We have not yet had a reasonable response to this, Mr. Chairman. The Minister has avoided that issue all day today. The discussion paper that has been put in front of the standing committee will not lead to an answer that we can deal with this on, because he earlier today, in question period, said he's not prepared to spend money he doesn't have. You can't deal with this issue unless the government is prepared to put some money on the table. That's really what it comes down to. Without money to take the inequity off the table, it's not going to be dealt with.

The discussion paper talks about four options, and they're so broad. Each one of the options is so broad it doesn't clearly define what it is we're talking about. There's no definition. He can't expect that the Standing Committee on Social Programs is going to come back to him and say, "Oh yes, we think that you should do number three and know exactly what's in there because it doesn't explain to us exactly what would be included in number three."

So I don't think that it's led to a productive discussion today, to say well, I'm just waiting for the Standing Committee on Social Programs to get back to me on this issue. The standing committee has let the Minister know, in no uncertain terms, what our position is on the medical travel co-payments. The Minister doesn't need to meet with us to hear from us about that again. This message was sent more than four months ago, and we're still waiting for a reasonable response. Thank you, Mr. Chairman.

The Minister of Health and Social Services, Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, as legislators we have to look at the whole picture in this case, in my opinion. Yes, there was a specific recommendation to come up with a way to rebate the $250 when medical services that are supposed to be in the community aren't there. We've attempted to look at the whole area, the patchwork of the supplementary health benefits that come up, with a way to revamp and update and modernize and better link those services. We also can't afford just to lightly say we're prepared to possibly turn our back on over $1 million of federal revenue that now comes through non-insured health benefits, if we don't handle the issue of medical co-payments in the right way. Anyway who thinks that we can just walk away from that and we'll just add it to our deficit? I don't think they would agree that that's the best way, and why should we let the federal government off the hook?

So we do have some fundamental questions to answer and, yes, we can look at tinkering. I'm trying to avoid tinkering so that we can in fact move as quickly, but in a measured and as comprehensive a way as possible, to come up with a way that's going to allow us to put a document on the table that will show how we can revamp those supplementary health benefit services.

That paper also points out that the way we're going is not fiscally sustainable, that's it's developing in an unplanned, uncoordinated, very expensive fashion. So we have some tough decisions to make. In all probability, yes, we may have to go back to the Legislature and Cabinet for more resources. But we definitely can't do that at the same time as we think we can just turn our back on federal money, which is why we have to take that look. I'm prepared to suffer the slings and arrows of outrageous fortune here in order to do that properly. That's the intent, Mr. Chairman. We'd like to get something on the table and we're prepared to work as fast as we can. I can do this with the departmental authorities in isolation, but then that defeats the whole point that the Members keep making about they want to be involved at the front end. The attempt here is to look at a major reworking of a key program area in a collaborative way that's long overdue. Thank you.

Mr. Dent.

Thank you, Mr. Chairman. The Minister again talked about working with departments and authorities. Earlier in talking to him, Ms. Lee said that they had been working together for 14 months on this issue. Again, you're talking to the people who rely on the department all of their funding. How are they going to talk about whether or not we should, for instance, remove the specified disease list as part of the criteria for the extended health benefits? They are going to depend on this government to come up with the funding before they can answer whether or not that should be done. It's exactly the same thing with the co-payment of medical travel. It should be the legislators that are involved in this policy discussion, because we're the ones who have to come up with the money. So let's not obfuscate the issue by saying that we're going to deal with the authorities to try to solve it. It has to be those of us who sit around this table that make the decisions about how and where the money is going to be spent. I've made it perfectly clear to the Minister that if it means that the people who cannot afford to pay the $250 co-payment get assistance from this government, if the cost of that is that $1 million to this government from the federal government, well, then we're going to have to maybe bite that bullet. Because we can't say that only some people, a small class of people, because there are just a limited number of people out there who are not covered by an insurance program that we collect this from. But that small group of people typically work for low wages, have no insurance, and wind up having to subsidize this program for the rest of the people. It doesn't cost a lot of people money because they're covered through an insurance program. But it isn't fair the way this program has worked out now, since we've put in that $250 co-payment. It's not productive to keep saying we have to deal with the authorities, and the department has been working on this. This is an issue that we're going to have either decide that we bite the bullet or we don't.

And it's the same thing with whether you look at a continuous program or a broad program. If you want to have a program that is seamless and broad, it's still going to cost the government money or else we're going to be reducing benefits across the table. That isn't a discussion that you're going to have to have with authorities. If you're talking about reducing benefits, that's something, again, we have to have around this table, because it's legislators who are going to hear the complaints from their constituents, as the elected officials who are going to have to deal with those complaints. People who are appointed to authorities don't have the same responsibility to the people in their service areas that we do. We have a responsibility and, therefore, we have to be accountable to the public for decisions that either increase or decrease the level of service. This is where the discussion needs to take place, but it has to be one that's very quickly past the concept stage. There's not much point of having an options paper if there is no money at the table. Thank you, Mr. Chairman.

Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, Mr. Dent and I will continue to disagree on the approach that's being used to revamp and work with the health and social services system. But we do agree -- and that's why we're here -- that there's a document on the table stamped draft, to have that discussion. It's not just about medical co-payment. There's medical travel to seniors, extended benefits, there's indigent benefits, there's ones for the Metis which are, effective April 1st , going to be raised to 100 percent. We have to look at this as a package. How do we look at revamping it? And I agree, it's more that just a concept stage, and it's more than telling the department we told you to get rid of that medical co-payment and rebate it and have done with it. We're here with a document that will hopefully take us to that next level, that will be more detailed at every step. Part of that will eventually be a costing out of what's finally, we think, the best way to proceed.

If it, upon review, is the decision of the Legislature that the status quo, for better or worse, is what we're going to go with, then that may be where we end up. But we have put a document on the table that was developed within the health and social services system as a starting point. Very clearly, the Legislature will determine, through this process and other processes, the final configuration of whatever is brought forward and we will be the final arbitrator of whatever money is put on the table. So we look forward to working with the Regular Members and the Social Programs committee to do that. Thank you.

General comments. Mr. Delorey.

Thank you, Mr. Chairman. I'm beginning to see why it's so hard to get anything done and bring some positive results to areas when we're trying to get answers. You talk about tinkering and probably that's what we've been doing all afternoon, I guess, but we're certainly not getting answers. Probably part of the reason is exactly what the Minister just finished saying, it's not just co-payments, it's a lot of other things. If we want to find a way to do absolutely nothing, I guess that's how we do it. Let's bury it with 100 or 1000 other pieces of legislation and areas, and then we'll never get anything done because we'll never find an answer for all of them and we can't do one of them at a time if it's the only issue that's being addressed.

But I wanted to go back, if I can. I didn't get any answers to my previous line of questioning. I wanted to ask the Minister a few more questions, and then I'm going to leave this, although it won't be a dead issue, I guarantee it. But in training for counsellors, when we look at alcohol and drug counselling and addictions, there have been people working in this territory very hard -- extremely diligently, as the Minister would say -- to try and eradicate and deal with addictions. If the program didn't work, it has been stated many times, it's because the department didn't give it an opportunity to work, to do the proper training, to make sure that our counsellors are certified.

I'm hearing now through this totally new program that they have no idea if it's going to work, because they're in the concept stage. Would the Minister state right now that the department has given up on using the standards that were established by the Canadian Addictions Counsellors' Certification Board? Has the department decided that they will not use that model and are not going to go into that area? Thank you, Mr. Chairman.

Minister of Health and Social Services, Mr. Miltenberger.

Thank you, Mr. Chairman. Mr. Chairman, the prevention workers will have a significant part of their duties still relating to alcohol and drugs and addictions. I indicated earlier, we intend to use the curriculum and training that's already there in that particular area. So we will make use of those resources and curriculum, and be able to meet part of the final training package that's there for prevention workers. Thank you.

Mr. Delorey.

I don't know. That's not a yes, that's not a no, at best it's a maybe. But it's not an answer again. If they are not using this program, it's simply no, we are not using that program. That is not what we're going to be using for a qualification and certification program. That is not it. That's all you say. No, we're not using it, and the people who are working in that field will know the department has no interest in it. Thank you, Mr. Chairman.

Minister of Health and Social Services.

Thank you, Mr. Chairman. Mr. Chairman, we are going to be developing a training and certification program through Aurora College, and there will be an addictions and an alcohol and drug component to that program, and it may, in fact, be part of the criteria and training that's currently offered, that Mr. Delorey has outlined. Are we washing our hands of that whole area? No, we're not, but our certification and training will be done through the college as the main vehicle. Thank you.

Mr. Delorey.

In the new integrated service model, it seems to me in reading through it if I remember correctly, that whole program delivery model identifies something like six supervisory positions -- I'm not sure if that's the right terminology -- that would require master's degrees to fill those positions. I would like to have the Minister clarify if that is a correct statement and, if so, how many of those people do we have in the North right now?

Minister of Health and Social Services.

Mr. Chairman, at this point the goal is to hire as many qualified people to do clinical supervision as possible. How many clinical supervisors do we have in the Northwest Territories working for the government or not? I can't tell you off the top of my head. If the Member would like, I can find out and report back, at least on the government side and with the authorities. Thank you.

Mr. Delorey.

Thank you, Mr. Chairman. The Minister didn't clarify if those six positions, the professionals that he's talking about, the training positions, do they require a master's degree in mental health?

Minister of Health and Social Services.