Thank you, Mr. Chairman. Mr. Chairman, on my left is Dr. David Kinloch, who is the deputy minister of Health and on my left is Darrell Bower, who is director of finance for the Department of Health. Thank you, Mr. Chairman.

Thank you. Mr. Antoine, you can now proceed.

Standing Committee On Finance Comments

Thank you, Mr. Chairman. In our report on the review of the 1994-95 main estimates of the Department of Health, we made the following recommendation regarding the Department of Health.

The committee recommends that the Department of Health develop a concrete plan for implementing the recommendations of the following groups:

-the Auditor General of Canada;

-the Standing Committee on Public Accounts;

-the Special Committee on Health and Social Services;

-the Standing Committee on Agencies, Boards, and Commissions; and,

-the Standing Committee on Finance.

The committee further recommends that the department report on how they plan to improve policy development capabilities within the department. The committee expects the department to presents its implementation plan as a prerequisite to the approval of the department's 1994-95 budget.

Mr. Chairman, on February 22, 1994, the Standing Committee on Finance received the Department of Health's response to recommendations of the Auditor General of Canada, the Standing Committee on Public Accounts and the Standing Committee on Agencies, Boards and Commissions. All of these responses were received late, contravening the rules of this House. These responses were tabled in this House yesterday by the Premier.

The first review of the comprehensive audit of the department was undertaken by the Auditor General of Canada in response to a Standing Committee on Finance recommendation. The comprehensive audit was conducted in late 1991 and early 1992. The Auditor General's report, which contained some 42 recommendations, was tabled on November 17, 1992. The Department of Health provided its response to this recommendation on February 22, 1994, to the standing committees' concerns.

The Standing Committee on Public Accounts held public hearings on the matter of the Auditor General's report on several occasions during the early months of 1993. This committee tabled its report with 28 recommendations on March 24, 1993. The process of following up the Public Accounts committee recommendations began in August 1993, in preparation for the September 1993 committee meetings.

The Department of Health provided a status report on its responses just prior to the commencement of the September meetings. When departmental officials appeared before the committee, Members were informed that this was not the official or formal response to recommendations, but rather an update on activities taken. Department of Health officials said that the official response would be submitted to the committee by the end of September, 1993. However, Mr. Chairman, the Public Accounts committee did not receive the formal response from the Department of Health until about five months later on February 22, 1994.

The Standing Committee on Agencies, Boards and Commissions, over a 14 month period in 1992 and early 1993, held public hearings and consultation processes with health and hospital boards and studied written submissions and other research material. The Standing Committee on Agencies, Boards and Commissions tabled its report, complete with ten recommendations, on March 15, 1993. The final recommendation of this committee required the Executive Council to table a comprehensive response within 120 days of the presentation of the report to the House.

Mr. Chairman, the Department of Health responded some 11 months later on February 22, 1994. In addition to the lateness, committee Members are very disappointed with the content of these responses provided by the Department of Health. The responses to each group were separate and no summary was provided. It appears that the responses to the various groups have not been coordinated by the department. Common issues or themes have not been identified.

In summary, Mr. Chairman, the responses demonstrate a lack of overall planning, coordination and monitoring in the department. Committee Members were disappointed to discover that, while mention is made in the responses of very strategic planning initiatives, no mention is made of an overall departmental strategic plan.

In addition to being late in responding to committees of this Legislature, the department missed many of the deadlines suggested in the recommendations and many self-determined

deadlines. This would suggest that the department is unable to lay out a realistic plan of activities and stick to it.

For example, during the September 1993 Public Accounts committee review of the department, the deputy minister assured committee Members that the functional review, which had been initiated at the time, would be complete by the end of the calendar year. The department is now saying that the final report of the functional review will be provided to the project steering committee by March 31, 1994. No target date has been suggested for its completion.

A specific illustration of the department's difficulty with planning is provided by the response to the Public Accounts committee recommendation which suggests that the department prepare and update regularly a document which formulates, defines the rationale, purpose and substance of The NWT Way for health delivery. The response is, "In June 1993, a draft document was developed and discussed by board chairs, CEOs, the Department of Health and professional health organizations. The final draft is expected to be ratified through the MOU process. The current estimated completion date of the MOU process is December 1994."

Mr. Chairman, yesterday, the Premier tabled two additional documents. One was a response to the Committee Motion 9-12(5), to adopt recommendation 20 of the Standing Committee on Finance. Committee Members were not at all satisfied with this document. It provided no evidence that the department has started developing a cohesive approach to dealing with the recommendation of the Auditor General and the committees of the Legislature.

A second document tabled yesterday by the Premier was entitled Renewed Partnerships. This document was developed in response to Talking and Working Together - the final report of the Special Committee on Health and Social Services. The Special Committee on Health and Social Services tabled their final report with 32 recommendations on November 18, 1993, and requested that the Executive Council respond within 120 days. The deadline has been missed by only a few days.

Mr. Chairman, although committee Members have not yet had an opportunity to thoroughly review the Renewed Partnerships document, it appears to be a considerable improvement over previous responses to committee recommendations. The response was a collaborative effort of a number of departments and was developed within the context of a number of major government initiatives.

The specific recommendations are arranged around nine major themes which reflect the current priorities of government and concerns expressed by the special committee. Many of the responses contained target completion dates and some refer to the resources required to implement plans.

However, Mr. Chairman, it appears, after our cursory review, that even these responses fall short of the committee expectations in terms of a concrete action plan which clearly demonstrates a cohesive approach in delivery of health services in the Northwest Territories. While recognizing the need for consultation, the committee still expects the Department of Health to take a leadership role in the timely development of such an action plan.

Committee Members recognize the effort that is involved in responding to legislative committees and the need to get on with the business of delivering health services to the citizens of the Northwest Territories. On the other hand, legislative committees and the public need assurance that the many important issues that have been identified will be addressed by the department and by the government in a timely and effective manner.

Therefore, the committee has structured a recommendation to the Department of Health in such a way as to assist the department and the government in focusing its efforts in the delivery of health and social services.

The recommendation also allows for consultation with health boards and other stakeholders. The Minister informed Members of the committee of the whole that he was unable to provide a plan to the Standing Committee on Finance during this session because it did not allow time for consultation. The Standing Committee on Finance understands that a meeting of board chairs and other stakeholders has been set for April 1994, in Taloyoak. Further, the department's responses to the Auditor General and the legislative committees indicate that most, if not all, of the major initiatives being undertaken by the department at this time will be discussed at that meeting.

By complying with this committee recommendation, the department will be able to provide some assurance to legislative committees and the public that issues and pressing concerns have been properly addressed.

Recommendation That The Department Of Health Develop A Two-Year Action Plan

The committee recommends that the Department of Health develop a concrete two year action plan which responds to the major issues raised in the reports of the Auditor General and the legislative committees. The committee further recommends that this action plan contain realistic milestone and target completion dates as well as the estimate of the resources required to implement the various elements of the plan.

The action plan should be provided to the Standing Committee on Finance no later than May 9, 1994. The department should be prepared to attend public hearings to explain this plan and answer questions about departmental responses to committee and Auditor General recommendations.

The committee recognizes that, during the life of this Assembly, a number of different Cabinet members have assumed responsibility for the Department of Health portfolio. On the other hand, there has been little turnover in the senior administrative staff of the department. When the Minister next appears before the committee to justify his action plan, Members will expect the Minister to explain why senior staff have been consistently unable to respond in a satisfactory and timely manner to the recommendations of the Auditor General and legislative committees.

Mr. Chairman, I have a motion now.

Thank you, Mr. Antoine. Proceed with the motion. Madam Premier.

Mr. Chairman, may we have a copy of those opening statements, please? Thank you.

Thank you. Mr. Antoine, I believe we have a copy here. Yes. It will be distributed right away. Mr. Antoine, proceed.

Thank you, Mr. Chairman.

The motion is in order. To the motion. Madam Premier.

Before we proceed with this motion, Mr. Chairman, I would like to have a copy of those opening remarks that the chairman made, because there are some points in the opening remarks that refer to the motion. Thank you.

Thank you. I believe the copy of the statement is on the way. In order to accommodate the Premier, we will take a five minute break. Agreed?

Agreed.

---Agreed

Thank you.

----SHORT RECESS

Thank you. The committee will now come to order. I believe the statement by the chairman of the Finance committee on behalf of the Standing Committee on Finance has been distributed. There was a motion on the floor prior to the short break we took. I would caution the Members of the committee to be very careful in the choice of words they use, not to offend the Crown. Thank you. I know this is a big department with big concerns and it is pretty emotional, but be very, very careful about the kinds of words used in this committee. Use of such words in this committee is not appropriate.

Regarding the motion on the floor. The motion is in order. To the motion. Madam Premier.

Mr. Chairman, in the statement that refers to the motion, I think there is recognition that for a number of years the department has faced a great deal of scrutiny. Perhaps that's because this particular department is a department that takes care of a lot of sensitive issues that relate to our constituents.

There have been continuing requests for replies to reports of one committee after another, plus the Auditor General, including the Standing Committee on Agencies, Boards and Commissions. There are deadlines for requests for information and requests for responses to recommendations.

The motion suggests that the department should be prepared to attend public hearings to explain its plan and answer questions about departmental responses to committee and Auditor General recommendations. I would like to get clarification on the scope and design of how the department is to take part in these public hearings. Is it the Standing Committee on Finance that is going to be having these public hearings? What is the anticipated time that the department is going to have to spend in these public hearings? I would like clarification. Thank you.

On behalf of the Standing Committee on Finance, Mr. Antoine.

To answer the question on who is conducting the public meetings, it will be the Standing Committee on Finance. We're looking at one or two days. We would like to get an action plan from the Department of Health by no later than May 9 and the Standing Committee on Finance is planning to meet the following week to look at the action plan and decide at that time the dates for a public hearing on this, perhaps in June. Thank you.

We are dealing with a motion here and I would remind Members to stick to the principle of the motion. Madam Premier.

Mr. Chairman, the motion indicates that recommendations from several other committees plus the Auditor General will become the framework of the public hearings that the Standing Committee on Finance will be holding. Will the Standing Committee on Finance be holding hearings on behalf of other committees of this Legislative Assembly? Is that my understanding? I'm not quite clear on that.

Thank you. Mr. Antoine, would you like to clarify this?

The motion we're making is consistent with the recommendation we made when we started dealing with this department during the session. That is to have a concrete plan for the implementation of the recommendations of the following groups: the Auditor General of Canada, the Standing Committee on Public Accounts, the Special Committee on Health and Social Services, the Standing Committee on Agencies, Boards and Commissions and the Standing Committee on Finance. These are the committees that this recommendation is making reference to.

These recommendations have already been made to the Department of Health. We would like to see a concrete action plan of how all these recommendations will be developed by the department. That's what we're looking for. Thank you.

Thank you, Mr. Antoine. Madam Premier.

Just a further clarification. I realize I am, as usual, concerned that we try as much as possible to respect the time set to respond to various demands from the standing committees, but previously it seemed to be that when the Standing Committee on Agencies, Boards and Commissions had a concern, we responded to that committee. Then, we made a response to the Standing Committee on Public Accounts. But, this is an all-inclusive recommendation, taking in all the various committees. Some areas are not really financial matters, but deal with policy, scope and other questions.

I know Members realize how much there is to respond to. Is it the intent that all the recommendations from all these other committees be dealt with? Is this a different type of approach, where you are incorporating the recommendations of the Standing Committee on Agencies, Boards and Commissions with the Standing Committee on Finance? Is this a new approach, where all these different agencies and committees will be incorporated? I'm just trying to get some clarification.

Thank you. To the motion, Mr. Antoine.