Question.

Question has been called. All those in favour? All those opposed? Motion is carried.

---Carried

Mr. Whitford.

Election Versus Appointment Of Board Members

Thank you, Mr. Whitford. Mr. Antoine.

Board Appointments

Thank you, Mr. Chairman. The Standing Committee on Agencies, Boards and Commissions recognized that a serious problem has existed with respect to delays in the appointment of members to health and hospital boards. This issue was highlighted at the November 21 consultation sessions by a number of board representatives, and was articulated most clearly in the written submission received from the board of management for Stanton Yellowknife Hospital:

"This is a definite area of concern which our board has experienced... The length of time which it takes for an appointment to proceed through the system is extreme. We recognize the Minister has heard our concerns and also are aware that other boards may suffer from this as well.

"The length of time creates problems when only a few members remain to carry on the function of the board. Some committee work does not get accomplished in a timely fashion.

"The time delay also does not present the board in a positive light to its community. Someone will come forth indicating their interest in serving on the board, and by the time the appointment process occurs, the interest may have waned, or the individual receives the impression that they are not wanted and turns their community interest to something else."

Appointments to health and hospital boards have been delayed, in many cases, far too long. The standing committee found it incredible that, at one point in early November, 1992, five of the six boards in the Northwest Territories had membership vacancy rates over 25 per cent. During the same period, the Stanton Yellowknife Hospital board of management was lacking ten of its 15 possible appointments.

The standing committee was also concerned that some quarters appeared to associate the delay in board appointments with a Legislative Assembly motion to postpone filling membership vacancies on all government boards and agencies. This motion was carried on December 12, 1991. It was introduced by the Standing Committee on Agencies, Boards and Commissions through Committee Report 1-12(1) and was intended only to provide a brief review period, without limiting government appointments over an extended time frame. In fact, the motion specifically stated that appointments should be postponed only until March 31, 1992.

There is no reason for any continued delay in making appointments to health and hospital boards. Where board restructuring initiatives are under way, these should be planned well enough in advance that they do not interfere with the ongoing membership status of the board.

The Standing Committee on Agencies, Boards and Commissions is of the opinion that the Minister of Health must take steps to ensure that board appointments are consistently made to fill vacancies. Situations should not be allowed to arise in which board operations are halted because there are insufficient members to carry out the work that needs to be done.

Therefore, I move that this committee recommends that the Minister of Health ensure that health and hospital boards remain fully constituted by filling membership vacancies through the timely appointments of members. Mahsi.

There is a motion on the floor. Motion is in order. To the motion.

Question.

Question has been called. All those in favour? All those opposed? Motion is carried.

---Carried

Mr. Koe.

Conclusion

Thank you, Mr. Chairman. In conclusion, the Standing Committee on Agencies, Boards and Commissions is concerned about the current status of health and hospital boards within the territorial health system. The present confusion over roles and responsibilities, and the sense of conflict which often pervades the relationship between boards and the Department of Health is a source of strain and inefficiency. The existing situation cannot be allowed to continue.

The standing committee has proposed that matters could be improved if greater clarification is provided regarding the respective roles of the boards and the department. A new outlook is also needed, away from centralized control and toward regionally-driven management of health facilities, programs and services. Decisions should be made by the people who are going to be most affected by them.

The Standing Committee on Agencies, Boards and Commissions realizes that it is sometimes difficult for government bureaucracies to shift away from the manner in which things have been done previously. In that regard, there is a role to be played by the Legislative Assembly in charting the course that should be followed and in laying down expectations for a new approach to health services management. This was pointed out in the written submission received from the Kitikmeot regional health board:

"These issues can only be resolved if the Legislative Assembly takes a lead role in setting the direction. Placing blame is a waste of time and energy. The assembly must quickly set up a mechanism to review the data gathered to date, and to follow through with the direction its constituents have identified. The assembly must ensure that roles and accountabilities are clearly delineated, and that there is an appropriate mechanism to ensure equal distribution of scarce resources for a valued commodity...health.

"Once this is done, the Assembly will have the ability to hold the department and the boards accountable for their respective actions."

The Standing Committee on Agencies, Boards and Commissions believes that its review of health and hospital boards has now provided the mechanism to which the Kitikmeot board referred. It is hopeful that the current report can be used as an initial step in the process that will lead to a more efficient, better defined and more accountable role for health and hospital boards in the Northwest Territories.

During the review, however, some concern was expressed by board representatives about whether there would be effective follow-up on recommendations and suggestions arising from the current review. Some seemed to believe that past reports on health administration and, in particular, board submissions have tended to "gather dust" in government filing cabinets.

The Standing Committee on Agencies, Boards and Commissions wishes to emphasize that its current recommendations and suggestions are forwarded in a serious and urgent context, and that specific government action is anticipated.

I move, that this committee recommends that in accordance with rule 94(4), the Executive Council table a comprehensive response within 120 days of the presentation of this report to the House. Mahsi.

Thank you. The motion is in order. To the motion.

Question.

Question has been called. All those in favour? All those opposed? Motion is carried.

---Carried

Does the committee agree that Committee Report 14-12(3) is concluded? Mr. Koe.

Yes, I would like to state that we have concluded our report. I would like to thank a few people for all their assistance over the past year and a half: all the research and clerical staff; and all the participants who spoke, wrote or talked to us in our visits, especially members of the health and hospital boards; all the hospital and Department of Health staff who talked, wrote or spoke to us; and, finally the Members of the Standing Committee on Agencies, Boards and Commissions for the fine effort and hard work they have put into preparing this report. Mahsi to everyone. Thank you.

Thank you, Mr. Koe. Is the

committee agreed that Committee Report 14-12(3) is concluded? Agreed?

Agreed.

---Agreed

Mr. Gargan, you would like to speak to the report? Proceed, Mr. Gargan.

Mr. Chairman, just for the record I would like to tell the Members that the Deh Cho regional council have, on a number of occasions, tried to address this whole issue of health and the health boards. One of the reasons they have not pushed on it is that at one time the region was going to go into a western Arctic health care commission type of structure. It was going to be based on Indian health. That did not happen so we have not pushed strongly in that area. We also did not push for education, for example, but the government got around it by consulting the local education boards and they were able to get the support through that. As far as Indian government goes, the band council never did support that concept. I thought, for the record, that I would let it be known because even though the report suggested some creation of boards, we would like it to be understood that we still have not said we are going to support a structure like that under this government regime. We are still looking at whether there is another way of doing it. The other way being maybe the federal program or the inherent right to self-government, that sort of a concept. Thank you, Mr. Chairman.

Thank you, Mr. Gargan. Is the committee agreed that the Standing Committee on Agencies, Boards and Commissions' final report on health and hospital boards in the NWT, Tabled Document 14-12(3), is concluded?

Agreed.

---Agreed

Thank you. What is the wish of the committee? Mrs. Marie-Jewell.

Mr. Chairman, I move that we report progress.

There is a motion on the floor to report progress and the motion is not debatable. All those in favour? All those opposed? Motion is carried.

---Carried

I will rise and report progress. Thank you.