Thank you, Ms. Lee. Please be seated. Good afternoon. Item 2, Ministers' statements. The honourable Minister responsible for Transportation, Mr. Handley.

Mr. Speaker, I am pleased to announce that as of April 1, 2002 the Department of Transportation will extend over-the-counter permanent document licensing services to the communities of Deline, Fort Good Hope, Fort McPherson, Fort Providence and Tuktoyaktuk. This would include driver licences, vehicle registrations and general identification cards.

Up until now, people in these communities have had to make do with temporary driver's licences and vehicle registrations until the permanent documents were processed and sent back to them. Now these communities will have the same licensing services that are available in the larger centres.

A direct electronic link to the motor vehicle information system and about $75,000 worth of licensing equipment have made the improvements possible. The department expects to extend this improved service to the communities of Aklavik, Holman, Tulita and Fort Resolution in the near future.

The new and improved licensing services, Mr. Speaker, shows that so far as possible, the Department of Transportation tries to offer the same quality of services in smaller communities as it can in the larger ones. Thank you, Mr. Speaker.

-- Applause

Thank you, Mr. Minister. Item 2, Ministers' statements. Item 3, Members' statements. The honourable Member for Deh Cho, Mr. McLeod.

Thank you, Mr. Speaker. Mr. Speaker, the Government of the Northwest Territories, through the Department of Health and Social Services, administers two separate health benefit programs. One is the GNWT Supplementary Health Program, which is both funded and administered by the Government of the Northwest Territories.

Mr. Speaker, the programs include the Extended Health Benefits Program for seniors, the Chronic Disease Program, Metis Health Benefits and the Indigent Health Benefits Program. Mr. Speaker, the second health benefits program is funded by the federal government and is also administered by the Department of Health and Social Services. This program is for registered First Nations and Inuit, regardless of age, income or place of residence in Canada.

Mr. Speaker, the Department of Health and Social Services has policies for all of their programs that are modelled on their services and provisions of the NIHB program. This was done to ensure some equity amongst all residents of the Northwest Territories.

All these programs, Mr. Speaker, say that they are insurers of last resort. This means that if any resident has private health insurance through their employer or company, they are expected to use that insurance first.

Mr. Speaker, over the past several years, there have been many statements made by First Nations leaders expressing concern that there appears to be an erosion in the level of benefits allowed under the NIHB. Even Ministers of this government have expressed concern in this Assembly about an increase in the number of services being disallowed under NIHB guidelines, resulting in an increased cost to the Territories.

Mr. Speaker, a Dene elder cannot decide that the benefits are better under the extended health seniors' benefits program and apply for benefits under that policy. If he or she does not have private insurance, they must take what is allowed under the NIHB guidelines.

I am concerned, Mr. Speaker, that different rules are being used to determine eligibility for supplementary health benefits, especially in the area of medical transportation. Mr. Speaker, I will be asking the Minister questions on this issue during question period. Thank you, Mr. Speaker.

-- Applause

Thank you, Mr. McLeod. Item 3, Members' statements. The honourable Member for Mackenzie Delta, Mr. Krutko.

Thank you, Mr. Speaker. People in the communities of Aklavik, Fort McPherson and Tsiigehtchic often have to go to Inuvik for medical services and treatment, which is not available in our communities. As a result, patients from communities on the Dempster Highway or the winter road system are usually sent by taxi or shuttle bus, rather than by aircraft, to Inuvik.

Mr. Speaker, the trip from Aklavik or Fort McPherson can take up to two-and-a-half hours or more, and costs approximately $200 one way by taxi. In the summer, you have to take the ferry from and to Tsiigehtchic and Fort McPherson, which runs once per hour and takes about 45 minutes to cross. For many patients, Mr. Speaker, the trip by taxi or private vehicle is not a great hardship, but there are those patients, especially those who are very frail, have a serious illness and are our elders, that have a hard time taking the long trip. Worse, Mr. Speaker, the patient has serious breathing problems and because of the trip being taken during the summer, it is very dusty travelling over a gravel road such as the Dempster Highway.

Mr. Speaker, Aklavik and Fort McPherson have scheduled air service to Inuvik twice daily during the break-up and freeze-up periods of the year. The cost from Aklavik is $140 and from Fort McPherson it is about $160 return. That trip takes about 25 minutes and 50 minutes from Fort McPherson back to Inuvik.

Mr. Speaker, I have received complaints from people who are asking the question, "Do we have a choice in regard to how travel is being done and who makes that choice, by road or by air?" Also, there are questions of the cost.

Is it clear, Mr. Speaker, that if it is necessary to go by road or by air, do the patients have a say in consideration of the comfort, the pain that the effect of travel on some of our patients may cause while travelling between Inuvik and our communities? Mr. Speaker, I see unanimous consent to conclude my statement.

Thank you. The honourable Member is seeking unanimous consent to conclude his statement. Are there any nays? There are no nays. You may conclude, Mr. Krutko.

Thank you, Mr. Speaker, and thank you, colleagues. Mr. Speaker, while travelling to Inuvik to see a doctor with regard to pain that they may have, it would be better if we had a say in the process of how travel would be taken so that people who travel from our communities to our regional health centres can have a say with regard to how this takes place. Mr. Speaker, I will be following up on this with questions for the Minister later today. Thank you.

Thank you, Mr. Krutko. Item 3, Members' statements. The honourable Member for Hay River North, Mr. Delorey.

Thank you, Mr. Speaker. Mr. Speaker, I rise today to discuss an issue with regard to medical travel. The issue I would like to bring to light, Mr. Speaker, is the issue of public awareness with regard to programs and services offered by the Department of Health and Social Services.

Mr. Speaker, we are all aware that at the time of initial diagnosis of a potential disease, or during a period of severe illness, patients are extremely anxious and uncertain. They are unsure of exactly what the diagnosis or illness entails. Mr. Speaker, very often, patients are just referred for medical travel without a thorough explanation of exactly what will transpire, never mind the impact of the potential costs involved.

Mr. Speaker, there are many assumptions made by the Department of Health and Social Services that people will just naturally have an understanding of everything involved when they have to travel for medical reasons or access a program or service offered by the Department of Health and Social Services.

I would like to state, Mr. Speaker, that the pamphlets, publications and brochures distributed by the Department of Health and Social Services are very well done. Of particular note is the seniors' handbook, which was produced in 2001.

However, Mr. Speaker, while these brochures and pamphlets are well done, there is no mention of a co-payment in any of these brochures. Many people are required to pay the co-payment of $250 when they travel for medical reasons. The co-payment of $250 is very cost prohibitive for a number of people.

Mr. Speaker, I believe the Department of Health and Social Services and their myriad of employees need to take a step back and simply view things from a user perspective. It is very simple, Mr. Speaker, for health care employees to recite policy over and over to people. It must be realized that these patients are distressed in many instances. A little information goes a long way.

Mr. Speaker, I would hate to think that a badly needed medical procedure would be passed over by a patient due to the fact that they were ill-informed, or worse yet, that the co-payment was too much of a financial burden for them.

Mr. Speaker, with all of the talk of the upcoming implementation of the department's action plan, it is my sincere hope that departmental officials have spent long hours discussing the best ways to get the pertinent information out to the people who require it the most, that being the patients.

Mr. Speaker, I feel strongly that...

Mr. Delorey, your time for your Member's statement is over. Mr. Delorey.

Mr. Speaker, I seek unanimous consent to conclude my statement.

Thank you. The honourable Member is seeking unanimous consent to conclude his statement. Are there any nays? There are no nays. You may conclude your statement, Mr. Delorey.

Thank you, Mr. Speaker. Thank you, colleagues. Mr. Speaker, I feel very strongly that we as legislators need to ensure that we have a strong, viable health care system. If there are constructive changes made to our health care system, we need to be assured that our programs are delivered in such a way as to ensure both accountability and efficiency. At the appropriate time, Mr. Speaker, I will have questions for the Minister. Thank you.

-- Applause

Thank you, Mr. Delorey. Item 3, Members' statements. The honourable Member for Yellowknife South, Mr. Bell.

Thank you, Mr. Speaker. My statement today is about medical travel co-payments. All residents in the Northwest Territories are eligible for territorial health insurance coverage. However, sometimes not all insured services are available in the communities or in the North. In these instances, people have to travel to the nearest centre that can provide the insured service.

Mr. Speaker, the cost of this medical travel is not always fully covered. Some residents have to pay a co-payment when they travel outside of their home communities for medical reasons. If you are a federal or territorial government employee, or if you work for one of the larger companies, Mr. Speaker, then you likely pay dues into a private insurance plan that will pick up the $250 co-payment.

Mr. Speaker, registered Indians and Inuit registered in the Northwest Territories have their co-payment paid by the Government of Canada under the Non-Insured Health Benefits Program. The Extended Health Benefits Policy and the Metis Health Benefit Policy provides the co-payment for indigenous Metis residents as well as for seniors, infants under two years of age and those residents who are verified indigent.

Who is not covered, Mr. Speaker? Typically, non-aboriginal or non-indigenous aboriginal people who do not work for the larger companies or who do not pay into a private insurance plan. Many of these residents will qualify to have the co-payment waived if their illness is a specified illness listed under the Extended Health Benefits Program.

Mr. Speaker, it seems that for the apparently small number of residents who are left to pay the co-payment by themselves, this government ought to be able to find a way to reduce the cost to those individuals. Often these people are employed in low-paying service jobs and do not meet the means test to qualify as indigent, but yet they cannot readily afford a payment of $250. This is especially so if more than one trip is necessary.

If the appropriate insured service is not available in the Northwest Territories, Mr. Speaker, then perhaps we should look at a mechanism to provide group insurance that includes all people who cannot afford a co-payment. Thank you, Mr. Speaker.

-- Applause

Thank you, Mr. Bell. Item 3, Members' statements. The honourable Member for Frame Lake, Mr. Dent.

Thank you, Mr. Speaker. Mr. Speaker, I too would like to address the issue of medical travel, and in particular, the co-payment required of our residents. This is one issue that I hear about frequently from a number of my constituents. That is because many of my constituents have been burdened with the expense of medical travel when they simply cannot afford it.

Medical needs and the subsequent cost to the patient are already too much for one to deal with. The co-payment is adding to many of our constituents' suffering. What is worse is it is usually the people who cannot really afford the expense who are having to deal with it.

Mr. Speaker, those who can afford it, higher income earners, are usually employed by larger companies who have medical benefits for their employees, so it is largely the middle and lower income earners who are not receiving these benefits through their employers or who otherwise qualify to have this co-payment covered, who are most affected.

Mr. Speaker, right now, unless it is an emergency, the patient must pay the co-payment charge before they get on the plane. That can be a difficult task for many. Not many people plan to have to travel for medical reasons, and $250 is not something that many people have sitting in their bank accounts. Many people live from pay-day to pay-day. In fact, Mr. Speaker, it is often likely that if they have purchased medication or taken time off work, they are already struggling.

Mr. Speaker, even in conservative Ontario, they charge less for their co-payment to northern residents. Manitoba used to charge $50 as the co-payment but, Mr. Speaker, they have dropped that. Other jurisdictions take the approach of capping the co-payment on an annual basis but here, patients are charged trip in, trip out, trip in, trip out. Mr. Speaker, people will often have recurring conditions that require more than one trip each way.

Mr. Speaker, we are setting our middle and lower income earners up for failure with the current policy. I urge the Minister to revisit this item with a view to eliminating this burden for our residents. Thank you, Mr. Speaker.

-- Applause

Thank you, Mr. Dent. Item 3, Members' statements. The honourable Member for Hay River South, Mrs. Groenewegen.

Thank you, Mr. Speaker. Mr. Speaker, in keeping with the theme of medical travel and extended health benefits, today I would like to articulate a gap in the support that our government provides for persons requiring medical attention outside of their home community.

At present, the government policy is that when you are referred for medical assessment or treatment, the patient is responsible for the first $250 in travel associated with that referral. I will not go over all of the list of people who are excluded from having to pay that co-payment because my colleagues have already done that but, Mr. Speaker, if you are not included in these various groups that have been referred to, you are on your own.

The excluded persons in most cases are people working for small business in the private sector. Most such employers do not have access to readily affordable coverage for their employees.

Yellowknife, on the other hand, with its territorial hospital, has the good fortune of having many resident specialists who are qualified to diagnose and treat more than general practitioners, who generally serve the smaller communities. Another half of the population may be quite less affected by this co-payment because they live in Yellowknife and can be referred by their family physician to a number of different specialists. It affects them when a referral is required to the south, but I would suggest that this is much less likely to occur than what is experienced by those living in communities like Hay River.

Mr. Speaker, I would like to see the Department of Health and Social Services determine how many people in the North are not covered by benefits through government or employee plans. When that number has been established, I would like to see the government facilitate a group insurance plan whereby those who are negatively impacted financially by this gap could elect to pay an affordable premium, which might cover even more than just medical travel. It could also cover things like dental, pharmaceutical and eyeglasses. It is the volume of people who would participate, which could make it affordable for the average working person or family.

Once a monthly premium for this insurance is established, small employers may even elect to pay it on behalf of their employees because their own numbers make the purchase of a plan too costly.

Mr. Speaker, this would not cost the government anything other than the administrative cost of acting as a facilitator. It would bring a level of fairness to Northerners who are not currently eligible for any other assistance. Later today, I will have questions for the Minister of Health and Social Services regarding this co-payment. Thank you, Mr. Speaker.

-- Applause

Thank you, Mrs. Groenewegen. Item 3, Members' statements. The honourable Member for Tu Nedhe, Mr. Nitah.

Thank you, Mr. Nitah. Item 3, Members' statements. The honourable Member for Inuvik Boot Lake, Mr. Roland.