Item 14, notices of motion. Item 15, notices of motions for first reading of bills. Item 16, motions. Mrs. Marie-Jewell.
Debates of Sept. 14th, 1992
Topics
Motion 31-12(2): Comprehensive Audit Of The Northwest Territories Power Corporation
Item 14: Notices Of Motions
Page 903
The Speaker Michael Ballantyne
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 903
Jeannie Marie-Jewell Thebacha
Thank you, Mr. Speaker.
WHEREAS the Fort Smith Health Centre has been regarded as a vital health care facility by the residents of Fort Smith for many years;
AND WHEREAS an agreement was made with the Commissioner of the Northwest Territories on September 12, 1980, establishing that the health centre should be managed and operated by an appointed board of management;
AND WHEREAS over the past year there has been growing public recognition of communication difficulties and conflict among the board of management administrative staff and medical personnel;
AND WHEREAS the Wilson and Associates reports identified major problems in the operation of the health centre, and there has been little or no action on the vast majority of recommendations included in this report;
AND WHEREAS the Saskatchewan College of Physicians and Surgeons was asked to prepare a report, which commented on aspects of the quality of medical services delivery;
AND WHEREAS this report has not been made public;
AND WHEREAS following the resignation of several board members, the Minister of Health appointed a public administrator under the Territorial Hospital Insurance Services Act;
AND WHEREAS this appointment has caused concern and speculation among the residents of Fort Smith, thus diminishing the community confidence in the Fort Smith Health Centre;
AND WHEREAS the status of a physician who has been a long term Fort Smith resident, is unclear in the public's mind;
AND WHEREAS by demonstration, petition and at a public meeting, the residents of Fort Smith have showed their support for an early public review, and resolution of the medical and administration activities of the Fort Smith Health Centre;
AND WHEREAS the Minister of Health has referred the non- public report of the Saskatchewan College of Physicians and Surgeons to a board of inquiry established under the Medical Professions Act;
AND WHEREAS the Public Inquiries Act, passed by the Legislative Assembly, provides the mechanism and opportunity for residents of the Northwest Territories to be able to request the Commissioner of the Northwest Territories to cause a public inquiry into the matters relating to the conduct of a public business of the territories, or any matter of public concern;
AND WHEREAS the public of Fort Smith have a grave concern with the administration, and quality, of medical services in the community of Fort Smith;
NOW THEREFORE I MOVE, seconded by the honourable Member for Mackenzie Delta, that this Legislative Assembly supports the need for a public inquiry into the issues surrounding the administration, and quality, of medical services provided by the Fort Smith Health Centre to the residents of Fort Smith;
AND FURTHER request the Commissioner of the Northwest Territories to give earnest and immediate consideration to cause an inquiry to be held on the matter pursuant to section two of the Public Inquiries Act. Thank you.
Thank you very much, Mr. Speaker. Mr. Speaker and honourable Members, I have indicated to the public prior to the session sitting, that I would ask for a public inquiry into the Fort Smith Health Centre.
The Minister of Health, however, prior to the session held, decided to, instead, create a board of inquiry under the Medical Profession Act, to address many concerns of the Fort Smith Health Centre. I would like to advise Members of this House as to what has happened to date, to my knowledge, and why I am asking for a public inquiry.
Last year I met with the board of the Fort Smith Health Centre. At that time, they indicated that they wanted to do a review, or a terms of reference was going to be developed. However, I recognized after the review was done, that even the terms of reference were not adhered to. I looked at section two of the terms of reference, that I tabled in this House last week, where it indicates that the committee will be comprised of at least four to five members, as selected by the Saskatchewan College of Physicians and Surgeons. I have since been advised that this report that was completed, that the Minister seems to be passing around, had been done by only two physicians of the College of Saskatchewan, they went into the Fort Smith Health Centre, and did a review in one and a half days. The terms of reference that the board developed, for the College of Physicians to go in to do the review, makes me wonder how the review was done.
I was advised that the report in question has some concern in respect to its validity, and the fairness, of how it is being done. It is a process used in developing the report that has caused concern, and even indicated that the terms of reference were not adhered to. I indicated that the process of the report was questionable. I also indicated, that at the time the operation of the board under the current chairmanship continued to be problematic, and that the board was questionable. That the board was operating under the dictatorship of the chairman and the administrator. The Minister at the time, I felt took action, wrote to the chairman, and requested a copy of the report. So, therefore, he wrote to him on July 23 and thanked him for the report. At that time, he directed the chairman to ensure three preconditions, be met prior to this profession going back to work in the Fort Smith Health Centre.
These preconditions were to be agreed to by July 31. He sent this letter on July 23. Seven days was granted to the board to deal with this. However, the board did not meet within those seven days. The chairman was not even in town, and they only ran a five member board, so it was difficult to meet. On August 5, though, the chairman went back to Fort Smith. He called all the board members, he requested that they resign, and he was willing to send to the board members, developed letters of resignation which they should sign, he stated.
He also indicated to two board members that three had already resigned. One board member indicated information to the public, at the public meeting, that I held on September 3. So, since three out of five board members resigned, the board was non-functioning. So quickly, exactly what the Minister wanted, he appointed a public administrator, Mr. Don Ellis, who is our Regional Director.
There are many questions that arose at the public meeting on September 3. The appointment of the public administrator was made without advising the public, they wanted to know why. I know it was because of the poor chairmanship that the board was under, but why did the Minister not just remove the chairman? Because the chairman at the time was at pleasure.
On August 10 I flew to Yellowknife to meet with the Minister, to ensure that it was not the intentions of his office to suspend a professional, that he referred to in the letter that he wrote to Peter Fraser, on July 23, who at the time was the chairman. The Minister assured me that the professional would not be suspended, and that he would give me a copy of the terms of reference for the public administrator. He also indicated that he would leave everything up to the public administrator to address on this issue.
I met with the public administrator, subsequently, on August 14, to advise him of my concerns on how this report was developed. However, my concerns fell on deaf ears. On August 20 the public administrator, Mr. Ellis, called to advise me that he was planning to suspend the professional in question, due to the College of Physicians' report. He also stated, that he may reconsider, if I could convince the professional to take a competency test, and a psychiatric test. I asked him at the time for even the courtesy of the weekend to see what we could do.
However, unfortunately, Mr. Ellis decided not to wait the weekend. He wrote to the professional, and advised him that his privileges in the Fort Smith Health Centre were suspended. On August 26, the Minister of Health was to open a personal care unit. He was greeted by a group of demonstrators asking for a public inquiry. At the time the Minister advised me that a public inquiry was premature without a public meeting. It was difficult, at the time, to call for a public meeting, because I did not have it confirmed that the administrator suspended the doctor's privileges.
On September 1, I knew that the privileges were officially suspended, therefore, I advertised for a public meeting on September 1, and I apologized to my constituents for not giving them enough time. However, my time frame did not allow for more time. On September 2, I came to Yellowknife to meet with the Special Committee on Health and Social Services. The Minister's officials were all in the room on September 2 and 3, so they knew where I was. In the afternoon of September 3, I was approached by a C.B.C. reporter, who advised me that the Minister of Health had set up a board of inquiry, and she asked, what did I think about it?
I guess that is one of the concerns in respect to why people want a public inquiry, Mr. Speaker, is the fact that none of this information, none of these decisions, are made at the community. None of the decisions are made with respect to consultation of the past board, or even consideration given to myself. So, therefore, I went to the public meeting on the evening of September 3, and we must remember that the board of inquiry was set up without even consideration of advising my office on the afternoon of September 3.
When I held a public meeting, of which I only gave two days notice, at least a hundred people from all across the community attended. Many of my constituents, unequivocally, requested a public inquiry. Mr. Speaker, my constituents and myself feel that there are too many unanswered questions, which I will attempt to outline for the honourable Members today.
First of all, the terms of reference, under section two, stated that the committee will comprise of at least four to five members elected by the College of Physicians. However, only two physicians from the Saskatchewan College developed the report. Why did the Board of Management not at least have the opportunity to address the report? From my understanding, the board did not want to, because of the way it was developed.
Why did the Minister send to the former chairman that the Board of Management place preconditions on this profession prior to the doctor returning from holidays? Why did the chairman have letters, all typed and developed, for each board member, and did not even call for a board meeting instead of requesting each board member to sign these developed letters of resignation?
Why was the public administrator appointed on August 7, and his terms of reference not developed until August 20? Generally, it is the practice of a Minister to develop terms of reference, and then appoint an individual to a mandated job.
The Minister of Health received a copy of my letter to Mr. Ellis on August 21, indicating my disappointment with his planned action, and also advising Mr. Ellis that it would leave me no alternative, but to request a public inquiry. So, the Minister knew I was going to ask for a public inquiry. The Minister knew I was conducting a public meeting on September 3, as I advised his Deputy Minister on September the 2, when he came in front of the Special Committee on Health and Social Services. I told him that I was having a meeting in Fort Smith the next day.
The Minister's Executive Assistant was right in the room, the same room as the Special Committee on Health and Social Services, so his saying that he did not know where I was, is very questionable. The Minister decided to hold a board of inquiry under the Medical Profession Act, because he knew that a public inquiry would bring out too many things that, I believe, he may want to hide. The public inquiry will bring out the report, and how it was developed, why the Board resigned, and why the Minister appointed a public administrator to make the decision to suspend a professional in Fort Smith, that people in Fort Smith want.
The Minister knows that the particular document he is circulating, and sent to Dr. Covert, or to his board of inquiry to address under the board of inquiry, is a document that apparently is sealed in the courts. So, there is no other avenue to even advise my constituents. I cannot even go to the courts. However, this document remains and is being circulated. I may even believe, Mr. Speaker, that the Minister may be in contempt of court. Mr. Speaker, this particular Minister, is the same Minister who wants to bring in access to information, but is denying unequivocally a request from my constituents for a public inquiry. How can we have an access to government and deny people of what is going on? There were many concerns when I held the public meeting.
There were concerns that an elder had just passed away of a heart attack, and they wondered whether that could have been prevented, and if he would have gone to the hospital, if he knew his doctor was there. I wonder how many more have to pass on.
The irony of this whole issue, Mr. Speaker, and I want to advise this House, is that the public, my constituents, want to have their doctors serve them out of the Fort Smith Health Centre, but because of the administration in the health department, they are denied of such a privilege.
Instead of allowing the public to know what is going on, this Minister is only allowing for this issue to be handled by a board of inquiry, not a public inquiry.
Friday afternoon, I agreed with the Minister of Health to get an independent legal opinion. An independent legal opinion is basically, what I was trying to tell the Minister all week. It was basically stating that the board of inquiry can only discipline or dismiss, which I know the Minister wants. It also indicated that the board of inquiry, and the medical professional inquiry, and I quote from the legal opinion "the purpose of the two statutes are very different," and that is what I was trying to tell the Minister last week.
Mr. Speaker, I feel that we at least owe it to the public of Fort Smith to bring this whole issue out, and further, to at least allow for justice to be done. Do we not owe it to the public, not to prosecute a person until proven guilty?
Members, honourable colleagues, it appears this Minister has done just that. All I can say is that I am happy he is no longer the Minister of Justice. There does not seem to be any justice in this whole fiasco. Mr. Speaker, I urge my honourable colleagues to support my motion for a public inquiry, because remember we requested the transfer of health so that we can bring the delivery of health to the people, for the people. Not to bring the health delivery for bureaucrats to tell us what to do, and this is exactly what is happening. Thank you.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 906
The Speaker Michael Ballantyne
Seconder of the motion, Mr. Nerysoo.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 906
Richard Nerysoo Mackenzie Delta
Thank you, Mr. Speaker. Mr. Speaker, when I first came to this session, the first week, I did not think I was going to be involved in a matter of this nature, in fact, if anything I probably would have stayed away from dealing with this particular issue, and allow my colleague to work out a solution with the honourable Minister. Unfortunately, that has not been the case and what is interesting in this whole debate, Mr. Speaker, is that there is, it seems, at times, significant confusion about what it is, what the intentions are, and what accomplishments are being made in terms of the review of the inquiry that has been suggested by the Minister, and on behalf of this government.
Mr. Speaker, I think that what I want to talk about with regard to this motion, is simply that there is a principle that most Members agree with, and that is the right of the people who we represent, to be involved in decisions that affect them. We are one of those institutions, and we have rights and privileges as Members to, in fact, represent our constituents. That we represent them as an institution, we do not take their place when they see it in their interests to represent themselves. We do not ignore, Mr. Speaker, their right and their responsibility for ensuring that they themselves, are being served by the institutions that they allow us to set up. We do not take their place, in fact, we are their representatives.
In this whole debate Mr. Speaker, it seems that we are not interested in hearing the views of those people, that we are not interested in listening to the concerns that they have about the service or program that is being brought to them, on behalf of this government, and on behalf of this Assembly. They are concerned about the manner in which their body of authority, I refer to their body of authority, not ours, but their body of authority, is delivering services to them.
Many of us here have worked diligently trying to ensure that the people in the communities have responsibility, authority and powers to make decisions for themselves. Unfortunately, in this particular case, that seems not to be happening.
I had not thought, Mr. Speaker, that I would be rising at any time during the session to challenge a decision of a Minister. What concerns me most, is the confusion and the kind of interpretation that are being given by our Cabinet Members with regard to legislation. I see this process, the public inquiry, as an opportunity for the people of Fort Smith, to present their concerns and to present their views about this particular matter.
I know that in some instances, there will be some limitations, because even the Public Inquiries Act does not allow every Member interested in making presentations to do so, but that is the nature of the legislation and it must be adhered to.
I think that the principle that I would argue for is, that the people must be heard, the people that are affected by the program, the service that is being delivered to them, and not simply to argue that the matter before the people is an administrative one. It is far more than that. I hope that the principle that we are going to vote on, is the matter of the people being involved. I know that the Minister will rise and say we are concerned about the costs, Mr. Speaker, government and Cabinet does not have the monopoly on the concern for cost. I think in our own comments we have made in this House, this side of the House has had as much concern about the over expenditure of government funds. If over expenditure of government funds challenges the principle that the people should be heard, the people have a right to be heard, then we are in the wrong business. They have every right to tell us what is wrong with this system, what is wrong with the services that are being delivered to them. If money is the basis on which we allow that principle to be protected, then I think, God help democracy in the right to elect people, because I think we are at risk and the peoples right to speak is at risk.
All of us here in this Assembly understand the matter of expenses. My first question was to ask the Minister, not in any way to be difficult, but to ask the Minister if there was any indication of no justice being seen, or being done, that he could consider a public inquiry? I did not challenge his ability to make a decision, initially, to have the Medical Professional Act to guide his decision, yet, he chose to say, "no" that would not be considered. So, Mr. Speaker, I have risen to speak on behalf of the motion, and second the motion, because I think that the fundamental principle we are arguing here, is a matter of the people being heard, and I think that principle is very important. That principle is applicable in Yellowknife Centre, in MacKenzie Delta, in Sahtu, as it is in every constituency, and every region. If we forget that is the principle, I think that we have lost sight of what we are trying to accomplish. Thank you, Mr. Speaker.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 906
The Speaker Michael Ballantyne
To the motion. Mr. Patterson.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 906
Dennis Patterson Iqaluit
Mr. Speaker, the honourable Member for MacKenzie Delta is quite right, I was going to point out that this will be a very expensive undertaking. Therefore, Mr. Speaker, I think there should be very good, compelling, clear reasons for spending a half a million dollars or more. Money that is not budgeted, that will have to come from somewhere else, whether it is the H.A.P. program, or whatever else. Mr. Speaker, the reason this will be a very expensive undertaking in contrast to the board of inquiry under the Medical Profession Act, is that under the Public Inquiries Act, the board shall accord by section seven, "to any person who satisfies the board that he or she has a substantial and direct interest in the subject matter of an inquiry, an opportunity to not only give evidence, but also to call and examine or cross-examine witnesses." I think it is quite conceivable that many citizens, including patients from the centre, might well wish to seek standing. This inquiry could go on for months, and the costs could easily run to sizeable amounts. The recent so-called Bourassa Inquiry, even though it has a fairly narrow focus, cost over $500,000. Part of the reasons for these costs, Mr. Speaker, is that under this Act, the Member is recommending, parties who are compelled to testify would likely want legal counsel, and if past precedent is followed, our government will be asked to bear those costs, and at rates of easily $100.00 and hour, the cash register can ring up quite a bill rather fast.
This is in contract to the board of inquiry under the Medical Profession Act, which is predicted to cost $50,000 - $100,000, and has the power to order costs. So, Mr. Speaker, in light of the high cost involved, I wish we had the luxury to say money does not matter, we should set aside the costs, and the precedent. I would say again, I think this House must be satisfied that there are good reasons. I think that with the greatest of respect, it is incumbent on the honourable Member moving this motion to show that those compelling and good reasons exist.
Mr. Speaker, I would like to reiterate a point I have tried to make in the debates in this House over the last week, and it is simply this, the president of the board of inquiry has been asked by myself, to inquire into allegations with respect to the medical practice of a certain physician at the Fort Smith Health Centre. Dr. Covert has also been invited to advise and recommend on whether other aspects of medical services at the Fort Smith Health Centre also require further investigation. Honourable Members have expressed concern that the report will have possibly too narrow a focus, that the other broader issues may not be dealt with. I want to, again, assure the House that Dr. Covert has been asked to advise on other aspects of medical services, and therefore, the board will have the broader mandate, sought by the honourable Member. So I would recommend that we let the medical inquiry run its course, as laid out in Legislation, and then let us see where we are, and respond accordingly. Mr. Nerysoo stated in his comments, if natural justice seems not to be done, or appears not to have been done, which, as I understand, natural justice includes the right to be heard, and the right to be given the reasons for a decision, then certainly further investigation, and further inquiry, should be held. I do not know what impression I gave Mr. Nerysoo in answer to a question earlier this week, but let me say right here and now, I agree entirely with Mr. Nerysoo. If the result of this procedure, which is laid out in the legislation, where there is an issue of medical practice involved, raises further questions, if there are matters that appear obviously necessary to pursue, Mr. Speaker, I am sure the honourable Member from Thebacha will let me know of such matters that arise, that are still outstanding, following the conclusion of the board of inquiry. Then I will be prepared to take further steps, and those steps might well include a public inquiry. Mr. Speaker, I wonder if it is premature at this stage, and I will use the word I used when I was confronted in Fort Smith, whether it is premature at this stage to set in the works, another expensive public inquiry, when we have not even got the result of the one that has been put in place. Mr. Speaker, I am aware that the particular physician the Member is speaking about, that is concerned about, has a strong following in Fort Smith, and has support from the patients. I understand that, Mr. Speaker, but I hope the Honourable Member also understands that as Minister of Health, when I am presented with information that leads me to question the adequacy of the medical practice, I have a duty, Mr. Speaker, under the Act, to take further action to inquire, and to satisfy myself, that the highest standards of public health care are being followed in that community, whether the physician is popular or not. Mr. Speaker, a suggestion has been made by the honourable Member that the board was intimidated, pressured into resigning, or otherwise pressured by the Minister. I will be forthright with the House, Mr. Speaker, yes, I became impatient with the Board of Management of the Health Centre. Why, Mr. Speaker, because I knew that they had received this information of serious concerns about medical practice at the Fort Smith Health Centre, and for whatever reason, they were not doing anything. The problem I had with the board, Mr. Speaker, was that they were not acting, and, yes, I wrote a strong letter to the chairman of the board, saying here are issues that have been raised in the Saskatchewan College of Physicians and Surgeons Report. Either you deal with them, and exercise your responsibility for the adequacy of health care in the Fort Smith Health Centre, or you must resign. Either do your job or resign. So, there was pressure and there were deadlines extended, upon which I wanted action taken, and I did have in mind that the particular physician was going to be returning from holidays, and that the issue should be resolved one way or the other, before that time as to whether he should continue to have privileges at the centre pending an inquiry into those serious questions.
So, Mr. Speaker, I want to reiterate that I think we should take the first step and determine whether the matter is dealt with and, of course, the physician in question may be exonerated by the board of inquiry. I have made no judgement in any way about that physician's competence. I told the honourable Member that I was confident that his rights would be respected and I would note that the Medical Profession Act refers to the need to pursue natural justice, and I would hope that inquiry follows that imperative set out in our legislation.
So, Mr. Speaker, I want to reiterate that if the matter of public concern, the Members refer to, are still not cleared up following the board of inquiry which has now been set up and is underway, under the Medical Profession Act, then I would be open to taking further steps. Now, Mr. Speaker, as I said, I think that the Member has to have compelling reasons to persuade this Legislature that the significant step of having another inquiry, I presume the Member would want a parallel inquiry, at great cost should be taken.
It is incumbent upon her to present reasons. Now, Mr. Speaker, I have just noted some of the reasons that the Member has laid out, and I would like to just make a few comments. The Member is concerned that there were only two Saskatchewan physicians, the terms of reference called for four or five members to be established. Now I have taken that question as notice earlier in this session, but I believe that there are adequate explanations for why the original terms of reference were revised. When the information comes forward, this House will get proper explanation as to why the original terms of reference were revised. I expect that there was a cost factor, and I expect that the board authorized the administrator to deal with this matter and to make alternative arrangements in light of the costs of bringing in four or five physicians, a burden to a small health centre, as opposed to two.
The Member suggested questions of the validity of the Saskatchewan College investigation. Now, Mr. Speaker, I think it is very important that the House get more questions about validity. I would like to know if she is suggesting that eminent doctors, who are on the panel of the Saskatchewan College, which is the physician's home college for registration, were unqualified or biased. We need something more than her saying that there are questions about the validity.
Mr. Speaker, she talks about the poor communications between my office and herself with respect to this matter. I will acknowledge that communications were not ideal, that there could have been better consultation, particularly about the decision to name a board of inquiry, for which I have offered my regrets already in this House. But, Mr. Speaker, I do believe that it is fair to point out to the honourable Member, that in our discussions, I pointed out to her very clearly that there were serious concerns about medical practice in the Fort Smith Health Centre with respect to a particular physician, and I did point out to her very clearly that I believed that these concerns could not be ignored by me.
To me, and I believe I told the honourable Member this at the time, it has some analogy to the tainted tuna fish. If a Minister is given information, with a responsibility for public health, that Minister refuses to act on because of political pressure or because of public pressure of one kind or another, then that Minister is not just discharging their responsibility. I think it is only fair for me to say that I think that the honourable Member knew that a board of medical inquiry, and a peer review, was certainly a possibility.
That is why we had discussions about her encouraging the physician to voluntarily agree to accept an evaluation, and an assessment by professionals, so that he could voluntarily clear his name. Unfortunately, he was not willing to do that. So, Mr. Speaker, I want to conclude by saying that it is up to this House to decide whether the compelling reasons have been presented, that I think are required to be presented, in order to undertake this extremely expensive inquiry which I think will start at $.5 million and could easily cost $1 million.
In light of the costs, Mr. Speaker, I would like to call for a recorded vote, and I would also like to state that this matter has been considered by Cabinet, and in order to appear objective and to preserve our objectivity, Cabinet will abstain on this motion. I would like to say, Mr. Speaker, that we will be guided by the direction from this Assembly. We will be putting the matter under active consideration from here on in. It is a dynamic consideration, I have received notice this morning that another court action will be initiated on this matter later this week, so the situation is rapidly changing.
I want to reiterate, Mr. Speaker, that the government is not ruling out a public inquiry. What we are suggesting is that, at this time, we should let the peer review process take place. When a client complains about a lawyer's conduct, an abuse of funds for example, the Legal Profession Act springs into action. You do not hold a public inquiry, when there is a complaint about the competence of an engineer, if a bridge collapses or a building collapses, the engineers deal with their peer review, and you do not hold a public inquiry.
The same occurs with a pharmacist. Now, I think we should follow the procedure laid out in our Act, Mr. Speaker. I will reiterate again, once that is done, if the Member comes back and says that there are still concerns, there are still matters at issue, my constituents are still asking questions, or still in the dark, then that avenue would be open to us. It is the view of government, at this time, that we should take the course that is laid out in our own legislation. Thank you, Mr. Speaker.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 908
The Speaker Michael Ballantyne
To the motion. Mr. Gargan.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 908
Samuel Gargan Deh Cho
Thank you, Mr. Speaker. I guess during the health transfer one of the basic principles was community and aboriginal control over the delivery of health services. This should mean that the community has a right to ensure the appropriate action is taken when it becomes concerned about the operations of a health facility.
There is more at stake here than an investigation into the performance of a single doctor. It has to do with the administration, and the operation, of the entire investigation into the performance of a single doctor. It has to do with the administration and the operation of the entire health centre and with the health centre's role in the community. The people of Fort Smith, particularly aboriginal people, have every right to be fully involved in all aspects of this operational review. That was a guaranteed condition of the health transfer.
The motion before the House is calling the Members to request that an inquiry be held under the Public Inquiries Act. The Minister seems to have taken a position that this should not occur, because it has decided to refer a report on a doctor's competency, to a board established under the Medical Profession Act.
I believe that the only appropriate framework in which to consider this matter is in a public inquiry established under the Public Inquiries Act. Here are the advantages of a public inquiry, it is stated clearly that the proceedings should take place in public, although there is a provision that if a board wishes, it can go in camera to deal with a very personal and private matter. The history of public inquiries in Canada has been that there has always been the best way to ensure that the public has an opportunity to provide input. For example, an inquiry earlier this year into the death of a prominent Manitoba native leader at the hands of police officers, dealt not only with the circumstances surrounding the misuse of power at that situation, but also with the larger concern of the aboriginal communities.
Two inquiries into the Alberta justice system, highlighted the short coming of European justice in terms of meeting the needs of aboriginal people. Again, the conclusion was reached with ample input from the public at large, and especially aboriginal organizations in that province.
Purely, Mr. Speaker, public inquiries have proven to be useful and efficient ways to get information out into the open in all Canadian jurisdictions. We should not be afraid to make full use of this vital approach in dealing with community concerns in the Northwest Territories.
There are many disadvantages to the Medical Profession Act. It is a form of peer review, no public review. By definition that means that it will focus on what the doctors think are important, not the people. There is far more to the trouble that the Fort Smith Health Centre, than the activities of a single doctor, whom the department seems to want to scapegoat.
---Applause
I have always been suspicious of the process of peer review. It is alright in a situation where there is a very narrow question to be considered. In this complicated situation, there must be an open and public process. The public inquiry is the only suitable approach.
I have publicly expressed, Mr. Speaker, my concerns over peer review approaches, used to override community concerns with respect to the Nursing Profession Act, the Engineering, Geologists, and Geophysicists Profession Act. In both these cases, there were commitments made when the legislation was reviewed under review, that there is an opportunity for community input and review of their findings. Even then, I am not entirely satisfied. However, in the case of the Medical Profession Act, there is not even a requirement that the board of inquiry has to submit a report. It can issue an order, but it does not even have to report its findings. How on earth is that going to answer the questions that members of Fort Smith community have on the working of their health centre?
A public inquiry is better. Further, the question on whether or not inquiry under the Medical Profession Act should not be misunderstood. The Act is silent on this issue, it does not say that the inquiry should be open, it does not say the inquiry should be closed.
The Minister has stated that this could mean that the medical board of inquiry hold a public process. However, we should not forget that the report referred to the board of inquiry, was that the commission on it, was on a strictly confidential basis. How on earth can the Minister expect the board to meet in public, when it will be dealing with a confidential report?
The public inquiry in the health centre is absolutely necessary. I must say that I found the Minister's comments on the inquiry very confusing. I must also say that I have received copies of the correspondence tabled by the honourable Member for Thebacha, including the Minister's correspondence of September 10, 1992. I find that his allegation that Mrs. Marie-Jewell has been working to prevent the successful resolution of the matter, is unfair and not accurate in my view.
I also find that the tone of his correspondence to be not becoming of a Minister of this government. A public inquiry is a must, and it is a culturally appropriate approach. The most important thing that honourable Members should ask themselves, in voting on this issue, is that when problems arise over the years, about aboriginal communities, how did our elders of the generations deal with them? Did they appoint a group of professionals to hold a private inquiry, or did they bring the community together as a whole to talk about the problems?
Honourable Members will know that through history, Dene and Inuit people have always dealt with community problems by bringing the communities together. Everyone had the opportunity to have input into how to resolve a community problem. Everyone knew what decisions would be made to solve the problem. These are the principles that we, as modern leaders, should be striving to achieve as well.
We will not achieve these with a board of inquiry under the Medical Profession Act. We will achieve this with an inquiry under the Public Inquiries Act. Thank you, Mr. Speaker.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
The Speaker Michael Ballantyne
To the motion. Mr. Koe.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
Fred Koe Inuvik
Thank you, Mr. Speaker. I would just like to state that my colleagues, who have moved and seconded the motions, and the statements made by Mr. Gargan, have made a very strong case, and I will be exercising my right and privilege as a M.L.A., and make a decision by supporting this motion.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
The Speaker Michael Ballantyne
To the motion. Mrs. Marie-Jewell, you have the opportunity to conclude debate.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
Jeannie Marie-Jewell Thebacha
Thank you, Mr. Speaker. I did not intend to say too much in closing my debate. I felt that my honourable colleagues have covered many of the areas. However, I do want to state to the House once again, that up to at least Friday afternoon, we tried to come to some type of resolution. I agreed along with the Minister of Health, and the House Leader, Mr. Pollard, that we would try to come to some type of resolution, where we finally agree that we would receive an independent legal opinion on the Public Inquiries Act, and the Medical Profession Act, for a board of inquiry, and I would like to quote some of that legal opinion. It says, "The purpose of the two statutes are very different. The Medical Profession Act allows for a board of inquiry for the limited purposes of examining discipline, complaints, or matters of a similar nature, referred by the Minister. The board of inquiry cannot report or recommend. It can only dismiss or discipline." The people of Fort Smith are asking why? There are many people in Fort Smith that believe that this doctor is a very good doctor. They have full confidence in him, and they want to know why the Department of Health is all of the sudden taking him out of the health centre. I believe that only in democracy, and the process of democracy, do we allow for these things to be answered. All I am asking is for these questions to be answered on behalf of my constituents.
The Minister indicated that we should let the board of inquiry run its course, because all it will do is bring forth recommendations, and I state unequivocally, "no, we do not want the medical board of inquiry to review, to run its course, because the medical board of inquiry consists of three members: one person nominated by the N.W.T. Medical Association, who is a medical practitioner; one person who is a medical practitioner, who is registered in the province; and at least one person who is neither of the above."
So, it is actually another peer review on a report that was submitted. What we are asking for is many unanswered questions into the whole Fort Smith Health Centre answered, and I believe, at the very least, my constituents deserve to be heard.
Mr. Speaker, at that public meeting, one constituent raised his hand and asked, "how can they ask me to obtain a public inquiry?" I stated, "I would like to ask one question, is there anyone in this room who does not want a public inquiry, for any reason?" Mr. Speaker, at that public meeting, not one person stood up or raised their hand, and that gave me the mandate to come to this House to ask for a public inquiry.
The Minister is indicating that he is saying that costs are already being absorbed, but yet in the House, when I questioned him under oral questions, he tells me that the board of inquiry has not even been set up yet. So, I wonder where the costs being absorbed are? I recognize that the costs of an inquiry is a lot of money, and I recognize the restraint we are in, but I believe that fundamentally, your health is very important, and if people are not healthy, what can they do? Do we put a price tag on health? Do we put a price tag to answer elders in our community, that they are deprived of some of their health opportunities, that we, as the government, should be giving them? I do not believe so. I believe that sometimes, for fundamental democracy, we cannot replace an answer with costs.
Mr. Speaker, in closing, I would like to urge my colleagues to support this motion. There are many unanswered questions with respect to this whole issue, that remain unanswered. I know a board of inquiry will not answer, but I know a public inquiry will. So, therefore, I call question on the motion. Thank you.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
The Speaker Michael Ballantyne
Question has been called. A recorded vote has been requested. All those in favour of the motion, please stand.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
Clerk Of The House Mr. David Hamilton
Mrs. Marie-Jewell, Mr. Gargan, Mr. Zoe, Mr. Koe, Mr. Antoine, Mr. Todd, Mr. Bernhardt, Mr. Lewis, Mr. Arngna'naaq, Mr. Pudluk, Mr. Ningark, Mr. Pudlat, Mr. Dent, Ms. Mike, and Mr. Nerysoo.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
The Speaker Michael Ballantyne
All those opposed to the motion, please rise. All those who abstain from the motion, please rise.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith
Item 16: Motions
Page 909
Clerk Of The House Mr. David Hamilton
Mr. Allooloo, Mr. Arvaluk, Mr. Pollard, Ms. Cournoyea, Mr. Kakfwi, Mr. Morin, Mr. Whitford, and Mr. Patterson.
Motion 30-12(2): Public Inquiry Into Medical Services In Fort Smith, Carried
Item 16: Motions
Page 909
The Speaker Michael Ballantyne
Motion is carried, 15 voting yes, 0 voting no, and 8 abstaining. First reading of bills. Mr. Pollard.
---Carried ITEM 17: FIRST READING OF BILLS
First Reading Of Bill 33: Appropriation Act No. 2, 1992-93
Item 16: Motions
Page 910
John Pollard Hay River
Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the honourable Member for Aivilik, that Bill 33, Appropriation Act No. 2, 1992-93, be read for the first time. Thank you, Mr. Speaker.
First Reading Of Bill 33: Appropriation Act No. 2, 1992-93
Item 16: Motions
Page 910
The Speaker Michael Ballantyne
Motion is in order, Mr. Pollard. All those in favour? All those opposed? Motion is carried.
---Carried
Item 18: Second Reading Of Bills
Item 18: Second Reading Of Bills
Page 910
The Speaker Michael Ballantyne
Second reading of bills. Mr. Pollard.
Second Reading Of Bill 33: Appropriation Act No. 2, 1992-93
Item 18: Second Reading Of Bills
Page 910
John Pollard Hay River
Mr. Speaker, I move, seconded by the honourable Member from Aivilik, that Bill 33, Appropriation Act No. 2, 1992-93, be read for the second time. Mr. Speaker, this Bill would authorize the Government of the Northwest Territories to make operations and maintenance expenditures for the fiscal year ending March 31, 1993. Thank you, Mr. Speaker.
Second Reading Of Bill 33: Appropriation Act No. 2, 1992-93
Item 18: Second Reading Of Bills
Page 910
The Speaker Michael Ballantyne
Motion is in order. Mr. Pollard to the principle of the bill. Question has been called. All those in favour? All those opposed? Motion is carried.
---Carried
Bill number 33 has had second reading, and the bill is referred to committee of the whole. Second reading of bills, Mr. Kakfwi.
Second Reading Of Bill 32: An Act To Amend The Young Offender's Act, No. 2
Item 18: Second Reading Of Bills
September 13th, 1992
Page 910
![Stephen Kakfwi](/media/CACHE/images/polpics/11-stephen-kakfwi/ab77c1961d45ad012958309f36c1cb37.jpg)
Stephen Kakfwi Sahtu
Mr. Speaker, I move, seconded by the honourable Member for Tu Nedhe, Bill 32, an Act to Amend the Young Offender's Act, No. 2, be read for the second time. This Bill would amend the Young Offender's Act to make the Minister of Justice responsible for the entire Act. Thank you.
Second Reading Of Bill 32: An Act To Amend The Young Offender's Act, No. 2
Item 18: Second Reading Of Bills
Page 910
The Speaker Michael Ballantyne
The Motion is in order, Mr. Kakfwi. All those in favour? All those opposed? Motion is carried.
---Carried
Second reading of bills, Mr. Arvaluk.
Second Reading Of Bill 31: An Act To Amend The Student Financial Assistance Act
Item 18: Second Reading Of Bills
Page 910
James Arvaluk Aivilik
Mr. Speaker, I move seconded by the honourable Member for Hay River, that Bill 31, an Act to Amend the Student Financial Assistance Act, be read for the second time. Mr. Speaker, this Bill would amend the schedule to the Student Financial Assistance Act, to increase for the 1992-93 subsequent and fiscal years. The maximum aggregate amount of principle, that may be outstanding, in respect to all those made under the Act.