Thank you, Mr. Chairman. The Minister and the committee discussed at some length, the problems associated with finalizing the role study, programming and design for the new regional health facilities in the Baffin and Inuvik regions. Members noted a number of specific problems, including the following: plans continue to be delayed; funding included in previous budgets is lapsed or carried forward; amounts shown for the current and forecast years are inconsistent with those reported in the previous year's document; the amount of federal cost-sharing and the accrual of federal funds paid, are uncertain; maintenance costs continue to rise particularly in the Baffin region; and, full community consultation is not always evident.
In spite of these difficulties, committee Members are optimistic that most of the concerns will be addressed this year. Further, the committee expects that realistic estimates for both the Baffin and the Inuvik Regional Health Centre projects will come before the committee to review next year.
Members also supported the need for thorough planning in the development of a Keewatin Regional Health Facility. The committee concurred with the Minister that a full and comprehensive needs assessment, involving all Keewatin communities, should now proceed. An economic analysis, comparing the cost of existing arrangements with the province of Manitoba to the expected cost of delivering health care services through a new regional facility, must also be completed.
In its previous report on the review of the capital estimates, the committee recommended that, in order to achieve economies of scale, the Departments of Social Services and Health assess the feasibility of integrating drug and alcohol treatment programs with health and hospital facilities. Therefore, the committee expects to see plans for all new drug and alcohol treatment programs linked with health facilities and included in the capital budget of the Department of Health.
Finally, negotiations for federal cost-sharing of the Keewatin facility should begin now. The goal of such negotiations should be to see if arrangements, similar to those made with respect to planned regional health facilities in the Baffin and Inuvik regions, could be concluded.
Committee Members noted with interest, the pilot project that involves providing a birthing unit for low-risk mothers in Rankin Inlet. The results of the pilot project will be reviewed to assess future expenditures for similar initiatives.
In at least one instance, community representation on regional health boards was called into question. It was determined that one community was without representation on a regional health board for a period of almost two years -- a period of time during which significant decisions were made. The committee appreciates the action taken by the Minister when informed of this particular situation. The department must monitor community participation on regional health boards to ensure the active participation of each community.
The committee was critical of the administration of health care in the North Slave, South Slave and Deh Cho regions. Decisions governing the delivery of health care services in these areas are made at the Department level, or by Mackenzie Regional Health Services, without the opportunity for community participation.
Members noted that, in two communities now falling within the jurisdiction of the Mackenzie Regional Health Service, conditions in the health centres were very poor. Further, it was noted that the design of some health facilities compromised patient confidentiality.
The committee is requesting that the Department re-examine the existing centralized decision-making structure in the Mackenzie area and look to replacing it with a structure that is more responsive to community needs.