Thank you, Mr. Miltenberger. Mr. Pokiak.

That's it, Madam Chair. Thanks.

Thank you, Mr. Pokiak. Under general comments, next I have Mr. Braden.

Thank you, Madam Chair. Reflecting on Ms. Lee's notes and remarks from committee, which I'm proud to be a member of the Standing Committee on Social Programs, perhaps reflecting the same thing, Madam Chair. When the Minister and his officials were before us we had a pretty comprehensive briefing on a number of the major indicators, measuring sticks in our health care system. It is a daunting and a disappointing kind of report card. Some of the highlights that come off this are that 20 percent of all deaths in the NWT are alcohol related. Forty percent of all accidents involve alcohol. Suicide is bigger by a wider margin than any other cause of death by injury. Diabetes, which was once a low-incidence disease in the NWT, is now gaining and now in the age bracket 40 to 64 years, the NWT is ahead of Canada. Our tuberculosis rate is seven times that of Canada, and it seems the spread of STDs is as much as eight times the rest of Canada. This is a particularly disturbing one because it is a major signal of the

incidence of HIV infection that is likely to follow. Half of the young men in the NWT are binge drinkers, as defined by people who take five or more drinks at a time 12 times a year.

The common thread through this is that just about all of these are preventable or avoidable situations, Madam Chair. It comes back to what the Minister has been saying to what we're hearing experts and other politicians have said in this House for some time now, that helping people understand the consequences of their choices and their lifestyles, the things we do or how we live, are really a major impact here.

We have a number of cost drivers in our system that we can't do very much about, Madam Chair. We have an aging population. Public expectations of what our institutions can do or should do are getting higher. There's an emphasis in our technological age that things can be fixed quicker, but this means that, of course, we have newer and more expensive technologies and the people, the skills that are required to run this are getting much more sophisticated. So salaries and getting access to these people is getting much more difficult and, of course, expensive. We have probably just a much greater awareness and readiness to try to do something about mental health issues, Madam Chair, than we have had. These are some of the things that are out of our control and are forcing the growth, compared to the kinds of things that we could be avoiding.

It's not something that government can or should take overall responsibility for, Madam Chair. I'm learning that, and it's a message that I guess I'm trying to communicate more and more to constituents and audiences that talk about this. So then we're in an age where government tries to make everybody happy all the time. We're just not able to on this one. The decisions and the choices that individuals take and then the environment that's created in healthy families and schools and communities is so much more the direction we have to go. It underlines what we have I think underlined in our report. What we'll be doing in motions throughout the rest of his day and this evening is urging much, much more emphasis on promotion and awareness and prevention measures as really probably our most effective tool to turn the tide on some of these really devastating situations.

This is going to take a long time and there is no magic way of doing it. We just can't sit down and write another program that is going to get people to buy into this. So I hope that in our work and for the people that are perhaps listening this afternoon, or maybe reading an account of this, that if our leaders in our communities can think about their role, leaders at the aboriginal First Nation level, Madam Chair, people who are active in our schools, in our health communities, our volunteer communities, who can take some of this message to heart and see what kind of a difference they can make at their own level.

Finally, Madam Chair, I was listening to the federal Finance Minister, Ralph Goodale, for a few minutes delivering the federal budget this afternoon. In the area of health care he said sustainability is really the overall question that federal, provincial and territorial leaders have to look at. How can we sustain the burgeoning and sophistication of the system? Here is where if there was an avenue that I would offer, it is try to get everybody to appreciate that they too have a role in this. They just can't show up at an emergency ward or at a clinic and expect that some magical band aid can be applied every time something goes wrong. There is, as the Minister has said, a great degree of responsibility that we should all be taking.

There is one thing that I would like the Minister to consider. I know he is already doing it but I would like to reinforce it. That is that at the federal level that we fight at least for recognition and adoption of the unfairness of the per capita funding formulas that always seem to be our lot. It seems to be our fate when it comes to funding programs, not only in health but in a number of other areas, and we won't get anywhere, we will lose ground if we are unable to win the battle for recognition that we are compelled up here to do things differently than the rest of Canada. Along with that comes differences in cost. So that is one area that I would like to leave with the Minister in his representation of us at the federal, provincial and territorial level. Thank you, Madam Chair.

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. I would like to thank the Member for his comments, and his bleak but true recitation of the issues facing us and the cause. I just want to acknowledge that the issue of per capita funding is one that we always take to the table as Ministers when we go to the federal/provincial/territorial table. It is part of the repertoire of unresolved issues that we have. Per capita doesn't suit us. We want to have a rebasing of things like tax effort that the Minister of Finance has talked about. So that is there and I know it gets raised at every opportunity. Thank you.

Thank you, Mr. Miltenberger. Next on the list for general comments I have Mr. Ramsay.

Thank you, Madam Chair. I will start off by saying I agree with a lot of what my colleague, Mr. Braden, had to say on this department and where we are in terms of delivering this important and vital function in our society. I know the Minister has his hands full with this department in trying to accomplish a lot of things with a minimal amount of resources. I think a lot of times folks take for granted the health care system that we have in place here. It is, in my opinion, one of the best in the country if I can say so. I have been in southern Canada, my parents are now living in New Brunswick and I know they can't even get a doctor in New Brunswick and it is very difficult. Some relatives of mine are faced with the same realities in southern Canada, and I think a lot of times we don't realize just how lucky we are to have the system in place that we do.

One thing that I think doesn't get enough attention--I know Mr. Braden alluded to it a little bit--is the fact that alcohol and drug addiction is something that I don't know how exactly we get a handle on it. I know in the Minister's opening comments there wasn't a lot of mention of it. Just at the end he says in addition our budget reflects investment into mental health and addiction services, but drugs are not mentioned and alcohol is not mentioned. Those are two key problems that face the Northwest Territories. The problem with elicit drugs in the communities is at an incredible rate. You can go to any small community in the Northwest Territories today and find cocaine, crack cocaine, marijuana, acid, anything you

want you can basically find on the streets of any of our communities, and our people are suffering as a result of this dependency now on drugs. Alcohol is a big enough problem in and of itself, but this drug culture that prevails now in the Northwest Territories is something I think we have to take very seriously as a government and try to find solutions to tackle it. We are going to lose a whole generation here if we are not careful, that are going to fall into this type of lifestyle with drug addiction and leading their lives in not worthwhile, healthy pursuits. I don't know how we tackle it, I will be careful with what I say here, but there are operations in a lot of communities where they are growing marijuana. I don't know what the RCMP are doing about it, but we have to crack down on what is happening in the small communities. You can walk from house to house in a lot of communities and the smell of marijuana permeates the air. It is quite alarming and it is something I think we don't pay enough attention to.

I will ask the Minister a question here, that investment into mental health and addiction services that the Minister speaks of in his opening comments; I guess the question I would have to him would be where would I find that in the budget? I am not a member of the Social Programs committee, I am a GED Member so I didn't have a chance through committee to ask that question, so I will ask it now, Madam Chair. Thank you.

Thank you, Mr. Ramsay. Mr. Miltenberger.

Thank you, Madam Chair. Firstly, I would like to thank the Member for his positive comments about the services. I agree; having travelled around the country and other places that we have a level of services in the North that is very high, and I think often unappreciated until you are in another jurisdiction and you recognize the value of what we have here.

The issue of alcohol would come under alcohol and addictions. Mental health services would come under integrated activity 500, which is, I think, integrated community health programs when we get to the budget.

With regard to the issue of alcohol, I agree that of all of the issues we deal with, in my mind the issue of alcohol runs like a river of misery and sorrow and hurt that runs through the North touching every community, causing us inestimable grief and cost. It is something that we have not yet come to grips with, and clearly as northerners we have a penchant for drinking and smoking, and doing all of those things that are hard on one's body, one's families, and one's health.

The issue of hard drugs is also one of growing concern. Though the statistics I have seen indicate that while it is a problem, it is still a relatively small one, especially in comparison to the alcohol issues, it is not one that can be ignored. I know in some communities like Yellowknife it is quite prevalent given the population, the transient nature, and the amount of money that is here. Thank you.

Thank you, Mr. Miltenberger. Mr. Ramsay.

Thank you, Madam Chair. I would just like to again ask the Minister, this investment is something new or is it an ongoing investment, or what his planned action to tackle the drug and alcohol questions in the Northwest Territories might be, and how he sees this fitting into his budget if there is any new money directed at those programs. Thank you.

Thank you, Mr. Ramsay. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, a couple of years ago there was work done on a mental health and addictions family violence strategy. As well, there was a report done on the alcohol and drug services in the Northwest Territories called the Chalmer's report, titled a State of Emergency. It clearly identified that that area of program delivery was very weak, suffering from many things, one of them probably being benign neglect. The attempt we have made is through a number of things we are doing, one of them -- the integrated service delivery model -- is to bring addictions workers into the fold, as it were, of the health and social service workers that we have at the community level. We also recognized, and one of the things that was pointed out very clearly, was that addictions workers, alcohol and drug workers had worked for years often in isolation at very, very low pay with no real job description in very difficult circumstances. Many had worked for years just because they were very dedicated to the issue. So what we have done and what our first focus has been is to get a decent job description, get some money for some decent wages and benefits for the workers, add some mental health workers, re-describe the alcohol and drug workers to become community wellness workers, as well as putting into place some clinical support for them in terms of some mental health supervisors at the regional levels. That has been the first major step that we have taken in terms of trying to enhance and better use the services. Keeping in mind that the focus is to work at the community level, trying to deal with prevention. Waiting until people are in facilities or waiting, as we talked about earlier on other areas, until they are sick, often we are too late. We have to continue to invest at the community level and we want to focus on the young people, we want to focus on pregnant mothers, and we want to give the community wellness workers that are in alcohol the tools and the training to in fact be more effective, recognizing that when you are dealing with alcohol issues, you are not just dealing with alcohol issues. There are usually multiple issues that come to the table and we have to give them the skills to be more effective.

So that is the thrust that we are on. It started a little over a year ago, and we are looking at trying to get it fully implemented. As a Minister, I can tell you I remain firmly convinced that our salvation lies at the community level and working on the ground there with the people and the services there. Thank you.

Thank you, Mr. Miltenberger. Mr. Ramsay.

Thank you, Madam Chair. I know in the Minister's opening comments he talks of the $5 million cash infusion from the federal government. Where is that $5 million reflected in his budget, or is it just absorbed into the whole function? Thank you, Madam Chair.

Thank you, Mr. Ramsay. Mr. Miltenberger.

Thank you, Madam Chair. The money is identified. I will get Mr. St. Germaine

to tell us exactly where we can point to it in the budget. I can tell the Member that we have added $1.4 million in new resources to mental health and addiction services in the main estimates. We have added another $276,000. As well, there is almost $1.3 million of federal money that we are going to be dealing with. We have primary health care in the Northwest Territories, it is laid out under program delivery support activity 200, the $.5.3 million.

Thank you, Mr. Miltenberger. Mr. Ramsay, did you want to respond to that? The 10-minute time ran out when you were speaking last time, but go ahead Mr. Ramsay.

Thank you for allowing me, Madam Chair. Just a quick question, I know he refers to some different page numbers, but in our main estimates what page number would that appear as, Madam Chair?

Thank you, Mr. Ramsay. Mr. Miltenberger.

I hate to delay the workings of the House, but I was just chatting to the director. The question is where is it in the main estimates?

Thank you, Mr. Miltenberger. Mr. St. Germaine.