Thank you. I wonder if the Chairman of the Standing Committee on Finance would like to have a comment, or opening. Mr. Todd.

Thank you, Mr. Chairman. I will try my best to be objective today. It all becomes difficult. I think we all recognize, and certainly the Standing Committee on Finance recognized the enormity of the problems associated with health, and the rising costs, and the demands that are currently being placed on the system.

However, the Standing Committee on Finance still fundamentally believes, that health services have to increase in the communities, not decrease. There is a tremendous, myself included, amount of feelings out there that, perhaps, some of the departmental plans have been done in isolation of regional and community input, and I am certainly talking from my own region that has a feeling of unease about the manner in which we are dealing with the fundamental issues.

I will not spend a lot of time on it today. We will deal with it probably in capital and future budgets. I am of the belief, as I said earlier, that this budget is six or seven months spent anyway.

We have two motions with respect to the Department of Health. One is in the value for money audit. The committee understands that the results of the value for money audit for the Department of Health will soon be concluded. However, we have not had the benefit of reviewing this document, and relating it to social requirements. It is our hope that it will be tabled at the current session of this Assembly, who knows, and will be reflected in the development of the 1993-94 Main Estimates.

I move that the committee recommends that the 1993-94 Main Estimates of the Department of Health reflect the results of the value for money audit.

Thank you. Motion is in order. To the motion.

Question.

Question has been called. All those in favour? All those opposed? The motion is carried.

---Carried

Mr. Todd.

In reviewing the budget there were a number of concerns whether it was the cutting of PYs, or the increase or decrease in costs on the funding for A.I.D.S. The committee is genuinely and sincerely concerned that the possibilities of the spread of A.I.D.S. in the Northwest Territories.

There is nothing specific in the objectives in the 1992-93 Main Estimates that deals with this. We feel there is clearly a need to accelerate preventative action, and support increase funding. For example, if we do not stop the spread of A.I.D.S., what will be the cost in the next 10 years both from a human perspective and a financial perspective.

Currently, in the eyes of this committee, there seems to be little action taking place in the communities at the community level, to increase knowledge levels and attempt to change attitudes and behaviours. We are fully aware it is a difficult task, but in reviewing this concern the committee simply cannot comprehend what the economic costs will be, should there be a significant increase in the H.I.V. and A.I.D.S. disease.

I move that the committee recommends that the Department of Health include preparation of a comprehensive A.I.D.S. preventative action plan in the objectives of the 1993-94 Main Estimates, and seek increased funding for the implementation of this plan.

Thank you. Motion is in order. To this motion.

Question.

Question has been called. All those in favour? All those opposed? Motion is carried.

---Carried

Mr. Todd.

Thank you, Mr. Chairman. Measuring output and effect is important to the Standing Committee on Finance. The Committee wishes to know what the department expects to accomplish with the money put into health programs? The department is to be congratulated as the only government department that provide key result areas in the main estimates. Now the department must be encouraged to provide measurable indicators, so that we will all know how successful they are in achieving results with the resources provided.

Thank you. Your motion is in order. To the motion. Question has been called. All those in favour? All those opposed? Motion is carried.

---Carried

Does that conclude the recommendations from the Standing Committee on Finance? Mr. Todd.

Yes, Mr. Chairman, that concludes the recommendations.

General comments? Mr. Nerysoo?

Thank you, Mr. Chairman. I do not want this government to get a sense of security by all the complimentary remarks that have been made today.

Order, please, order. Mr. Nerysoo.

I do have some remarks to make here in this department. First of all, I know that the Minister knows full well that I was concerned, and I am not going to hide the fact, I did

not hide it from him, and I did not hide it from the board and I did not hide it in the meetings that we held in Inuvik last weekend about the process that has been used to select the Chairman of the Inuvik Health Board.

When I was first notified, I believe that it was clear that I did not support the selection. Not so much the individual, and that is the problem with the process. Criticism of the process points to the individual, as though the person is incapable of doing the job. The fact is, that was not my argument. The Minister knows that to ensure that there is a certain amount of success in the appointments to hospital boards, whether or not you are involved, or others are involved, that all M.L.A.s that are, in fact, affected by a particular appointment and should be contacted. Even more so, those Members who are on the hospital board should either have a say or an input to determine who the health board chairperson should be. I think, that has been overlooked.

I also suggest to the Minister, if you are going to make decisions about hospital board Chairs, you also contact the regional organizations or the aboriginal organizations in that region that are affected by those boards. At least receive some input from them, and some advice. That did not happen in this particular case, so I want to raise with you, that I am not going to argue against the appointment that was made, but simply voice my concern about the process that lead up to the appointment, and the fact that some of the Members of this Assembly were not even contacted, until after a decision was made. I hope that does not occur with other appointments, and other Members of this Assembly, because I do not think that is the way to do business.

Secondly, Mr. Chairman, I want to point out, and the Standing Committee on Finance has already pointed this particular matter out, on a number of occasions, and it is with the non-insured health benefits, Mr. Chairman, Mr. Patterson knows that I have raised this particular concern on a number of occasions. The whole matter of the administrative agreement that we have reached, or that we negotiated and concluded with the federal government, has put us in a position where we are having to pick up the responsibility for the federal government, in a program area which I believe, and I think that most people can argue from a constitutional perspective, that this responsibility clearly lies within the jurisdiction of the federal government.

I do not think that the intention of the agreement was to replace the jurisdiction of the federal government. I think that is occurring. The federal government is beginning to off-load to this government, and it is a concern that I have, and I hope in your own deliberations, Mr. Minister, that you will try to find someone that will deal with this matter, at least negotiate this particular matter, and I am not being critical, or maybe I am, I should be critical, but I think it should be someone from outside the department. The department has been involved in this process all along, and for me, they have not done a very good job. Maybe it is the advice they are receiving, but they have not, clearly, in my opinion, helped this government at all. I think it should be the Minister who should try to find a way, either of resolving this particular matter, or at least finding someone that understands the whole issue, and has something to lose by this program not being under the jurisdiction of the federal government.

I want to say, and make the point that I made at the Inuvik Regional Hospital Board meeting, that this issue of non-insured health benefits is not an Indian issue, it is not simply an Indian issue. It is an Inuit issue as well because the federal government pays for non-insured benefits for Inuit men and women. If the federal government is now off-loading that responsibility to this government, then they are truly off-loading a responsibility, that, in my view, is under the responsibility of section 91.24 and other agreements that they have reached in this country. I want to make that point to people here.

My issue is not simply a matter of speaking from a Status Indian perspective, but also making it known that those Inuit Members here for which the government of Canada picks up the health costs, could possibly lose those services, if the federal government does not continue to pay for those benefits. As such, your communities are going to suffer.

I have more serious concerns, Mr. Chairman, and I will deal with them as we get into the detail of the Department of Health.

Thank you. Before I ask the Minister to reply to those comments. Mr. Minister, would you like to bring your witnesses in at this time.

Yes, thank you, Mr. Chairman, I will.

Is this committee agreed?

Agreed.

Thank you, proceed, Mr. Minister and invite the witnesses at this time.

Department Of Health