The health debate nearly cost Premier Stephen McNeil his majority in this spring's election, but on Tuesday his Liberal government tabled a budget with a tiny $6.2-million increase from April for the Health Department, which spends more than $4 billion annually.

Overall, the budget is similar to what the Liberals introduced — but did not pass — in the spring before calling an election. Estimated revenues are $10.6 billion, expenses come in at $10.5 billion and the surplus is estimated at $21.3 million.

McNeil told reporters the budget represents a balance between calls for more investment in health care and other fields, and maintaining a sound fiscal house. He downplayed the notion that voters during the election wanted more funding for primary health care.

"There's a number of issues that we continue to invest in; the issue was not just about health care," he said. "This budget reflects what we were hearing on all corners of the province."

The money comes amid major concerns in parts of the province about family doctor shortages, and lengthy wait times to see specialists and for certain surgeries.

Speaking to reporters, Finance Minister Karen Casey stressed that all commitments from the spring remain in the new budget as well as what was announced Tuesday.

"There's never enough money to address all the needs, particularly in health care," she said.

Pie chart - Nova Scotia budget spending - 2017-18

In terms of big-ticket spending items, 40.1 per cent of the provincial government's funds have been earmarked for health care in 2017-18 budget. (Robert Short/CBC)

New health-care money

The investment translates to $2.7 million more since the spring document for orthopedic surgeries and supports, which health department officials said will lead to an additional 100 to 150 procedures across the province.

There's $1.8 million more for youth mental health, including an expansion of Kids Help Phone, more outreach services and about five new social workers or psychologists across the province by spring. The government is also putting $800,000 toward the opioid use and overdose framework.

And there's $800,000 for a new take-home cancer therapies program. The money is intended to help people mitigate what can become catastrophic drug costs, but will not slash costs to patients to zero. Annually, the program is worth about $2 million and intended to serve as a bridge while the government attempts to reach a pharmacare agreement with the other Atlantic provinces.

Extras for pre-primary, mental health

Pre-primary

Children attend pre-primary class at Hillside Park Elementary School in Lower Sackville on Monday. (Jean Laroche/CBC)

There is an extra $800,000 for the pre-primary program above the $3.7 million already announced, a reflection of the popularity of that initiative.

And $200,000 in new mental health support is heading to the Cape Breton-Victoria Regional School Board, a direct result of the suicide crisis the school system has faced in the last year. Three students took their own lives over the course of the last school year.

The other big single expense in this updated budget is an extra $4.7 million for site preparation for the Queen's Marque development on the Halifax waterfront. Business department officials say unexpected levels of contamination at the site have now doubled the expected cost of the work, possibly driving it to more than $9 million. As per the property lease, the province is obligated to provide the developer with a clean site for building.

The Justice Department is getting an additional $200,000 to go toward the national inquiry on murdered and missing Indigenous women and girls.

A drop in the bucket

Opposition leaders said the budget doesn't come close to living up to the premier's claims that his party was listening to voters during the election, nor that they took concerns about health care to heart.

"They'd rather protect their change purse than actually help people who need family doctors," said Tory Leader Jamie Baillie, who called the new health-care increase "inflation."

"When it comes time to put his money where his mouth is, the premier lets everybody down."

NDP Leader Gary Burrill said the extra money for health care amounts to "a few grains [of sand] on a beach."

"It's a bit like they've brought a garden hose to a house fire," he said.

Burrill said he's particularly concerned about the lack of any new support for nursing homes or even restoration of money previously cut by the Liberals. He's also disappointed there isn't more help for low-income Nova Scotians and students who are seeing rising tuition costs.

$1 million more for CBU

Cape Breton University

Cape Breton University. (CBC)

For university administrators and students hoping for more support than was offered in the spring, there will be disappointment.

While Acadia University sees an extra $3.5 million, it is money the school has received for years (although it was only recently acknowledge by the government). Tuesday's budget just makes the extra money permanent. There is also an extra $1 million for Cape Breton University.

The government has said this is to make up for a funding formula change under the previous government that disadvantaged the two schools. Unlike Acadia, however, this is the first time CBU is getting extra money.

No Bill 148 contingency

Protests outside Province House - Sept. 21, 2017

Union members rallied outside Province House last Thursday as the Nova Scotia government prepared to kick off the legislative session. (Jean Laroche/CBC)

There is no contingency built into the budget if the Nova Scotia Court of Appeal rules against Bill 148, which imposes a four-year wage package on large sections of the civil service.

Public sector unions have vehemently opposed the measure and have launched a court challenge.

The budget includes the tax changes promised in the spring, which will see 500,000 people paying lower provincial income taxes and 63,000 more people no longer paying any provincial tax thanks to an increase of up to $3,000 in the tax-free basic personal amount.

There is also the increased small business threshold and a fuel tax savings for the mining industry, both of which were also announced in the spring.

The tax changes are expected to cost about $100 million a year.

Annie Leibovitz and debt

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Annie Leibovitz at a Brooklyn, N.Y., gallery in 2006. (Timothy A. Clary/AFP/Getty Images)

One thing that's not in this budget is any additional money since the spring for the Art Gallery of Nova Scotia. 

Although there has been some speculation the province might step in to try to settle a financial mess that's prevented the display of artwork at the gallery by famed photographer Annie Leibovitz, government officials confirmed Tuesday that won't happen.

The net debt comes in at $15.1 billion and net debt to GDP ratio is 35.5 per cent. The government is forecasting surpluses for the next three years.

"It's not our plan to add to a debt for some other generation to live with."