Thank you, Mr. Chairman. I have another motion. I move that the committee recommends that the Cabinet prepare a transition plan which would assist the Cabinet of the 13th Assembly in the management of the affairs of the government; and further, that this plan should be completed in time for the standing committee to review it and report its findings to the Cabinet before the dissolution of the 12th Legislative Assembly. Mahsi.
Committee Motion 26-12(7): To Adopt Recommendation 2, Carried
In the Legislative Assembly on February 23rd, 1995. See this topic in context.
Committee Motion 26-12(7): To Adopt Recommendation 2, Carried
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
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Jim Antoine Nahendeh
Committee Motion 26-12(7): To Adopt Recommendation 2, Carried
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Committee Motion 26-12(7): To Adopt Recommendation 2, Carried
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An Hon. Member
Question.
Committee Motion 26-12(7): To Adopt Recommendation 2, Carried
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The Chair Tony Whitford
Question has been called. All those in favour? All those opposed? Motion is carried.
---Carried
At this point, we will now take a short break.
---SHORT RECESS
Department Of Health And Social Services
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The Chair Tony Whitford
The committee will again come to order. Does the Minister responsible for the Department of Health and Social Services have any opening comments? The Honourable Nellie Cournoyea.
Minister's Introductory Remarks
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Nellie Cournoyea Nunakput
Thank you, Mr. Chairman. The budget for Health and Social Services has increased from $257.964 million in 1994-95 to $262.237 million in 1995-96, for a total increase of $4.273 million or two per cent. This is a significant increase in these economic times. The budget that is being presented for your review is a true consolidation of two previously separate budgets. It has been a major achievement to consolidate both the capital and main estimates in a few short months.
The consolidation at headquarters is now complete. There is an appropriate integration of both Health and Social Services functions throughout the department and it has been possible to eliminate 14 person years as a result of the reorganization, and to save money in operations and maintenance for a total savings of $1.2 million. These savings will help to offset some of the increases that are being recommended in this budget. I am convinced that the decision to consolidate was a good one and this is reflected in immediate cost savings.
The consolidation at the regional and community level will not proceed as quickly as it did at headquarters. That is because we will have to proceed carefully in the restructuring to avoid disruptions to the existing level of community service. A major priority over the coming year will be the development of a funding formula designed to provide equitable resources to all regions in both Health and Social Services. As well, it will be important to examine the existing governing structure for departments in the social envelope.
It is true that boards of management are expensive, but this price has to be paid to ensure a level of public involvement in the system and to make the system responsive to the needs of communities. However, having separate boards of management for health and education, along with separate community justice and housing committees, is not only costly, but may be fragmenting the system in communities to the point where there is not enough interagency cooperation for effective government.
I have been approached by the Dogrib region to try an experiment aimed at establishing one community services board that would combine health and social services and schools. This would recognize the fact that it is difficult to locate qualified residents to sit on a board of management with a large budget and it should also cut costs to a manageable level through a single board with an all-inclusive mandate.
Another reality we face is that we cannot maintain the existing levels of service without changing the way we manage. Our social funding is divided amongst three departments and the Housing Corporation. We know that if we are to achieve real gains, we have to work together and integrate our efforts. That is why the government presented the social envelope budget in one comprehensive package that outlined the major initiatives that the partners in the social envelope would undertake in 1995-96. A joint presentation was made to SCOF by the social envelope departments and the Housing Corporation and, by now, you will have a copy of the budget supplement document that summarizes the cooperative efforts that are under way.
Departments in the social envelope have also been involved in extensive consultations with communities to develop a community wellness strategy that will be tabled later in this session. Communities have told us that they want to play the lead role in determining what initiatives will work best for them and to decide how to spend the money that is available within their community. The challenge to the departments in the social envelope is to find ways of making funding mechanisms more flexible to allow this. The departments will spend the next year evaluating what is currently being done and modifying the terms and conditions attached to the programs to make them flexible and accessible.
In the meantime, there is a need to try new approaches to deal with priorities in areas such as family violence, early intervention and services to youth. That is why the social envelope Ministers recommended a community action fund to help community groups test their ideas. The viability of such a fund and the means of raising the money need to be discussed.
I hope these comments have put the Health and Social Services' budget into context with the overall directions of the social envelope. Mr. Chairman, the budget supplement document circulated to the Members gives a good description of the department's strategic directions for 1995-96. I won't go into any more detail now, but I am open to questions as the department's budget comes up for detailed questioning. Thank you, Mr. Chairman.
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The Chair Tony Whitford
Thank you, Madam Premier. Does the chairman of the Standing Committee on Finance have opening remarks? The chair recognizes the Member for Nahendeh, Mr. Antoine.
Standing Committee On Finance Comments
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February 22nd, 1995
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Jim Antoine Nahendeh
Thank you, Mr. Chairman. In last year's report, the committee expressed a great deal of concern about the then separate departments of Health and Social Services. Committee Members felt that the departments were not responding to the recommendations of this and other committees and, indeed, were not responding well to the needs of northerners. The diligent efforts of the dedicated front-line workers, such as nurses, social workers, alcohol and drug counsellors, and so on, will not be as effective as they could be without a strong, well-organized department structure backing them up.
The standing committee believes that the amalgamation of the departments -- as had been recommended by the Special Committee on Health and Social Services -- may provide the foundation to that well organized structure. Now that the new department has a strategic plan to guide decision-making, and now that they are also now responding to relevant recommendations -- including those made by this committee regarding early intervention and a school-based youth services model -- committee Members expect the senior managers of the department to improve in their planning and in relations with departmental employees. The emphasis on the "envelope" model appears to have helped, as well. This government has, with this budget, demonstrated a stronger commitment to improving social services to northerners.
There are still some concerns that the new department must address. Chief among them is the implementation of the amalgamation at the regional and community level. As discussed earlier, bringing staff from different departments together is a challenging exercise. Committee Members were concerned to learn that there is no clear strategy for implementation at the regional level. The committee encourages the department to take advantage of the resources
available in the regions and communities to make the merger go as smoothly as possible.
Health And Hospital Boards
With the new departmental structure comes hope of a new and improved relationship between the department and the health and hospital boards. It appears that a memorandum of understanding -- MOU -- will finally be signed this year, allowing the boards and the department to more clearly understand what their respective responsibilities are.
As well, the committee was encouraged to hear that the department is developing a formula for funding the health and hospital boards. This step is long overdue. It is important that the boards manage the resources available to them wisely and efficiently, and the current funding methods obviously do not encourage that. A funding formula will provide the framework necessary for the boards to start managing their resources more carefully, especially in a fiscal climate of growing cutbacks.
Finally, the standing committee is frustrated that progress on establishing health boards in the Dogrib and Deh Cho regions has been so slow. The department has a responsibility to ensure that all regions of the NWT are serviced by local health boards responsive to their needs. Further delay in this area is unacceptable, and the committee urges the department to make this a top priority for the 1995-96 fiscal year.
Mr. Chairman, I would like to turn this over to my colleague, Mr. Zoe.
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The Chair Tony Whitford
The chair recognizes Mr. Zoe.
Savings On Medical Travel And Out Of Territories Care
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Henry Zoe North Slave
Thank you, Mr. Chairman. The committee would like to note the significant savings expected by the government on reduced medical travel and payment to hospitals outside the Northwest Territories. With enhancements to the capabilities of Stanton Yellowknife Hospital, more patients can be treated in the north, and the additional travel previously required to Edmonton and other centres is often not required. The new arrangement with the Royal Alexandra Hospital in Edmonton has already greatly reduced the government's costs for out-of-territories care.
Committee Members applaud the department's initiative in these two areas. However, the department can go further. For example, increased use of distance technology can provide improved health care services to community residents while reducing the need for travel. Appropriate enhancements to the use of local facilities -- such as the underused Fort Simpson hospital -- can also reduce the need for travel and provide quality health care to northerners closer to their homes. Finally, the department must do a better job in communicating with northerners. This is an area where health boards can excel; but it will not be possible in regions such as the Deh Cho and Dogrib regions that do not yet have health boards.
Medical Travel Co-Payments
A related issue that concerned committee Members is the planned increases in medical travel co-payments. Currently, when a resident of the Northwest Territories has to travel for treatment, a co-payment of $50 one way or $100 return is levied. The department has proposed increasing this to $125 and $250, respectively.
Committee Members recognize that, for many people, this cost is covered: either by their employer, especially if they work for the government; or by Department of Indian and Northern Development, if they are status. But those who are unemployed, non-status, or working for low wages and benefits, could be seriously affected by this change. For example, a patient who required three trips in a short period would end up paying $750 under the new rates, instead of $300 as at present. That extra expense could be difficult or impossible for some people to cover. The committee wants to see the department provide a way to avoid this rate increase becoming a hardship.