Thank you, Mr. Chairman. These health profile studies of the communities, even if the department initially starts them, could be the blueprint or one way to get the community involved. We should work on that and develop it further from there on. I certainly could work with Mr. Antoine, I could discuss this further and get more information on other commitments that were made before I received the portfolio. Thank you.

Thank you, Mr. Chairman. Another concern I have, and I raised it during the discussion with the public accounts board, is with regard to training. I was going to make a Member's statement on that until the Minister of Education, Culture and Employment Programs made a statement that there is going to be a registered nurse program in Arctic College. In your definitive objectives, this department is going to assist Arctic College with implementation of a registered nurse program, which is a good step in the right direction. There are other types of training that could be offered in the Department of Health besides registered nursing. People in the north may want to take on careers in the health field other than just registered nursing. Is this department going to implement training programs in other areas besides registered nursing? Thank you.

Thank you, Mr. Chairman. In the management level, there have been training positions identified. Thank you.

Thank you, Mr. Chairman. You indicated there is going to be training in the management area, but are there going to be other areas in the health profession that training and education will be provided for? Thank you.

Thank you, Mr. Chairman. Yes, we are going to be looking at what other health professions can be made available for training. Thank you.

Thank you, Mr. Chairman. On November 24, 1992, my honourable colleague for Natilikmiot asked the former Minister about the length of time that doctors and specialists are remaining in communities when they go into these communities. Many of the people in the communities believe these professionals are not coming often enough and are not seeing as many people as they should when they visit the communities. The former Minister had agreed to ask the department to review whether there are ways to improve the level of service being delivered. Can the Minister tell us whether this review has been completed?

Thank you, Mr. Chairman. I was not aware there was a commitment made by my predecessor. Being new to the portfolio, I would much rather have the regional health boards deal with these because they are the ones that do the scheduling, not the Department of Health. Certainly, as the Minister of Health, I could try and provide my advice, but most of the regional health boards function on their own. They are at arm's length. I could consult with them. I would prefer that be the only kind of relationship I have with these health boards. The decisions are usually made by the health boards. The number of visits to the communities by the health professionals are decided by the regional health boards. Thank you.

Thank you. The Minister probably knows that, in my constituency, we do not have a health board. We have a public administrator by the name of Tom Menzies. He seems to be calling all the shots in these kinds of decisions. It is not a health board that makes these decisions. For us, he is more than arm's length away. He is in Yellowknife. The decisions he makes are made from Yellowknife, not from our

communities. The people are asking that the doctors and specialists who go to the communities go more often than they have in the past and they see as many people as they should when they are there. They have been asking that for a long time. Nothing seems to be happening. We are here to tell you, as Minister, what people tell us. I am not saying this for the sake of talking, I am saying this because this is what I have been asked to tell you and your staff. They want to see these people coming in more often for eyes, teeth, ears, nose and throat. There is a need for more visits.

I have another question with regard to nurse practitioners. I know the government has been working hard to develop the role of nurse practitioners. People expect doctors and nurse practitioners to provide primary care. This would mean the doctors will be more like consultants in supporting role functions. There is confusion at the community level about what residents should expect doctors and nurses to do. What is the Minister doing to clarify the nurse practitioner model both within the nursing and medical professions and within the public at large?

Thank you, Mr. Chairman. I will let Dr. Kinloch answer that.

Thank you, Madam Minister. Mr. Chairman, the delegation of functions from one professional to another is well-advanced in the Northwest Territories. For nurses, it is governed by a protocol which was developed jointly by the Northwest Territories Registered Nurses' Association and the Northwest Territories Medical Association, with involvement of the department. It sets out those circumstances under which functions may be delegated for performance by a nurse, not only those that are currently delegated, but the circumstances that could prevail for future delegation.

The functions of nurses are expanded through continued training, such as the ANSIP program and through other specific training programs as well. There is a regular discussion of these matters with the professional associations with a view to ensuring delegations are appropriate and are appropriately monitored.

Thank you, Mr. Chairman. I was going to save my general comments for the detail, but since other Members have talked about the planning exercise, I would like to make a few comments at this time. Mr. Chairman, the honourable Minister is aware of the tremendous pressures which have been put on the 30 year old Baffin hospital. As I see it, the pressures are not just numbers of patients but current needs, such as chronic care, dealing with the mentally ill and people who have mental health problems, dealing with AIDS patients, dying patients, and palliative care. The hospital was not designed to meet those needs. I think it is simplistic to say that the only problems the Baffin hospital has been dealing with is that it has been crowded. I am aware of the fact that patients have been put in the hallways. Most patients are handled by the very busy out patient clinic, even patients from out of town.

Mr. Chairman, I am also aware that, over the years, many planning activities and studies have already taken place with reference to the Baffin hospital, even to the point a few years ago when I was involved in consultations about possible sites for a new hospital facility. I am not sure that all of those planning activities were ever brought together in one coherent package. I am very pleased that, as I understand it, the monies set aside in this year's operations and maintenance budget will allow a comprehensive planning exercise to take place in an orderly fashion. As I understand it, the planning exercise will assess the adequacy of the present health services in the Baffin region, in each community, what is working and what is not, and then it will assess how needs could be delivered and how existing services can better be delivered. I understand it may well be that in many cases a serious option will be to deliver even more services at the community level, rather than at the regional hospital, which happens to be located in my constituency. This is perfectly fine with me. I think it is cost-effective and it is more humane to deliver the maximum services closer to home.

I am delighted to learn that the research which will be undertaken in the Baffin, and which I believe is being undertaken, will involve community health representatives as a key device for the community consultation. This makes a great deal of sense to me and is a way of getting credibility for the study that, I hear from other colleagues in this Assembly, may be lacking in other regions. If we can take full advantage of the local knowledge of the CHRs in the Baffin, we will be well ahead in seeking an accurate picture of what people in our communities want.

Thank you, Mr. Chairman. One of our staff has just recently returned from the Baffin, and has not made her report yet. As soon as this is ready, we would be more than pleased to provide Mr. Patterson with the status of the process which is going to be used in the Baffin region. Thank you.