Thank you, Mr. Chairman. Mr. Chairman, when Ms. Lee asks why we need to review the system, what is driving the need for a review and an action plan, I did identify some of these in a Minister's statement I made last Friday, but I will just touch on a few of them again.

Today, we have a very complex, fragmented system with multiple boards serving the needs of our 42,000 residents, so we have a relatively small population. We have everything from a community health board for a community of 300 people to a territorial board like Stanton, with a territorial role, with budgets of $48 million.

We have a lot of duplication and overlap and we do not take advantage of the economies of scale.

The accountability relationships are also fragmented. The legislative and policy responsibility is held with the department. The operational functions, which we have devolved to the boards, make it difficult to enforce standards of care.

There have been a number of things that have contributed to the erosion of our capacity to monitor and enforce the standards and provide administrative and clinical leadership and oversight. One of those things that has contributed to that, Mr. Chairman, is the downsizing within the department over the past years.

The things we are beginning to see because of a lot of the pressures on the health system are the operating deficits that the boards are experiencing. We want to be able to respond to those kinds of pressures, but we need a better way of accurately reporting what is contributing to that.

As I mentioned in my comments yesterday, some of the things that drive the deficits are things that really are out of the control of the boards. Some of the forced growth costs or expenditures that are not within the control of the CEOs that manage the facilities and the boards. In order to be able to clearly identify that, we need very good accounting and reporting structures in place.

A lot of the functions that we have devolved as well, such as the pay and benefits, are very complex. It is difficult for there always to be the capacity for stand-alone boards to be able to fulfill those functions.

When you consider all of the pressures on the system, it really is important that we find ways of making it as efficient and, as I said before, as good quality as possible.

Mr. Chairman, Ms. Lee also referred to a lot of the question around the review relating to governance. I just wanted to point out that the four key areas of the review are:

• • To optimize the effectiveness and efficiency of the Northwest Territories health and social services system today and for the future, which speaks to the sustainability;
• • To establish an appropriate accountability framework that clearly defines roles, responsibilities, and authorities;
• • To recommend a governance structure that supports the accountability framework while respecting strategic directions of Northwest Territories governments, which includes things like self-government negotiations and regionalization; and
• • To recommend an appropriate financing framework for the health and social services system. We are committed to ensuring the system is resourced so it is able to carry out the much-needed programs and services it delivers.

When we talk about the previous reviews that have been done, the reason why we say we are looking for very clear recommendations is, I will give you an example. Recommendations from some of the previous reports have tended to be fairly general. For example, the following recommendation and priorities from the Minister's Forum on Health and Social Services report entitled Our Communities, Our Decisions, "Initiate a new way of governing health and social services programs in the Northwest Territories."

This is characteristic of quite a number of the recommendations contained in that report. They are good recommendations, but we need to take it to the next step so we have a very clear action plan for implementing some of those former recommendations. Thank you, Mr. Chairman.