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.