Thank you, Mr. Chairman. The Standing Committee on Social Programs met with the Minister and his officials on January 20, 2003, to discuss the 2003-2004 Main Estimates for the Department of Health and Social Services. The standing committee notes a $13.064 million increase in the budget were the figures presented during the business plan review in September. There is a $426,000 increase in the amortization estimates, a $957,000 increase for the implementation of the Social Agenda action plan; a negative $440,000 reduction for cancelled transfer of Hay River Health and Social Services Board contract; a negative $226,000 transfer of payroll benefit administration for the Fort Smith and Deh Cho boards to the FMBS; $738,000 to deal with recruitment and retention issues; $1.409 million for the implementation of the mental health, addictions and family violence strategy; and finally, Mr. Chairman, $8.259 million for the implementation of interim health professional plan.
Members of the committee were pleased the interim health professional plan contained funding to hire one midwife each for Fort Smith and Hay River. This will allow expectant mothers without any medical complications to give birth in their home communities.
The Standing Committee on Social Programs is concerned with how the capital allocation process determines which facility will be built or renovated in advance of other projects. One of the criteria deputy ministers use in deciding capital allocations is the protection of existing government assets, Mr. Chairman. This means the government will spend money to make sure existing facilities will achieve the maximum operational life. In the case of major facilities such as schools and hospitals, the cost of these renovations can run into the millions of dollars. Such is the case with the health centre in Fort Smith. Members of the standing committee were first made aware of the perceived need to renovate the health centre during a discussion of the 2002-03 draft main estimates. The renovations and the proposed figure of $10 million first appeared in the capital acquisition plan in September of 2002.
Committee members noted the roof of the Fort Smith Health Centre was renovated this year at a cost of $272,000. The committee is having trouble justifying the half-life renovation of a facility when there are communities that do not even have a community health centre or resident nurses, Mr. Chairman. The bigger question is how the capital allocation plan addresses the issue of needed new infrastructure in the communities with the need to protect the government's investment in existing infrastructure. As one Member asked, are we, meaning the Department of Health and Social Services, in the business of protecting people's lives or protecting government assets?
Until such time as the department can provide justification for the midlife renovation of the Fort Smith Health Centre in advance of needed health infrastructure in the communities, the standing committee recommends the proposed funding be removed from the capital allocation plan. This recommendation was passed on to the Standing Committee on Accountability and Oversight and conveyed by a letter to the Minister of Finance for a response. A response from the Minister indicates the department is planning to complete the master development plan in 2003-2004 to determine program requirements and required facility functionality. The government went on to say it prefers to leave the project in the five-year capital acquisition plan subject to the outcome of the master development plan for the Fort Smith Health Centre. Members of the committee are concerned with this approach, believing there may be a tendency for the program requirements to end up matching the available capital funds.
Mr. Chairman, Members of the standing committee shared the Minister's disappointment over the response to the request for proposals issued on providing a health information toll-free service and agreed that proposed costs were significantly higher than anticipated. The committee could understand the Minister's reluctance to go back to the trough, as it were, for increased funding, given the significant investment of over $13 million the government has made in health care since the review of the business plan.
However, members of the standing committee would be even more disappointed if the government would have let the idea of a toll-free line to provide health information to NWT residents die because there are insufficient funds at this time. It is hoped that funding may become available through the increase in federal funding for health care.
Mr. Chairman, the Standing Committee on Social Programs remains committed to expanding telehealth availability in the NWT. Information provided by the department subsequent to the discussions of the draft main estimates indicate the program is on track and is providing benefit to the medical community and their patients.
Members took note of the current registration process underway for NWT health care cards, Mr. Chairman. With the attempt to match residents with addresses, it should be possible for the Department of Health and Social Services to eliminate much of the health care card abuse that anecdotal evidence suggests is happening. Members of the standing committee and likely the residents of the NWT would be interested in having the Minister communicate the results of the registration process once they are available.
Members of the Standing Committee on Social Programs are aware of the serious increase in the number of child apprehensions, particularly in Yellowknife and Inuvik and have commented on this disturbing trend in past reports. The department, up until this year, has done a good job of implementing recommendations contained in the Child Welfare League of Canada report on the state of the child protection service in the NWT. Members were very disappointed that funding for the last 11 child protection workers recommended by the Child Welfare League was not contained in this year's budget. This was despite Members' understanding that the implementation of the recommendations was a three-year process and would remain a priority in the department.
The standing committee's understanding of the Child Welfare League report also had a recommendation leading to the effective supervision of any new child protection worker hired as a result of the report. Members are concerned that failure to hire the additional 11 child protection workers has also impacted on the number of supervisors and the quality of support available to newly hired child protection workers.
There are some who will argue that the reason there have been more apprehensions over the last few years is that by implementing the Child Welfare League recommendations we have hired more child protection workers. More workers translates into more apprehensions. Or, it may be a case of there being not enough supervisors overseeing the work of the child protection workers and the workers are choosing to apprehend in situations that may not require such drastic measures but which are outside of their experience.
The committee does not believe the issues are that simple. The protection of a child is the focus of the child protection worker. If a child is in an unsafe living environment, the worker has a duty and responsibility to remove the child from the situation that gives rise to their potential concerns. What has been missing from this discussion, Mr. Chairman, is the realization that many of the problems that families are experiencing that give rise to protection concerns and children being apprehended are not that easy to correct, given the lack of services and support available to residents.
The committee will use the example of parents with an alcohol dependency in one of our smaller communities who have had their children apprehended. Before a child protection worker will allow these parents to regain custody of their children, they would have to show they no longer drink irresponsibly. The problem with this is there are no services available in our smaller communities to help the parents recover. There is only one residential treatment program in the NWT, and even if treatment were successful, there is a lack of follow-up and support programs available in the person's home community. If you can't access the services, if you cannot get better, you cannot regain custody of your children. The committee is sure there are people who have given up any attempts to regain custody of their children, because the challenge of regaining sobriety or dealing with issues surrounding residential school abuse has proved too onerous. The committee is of the opinion there is a need to adjust the current child protection system to address the problems that are at the root of the need for apprehensions.
The need for prevention will always be present. Any apprehensions of children in danger are a necessary part of the equation. However, Mr. Chairman, the committee believes that the other side of the coin is the need to support the family in crisis. There must be programs and services in place that help families that want to be together and stay that way. The new Addictions, Mental Health and Family Violence Strategy may help address some of the issues, but it cannot be used by the department to abrogate its responsibility to provide support to families in need.
Mr. Chairman, the standing committee is pleased with the Minister responsible for the Housing Corporation's commitment to work with the Department of Health and Social Services to determine the best utilization of the Samba K'e Healing Centre, including the possibility of using it as a territorial treatment centre for youth.
Mr. Chairman, members of the standing committee had expressed reservations with the department's plans to spend $3.3 million in renovating the current Territorial Treatment Centre in Yellowknife, in light of an existing suitable facility being available.
Mr. Chairman, that concludes the committee's report.