Thank you. The Member is recommending we deal with Bill 13 and once we conclude that, call it a day. Agreed?

Agreed.

Thank you. We will take a break, come back and proceed with Bill 13. Thank you.

--Break

I would like to call the committee back to order. We are dealing with Bill 13, Supplementary Appropriation Act, No. 3, 1998/99. I recognize the Minister responsible, Mr. Todd, to make an opening remark. Mr. Todd.

Thank you, Mr. Chairman. Mr. Chairman, the Supplementary Appropriation Act, No. 3, requests authority for additional appropriation of $6.920 million made up of $2.939 million for operations and maintenance expenditures and $3.981 million for capital expenditures.

The total supplementary appropriations, year to date, do exceed the supplementary appropriation reserve included in the main estimates. The improvement in the 1998/99 revenue forecast has permitted the government to address a few critical needs through these supplementary appropriations. However, our fiscal situation still requires vigilance.

With these additional funding requirements, included in Supplementary Appropriation No. 3, the projection is still for a balanced budget in 1998/99.

The operations and maintenance appropriation requirements includes:

1.$2.8 million to support the recruitment and retention of health and social service providers. This includes $2.4 million for the Department of Health and Social Services and an additional $.4 million for Education, Culture and Employment. The current situation of high vacancies and turnover rates, amongst nursing positions, demands definitive action on the part of the government.

The capital appropriation requirements include:

1.$2 million for the Department of Education, Culture and Employment to complete urgent projects. These include: the conversion of the heating systems in school and college facilities in Inuvik resulting from the decommissioning of the high temperature water system; and technical and program upgrades for the Mangilaluk School in Tuktoyaktuk.

2.$1.6 million for the Department of Health and Social Services to address urgent capital requirements, including a CAT scanner for the Stanton Regional Health Board; furniture and equipment for the Gjoa Haven Health Centre and various other urgent needs for both western and eastern health boards.

Thank you, Mr. Chairman.

Thank you, Mr. Minister. Before we get into general comments I would like to ask the Minister if he would like to bring in witnesses. Mr. Todd, would you like to bring in your witnesses?

Thank you very much, Mr. Chairman. I would like to bring in my witnesses now. Thank you.

For the record, Mr. Todd, would you like to introduce your witnesses please.

Thank you, Mr. Chairman, on my immediate right is Mr. Lew Voytilla, the deputy minister of the Financial Management Board Secretariat. Thank you.

Thank you. Welcome to the committee, Mr. Voytilla. The floor is now open to general comments from the membership. Mr. Krutko.

Mr. Todd.

Thank you, Mr. Chairman, while I did speak to the committee earlier on this morning I did indicate to them, as I have said many times, you cannot spend what you do not have. However, recognizing that and recognizing the priority the House placed on education along with a number of other issues, my colleague, Mr. Dent, is working aggressively to try to address both, on the special needs side of education, where there is a desperate need. Also, of course, as my colleague indicates, on the pupil/teacher ratio. However, again there are some limitations. We are determined as I have said on a number of occasions, with the support of the House, to ensure we meet a balanced budget. Hopefully at the end of the day we will be able to. I cannot promise we will be able to bring forward the possibility of some appropriations at a later date on some additional dollars that may be required in that area.

The fiscal reality is we are not in a position today to expend money we do not have. Mr. Dent is, I believe, working towards that and it will be part of the business planning process which you will enter into in the next two or three weeks. At that time, it will give you a clear opportunity to provide the government, both myself and the Cabinet Ministers, with some direction as to where you feel the money should go. Thank you.

Thank you, Mr. Todd. General comments. Are there further general comments from the membership? Do you wish to go into detail? Thank you. On your Supplementary Appropriation No. 3, 1998, page 5, Municipal and Community Affairs, operations and maintenance. Emergency services, not previously authorized, $154,000. Do we agree?

Agreed.

Thank you. Total department, not previously authorized, $154,000. Agreed?

Agreed.

Thank you. We move onto the next page, in this case, page 6. Health and Social Services, operations and maintenance. Administration, not previously authorized, $2.386 million. Mr. Ootes.

Thank you. The Chair recognizes Mr. Todd.

No, that has no relationship to this budget, to what we are reviewing today.

Thank you. Administration, not previously authorized, $2.386 million. Do we agree?

Agreed.

Yes, I have Mr. O'Brien.

Thank you, Mr. Chairman. I wonder if the Minister could provide some more detail as to what exactly is in this amount that is going to help retain medical staff, nurses and doctors and so on in the north?

Thank you. Mr. Todd.

Thank you, Mr. Chairman. Well I did provide the committee with the detailed breakdown of the two plus million dollars but just for the benefit of the House, I will try to quickly go through it, although I could provide a copy to the House. An example is, undergraduate sponsorships, for about $120,000. This is for a full year, as Mr. Voytilla points out, so it is about $120,000 for a full year. It is summer employment, internship opportunities for about $300,000 for a full year. It is mentoring programs for social workers and nurses for about $300,000. It is the recruitment of northern graduates and students, high school students orientation and recruitment. It is coordinating a northern workforce development. It is a variety of programs that were outlined in the document the Minister tabled in this House earlier last week, in terms of the retention plan. Thank you.

Thank you. Mr. O'Brien.

That you, Mr. Chairman. That is correct, Mr. Todd. I realize that information was provided to us, but I am asking you to provide it to the House and the public. Mr. Todd, one of the concerns I believe the Minister brought up, in relationship to some of the major problems with our nursing staff, why they are leaving and the concerns they have. The Minister indicated one of the problems was isolation, the other was call-out time. In this plan or this area here, you indicate there will be money set aside to bring in extra staff, to help alleviate these long hours and call-outs. How do you expect to do that if we do not have enough nurses to go around as it is now, just for regular duties?

Thank you. Mr. Minister.

Perhaps it would be appropriate is the Minister is sitting in the House, for him to answer that question. He is much more knowledgeable of the details of his program than I am. I am here to defend the money, so I will defer to the Minister.

Thank you. I recognize Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, the intent is the development of the locum relief pool would provide the bulk of the support for community nurses that are operating under the stress if they needed additional relief, because of whatever circumstances were happening in the community at the time. They need the relief to get out for professional development or for the Advanced Nurses Skills Education Program to upgrade their skills. That is the intent, that the locum relief pool would provide the support, Mr. Chairman. Thank you.

Thank you. Mr. O'Brien.

Final question in this area, Mr. Chairman. Is that pool of people, resources, available now?

Thank you, Mr. O'Brien. The last line was not picked up because your microphone was out so, try again, Mr. O'Brien, please.

Thank you, Mr. Chairman. I was asking the Minister whether or not this pool of resources is available now? If not, when it will be, so these changes could take effect to benefit the nurses, and so on?

Thank you. Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, we started advertising for relief assistance in this area about a month ago. To date, from my understanding, we have six individuals we have signed on to be available and obviously we are expecting that to grow, now that we have some resources to assist in that area. Thank you.

Thank you. Mr. O'Brien.

Thank you, Mr. Chairman. When does the Minister think we can fully benefit from these new programs, additional staff and this pool of resources that is underway or being put together now? When will the nurses in the nursing stations feel the full impact of the benefits of what you are proposing?

Thank you. The honourable Minister, Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, I would think it depends upon the circumstances, what aspect of the whole recruitment and retention plan is implemented. In respect to some of the professional development, ANSIP development or facilitating workshops with their peers, that type of thing. That will have to be worked out between the boards and their existing resources they have on staff, in

coordinating how they can manage that.

In respect to an area like the locum relief pool, obviously if there are six individuals that are already signed on, I could perceive that would be put into place if a need were to arise now that they would be able to call upon these individuals to assist some of the existing health care professionals in the territories. It is just a matter of identifying that need and putting the resources to that, Mr. Chairman. Thank you.

Thank you. Mr. O'Brien.

Thank you, Mr. Chairman. Mr. Chairman, is the Minister saying that he is confident with this pool of resources, these six people or whoever he has on hand, this is sufficient so the nurses or medical staff can benefit fully from what he is proposing? An example would be where you have nurses with holidays or off on sick leave, whatever, I believe the issue was that they had great difficulty to get people to come in to help them out from other regions. Is the Minister saying with the pool of people he has now, this will benefit the nurses on staff now?

Thank you. Again I will recognize the Minister for Health, Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, what I said was we have six individuals who have signed on and that is a start and we hope to be able to develop more. Certainly I do not think six is enough. I do not know what the correct number would be. When you recognize there are vacancies, it depends on the various stages of the communities and what their vacancy rates are. It depends on the circumstances of the community who are under stress because of an outbreak of a virus or with the conditions they are working under. Ideally, we would have enough individuals signed up to cover all vacancies, for whatever reasons. If there was stress on the system and the need was there or individuals were designated for holidays or upgrading, that they would not be available to their communities. I cannot say right now what is the ideal amount. All I am trying to suggest is this is a start. I am trying to address the problem of recruitment and retention. We are hoping in the medium and longer term, there is going to be some solution and hopefully it will address some of the immediate, short-term needs as well, over time. Thank you.

Thank you. Mr. O'Brien.

Thank you, Mr. Chairman. The six support staff or pool staff that you have now...is that, at this point in time, to cover the whole Northwest Territories?

The allotted time for Mr. O'Brien is over. I have Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, as it stands now, yes it is NWT locum relief pool. Thank you.

Thank you. On page 6, Health and Social Services, operations and maintenance, administration, not previously authorized, $2.386 million. I have Mr. Ootes.

Thank you. Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, the intent is in respect to the professional development in the interaction fund that is going to assist our health care professionals. There would be an ongoing evaluation of the development, obviously to see if the funds are being properly resourced, that there are actually upgraded individuals within our system and hopefully that we will be able to retain those same individuals. The last thing we want to be doing is upgrading individuals to move on to other jurisdictions or other pursuits that would be detrimental to our health care system, Mr. Chairman. Thank you.

Thank you. Mr. Ootes.

Thank you. Mr. Ng.

Yes, Mr. Chairman. That is what is outlined in the funding proposal. There is going to be a coordinator of Northern Workforce Development, from the aspect of the health field and the aspect of the social service field. That would be over and above the overseer, the recruitment and retention specialist we have within the department, Mr. Chairman. Thank you.

Thank you. Mr. Ootes.

Thank you. Mr. Minister.

Mr. Chairman, I believe we would facilitate this probably in conjunction with the Registered Nurses Association, in the case of nurses. In conjunction with the newly formed NWT Social Workers Association, in respect to any social worker programs. Also we would have our partners, the NWT Health Care Association, the boards that have been a part of this whole process of developing this recruitment and retention plan from day one. So everybody is at the table as it stands now. Everybody has a concerted effort in trying to make this work. Now we have some resources to move

forward on this, Mr. Chairman. Thank you.

Thank you. Mr. Ootes.

Thank you. It requires detail, Mr. Todd.

Mr. Chairman, we are just going to approve these monies today. The Minister did table last February or March, I believe, the whole retention program. If my colleague is asking can we provide the House, prior to March 31, 1999, with an update of its success, I do not anticipate that being a problem.

Thank you. I have Mr. Steen.

Thank you. For the record, Mr. Todd is at the witness table, but I will recognize Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, the intent is there be one pool available to all boards. Thank you.

Thank you. Member for Nunakput, Mr. Steen.

Thank you. Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, I do not particularly have the answer to that today. I believe that is fair to say there are all sorts of discussions ongoing right now between the Nunavut Interim Commissioner Office and our government on shared services. We are aware of that, in particular in the area of health. I do not think it has got down to the level of detail in respect to something like this locum pool that we are just in the process of establishing. I can see there is a possibility of having shared resources, but I cannot speak to that today, at this moment. Thank you.

Thank you. Mr. Steen.

Thank you. Minister Todd.

Yes, I believe the Minister recognizes, as the House has talked about on a number of occasions, the difficulties we are under in retaining medical professionals. The intent here is this to be ongoing expenditures, east and west. It would be all part and parcel of the business planning process, which you will be addressing in the next two or three weeks. Correct.

Administration, Mr. Steen.

Yes. Mr. Todd.

Thank you, Mr. Chairman. Well we will vote these funds today and I suppose, in retrospect, we should have been at this thing a lot sooner, but that is just the way life goes. Mr. Ng will do his best to get up and running along with his staff, all the aspects of the program as he laid out in the documents he tabled earlier in the year. In keeping with the business plans you will do for the west, through the Western Caucus, the retention program will be in there. I am assuming there will also be a retention program in there for the east. That would certainly be the intent.

Thank you. Administration, not previously authorized. I have Mr. Krutko.

Thank you. Mr. Todd.

The intent, I believe, and I do not want to speak on behalf of the Minister, but my understanding of the situation, reading the file, is you are going to have a centralized pool of resources, that as a community requires it, whether it is an emergency or just in respect to additional support that is required; if there are some problems, they would go to this pool and pull upon the resources there. It is not being designed for one particular community because the issue of shortages of medical health care workers is right across the territories. As I said earlier to some questions this week or last week, it is right across the country.

Thank you. That is depending upon the situation, I suppose. Mr. Krutko.

Thank you. On the primary plan, Mr. Todd.

Mr. Speaker, I will let the Minister speak to the detail, but let me once again draw, this is a very serious issue. There are broad-based problems out there, no matter what community you are in. The Minister is trying, through this recruitment and retention plan, to provide a centralized pool of expertise that all communities can pull on when required. It is that simple. We have got to treat this thing seriously. I will ask the Minister to maybe add to my initial comments.

Thank you. Mr. Minister would you elaborate further? Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, if the honourable Member is speaking in respect to the locum relief pool, that is exactly what the Minister of Finance has outlined, in respect of there is no targeted community where those individuals are going to go. It is going to be on an as-required basis and determined by health care professionals. It certainly not going to be a political exercise of, well this community needs it more than this one. A decision will be made by health care professionals where the needs are, Mr. Chairman. Thank you.

Thank you. Administration, not previously authorized. I have Mr. Erasmus.

Thank you, Mr. Chairman. This recruitment and retention plan. We have heard a lot about the problems that are occurring in the smaller communities. It is not only the smaller communities that are feeling the effects of the nursing crisis across Canada. The larger communities are also losing nurses from what I understand. They are also experiencing shortages. Will these funds that are being asked be put into place to assist the larger communities, the hospitals as well so they can retain and recruit nurses as needed? Thank you.

Thank you. Mr. Ng.

Thank you, Mr. Chairman. Mr. Chairman, yes, the plan is that the NWT recruitment and retention plan, that resources are for the Northwest Territories, as I had indicated in respect to the locum relief pool, that is, right now, to be based in Yellowknife. Some of the resources of headquarters, of course, are in Yellowknife and there will be some that will be moved to Iqaluit, depending on what the base funding split is for the recruitment and retention plan. As it stands now, it is at headquarters and the distribution, for example, I used the professional development fund that goes to all boards, no matter where they may be, because there is staff in every community throughout the Northwest Territories. Thank you, Mr. Chairman.

Thank you. We all indicated we have near to a crisis situation here and money is being appropriated, so I do not know. Administration not previously authorized, $2.386 million. Mr. O'Brien.

Thank you, Mr. Chairman. Mr. Chairman, I agree with Mr. Steen in reference to the dollars that are being allocated now put forward to improve our health care. I agree 100 percent. It is long overdue. I am just curious, and my question would be at this point, where we now have allocated and found some money to put toward the problem, given the fact that for the last few years our health care situation has been almost in a death spiral, why is it that we had to wait this long, could we have not done it sooner?

Thank you. Mr. Todd.

We would all like to have done a whole bunch of things sooner, whether it is in health care or whether it is in teacher education, et cetera. The reality is we have been living for some time now with severe fiscal limitations and that is really, to some extent, what it boils down to. We have found some money, as I said in committee earlier today, that we think is targeted in the right areas, and hopefully we will be able to come about and bring the kind of stability that the Minister and the Members are looking for.

I am also, as I said in committee, hopeful, and I say hopeful, that the federal Finance Minister will in his budget in February allocate some money to health care and, if he does, then hopefully we will be the beneficiary of that. I think that is really the reason behind it, but even in these difficult times, there is some reason for optimism. As I have said, we have found these dollars as difficult as it is, and I am optimistic that we may see some additional dollars coming into the federal budget in February. If that is the case, then I am sure my colleague, Mr. Ng, is working hard to convince his federal counterpart that the territory should get their share. Thank you.

Thank you. Mr. O'Brien.

Thank you, Mr. Chairman. Mr. Chairman, not to belabour the point, Mr. Todd, but I am just curious as to when these monies became available that we are now going to put into play, and my concern would be that it may be too little, too late, given the fact that, especially for the Nunavut MLAs, we are on the last days of our term. I am concerned as to the full impact that the eastern nursing stations, the full benefit that they will get.

Thank you. Mr. Todd.

Well, the answer to the first question is that September was when we knew what our fiscal position was. The answer to the second question about Nunavut is that this money will be proportioned out and there will be an

ongoing program, subject to the new Assembly recognizing it will be part and parcel of the business plans, and it will be proportionately divided up as we have done with everything else. As Mr. Voytilla pointed out, it will be up to the new Nunavut government as to how much they want to spend, but we are allocating this money right now, it is territorial money, and we will move as quickly as we can to meet the difficult requirements that are currently in place with respect to nurses.

Thank you. Do we not wish to approve Administration? Not previously authorized, $2.386 million. Mr. Ootes.

Thank you. Mr. Todd.

Yes, you have our assurances, both myself as the Finance Minister and Mr. Ng, who has the responsibility for the program that, in fact, will take place. Thank you.

Yes, once we approve the appropriated money. Administration. Not previously authorized, $2.386 million. Do we agree?

Agreed.

Thank you very much. Total department, in this case, Health and Social Services, operations and maintenance, $2.386 million. Agreed.

Agreed.

Thank you. On page 7, Education, Culture and Employment. Operations and maintenance, culture and careers, not previously authorized, $399,000. Agreed?

Agreed.

Thank you, colleagues. Total department is $399,000. Agreed?

Agreed.