This is page numbers 821 - 851 of the Hansard for the 12th Assembly, 7th Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.

Topics

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair Brian Lewis

Thank you very much, Mr. Patterson. I counted at least six or seven concerns. Madam Premier.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Nellie Cournoyea Nunakput

Thank you, Mr. Chairman. With regard to the planning for hospitals, indeed, the Baffin hospital plan is progressing very well. It's on schedule and looks like they've taken into consideration some of the other components of health care in a more holistic way in providing a hospital facility. We're pleased that it seems to be progressing very well.

Regarding the long-sought-after health facility for the Keewatin, they've done a health needs studies and right now they're doing an economic analysis of an approach to put a facility there. In the Inuvik region, because some of the Sahtu residents are accessing Yellowknife for medical services, they're well on the way to realigning according to the needs assessment that they've been working on now for some years. What they're doing presently because of the community-based rationalization of what would be required in the community and region, are community profiles so they can rationalize the type of facility that would go into Inuvik. They're a bit behind because they've had to refocus because of the decision to allow Sahtu residents to come to Yellowknife.

In terms of the other hospital boards, we still have a lot of work to do to rationalize the Hay River, Fort Simpson and Fort Smith hospitals as they relate to Stanton. I hope we'll be able to carry on much of that consultation this summer. There have been a number of studies done and a series of recommendations have emerged on how each can function within the southern Mackenzie catchment area. It seems that everyone is taking their needs study and their facility planning very seriously and are moving along quite well.

In terms of the Custom Adoption Recognition Act, I had hoped as well that we would be able to move much more quickly on that because it has been a long-outstanding issue. And I think both the Member and myself have advocated that something should be done about that for a long, long time. However, it seems that the actual implementation of the regulations and the selection of people probably couldn't be done until September. In the meantime, the plan is to seek out one individual who will do some of the backlog that we have now, so that there won't be some activity in trying to address those outstanding issue on those individuals that we know are there. So rather than saying that we cannot do anything until September, we will almost immediately get one person to coordinate the activity and get the backlog and the individuals that we know about now updated and put in the process. So we will be doing something.

In terms of the training for professional nurses, I am very much aware that often we can start the pilot project in one region. But I see it that this program will have to move to the Baffin to try to catch the eastern Arctic catchment area. This is a program that started off here in Yellowknife and we will continue with it, but that is not in absence of planning for one in the eastern Arctic because I think it is needed. There are a lot of opportunities there for Inuit to take part in the professional nursing area. I know that we have a lot of changeovers and this will provide some stability if we can train our people to take over some of the responsibility in the nursing profession. What we have in Yellowknife has not been done with the intention of doing something for Baffin, because I believe that it is very necessary.

With regard to the progress on distance technology, I know that the Department of Education is working quite extensively on trying to see how they could use distance technology. The Department of Health is working with NorthwesTel right now with regard to telemedicine and how that can be made available and transmitted.

The other area, on Metis benefits, there is some work that has to be done to determine the type of benefits that we can cover within the parameters of the $1 million that has been put in the budget for that. We won't be able to cover everything, so we will have to work with the Metis Nation and look at their eligibility list. As well, they will have to meet the same criteria, where if they have a medical plan, they have to access that first, like everyone else. This is one of the reasons why they felt that the cost wouldn't be as great, because a majority of Metis people who are working are either in government or have a medical plan as it relates to the work they have.

I will let Mr. Ken Lovely deal with the orthodontist issue and give you an update on that. I am pleased to say that our relationship with the health boards has improved extremely well. And in terms of the agreements, we have five finalized agreements and all we are waiting for is some of the health boards because they just haven't had a meeting to finally consider it. But I am very pleased with the really positive working relationship that we have established with them in the last year, and I think that has gone a long way. I think the compliment has to go towards the deputy minister of Health and Social Services. So on that final issue of orthodontists, Mr. Lovely could probably give you an update on that while I dig out my cough medicine here.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Thank you. Mr. Deputy Minister.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Lovely

Thank you, Mr. Chairman. The orthodontic travel issue has been a very sensitive one because it is costing us a lot of money to send people outside the Northwest Territories to obtain treatment that should be available here in the territories.

The department developed a draft call for proposals that could be used by all of the health boards to ask dental clinics and orthodontists to submit proposals to provide those services at the major regional centres. That would mean that our expenses would go down significantly because of the reduction in travel. Those calls for proposal are at various stages now. Some of them are advertised and the boards have received proposals. There are varying responses. I understand that the Inuvik board, for example, has received five proposals. Another board has received two. There are a couple of boards who are simply in the middle of the process of advertising it and that is expected to be complete by mid-April.

We are also working with the communities in the South Slave to allow more of them to access the orthodontic contract already in place between the Government of the Northwest Territories and a southern orthodontist who travels to Yellowknife to provide services in this community. That is a bit of a different negotiating process, but we are satisfied that we will have coverage across the Northwest Territories within the next two to three months, or at least we will have an agreement for that coverage. That will allow us to achieve one of the objectives that is identified in the main estimates: reducing orthodontic travel by about $400,000. Thank you.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Thank you. General comments. Mr. Patterson, are you done?

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Dennis Patterson Iqaluit

(Microphone turned off)...Thank you.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Okay, thank you. Mr. Kenoayoak Pudlat.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

April 4th, 1995

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Kenoayoak Pudlat Baffin South

(Translation) Mr. Chairman, regarding Health and Social Services, regarding capital planning; first, I would like to say the patients who have to go through regional or southern hospitals for treatment are treated very well and that is the least we can do for them.

I would like to say that in the east one of our problems is, for the smaller communities, only small aircraft are able to land there. Some communities are accessible by larger airplanes. A lot of times patients that have to go out for treatment have difficulty returning home because other patients are using the same aircraft. This has been a major concern in the smaller communities for patients who have to go out.

The other concern is -- we are aware of this ourselves -- that these people do not travel on their own; that is a necessity for them to go out for treatment. I know that many of the same people go out because I travel a lot. I have seen many patients who have gone out for treatment who have difficulty returning home. I wonder what the problem is. I am not too sure about the reasons they seem to get bumped off of scheduled flights. It seems that there are no problems when they can get a seat on an airplane. We feel really sorry for the people who are unable to get home because they have no seat on the aircraft. I don't know if this is a problem elsewhere, but there have been a lot of problems in this area up to now. There are patients who are not there of their own making and are not able to get home when they should. Perhaps the Minister is aware of that or she may not be. I think that you should know the problem in this area so that you are aware of how patients who go out for treatment from their home communities are handled and treated. I think that we should be very sympathetic towards these people. Sometimes we feel sorry for them when they become unhappy because they are homesick when they are unable to go home. It is very sad to see these people. I would just like to say something about that further.

Also, in the Baffin, especially Sanikiluaq, Yellowknife is used as a major centre to treat these people. As well, the Kitikmeot Boarding Home is used by those patients who have to come in. I would like to say again that these patients are not here just because they want to come here; they are here out of necessity. I think that there should be Inuktitut services or translation services made available for that dialect at the Stanton Yellowknife Hospital. I think that there should be a telephone available with an interpreter in a language that they can understand. In the Baffin region there is Inuktitut available at the hospital all the time to answer any questions or enquiries, and translation services in that hospital. There are many other centres in the south that are used by northern residents. I think there should perhaps be a toll-free number or a number to call in our own language, Inuktitut, available in all major centres. I think there should be one made available at the Stanton Yellowknife Hospital. I don't know if there's one now or if there are plans to have one, someone who can answer questions in Inuktitut, because I know that Stanton, as it is at the present time, will continue to be used to treat other people from other regions, mainly the Inuit-speaking people, and there has to be someone looking after the patients who do come in.

We are very thankful that the Kitikmeot Boarding Home is available to be used by patients who come in, but even in the Inuktitut language we have many different dialects. A lot of times we can communicate but there are some problems that may occur especially for people who don't often get out of their own regions. There may be an interpreter available as needed in the Kitikmeot Boarding Home or at the hospital but I think there needs to be an improvement in this area because many people from Sanikiluaq have travelled to Yellowknife for treatment. It seems that we had a tuberculosis problem in Cape Dorset and there were many people travelling out for treatment. They were having trouble getting out of airports going into boarding homes or hospitals. I don't know what services you have about where to call or who to call in case there is no one from the hospital to pick them up. That is part of my concern.

The other concern that we have is in the social services area. When there is a death of a relative in another community, or if there is a serious illness of a member of the family, I know that there is one airfare that can be paid for a close relative to go to that community. We feel that there should be more than one airfare for a relative to go to that community for a funeral or to see a person who is terminally ill. This is a very serious concern for people from small communities who have no employment opportunities and want to fly out to see a dying relative or attend the funeral of someone who has died. When you are travelling from Cape Dorset to Lake Harbour, it is very expensive to fly between those two communities. I would like the Minister and his officials to think about this in the future. This is one of the major concerns in my constituency, whether or not Social Services can provide more than one airfare ticket to go see a dead relative or a terminally ill person.

I will stop at this point, Mr. Chairman, so that my points are understood more.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

I believe the honourable Member covered the medical referral from a medical centre to transportation, that's referral. The second item that he came up with was medical travel patient service in boarding homes, and transportation from the airport to the boarding homes. The third item that I think he talked about was compassionate travel assistance for those who otherwise cannot afford to travel. Madam Premier.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Nellie Cournoyea Nunakput

Mr. Chairman, I believe that most of the topics that were raised by the Member had been raised a little earlier. I know that these issues continue to be raised. Most of the issues raised by the Member are issues that are handled by the Baffin Regional Health Board. My understanding is that they have a very similar policy and guidelines and also initiatives to make sure that translation communication is in place. As I say, in these areas there's always room for improvement. What I will do is take the comments from the Member and write them up in a memo and relate them to the Baffin Regional Health Board and have a discussion around these issues with them because they are closer to the points that have been made. I can ask for a response as well. I will undertake to personally communicate with the Baffin Health Board in writing and ask them to reply and see if they can offer some solutions or give some explanations on areas where they may have been making improvements over the long-term.

In terms of the compassionate travel, I realize that this is always a big issue when someone is ill, because having any member of the family very ill or terminally ill is always a great concern. All the compassionate travel in the Northwest Territories, whether it's in the Baffin or the western or eastern Arctic. We do have compassionate travel guidelines which change from time to time, but are available. Compassionate travel guidelines require that a person wishing to travel to visit a relative who is in long-term institutional care or visit a relative in hospital who is critically ill, provide a medical certificate from the physician attending the patient to verify the person is in critical condition in hospital or to attend a funeral of a relative.

For visits to relatives in long-term care or critically-ill relatives, assistance may be given for one visit a year for the patient's next of kin. The next of kin refers to one person only and is the closest living relative in this order: a spouse; parent; brother or sister; another relative the patient lived with before being hospitalized; an escort, if one is necessary; and, an interpreter. These are the general guidelines but I know, from time to time, these are stretched. I will take the comments under consideration as we continue to look at how we are going to provide assistance to the ill and the people who are close family to the people who have to leave home to seek medical treatment. Thank you.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 847

The Chair John Ningark

Thank you. Qujannamiik. On my list I have Mr. Tony Whitford, Member for Yellowknife South.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Tony Whitford

Tony Whitford Yellowknife South

Thank you, Mr. Chairman. I think my colleagues have already spoken about my concerns. I have had concerns expressed by constituents over the proposed copayment increase that is, and has already been, a problem with a number of people who reside in my area. While I say there is a concern now, there will be even more now with the proposed increase. In the past we've had excellent cooperation from the Department of Health staff who I brought these concerns to. They've always managed to work something out. But, it is not always possible to resolve these issues satisfactorily.

In addition to that, it's quite difficult for individuals to have to always challenge the department when they have to -- through no fault of their own, of course -- travel south for treatment more than once. It's okay if this happens once every so often and affects a person maybe once or twice in their lifetime, but when there are instances, such as broken bones or other major surgery that requires a person to go for additional treatment, it does become quite a burden on the household. It's tough enough to live in the north as it is, and anytime disposable income is used for such things, it is less money for things that people need in the territories.

It appears that from what the Minister has said, that perhaps they have to look at the criteria for eligibility to see if that can be changed; that's encouraging. I would like to encourage the department to do that. I recognize the need for increasing revenues, but health is one thing that I think is an investment. If we can eradicate diseases and illnesses, we would be saving a lot of money. If people, because of cost, neglect themselves, it is going to cost us a lot more money in the long run.

Another thing is, when I read through the budget, I see there are going to be some increases in some of the services that the residents of the north will be receiving through the hospitals that we have here; particularly those that are servicing a good portion of the territories at present. It is encouraging to learn that -- although it's not in the book yet -- the dialysis program will be coming to the Stanton hospital in the very near future. I asked a question about it and was informed that this was going to be possible by the fall. I've received some happy peoples' comments and will pass them on to the department for their initiative in this area.

The increase in services for patients in the north is encouraging. Years ago we had to go south for surgery of every kind. We can now get it done here. I think there's an experiment in a small way of the use of laparoscopic surgery which reduces the amount of trauma a patient would experience in surgery. It is certainly encouraging to see all of these things coming here, such as hip replacement surgery. I think one of the areas still of concern is something that we have heard about lately in the news, although we've known about it for awhile. It is the great concern about the vast numbers of northern people who are smoking and the increase in the amount of cigarette consumption over the past years.

Smoking has always been a pastime of northerners but, for some reason or other, it has increased in the last little while. I think not very long ago Members of this House saw, or heard in the news, statistics that indicate that a tremendous number of Inuit people smoke. I don't mean to just single out Inuit, but that is what the report claimed. I know that there is a substantial increase in the numbers of young people smoking, in spite of the programs we have. I'm just wondering why this is happening. The anti-smoking awareness program held in the past year showed very graphically the effects of the use of tobacco products on humans. Maybe it's not being delivered as much as it used to be or maybe people have become just so desensitized now that they don't really care.

I know on the back of cigarette packs there are black labels that warn people about the dangers of smoking and these are required to be put on the packages. Recently, I saw in some of the novelty stores here black labels that have some very cute little sayings on them which people tape over the warnings on the packages. They make a joke out of it. All of a sudden what was a very serious warning about the use of tobacco products is now taken very lightly. I wonder if maybe our approach and programs to having people reduce smoking are becoming obsolete and aren't seriously being observed by our residents.

It's a great concern to many of us that this happens, especially when you see the increase in young people smoking now. They seem to be getting younger and younger; in spite of the law. They still manage, for some reason or another, to secure tobacco products and use them. Whether it is against the law, they still do it. I think more than making it a law, we need to be able to come up with some ways of making sure that young people don't start smoking because of the adverse affects it is going to have on them, rather than making it a challenge because it is against the law and they have nothing else to do. It has been attributed to some people who I have talked to as being a very slow form of suicide. The effects are not noticeable right now, but the more you smoke, the greater the increase of long-term health problems the person will face.

I guess I would want to see a little bit more of those types of programs continued or revisited, for sure. As I have said, they seem to have lost their impact, if they are still being delivered. They don't seem to have the same impact as they had some time ago. Maybe it is time to revisit this and see what else we can come up with. One other area that is of concern that I wanted to bring to the attention of the department here, while we deal with their budget, is the support that special health treatments require. We have a few people who have had transplants; a very major medical item. They require certain medication that is of a very specialized nature and not only is it specialized, but there is the issue of the quantities that are required. Because it is specialized and of the large amounts, it is very costly. Some of those things are not covered under an insured program. It isn't on the list. If a person has a kidney transplant or a liver or lung transplant -- which are becoming more common -- the amounts of medication required to stave off the rejection effects are quite costly.

If a person does not have a health plan, although they may be gainfully employed or have a certain amount of income in that home, a tremendous financial burden is devastating. I would encourage that we look at those particular types of medical treatments that are unusual. It is one thing if you are going to get some minor thing done because there are quite a number of things like that, such as gall bladder surgery. But if you go in for a transplant, this is major stuff. Something like that is not a great financial burden to the territorial government, at leats in my opinion, because of the few people it affects. It is something worthwhile doing. I would like to encourage the department to look at that and recognize the long-term benefits that will be realized from people who have recovered successfully through our efforts. I probably will have more to say as we move along but, for the time being, I will say we are on the right track. There are many good things happening; probably too many to go over here in any great detail. There is the nursing program that will be established, so we can have more and more people trained in the north to do the jobs that are required to deliver good health to northerners; that is very encouraging. The department is to be commended on that initiative and other initiatives undertaken.

I haven't touched on Social Services because a lot has been covered. I think the social workers are doing a tremendous job in delivering programs to the people. People have gone through a traumatic time over the past three or four years with the reorganization of the department. It has shown the fortitude that they have, that they have been able to do their jobs and still go through the trauma of amalgamation, which we are well aware has been traumatic. It has been a long process. They are working to some fruition.

Mr. Chairman, I just wanted to make those few comments to the Minister. I don't think there is anything that requires an answer at this point. There is a list of drugs that are required for transplant patients -- I am not sure what the name of the program is -- that recognizes illnesses or treatments that require a lot of cost to individuals and more assistance can be given to the people who are undergoing that kind of treatment. I only hope that the department will take a good look at that, as they have had due to requests of people who use southern facilities for dialysis purposes. It is encouraging to know that we will have that in the north by the fall and it will reduce our costs to southern hospitals and increase the use of our own facilities here. With that, Mr. Chairman, I will leave it there. I say congratulations to the department and the staff who have put so much into the north over the past year, since we have dealt with this matter. Thank you.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Thank you, Mr. Whitford. Mr. Whitford, I am told smokers know the tranquillity of inner peace. Madam Premier, do you have a response?

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Nellie Cournoyea Nunakput

Thank you, Mr. Chairman. With regard to the never-ending quest for finding better and more innovative ways of trying to get to the smoking public, particularly to youth, I think there have been many programs; however, they have an extended shelf life, where after people have looked at them for a certain period of time, they aren't interested.

The Pauktuutit organization has negotiated some funds from the federal government, so they are going to try to take a different approach and go on a campaign for encouraging people to become non-smokers. Throughout their tranquillity, they become as stressed as everyone else. We just have to keep finding different approaches because an approach can be very valid, but it only lasts so long and people look through it. It doesn't have the impact for very long, so we just have to keep looking for newer and more innovative ways.

Regarding the area of concern about extended health benefits on pharmacare, there is a list and we've expanded it from time to time. We've dropped some drugs that really weren't necessary or weren't used, and added on according to the requirements and the needs of the general public. So we continue to do that under extended health benefits. So if there is a case to be made, we can't always come to a positive conclusion, but the Department of Health has been fairly responsive to requests that have been very critical and made some changes to the ongoing list of what will be covered under the extended health care benefits and we will continue to do so. Thank you.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Thank you. We are reviewing the 1995-96 main estimates of the Department of Health and Social Services. General comments. Mr. Antoine.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jim Antoine Nahendeh

Thank you, Mr. Chairman. On the Department of Health and Social Services, I have some comments I would like to make. Again, this is the never-ending saga in my constituency of not having a board. At the same time, this government is trying to provide programs and services to people in the communities. My concern is the type of services that are provided to people in my constituency.

In the past little while, there seems to have been a concern for getting the type of services that people require. I know the Minister has been pursuing this one for some time now, trying to get some sort of accountability in place by the providers of health services in my constituency. There is really no way to do it. There are a lot of problems there, but how do we solve it? I know there are problems that arise out of, for example, Fort Simpson, where there are health concerns coming out. The band there is doing a study now about culturally-appropriate health care in the community. The Deh Cho First Nations is also doing a study on a broader scale for the region. In the meantime, the Department of Health has a hospital there which is providing care to community people in the area.

A lot of my constituents in Wrigley, Simpson, Jean Marie, Nahanni Butte, Trout Lake, and Liard are going to Yellowknife to get treatment. They have to charter or even take a taxi into Simpson and then fly into Yellowknife and stay at the Vital Abel Home to get the care of the hospital here. In some cases we are hearing that people want to come here to get treatment but, somehow or other, they don't have the opportunity to come here. So there are problems like that, where do the people go to now that they don't have a health board to deal with? There is Mackenzie Regional Health Services, but it is really an office here in town. There are appointed people in there. There is a staff of maybe 10 to 13, I don't know exactly. I would like to know how many people are in that department.

With the amalgamation of Health and Social Services, as well there is going to be amalgamation in the regions. My concern is that in the regions where they have health boards, they already have a body in place that will oversee the health services, but in my constituency -- and also in my colleague's, the honourable Henry Zoe's region, and in the Speaker's area, there are concerns that we don't have a board in place. With the amalgamation that is being worked on now, how is it all going to work in? Is there going to be an interim type of body put in place now, in the regions or at the community level, to deal with concerns and complaints that come forward by the health services?

As an MLA, I have received a lot of different calls and letters with regards to health services. I move them forward to the Minister and her department. I am also going to the Mackenzie Regional Health Services. There is no real coordinated place where people can go and feel comfortable about expressing their concerns with regards to health services because we don't have a health board or a community health committee. Only in Wrigley, where they have set up a community committee to deal with health, does there seem to be a body that deals with issues from the community, as well as the health delivers -- they go to this body as well. So it goes both ways.

What I am seeking here is how we can deal with this issue now, before amalgamation happens and before a health board is created, because there is no coordinated approach in how to deal with the concerns that come forward. I have a concern with that.

Keeping in mind that this government is responsible to provide the health care to people in my constituency, as well as constituents in other regions where there are health boards, we don't have it. With the devolution of health care from the feds to the territorial government, this government took over the responsibility of delivering health care to treaty Indians and Inuit people, and the majority of the people in my constituency are treaty Dene people. The treaty rights include having medical checks in the communities. And with these translated to medical services, I want to make sure that they have adequate care, not only treaty Indians but everybody else in my area which the government is supposed to provide. There are many people that come through the system for health care and whenever there is a problem, people think that they should come and get treatment, but they don't. If there's problems in the way, I end up dealing with it. I have no problem with it but there should be a system in place for that. Could the Minister tell me if there's something in place now on how to deal with these issues that seem to be becoming more and more of a problem? How should we deal with it? Thank you, Mr. Chairman.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair John Ningark

Madam Premier.

Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters

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Nellie Cournoyea Nunakput

Mr. Chairman, the Mackenzie Regional Health Services -- and that's what it's called because it doesn't have a board, but it does have a unit -- is a bureaucracy that serves these two regions. In the past I've tried on numerous occasions to try to get the board set up or a semblance of some kind of a board so that the representation could be there. In the past it was a bit difficult because there was quite a bit of work being done on the claim and people just really weren't available to put a lot of attention to it. It just really wasn't moved forward but came in bits and pieces. As I stated earlier in the proposal from the Dogrib Nation, perhaps a way to save some of the money on forming more and more bureaucracies is look for a board that takes in health, social services, education; a social program board. We would be willing to carry out some of these meetings to see what direction the Deh Cho themselves would like to move in. We're prepared to do that as soon as the people are ready to have those meetings and discussions.

Right now the Mackenzie Regional Health Services system takes care of that region as though they were a board but the Member is quite right, you don't have people sitting on a board but they do act as a service unit to those two regions and attempt to make sure that the health centres in each community... As much as possible, it's handled locally through the health centres and if there is a requirement for further treatment, sometimes the Fort Smith Hospital is accessed and then Yellowknife. There is a process for how people get from one place to another or how they get their health needs taken care. In that regard, the MLA probably gets more involved because of the lack of a health board. We try as much as possible to be positive in trying to get through those requests, whether it comes from a community, a chief or from the MLA to deal with those issues. We're prepared to start looking at the kind of organization that the Deh Cho sees as a model to serve the needs of the Deh Cho and if that can happen right away, we're prepared to have those meetings. I talked with Gerry Antoine and he had said that their study was almost complete, on what they feel should be a health delivery system. So, incorporating that, we would be prepared to meet at the earliest possible time.

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The Chair John Ningark

Thank you. General comments. Mr. Antoine.

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Jim Antoine Nahendeh

Well, it's very frustrating and that isn't very satisfactory to me. I have been dealing with this one for the last couple of years. All I'm hearing is the same thing I heard before. I don't mind getting involved on some issues. However, if these issues could be resolved, I would probably feel a little better. The issues are still the same. There are some specific medical problems that even come to my attention. I'm not a medical doctor, I cannot diagnose or make any suggestions. I just want to get some attention paid to the type of medical treatment some people have or have not been receiving. There should be a way for people who have these problems in the communities to go to someone in the medical system to address these issues, so these issues could be dealt with in the medical system, itself. That's what I'm getting at.

I asked the Minister if there is anything in place in the interim until a board is created. Regarding the problems we are having with the boards, the Minister is saying that there is a proposal from the Dogrib region to have a social services board and they will be meeting with them to see if this would be feasible. How long are these meetings going to go on? Maybe they'll go on for another year or so. She is saying they are going to meet with the Deh Cho region to see if this is the type of board they would want to see in place. In the meantime, there is no board. That's my concern.

What is in place in the interim to deal with these kinds of medical concerns? In the other regions, I assume there are health boards that deal with different specific issues. They probably have a process in place so when somebody has a problem, someone goes to the board, voices the issues, and tries to resolve it. There may be problems with doctors, with different personnel in the medical treatment system or with transportation. These are the different types of problems I'm getting at. More and more of these problems are coming to my attention. This department has the responsibility to provide health services and all of these problems are included within health services.

If there is nowhere for my constituents to go to address some of these medical issues, then there is a problem. That's what I'm raising a concern about. Is there anything in the interim? I've gone to the Minister and the deputy minister and raised these issues. I cannot keep coming back to the Minister for specific issues on an ongoing basis. Finally, I've gone to the director of Mackenzie regional health services and whenever I hear of a specific problem or concern, I go to this person. I

get a more positive response because they are on the ball and doing things.

Can there be an interim arrangement made somehow? Maybe there could be an interim body of some sort at the community level. In Fort Simpson, maybe there could be a community health committee of some sort comprised of different people. There was a committee looking at health problems, doing a study for the band. There's a group of people in the community who are aware of these different issues. They've been at it for a number of months now and their report is just about done. Can a group like that be recognized as an interim body for the time being to deal with different health issues that come into the community?

Is there something in the works that the department is doing to deal with these types of problems that arise, so the community can be involved in dealing with these health issues? At this point in time, Mackenzie Regional Health Services is dealing with some of these problems but the entire staff is in Yellowknife. They travel to Simpson once in awhile but there are people in the community who would like to be involved and should be involved because they are there on a daily basis and see how things happen in the communities. I would like the Minister to tell me if there's something that could be done in the interim until we come up with some sort of a health board in my region. Thank you.

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The Chair John Ningark

Thank you, Mr. Antoine. Madam Premier.

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Nellie Cournoyea Nunakput

Mr. Chairman, what is in place right now is Mackenzie Regional Health Services. That's what's in place now for that region. It is in Yellowknife, but that's what exists today. It's the interim body that tries to make sure that the health stations are staffed and that the programs are run in the communities of both those regions. As for a community health board, there's always the option for a community to make a request and say they want to be the ones to be consulted on a continuous basis about the health needs of Fort Simpson or any other community. It's not the Department of Health that's dragging its feet, it's the will of the people. If the community says they have an organization that they feel should be the organization mandated to be the link between the health unit and the community, we're not putting any impediments in their way to becoming formalized. Thank you.

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The Chair John Ningark

Thank you. Mr. Antoine.

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Jim Antoine Nahendeh

Thank you, Mr. Chairman. The will of the people is always there, Mr. Chairman. Health is always a key issue. We have political bodies in the communities. We had a chief and band council in the community a long time before the municipal government was put into place there. It's still in existence and will exist for a long time yet. The band council represents a lot of people in the communities. They have regular meetings and they have provisions in their meetings to have delegations come forward. The suggestions here are that if a representative of the hospital in Simpson -- the doctors and the different people in charge of the health services area -- could meet with the band on a timely basis, I think a lot of these problems could be dealt with at that level. Perhaps some misunderstandings could be cleared up. The band council is there and I don't see why they couldn't use that

vehicle to try to resolve some of these health issues. After all, this government took on the health transfer to administer health services to treaty Indians and Inuit and that is one part of it. There's also the village council who also have meetings on a timely basis that represent everybody else in the community. At that level, perhaps some of these problems could be resolved. Thank you, Mr. Chairman.

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The Chair John Ningark

Thank you, Mr. Antoine. The hour being a little after 6:00 pm, I will recognize the clock. On behalf of the committee I would like to thank the Premier and her witnesses for appearing before the committee. I will rise and report progress to the Speaker.