Yes, Mr. Chairman, thank you.

Thank you, Mr. Chairman. With me I have Mark Cleveland, deputy minister of Health and Social Services, and Warren St. Germaine, director of financial management services. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, one of the concerns we have in a lot of the small communities is that we do not seem to receive the services we should be receiving, especially from the regional health centres and what not in our communities. I think that you have all the specialists, the mental health specialist, the alcohol and drug specialist...you have all of these positions filled at the regional health centres, but there seems to be a real lack of visits and what not to our communities.

It seems like a lot of times these people are spending time dealing with regional issues at the regional health centres but not providing the service to the communities.

I would like to ask the Minister, will he consider looking at the reallocation of those resources and those positions to communities that would want to take on those responsibilities, especially where they do have a large population base?

In the communities I represent, Fort McPherson is almost at a thousand people and Aklavik is at 800. I think the communities have made it clear to this government that they want to take on more programs and services and deliver those programs and services at the community level.

I would like to ask the Minister, what are you doing to ensure communities are able to carry out programs and services in their communities on behalf of the representatives in their communities?

Thank you, Mr. Chairman. Mr. Chairman, if there is an interest by communities in a region to help with how programs are delivered in their community, then very clearly there is an interest by the Department of Health and Social Services and I am sure, in the case of Mr. Krutko's constituency, the Inuvik Regional Health and Social Services Board to discuss that and what the issues are.

As we talked previously over the last few days, in the case of the impacted areas where there is major resource development, we are also committed to looking at issues that deal with that particular impact on a project-by-project basis with the impacted communities. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I think this government has to show more leadership and more respect to communities, especially communities that have a history of providing programs and services. If they can provide federal programs and services through Brighter Futures, funding they might have been able to access through the Aboriginal Healing Foundation...these are national programs that communities are administering right now.

Yet, Mr. Chairman, when it comes to government programs, it seems like there is a reluctancy, either within the bureaucracy or even at the regional level, to allow communities to get the resources and get the infrastructure and people in place so that they can run these programs.

A good example is what we see happening with alcohol and drug programs. Even here just outside of Yellowknife you have a drug and alcohol facility, which I believe there is something like two individuals in there from Corrections. Yet the government is paying for the mortgage on that building. Yet in regions, the Inuvik region and other communities, such as the Delta House, which has been shut down, the Tl'oondih Healing Camp has been shut down outside of Fort McPherson because this government has, for some reason, made a decision that those dollars are now allocated to the regional level, but they do not seem to surface in the communities. If they do surface in the communities, the amounts are so minute that you cannot really do anything with them.

I would like to ask the Minister if he can start redirecting those funds from headquarters directly into the communities and skip the regional level with regard to regional health boards, so that we do not have to have the mosaic of people in the regional centre and no one in the communities. I would like to ask the Minister if he will consider looking at programs, proposals, contracts or what not with community organizations that are willing to take on programs and services delivered by this government in the communities?

Thank you, Mr. Chairman. Mr. Chairman, the Department of Health and Social Services has roughly a $200 million budget and about $148 million of that goes to the various health boards. They, in turn with their representatives from the community or communities, following the standards, legislated requirements and mandated programs and standards of the department, administer the programs and oversee those budgets.

If there is a concern, as my colleague has mentioned, in terms of the communities he represents, then I would just like to restate that I think it is very important that we sit down with the Inuvik Health and Social Services Board and the communities and look at the services that are required and issues that may be there, to see how best we can address those with the resources that are there, in addition to the funds that we are going to try to get appropriated to us as we move ahead with the impact of major resource development. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, another concern I have is the delivery of health care services in small communities such as Tsiigehtchic. For them to acquire programs and services, a lot of time you might have a part-time mental health position, but one thing you run into in the small communities is the lack of housing and lack of office space for these people to carry out their responsibilities or duties. As a government, I think we have to keep in mind that all communities are not the same. The challenges are different in small communities. You do not have available housing or office space.

I would like to ask the Minister if he is looking at those problems and concerns from communities so that we ensure there is a system in place where those communities that need support mechanisms, because of restrictions or restraints on the delivery of programs, are overcome by initiatives of this government, realizing that not all communities are the same? What are we doing for the smaller communities to ensure that health care services and programs are being carried out?

Thank you, Mr. Chairman. There are a number of things that are being done and I will just highlight some of them. On the issue of housing, we are very aware that this is a shortfall in the small communities in terms of acquiring and maintaining professional people. We are working with the Minister of Housing to come up with ways that we can try to create an environment where housing is built that is not going to be so expensive that nobody can afford to stay in it.

I would also make the case that one of the benefits of the smaller communities being tied into larger health boards is that they get the benefit of some of the staffing capability that may be there because of the critical mass of nurses, social workers and other staff that may be available to backstop small communities if there is for some reason a vacancy. I know we have a way to go and the vacancy rates are still an issue. Recruitment and retention is still an issue, but we are working with all the boards and the department to try to improve that.

We are very aware that the small communities are especially impacted. When a nurse goes, it leaves a big hole, or if a social worker is not there, it leaves a big hole in the service delivery structure. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I think what I am asking for here is to improve the capacity in communities, not to get back to the dependence here of having to depend on regions and other larger centres. That is the concern that I have. You might have all these people at headquarters and at the regional level, but they are not available to a lot of communities in regard to delivering programs and services. You might see a doctor in the community once a month if you are lucky, and if you are not on the waiting list, you wait until the next month.

Then you wonder why we are spending so much money on medical travel and other things. It is because of the lack of services being provided to our communities. I would like again to hopefully get the Minister to hear clearly that he did not misconstrue what I am saying, that we will continue to depend on regional centres. That is a concern of the communities, that we are not being served by regional centres.

Whenever they have to shut down the health centres, they do not shut down the wards in the Inuvik hospital. They shut down the health centres in our communities. What are you doing to ensure that our health centres and programs that are being delivered are being filled, and that we do not have to see health centres being closed at certain times of the year because of the lack of nurses or service people, and we are not able to fill it or else there is a reluctance to fill it and they say we will take care of you at the regional level? That is not working.

Thank you, Mr. Chairman. Mr. Chairman, we are, as the health and social services system, making extensive efforts through recruitment and retention in trying to make sure that we fill the vacancies with doctors and nurses. We have come together with the board chairs and the department and myself to see if we can better coordinate those efforts. We have, for example, just come back in the last number of weeks from a recruiting trip to the Philippines that was initially initiated by the Inuvik region, and we have had some success there.

We are looking at both trying to recruit and we are also spending significant amounts of money and effort trying to train Northerners to become nurses. We have a fair number in training right now, some that will be graduating this year. We are going to make every effort to make sure they stay in the North and help fill these critical positions. Thank you.

Thank you, Mr. Chairman. I have a question under community services support, funding for community organizations and governments at the community level to promote mental health. I notice there is a significant drop in funding in this year's main estimates compared to what is proposed in the main estimates. Could we get an explanation of why that would be?