Thank you, Mr. Chairman. I think the bigger issue that the honourable Member is speaking around is the fiduciary responsibility of the federal government for providing health care, generally not just non-insured health benefits, but all health care for aboriginal peoples throughout Canada. That has been an issue that has not been resolved. It is shared by my provincial colleagues at provincial/territorial health ministers' meetings. That issue is always on the agenda. The federal government does not recognize the fiduciary responsibility for health care. They determine that it is a policy issue for them. They provide benefits to aboriginal peoples by policy. We always speak of the inadequacy of the funding, never mind on reserve, but off reserve as well. As you know in the Northwest Territories, we only have the one reserve, but in a lot of the southern jurisdictions, the aboriginal people are coming off the reserves into some of the larger urban centres. The federal government is not recognizing costs for providing services to those individuals. It is an ongoing major issue that remains unresolved between the federal government and provincial/territorial jurisdictions who see it as federal off loading their responsibilities, Mr. Chairman. Thank you.
Debates of Feb. 24th, 1998
This is page numbers 1041 - 1091 of the Hansard for the 13th Assembly, 5th 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 chairperson.
Topics
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Kelvin Ng Kitikmeot
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
The Chair Vince Steen
Thank you, Mr. Ng. I am getting some indications we want a break here. Operations and maintenance, total operations and maintenance, $59.435 million. Agreed?
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Some Hon. Members
Agreed.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
The Chair Jane Groenewegen
I would like to call the committee back to order. We are on Health and Social Services, health insurance programs, operations and maintenance, total operations and maintenance, $59.435 million. Agreed? Mr. Krutko.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
David Krutko Mackenzie Delta
Thank you, Madam Chairperson. My question to the Minister is, is there any way of evaluating or monitoring how funds are given to this government in health and social services from the federal government for aboriginal people?
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Kelvin Ng Kitikmeot
Thank you, Madam Chairperson. Madam Chairperson, we receive some funding from the federal government. The programs that we provide are a lot broader and more encompassing, so we spend quite a significant amount of dollars more on our programs than we get in. We do not track, per se, the dollars spent on aboriginal people and dollars spent on non-aboriginal people, unless it is specific to a program such as non-insured health benefits. We have to account to the federal government for those expenditures. Thank you.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
David Krutko Mackenzie Delta
Thank you, Madam Chairperson. If you do not monitor, how do you know we spend more from this government than the federal government does on aboriginal people? If you have not worked out the scenario, where the money is allocated, where it comes from and what not. How do you make the conclusion that we spend more money on aboriginal people than the federal government does?
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Kelvin Ng Kitikmeot
Thank you, general speaking, Madam Chairperson, we receive approximately $90 million from the federal government for different aspects of health programs, including those for aboriginal peoples. Our budget is $260 million, somewhere around those lines, that is why I am saying we spend significantly more than what we receive from the federal government, Madam Chairperson.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
David Krutko Mackenzie Delta
Thank you, Madam Chairperson. Has your department tried to sit down with the federal government to work out some mechanism to tracking the exact amount of federal program dollars that are spent in the north which are basically earmarked aboriginal funds?
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Kelvin Ng Kitikmeot
Thank you, Madam Chairperson. Madam Chairperson, no, like I said, unless it is specific for aboriginal programs, like non-insured health benefits, we do not.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1073
David Krutko Mackenzie Delta
Thank you, Madam Chairperson. The reason I ask the question is, especially coming from an aboriginal community where they feel that they should be receiving more in the way of health care and also because of their status as aboriginal people, that there is a responsibility of the federal government who funds this government to deliver programs and services on their behalf. We always seem to come to the
conclusion, no one knows exactly what that amount is or exactly how much is really going into the overall part of this government. We all know that a large majority of the funds that we do get from this government come from Ottawa. There are program dollars that are delivered to this government from the Department of Indian Affairs in Ottawa because of treaties. I would like to know exactly when self-government agreements come into play, the role in the territories for aboriginal groups has the right to deliver programs and services on behalf of the people they represent. In the case of the aboriginal groups I represent, the Gwich'in and the Inuvialuit, basically if they decide they want to take over the whole health care system in the Inuvik region for the Inuvialuit and the Gwich'in, that it has to be based on some formula or some scenario of how much does it cost to deliver health care and exactly how much money is there in the overall pot which will be divided up by the different regions in the west and the different political structures we have. I would like to know exactly what is being done so that when that scenario comes to be, that there will be some number crunching done to identify exactly what is going to be classified as fair allocations and how do you determine those allocations. Can the Minister tell me exactly if any of that work has been done and exactly how soon can we get an idea of what these amounts are going to look like?
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
Kelvin Ng Kitikmeot
Madam Chairperson, I may not have provided the proper information in respect to that area of the billing for aboriginal health care, and I will ask Mr. Ramsden to speak in more detail on that. Thank you.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
Ramsden
Thank you, Madam Chairperson. With the main estimates that are before the committee today, we have an operations and maintenance budget that is some $255 million that being used to support the delivery of programs and services to all people in the Northwest Territories. It is a public system that supports a public that has a significant aboriginal component in it. In reflection of that, we bill and obtain revenue from the federal government for some small fractions. We bill them for hospital care for status Indians and Inuit that is some $29 million. We bill for general medical care for status Indians and Inuit, some $8 million. We have a very, very defined billing process that is audited annually that provides for a process to delineate the costs of hospital and essentially, physician care for status Indians and Inuit. In the course of discussions in the Beaufort Delta, we have shared on an ongoing basis information around the amount of money that is available for the overall system in the Beaufort Delta. Discussions, as I understand it to date in that whole area, have been in regard to the operation of a public system and the information has been shared continuously. There has been no effort to date to try to cost a parallel system for aboriginal people in the Beaufort Delta. I am not sure that the department is able to undertake the costing and the design of a system to run two parallel health care systems in the Beaufort Delta, Madam Chairperson.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074
David Krutko Mackenzie Delta
Thank you, Madam Chairperson. In regards to the way the regional government in the Beaufort region is going to look like, I think it is up to the people to make that final decision. I think, my personal view is that aboriginal self-government is based on an aboriginal inherent right in which the aboriginal people have the right to run programs and services on behalf of the people whom they represent. This thing about a public government structure, at the end of the day, it may fly or it may not. I think that the choice has to be in light of the people who basically are going to benefit in the long run, which are the aboriginal people where this right originally came from. I think if they want to deliver programs and services on behalf of their own membership, there has to be a clear understanding that the pot of money that they are talking about may be over and above what the existing structure may maintain or hold today. So with that, Madam Chairperson, I would like to move a motion.
Committee Motion 21-13(5): To Establish Guidelines And Standards For The Operation Of All NWT Health Boards
Item 19: Consideration In Committee Of The Whole Of Bills And Other Matters
Page 1074