Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, first I would like to acknowledge to the Member that community alcohol and drug workers do provide an important service and the amount of pay they get is definitely not commensurate with other government positions. The ones that I know in my community are extremely dedicated and have been there for a long time.

Since becoming Minister, I have developed an extensive to-do list. One of the items on that list is the issue of NGOs and the funding that they are paid and how staff are remunerated. I just acknowledge to the Member that this is something that I intend to look at. We are doing a number of action items that relate to this. There is going to be a significant dollar figure attached to this as we go to full parity. In the very least, we would like to recognize that it has been some time since there have been any increases and we have to make sure that we recognize the value of the work that these folks provide. Yes, it is on my list.

Mr. McLeod.

Thank you, Mr. Chairman. I have one final area that I wanted to talk about and that is regarding the doctor visits and the concern arising from that, the limited amount of visits. I know for a fact, it was raised to me a number of times over the summer, in the community of Fort Providence, we had not seen a doctor in over three months, as a result of the lack of doctors being available in other regional centres, mainly Hay River.

The concerns that were brought up to me and some of the recommendations that they suggested I bring up here, should that happen, given the long periods when we do not have anyone coming into the community, especially with the seniors, if there was any way we could look at providing them with medical travel to go to other institutions. It was pointed out that possibly southern institutions. It is not a good situation to be ill with any kind of disease or health problem and then have to sit there and wait and wait and not really know when the problem or the situation will be rectified and we will see a doctor in our communities.

I think that it was a fairly good comment that was made and I wish to bring it to the Minister's attention. I brought it up in the House and he has indicated that he is willing to talk about it, but I would like to hear if there is a solution, if there is another way we can deal with the people in the communities who are not well, while there is no doctor who lives in the community on a regular basis.

Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, this is a difficult situation and a difficult issue. I, as a Member, indicated that it is tied to the inability to get, in many cases, permanent doctors in the communities. I know there is an arrangement between Hay River and Providence. There is the capacity now for nurses to send people out of the community. If the Member is suggesting other than a medical emergency but just for check-ups or to do follow-ups because there is no doctor, I am not sure what the process would be for that. I am interested to try to come up with a way to make sure that there are no big holes in our safety net, and that people do not go without adequate medical attention. We are looking at all of these areas. I have met with the Deh Cho board and I have met with the Hay River board, as I met with all of the other boards as we look at how do we get the doctors in there. How do we make sure we are staffed up?

As far as I am aware, if there was adequate staffing in Hay River, they would be able to honour their commitments. They have been working at it. I think they have had some success.

What the fallback should be is not clear to me, but it is something that I am prepared to have the folks doing this review look at to see what is an acceptable and affordable fallback, so there is no gap and people do not go untreated. Thank you.

Thank you, Mr. Minister. The latest hockey newsflash, the score is four to one for Canada. Mr. Lafferty.

Mr. Miltenberger.

Thank you, Mr. Chairman. Recruitment and retention is one area that we are actively working together to better coordinate and collaborate, so that we have a common approach to the recruiting. Right now, what has happened in many cases is that health boards have recruited, or attempted to recruit on their own, often with mixed success, sometimes with no success.

We are attempting and we are bringing all the players to the table, the department, the health boards, and we are coming up with a review of that process, so we do have a standard approach, standard criteria that we are not competing down south with each other. We are going to work out the arrangement so that the doctors get to where they are needed. Some doctors are specialists and practice in places like Yellowknife where specialists reside. Trying to find general practitioners or doctors who will practice in the other communities is part of that process. Thank you.

Mr. Lafferty.

Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, I do not think either of the scenarios would be the ones that I would be inclined to agree with. If there is a requirement to medevac somebody, it is done. It is not an issue where once you finish spending a certain amount of your budget, you cannot medevac anymore.

The issue of diagnosis is always one that requires skill and has to be done in a timely way. If it is not done and there are problems, then there are mechanisms to deal with that.

As a matter of course, I would say that the nurses in the communities provide a high level of service. Without that service, we would, as communities, be in very dire straits. We are going to work through nurse practitioner legislation to try to improve those skills and give added technology and equipment through telehealth to give better diagnostic capabilities to the small communities and nursing stations, so that they can connect into professionals, either in Yellowknife or in other communities or down south. We are very sensitive to the issue raised by Mr. Lafferty and we know it is not a perfect system. We are trying to do all the things we can to make it the best we possibly can. Thank you.

Mr. Lafferty.

Mr. Miltenberger.

Thank you, Mr. Chairman. I would just like to assure my colleague that one of the underpinnings of how we do business is the issue of equity and balance. We want to make sure that the services are where they are needed. We have committed to recognizing the socio-economic impact of major resource development to work with communities on a project-by-project basis.

In terms of the alcohol and drugs, I know there was a significant push in the early 90s for the government to build facilities and have residential alcohol and drug treatment centres. By the mid 1990s, there was a move away from that, and now we are left with one facility in Hay River, which has 30 beds, which puts us at about four times the national average in terms of bed per thousand.

The issue to me is what kind of service are we providing? Is it more of a program issue than necessarily building and investing a lot of money in bricks and mortar? It is a discussion I am prepared to have with the communities and the regions.

I also want to make the case that I think it is time as a government, as a department, that we have to look at linking the pots of money that we have, like addictions and wellness, and blurring those lines, because we are dealing with the same people in very similar program areas, but we tend to parcel out the money separately. What is the most effective way to deal with addictions in a community? Is it just automatically building a facility? I am not convinced of that.

I am prepared to work with the Member and with his region to look at the money we are spending and if we are going to go ahead, because his area is one of the impacted ones with all the resource development. How do we better address those impacts? They are not just alcohol and drugs. There are suicides, there is abuse, there are all these issues.

We are prepared to work with him and his region to come up with a plan that will link a lot of these areas and not just attempt to deal with them as separate issues. Thank you.

Thank you. General comments? Mr. Lafferty.

Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, we have noted the concerns on medical travel and as the Member indicated, he is reinforcing the concerns already raised by his colleagues. We thank him for his comments. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, my question to the Minister is in the area of assisting communities to develop capacity, especially in the areas that a couple of my colleagues have touched on. In small communities, we have definitely seen a decline in programs and services. Also, because of the dependency on regional centres, Yellowknife and Inuvik, we in the communities have seen a major decline with regard to the whole area of capacity in our communities and the imbalance between the health professionals in our communities and elsewhere.

I am talking about the areas of mental health, looking at social workers. We always seem to have a problem with social workers. Simply to try to keep professionals in our communities and ensuring that we have a full slate of nurses and other people to work within the health and social services area is a real problem, trying to deal with retention and ensuring that we have the people there.

One of the other concerns is the whole imbalance between what we are paying people to work in the different mental health areas, social workers and also alcohol and drugs. We seem to have a real problem of maintaining staff for a long period of time. We seem to have a high turnover in those different areas. I would like to ask the Minister what he is doing to improve the capacity of our health professionals in our communities. I mentioned yesterday the problem we seem to run into every spring and summer, especially in Aklavik, the Delta communities and the Beaufort communities.

I would like to ask the Minister what he is doing to ensure that the communities have the capacity, so when we do have a lack of health professionals such as nurses, we have a backup system there to ensure that the other people in the different areas are able to either fill in or ensure that we have people who are there for the long term and we do not continue to see the problems we have seen over the last number of years. Thank you.