Department Of Health And Social Services

I would like to invite the Minister responsible for Health to make any opening comments.

Minister's Introductory Remarks

Thank you, Mr. Chairman. Mr. Chairman, the 1995-96 capital estimates for the Department of Health and Social Services include 344 projects totalling $10.403 million.

As you know, this is the first capital budget to reflect the consolidation of the two departments as recommended by the Special Committee on Health and Social Services. The budget reflects the beginning of an approach that will result in a better level of integration of health and social services facilities.

The first major integration will be the alcohol and drug treatment centre and the hospital in Inuvik, to be planned in the coming year. Other opportunities for integration will be explored in preparing plans for the future.

One area that will receive more attention over the coming year is housing for elders. The Department of Health and Social Services and the Housing Corporation are working together to clarify the roles of each organization. Mr. Morin and I will be tabling a strategy in the House during the winter session to deal with the provision of housing and care to elders.

Mr. Chairman, there has not been time to make major changes in the 1995-96 capital plan for the newly consolidated department. However, in consultation with communities, we will bring forward a rationalized departmental capital plan for consideration in 1995-96. Some hard decisions will be needed,

but they are necessary if the department is going to do a better job of satisfying community needs.

There are a wide variety of projects in the 1995-96 capital plan.

Functional programs will be developed for replacement hospitals. In Inuvik and Iqaluit, these will be funded under cost-sharing agreements with the federal government which were part of the health transfer agreement in 1988.

In addition, health centres will be upgraded in Fort Providence and Fort Resolution, along with health stations in Trout Lake and Jean Marie River. The design of a health station in Snare Lake and a replacement health centre in Gjoa Haven will be finalized and the construction of replacement health centres in Clyde River and Fort Good Hope will be completed.

In family support, the planning and design for a family group home in Pangnirtung will be completed.

In community development, an elders' residence will be built in Fort Resolution and the planning and design for an elders' residence in Fort Norman will be completed. Planning for an alcohol and drug treatment centre in the Keewatin will be completed and a psychiatric half-way house will be built in Yellowknife.

The remainder of the budget is for equipment, technology enhancements and renovations to existing facilities.

Mr. Chairman, over the past year, the department has consulted with communities and regions, as directed by the Standing Committee on Finance in its review of the 1994-95 plan, and it continues to work with health boards to develop community and regional health services plans.

The department is also revising its standards and criteria for capital planning and facilities. These revised standards and criteria will be completed by the end of the fiscal year. They will improve our ability to complete regional and community needs assessments, which will also improve the consultation process. Mr. Chairman, that completes my comments.

Thank you, Madam Premier. The standing committee report on this department. Mr. Ng.

Standing Committee On Finance Comments

Thank you, Mr. Chairman. The committee notes with approval that this is the first budget since the amalgamation of the departments of Health and Social Services. Committee Members hope that the new combined department will be better able to provide facilities to care for NWT residents' physical and mental health needs.

New Technologies

Members welcomed new initiatives such as capital funding for distance health system technologies, as advised by the Special Committee on Health and Social Services. This specific project will allow for remote consultations between Edmonton and Yellowknife, as well as for transmission of radiology, ultrasound and electrocardiogram data between Inuvik and Yellowknife. The committee recognizes that such initiatives may save a great deal of expense in the long term, and will improve the efficient delivery of health services to northerners. Committee Members encourage the department to pursue further developments in this area.

Alternatives To Institutions

Sometimes, there are alternatives to building institutional facilities. An example would be to consider providing home care to elders, rather than building a new elders' facility. Committee Members urge the department, however, to ensure that choices to use alternatives such as home care rather than building new facilities are made only after full and thorough consultation with those affected, with interested organizations and with all community leaders, including the communities' MLA, in the communities affected. Choosing such alternatives should never be done just to cut the budget.

In one specific example, previously mentioned in capital planning and consultation process, a proposed elders' facility in Gjoa Haven was removed from the capital plan in favour of providing home care to the Kitikmeot elders who would have used that facility. Committee Members felt that the department did not consult adequately with all community leaders, especially the MLA for that area. As a result, the committee feels that deleting the project from the capital plan was not appropriate, and that the project should be reinstated.

Hospitals New And Old

Committee Members note that projects for building new regional hospitals in Iqaluit and Inuvik have been added to the capital plan. These facilities will be of great benefit to the Baffin and Inuvik regions respectively, and the committee is looking forward to their completion. Cost-sharing assistance provided by the federal government for these projects is also worthy of note. Also, the committee is looking forward to the completion of the analysis regarding the proposed Keewatin regional health facility. If such a project will indeed be a net benefit to the people of the Keewatin and of the NWT in general, then committee Members will look forward to seeing the proposal in next year's capital plan.

Along with these new facilities, the committee encourages the department to continue to examine providing capital funding to the Stanton Yellowknife Hospital to provide services to northerners that are now only available in southern Canada. Often, the cost of new capital equipment may be more than offset by savings in travel expenses for patients. Committee Members recognize that there may not be enough demand to justify some equipment, such as a CT scanner, perhaps. But the department should constantly be looking for ways to provide more cost-effective health services to northerners in the north. Medical travel costs are increasing, and whether this is due to increased utilization or increased costs, any initiative which can reduce this item is worth examining. This issue may also become increasingly crucial if there are further cutbacks to health services in Alberta and other provinces which receive NWT referrals.

Birthing Centres

The committee again discussed the pilot project of a birthing centre in Rankin Inlet. Members are looking forward to the analysis of the project when its two-year term is completed in the next few months. It is hoped that such centres can be provided in other communities.

By allowing northern women to have their babies closer to home, birthing centres could reduce the social costs of disruption to families resulting from mothers being away from home for weeks at a time. Also, birthing centres may well be a more cost-effective means of serving women's health needs. In fact, if the project is deemed successful, committee Members would like to see future plans for health centre construction or renovation include space for possible birthing centres. This would allow these centres to be established in communities at future dates, when the community is ready for such a centre, without significant added expense.

Social Services Planning

In last year's review, the committee made a strong recommendation concerning the capital planning strategy of the Department of Social Services. Committee Members were glad to see the new combined department develop a new capital planning framework, which will be implemented in 1995. While Members have not yet been able to study the framework in detail, the mere fact that such a strategy exists is gratifying.

Committee Members appreciate that alcohol and drug abuse is one of the most serious problems facing northerners. There are a number of good facilities and programs available for helping NWT residents overcome abuse. However, many are not used to capacity and yet some northerners go south for treatment instead. The committee encourages the department to find ways to convince northerners in need of such treatment to make use of the facilities here. Not only will money be saved, but local and culturally-relevant programs may very well be more effective.

Thank you, Mr. Ng. The motion was originally read when you read the report, but this is your motion now. The motion is in order. To the motion.

Question.

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

---Carried

---Applause

Madam Premier, would you like to take the stand and bring in your witnesses, please? Do Members agree?

Agreed.

---Agreed

Members agree. Madam Premier, go ahead.

I would like to recognize Mr. Merlyn Williams, an alderman-elect to the city council of Yellowknife. He has just entered the visitor's gallery.

---Applause

Madam Premier, would you like to introduce your witnesses, please?

Mr. Chairman, I have with me the deputy minister of Health and Social Services, Mr. Ken Lovely and the director of capital planning, Norm Hatlevik.

Thank you, Madam Premier. Do any Members have any general comments, statement or questions they would like to raise with this department? Mr. Koe.

General Comments

Mahsi, Mr. Chairman. For obvious reasons, I'm very pleased with the capital plan of this restructured department of Health and Social Services. The departments have, in their good wisdom, included several projects that are urgently required in Inuvik. They were mentioned in the Minister's opening remarks. The hospital, the need for which I've been raising since I've been in this House, seriously needs to be looked at, and the planning is well under way.

Also, the group home for handicapped adults -- and when we get to that specific page, I'll be asking questions on that project -- is one that fits in with the policy of repatriating people from the south to northern institutions. Also in the plans is money for an alcohol and drug centre in Inuvik. That has to be seriously considered in view of the problems we have with alcohol and drug abuse in the north.

The one caution I would like to make is that it is really imperative in doing major project planning, that we get as much local and community input in the planning phases and, eventually, in the design phases of these projects. Without community and local support, we always seem to run into problems and we are always backtracking. I would like to say thank you to the departments for the work they've done and for listening to the concerns of the residents of Inuvik and for including the projects in the plan.

As always, though, there is something missing. I've listened very carefully to the questions and statements made by my colleagues from other communities about the need for elders' residences. The people in Inuvik are no different. There has been a needs study done; an assessment of the requirements of our senior citizens in Inuvik and I think the numbers warrant careful consideration. Eventually, we have to look at something for that community. Within the region, itself, there are a lot of elders and I think we have to look at the needs of the regions and determine the best possible locations for elders' centres.

But, generally, I'm pleased with the work the department has done in terms of capital planning and I want to say, again, mahsi cho.

Thank you, Mr. Koe. Are there any other Members with general statements, comments or questions? Mr. Ningark.

Thank you, Mr. Chairman. Mr. Chairman, in the departmental overview, item 4 implies that social well-being and independence of the aged, disabled, and mentally handicapped are supported and promoted. Mr. Chairman, to me that means that we have to look after our elders. Even when the elders are not able to look after themselves, there may be some requirement to send the elders from one community to another where there is an elders' facility.

Mr. Chairman, when we talk about the elders in our communities, we are, in fact, talking about those people who have looked after us from the time we were too young to care for ourselves. When you move an elder from his or her community to another community where there is an elders' centre, you are taking away the pride of that person, whether they be a man or a woman, especially when that person is native to his or her community. That person is taken to a strange environment, the language is different and the food is different.

I've talked to people in my area, in the Kitikmeot region, not only in Pelly Bay, Gjoa Haven and Taloyoak, but as well, other communities like Coppermine and Cambridge Bay.

Mr. Chairman, I remember many years ago, about 20 to 30 years ago, there was an elder who was too old to look after himself and he was sent to Aklavik. The communication was not very good at that time. We rarely heard anything from that person, only by word of mouth through another person who would have travelled to Aklavik and come back to the community and talked to his family. But in the end, we heard that the old man was very ill and he wanted to go back to his community. He never complained when he was in Pelly Bay. He knew he was leaving the town but he never complained. But in the end, when the man was critically ill, he finally told his family that he wanted to stay at home with his family.

Subsequently, because the man was introduced to a different community, different lifestyle, different language, different culture, that was the cause of his illness in the end.

Mr. Chairman, I have talked with the people of Gjoa Haven, especially the mayor of Gjoa Haven. The community profoundly wants their own facility for elders. Even Taloyoak wants their own facility, Pelly Bay wants their own facility, Coppermine and Cambridge Bay. We are not able to accomplish that, we know, because we don't have all the resources needed to facilitate every community. But I hope that -- and I need your support, my colleagues -- that we will be able to have a facility in the Kitikmeot; one for the west and one for the east. I also hope that every region will be able to enjoy facilities in their own region.

Mr. Chairman, I know it's very difficult and very hard to try and get a facility for every community and every region, and I know that the department is trying very hard to promote the well-being of the elders, the handicapped, the disabled and so on. Mr. Chairman, that is my comment. Thank you.

Thanks, Mr. Ningark. General comments. Any further general comments? Are we ready to go into the book? Mr. Ng.

Thank you, Mr. Chairman. These are general comments. I guess I don't have to speak on the elders' residence issue just yet; the Minister and the departmental staff are aware of my position on it. But I would like to ask for some clarification since this budget that's coming forward does have funding to two elders' residences, and we're aware that the funding from the federal CMHC has been virtually eliminated now. So, has the department acknowledged and taken on the responsibilities for funding for elders' residences now within our territorial programs? Thank you.

Any response?

Mr. Chairman, in the issue of the elders' residence and the requirement for extraordinary needs and the fact that the federal government continues not to respond to the request of restoration of funds as we've had in the past, the department, with the Housing Corporation, feels compelled to try to address the problem with the resources that we do have. But that is not to say that the communications with the federal government and federal agency are not ongoing. However, there are some needs that have to be met and we're going to try to do that with bringing together a strategy on some of those immediate needs, as well as a longer-term strategy on housing for elders.

Mr. Ng.

Thank you, Mr. Chairman. In relation to a different item, family violence shelters, that I had spoken on earlier. I recognize that the department doesn't provide capital, but I know it's related to the overall budget in that they provide operating funds for these shelters. So, does the department, first of all, have any family violence shelters that they actually own outright, or is it strictly that they provide operating money for existing facilities, I would like to ask. Thank you.

Thank you, Mr. Ng. Madam Premier.

Mr. Chairman, the Member is correct in saying that we do provide contributions for such a program, but we do not, to my knowledge, have ownership of any particular building in that category.