Thank you, Mr. Speaker. Mr. Speaker, my statement concerns the health billings dispute with the federal government. On December 8, 1992, the Government of the Northwest Territories began a legal action in the federal court of Canada against the Department of Indian Affairs and Northern Development and Health and Welfare Canada.
The legal action is claiming about $80 million in unpaid invoices for hospital care services provided to aboriginal persons in the Northwest Territories. Payment for treatment of aboriginal persons in the NWT is a federal responsibility and is covered under contribution agreements dated October 28, 1986 and August 23, 1989.
The preamble of the contribution agreement reads as follows, and I quote: "WHEREAS Parliament annually approves the payment of a contribution to the territories (in addition to the amount payable pursuant to the Hospital Insurance and Diagnostic Services Act) so calculated that Canada will assume the total cost of hospital care provided to status Indians and Inuit as interpreted in the Indian Act."
Clause one of both agreements states, and I quote: "This contribution is being made available to the territories for the purpose of financing the total cost of hospital care for status Indians and Inuit."
Mr. Speaker, it is the position of the GNWT that Canada's legal obligations under these contribution agreements were not altered by the 1988 health transfer agreement, although the method of calculating the reciprocal billing amounts was affected slightly. During the year 1990, disputes between Canada and the Government of the Northwest Territories arose relating to aspects of the calculation of hospital costs and the legal status of nursing stations providing care.
During subsequent discussion between officials, Canada began to advance the position that the 1988 health transfer agreement had devolved to the GNWT all responsibility for the provision and funding of hospital care for aboriginal persons.
This position is advanced by Mr. Richard Van Loon, who was then the assistant deputy minister of the Department of Indian and Northern Development, in his letter of April 4,1991, to Mr. Bob Cowcill, former deputy minister of Health for the GNWT. Mr. Van Loon states, and I quote:
"DIAND's position is that Health and Welfare Canada transferred, and the GNWT accepted, a fully funded hospital and health care system when it took over the responsibility for the Baffin health services in 1986 and 1987 and the remainder of nursing stations and health services in the west in 1988. The acceptance of these program transfers also assumes GNWT's responsibility for the subsequent delivery and complete funding of these services to all residents from existing financial resources."
Mr. Speaker, it has always been the understanding and position of the GNWT that the effect of the 1988 health transfer was to mandate the GNWT to deliver, but not to fund, hospital care to aboriginal persons. This position was clearly articulated by the Government Leader, the Honourable Nellie Cournoyea in her letter of September 28, 1991, to the Honourable Tom Siddon when she stated, and I quote:
"In our telephone discussion, you inquired as to why the health transfer should be treated any differently than other federal program devolution's to the GNWT. The answer is simple. The Government of Canada, represented by the Minister of Indian Affairs and Northern Development, had in place before each health transfer, and renewed after each transfer, separate contribution agreements with the GNWT so calculated that Canada would assume the total cost of hospital and medical care provided to status Indians and Inuit.'
"With each of the successive health transfers, the GNWT assumed the full service delivery responsibility for the areas affected and the financial risk for growth beyond the health transfer funding amounts received for Health headquarters costs, medical travel (excluding the non-insured co-payment for status Indian and Inuit), and for hospital and medical care services for non-natives. The GNWT was, however, afforded protection through the DIAND contribution agreements against escalating hospital and medical care costs beyond any transferred amounts received for Indians and Inuit.
"In our view, DIAND must recognize its fundamental responsibilities to registered Indians and Inuit, which were not altered by the transfer of health services, and the unique role of GNWT as the agent of DIAND in managing a health services delivery system on their behalf through a legal agreement. We believe we are doing so in an effective, efficient, and culturally sensitive manner."
Paragraph 32 of the statement of defence states, in part, and I quote: "The phased devolution and all associated federal funding provided a complete and unified health service for status Indians and Inuit utilizing the hospitals, nursing stations and related health services previously operated by the Department of National Health and Welfare."
Canada goes further and alleges the following in paragraph 34 of the statement of defence, and I quote: "Status Indians and Inuit groups were consulted and they approved of the phased devolution of health services from the Department of National Health and Welfare to the Government of the Northwest Territories."
Mr. Speaker, the Government of the Northwest Territories is determined it must take all lawful steps and means to resist Canada's devolution interpretation of the 198 health transfer agreement for two basic and compelling reasons:
1. Financial
If the GNWT has total responsibility for the funding of aboriginal hospital care then there is no limit to the amount of financial off-loading that can be done by Canada to the detriment of hospital care for aboriginal people in the Northwest Territories.
---Applause
2. Historical And Political
Historically and continuing to the present day, there has always been a special relationship between Canada and aboriginal people in the Northwest Territories with respect to health care. It would be wrong for Canada and the GNWT to interfere with and change that special relationship without the informed consent of aboriginal people.
---Applause
It is the position of the GNWT that it has not been, nor will it every be, a participant in a transaction which interferes with any special relationship enjoyed by aboriginal people with Canada, unless prior informed consent has been given.
---Applause
The GNWT has made every effort to induce Canada to return to the negotiating table pursuant to finding an interim solution for the next three years. Thereafter, Mr. Speaker, tripartite discussions will have to be held by the Government of the Northwest Territories, Canada and Nunavut to transfer the Nunavut portion of health services.
In the view of the GNWT, if Canada wishes to attempt to devolve aspects of its special health care relationship with aboriginal persons, the opportune time to explore the question is during the Nunavut discussions. Mr. Speaker, Canada refuses to return to the negotiating table and continues to insist that it no longer has any responsibility for aboriginal hospital care in the Northwest Territories.
The Government of the Northwest Territories will not materially interfere with the special relationship between Canada and aboriginal peoples concerning health care, without first obtaining the informed consent of the aboriginal people.
Accordingly, the GNWT can never acquiesce or agree to Canada's devolution interpretation of the 1988 health transfer agreement.
As a result, the Government of the Northwest Territories has instructed its lawyers to take the position that if the court accepts that the legal effect of the 1988 health transfer agreement is to devolve all responsibility for aboriginal hospital care to the GNWT, then the court must go on to rescind the 1988 health transfer agreement on the basis of mistake or fundamental error as to the nature and effect of the agreement. If the court was to order rescission the result would be a return to Canada of the hospitals, nursing stations, equipment and personnel that were transferred in 1988.
Mr. Speaker, the Government of the Northwest Territories regrets exposing the current health system to the possibility of being returned to Canada, but there is no other reasonable alternative presently available to resolve the impasse with Canada. Thank you, Mr. Speaker.
---Applause