Mr. Chairman, we believe that a number of steps can and must be taken to improve the delivery of health and social services in the Northwest Territories. People told us on many occasions that they expect the government to act on the information provided during our review. They have done their part by sharing their needs and concerns with us. Now it is time for public officials to do their part.
The need for action on these matters is great. Our recommendations should be acted upon quickly.
The following general recommendations provide a framework to guide the government in its approach to a number of issues.
The government should better inform the people of the Northwest Territories about the cost and workings of their health and social services. An effective program to communicate this information and to encourage the responsible use of these services should be implemented. This will help people to feel a greater degree of ownership of the system. It may also help us to provide the services we require while living within our means.
Communities should be encouraged and assisted in the development and leadership of local initiatives. It is especially important to support those programs in which individuals and families assume greater responsibility for and control over their quality of life.
The use of specialists should be reviewed. We must ensure that our communities are receiving the greatest benefit from this expertise. While they are in the community, efforts should be made to share their expertise by providing training and advice to local residents, such as in the areas of prevention and treatment. The specialist assignment and visitation schedule should also be reviewed to ensure that these visits are convenient for the people they are meant to serve.
The use of telecommunications technology and other forms of distance medicine should be increased. This will provide front line workers with the information they need to provide more timely, effective and quality health services. Had the Department of Health not already initiated a pilot project in this area, we would certainly have recommended that it do so. The department should be instructed to proceed as quickly as possible with the pilot projects that are proposed for the next two years.
The Government of Canada should live up to its commitments. We can not accept Ottawa's ongoing refusal to honour its financial responsibilities for the provision of health care to our aboriginal residents. These obligations exist in treaty. They also exist in the agreements which transferred authority over a number of health related matters to the territorial government in 1988.
The government of the Northwest Territories should honour its commitment as well. In return for their support of the 1988 Health Transfer Agreement, communities were promised greater authority over their health and social services. This was to be achieved through a transfer of responsibility to regional health boards, hospital boards and local committees. This transfer has never occurred to the extent it should. The system remains distant from and unresponsive to the people who best know the needs of their communities.
Efforts must be made to develop more community-based mental health services. The government should consider undertaking a pilot project in a given community. The project could involve a team approach involving local residents with back up support provided by skilled professionals from regional offices. This team would develop and implement promotional activities around mental health issues. We saw two proposals for such a project during our review. We strongly suggest that the government move in this direction.
The confidentiality of medical and related information needs to be addressed on two levels. First, the government should encourage staff in different departments to get the client consent needed to share information among themselves. Second, front line workers should be reminded to take steps to avoid even accidentally releasing confidential information to the public.
We heard of the problems facing families who care for mentally handicapped young people in the home. Possible solutions that were raised include appropriate counselling and training for parents.
Additional respite care services and facilities need to be provided as part of a community-based system of health and social services. These resources will help relieve the strain on families who care for ill, elderly or disabled family members at home.
An immediate search must begin for ways to relieve the impossible workload of front line social workers. In smaller communities, one or two workers are responsible for delivering a great number of programs, each requiring certain skills. In larger communities, workers are more specialized but face an incredible volume of work. In both cases there is not enough time to perform prevention activities. In short, the current situation leaves workers overburdened and communities under-served. One immediate step would be for the government to speed the transfer of responsibility for social assistance to the Department of Education, Culture and Employment.
Women should be protected from acts of physical abuse. Part of this protection must come in the form of new attitudes on the part of many people. The government has an important role to play in this process. This role includes setting policies and communicating them to the people of the Northwest Territories.
The government is to be commended on its efforts to date in the area of family violence, but too many people are still being abused. The committee is pleased that the Department of Justice is presently working on a new strategy to deal with violence in the Northwest Territories. We strongly urge the Minister to proceed swiftly to address this serious issue. More must be done to communicate this policy and the fact that violence against women and other family members is totally unacceptable.
Mr. Chairman, people need to be better informed of the ways in which they can take greater control over their quality of life. Information about successful programs developed at the community level should be gathered and distributed throughout the Northwest Territories.
The government should encourage the development of more effective and innovative public information programs. These activities should move beyond the conventional printed materials and lectures which are simply not working. Programs must become more interactive with the people they are meant to reach. People must be participants rather than recipients in the process of public health education.
We heard too many stories of duplication, waste and lack of coordination between government departments. It is time to begin correcting these problems in the best interests of the people who receive and deliver health and social services. We need to develop new partnerships with the input of public officials, front line workers and the people of our communities.