Mr. Chairman, to answer the Member's question, I would have to describe the funding problem we are having with the Keewatin clinic. Right now, there is no problem in getting the federal government to pay for a specific dental procedure, where it is performed by say, a Yellowknife dentist, on an aboriginal person. We are not having those kinds of problems, yet. However, what has happened is, the Keewatin Health Board entered into a contract with the new group formed in Keewatin, and that contract was at about the same funding level as had previously been spent by the federal government through the University of Manitoba. Once the contract was entered into, the Department of Health and the Keewatin Health Board were told, in no uncertain terms, that many of the costs reflected in that contract were ineligible for funding by the Department of National Health and Welfare. They said we will not pay for an office manager, for example, which I believe is one of key components of the clinic. We will only pay for so many days travel in the communities, and we will pay less than the days contracted for. So they have scrutinized this contract, they have said they will not pay many of the aspects of the contract, and the Government of the Northwest Territories is left holding the bag for the difference. I think so far it looks like that will be something like $300,000 a year. It is not getting paid for a specific dental procedure, it is getting the same level of funding that they seem to pay quite readily to a southern based service out of the University of Manitoba. When we do it in the north, we cannot get the same level of funding, and it is because the federal government is trying to off-load onto the Government of the Northwest Territories. What I am hoping we can do is tackle this problem at the political level, if necessary, because it amounts to discrimination against northerners, and possibly, against Inuit if you want to look at it that way, as I do, and as the Keewatin Health Board does. Thank you.

General comments. Mr. Gargan.

Mr. Arngna'naaq was first on the list.

Mr. Arngna'naaq.

Thank you, Mr. Chairman. I think I understand what Mr. Patterson is saying here. So, in fact, to keep the level of service that was maintained by the University of Manitoba, it will cost this government $300,000, more to maintain that level of service that was given by the University of Manitoba. Thank you, Mr. Chairman.

Thank you. Mr. Minister.

Mr. Chairman, I think, in many ways, through this new approach developed by the Keewatin Regional Health Board, for which they should be given credit, the level and quality of service is in many ways probably improved over the previous model. The simple problem is that the federal government is not wiling to pay a northern based northern owned clinic the same amount of money they were willing to pay the University of Manitoba to deliver those services from Winnipeg, and we are short, somebody is short, as a result. I hope it is not the Government of the Northwest Territories that has to pick up the bill because we are not budgeted for those expenses.

We are going to insist that the federal government should pay at the same level as before, and if I have not got this right, I am sure Mr. Todd will correct me.

Thank you. General comments, Mr. Arngna'naaq.

Thank you, Mr. Chairman. We have not heard much recently about The N.W.T. Way, which was coming out of the Strength at Two Levels. I wanted to find out if the transportation routes from the Keewatin, that were being proposed by The N.W.T. Way, are being carried forward by the Department of Health.

Thank you. Mr. Minister.

Mr. Chairman, I am not sure what the Member is getting at with respect to transportation in Keewatin, but I want to clarify to the Member that The N.W.T. Way and I know it was much maligned in previous discussions in this House before I took on this job The N.W.T. Way has probably been around for 35 years, and it refers to the concept, as I understand it, of delivering as much service at the community level as possible; primary health care wherever possible; avoidance of expensive and remote physician services where ever possible, and we are actually leading the country in that concept of primary health care. It is the way many jurisdictions facing crushing doctor's bills are trying to deal with rising health care costs. It also features health promotion and prevention wherever possible.

I am sorry, I am just not sure what the Member is referring to in the Strength at Two Levels report on transportation in the Keewatin. Thank you.

Thank you, Mr. Minister. Mr. Arngna'naaq.

Thank you, Mr. Chairman. Maybe I could clarify it for the Minister. What I was referring to was the matter of transporting patients, right now, from the Keewatin communities to Churchill in Winnipeg, that route. What was being proposed, as I understood it, was that the patients would be transported from the Keewatin communities to Yellowknife, and being treated in Yellowknife, and if they needed further care, which is not available in Yellowknife, then they would be transported down to Edmonton. Thank you, Mr. Chairman.

Thank you. Mr. Minister.

Mr. Chairman, the current policy on the Department of Health on transportation of Keewatin patients is very flexible, and it is really based on what is appropriate and what makes sense with the particular patient. There are times when it would make sense to use services in Yellowknife, such as patients having babies, or other obstetrical problems. We had occasion to try this out when there was a strike in Manitoba, and we really had to put all obstetric patients into Stanton Yellowknife Hospital, and it seemed that there was general satisfaction with the services they were able

to offer at that time, so it is done on a per patient basis; on the basis of what makes sense.

I think generally speaking, if we can spend the dollars in the Northwest Territories, and save money, we will look for every opportunity to do so, and of course, the rising costs of hospitals in southern Canada, means that sometimes putting a patient in one of our northern hospitals could save up to $1000 a day just in hospital fees alone. So, it is a judgement call. There is no arbitrary rule being applied. Thank you.

Thank you. General comments, Mr. Gargan.

Mr. Chairman, I have one health concern that I would like to address. I have been looking into the objectives, but I do not see it. It is in regard to gathering statistics, and I do not think it will take much for this government to take a few minutes, or if they have someone who specializes in that area, to go into the river to take soil samples, plant samples, and test them to see whether it is healthy, or the condition of the environment as well as the human condition, hair samples, blood samples, tests. I always found that, for example, in Black Lake, Saskatchewan, where there is a uranium mine, people are dying of cancer over there, and they cannot do anything because they cannot prove whether or not it is a result of the mine that has caused this.

If we were to establish the conditions before the mine was built, then you have some basis for taking a company to court, for polluting or for causing. I am always concerned about that, we still think it is not an issue, but I really am quite concerned that somewhere down the road if, for example, they went ahead with the mine near Baker Lake, I would be concerned about the people over there.

We do not know what the conditions of those people were at that time, then we cannot prove anything. I would hope that by doing yearly samples, and yearly tests, we will be able to determine if these were the conditions before the mine, and gradually from there you could say whether, or not, that the results of the health, or the conditions of those people were as a result of this.

Thank you. Mr. Minister.

Mr. Chairman, I certainly agree with the Member that the health effects of any industrial development should be measured and should be taken into an account before a development decision is made. I can assure the Member that if we were facing a project, like the uranium mining project in the Keewatin, the Department of Health would have been ready, and actually preparing to intervene in the review process to ensure that the health concerns that the Members have expressed were going to be addressed, before the decision was made.

I want to also say that the issue of contaminants in the Arctic has not gone away, and this House, and the previous Legislature debated that issue quite extensively. We have pressed for monies to continue work on this issue through the federal Green Plan, and $200,000 has been committed in this fiscal year to work on the contaminants issue, although I am disappointed to report that notwithstanding that commitment, we still have not yet received the funds that were promised; therefore, we cannot carry out the studies that we were planning to undertake. I am hopeful that the issue of funding can be solved so that we can continue this important work. Thank you.

Thank you. Department of Health. Mr. Gargan.

Mr. Chairman, I realize, that perhaps there are contaminants in the environment, but what I was trying to get at, Mr. Chairman, is monitoring. A monitoring system on the health conditions of people in the north, in designated areas. You monitor it so that you will know a level, if development happens, and there are changes happening, then you could very well say that for the last 20 years it was at this level, and as soon as they put this mine in, it started to going up, cancer started going up, or liver sickness. Things started happening, then you could prove, in the event of a court challenge, that it was as a result of the mine, because before that, these were the conditions of the people, and there is a consistent trend. When developments happened, the trend changed. That is what I am trying to get at. I certainly agree that before anything, any development happens, that the health of the people and the environment should be considered.

What I am suggesting is that we do not have any monitoring programs, which could be done by the nurse maybe to take water samples, or tear samples, or blood samples, so that you are always monitoring on a yearly basis the health conditions of the people. Every year, it does not matter whether the development is 50 years away, the monitoring should start now. So that in the event that development does happen, this government or the communities can say that these are the conditions before you came for the last 50 years, and it has changed all of a sudden because of your pollution, or whatever the case may be. That is all I am trying to get at.

Thank you, Mr. Gargan. Mr. Minister, would you like to respond to that.

Mr. Chairman, I would just hope that we can be vigilant enough about our health, that instead of measuring whether an industrial project produced disease of some kind, because we monitored the health of the people before, and after, instead of doing that, I would hope that we would have stood up and said, to whoever was making that decision, this project cannot go ahead in this form, or cannot go ahead at all because we predict that it will harm the health of the people. I think that is the preferable way to do it, rather than measuring how sick they got after.

Just consulting with my Deputy Minister on that point, Mr. Chairman, I think we do measure certain basic things, like the weight of infants at birth, and basic health statistics and mortality rates and that sort of thing. We do not take the kind of detailed sampling that the Member is suggesting. I think that is would possibly be very expensive to do that, at least in the whole Northwest Territories, but if there is any area where this should be done, I would like to hear about it, and I would be open to working on that. I would like to say, that as far as cancer is concerned, Mr. Chairman, there is a very easy way to reduce the higher incidents of cancer in the Northwest Territories, and that is by attacking the single largest cause of cancer, and that is cigarette smoking. That would be a wonderful way, if we could reduce that, a wonderful way of reducing cancer. We know all about it, we know all about the horrendous rates of smoking in the Northwest Territories and if the Member is concerned about cancer, that is a thing that we can do to tackle cancer deaths and rates of cancer, is to tackle smoking. Thank you.

Thank you, Mr. Patterson. I know of cases where people died of cancer who have not smoked in their whole life. Mr. Gargan.