Mr. Chairman, I would like the deputy minister to answer the question because there was movement of some money, although it stays relatively the same. Mr. Lovely can probably explain that more in detail.
Debates of April 7th, 1995
Topics
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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Nellie Cournoyea Nunakput
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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Lovely
Thank you, Mr. Chairman. The budget has been reorganized since 1994-95. We have placed some of the money that used to be in public health into the chief medical health officer task within the same activity. It's also devoted to the activity of public health so, overall, the amount of money has not decreased.
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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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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Charles Dent Yellowknife Frame Lake
Mr. Chairman, from that response, I think we can take it that it has also not increased. Mr. Chairman, when I was working with the Special Committee on Health and Social Services, one of the things we heard from people across the territories was there was a real need to increase the amount of work we do in public health; that dealing with prevention up front is, in the long run, much more cost-effective than trying to deal with treating illnesses after they occur. I have to express surprise that the government hasn't looked at ways to cut down the costs in the long run by increasing the emphasis on preventative public health work. This area needs to be made more of a priority in order to save money in some of those other areas that the Minister has suggested we can save money in. What plans does the department have to improve our public health and preventative health activities?
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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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, public health is one of those community issues that we continually try to deal with. I would think that one of the areas that has been identified in the work of the public health nurses or at the community level is, given that they deal with a lot of different things like mental health and social issues, sometimes their time is confined to dealing with the clinical operation of the public health unit. I am talking generally and about the majority of communities that don't have a hospital facility.
One of the things we have tried to do over the last six or seven years is to provide ongoing nurse training accelerated programs where the ANSIP program is available to public health nurses, so they are better able to function at the community level, as well as the continued support of the community health representatives in the community. In the Keewatin a number of community health representatives graduated which gives a very strong component, if used correctly, to these health centres. They are liaisons between the communities and the health centre.
In putting together health, social services and these components of health support services, we would like to look towards a longer approach. This would be something that we can do in dealing with communities: how best these groups of health and social workers can consolidate a program to complement each other's work. At the same time, I would like, in the near future, to bring forward more formula-based support for public health or health personnel in a community, more in line with how we do the formula in the Department of Education for teachers. In a lot of the communities, there hasn't been a change over the last seven or eight years in the number of nurses in a community. If a community had one nurse with a population of 250, since the community grew to 350, the number of nurses hasn't changed. I think this has to be addressed in the short term. The working together of these different health and social services providers will determine where people can deal with preventative educational requirements, but still there is a lot more to do in terms of determining the make-up of what is required at a community level in these health fields.
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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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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Charles Dent Yellowknife Frame Lake
Thank you, Mr. Chairman. As we heard during the public hearings of the Special Committee on Health and
Social Services, the department really needs to take a look at the philosophy that it has right now. I realize it is a difficult process to deal with when you are faced with budget cuts and you are running from crisis to crisis. If we don't find some way to get our heads around a shift in philosophy whereby we set up programs and strategies to reduce illness and disease in advance, we are not going to have enough money to deal with the health problems of people in the north. The costs, if we try to stay reactive with our programs, will be out of reach in very short order.
I am glad to hear the Minister is considering a formula for public health nurses. I know, for instance, that of all the communities that have public health nurses, I am not aware of any that have had increases in the last seven or eight years. It is a concern here in Yellowknife. I am sure it is a concern in many of the communities. I don't think it is just the public health nurses. It is a philosophy that has to be embraced by the whole department -- a shift in the approach to providing health services to northerners. Public health nurses are a very important part of that, but I just want to impress on the Minister that it has to start with the Minister and work through the entire department. There has to be a shift in philosophy in the way we approach our health problems in the north or within three to four years we will run out of enough money to come anywhere near dealing with just day-to-day problems. 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
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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 whole-heartedly agree with the Member. I don't think our thinking is different in this regard. We are all painfully aware of the responsibilities we have in this department and we have to do something about our philosophy. We intend to do that in the strategy we are developing. I cannot disagree with the Member's statement.
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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The Chair Tony Whitford
Thank you, Madam Minister. We are on health services development, operations and maintenance, total O and M...Mr. Ningark.
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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John Ningark Natilikmiot
Thank you, Mr. Chairman. Without naming specific communities or regions, can the honourable Minister answer a question? How many of the communities in our jurisdiction have known cases of HIV infections? 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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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 will answer the question in a moment. We have the figures. Mr. Chairman, since 1987 the number was 27.
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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The Chair Tony Whitford
Thank you, Madam Minister. We cut you off before you could conclude. Carry on.
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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Nellie Cournoyea Nunakput
From 1987 to 1994, in total, there were 27 cases.
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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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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John Ningark Natilikmiot
Thank you. I believe that 27 cases are of the individual who carry the infection. My question to the honourable Minister is up to this point in time how many of the communities have no HIV infections, without naming the specific community or the region? 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 Tony Whitford
Thank you. Does that help clarify it, Madam Minister? They are looking for the number of communities that AIDS are found in. 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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Nellie Cournoyea Nunakput
Mr. Chairman, I don't have them by community, but we know that in each region there are number of known cases of HIV.
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 Tony Whitford
Thank you, Madam Minister. Mr. Ningark, does that answer your question? Good.
Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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John Ningark Natilikmiot
Thank you, Mr. Chairman. Mr. Chairman, up to this point in time, are there 27 known cases? I forgot what the response was.
Yes, okay, 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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Bill 1: Appropriation Act, No. 2, 1995-96Committee Report 4-12(7): Report On The Review Of The 1995-96 Main Estimates
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Some Hon. Members
Agreed.
---Agreed