Thank you, Madam Premier. Mr. Dent.

That is a comment. I don't know if you want to respond, Madam Premier.

Mr. Chairman, I have already commented on the numbers that are there and the issue of the increase. If there are people who feel that they are unfairly treated at one level, there is a means test on this. I agree with that. If it is a hardship, then we should reconsider the individuals who are having the hardships. Thank you.

Thank you very much, indeed, Madam Premier. Mr. Dent.

Thank you, Mr. Dent. Madam Premier.

Mr. Chairman, perhaps I could make a suggestion. Rather than a cap, maybe I could commit to looking at how we're dealing with the means test, formulating a more encompassing means test, to determine aid that people would be judged for. I think perhaps it may be more beneficial for everyone concerned that the means test is what gets looked at. We could look at both things, but in terms of benefits, I wonder if the Member would be satisfied if we would pay more attention to looking at the means test.

Thank you. Mr. Dent.

Thank you very much, Mr. Dent. You were so overwhelmed with the response, that you forgot who you were for a minute. Madam Premier.

Mr. Chairman, I will make that commitment.

Are you done, Mr. Dent? Mr. Ningark was next and then Mr. Patterson.

Thank you, Mr. Chairman. Mr. Chairman, besides the hospital care for medical patients, especially those who are unilingual and only speak Inuktitut or Dene, the ability to communicate is also very important at boarding homes, whether in Yellowknife, Edmonton, Winnipeg, or wherever people of the NWT generally go for medical treatment. Mr. Chairman, I think it's crucially important that we try to make medical patients absolutely comfortable, wherever they are.

I have been told, especially by people in my area and also the Keewatin region and the Baffin region, through my honourable colleagues who represent those regions, that there are times when medical patients going to major medical centres have to wait at the airports for transportation. On many occasions, Mr. Chairman, they are not even picked up. They have had to provide their own transportation by way of paying for taxis to and from the airport, especially from the airport to the boarding homes.

There are times when medical patients from the eastern Arctic are not able to communicate with boarding home staff because the dialects are different or there is no one on staff who are able to speak the language, Inuktitut mainly. I notice, Mr. Chairman, that medical patients from the western Arctic, mainly Cambridge Bay, Coppermine, and other communities are, in most cases, able to speak English and Inuktitut. They are more or less bilingual. But most patients, especially elders, coming from the eastern Arctic, from the Kitikmeot, Keewatin and Baffin regions, are not able speak the English language which seems to be and is deemed to be a universal language in this area.

Mr. Chairman, I think the well-being of the patients is crucially important. Mostly medical patients who go to larger centres are elders or pregnant women and these are the people most easily subject to the slightest problem of stress. I don't think that we should undermine the system, Mr. Chairman. Many times people have come to me to talk about their appreciation for medical treatment at the hospitals, not having to pay for the transportation from their community to a major medical centre and back to their community, not having to pay for the accommodation -- either boarding homes, hotels and so on -- yes, Mr. Chairman, we appreciate those things very much.

But, I think that it is very important that the comfort is there for those patients, as well. When the patient is not being treated as expected, when a patient is not comfortable, when a patient is away from home is a strange environment, a patient, even when faced with the slightest problem, may experience stress, therefore prolonging the recovery for whatever medical problem that person has.

I would like to urge the honourable Minister to make sure that she communicates with the boarding homes, either here in Yellowknife, Edmonton, Winnipeg, Manitoba, and other major centres where people go from the Canadian north to the south for medical treatment. There are people who have talked to me about this. I have not taken a stand on the issue previously, because I was told by some other medical patients that they have no problems with the boarding homes when it comes to communication, being picked up at the airport or not being picked up at the airport. They are able to read, write and speak the English language.

From the airport to boarding homes, they are able to call the taxi on their own, they are able to talk to taxi drivers at the airports. But the majority of those people who feel that the services aren't all that great, are those people who are unilingual. They have no complaint about the food, they have no complaint about other things, except the ability to communicate and not being picked up at the airport on time. I think these are very crucial and important and I would like to stress that to the honourable Minister. Thank you, Mr. Chairman.

Thank you very much, Mr. Ningark. Madam Premier.

Mr. Chairman, the Member has continually made sure that the times that patients that are not feeling comfortable has been brought to the attention of myself or to the medical service, and I very much appreciate that. I know that particularly the Kitikmeot boarding home tries very hard to do the very best job they can.

But it is true that we have boarding homes in Quebec, Winnipeg, and Edmonton, and I know that we have to strive to achieve as best we can in setting our goals to provide that services. I believe that there has been significant improvement but we still have a ways to go. I will continue to express to the boarding homes, and even within the terminals, that directions could be better presented.

I know that if someone is missed, the people who are responsible feel badly about it. But the only thing that we can do is try to do better all the time and I will continue to express that concern and continue to try to improve the service around the interpretation and creating understanding, particularly for unilingual people. By and large, we attempt to have an escort for each a person, but sometimes that doesn't happen and I realize that causes difficulties.

So we will try to improve that service and continue to keep that in mind for the daily activities of the Department of Health and Social Services, because I know that it is important.

Thanks very much, Madam Premier. Do you have further comments or questions, Mr. Ningark?

Thank you, Mr. Chairman. There were not too many things that I wanted to talk about regarding this issue at this particular time, but since you recognized me, I thank you very much.

Another concern I came upon with medical patients...I am not saying, Mr. Chairman, that one particular staff has ever been pointed out as having not looked after the patients. There have been no complaints in that area. In general, it is the inability to communicate and sometimes not being picked up at the airport. It is frustrating when the patient is not able to look after himself/herself; not able to communicate with officials at the airport; not able to call for a taxi -- they don't know how to do it, let alone know how to communicate with the dispatcher, in this case.

Another concern that came to my attention -- not too many times, Mr. Chairman -- is that there are times when the Kitikmeot boarding home in Yellowknife is full, it is booked, at the same time Rainbow Valley is booked. I think we should start to plan for expansion in the area of providing accommodations for medical patients.

There are times when Yellowknife receives patients from the Baffin. There are times when Yellowknife receives patients from the Kitikmeot region. I think we should start thinking about expanding or putting additions to either the Kitikmeot boarding home or maybe have Rainbow Valley...I don't pretend to speak for Rainbow Valley, as Rainbow Valley is mainly for the western Arctic people, according to my understanding. The Kitikmeot boarding home was mainly put up to accommodate the Kitikmeot region, but we also appreciate the fact that we are able to accommodate people from the Keewatin. We are able to accommodate people or consolidate people from Baffin at times.

Mr. Chairman, isn't it about time that all the health boards interested -- Keewatin, Baffin, Kitikmeot -- perhaps, meet with the Premier, the Minister entrusted for the Health department, and start to plan to expand the boarding homes for accommodations. The population is growing. We have had this problem of not being able to accommodate medical people for the past few years now.

Mr. Chairman, we are growing, and there will be more patients coming into this area. I hope, Mr. Chairman, that Madam Premier will take this very, very seriously.

Thank you very much, Mr. Ningark. Any response Madam Premier?

Yes, Mr. Chairman. We have a number of letters from individuals from the Kitikmeot region indicating that they often have to be put in another boarding home or in a hotel. I have started discussions with the Kitikmeot Health Board and my understanding is that they wanted to talk to the present owners of the building, the Inuk Development Corporation, who put up the boarding home. They felt it was in their best interest, if they are going to expand, to put it in the same place because people were fairly satisfied with the management and the kind of facility that has been run from there. I know at the very beginning when it was put up there was a shortfall on space and there was the intention to take over a second lot but they couldn't really afford it. I don't know if there's a place for expansion but I believe that at the Kitikmeot Health Board level it's an active discussion and I'll continue to pursue that as well.

Mr. Ningark.

Thank you, Mr. Chairman. At this point in time, I would like to take this opportunity to thank people at the Rainbow Valley who have looked after patients from the Kitikmeot region. I know the Rainbow Valley was mainly designed and made for the people of the western Arctic. There are times when the Kitikmeot Boarding Home is booked that they're able to welcome people from the eastern Arctic, mainly from the Kitikmeot region. Also, the staff and management from the Kitikmeot Boarding Home will look after people while they are here, in spite of the fact that they may not be able to confidently communicate Inuktitut with the people. Thank you.

Thank you, Mr. Ningark. Anybody else? Next on my list I have Mr. Patterson.

Thank you, Mr. Chairman. Mr. Chairman, I would like to identify some of the issues of concern in this department and perhaps give the Minister of Health and Social Services a chance to answer now or perhaps await the detailed consideration of the estimates as appropriate.

Mr. Chairman, I've been briefed on the community-based planning exercise in the Baffin region to plan for the long-awaited new hospital. I am impressed that the work is community-based. I'm impressed with the way existing hospital and community health representatives personnel have been involved in the research that has now started to identify health planning issues and needs. I think it's been a very sensitive and effective process and will lead to a very clear definition of the priorities and the needs for the new hospital. I would like to ask the Minister if, in the course of presenting her budget, she could give an update on the planning process in the Baffin region and perhaps in other regions. This is really the fundamental issue in our region. There are so many needs that are not met by the present facilities and so many needs that can be forecast in future. I will only mention a few: chronic care for the elderly; psychiatric care; hospices for the dying which unfortunately will probably have to include AIDS patients and the range of needs that have been identified in the very good planning work that's under way. I would like to ask the Premier for her assessment of the progress and whether we're on target with the plans to build the new hospital as previously committed to in this House.

Secondly, Mr. Chairman, I made a statement about this yesterday. I'm very anxious to see the very good legislation implemented that's been developed on the Custom Adoption Recognition Act. I think this is an excellent piece of legislation that was developed by Mr. Graeme Garson and we should get on with making it work. I believe, Mr. Chairman, that the Minister's Department of Health and Social Services will have a role in implementing this act; will have a role in identifying the local Custom Adoption Commissioners, which I see as something like Marriage Commissioners; and, will have a role in making the act come into being. I understand, and I may be portraying my ignorance here, but I understand that community social workers may be expected to help get the program off the ground given their closeness to the community and their involvement with family and social issues.

Mr. Chairman, I know bureaucracies can make things more complicated than they have to be. Perhaps I'm naive but to me there are a few simple steps required. I would have hoped that by now perhaps MLAs would have been asked for input into -- MLAs or elders, or both, or local governments -- would have been asked for names of respected people in each of our communities who would be able to serve as Adoption Commissioners and would be knowledgeable of the area of custom adoption. I want to ask the Minister who, I believe, has a role in implementing this act, how things are going and how we can help to get this long-awaited new act off the ground.

Another issue, Mr. Chairman, that is of concern to me -- which I've mentioned in the discussion of the main estimates of the Department of Education, Culture and Employment -- is the area of training in the health professions. Particularly training for nursing in Nunavut. There are some 250 jobs. We've only got some 10 students from Nunavut in the Yellowknife-based program. I'm sure it's an excellent program but I'm also sure that if it's working in Yellowknife at the Stanton Hospital it could work in hospitals closer to Nunavut. Of course I have in mind the Baffin Regional Hospital as a training ground. I know that the Baffin Regional Health Board, through it's health promotion officer, is actively working on nursing training and a nursing training program. I would like to find out if the Minister is aware of this; if training nurses is a priority of her department, and whether or not we can build on the good work of the program that's now been established in Yellowknife and plan for a program that would give a bit more access to students from Nunavut for nursing. It is true and we all know that we've got a long way to go in getting northern people involved in nursing, particularly in our hospitals and health centres.

Finally, Mr. Chairman -- no, almost finally -- I would like to ask the Minister about the thrust of the recommendation of the Standing Committee on Finance in a previous report about making progress on distance technology. About how we're advanced in the Department of Health in taking advantage of the wonderful technology that is now available to transmit electrocardiograms and other medical information through the telephone and using existing telephone communications and electronic communication. I would just like to generally find out what initiatives the department is taking and whether or not we're starting to find ways of saving costly travel and perhaps, on occasion, costly medevacs through distance technology.

Another question I would like to ask the Minister, Mr. Chairman, is about, I think it's called, non-insured health benefits. I have heard the announcement about benefits for the Metis and I heard Mr. Bohnet, president of the Metis Nation, talking about the Metis in communities who do not have employer health plans and who have not been able to afford health benefits and how beneficial this new program will be for them. I know that money is scarce and I would like to ask the Minister, in order to ensure that the medical benefits go to those who most need them, those who cannot afford medical services, what the procedure is going to be for determining eligibility for the Metis? Will there be a means test to ensure that the benefits go to the poor and not people who have the means or health programs in place as Mr. Bohnet described them?

Secondly, now that this step forward has been taken by the Metis, I would like to ask the Minister if she's concerned about others in the Northwest Territories who cannot afford medical services who don't happen to be Metis, status, Dene or Inuit, who don't happen to have the benefit of an employer or other health plan? Is there a plan to do something for those people as well? It seems now, according to the CBC report, that there's really only one class of people now who are not eligible for these basic medical benefits, and those are non-native people in the Northwest Territories who may not have employer health programs or the means to afford those services themselves.

I think the government should look at extending these services to the whole population as an investment in preventive health care. I believe there are still people in the Northwest Territories who do not treat themselves with proper medication, simply because they cannot afford those services. This deteriorates their health and perhaps contributes to problems accumulating later on. I would like to ask whether or not there's a plan to extend benefits to all people who need them in the Northwest Territories.

Finally, Mr. Chairman, I would like to congratulate the Minister. I was very pleased that proposals have been put out for the tendering of orthodontic services in the regions of the Northwest Territories. I think the Minister, herself, admitted that it was discomforting that we were spending so much money sending people south with escorts for a procedure that sometimes involves very little time and, in some cases, where braces don't even require adjustment.

I think the tenders have now closed and I would like to get a progress report on whether or not bids have been received to provide orthodontic services, and what the status of that program is. I think it's welcome and now we want to make sure it gets off the ground. There are many people in my constituency who object to the waste of public money that is involved in their travelling regularly to Montreal or Ottawa for these services. I've had a number of people complain to me that they are uncomfortable, since they know we don't have a lot of money in our health system, in taking these benefits.

Then there is another group of people who have complained to me, Inuit who say that the criteria and procedures for getting orthodontic benefits through the non-insured benefits, the system now set up by Indian and Northern Affairs, is extremely convoluted, expensive and difficult to access. You pretty well have to be incapable of eating before you're eligible for orthodontic services as an aboriginal person.

I'm hoping that if we can bring orthodontic services to the north through the tender calls that have been put out in the various regions, we'll also somehow be able to give northern aboriginal people, who are funded for these benefits through the federal government, a little more access to the service than they've been able to get through the convoluted committee approval process they are now subject to.

Mr. Chairman, I apologize for having listed a rambling series of issues. I don't know where they fall in the activities of the department but these are issues that are of concern to me. Generally, I'd like to say, Mr. Chairman, that I was impressed with the plan to base health services and funding to health boards more on a formula, to promote more fairness and equity in the system, and to re-establish better relations with health boards. I guess that relates to my final questions: how are relations with the health boards; is the long-awaited memorandum of understanding between the Department of Health and health boards close to being finalized; and, will we be able to get on with a new, more cooperative partnership between the boards and ministry based on a clearer understanding of appropriate roles and responsibilities? Thank you, Mr. Chairman.