Thank you, Mr. Chairman. Mr. Chairman, to my right is David Ramsden, deputy minister. To my left Derek Elkin, manager of corporate and capital planning. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I am glad to see that the department is working with boards, professional associations, and other stakeholders in starting a full review of the health and social services in the NWT. It has been a while now, I imagine, since this type of thing has happened. I think it is important that we do have some new blood doing this. One of the things that struck me from the Minister's opening remarks, was the fact that the department is striving to achieve an integrated system of care that is financially sustainable. I am just wondering what financially sustainable means. I do not imagine that this would mean that it is fully financed by the people of the Northwest Territories. I know that at one point, there was some thought put towards implementing premiums for health care, like Alberta, where I went to school for a couple of years. I had to pay $30 a month, I think it was. I guess I need an indication of what that means. Also, the Minister indicated, under care givers, the department is finding creative ways to involve more local and aboriginal people in the delivery of health and social care in the NWT. I believe that this is an honourable goal, but this particular item needs further explanation, so that people who are not on the Social Programs Committee will have a better idea of what this means. The Minister also indicated that the department is strengthening its ability to monitor things in order to help us control our spending. I think that this is also a very laudable goal and something that needs implementation. I certainly hope that it is successful. Considering the fact that spending has not been held under control in the past, it would be good to find out what type of monitoring is now being put into place.

In the area of addictions, I have had the opportunity to speak with people who work in the field. It was their feeling that the problem with the rehabilitation programs is not necessarily the way that the rehab programs themselves have been run. It is actually the assessment of the people going into rehabilitation and the aftercare that is put into place once a person comes out of rehab. We understand that the department has looked at the success rate. I am not exactly sure how they measured success, but I guess one of the measurements is the number of times a person has to go back to a rehab centre in order to finally stop drinking. I understand that there are some people who have gone numerous times and they still have not stopped. I am not sure if there has been enough thought gone into the problem, that there never has been proper assessment done before a person goes to rehab. We have heard of problems where people wanting to go to rehab and people who actually go to rehab, say in Yellowknife and Hay River, increases dramatically when Caribou Carnival is going on or if there is a huge bingo, that type of thing. I think that the commitment of the people that have gone into rehab in the past has not necessarily been there. That has been a big problem that this proposal, to me, does not seem to address. Unless this is addressed, whatever we put into place will be unsuccessful. Similarly, with the after care, it is absolutely essential that, after a person gets out of rehab, there is a support system in place for that person. Otherwise, it is very easy to fall back into the same trap that the person was in before, hanging around with their friends, perhaps going to bars, going to parties, that type of thing. Once you start doing that, it is very easy to start drinking again. It is very important that after care programs are put into place in the communities to ensure that people who come out of rehab are more successful. I just want to stress the importance of that.

Similarly, under the addictions, a new plan calls for providing 50 percent core funding to treatment centres, and the balance will be based on occupancy. I believe that this is a good move. It could make the centres more accountable as to help them to strive for a greater efficiencies, the rest of that type of thing. There seems to be an indication that it might go beyond, that they might get less than 50 percent core funding in the future. I could not support this type of move, Mr. Chairman. The treatment centres need some type of stability. They need the assurance that they will be getting enough money, so that people can get paid every two weeks. Without that assurance, it is very difficult to hold your staff. This is a very delicate area to begin with and if people cannot be assured that there is going to be a pay cheque four months down the road, then you could be losing good people to go work in the south or wherever. I understand that the money will be going to the regions. I need some kind of an assurance that money that is supposed to be for rehabilitation remains for rehabilitation.

Meaning that, if the three centres that we are supporting in the Northwest Territories, in Iqaluit, Yellowknife, and Hay River, if those three require a million dollars, then that million dollars has to remain in a kitty specifically for those three centres. It should not be allowed to be spent on other things. If it is allowed to be spent on other things, then we are theoretically setting up every one of those treatment centres for failure. For instance, if money goes to the smaller communities so they can set up rehab programs, one week things or whatever, and also for mobile treatment, then I understand that there are mobile, for instance, in High Level. Now, if communities bring in mobile teams from High Level, then there is going to be less money in the kitty for these three centres. We could wind up in a situation where everyone of those three centres winds up in a deficit. I do not think that is the intent of this program.

I sincerely hope that the Minister and his cronies have a plan in their hip pocket to ensure that the money is always available for the three centres that are eligible, so that they can receive 100 percent of the money they are eligible for if they maintain their numbers. Mr. Chairman, I seek consent to conclude my opening remarks.

Thank you, Mr. Chairman. As I was saying, I think we need some type of assurance that the three government treatment centres that we are sponsoring that they are...

Mr. Chairman, I am getting an indication from the Members here just to continue. I request that I would be allowed to continue now.

Thank you. Mr. Chairman, as I indicated, I believe that we have to put some type of mechanism in place to ensure that these three government sponsored alcohol and drug treatment centres will have that pot of money available to them, if they are able to meet the numbers that they are supposed to put through their centre over the course of a year. The Minister also indicated that Fort Smith and Fort Simpson hospitals will be reprofiled, and I think that it is important that Members as well as the public find out now exactly what reprofiled means. The work on the Inuvik and Iqaluit hospitals will only proceed when their respective roles within the integrated health system are clarified.

We need to know, what does this mean, when their respective roles are going to be clarified? Does this mean, for instance, the Inuvik hospital, they have to feed people to the Stanton Hospital so they can only get a small hospital? I think we need a better indication of what this means. In the Community Action Fund, I have received a complaint as well. I know at least one other Member has received a complaint, that the money that went to Yellowknife, once again, there was not a penny that went to the aboriginal groups in Yellowknife. We had asked the Minister to look into this last year. I do not know what types of things were put into place to try to ensure that aboriginal people will get their fair share of the money.

We now know that 20 to 25 percent of the population in Yellowknife are of aboriginal descent. This makes it the largest aboriginal community by population in the Northwest Territories. There are over 4,000 aboriginal people here. It does not seem right that none of the money would go for aboriginal programs. Under medical travel, Mr. Chairman, I understand that our students are being asked to travel by excursion. Is there a plan to put some type of similar limitations on medical travel as well where it is feasible if a person is not going to be harmed by going on excursion fare and possibly going a day late. Would we be looking at that type of thing?

Also, the air miles points that people receive for travelling, I am assuming at this point in time if they go by regular airfare that those points pile up on their own Canadian Plus. I would think that these types of things should go to the government, and similarly, for government staff, it is time that all government travel, all air miles went to the government and we could use this to fight our deficit.

Mr. Chairman, the Minister had indicated that they are going to be directing medical travel monies towards the boards that this would pay the way to an appropriate sharing resources between Nunavut and the western territory. I agree that this is a good start and I sincerely hope that this leads to move into other areas as well, where we can split the monies, and perhaps we should be looking at a split for the next budget, something along the line of population, 60/40 or whatever it is. Each side could then use their money as they see fit for their programs. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I forgive you for getting mixed up with the names. I do not blame you. We are from the same region, we are about the same height, and we are about the same age. Thank you, Mr. Chairman. Mr. Chairman, on behalf of the people of Natilikmiot area, (inaudible), I would like to thank the government for giving concern beyond, in some cases, our expectation. I would also like to thank the staff at the Stanton Hospital for treating people from my area as well as the hospital in Edmonton. There are many concerns that I have under this department and one concern that seems to prevail over others for my communities that I mentioned earlier is in the area of medical travel.

Mr. Chairman, there are times when a unilingual elder is required to travel for medical reasons either by the charter aircraft or by scheduled airline. In many instances, Mr. Chairman, I have people coming over to me, in three of my communities, that at times did not have adequate escort or in some cases, none at all that speak the language. I am not saying that translation services at Stanton Hospital is incapable of translating. On the contrary, Mr. Chairman, I think the translators at the Stanton Hospital are very highly capable given the language. But in the eastern Arctic there are in fact different dialects from one region to another region, in some cases even in the same region. Inuktitut, for instance, Natilik, Pelly Bay, Gjoa Haven, Taloyoak speak about the same dialect. West of Gjoa Haven, Coppermine and Cambridge Bay also speak a slightly different dialect from that same region.

Mr. Chairman, imagine any of the Members here going to a hospital from point A to point B, between your community and the medical centre community, that you do not understand the language, either of the crew of the aircraft, the people that are meeting you at the airport, and then, subsequently, people at the residence that you are going to be staying at, finally the medical profession at the medical centre. I think when the patient is put through that kind of stress, it may not help the patient. In most cases, I am told, from my community, Mr. Chairman, there are times when the patient, even an English patient, is not really able to understand the interpreter/translator. Again, I would like to stress that I am not saying that whoever that person is is not capable, they are very capable, but the problem is the dialects are different between the interpreter and the patient. Mr. Chairman, I think lacking the appropriate escort and interpreter for a patient, even an English patient, may in fact prolong the recovery of that patient. There has to be a dialogue between the medical profession and the patient. I think that is rule number one. In order for the doctor to diagnosis the patient, he has to be able to understand what the problem is, where the pain is coming from. By the same token, for a patient to be able to be comfortable with the doctor, she or he has to understand the doctor. Every bit of communication along the process is very important. I would like to stress that to the Members here. Mr. Chairman, I think, we have talked about cutting services, we have talked about reductions. I understand that concept. I think the public in the territories understand that. But, on the other hand, when the patient is not having an appropriate translator, that is not able to speak his or her language, that may prolong the recovery as I indicated before. I think there is a money saving in this area, of having an escort for the patient, an appropriate translation service for that patient. That is one of the issues that come from my area. I am not only speaking for those people because they have spoken to me. I know of cases where the patient was not able to relate to or understand the language. I would like to stress that the important point is the communication, the dialogue between the doctor and the patient. That should be understood. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. Good afternoon. Mr. Chairman, I would like to begin my general comments on the Department of Health and Social Services, bringing up some points that I have noted in the report from the Standing Committee on Social Programs that I was researching a few minutes ago and from the general comments made by the Minister and from the department's work over the past 12 months.

I would like to start off by simply talking about the reforms brought up by the Minister and the Social Programs Committee. Reforming does not mean simply abandoning, downsizing, and reductions. Some have said that we are moving too fast on the reductions that we have seen in this department. I guess we do not want to be concerned with every criticism, unless they are valid. Mr. Chairman, I think that criticism is a valid one. I do not think that we want to be compared to southern jurisdictions where health care has taken a beating, where they are moving toward more privatization of health care. Mr. Chairman, I would note that the current major review being done by Med-Emerg, and again I have to reiterate our concern that the Nunavut hospital located in Iqaluit, and the Inuvik hospital construction proceed post-haste, following on the heels of the memorandum of understanding in the agreement that was placed by the federal Department of Health Canada in 1997/98, when they transferred the responsibility for health to the Northwest Territories, at that time had promised funding for the construction of these hospitals. I hope this initiative moves forward and I will be asking the Minister later today or tomorrow on that initiative.

There is a major concern with the Department of Health and Social Services having relinquished its responsibility for social assistance. Although the name is Health and Social Services, social services has fallen now under the Department of Education, Culture, and Employment, and is being called income support. Income support or social assistance causes a cross pollenization of departments and responsibilities. This causes confusion, not only for the Members, but also for the public at large who are asking questions and seeking information at the local level. The confusion here is who do you address the questions to? Do you go to the town social services department, or do you go to education, culture, and careers about income support? Do you ask a question in the House to the Minister of Social Services or do you ask the question to the Minister of Income Support? There is confusion not only at this level, but at the local level. Thank you. I see the Minister acknowledges that there is a problem. The high rates of infant mortality, FAS/FAE, and other health matters have to be shown and demonstrated that the root cause here, Mr. Chairman, is the social economic problems of the Northwest Territories.

Reforming our health strategy is not going to address those, unless we look at the total package, the total situation regarding housing. The stop gap measure that was announced today is a step in the right direction, but it is a small step. The social economic problems that we are dealing with at the community level, at the regional and the territorial level, have to be addressed.

Mr. Chairman, the Minister, Mr. Ng, has taken on a difficult challenge with this department over the last 12 or 14 months. It has been reflected, I think, and demonstrated over the past few weeks with the announced closure of Delta House and some other facilities. It demonstrates the tough fiscal situation that this territory has found itself in, because of the mismanagement and the largesse of past governments. With a short 18 months left before division, there is very little concrete that you can plan in a five to 10 year strategy, because you cannot tie one government into carrying out the wishes of another government in that successive right. That is something that has to be addressed.

Mr. Chairman, I understand the Minister and the work that he has put in. The Social Programs Standing Committee of this government, of this House, has done a lot of work in addressing some of the concerns and needs of the constituency at large. The recommendations following out of the Standing Committee on Social Programs, I hope will be taken seriously by the Minister, and implemented as part of the policy and programs and ongoing operations of this government.

Mr. Chairman, the time for rhetoric is past. Concrete measures and initiatives need to be taken now. Although, we live in the envelope of reductions and downsizing, we have to remember the people that we are here to serve. As legislators in this Assembly, we are here primarily as law makers. But we also have to look at the public purse and hopefully provide programs and policies that are beneficial to all residents of the Northwest Territories. I think that after reviewing the Social Programs Standing Committee report and the address and the budget of this envelope of Health and Social Services, we are moving toward that goal. I also see that there is a lot of pain to come, and there is no way that you can look at the budget of this department, or ECE, or any other of the major departments under the social envelope, without looking at the social economic conditions that have caused the problems that we see right now in our society. With that, I would like to end my opening comments, Mr. Chairman. I look forward to reviewing this budget in some detail with the Minister and the departmental staff. Thank you.

Thank you, Mr. Roland. For the record we are on Bill 8 Appropriation Act, 1997-98. Health and Social Services, program summary and we are on general comments of the Members. I have Mr. Miltenberger.

Thank you, Mr. Miltenberger. General comments. We are considering Health and Social Services. Are there further general comments? If not, do we agree that we go into detail?

Agreed.

Thank you, on page 6-12, directorate, operations and maintenance, total operations and maintenance is $1,446,000. Agreed?

Agreed.

Thank you. Total expenditures, $1,446,000. Agreed?