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

---Carried

Mr. Koe.

Planning For The Future

Thank you, Mr. Chairman. The Standing Committee on Public Accounts played close attention to the third chapter of the Auditor General's report which deals with

the absence of a plan to direct initiatives and expenditures within the Department of Health.

Over and over during the public hearings, the standing committee heard evidence that the lack of planning has implications on all the stakeholders. It is having an implication, for instance, on leasing arrangements for ambulances and on other capital planning decisions. It is having an impact on human resource allocations. It is having an impact on the budgeting process and it is something which has been affecting the relationship between the department and the regional health and hospital boards.

In many ways, and the Auditor General was clear, the fact that there is no plan for the Department of Health can be seen to be at the root of most of the problems that have been identified. The Auditor General describes the department as being in a "planning to plan posture." The Standing Committee on Public Accounts found that to be a very accurate description of what we observed. The Auditor General's report gives examples which show that over and over the department has initiated processes for planning, only to have them stall and never achieve completion. For example, a work load assessment study for nurses was begun and never finished due to staff shortages. A functional review of the department was supposed to take place and was never finished due to due to consolidation. Work to improve the receipt of cost data on health insurance services was undertaken and has been set aside due to the decentralization initiative. The Department of Health has been spinning its wheels because there is not an adequate process for planning. The standing committee is of the opinion that this area has to be addressed. We have a number of recommendations that we will be discussing in a few minutes. However, I should note that the committee cannot, at present, support the remarks which the Auditor General made with respect to the status of private medical clinics in the Northwest Territories. This is something which is dealt with on page 40 of the committee report and I would invite honourable Members to comment on this if they wish to.

Mr. Chairman, I have a motion. I move that this committee recommends that the Department of Health should complete a functional review quickly and ensure that it considers all headquarters functions.

The motion is in order. To the motion. Mr. Koe.

Thank you, Mr. Chairman. Apparently, this is something which the department started to do but then stopped when the plan to consolidate Health and Social Services was developed. The standing committee is of the opinion that it is wrong to put everything on hold until after the departmental consolidation is completed. The committee learned through public hearings that the department needs to take a good hard look at the mandates and performance of each of its divisions and plan how these should be developed over the years to come. A functional review is badly needed and should be completed even though there may be some costs. This is the reason for the motion and I hope Members will support it. Thank you.

Thank you. The motion is in order. There is no quorum. Mr. Clerk, please ring the bell.

Thank you. The chair recognizes a quorum. To the motion.

Question.

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

---Carried

Mr. Koe, please proceed.

Mahsi, Mr. Chairman. I have another motion. Recommendation number five, I move that this committee recommends that the Department of Health prepare, and when necessary, a regularly updated document which formally defines the rational, purpose and substance of "The NWT Way" for health delivery;

And further, that the Department of Health develop a process through which stakeholder organizations and others can provide input into the ongoing formulation of this approach.

The motion is in order. To the motion. Mr. Koe.

Question.

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

---Carried

Mr. Koe.

Mr. Chairman, I have another motion, recommendation number six. Mr. Chairman, I move that this committee recommends that the Department of Health prepare, in consultation with health and hospital boards, aboriginal organizations and other health stakeholder groups, a plan for the ongoing administration and delivery of health services in the Northwest Territories;

And further, that a draft version of the plan should be brought forward no later than December 31, 1993.

The motion is in order. To the motion. Mr. Koe.

Mr. Chairman, the reason for the motion is self-evident. The Auditor General's report points out that there is a definite need for an overall plan for health services in the Northwest Territories. The standing committee agrees and is recommending this as a much needed approach to addressing the confusion which currently exists. Mahsi.

Thank you. To the motion.

Question.

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

---Carried

Mr. Koe.

I have another motion regarding recommendation number seven. Mr. Chairman, I move that this committee recommends that the Department of Health accord a high priority to the development of work load assessment instruments and procedures applicable to nurses in the Northwest Territories;

And further, the Department of Health, in consultation with the NWT Registered Nurses' Association and other stakeholders, should carry out work load assessment studies which enable better planning for the allocation of nursing resources.

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

Mr. Gargan.

Managing People

Thank you, Mr. Chairman. I will be reading the portion of the report which deals with human resource management. This is one of the areas in which the committee's concerns were the greatest. In particular, Members were absolutely dismayed at the poor job the department has done with respect to the hiring of aboriginal people and promoting health careers for aboriginal people. The department simply cannot continue to stand back and wait for the education system to turn out doctors or nurses who are Dene, Inuit or Metis. They cannot continue to sit back and wait.

This is a point which was made by my honourable colleague for Nahendeh when he appeared before the standing committee. His presentation had a significant impact on the way Members look at this issue. The department should be targeting people in the communities and helping them realize career goals in the health profession and in health administration. That is something which Mr. Whitford stressed repeatedly along with other Members. This has to be planned within a reasonable workable strategy. Presently, headquarters has only about 11 per cent aboriginal representation. That is unacceptable. The health and hospital boards are doing a little better, about 40 per cent on the average but it is not good enough. Later I will be making a number of motions in this area. It is something which the Department of Health is going to have to address.

The committee was also concerned about certain personnel management procedures and especially about the need to ensure adequate cross-cultural awareness. We will be making motions in that area as well.

There were a couple of areas in which the committee was not prepared to support the Auditor General's recommendations. First, the Auditor General's recommendation that the department should develop performance standards for doctors. The standing committee is of the opinion that this should not be attempted until a college of physicians and surgeons is established for the Northwest Territories.

Secondly, the Auditor General recommended that the recruitment function of the department's human resource management division should be eliminated. The standing committee heard strong presentations from some of the regional boards, and especially from the Kitikmeot regional health board, that this would not be a good idea. Accordingly, the standing committee is not recommending any change in this area. Mr. Speaker, if there are no general comments, I would like to make a motion.