or money for creating one.

Preventative measures

All the parties are talking about the importance of taking preventative action when dealing with addictions, with a platform focus on measures to increase wellness.

Both Green Leader Peter Bevan-Baker and NDP Leader Mike Redmond have pointed to the social determinants of health, particularly poverty. They have talked about poverty reduction being a key component of preventative care, particularly with regards to mental health.

Green MLAs would "acknowledge that economic, social and environmental factors play a profound role in health and wellness," according to the party's platform, "and increase emphasis on proactive wellness promotion and prevention rather than reactive-based treatment."

Among their wellness commitments, the PCs promise to establish a "Premier's Wellness Initiative" to promote healthy living, and to offer a children's fitness tax credit similar to that offered by the federal government.

The Liberals promise to "expand the use and availability of public infrastructure such as schools for off-hours physical activities for adults, particularly in rural areas during winter months."

The heart of the NDP health platform is what the party is calling the P.E.I. Health Accord, an accountability measure to try to make sure Health PEI is meeting the needs of Islanders. The party says the accord would focus on health care governance, community engagement as well as income security and the social determinants of health.

There is some question about whether Health PEI would continue under an NDP government. Redmond has said the agency could be dissolved.

"The Health PEI structure is not guaranteed to be in existence after two years of an NDP government," Remond was quoted in a party statement. "We will review the mandate, operations and performance of Health PEI. If it is determined to be not the best option for the management and delivery of health care, Health PEI will be replaced,"

Access to abortion services

While neither of the two parties currently holding seats in the legislature want to talk about it, access to abortion services has emerged as an issue in this campaign.

P.E.I. pays for abortions, as it is required to under the Canada Health Act, but it does not provide the service itself. Women must travel to the mainland for that. P.E.I. is the only province in the country where legal abortions are not performed.

Both the Greens and the NDP have promised to create a women's health clinic that would provide abortion services on P.E.I.

Last year, an exclusive report by CBC News revealed Health PEI reviewed a proposal that would have allowed abortions to be performed on P.E.I., possibly at a cost savings versus the current practice of sending women to Halifax. But government told Health PEI to drop the review.

The Tories have committed to provide as many medical services as possible on-Island, but that pledge has never been coupled by the party with regards to abortion. The Tories say P.E.I. is meeting the legal requirements of the Canada Health Act, and a PC government would only review the situation if that was no longer the case. Wade MacLauchlan of the Liberals made a similar statement earlier in the campaign.

At the CBC P.E.I debate MacLauchlan talked about wanting to address barriers to access, including a lack of information, and out-of-pocket costs for women to travel to Halifax, but supported maintaining the status quo in terms of where services are offered.

Big spending

As health is the biggest line item in the provincial budget, it is not surprising that some of the most expensive promises of the campaign are coming in this area.

The biggest cost item in the Liberal platform is a new linear accelerator for the Cancer Treatment Center at Charlottetown's Queen Elizabeth Hospital to reduce wait times for treatment. That would cost $8 million.

The Liberals are also promising to reduce wait times by recruiting more specialists, and to free up more operating space at the QEH to reduce surgical wait times. In 2011 the Liberals promised to reduce wait times by opening up a fifth operating room at the QEH, which they said would allow for another 1,200 surgeries a year.

As of 2013 that fifth OR was not being used. Health PEI has not responded to requests for information on whether it is being used now.

The Liberals have also pledged to reduce wait times for MRI by adding an evening shift at the QEH.

The Liberals also committed in 2011 to open a new primary health centre in Morell. The community still has only a walk-in clinic that is open one morning a week with a nurse practitioner. People in the community wanted to see a doctor based there.

A key component of the Liberal health plan is a commitment to cap generic drug costs for Islanders not covered by a drug plan at $19.95 per prescription. That's a promise the party says would cost government $4 million a year.

The PCs have also pledged to reduce wait times for MRI and for surgical procedures like cataract surgery and hip and knee replacements.

While the Liberals have pledged to add one addition ambulance to serve Eastern Kings, the Conservatives pledge to add multiple ambulances to improve response times, including a dedicated vehicle for off-island patient transfers.

The Tories have also targetted a number of pocketbook-related health care issues: offering to reduce the seniors co-pay on prescriptions by 20%, which would result in a savings of about $2 per prescription; to cover glucose monitoring strips for Islanders with type 2 diabetes; and to eliminate parking fees at the QEH.