Thank you, Mr. Chairman. I would like to recommend that we start consideration of The Final Report of the Minister's Forum on Health and Social Services.

Thank you, Mr. Chairman. I will not have many questions today. I recognize this is our first opportunity to speak on this. We have not had our briefings as Members of our respective committees, or Health and Social Services, in this case. I would like to give the Minister assurances that I will have many specific questions once we have a chance to meet in committee to talk about this particular report and how it figures into the overall planning of the department.

I would like to reiterate some of the concerns I raised in question period today regarding this report and the department.

The first concern is this is the latest in a fairly long list of studies and strategy documents which will be followed, I think sometime in April, by the Children and Family Services Review. I just wanted to clarify some of the wording of the document because it is quite vague and subject to interpretation in a lot of cases. I wanted to make sure I had the right sense of what they were trying to say. I found, based on my discussions with a board member, that we shared some of the concerns and the interpretations of this particular document, specifically the department is a main part of the problem in the delivery of health and social services in the Northwest Territories.

There is a focus on process, as these repeated studies of strategizing documents indicate. We spent hundreds of thousands of dollars, if not over $1 million to $2 million mark, on these particular kinds of studies. I think it is time, as the report indicates, to get on with it, and that is directed to the department.

There are many issues here that I feel we have to look at. This document looks at integration at the community level. But it does not adequately touch on the need, in my opinion, for the department to look at how it is doing business.

My numbers show me there has been an overall increase after the deficit reduction cuts in 1997. The Department of Health and Social Services managed to re-inflate itself at the headquarters level by 11 percent, according to the numbers I received from the Financial Management Board Secretariat. It was pointed out to me that there are up to 24 consultants sitting in headquarters in Yellowknife to provide these various support services to the communities and health boards. That number alone causes significant concern.

The fundamental issue is the department gives a lot of responsibility but insufficient authority for boards to make decisions. Unlike education boards, who have authority in the budget side, they can make financial decisions. Health boards cannot. I believe one education board has an acceptable surplus. Health boards, without exception, are running in the red. There is no incentive for them because the department claws back any kind of surplus in key areas where there may be some savings. There is no reward for showing any kind of incentive, ingenuity, creativity or initiative. It is a fundamental difference in approach, which I think speaks to the need to look at how we do business.

I am also concerned about the number of regional program dollars that are actually kept in headquarters that boards have to apply for. Often times it is so convoluted and difficult that many boards do not apply. In effect, what is left is lump sums of money at the headquarters level that is left to the latitude of the headquarters people to put to their own projects because the money is being lapsed by the regions. That was the basic thrust to the question I asked in the House today.

I think the concern of sharing of best practices, which speaks to the issue of communication as well, focuses on the community level. In my opinion, there are critical communication shortcomings and the lack of sharing of best practices in the coordination at the headquarters level.

The board chairs in education, for example, have come up with a format in the process where the board chairs and the Minister can sit down and do some substantive decision making, deciding on issues and setting direction.

The situation with the health boards is so frustrating. They set up their own separate association of health boards. The sense I have is it is almost an adversarial kind of relationship. Which begs the question, why? Why is the cooperative approach not there? Why is there that inability to be cooperative and make the necessary steps to bring people together? That way, you can demonstrate to the communities that there is work being done at the headquarters level.

That work, Mr. Chairman, is not only within the government, but encompasses the pressing need for health and education to play a leadership role in the link with the social envelope. If we are going to make the progress and advances in the area of strong healthy families, children being conceived and born healthy, more than ever the department is going to have to demonstrate leadership. It is going to be incumbent upon them to do that.

This is a continuation of the process that started back in the 13th Assembly when I first went on the Social Programs Committee. I have been tracking this. We have worked through four budgets with the Department of Health and Social Services. I know there is a focus on process, an inadequate attention to outcomes, to numbers, to accountabilities.

Therefore, I would like to suggest that, like education, Health and Social Services should come up with an accountability framework. They should develop a process that puts things on the table for health boards, yet also outlines the obligations and duties of the department, in order that they may be accountable and justify what they are doing. They need to demonstrate how they are providing leadership and trying to carry out the priorities that are identified by this Assembly and by the department.

The structure of governance issues, Mr. Chairman, is also a significant concern to me as we look at the layers of committees, board structures, agencies: the proliferation across the board is very confusing. We have touched on this very briefly. I am glad to hear the Minister say she is open to seeing what possible changes can be made.

It is not just a question of looking at improving health and social services boards anymore. I think we clearly have to look at how we are going to integrate our services under the social envelope. I have a lot of interest and respect for the work the Dogrib people have done in the area of community services boards. When I met with the health and social services board in Fort Smith, I made the case to them that I thought this was the way we had to go as a community. I did not see a regional board in the South Slave being able to be established and effective.

I think we have to look at the other areas. While the mandate of the committee was not to create any new costs and to keep within the existing budgets, the issue of addiction treatment centres, training for people, board restructuring, are all areas in which we can use existing resources and re-profile. Otherwise, there is going to be a cost. There will be some new requirements. My colleague for the North Slave has requested and made it clear they need an alcohol and drug treatment centre.

Mr. Chairman, there are a whole host of very detailed areas I look forward to going into with the Minister. I would like to point out I will be pushing for an accountability framework, along with a regular reporting back by the department to the Legislature and the Social Programs Committee on a timely basis. They can report on how these recommendations are being implemented and how they tie into the business plan, and what kind of progress is being made on all these key areas. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. Mr. Chairman, the Member is right. Over the next couple of days, we are going to have the opportunity to go through more briefings and departmental overviews. He says questions are coming, and that is good because we all have a job to do. The job of the Ordinary Members is to express your opinions and ask the questions. The job of Ministers is the undertaking to get departments to answer those questions as best they can.

The Member once again makes reference to the long list of studies. I think there are about 180 recommendations in those combined studies. We have a large amount of material to deal with. I think this material effectively represents the opinion that is out there.

One of the things about the forum is that it does make the recommendations. It has a lot to do with process. The priority the Member speaks of when he says accountability and reporting back to the Legislative Assembly on the progress... one of the things that is not identified in the forum report is the clear targets with the ability for measurable results. I think we need to now take these documents and try to set clear targets.

If everything is a priority, nothing is a priority. That is the kind of information I am hoping to help come up with by meeting with the Social Programs Committee and hearing from other Members.

It is good to evaluate the results and see whether or not we are receiving outcomes from our efforts. I do agree with the Member on that. I think we need to take this information and set some obtainable and clear targets so we can see whether or not we are reaching them.

The Member spoke about the integration of services at the community level. Taking that back a step further, I think we need to look at a more integrated approach. We have so many different funding sources for communities. The Member asked the written question today as to funding sources for boards. Just to give you an idea of some of the federally funded programs, Aboriginal Head Starts, AIDS Community Action program, Canada Prenatal Nutrition Program, Community Action Program for Children, Population Health Fund, Community Animation Programming. There are all these different programs and funding sources, which amounts to millions of dollars.

I think what happens once the programs get down to the community level, the organizations build up around these certain directions. What we end up with at the community level are quite a number of interested organizations who, all in their own right, require administration and the ability to write funding proposals.

When I was in Fort Providence, I was able to get together with a large committee of people. They have said they want to coordinate their efforts at the community level so they can put more emphasis on workers to do the actual work, as opposed to the administrative function.

I think that is a realization communities are going to arrive at over the next while. Each of these NGOs and special committees that spring up at the community level generate a certain amount of economy in the community. There are jobs associated with them. I think it would be better to see if there is a way to pool those resources and the delivery of those resources, so we can avoid duplication. We certainly need every dollar we have to go to good results.

Another issue the Member raised is the number of consultants at headquarters. I will have to ask him for more specific detail on that issue. My impression is there certainly seems to be a good relationship between the boards and the department. But the Member may have to elaborate on further information if he feels things are to the contrary.

I appreciate the Member has a long history of not only working in the social field and health field, but also three years on the Social Programs Committee. He would be in a good position to have made observations that some of the rest of us would not be, because we worked on different envelope committees. That is all I have to say in response to Mr. Miltenberger's opening remarks. I look forward to meeting with him on Wednesday when he chairs the Social Programs Committee. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. I also look forward to Wednesday when we will get a chance to sit down with the Minister and get a briefing. I think that is very important. While I have had a chance to take a cursory glance at the report, we have not really been able to examine it closely yet. But one of the things I have been able to glean from the pages as I go through this, is that no report can be done in isolation.

To borrow a concept from my colleague, Mr. Roland, I think we get into trouble when we try to take a stove-pipe approach to these problems. Mr. Miltenberger alluded to the same thing. One of the things I gleaned from the information was that education is an underlying theme and a priority.

One of the things the report mentions is we have real problems in the area of recruitment and retention. We know we are battling a shortage of professionals in the health care field in the south. Our prospects for recruiting people from the south are not great in the short-term future. I think we realize one of the things we have to be focused on is training Northerners.

We have a great program at Aurora College that is training nurses. I think 39 or 40 nurses have graduated in the last three or four years. This is a great step. But when we look at the numbers that we need across the Territories, we have some 400 nurses who are currently employed. My numbers might not be correct, Mr. Chairman. Roughly, we are currently able to train about 10 percent of the work force.

We also see that of the 39 nurses we have been able to train, most of them are currently working in Yellowknife. It has to be this department's priority and focus to be able to not only train Northerners, but to get Northerners back to the communities where they can work with the people and make a difference.

FAS and FAE is a huge concern, and I think education plays a major role here. People have to understand the implications of the choices they make. We have to promote healthy lifestyles. Education will play a large role in how successful we are in doing this. I think now we need that, with the discussions on teacher to pupil ratio and problems in the classroom, special needs is a huge issue. We are going to find we will have to mainstream special needs students and provide special or extra help to students who are at what we would have previously considered a normal level. That is how large this problem has become. I think it is epidemic. This is something we are going to have to work on. Education is the key here.

Mrs. Groenewegen alluded to the fact that we cannot just pour money down a black hole. We have to do something at the front end. We can throw a lot of dollars at this problem, and it will not go away. Education has to be a real priority.

I mentioned healthy life choices. This is something we really have to promote. Essentially, we all know we are smoking, drinking and gambling ourselves to death, furthermore to veritable bankruptcy. We are spending a huge portion of every dollar on the social envelope, and health problems are the majority of the spending. Citizens have to be aware of this and realize that we are in a catch 22 situation.

The key has to be education. If we can educate our people and make them realize they have to make decisions that will impact their own health, we will be a lot further down the road. I would like to thank the Minister for her comments today. I look forward to working with her in the Social Programs Committee and getting briefings from her. This is a critical and very important piece of work we have here and I look forward to looking into it further. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. Mr. Chairman, the Member is right that no report can be taken in isolation. There are so many areas of life in the North that are impacted by aspects of the way people live their lives. Everything is inter-related. The Member refers to education as an underlying theme and I could not agree with him more. We as a government have a wonderful opportunity to raise that awareness to the fact that we do have a problem. It is epidemic and it is escalating.

I do not know if there has been a willingness in the past to admit to the seriousness of the problem. It is catching up with us at an alarming rate. We hear statistics from teachers telling us that 40 percent of the children in their classrooms have special needs. We cannot afford either the monetary or the human costs of not pursuing these needs proactively.

With respect to recruitment and retention, the Aurora College's membership is excellent and expanding, training workers to go into the communities with the specialized skills and tools they will need to serve the communities. I am pleased to see the cooperation with Aurora College in helping to create a Northern workforce, which is ultimately what we need. Anything else in the short term is not a permanent solution.

When we talk about education and awareness, one of our best focuses could be creating awareness in children who have not yet taken up an unhealthy lifestyle. I was very pleased in Fort Providence when we saw children talking about tobacco addiction and the program going on in the community. With some of the more senior people in the community, I do not know if we would ever really register a lot of results in terms of tobacco cessation.

When we are talking about FAS and FAE, if we could focus our attention on the child right from conception to the age of six years, there is a tremendous amount that could be done during that time period. I know the department has talked about that in some of the overviews which have been given to Members. Those are the kinds of areas we have to decide on, if that is a priority we want to direct our attention to.

One of the things we have already talked about as a group is how much awareness there is in the communities as to the cost of some of these indicators we refer to. How can we get the message out to communities that if this amount of money was not spent on addressing this problem, this is the positive direction in which that money could be spent?

I think sometimes we quote statistics, but we need to break it down into bite size pieces that people can take and relate to. Then, communities can set goals and targets, just as we as a government need to do.

When we talk about healthy life choices, we look at the area of role models. I think there is a tremendous amount of good that can be done with that. We sometimes tend to focus on the negative statistics. There are people in our communities that are healthy, stable, and doing well. We do not celebrate that. We could be more positive in our awareness campaigns in depicting them and their actions, and the result of their healthy life choices.

Members of this House carry a lot of responsibility for creating awareness through what we do as role models as well. People watch us and what we do and say, so we have a huge responsibility in that area as well.

It was only five weeks ago the majority of the Members of this House entrusted me with this responsibility, and subsequently Mr. Kakfwi assigned me with the portfolio of Health and Social Services. I just want to tell you, even though the forum report points out many challenges, I think it is an area where we can make progress. I certainly sense optimism in the department and amongst the Members as well. Any positive impact we have will be good and make this worthwhile. Thank you, Mr. Chairman.

Thank you, Mrs. Groenewegen. General comments, Mr. Roland.

Thank you, Mr. Chairman. Mr. Chairman we have heard on a number of occasions about work that has been done by previous governments, trying to make a difference when it comes to the health and social well-being of the residents of the Northwest Territories. This particular one was started in the 13th Assembly when Members of that Assembly requested the government look into health practices of the departments and boards in the Northwest Territories.

I think we have to do a little history on this process. For example, one of the terms of reference is to seek recommendations in four specific areas, one of those being governance.

If you look at the system that existed when the Government of the Northwest Territories was first created, there was a central agency that took care of health and social services for the entire Northwest Territories. Over the years, it has slowly devolved to communities and regions. For example, the health boards do a large portion of the delivery of the programs the department was once responsible for. One can always argue there is more work that needs to be done in that area to pursue the further devolution of responsibilities. We have to look at having community representatives, whether it is education boards or health boards, representing the department at the community and regional level.

Those areas still need to be worked on and approved. For example, on health boards, the majority of those positions are appointed by the Minister. There are numbers changing where communities are requesting to take over that responsibility and join with the district education authority, and have those positions elected. I think that is definitely a step in the right direction.

There is still much work to be done in that area if we are going to improve on it. We will need to work closely with the boards. For example, it was a problem to some degree in the 13th Assembly, when Members of the House would question the Health Minister about certain activities that were happening in a community or region. There were, at different times, a statement that this would have to be checked with the boards first before a response could be made.

In my past role as a Minister in that department, I know that at the end of the day, the buck stops with the Minister. This has to be clarified. What roles do departments play versus boards? We have given a fair amount of authority to communities and regions. Accountability also has to go with that. There is such an array of issues when it comes to something as big as heath and social services. I think we are going to have to take it step by step, but I believe some areas can be clarified early on and acted on because they have been raised again and again.

Governance is one of those areas. We are going to have to make clear to people some of the changes that have happened as an impact of devolution. For example, In the area of income support, communities have taken it on at one point but returned it back to this government because the negative decisions that had to be made at the community level were very stressful. There are pros and cons to this. As we slowly develop as the Northwest Territories and continue to pursue higher goals, we will come up with a system that is more appropriate for the people of the Northwest Territories.

We have to get on with it, we have to move forward. The title of this document is very clear, Our Communities, Our Decisions, Let's Get On With It. The Minister has even made comments in the area that it is a very appropriate title. I hope the department is going to move on a lot of these areas once we receive clarification on a number of issues.

There are areas in governance where they talk about moving the authority down. How do you do that in light of some of the concerns in the communities now, where that process is not working? How do you give authority down when at the end of the day, the buck stops at the Minister and the Minister has to respond to Members in this House? That is how many people feel. The last step in the process seems to come back to this House when there are concerns raised in the community and it is questioned in this House. One of the responses is that it has to be clarified with the board first before any formal response can be given. That is an area we are going to have to improve on.

Mr. Chairman, the roles of the boards and how you establish those health and social services boards is vital. For example, in my region there used to be 14 members on the health board, one representative from each community. That cost a lot to bring those people together to go through the business of the health board. One of the ways of changing was to try to use the aboriginal organizations, the Gwich'in organization, the Inuvialuit organization and the town councils of Inuvik and Norman Wells. We would try to use those organizations and do work to reduce the size of the board so the work can be done, and to use those organizations to spread the information. We have heard a number of times in this House that this is not the best process, as it continues to run into problems.

Information flow, as we heard, is a common theme, not only in the government, but specifically in the Department of Health and Social Services. The Minister herself has said the department can do better work in the area of getting information out to the public. Get out some of the positive news, which is very rare in the Department of Health and Social Services. We found on many occasions the news you hear coming from Health and Social Services is more of a somber nature. The name that was given to this department behind closed doors or in committee was the department of pain and suffering. That seems to be the issues you are dealing with. Every decision you make affects the lives of individuals in the Northwest Territories.

We have heard of the medical travel situation. I was a member of the committee when we first sat down and were told there could be savings in the area of medical travel. That was our very first budget. Unfortunately, six months out of the gate, we were informed that they did not meet the targets. They overspent six months into the budget. How do we clarify those? They thought they had the answer back then, and it did not work. I am aware the boards have done a study on medical travel. I would like to get a copy of that report.

We get into the area of programs and services that are delivered in communities and regions. We heard the Minister agreeing with a Member here on combining Education and Health and Social Services. We, as members of the Social Programs Committee, heard on a number of occasions the concerns raised because of legislation that is in place that prevents staff from Health and Social Services working with staff from the education department because of privacy of certain types of information. Although it is the same client working with one government, it seems legislation is set up, that says no, this information is particularly good for ourselves and we cannot share that. When in fact, the client is working with the same government. I think that needs to be looked at.

In the area of special needs, we heard the Minister agree there are 30 percent of classrooms with special needs. I believe Inuvik was the one where they had a specialist come up and do a series of tests in that area, mainly in FAS and FAE. Can the Minister inform us on whether or not that has actually been formally accepted? There was some difficulty with the previous government accepting that information. But we are hearing that number being used here. It would be good to know this is an accepted form of testing, because there were considerations and difficulties of getting that accepted.

A lot of the comments that come forward implied the tests that are out there are very expensive with unclear results. You will not start getting clear answers until you pull a birth mother into the picture and do some work there. I do not know if the department has gone that far. It would be nice to know and to clarify the situation because there is a definite need to get clear information out there. We need to say yes or no. Do we accept the situation with the tests that are out there so other regions can use that kind of test and get on with the job? As the report says, let us get on with it. I will leave that with the Minister. Thank you very much, Mr. Chairman.

Thank you, Mr. Chairman. Mr. Chairman, as a government, I think one of the areas we are going into is seeing the social well-being of Northerners is a priority of this government. As Mr. Roland said, we have to build on the work of previous Ministers and previous governments. When we talk of wanting to address the social well being of Northerners, what makes this government's claims or aspirations in this area any different than any other government?

I think there is an opportunity. That is why I am optimistic. There is an opportunity to take a new look at these challenges. We are driven by our fiscal realities, as well, besides the fact many of these demands for services are growing because of needs. I think we have to do some soul searching and make some very honest admissions about the state of affairs when it comes to some of these social indicators.

The Member is right, Mr. Chairman. We have made some progress. Hopefully, the department will no longer be dubbed the "department of pain and suffering". Mr. Chairman, when thinking about the name of the department, Health and Social Services, I would like to take the first four letters of that word health, which would produce the word heal. When we are dealing with people, we have to recognize the fact that we are dealing with whole people, not just with their physical needs. We are dealing with complex people, and emotional, physical, psychological, and spiritual needs. There is a tremendous need for healing in the North.

I think we need to say that and admit that and say it loudly and clearly so our people hear that. Then we should express our commitment as a government to work with people to find the best ways of addressing that. Mr. Chairman, we cannot afford complacency. That is the bottom line.

As for bringing governance structures and problem solving solutions closer to the community, I believe, again, this is an effort that is in progress and there has been some advancement. Sometimes we talk about boards and bringing the decision making closer to the people, but we do not necessarily recognize that in doing that, we are building capacities at the community level within those boards to systematically and in an organized fashion look at the needs of other people and hear directly from the people and respond to that. That is something that happens over a period of time.

For example, the Chairs that come in for representation on the Stanton Regional Health Board spend a certain amount of time on their board business, but they also spend some time on various aspects of training which they then take back to their respective boards and work with them to build that capacity at that level. It is not just something the department can hand off overnight. There has to be the capacity to deal with those issues at the community level.

I do not think that we are going to see all of the results we want to on a quick basis, but the pendulum that swings between devolving and consolidating is a very expensive exercise. I think we need to state a course in terms of developing capacity at the regional and community levels to deal with these issues. The department has a key role to play in that. From what I have seen, I see them responding to that and doing that. Some Members may have concerns about how that looks, but from what I have seen so far, I have been very impressed and was not aware of all that had gone on in the department prior to this.

The Member speaks of the testing on FAS and FAE and the report from Inuvik. I do not know what tests and standardized tests are available right now, for articulating the degree of FAS and FAE in our communities and in our schools. Without committing to any kind of a further study, I think it would be good to have some means by which to measure this. The reality of FAS and FAE is the indicators from surveys are 25 percent of pregnant women in the Northwest Territories are still admitting to consuming alcohol while pregnant. FAS and FAE is something that can overtake us very quickly.

We have heard of an extreme case where the person is requiring specialized care in a southern facility at a cost of $300,000 per year to this government. People in the communities and we, as a government, have got to become indignant. We have to become very concerned when we hear of people being robbed of their quality of life because of these addictions to tobacco and smoking and things like this. It is a big challenge. I do not know if Mr. Roland is on the Social Programs Committee this time or not, but I am pleased to hear that Mr. Bell and Mr. Miltenberger are committed to working together to address some of these issues. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. Mr. Chairman, I would like to congratulate the members of the committee that went around and obtained this information. It really gives us a reflection of what we are facing out there. I think it is up to us as Legislators to ensure the recommendations have come forth are carried out and we change the way we do things.

I believe they are right when they say the money is adequate to a point, especially regarding the amount of money we spend in the area of Health and Social Services. I believe the problem is the avenue we use to deliver health care in the North. This has to change. We have to find new ways of consolidating the different boards and agencies we have, while at the same time realizing we represent some 40,000 people in the Western Territory in which, with division, we have a smaller area to control, oversee and deliver healthcare and social services.

One area where we are seriously weak is in the provision of community service. We have taken a stroll up the mountain in where we were talking about moving health and services decision making bodies closer to the communities. What has happened is we have moved it into the regions, but we have not continued that journey to its goal, which is in the communities.

My riding has tabled petitions in this House asking for a public inquiry into the delivery of health and social services in my riding, because the regional health board was broken up from the original process of having communities represented to having aboriginal representation and representation of municipalities. Due to that, the communities feel they lost their voice at the table. I think we have to revamp the whole system, realizing we have limited resources. We have to ensure we do it in a way that we hear what the communities are saying. We have to streamline the level of bureaucracy we have now. We spend a lot of money on duplicate services within the Department of Health, where we have regional boards with regional specialists. Most boards have their own mental health officer, alcohol and drug specialist, and somebody in charge of home care and other projects. We have to somehow start sharing our services between the different boards, realizing there is a cost-saving measure there.

We hear a lot about alcohol and drugs. I had motions passed in this House about the Tl'oondih Healing Program. The Minister says we realize we have a major problem with substance abuse, alcohol and drugs, and violence. We have to realize we cannot just heal an individual, send him home and say; "you are going to be okay. I do not worry about you. We will not see you again." Unless you deal with the problem at its source, and deal with the problems in our communities, you can send all the people in the world to all the treatment centres, but they will end up back where the problems come from.

In order to deal with these problems, we have to find solutions which are made in the communities, by the communities and carried out by the communities. In order to do that, we have to have the resources and infrastructure in the communities. The Tl'oondih Healing Program was exactly what the Minister stated. We needed something that was developed by the community for the community to look at problems, not in light of individuals, but in light of the family as a whole.

Even if one member of the family has a problem, every member in the family is affected. Unless you deal with the family as a whole, you cannot just mend or help one individual. They are going to go back into the household where the other members have not had the opportunity to be dealt with. I think we have to seriously consider that as one of the possibilities of dealing with these healing programs dealing with the family as a whole.

The other area basically identified was the lack of funding in the area of alcohol and drug addictions. I have seen the downfall of the alcohol and drug programs in the North. We used to have programs in the Delta. You had Tl'oondih, Delta House, and programs out of Hay River. In Yellowknife, you had the Northern Addictions Program. Those programs have come to a point where they have collapsed because of the demand, but also because of the inadequacy of funding for those programs to do the job they were supposed to do.

I feel we have to find new ways of finding revenues to ensure we have programs to deal with the problems at the community and regional level. If we continue to send people south, we are just back to where we were a number of years ago.

We have to start pooling resources between the different organizations, regardless if it is a health board, education board, or the community infrastructure. We have education councils, yet the communities say there is nothing really in place to deal with the health problems because you do not have community health boards.

I believe there should be a consolidation of all of these boards into one board that oversees health, education, and social services, so we cut down on the bureaucracy but also find ways these boards all work together for the betterment of the people at a lesser cost to this government.

The other area I feel we have to put more emphasis on is health care. The whole area of medical care in our communities has a lot to do with the social and economic well being of people in our communities. We know what the problems are, but if a person does not have the educational background, does not have an economic base such as a job, all you are doing is dealing with one problem after another. The problems keep piling on top of each other to a point where it is just uncontrollable.

I think in order to deal with the health and social problems of this government, we also have to have an economic base established in our communities so those people who do want to take the road of being healthy, have an outlook on life where they can see a future for themselves. They can see themselves with a job and the ability to put food on the table for their families so they are not socially dependent on this government.

With that, I would like to touch on another issue, elders' care in our communities. One thing this government has to realize is that we have an elderly population where we are dealing with the baby boomers. We will have a major increase in the cost of care for our elders. How do communities deal with the health problem of our elders, ensuring they have a quality of life they feel comfortable with and dealing with this at the community level?

Last but not least is the area of the environmental health problems. In the report, I see that they did touch on the water problem in Fort McPherson. I feel it is a health problem. It is not just a municipal public infrastructure problem. It is a health problem. You are dealing with a chemical component which, once mixed with chlorine, activates to a point where you cannot just run it into Brita filters and, at the end of the day say your problem is solved. It is not. I feel this government has to do more to ensure the environmental health of our communities is looked at, not just what is happening in Fort McPherson, but in other communities as well. Because of the infrastructure we have in our communities, this can happen anywhere. I would like to note I am thankful for the report and I look forward to the Minister's responses. Thank you.

Thank you, Mr. Chairman, Mr. Chairman, the Member raises many good points. I am interested in hearing from some of the other Members, so I am going to try and keep my response brief.

The Member touched on a new area no one else had brought up and that was elders' care and its growing need. Indeed, the life expectancy in the Northwest Territories is steadily growing. We are looking at a large increase. I believe it is a 135 percent increase in our elder population by the year 2018. We need to plan for those realities. We cannot wait and respond to them when the time comes. There is a need for elders' care homes in some of the communities right now as we speak, and we need to look at that area as a priority because there is a growing need in that area as well.

I have made a note of a number of the other points the Member has touched on. I agree wholeheartedly we need to look at the family as a whole unit in terms of treatment. Some of the options that are being examined for some of the facilities that we may have in the future that are not being utilized right, is looking at that very need. It is difficult for people to leave families at home in their communities and go other places to receive treatment. We need to look at treatment that is close to home and also looks at the entire family as opposed to individuals in isolation.

On the whole issue of governance, I have asked the department to help develop some criteria for the establishment and continuation of the health and social services boards. As suggested by the Minister's forum, the criteria will need to consider regional issues and anticipate future resolution of more aboriginal self-government land claims being settled as well.

All potential solutions need to be looked at. The model of community services boards which deal with more than just one specific area, seems like it could hold some potential due to the efficiencies of having one group looking at different areas as apposed to several. That makes a considerable amount of sense. I will be getting back to Members and discussing with them what kinds of models we should be looking at. I think that is all that I am going to say at this time in response to Mr. Krutko's remarks. I have made note of his remarks, and he raised some very good points. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. I just have a few comments to make. I plan on writing to the Minister more in depth on my opinion about this report. I would just like to comment first on the issue of governance. This issue has already been touched on by many other Members. There is a balancing act between giving the control over management of health and social issues versus giving control over education. It is a balancing act between giving the control over to the communities versus the economies of scale.

For example, in Maritime and Atlantic provinces, where the scale of population is much larger, the provinces of Prince Edward Island, Nova Scotia and New Brunswick found it was too expensive to purchase hospital supplies separately. They thought it was more economical to combine together, even though they are about 10 times larger than us.

I think the challenge for the Minister is great. Giving enough control to the communities so they feel they have a say in what is going on in Health and Social Services, as well other community issues.

The recommendations in this report are conflicting. They talk of governance, and then they talk about the need to train the people on the board. That is recommendation two. Then there are the recommendations for talks about more integration of NGOs. Right there, you are looking at very conflicting recommendations and more need for resources. I understand the Minister is a little bit adverse to any more studies or reviews.

In listening to what she has to say about this report, especially with respect to governance, it is clear to me she has given some direction to her department already. I would like for her to summarize, for my benefit, what she has done so far in terms of what her vision is for the governance and the structure of the health care. I am very interested in hearing what she has to say about that.

The second issue I wish to address is more specific than the previous point. It has to do with telehealth. I recently had the occasion of being briefed on telehealth by the person who is in charge of delivering that program. It sounded like a very attractive idea, in terms of allowing medical care to be provided to remote areas. I think we have to understand that in order for the program to be successful, there has to be technological infrastructure in place in these communities.

As far as I am aware, most communities do not even have access to the internet. I think it is really crucial that if we are going to introduce that sort of program, which I do not oppose on principle, I think we have to make sure enough resources are provided to make sure the people who are in charge of delivering that service can do it to the full extent possible.

Another point I wanted to address with the Minister is with respect to dental care. I think it is an issue in the Minister's riding, as well as a concern for everyone in the Northwest Territories in general. I would like to have the Minister's update on what she is doing about the licensing of foreign dentists. That may pose a problem with respect to the supply of dentists in the Northwest Territories.

I think the most important issue here is my fourth point, which is substance abuse and alcohol and drugs. I do not want to go into that, not because I do not think it is an important issue, but it is such a big area. I am sure this Assembly will have many other occasions to deal with this issue, and I intend to do so.

With that, I intend on giving the Minister my reply in writing, but those were my comments. If the Minister could please respond to them for me. Thank you, Mr. Chairman.