Mahsi, Mr. Speaker. I would like to say a few words about what we heard. During our five days in the region people told us many things. Some of the issues echoed those we had heard in the Keewatin. Other concerns expressed were unique to the area. Underlying many comments was a central theme: people want more local resources, more access to services, more skills, more training and support for local staff and, especially, more local control over the services provided to community members to help them meet their personal needs.
On the other hand, we heard many calls for the Government of the Northwest Territories "to do something" about many things. It was as if some saw the territorial government as the only party who could take action to address many of the concerns raised. This was the case even when the mandate and opportunity was already there for the issues to be resolved locally. Much of what people saw as being wrong did not meet government policy or program changes, just local community action.
An example of this centred around concerns in one community about access to health services. Some residents noted the lack of reliable transportation to the health centre. They also told us their concerns with the current sick clinic schedule. They looked to our committee for resolution of these concerns. In a meeting with local health personnel we heard of their frustration that they could not get out into the community to liaise with local officials and gain community input. The staff wished for the establishment of a local health committee that could help them plan clinic hours and clarify other local needs and priorities.
Both residents and local service providers wanted the same thing. Neither group appeared to realize this however, because there was no communication between them. To resolve the issues facing them in their community, they need to start talking to each other. With some time to sit and talk together, the two groups will probably discover that they do want the same things. To allow that to happen, staff will need time away from their service provision duties and residents may need some encouragement to share their concerns with staff. Here, perhaps, the Government of the Northwest Territories could help by providing relief staff or skills training for local health committee volunteers. Such basic support for efforts to build on local strengths and abilities can play an important role in preparing communities for taking on more responsibilities in both health and social service delivery.
I would like to quote from Jim Antoine, MLA, "There is a real need to develop the communities to a level where they are able to even start thinking or talking about taking over programs and services."
A complicating factor is that there is not much ongoing support available to develop community leadership skills. Training in community development used to be part of the preparation for settlement and band councillors and administrators. Workshops on an approach to community development called "popular education" were offered through the Department of Health. They are no longer being offered. At Arctic College, out of a curriculum of 20 courses, social work students now take two courses in community development. Given this situation, there is little opportunity for training to help empower community members and to support them in their efforts to take more control over local services.
As far as we are aware, there is currently only one community development worker now doing such work. This lone worker is employed by the Status of Women Council and works with women's groups. Some northern consultants also have strong community development skills but few communities have the resources to pay for these services.
What follows is an overview of the major issues that were raised during our consultation. The issues are arranged according to the subject or to the target group to which they primarily apply.
Health Care Delivery
Improved access to services and more local control over those services were the most common issues raised in the area of health care delivery. There were many calls for the establishment of a regional health board. Concerns were strongly expressed that people did not feel as if they had meaningful input into the decisions being made about their health care. Some speakers did not believe the current regional health planning initiatives would be successful. They saw it as a process imposed by the department that was not accepted by the residents.
In Fort Simpson we clearly heard that residents did not want any reduction in their access to health services. Some called for improved and expanded services. We heard constructive suggestions about how existing community resources could be restructured so as to better meet local needs for services like extended care and home care services. Such suggestions may be of great help to the community health working group grappling with these issues, if they first deal with the issue of the credibility of the process.
In Hay River and elsewhere there were concerns expressed that the composition of the H H Williams hospital board did not reflect the profile of the population that it served. Some expressed strong concerns that the religious beliefs of the sponsoring body and of some staff meant that women have been denied abortion or birth control related services.
Various groups told us that they did not feel that they treated fairly by the health care system because of their age or ethnic background. Specific cases were presented to us where individuals were misdiagnosed or otherwise poorly served by the system.
People in small communities wanted more ability to respond to local health emergencies. They called for better communication to outside resources and for stronger pain medication to be available while they waited for help to arrive. People in all communities wanted access to a wider range of health services, including traditional health. We were told of cases of staff "jigging" the books to cover the costs of sending someone to a traditional healer. There were calls for more and legitimate access to such traditional methods of health care.
Participants wanted more resources spent on prevention. Both health care providers and service users called for more prevention, but we sometimes got the feeling that each party thought that the other group did not support it.
Residents wanted to reduce the turnover of medical staff. Home care was also supported.
This range of concerns about health care delivery suggest that the current health planning efforts in the region will be a challenging process.
HIV/AIDS
Some speakers expressed strong fear about getting AIDS. They wanted to know who had AIDS so they could take steps to avoid getting it. Some speakers wanted regional statistics released on people who are HIV positive:
"It will tell us and our children that this thing is very near us," helping make the issue more real and making the people more aware and more careful.
Others feared that they may be HIV positive but were afraid to get tested locally in case word got out that they were doing so. Some youth said that they did not have enough information on the disease. Social service workers raised questions about who could give permission for testing of children in foster care. They also called for training about AIDS and about how to work effectively and safely with HIV positive clients.
Mr. Speaker, I would like to turn over the next portion to my colleague, Dennis Patterson.