Yes, go ahead, Mr. Dent.

Thank you. Mr. Minister.

Thank you, Mr. Chairman. The two documents Mr. Dent mentioned have gone to the boards at the present time. Medical professionals also have some input into the documents. I gave them to the boards on February 1 or 2 of this year. They are to be discussed at the next meeting, which was to take place in your constituency of Taloyoak in April. Thank you, Mr. Chairman.

Thank you. Mr. Dent.

Thank you. The honourable Minister.

Mr. Chairman, I would like to back up a little bit and I hope Members will bear with me. I'll use the example of the western Arctic and the Kitikmeot and perhaps you can see where the medevac and the standards fit into this overall plan.

If we look specifically at Inuvik, we have a hospital there that is able to deliver a certain level of care for people. It handles certain emergencies and does certain procedures. Patients flow from another community, say Tuktoyaktuk, into the Inuvik hospital and if they cannot be treated there, they would be forwarded to Stanton, which can do more work than Inuvik. Theoretically, if that patient can't be treated in Stanton, then that person would be forwarded to the Royal Alec, which is the hospital in Edmonton that we are presently making arrangements with to handle people from the western Arctic and from the Kitikmeot.

How do we decide to move that patient? There has to be a certain level of care that we're confident is available at all times in Inuvik and if it's not available for a particular time, we have to know that it's not. There has to be an assessment made of the patient who is in Tuktoyaktuk and if he or she should be sent to Inuvik. If he or she cannot be sent to Inuvik and it is Stanton, then we have to look at the amount of care that is going to be delivered at Stanton and whether they can handle the emergency. If that hospital can't handle the emergency, then we know that we want to send it on to the Royal Alec.

There needs to be communication from the nursing station, the health centre, the physician who's attending this person to some person who says that case has to go to this particular location. Once that's been done, then we have to transport that person. In order to efficiently transport that person, we don't want to be first flying that person to Inuvik and finding out that he or she should have gone to Stanton and then finding out that Stanton really shouldn't have had the patient and the patient should have gone to Edmonton. That is wasting a lot of time. In many instances, in emergencies, there's not a lot of time that can be wasted.

So, we now need to put together a plan that works with the flow of the patients from the small communities into the regional hospital, into the larger regional hospital and then into the southern hospital. That has to work hand in glove with the medical requirements. It also has to work with what we perceive in the Northwest Territories as a logistical problem -- it sometimes becomes a political problem, and it is certainly is an economic problem -- on how you decide which carrier is going to get the medevac.

Just recently, we've had at least three or four Lear jets coming in from Edmonton. I'm going to try to find out why we are using planes from south of the 60th parallel when there are certainly planes in the Northwest Territories -- at least all the air carriers tell me there are. So, what the boards and I have agreed on -- and this is just the one thing we've agreed on at the present time -- is that we will try to base aircraft regionally. I don't know how we'll do that. We're certainly not saying that all the medevacs will come out of Yellowknife or Iqaluit. We're saying that we will deal with medevac aircraft on a regional basis.

Now we want to work the boards and see what their suggestions are. They know their areas best. Cost is a big consideration, too. We don't want a Lear jet delivering a patient who could have been handled much better, size-wise anyway, in a King 400 and when time wasn't of the greatest essence, it was just getting the patient in stable condition to another facility. That's where this issue fits into the plan. It is the orderly flow of patients, when they have to go from their home community to another community -- be it Inuvik, Edmonton or Yellowknife -- for treatment.

Mr. Chairman, as I said, we've only agreed so far on doing it on a regional basis. The next thing we'll have to decide is if a plane is out of a region and there's another one required -- and that happens quite regularly -- how we backfill that aircraft and where it comes from. That leads me to believe that we're going to have to have some sort of central despatch system. If you look at the situation where you may have a physician in a central location saying the best place for this patient is this place, we would want to say that because this is the best location, the closest aircraft to you that we have an arrangement with is here, and that aircraft is available because it is on a ready board.

That's what we're trying to do, to work out these arrangements with the boards. Logistically, it's hard to do. We're changing things that have been in place for a long time. In many instances, it's changing some of the physician's views because they are so used to doing things in a certain way. It's going to take some time. I anticipate that we will be able to say that we've reached an arrangement on how to do that some time this summer and would look for implementation some time later on this year. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, when I said that I hoped that some time in the summer we would have a plan, I suggest that then we will go to the carriers. I have promised all the carriers I have spoken to and I've promised MLAs in this House that we will not make another move after coming up with how the boards and the Department of Health want to handle this, without sitting down and talking to the carriers.

All carriers in the Northwest Territories, as far as I'm concerned, will be eligible to come to a meeting and discuss with me what we are trying to do. They may want to suggest to us some of the ways they could support each other if we are going to go on this regional basis, simply because there will be times when there won't be enough aircraft in a region. After having talked to the carriers about the logistics and the standards that we are asking for in aircraft, then I would suggest to the carriers that they may want to make recommendations on a process to acquire those services from northern companies.

Mr. Chairman, I may not take their recommendations, but as they are the transportation specialists, it would be only right to give them a chance to say collectively what they would propose to meet our objectives and to feel they're being treated fairly in the Northwest Territories. Thank you, Mr. Chairman.

Mr. Chairman, if we're successful in having some arrangements between ourselves and the boards by the summer and in sitting down with the carriers and getting their input, then it would be my intention to place before this House in the fall session the plan about how we intend to go about seeking aircraft services in the Northwest Territories. Members could then comment and give me their considerations of our suggestions. In the latter part of the year, then we would either go to tender, proposal call, or whatever falls out of the consultative process. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. The Member is correct. We looked at other jurisdictions, namely Alberta and BC, although we did look further afield as well. We have consulted with Public Works, which is responsible for air charters, formerly Government Services. We talked to medical experts. We have had some considerable documentation from St. John's Ambulance on problems that they have experienced. I had asked for other problems that they have had, so we were fairly well aware of the problems that we were experiencing. We put that together with what other jurisdictions had done. We talked to the professionals about when speed is important or when room to manoeuvre on an airplane and get around a patient is more important. From that, we came up with the standards that the Member is in possession of. Thank you, Mr. Chairman.

Mr. Chairman, I have taken it as far as I would like to go right now without consulting or getting the feedback from the hospital and health boards. I think it is a reasonable document. They may suggest that, ultimately, we have to get some further expertise. I am certainly expecting some constructive criticism from the industry when the standards are placed before them. My nervousness about bringing in some southern expert who has done this before is that we will get an imprint upon ourselves of some other jurisdiction, whereas, I think in the Northwest Territories, there is already much knowledge within this government with regard to aircraft. There is certainly enough expertise around in the industry so that, as we get into late summer, and the industry sees what we have placed before it, if there are concerns or technical considerations, then, at that time, Mr. Chairman, I will consider bringing in a technician to straighten the thing around. I don't think there is a need for it at the present time, though. Thank you.