Agreed.

--- Agreed

Thank you, Mr. Chairman. It is a pleasure to present to you the main estimates of the Department of Health and Social Services. Although these main estimates represent the beginning of the department's revised budgeting process, we have already taken steps to control costs; particularly in the administrative area. For example, headquarters reduced 45 positions during consolidation and restructuring; and medical travel administration has been moved to boards to bring it closer to where decisions are made.

As directed by the Premier and the Minister of Finance, the department's 1996-97 reductions have been designed to minimize the impact on program delivery. As a consequence of initiatives referred to in these estimates, a number of legislative and regulatory changes may be required. These changes include implementation of the proposed child welfare and adoption legislation; amendments to the Medical Care Act and regulations to enable the return of clients and services to the NWT, and allow de-insuring some medicare fee items; amendments...

(Translation) The interpreters cannot keep up. The Minister is talking too fast. Thank you.

I apologize, Mr. Chairman. Amendments to the eating or drinking places regulations, under the Public Health Act to allow for permit fees. Other legislative changes may be required depending on final decisions regarding board structures.

This year's capital plan requires $13.5 million, but $4.9 million of this is carryover for projects previously identified in last year's capital plan. The replacement of hospitals in Inuvik and Iqaluit remain at the forefront of the department's capital plan. We are working with the respective boards to develop cohesive plans that will lay the foundation for design and construction work over the next four to five years. The year 1996-97 will be an intensive planning year.

Replacement of the health centre in Fort Good Hope is under way and will be completed in 1996-97, while the Clyde River health centre will be operational at the end of this month. Renovations are under way in Jean Marie River and Trout Lake and planned for Fort Providence, Fort Resolution, Arviat and Gjoa Haven. Planning will begin for a group home for handicapped adults in Fort Simpson. We expect construction to start next year.

We are working with the Department of Municipal and Community Affairs to construct a facility in Snare Lake which combines a health centre and a community office. Design will be completed this year. We are also working with the Department of Education, Culture and Employment to provide an appropriate facility in Yellowknife for MacAteer House, a shelter for victims of spousal assault.

There have been and will be lay-offs and elimination of positions. Our main estimates present a net change in reported PYs of 14.5 positions for the 1996-97 fiscal year. We are proposing that 18.5 social worker positions that are currently underfunded will be funded. These are not new positions. We will create three new positions. Two are required to implement the Guardianship and Trustee Act, and one will coordinate a mentoring program for northern nursing graduates. Through a combination of lay-offs and eliminating vacant positions, we have already reduced 15 positions at headquarters, including one assistant deputy minister position.

We will privatize the Trailcross Treatment Centre in Fort Smith which, unfortunately, means laying off 15 employees. Because this action takes place mid-year, the net effect will be a reduction of 10 person years. However, on the positive side of this initiative, business and employment opportunities in the private sector will be created.

We expect changes as a result of health board initiatives. Health boards were given budget targets and challenged to find ways of providing services with less money. The department reviewed reduction plans prepared by the boards, but did so only to monitor compliance with existing legislative, policy and financial requirements. Boards therefore had significant latitude in making their own reduction decisions and will be held accountable. Board proposals have dealt with staffing changes through a combination of lay-offs, eliminating vacant positions and privatizing functions. The boards have not finalized their plans, but I can give you an idea of the magnitude of change they are proposing. We have reviewed submissions from all eight boards. Over the next two years, boards proposed a net elimination of 137 positions. Of these positions, 35 are vacant and 102 are staffed. Fifty-eight positions are connected with services boards propose to privatize.

These proposals are not new to many of you. They have been shared with the Standing Committee on Social Programs during their review. The department has benefited from the frank and open discussion with the standing committee on the financial and program challenges facing the department. The comments and recommendations received from the standing committee have been incorporated in the main estimates before you today.

Non-government organizations which receive funding from the department will also be affected. The department can no longer fund the many service, advocacy, and professional organizations at current levels. They too will have to look at doing things differently or find alternative sources of funding. Today's main estimates are not all about reductions. They also say where the department will be spending in the coming year. Wellness and empowerment are key pillars of this government's agenda. We share the belief of the Standing Committee on Social Programs that community wellness is crucial to the health and well-being of the people of the Northwest Territories.

The department is working with envelope partners and the communities on many wellness projects, including developing a community wellness framework to guide the creation of community wellness action plans; redesigning the community action fund to bring more focus on specific community problems; consolidating health and social services at the regional level to help integrate programs and make resources flexible and give communities greater influence in determining how their programs are delivered; working with communities in taking a now approach to drug and alcohol programs and facilities; fast-tracking programs for children, youth and elders; reducing the number of clients in long-term institutional care by developing programs and services to encourage and promote independent living; and, repatriating clients and services from southern Canada to the NWT where appropriate.

Empowering communities is another important priority of the government. To further this goal, the department will work with Municipal and Community Affairs and Public Works and Services to transfer infrastructure to the communities; restructure health boards to increase local accountability; and introduce a funding formula to ensure equitable and flexible funding for health and social services programs.

I would like to repeat that the 1996-97 main estimates mark only the beginning of the task we face. Together with communities, boards, regions and other stakeholders, we must do more work over the coming months to meet our department's budget target for 1997-98. We must all play our part in protecting the northern health and social services system to ensure all northerners continue to have access to quality care close to home.

Thank you for this opportunity to speak to the main estimates. I welcome questions on our submission later. Thank you.

Thank you, Mr. Chairman. I am pleased to present the Standing Committee on Social Programs report on our review of the Department of Health and Social Services. The concept of community wellness has been well promoted during the past year. The standing committee strongly believes that community wellness is the right approach to addressing the myriad of social problems in our communities. However, the standing committee would now like to see action. The standing committee would like the government to move quickly and aggressively on making community wellness a reality, not just a theory. The Department of Health and Social Services is clearly the lead on this.

The standing committee supports the idea of community wellness centres as a gathering place for resources. This would accomplish three important objectives: First, it would make it easier for residents to access services since they would be located in the same place. Second, it would provide a natural support group for the front-line workers. These workers -- nurses, CSSWs, teachers, alcohol and drug workers -- currently often work in isolation; this increases the risk and rate of burn-out. Finally, community wellness centres would facilitate sharing ideas and resources and would make it easier for a community to focus the limited resources where that community needs them most. The standing committee hopes to see these centres included in the community wellness framework.

Within the past decade, the department created a number of regional specialist positions. These are in areas such as family violence specialist, child sexual abuse specialist, and alcohol and drug specialist. While the idea was to provide these services closer to the communities, these specialists are still distant from the day-to-day problems. The standing committee looks forward to additional information on potential new direction in this area as part of the wellness framework.

The department proposed a very ambitious slate of reductions and program changes. A number of these reductions are interrelated and will require a planned approach, particularly in the areas of repatriation of clients in southern institutions; foster care, alcohol and drug treatment and medical travel.

The department proposed a number of initiatives which have a direct or indirect impact on foster parents. In most communities, there is a limited supply of foster parents. Some of the proposals from the department indicate a need not only for more foster parents, but for foster parents who will need specialized training. The department plans to develop the foster care base to repatriate clients in southern institutions. The standing committee supports the repatriation efforts of the department. There must be a clear plan outlining how this will be accomplished and how competent trained foster families or other placements will be located for these children. The standing committee also encourages the department to limit short-term referrals to southern institutions.

The misuse of alcohol and drugs is directly related to the other social problems the NWT faces; from sexual abuse and other violent crimes, to rates of STDs, to absentee problems.

The standing committee wants to see a new approach to alcohol and drug treatment which is more consistent with community wellness. Given the very large expenditures for medical travel, the standing committee is pleased to see a number of initiatives within the department to try to get these costs under control.

The standing committee is also satisfied with the new approach to funding for non-government organizations. This approach seemed to be consistent with the principle of community empowerment, community wellness and supporting local organizations.

The department has committed to a number of reduction initiatives with very tight time frames. The standing committee is concerned about the potential for slippage in the deadlines required to achieve the reductions that were identified. With the current financial situation facing this government, departments must achieve the reductions they have proposed in the business plans and budget. The standing committee will be watching the progress of this department, along with the other departments in the social envelope, in meeting the budget targets. In part, this will be done through a review of the quarterly variance reports.

Mr. Chairman, this concludes the report of the Standing Committee on Social Programs for the department. Thank you.

Yes, Mr. Chairman. Thank you.

Thank you, Mr. Chairman. To my immediate right is Mr. Dave Ramsden, deputy minister; to my left, Mr. Warren St. Germaine, director of financial and management services. Thank you.

Yes, thank you, Mr. Chairman. Mr. Chairman, I'm not disputing the comments of the Member with respect to the value of the Tl'oondih program: Their treatment from a family versus an individual perspective; the fact that it creates employment and generally benefits participants through the program. As I indicated to the Member on several occasions, we have provided funding to them to date and we continue to provide funding to them. We are also looking at ways to try to increase some of the funding that would be available to them from other avenues. For example, our officials are coordinating a meeting between operators of the Tl'oondih operation and the medical community to try to make medical referrals accessible to clients so they can benefit from some additional clientele being paid through the medical referral avenues that were used. So we are attempting to work with the operators of the Tl'oondih operation to assist them in enhancing their funding. Thank you, Mr. Chairman.

No thank you, Mr. Chairman. When it comes to that point, we'll point it out to the Member.

Thank you, Mr. Chairman. Mr. Chairman, I'll speak to the Minister's opening remarks. On page 2, the second-last paragraph, the Minister talks about renovations being under way in Jean Marie River, Trout Lake, Fort Providence, Fort Resolution, Arviat and Gjoa Haven; and Gjoa Haven is the one I would like to speak to, Mr. Chairman.

Mr. Chairman, the people of Gjoa Haven are not new to disappointment, setbacks, bad news, letdown. During the 11th and 12th assemblies, a commitment was made from this government to build a new health centre in Gjoa Haven. I remember having to attend the meeting in Gjoa Haven with the hamlet council of Pelly Bay, with the honourable Premier of the government of the day. The Premier, at the time, had committed to build a new health centre in Gjoa Haven. The materials were ready to be shipped to that community. The hamlet council in attendance at that meeting were-very happy to know that within a few months, the new facility would be built for the community. Even the site to build that new centre was located by the hamlet council of Gjoa Haven. We wanted to celebrate the occasion of being told a new centre would be built, only to be told that the facility was being deferred for another year.

Mr. Chairman, it has been two or three years now since the commitment of this government for the community of Gjoa Haven. The structure of the old centre is too old. It may, Mr. Chairman, be substandard. Having to add a new section to the old building may not be an ideal thing to do. I say this because having to add a new section to an old building may, in fact, decrease the lifespan of the new structure because of the old building being unstable.

Mr. Chairman, I have talked with the hamlet council of Gjoa Haven on many occasions and have told the people that perhaps the next government will be able to provide a new building for that community.

Mr. Chairman, will the Minister indicate to this committee that a new centre, as was committed, will be built? Mr. Chairman, is it because that riding happens to be the riding of an ordinary MLA that we may not realize a new facility? Mr. Chairman, is it because the squeaky wheel gets the oil that we may not get that new building?

Mr. Chairman, I have other comments to make, but I would like to get a response from the honourable Minister. Thank you.