Yes, Mr. Chairman. I am pleased to present the 1999-2000 Main Estimates for the Department of Health and Social Services. The Main Estimates are based on the strategic plan and business plan presented to the Western Caucus last November. The department continues to work towards an integrated system of care that meets the needs of northerners and is financially sustainable. Our success depends upon effective collaboration with boards and professional associations, non-governmental organizations and other stakeholders.
Across Canada, there is serious public concern about the future of our national health care system. In the NWT, we face many of the same pressures. Some of these challenges include a shortage of nurses, physicians and social workers; an aging population; a high birth rate; an increase in preventable conditions and diseases; an increased reliance on rapidly changing and expensive technology and new drugs; and increased public expectations.
These are just some of the factors that are driving up costs. Unless these pressures are addressed, health care costs and social services pressures can be expected to increase. We need to take bold steps today to ensure that we will have an effective health and social services system in the NWT in the future.
Part of the answer lies in improving the efficiency and effectiveness of our health and social services system but perhaps the greatest challenge is finding ways to divert limited resources from acute care to prevention and early intervention.
The department is requesting a total of $166.466 million for 1999-2000. Key features of the Main Estimates. Over $1.8 million has been committed to the ongoing implementation of the recruitment and retention strategy announced earlier this year. The strategy has three key goals: developing a northern health and social services workforce; stabilizing the health and social services workforce; and increasing competencies in the northern health and social services workforce.
Developing a northern workforce is a long term goal. The department has partnered with Aurora College, the Department of Education, Culture and Employment and the NWT Registered Nurses Association to increase opportunities for Northerners to train as nurses. We are also expanding and revising our northern nursing programs to ensure that our graduates have the skills they need to deliver high-quality care to our people.
The government has also allocated an additional $3 million over the next two years for the recruitment and retention of nurses. As outlined in my earlier Minister's statement on this matter, Canada faces a national shortage of nurses. Additional funding is urgently required to ensure that the Northwest Territories is able to compete for a diminishing pool of nurses.
Medical travel continues to be an integral part of our delivery system. The budget includes a $500,000 increase in medical travel, or about 8 percent. The boards are looking at ways to contain these costs and are working together to find system-wide solutions. Physicians continue to play a vital role in our delivery system. Over the past several years, the NWT Medical Association has voluntarily agreed to decreases in the fee schedule in response to fiscal restraint. The current fee schedule will be renegotiated in 1999-2000.
A number of commitments have been made to help improve the health and well-being of northerners, including the development of new strategies for health promotion, mental health and services to children and youth. A new territorial health promotion strategy will focus on healthy pregnancies, tobacco harm reduction and cessation and active living.
It is often said that an ounce of prevention is worth a pound of cure. This is especially true when it comes to children. New research about brain development in infants and children tells us that the first five years of a child's life are the most critical. Preventing Fetal Alcohol Syndrome and Fetal Alcohol Effect must be a priority. In human terms, the cost of FAS and FAE cannot be measured. In financial terms, the costs are also great. The number of children who require special needs assistance in our schools is rising, as is the number of children who will require a lifetime of institutional care and community support. Mr. Chairman, Fetal Alcohol Syndrome and Fetal Alcohol Effect are completely preventable and we must do more to help ensure all babies are born healthy.
Mr. Chairman, there is a lot of concern in our communities about cancer. Unfortunately, most of the cancers we see in the NWT are tobacco-related. Tobacco is also linked to a number of illnesses in children. The benefit of smoke-free homes and smoke-free public places where children are present cannot be overstated. Our health promotion strategy will address tobacco use in two ways: reducing the harm caused by tobacco and helping people stop smoking.
The third thrust of the health promotion strategy is active living. We look forward to partnering with the Department of Municipal and Community Affairs, the Department of Education, Culture and Employment, boards, and communities to promote the benefits of exercise. Mr. Chairman, northern people were always very physically active. Today, like other Canadians, northern people do not always get the exercise they need to prevent illnesses and stay healthy. Many of our traditional activities, like fishing and hunting, not only provide good physical exercise in the great outdoors, but also an opportunity for families to have fun together. Mr. Chairman, as the father of six children, I believe that strong families are the key to healthy communities. Without good parents and healthy homes, the programs governments provide have a very limited benefit.
The Strategic Investment Fund will continue this year with an investment of $1.5 million. This fund helps boards invest in community initiatives that focus on health promotion, early intervention and prevention activities. I am pleased to report that many of the community projects funded in the past have focused on parenting and early childhood activities. Investments in these areas will reap long term benefits by building healthy families and communities, and by preventing diseases and thus avoiding costly interventions. The rules for the Strategic Initiatives Fund will change this year, making the funding more accessible to boards.
Care and protection of children and youth is a continuing concern. An additional $1.2 million has been allocated to meet the growing demand for foster care services and for sending youth to treatment facilities in southern Canada. The social envelope departments are working together on an integrated strategy for children and youth. The strategy will establish baseline information on the health and social status of northern children so that we will have benchmarks against which to measure progress. The strategy will also identify cost-effective improvements to programs and services for children and youth. The approach will be evidence-based, drawing on the experience and research on best practices undertaken in other jurisdictions in Canada and internationally.
Moving to the capital side of the budget, minor capital is proposed to increase by $3 million. Part of this investment will be spent to develop and implement a comprehensive capital planning system for both equipment and buildings. The results of this work will allow the boards and the department to better forecast capital replacement needs in future years. It will also ensure that limited capital dollars are spent where most required.
Work is progressing on schedule with the Inuvik Regional Health and Social Services Centre replacement project. As this project is being developed under the P3 policy, no funding is requested in the Main Estimates. The Main Estimates also include funding for work on children's facilities in Fort Smith and in Yellowknife. These projects will be further elaborated once a review of children's programs and services, now underway, has been completed in the fall.
Mr. Chairman, earlier today I announced a Minister's Forum on Health and Social Services in the Northwest Territories. This forum will build on the strategic plan released last spring. The goal of the review is to find ways to ensure the sustainability of our health and social services system. Northerners generally have good access to good care, but demands and needs are growing. At the same time, our ability to meet those demands is challenged.
In addition to the fiscal realities outlined by the Finance Minister in the Budget Address, the system faces many challenges. The national shortage of nurses has resulted in high turnover and high vacancy rates, particularly at the community level. We also see alarming increases in the number of preventable illnesses and conditions, some of which are very costly to address, in both human and financial terms.
Mr. Chairman, I want to once again be very clear and upfront with the Members of this House and with the public. This forum is not a fishing expedition to raise public expectations that we can get more money for health and social services. The focus of the forum will be how to preserve the sustainability of the health and social services system.
There is a need for a review of spending practices in the entire health and social services system to ensure we are obtaining optimal value for our expenditures. As part of the review, information about health and social trends and cost-drivers will be shared with the public, so that we can have an informed and constructive discussion about how to ensure the sustainability of the health and social services system.
Mr. Chairman, I am confident that with continued good cooperation and support of all of our partners, the boards, the professional organizations, communities, non-government organizations and the social envelope departments, we can continue to have an excellent health and social services system in the Northwest Territories. Thank you.
