Thank you. Madam Government Leader.

Inefficiencies Of Duplication

I suppose, to give an example, if that is what the Member wants, the Department of Social Services and the Department of Health are run as two separate departments at this point in time. The inefficiencies that people have complained about is that when they want to access the Department of Health, it has one set of rules, policies and guidelines. They will go so far, and then it stops, and then they have to begin the process all over in accessing Social Services. The feeling of people all throughout the Northwest Territories is, why are not the Departments of Health and Social Services combined? Some of them have functions that are somewhat in duplication of each department. It is very difficult for an average person to move in and access the departments because of the duplication. As well, the functions are similar, so in collapsing Health and Social Services together, obviously the savings would be increased, presumably.

Once we go through the exercise, it appears from the outset that they would be somewhat reduced because of the administrative factor; rather than running two duplicate administrative factors to support Health and Social Services, you would have one. I am talking from some of the discussions that we have had, and once we go into the implementation I think that will flesh out a little bit more. Certainly, from the people's point of view, this has been an ongoing issue for some time, so in putting these two departments together you would probably have a better way of dealing with the duplication, and there would be administrative support and easier access by the clientele. That is one area, as an example, that would, at the outset, be more cost-effective and also provide easier access and eliminate some of the duplication. I do not know if that is what the Member is asking for, as an example.

For example, when you look at the Power Corporation and petroleum products delivery, each agency in the communities has a tankage system, and from time to time, in the last while, the issue has been how much of a tankage system is required at the community level since they are very expensive commodities. In putting the two together I would presume that we would have, collectively, much more capacity for storage for all the needs of the communities. Thank you.

Thank you. Mr. Lewis.

Thank you. I appreciate the Government Leader's identifying an area in which she has some familiarity as the former Minister of Health, but I would like to narrow it down even further, using the example that the Minister has used. I can see that there is an inconvenience to a person who has to go to two different places for the same services. It is not clear to me what it is that is duplicated in Health and Social Services. What is the precise thing that you have to go to two different places to get? That is not quite clear. What is duplicated in those two places?

Thank you. Madam Government Leader.

An example is for removal and travel when you are accessing health services. This is one area where there has been a continued complaint, that once you leave the Department of Health and if, you are indigent, and go to another department, such as the Department of Social Services, oftentimes both departments are not working collectively in how we are going to support people who have to have medical assistance. Social Services does have a program that people can access after a certain point under certain guidelines.

Those two things often cause a great deal of anxiety and apprehension at the community level when people are not well and they really do need medical treatment. So those two have been causing a lot of concern, and if we can put those two functions together you would have a one-window approach when a person comes and it gets dealt with, so it is not going from one department and starting over in another department.

Thank you. Mr. Lewis.

Is that not just a simple policy question? If I know my circumstance and what it is that I need, the government is there to provide policy; this is a policy issue; this is how we handle it. So does this mean that the government has failed to have policy so that it is clear where you get a particular service in our government, and it has nothing to do with amalgamation at all but a lack of clarity of policy?

Government Leader.

No, Mr. Chairman, that is not the case. If you are living in a larger area, a regional centre, probably we would have more access to having people move around, although the complaint is right here in Yellowknife as well. There may be a grey area in how you deal with a person, a person's financial ability to pay. But when you go to a small community, for example a community of 500 or less, you would have the social service worker, and you would have the health centre station. The health centre would have a certain criterion that they deal with and that is their job.

Basically this government is departmentalized, and it has been trying to meet the criticisms we have in Health and Social Services. When a person goes to access a service at a smaller community -- and I did not hear any fewer complaints in Yellowknife, Inuvik or Hay River -- they go into the health centre. The health centre can do so much, and then after that point in time they have to contact the social service worker. If the social service worker is not clear on the details, they would go either to a regional level or to the Yellowknife level. It depends on what the area of request is.

So it is not as simple as just policies. It is how those two departments dovetail into each other. There are all kinds of circumstances, and I am sure while we are moving through the implementation stage, when we are putting those departments together, we will deal with what those issues are and the concerns that are there, so that when we finally come to a conclusion we would do an adequate job on meeting those guidelines. I do not believe we will totally get rid of guidelines, because those have to exist. But it is an easy movement from one department to another for a person's social or medical needs. That is just an example. There are a lot of other things as well. Thank you.

Thank you. Mr. Todd.

"Northwest Territories Way"

Thank you, Mr. Speaker. I wonder if I could get clarification. On page 19 it says, "The Department of Health must be given every possible encouragement to continue with implementation of its `Northwest Territories Way' model for health delivery and rationalization of hospital facilities." Let us say hypothetically that I disagree with that particular recommendation and cabinet agrees with that recommendation. What process is there in this discussion, in the review of this, for me to express my position in a vote? I know I have spoken on a number of occasions on the "Northwest Territories Way" because my constituents have asked me to. I am not convinced that reducing the level of service of health is the answer. I do, however, recognize that it is the largest financial commitment of the budget. However, I am not prepared to support the Northwest Territories model if it is going to jeopardize the health of the constituents that I represent. What I am wondering is, where is the process for me to express to this government, with this document, that I wish this government not to proceed with the "Northwest Territories Way"? I am using it hypothetically; Is there a process?

You noted page 19 and we are only on page 13 at the moment. Despite that, I will allow the honourable Minister to answer if she chooses to.

I was only using it as a example. There may be other contentious areas; there are also other areas we can support, obviously. It is in terms of process that I am asking here. Where there is a dispute, how do we determine the process for ordinary Members' participation in expressing their concerns? Rather than using "Northwest Territories Way," we will just talk to the principle of the thing.

Government Leader.

Mr. Chairman, I did send a letter today to the MLAs who had their names put forward, setting out a process of how we are going to be dealing with implementation. If they are still willing, at the earliest convenience, we will sit down. The Members working with them would be Mr. Pollard, myself and Mr. Kakfwi. We will form the working team on the implementation. That was the intent from the beginning.

As well, I would also like to indicate that we have not implemented anything in the document. We have not set one policy. We have not made one decision. I want to assure the Members that we have not done that. The process has been set up, and some of the suggestions have been put forward for implementation and the work to be done from here on.

In terms of the "Northwest Territories Way," I know there are a number of issues in there, but I want to read you three or four broader areas that are known as the "Northwest Territories Way."

"A broad approach to health which includes the improvements to health which come from outside the health care system, such as housing and sanitation; emphasis on health promotion and disease prevention and delivery of health services; delegation of responsibility for providing care from medical specialist to family physicians, from family physician to nurses, and from nurses to other providers of care; and involvement of the people in the planning and management of the health care system."

Mr. Chairman, this is the general idea on those issues. What is in this Strength at Two Levels -- we have not drawn anything out of it, we have not made any decisions on what we are going to do with it and we have not set one policy. Thank you.

Mr. Todd.

Priorities Of Government

Thank you, Mr. Speaker. Where I am having some difficulty is that I am not sure what the priorities are of this government. First of all, I do recognize the need for restraint. Secondly, I recognize the need for change. I want to say that up front. There is no question, and I have said on a number of occasions, we have to cut where it is fattest to protect where it is leanest.

There is no fat.

The thing is, what I am having difficulty with is that when we look at some of these recommendations that are coming forward, I still have not got a clear understanding of what the priorities of this government are. Are our three priorities to ensure that people have food, shelter and employment? If these are the basic principles, then the changes have to reflect these principles. I had some real difficulty when I looked at the capital budget, for example, and

some of the things that came forward, because I think they are all inter-related. You cannot look at one without looking at the other. I could not quite get a feel for where the priorities of this government were. Is it more important to put parks into communities or to build houses for people who need shelter? Is it more important to look after people's health or to build legislative assembly buildings? So I personally have a real struggle here trying to determine what the priorities are of this government. To me, the priorities should be making sure people have got shelter and food in their mouths and making the best effort to find people employment, and I have to view this document in that light; so I am a little confused as to how I would approach some of these recommendations and how I would support some of these recommendations if they do not relate to the principles of what I see as priorities. Do you understand what I am trying to say, or am I jumping all over the place?

You know, if I may, we talk about Arctic College. Education is an important subject to many. We talk about Arctic College and some of the changes we want to make there, yet we still have not solved the problem of getting kids out of school with a decent education. To me, the priority is education, so I view this document with respect to, how can it best serve the interests of the kids in school? It may be a little philosophical, but that is the dilemma I am in right now. I have to view the document as I view the basic needs of Northerners. I am not sure, in a number of situations, that they necessarily reflect the basic needs of some of the Northerners, and that is why I was asking the question. I want to be able to stand up in areas which I have got some serious concerns with and be able to voice my opinion and opposition to that particular part of the report and also, at the same time, my support for the parts of the report that I can support. Thank you.

Thank you. The Government Leader.

I think that there has been, and not on our part here, but in the Strength at Two Levels report -- as cabinet or as a government we are not bound to implement every recommendation. I agree with the Member that there should be some guiding principles, but one of the problems we have had in the past is exactly what he mentioned -- education, health. He did not mention education -- those are the areas where we have an automatic request or obligation to support. We have to support that. What we have been finding is that with the fiscal arrangement we have and with the resources we have, we are not going to be able to meet those basic areas that were just mentioned, and I do not think there will be any question that there is no support for those basic principles, none whatsoever. However, in trying to meet those basic principles on where we are going to finance them from, we have got into a problem. Where do we make some cost savings so we can continue to just take care of those basic needs, and that is a problem we faced right from the beginning. I believe that in looking at that in the past, what we have been told is that there are funds available but it is being burnt up in areas that are really not necessary. I think that is a very strong statement from many areas. We are burning up money in the wrong areas, and I believe that this document, which we have not adopted in cabinet, is a reference document, and I think that opportunity, as we are going into the implementation, will have that course. If we make any changes to the consolidation or whatever in the process it would have to come to this Legislative Assembly, which would say "yea" or "nay." We would appear before standing committees giving a program of activities that can be expressed at that level as well. So I do not want to belabour a long statement, but to say yes, the basic principles -- we stand by them. And right now, in order to support those basic principles we have to find the resources to support them, and that is all we are attempting to do, Mr. Chairman.

Thank you. Mr. Todd.

You know, Madam Leader, I want to be assured and I need to feel comfortable that we are not going to balance the budget on the backs of the communities. We are not going to balance the budget on the people who have least. That is my fear here, and this document is part of balancing the budget and is an integrated document. I need to be assured, and I need some level of comfort that when we look at these things we are not looking at things from purely a monetary point of view. Other considerations have to come into the argument. I recognize the difficulties, do not misunderstand me, and I know things are not being run as well. There is no stronger advocate for change than I have been, but our job, and my job -- after waiting 20 years to get this job -- is to make sure that the little guy in Arviat, Whale Cove and Rankin Inlet is protected in a sense, and he is represented in a responsible manner. And I need some assurances that when we look at the changes that are necessary, other arguments besides only monetary ones, and other considerations have to be taken into place. It seems to me that in some of this document, which I will talk to later, there is a preoccupation, if you want, with the need to save money, which is understandable. It is a bit of a contradiction, what I am going to say, but not necessarily taking into consideration the impact it is going to have on the people at the community level. Now, last weekend I got a call, for example, if I may -- and I realize that they perhaps over-reacted -- but the community of Whale Cove absolutely panicked because for some reason they had got some indication that the Northwest Territories --- we were going to close the nursing station and the nurse was going to go bye-bye. Now I do realize it is an over-reaction, but it is symptomatic of the kinds of concerns I have, and it is my responsibility as the MLA for that region to ensure that the interests of the ones who cannot represent themselves are represented. And again I reiterate, my concern here is, recognizing the difficulties we are in, knowing there is a need for change and being supportive of it. And I want to say that today, being supportive of the need for change, other factors have to be taken into consideration.

We have got to ensure that if we are going to amalgamate Health and Social Services, for example, that it is going to deliver a better level of service to the communities. We have to ensure that if we are going to turn over drug and alcohol and public works responsibilities to municipal government, they have the capabilities, they have the manpower, and they have the financial resources to do it. I mean, if we as a government, with the kind of wealth we have had in the past, were unable to do the job well, I am not so sure that unless we put the resources in behind people, that they will be able to do any better. And that is all I am asking for; a kind of approach of caution with some consideration outside of the monetary component which we seem to be totally preoccupied with lately. Thank you.