It became apparent as the committee reviewed the departments within its envelope, that there were several different interpretations of what forced growth was. The committee heard that the department has submitted an estimate of $5.1 million to FMB for forced growth to be included in the department's main estimates. The committee also heard that, unlike the other departments in the social envelope, a four-month portion of the $5.1 million forced growth requirement was not factored in the interim appropriation.

The committee questions how it can be expected to offer valid criticism on the state of department finances when it is kept in isolation of important facts. In approving the interim appropriation, the committee will be essentially approving the department's budget for one-third of the year. Committee members believe that by not factoring in forced growth in the interim appropriation, possible belt-tightening exercises that should follow may be impossible to implement in the last two-thirds of the year.

Committee members were disappointed that all forced growth was not factored into the department's interim appropriation and that they were not informed of this omission from the outset of the review. It was only the questioning of the committee members that brought this matter to light. In the future the committee recommends that the department or the Financial Management Board provide notes that describe exceptions in the way the department presents its information.

Nurse Practitioners

Members were particularly interested in the development of a health care system that utilizes nurse practitioners, in conjunction with physicians, to treat patients in the Northwest Territories communities.

Committee members are well aware of the problems the boards and the department are having in attracting physicians to the North. Consequently, this doctor shortage has led to excessive waits for appointments at medical clinics and a resultant increased usage of emergency room services, particularly in Yellowknife.

Committee members believe if well-trained nurse practitioners provided front-line service and dealt with the minor complaints, that doctors would be able to concentrate on the patients that truly needed their attention.

There may be some resistance on the part of residents, used to dealing with doctors for every complaint, to a nurse practitioner based system. However, committee members believe that this is the best option that the department and the boards have in meeting the doctor shortage in the larger communities. After all, the community nurses have been providing quality health care to residents of our smaller communities for years and are the backbone of our rural health care system.

The committee strongly encourages all parties to seriously examine the role that nurse practitioners could play in the delivery of health care. The committee looks forward to reviewing an implementation plan for a Nurse Practitioner Program during the business plan.

Early Childhood Education and Programs

Committee members are very concerned that given the lack of money available for early childhood programming that there be a coordinated effort between the department, the Department of Education, Culture and Employment, the federal government and any aboriginal government delivering such programming. This coordination is essential if governments as a whole want to make progress in meeting the needs of our youngest residents and provide the children with the head start that they need to be successful in life.

It is the committee's hope that a proactive, cooperative approach could be developed between all levels of government involved in early childhood programming. The committee expects to review a coordinated effort on early childhood programming during the business plan review.

Undedicated Capital Funds

Committee members were very concerned that they were being asked to approve $200,000 for new capital projects in the interim appropriation. Members were uncomfortable with not knowing the specifics of what and where the project was to be located. Committee members believe that giving approval, at a time when other capital projects are being deferred, was tantamount to the committee giving the department permission to operate a "slush fund". This "slush fund" would not be subject to the oversight the committee exercises over other capital projects.

The committee also noted that the department is proposing $250,000 in carry-over funding in the interim appropriation for the possible renovation of the Territorial Treatment Centre in Yellowknife. In the minds of the committee members, the department's explanation of the variables needed to fall into place for this renovation to proceed meant little chance of a start within the four-month window covered by the interim appropriation. The explanation that one of the major variables involves decisions by a board outside the direct control of the government reinforced the committee's belief that the department's timeline for the renovation was overly optimistic. Committee members could not justify the inclusion of the renovation to the Territorial Treatment Centre in the interim appropriation.

In the future, the committee would like to see the specifics of major capital projects. It is believed that the department has had sufficient time to evaluate the condition of the infrastructure inherited from the federal government in the health transfer and that a plan to address the inadequacies should be in place.

Unless the committee can be convinced otherwise, the committee looks forward to being presented with a plan for new capital projects during the business plan review.

There was some concern on the part of committee members that the single largest capital project the government will be involved with in the upcoming fiscal year was not mentioned in the interim appropriation or in the department's presentation to the committee.

The committee does understand that the Inuvik Hospital is scheduled as a P3 project and, as such, there are no funds committed in the interim appropriation. However, as a matter of public education, the committee would like to make the department's responses to Member's questions on the timelines for the project a matter of public record.

The request for proposals closes on April 28, 2000. There will be three to four weeks required for evaluation of the different proposals. Once the evaluation is completed, a recommendation will be made to the Financial Management Board. If the board accepts the recommendation, negotiations will be entered into with the successful proponent on the actual lease and development agreements. The Financial Management Board then gives these agreements. It is hoped that this process would only take until late May or early June and that actual construction can begin shortly thereafter. Thank you, Mr. Chairman.

Thank you, Mr. Miltenberger. At this time I would like to ask the Minister if she would like to bring in witnesses. Does the committee agree?

Would the Sergeant-at-Arms escort the witnesses in please. At this time I would like to ask the Minister to introduce her witnesses for the record.

Thank you, Madam Minister. Welcome, witnesses. At this time I would like to ask if anyone has any general comments or questions for the Minister on the Department of Health and Social Services. Mr. Bell.

Thank you, Mr. Chairman. I have some general comments on the interim appropriation as Health has brought it before us. It seems to me, that when we look at this department, what we are given appears to be a different treatment of this process than other departments have undertaken. It almost seems to be a double standard. We have seen departments come back to us and talk about their forced growth, and tell us that they recognize forced growth has to be taken into account in the interim appropriation. They have identified what they think it will be, and they have laid it out for us to have a look at.

This department has told us in briefings while they do now know what the forced growth will be, and that there will be some forced growth for that four-month period, it was not included when they made their interim projections. I find this somewhat shocking. I do not know why, if the other departments can come forward and toe the line, this department cannot. I recognize that it is a large budget, but I think it is critical, especially with, I am sure, how easy it is for costs to get out of hand and escalate quickly in this area.

Undedicated capital is another concern that I have. I think that we have seen that the government overall has decided that it needed to defer $10 million worth of capital projects that are needed, necessary and important. Yet this department has not deferred any capital, and even further to that, they are holding $200,000 in this interim for new major projects. Now, they do not know what this new major project is going to be, but they assure us that when they do decide what, when and if it will be, it will be an important one.

While I am sure that is the case, I think it would comfort this committee to know exactly what that project might be, because as I have said, we have to sit here and swallow this idea that other important capital projects have been deferred. The Territorial Treatment Centre, $250,000 in this interim, to reprofile this treatment centre for what may or may not become its future use. We do not know what is going to happen with this building. A lot of things here are hinging on what happens to the NAS, what happens to the building as far as the Housing Corporation is concerned. I think, as the committee mentioned, there are a lot of variables that have to fall into place here for us to actually get down the road to needing this money to reprofile this treatment centre.

I do not believe this is something that is going to happen in the next four months and I do not believe, as we are told, the justification that the expenditure must be urgently required in the interim period. I cannot imagine that the Minister will sit here and tell us that they are certain this is going to happen in these four months and that they need this money.

The other concern that I have with the department, and it is not just health, but the Digital Communication Network. Four years ago, when this was set up, I do not know if this was ill-conceived, or if it was not planned properly, but we are now finding out that there is not the bandwidth to do the kinds of things we need to do. I would urge the Minister to take this to the Premier and say, "Listen, we have to make a decision here. We either have to throw some real money at this thing, and buy some bandwidth and make this work, so that we can start to reduce costs in medical travel and start to reap some of the benefits of having the system up and running, or cut it off and get rid of it." I do not see that we have a lot of choice here. So, I would urge the Minister to take a hard look at this and fix this thing or get rid of it. Generally, those are my comments. Thank you, Mr. Chairman.

Thank you, Mr. Bell. Madam Minister. Would you respond to the comments.

Thank you, Madam Minister. Mr. St. Germaine.

Thank you, Mr. St. Germaine. Mr. Bell.

I would like to respond if I could, and request some clarification. I believe the Minister said that it is her understanding that in these four months, they will not require any additional money for forced growth, so that is why it was not put in. My understanding from committee briefings was that they were told they did not have to put forced growth into the interim projections. Although it would factor in here, they had not been able to do it in time. It is not a question, I guess, but a point. There seems to be some discrepancy, but I am glad the Minister has cleared this up.

As far as the functional review of capital projects, I am still concerned about what seems to be "just in case" planning and design money. It does not seem like this fits the category of an expenditure that is urgently required within the interim period. I do have some concerns. DCN has been addressed. It was mentioned that 384 kilobytes are needed for Telehealth to operate and work. I am wondering if it was known at the outset, when we started to pump money into this project, that this would be the case and there would be a downfall in this area as far as providing it to all of the communities. It seems that if we can only provide it to a few of the communities then it is not really doing what we need it to do.

The Minister mentioned that it was conceived with good intentions. That is fine, but as one of my colleagues mentioned here, some roads are paved with good intentions, and I would say that Highway No. 3 fits the bill there, Mr. Krutko, considering it is not paved. Just a comment. Thank you.

Thank you, Mr. Bell. Madam Minister.

Thank you, Madam Minister. Mr. St. Germaine.

General comments. Mr. Roland.

Thank you, Mr. Chairman. Mr. Chairman, there has been a lot of discussion in the area of health and social services in the Northwest Territories for many years. It was always hard to see if we were making headway in the area of improving the health standards for residents of the Northwest Territories. It was not until the recent report on the status of the health of the residents of the Northwest Territories, almost ten years prior, before we saw any statistics. It was good to see that report out, and see that, in fact, in the Northwest Territories, our health as individuals is improving.

But yet, there remain many hot topics out there that continue to plague this government and the department, demanding more resources to try and deal with the ills of our society, in a sense. I refer specifically to the area of drug and alcohol funding. Mr. Chairman, it has been brought to my attention that concerns have been raised in my community, and it was raised at the Beaufort Delta Leaders' Conference in Inuvik recently, in the area of expenditures in the area of drugs and alcohol, and where they are going. I had questions posed to myself by a few people in my community, and I believe the town council has written a letter to the Minister about funding. There seems to be a concern out there that there are some new dollars going into the area of drugs and alcohol, whether it be in the programming side or the capital side.

The concern is that there has not been proper discussion and potential placement of those capital dollars. In my community, it has been a sore point since the 13th Assembly when Delta House was closed down due to the funding shortfalls of this government. We hear that there is the potential of new dollars being spent on drug and alcohol facilities in the southern part of the Territory, where in the northern part there are no actual facilities for drug and alcohol programming. I would like to get some information from the Minister in this area. When are new dollars identified in this budget, because as I go through here, I cannot see any specific dollars being identified. I would like to know if there is somewhere in the budget where there is an O and M, where they are coming up with new dollars for new initiatives, whether it be in the O and M side or the capital side with drug and alcohol funding. Thank you, Mr. Chairman.

Thank you, Mr. Roland. Madam Minister.

Thank you, Madam Minister. Mr. Roland.

Thank you, Mr. Chairman. Could the Minister inform us with these numbers, what is the ongoing area for drug and alcohol that dollars are being applied to if it was identified in the previous year, were there any dollars being put toward any development or improvement of systems for drug and alcohol facilities throughout the Northwest Territories? Thank you.