Thank you, Mr. Chairman. Mr. Chairman, I think our intention is to commence with reading our report into the record and to deal with our recommendations and motions as we get to them. So, Mr. Chairman, I will be asking all Members of the committee to share in the reading of the report into the record.
This Is What We Heard About The Delivery Of Health And Social Services
Mr. Chairman, we were instructed by the Legislative Assembly to examine all matters relating to health and social services in the Northwest Territories. One of the matters we examined was the delivery of these services. We wanted to know what people think about the programs themselves, the way in which they are organized and the front line workers who provide them.
We have examined all of the information generated during our review of these questions. As mentioned previously, it is impossible to fully examine either health or social services without considering the other. As a result, we have not tried to maintain an artificial separation between these two areas. We have organized the opinions and concerns we heard about, the overall organization and delivery of these services, under a number of headings. Here is what we heard:
We Heard That Many People Feel The System Is Not Meeting Their Needs
Mr. Chairman, people told us that they do not think the present system of health and social services is working. They feel they have little control or ownership over the shaping of policies and the delivery of programs. The decision making process is viewed as slow, distant and unresponsive. As a result, many people feel that it does not meet their requirements.
A number of people also find the system too complex and sophisticated for them to understand. They do not know who to contact or how to find the proper programs. We heard the perception that you have to already know your way around the system, have money or know the right people before you can receive the services you require.
People Want Greater Control Over The System
Mr. Chairman, people told us that governments cannot solve all our health and social problems simply by spending more money, providing more buildings or buying new equipment. Individuals, organizations and area representatives want to play a greater role in shaping their own quality of life. They believe they can provide more effective and relevant service through locally controlled policies and programs. They want to see a shift to a system in which greater control rests at the community level.
Our survey of community controlled health and social services clearly indicated that greater local authority can produce a number of positive benefits. These include greater sensitivity to local needs, the involvement of people in shaping their own solutions, less reliance on outside agencies for assistance, increased efficiency and effectiveness, increased public awareness of local problems and more sources of information.
While many people want greater local control over health and social services, there are differences of opinion as to whether front line workers should come from inside or outside the community. Some people think that local workers have a better understanding of the area and the needs of its residents.
Others feel that some communities may simply be too small for a local resident to effectively provide health and social services programs. These people believe that it would be difficult to cope with making difficult decisions affecting relatives and friends.
People expressed concern about whether the confidentiality of patient or client information would be maintained if local residents serve as front line workers. We heard that these workers might be subjected to pressure or be shunned by the community because of decisions made in their professional role.
People Told Us There Must Be Greater Cooperation Between Government Departments
Mr. Chairman, we heard that health and social matters are closely related. People want this fact to be reflected in the prevention and treatment of these problems by appropriate government departments and agencies. Too often, we heard that information is kept within a department instead of being shared between appropriate agencies. Front line workers in one department are often unaware of services being provided the same client by workers in other departments.
People identified a number of departments which directly or indirectly shape their quality of life. They include Health, Social Services, Economic Development and Tourism, Education, Justice, Municipal and Community Affairs, including the field of sport and recreation, and Renewable Resources. Yet, we heard that many residents of the north have not been informed of the responsibilities that each department has over various health and social service issues.
People want to see better cooperation and communication between these departments. We heard examples of people being shunted from one department to another as they sought information or assistance. Public servants would not or could not agree on how to accept or divide responsibility. As a result, people did not receive the care they required, were passed back and forth between departments or were in danger of falling through the cracks of the system.
We also heard stories of duplication, waste and inefficiency as a result of the lack of coordination between government departments. For example, people spoke of having to deal with several officials from different departments on the same matter. We also heard of situations where money was available for medical travel only to find that no hospital beds were open once the patient got there.
On the other hand, we were told of money being available for alcohol and drug treatment programs but no travel money being provided to help people get to where those programs are offered.
Experiences like these merely increase the frustration that people feel about a system they already believe is out of touch with their needs. This is particularly true of our justice system. People do not understand how the courts work, the stages involved in bringing an action to trial or the length of time involved. This makes life very difficult for the families and communities of those charged with an offence and who are awaiting trial.
People Told Us That Government Must Focus More On Prevention
Mr. Chairman, people told us that our quality of life is shaped by more than medical treatments and definitions. It is also determined by social and other factors we might not normally associate with "health" in a clinical sense. These factors include our housing conditions, life-style choices, recreational activity, economic status, education and public health information. As a result, people want these factors considered as policies and programs are developed.
Many people we spoke with believe that government should show greater initiative in improving our quality of life. They want policies that focus more on preventing problems than on treating them. Public health education is seen as playing an important role in this process. People want regional health boards to spend more time on health promotion activities that might reduce the number of patients they have to treat.
We Are Told That Local Control Should Lead To Better Programs
Like people in other parts of Canada, residents of the NWT want to increase the number of health and social service programs that can be delivered in their own communities.
Increasing the number of home care programs, in particular, is seen as a very positive step. These services are viewed as more responsive, independent, effective, cost-efficient and familiar than institutional treatment.
The results of the study we commissioned, on the benefits of community control over health and social services in northern and aboriginal communities, point to a similar conclusion.
The survey identified a number of benefits associated with programs developed and implemented in local settings.
These benefits include an increased level of service, more services than might have been available before, greater recruitment of aboriginal front line workers, community involvement in the design of policies and greater local acceptance of those programs.
At the same time, people told us that the current focus on community-based programs should be changed as well. We heard that these services should concentrate on the family and the community as much as on the individual. There is a sense that, "when one of us suffers, we all do." Problems like illness, addiction, violence and other forms of abuse can affect more people than the immediate patient, client, victim or offender. Policies and programs must recognize that family members and other people in the community have just as much need of healing and attention, throughout and after the treatment process.
Mr. Chairman, I would like to ask if the deputy chairman of the committee, the Member for Inuvik, could carry on.