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.

Therefore, Mr. Chairman, I move that this committee recommend that the amalgamation of the Departments of Health and Social Services should proceed immediately. The first step in this process should be the designation of one Minister responsible for both departments by March 31, 1994.

Thank you, Mr. Chairman. Mr. Chairman, efforts have to be made to improve the coordination and health and social services during the amalgamation process. Legislative, regulatory or administrative obstacles to increased cooperation between departments must be identified and removed.

Therefore, Mr. Chairman, I move that this committee recommend that the level of cooperation and information sharing between all government departments involved in the delivery of health and social services must improve, and the government should report to the 1994 fall session of the Legislative Assembly on measures taken to achieve this goal.

Thank you, Mr. Chairman. About this motion and the previous motion that was just passed, I wonder if the time line that has been stated is reasonable? I say that because, as Members know, the other standing committee of the House made a report a year ago and the Department of Health, in

particular, has not followed up on the recommendations. From the workings of various departments, it takes between 12 months to two years to implement recommendations.

Thank you, Mr. Chairman. I can't speak for the Department of Health as to whether they are going to meet this time line, but Members of the committee felt that we should at least hear from them about what sort of progress they had made towards achieving the goal set by this recommendation, by next fall. In our travels we heard from across the Northwest Territories that people do want to see better cooperation between government departments that are involved, especially in the areas of health and social services.

Right now, people feel they are being shuffled from department to department and there isn't the sort of coordination that there should be. Whether they will have solved all the problems a year from now, I can't answer. I think only the Minister of Health could advise us on that. We still feel that the House should be advised what sort of progress the department has made. That is why we put this deadline in there.

Mr. Chairman, I'm in agreement with the motion that is in front of us, but the point I'm trying to make is that, once the department is amalgamated by March 31, 1994 -- and we're asking through the second motion to see what measures the department has taken -- I guess they can comment on the progress they have been making from the date of amalgamation. The point I'm making, Mr. Chairman, is based on past experience of other committee reports to this

government...I will use one of the departments they are asking to be amalgamated as an example, the Department of Health.

They have a number of internal problems that have not been rectified, to date. Just looking at that department, Mr. Chairman, the issues and concerns that were raised in some of our standing committees have not been cleared up with just that department. Even if we put those two departments together, I can't see the government house cleaning with two departments when they can't even do it with one. That's the point I'm trying to make, Mr. Chairman.

I agree with this particular motion, but I don't think it's going to work. Although the department will be able to report on the progress they have made by the 1994 fall session, I can tell you, Mr. Chairman, that the report that we are going to get in the fall is going to be, "little progress." Thank you.

Mr. Chairman, we heard about this in the Baffin, Fort Smith, Inuvik and Yellowknife. For interest's sake, one of the quotes that we have from the Resolute Bay public meeting was, "Health and Social Services people should try to get together. If they were to work together, you would know more about these problems." What people were saying is they didn't understand why they would have to bounce back and forth from Health personnel to Social Services' personnel depending on the nature of their problem. That is what people told us they found frustrating. They didn't understand why there was a difference. They saw a need for services to be provided and thought it should be coming from one person.