Regarding a question of attitude, the Standing Committee on Agencies, Boards and Commissions is concerned that, to a large degree, the problems which surround the debate over board autonomy, accountability and role appear to have arisen as much from differing attitudes among key officials as they have from the historical and legislative factors expounded upon earlier.

Throughout the review, the standing committee heard that departmental officials working in Yellowknife were perceived by boards and their staff as being reluctant to accept input, possessive about information and, at times, condescending. The sum of this perception has been that some senior public service managers within the Department of Health may be presenting impediments to effective board function, simply through the approach they are bringing to their interaction with board officials.

The standing committee is concerned about the considerable evidence before it which suggests that there is too much central control. Members heard about a situation in which requests for medical technology were denied by headquarters but direction was provided to spend the money on a floor polisher. Boards related repeated instances in which needs had been identified and dollars has been found to support new programming, but the process was halted at departmental direction. It has seemed to the standing committee that the Department of Health has crippled itself with an inability to accept that health and hospital boards are capable of carrying out important responsibilities and is now unable to stand back and allow regionally driven initiatives to proceed as they should.

This, to be fair, may be a consequence of the lack of definition surrounding board roles. Once the MOU is finalized, it will be important for the Minister of Health to motivate a shift in outlook among her senior officials. The department must realize that goals can be better achieved if the central authority moves away from trying to "run things" in the regions and moves instead toward a process where it assists boards to best achieve their own priorities.

Where it is not possible to shape these new attitudes through staff inservice training and supervision, the standing committee would urge the Minister to take more final action. Clearly, it is the opinion of the committee that the current posture within headquarters operations at the Department of Health must change. If the change cannot be achieved with current personnel, then the replacement of officials should be contemplated.

Legislative Review

The Standing Committee on Agencies, Boards and Commissions has confidence that the establishment of an MOU will contribute greatly to the correction of existing problems. However, the committee is concerned that this will not necessarily go far enough.

During the 11th Assembly, the previous Standing Committee on Agencies, Boards and Commissions brought forward a report in October 1990, which recommended that the Territorial Hospital Insurance Services Act should be repealed and replaced with one "that better reflects the government's philosophy of supporting regional autonomy."

Although subsequent amendments dissolved the Territorial Hospital Insurance Services Board, a major overview and shift in legislative framework have still not been undertaken.

At the present time, the standing committee does not wish to recommend specific changes to the legislation. These will be more appropriately identified through the consultation process between the Department of Health and the boards.

The Standing Committee on Agencies, Boards and Commissions believes, however, that legislative review and amendment, when identified through consultation with the boards, should not be delayed.