This is page numbers 1125 - 1161 of the Hansard for the 14th Assembly, 3rd Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was chairman.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1144

David Krutko

David Krutko Mackenzie Delta

Thank you, Mr. Chairman. My question today is that, again going back to the training and the skills that we need to develop especially in our communities where we do have a lot of the frontline workers, I think that it is important that we do carry on the training to do the responsibilities that they have, where the people in social services and the health care system have a whole bunch of paper work that they have to do as part of their responsibility.

I think they do have people there, receptionists and part-time secretarial services, for example. However, I think that we have to improve on that because one of my concerns is, in response to the Minister's opening remarks, when you talk about the lack or short coming of information or reporting back to the central government on how money is being expended.

The problem that I see, especially in the small communities, is that we have people there, but they either do not have the skills or the training to be able to conclude those reports within a short timeframe, or they do not have the tools to do it with.

I will use Aklavik, for instance. I spoke to the department in Aklavik and the little things that we take for granted, where they do not even have a printer for their computers. They have to run somewhere else, print off something off a disk, and run back to their office. I mean, that should not be called for today. They have two computers, one is down and one is working, but yet you have three people in the office. Also, the person that they have for the secretarial service only works half-days.

So there are these little things that are having an effect on the whole area of the sharing of that information and also making sure that the information is developed and also submitted within a short timeframe, because that seems to be a problem. The whole information gathering and making sure that people have those tools.

So those are some of the areas that I feel in ensuring that we have people who do have the resources, but also along with taking on these responsibilities, the government also has to allocate resources for training, skill development, making sure the different resource programs are out there so that people know that when you take on a program, you have skilled labour and qualified people in those different positions.

What we are seeing is the people are put in these positions, but they are put in it either not having the opportunity to take more advancements on their training or on the education skills that are out there where we see a lot of money being lapsed in different areas, especially when it comes to training where it is going back. I think we have to start ensuring that the frontline workers we do have are offered these courses and offered the ability to move up with the training.

So I would like to ask the Minister, what is her department doing to improve the front-line workers to ensure they do have the training and the skill development that is needed to make their jobs easier?

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Mr. Krutko. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Mr. Chairman, Mr. Krutko raises some very valid points with respect to the capacity of communities to deal with what are really a complex set of activities and the people who work for the health boards are not the employees of the department. They are the employees of the health board, but we do agree that there is a function in terms of training and upgrading of skills in order to build the capacity to be able to carry out those roles and responsibilities. That is on the administrative side.

When it comes to the medical professionals themselves, they do have to have a certain amount of credentials before they would be considered to be hired in some of those positions. There are other people who are offering support services to those people who need to be properly equipped and have the proper training and skills themselves to perform those roles. So although the board can be involved to some degree, it is important that the boards also consider this and look at the capabilities of people when they are hiring them and instances where they can offer support for upgrading skills and training, that is a useful exercise as well. Thank you, Mr. Chairman.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Madam Minister. Mr. Krutko.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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David Krutko

David Krutko Mackenzie Delta

Thank you, Mr. Chairman. Another area of concern I have is a lot of people do not really understand what rights they have as a patient. It works both ways. You get an opinion from a doctor and I think a lot of people do not realize you have the right to a second opinion. I think that people have to be able to know that as a patient, there are certain things that you should be able to ask questions on or have information revealed to you as you requested. Is there such a thing as a patient bill of rights within this government or is that something we can look at?

With the problems we are running into now...I have had constituents of mine approach me where they have written letters to different health boards, they have hand delivered letters to people that sit on these boards to bring information forth and they never get a response back. They do not get a simple acknowledgement that they have submitted these concerns to the different boards. It seems like more and more, especially with our elderly people, because of the whole area of cutbacks and what not, a lot of translating services are no longer there.

A lot of people would automatically assume a doctor said this is his analysis and then six months down the road, you get a different opinion from a different doctor. The same thing applies with different medications that a lot of people take. On one day, you might get this medication from this doctor, a new doctor comes in and he will put you on a different medication knowingly or unknowingly that it could have a major effect on you, especially if you have allergic reactions.

I think people have to understand you have a right to know that what you are being prescribed is explained to you in such a manner that you understand. Also, if you do not like the decision by a particular doctor, you have the right to request another opinion. Is there such a thing in place considering patient rights with regard to some kind of patient bill of rights or is that something that this government can consider looking at?

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Mr. Krutko. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. That is not something that is in place right now, but it is something that could be put in place, particularly for people who may have language barriers who may need things communicated to them in plain language in terms of what kind of services, what kinds of support, what kinds of insurance benefits, things like this, are available to them. That is something that I would like to check into to see what kinds of things like that other jurisdictions have in place, but it is a very good idea and it is something worth pursuing. Thank you.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1145

The Chair

The Chair Paul Delorey

Thank you, Madam Minister. Mr. Krutko.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1145

David Krutko

David Krutko Mackenzie Delta

Thank you, Mr. Chairman. With regard to the Aklavik Health Centre, there has been a delay in place, yet going through the budget I noticed from previous years to this year's budget, they have almost $3.5 million. I received a letter from the Minister of Public Works stating that the department is reviewing or assessing the proposal for the Aklavik Health Centre. They are doing an adjustment to lowering the cost to no more than $3 million. Yet, in the budget, the budget shows it is $3.5 million.

Who is the one who makes the decision on how the money is being spent within the budget? Is it the Department of Public Works or the Minister? The letter I received was signed by the deputy minister to myself with regard to a request I made in the House asking for information with regard to the health centre project for Aklavik.

The community is concerned. I have spoken to the nurses and also the nurse-in-charge. They cannot see themselves having their staff room in the same room that is classified as a lab room where you do your tests and what not. The size of the facility that is being described has been cutback. Where the community has requested some 700 square metres, now it has been cut back to 750. They are still continuing to bring down the price of the budget.

In the capital allocation within this budget, it clearly states previous year was $1 million and there is $2.5 million being spent, yet there hasn't been one piece of material or the contract has been let go yet. I would like to ask the Minister what can the department do to ensure the community of Aklavik will be getting what they are requesting, which is the $3.5 million allocation that is in the budget, not what the Department of Public Works is stating where they are reducing the cost to $3 million?

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1145

The Chair

The Chair Paul Delorey

Thank you, Mr. Krutko. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1145

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Mr. Chairman, we just happen to have both our briefing note and Public Works and Services' latest briefing note here. So I am going to ask Mr. St. Germaine if he will respond to that question. Thank you.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

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

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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St. Germaine

Thank you, Mr. Chairman. Just to clarify some of the numbers that Public Works and Services has disclosed to the Member, the construction cost is $3 million. The actual total project cost is now estimated to be $4 million. In the Main Estimates at this point in time, we have a proposed budget of $3.5 million. At this point in time, part of the process the project team is looking at is looking at the preliminary design that has been imposed to see if there are alternatives in terms of construction materials, foundation systems, looking at some way to get the budget closer to what's in the Main Estimates at this point in time. Certainly there will be no effort made or review done in terms of changing the program in terms of the space available for the program. That is currently at 650 square metres and the intent would be to leave that at that amount. So the review at this point in time is looking at what we can do in terms of building the health centre more efficiently. If all those avenues are exhausted, we will be in the position of having to seek additional funding to complete the project. Thank you, Mr. Chairman.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Mr. St. Germaine. Mrs. Ballantyne, did you have something to add there? Mr. Miltenberger.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. Yesterday, when we concluded our committee of the whole, the issue that was on the table was the inability of the department to seemingly come to grips with the financial situations in the boards, and agree what numbers would be presented. Mr. St. Germaine, on page 1997 of unedited Hansard, yesterday does confirm that the common systems and structures are in place, but the issue really evolves around getting a clear understanding of what transactions occurred. He goes further on to say that it is an underlying business situation that results in the deficits that have become a problem.

Mr. Chairman, I raised the issue, does this mean that since the systems are there, the numbers are there, a trust factor of not being able to trust and accept the numbers at face value that are given to them by the health boards? Mr. Chairman on page 1998 the Minister herself indicated that the issue is not so much about trust as it appears to be, it seems to be more on the capacity of boards to be able to provide this kind of financial information.

Mr. Chairman, I am going to ask the Minister to maybe speak to that comment. I would like to use, for example, Stanton, the flagship of our health and social services in the North, the crown jewel in the continuum of care provided by the department with a staff bigger than headquarters, and a budget of somewhere near $40 million. Is the Minister saying that with all the talent and expertise they have over there between the board and the staff, that their accounting systems and structures are in place, yet that particular operation does not have the capacity to provide this kind of financial information to the department?

Or for that matter, the Inuvik Hospital which will be replaced with a $30 million new facility to provide key services in that area, is the Minister saying that the Beaufort-Delta board and all their staff are unable to, and do not have the capacity to, provide the kind of financial information that the department requires? Or they are providing it in such a way that it cannot be interpreted?

This to me gets to the nub of the issue that seems to be plaguing the department. Very clearly on the clinical side, as has been pointed out, the services we provide are very good. The problem always comes back to counting the money. I would appreciate it if the Minister could speak to that issue, because I think it is a very significant one. Thank you.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Mr. Miltenberger. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Mr. Chairman, I do not think it is very accurate to paint all of the boards with the same brush. It is not accurate to make a sweeping summary of the ability for the boards to report good financial information and accurate and timely financial information.

In the instances of the boards where we are having difficulty getting a handle on the expenditures and the factors which are contributing to the deficit, Mr. Miltenberger is right. It does appear that there is a problem with capacity to deliver that information to the department, but I just want to clear up for the record, this does not include all boards. Thank you, Mr. Chairman.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1146

The Chair

The Chair Paul Delorey

Thank you, Madam Minister. Mr. Miltenberger.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. Just so it is clear and what I was quoting, page 1998 of Hansard, "It seems to be more around the capacity of the boards to be able to provide this kind of financial information" were the words spoken by the Minister.

The reality being that two of the largest health boards, two of the biggest with the most staff, do not have the capacity to provide this basic information even when all the systems are in place. Could the Minister indicate, since they have made that determination, why is that? Are they going to wait for Mr. Cuff to tell them what to do about it, or is there a way to ensure that that capacity is there and that standard financial and accounting procedures are followed? It seems to me, that since the information is provided, that the department does not accept on face value the information provided by the boards. Thank you.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1146

The Chair

The Chair Paul Delorey

Thank you, Mr. Miltenberger. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Mr. Chairman, I find it interesting that the Member is referring to the Stanton and the Inuvik boards. I find it interesting that he does not raise the issue of capacity with the Fort Smith board, given that that is the community that he represents.

Mr. Chairman, the structures, the practices and the framework are all in place. The lack of information mostly surrounds the issue of the deficits, which does speak to the ongoing ability to keep records. Mr. Chairman, as the results of the operational audits and the payroll audits and other additional information does become public, I think that the Members of this House will agree that, in spite of the fact that processes and guidelines were in place -- for reasons of what I will say again are more to my mind, capacity versus trust issues -- these practices were not followed in such a way as for us to be able to receive the kind of information we need in order to come into this House and stand up and present a request for public funds to devolve to these boards. Thank you, Mr. Chairman.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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The Chair

The Chair Paul Delorey

Thank you, Madam Minister. Mr. Miltenberger.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1147

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. The Minister seems to be unable to contain herself when it comes to making personal observations. Very clearly, the Minister stated in this House that payroll functions, for example, have been removed from the Fort Smith health board. Fort Smith is a very small health board. I chose to use the other two main health boards -- the biggest ones, the flagship, because it is the flagship -- and if the Minister wishes we could always take the discussion into the capacity of the department to provide the leadership from the Minister on down to run the department. Or the capacity to keep it healthy, and not run it into the ground. Mr. Chairman, I will choose to stay on the high ground here.

The question I have for the Minister, the Minister has indicated, given a veiled reference to, that there is information that is going to come up and it is going to show that the boards do not have the capacity. The question also becomes then, after all this time, what about the accountability and framework that is there, and the ability of the board support people and all the financial people in headquarters to in fact deal with this issue? This did not pop out of the woodwork yesterday, it has been there for some time. Boards have struggled with it. But it comes back to headquarters, the head of the organization for the department. Where were they, and what is going to happen to the needs that are going to be possibly identified there?

Once again, will it be set up that the boards are going to be pointed out as the fall guys because the department will say that they did all these bad things behind our backs, or whatever is going to come out of this? And when the flagship of health and services in terms of the service they provide is characterized as not having that kind of capacity, it seems to me to be a significant problem. Thank you.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

Page 1147

The Chair

The Chair Paul Delorey

Thank you, Mr. Miltenberger. Madam Minister.

Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters
Item 20: Consideration In Committee Of The Whole Of Bills And Other Matters

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Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. Mr. Chairman, I have tried to make it clear, and I have stated several times in this House, that I do not wish to use any particular board as an example because we are awaiting information to come in. I just found it interesting that the Member chose to apply his questions to other health boards from constituencies which he does not represent. That was just an observation.

I will not, Mr. Chairman, take that path the Member has taken with naming specific boards in relation to some of these deficiencies because, Mr. Chairman, to put it in context it is some boards and it is in some area of operation. I do not think we should overstate it. On the other hand, we have a responsibility to flag the issues.

When the Member keeps saying where was the department, Mr. Chairman, I have been responsible for the Department of Health and Social Services for just over one year and during that time is what I can speak to. I cannot speak to the past. I am not even sure that it is particularly...I just can't knowledgeably speak to the past. All I can speak to is that in the 13 or so months that I have been Minister, we have tried to be proactive.

Mr. Chairman, let me say, this is not intended to be a reflection on any previous Minister's leadership as well, as I look over at Mr. Roland. Surely, people can understand that I can only speak to the time that I have been involved with the department. During that time, I can assure Members that we have taken a proactive approach to the issues and have tried to share and flag the problems in a responsible manner, in a constructive way with the intent to finding resolutions. Thank you, Mr. Chairman.