Thank you, Madam Chair. I look forward to having the Minister answer questions that he has stated in his statement.

Introduction

Madam Chair, the Standing Committee on Social Programs met with the Minister and his officials on January 14, 2005, to discuss the draft main estimates for the department of Health and Social Services. Committee members made note that the department is proposing to spend $250.649 million in operations expense and $6.875 million on capital projects in fiscal year 2005-06.

Committee members offer the following comments on issues arising out of the review of the 2005-2006 Draft Main Estimates.

Preface

It is important for the public to note that the new federal funding for health care announced in the fall of 2004 is not included in 2005-2006 Draft Main Estimates, and as such the committee did not have opportunity to comment on the final disposition of the funds. This is a one-time anomaly that clouded our discussion with the Minister and his officials.

The department has a handle on how much money is expected to flow from these new funding arrangements. What is not clear are the conditions the federal government will place on the usage of the new funding. Until such time as the allowed usages for the funding can be established, the department is unable to include in the main estimates funding to restore programming or pay for new initiatives.

Committee noted that some reductions, proposed delays of program implementation and facility closures that were discussed during the business plan would not be taking place.

The areas where the committee would like the department to target new or increased spending are discussed within the rest of our report.

Mental Health And Addictions Strategy

The committee was pleased the department was able secure funding to roll out the last year of the Mental Health and Addictions Strategy. In this time of restraint, the government was able to see the need to hire the nine mental health workers and three clinical supervisors.

Committee is still concerned that the department will have difficulty in recruiting for these positions given the requirement to have either a bachelor or master's degree in social work. Alcohol abuse remains the most important issue facing many of our communities and strategies that cannot put mental health/addiction workers in the communities are of no use to them.

The abuse of drugs is becoming more and more prevalent, as increases in disposable incomes have led many northerners to make poor life choices. This is readily apparent in Yellowknife's downtown core but is also becoming a problem in smaller communities. More resources will have to be directed towards drug addictions.

The concern that there are not enough treatment facilities to meet the needs of northerners in dealing with their addictions remains. Any reprofiling of the Mental Health and Addictions Strategy by using the new federal money should address the issue of facilities, in addition to staffing concerns.

Gambling is a problem for many northerners and does not seem to be adequately addressed or, at the very least, given a meaningful profile within the context of the Mental Health and Addictions Strategy. Beating an addiction like alcohol dependency is a laudable feat. Replacing an alcohol addiction with a gambling addiction does not put a person any further ahead.

Members will look for evidence of increased programming for gambling addicts in future business plans.

Madam Chair, I would now like to ask the Member for Great Slave, Mr. Braden, to continue with the report of the committee. Sorry, Madam Chair; I would like to ask the Member for Nunakput, Mr. Pokiak, to continue with the report.

Thank you, Ms. Lee. Mr. Pokiak.

Professional Development Opportunities

Thank you, Mr. Chairman. Members were concerned with the reduction to the professional development funds available for health care workers. Although it is apparent that the department did not expend the total funding available over the last two years and that this would be a logical activity to consider for cost-cutting measures, committee members have heard anecdotal evidence that one of the reasons for poor uptake was the inability of the department and the authorities to provide the short-term relief necessary for nurses to take advantage of the program.

One solution that was discussed at committee was the possibility of allowing health professionals to accrue their professional development funds for two years. More money would allow the health professionals a wider choice in training opportunities, and having some professionals attending every two years could make it easier to schedule replacement coverage.

The department has made it clear to Members that nurses' salaries in the Northwest Territories are competitive with other Canadian jurisdictions. While this is an important component of any recruitment and retention plan, it has become important to include items such as professional development opportunities, which allow nurses to upgrade their skills and interact with their peers, to ensure retention of valued employees.

The onus is on senior management at the departmental and authority level to ensure there is sufficient staff on hand to cover off those nurses who want to take advantage of relevant professional development opportunities.

Members are concerned that the use of contract nurses is contributing to the turnover of nurses in the NWT. Why would a nurse take a permanent position and pay rent and travel costs, when he or she could take a contract position and have rent and removal costs paid for?

Committee members will be tracking these issues through the next business planning cycle.

Homelessness

The committee supports the new position proposed in the main estimate to develop a long-term strategy to deal with the homelessness issue. This two-year term position is important in coordinating information and programs within the social envelope to ensure a consistent government-wide approach in working with our NGO partners to develop a new long-term strategy.

In recognition of the fact that NGOs are, and probably will be, doing most of the program delivery related to homelessness on behalf of the government, committee members expressed concerns that this new position would become a first step in the development of a bureaucracy to work on the homelessness file. Members want to see spending on programs rather than on bureaucracy.

Supplementary Health Benefit Programs

As more and more of their time is spent helping constituents access supplementary health benefits, committee members look forward to further briefings and discussions on the redesign of this program.

The issue of third-party coverage for the small segment of our population without private health care insurance or coverage under the federal Non-Insured Health Benefits program is of concern to Members. As it stands now, the coverage available through the Supplementary Health Benefit Program is insufficient to meet basic needs in some circumstances and does not adequately deal with the use of medical escorts. These issues must be addressed in any program redesign.

Some of the complaints that MLAs have heard through constituents deal with the problems they have experienced in trying to determine the level of benefits they are entitled to. Members have heard of decisions taking up to five weeks. This is unacceptable in this time of instant communications and clearly points to the need to establish concise program eligibility guidelines for staff to follow as part of any program redesign. Program delivery staff must be sensitive and diligent in helping clients access the benefits to which they are entitled.

Members also look forward to reviewing the criteria for the inclusion or exclusion of any disease or condition under the Supplementary Health Benefit Program. How we determine and apply any such criteria can have a profound effect on the wellbeing of a family with a loved one suffering from a chronic condition or disease.

As previously stated, Members look forward to further discussions with the Minister in the spring.

Madam Chair, at this time, Mr. Braden, will complete the report.

Thank you, Mr. Pokiak. Mr. Braden.

Medical Travel And Stanton Territorial Hospital

Thank you, Mr. Chairman. To continue the standing committee's report in the area of medical travel and Stanton Territorial Hospital. Committee members are pleased that Stanton will be taking a central, coordinating role in determining which patients require primary care in Alberta. The department's own consultants have estimated that during one sample year, anywhere from 1,000 to 1,800 bed days were paid for in Alberta for patients who could have been treated at Stanton.

We are paying to staff a hospital to operate at or near capacity. It makes no sense to send patients from Inuvik directly to Edmonton, when the bed space required, specialists and level of nursing care are readily available at Stanton.

Except in the most extreme life-threatening situations, sending all patients to Stanton for advanced diagnosis and treatment makes good economic sense.

Members see a need to involve the specialists and other medical professionals to determine whether the capacity and skill set exist at Stanton Territorial Hospital to deal with referred patients' medical conditions.

Fetal Alcohol Spectrum Disorder

Members are concerned that the issue of FASD may not have the profile within the government's business plans and main estimates that its devastating effects on the North demand.

There is good work going on in this department. It is actively involved with the Pacific Northwest Partnership in establishing best practices and centres of excellence for research. Social workers and frontline health care workers provide treatment and programs to northerners who may be suffering from the effects of FASD as part of our continuum of care.

The Department of Education, Culture and Employment provides funding and support to the authorities to help all northerners, including those who may suffer from FASD, to get the most out of their educational opportunities. Early childhood development programs can also do a lot to mitigate the long-term consequences of FASD.

The Department of Justice has done groundbreaking work in dealing with cognitively impaired inmates.

A significant portion of our budget is spent dealing with the long-term effects of alcohol abuse as it relates to FASD, Madam Chair. Educational programs are raising awareness, and expectant mothers are much less likely to drink than they were just 20 years ago.

Members have taken this concern to their counterparts on the Accountability and Oversight committee, and there is general support for increasing the profile of FASD in the next business planning cycle.

Territorial Dementia Facility And Long-Term Care Facilities

Recent statistical population projections for the Northwest Territories have indicated a doubling in the number of seniors by the year 2018. The department has acknowledged this will mean an increase in the number of northerners requiring long-term care in facilities like the Joe Greenland Centre in Aklavik, or placement in a dedicated dementia facility.

The Yellowknife Association of Concerned Citizens for Seniors, or YACCS, has done an excellent job in preparing the business case showing the need for a territorial dementia facility, as well as doing some preliminary design work. The members of the standing committee appreciate the work of these dedicated volunteers, and all other people who volunteer at long-term care facilities across the NWT, in addressing the needs of elders.

Members look forward to reviewing the results of the facility review currently underway and note that there may be an opportunity to use some of the new federal funding to address the infrastructure requirements of our long-term care program, including the building of a dedicated dementia facility in the NWT.

Respite Care

As part of any plan to deal with the issue of long-term care in the NWT, committee members see a need to develop respite programs for those caregivers who decide to look after their loved ones at home.

There is a clear need for medical and non-medical respite care. If we cannot offer respite programs, there is a significant possibility that we will end up with these people in our long-term care facilities as the caregivers burn out. For committee members it is a simple matter of pay now or pay more later.

The committee would be interested in the results of the pilot project on respite care that ended in 2004.

There is an opportunity to ramp up a respite care program in the NWT to respond to the needs of our aging population, as well as dealing with the immediate needs of other northern caregivers who may require respite relief.

In closing, Madam Chair, committee members will be looking for evidence of such an approach in the next business planning cycle.

Thank you. That completes the report of the Standing Committee on Social Programs on this department.

Thank you, Mr. Braden. What is the wish of the committee? Mr. Braden.

Madam Chair, I move that committee report progress.

The motion is in order. The motion is not debatable. All those in favour of the motion to report progress? All those opposed? The motion is carried.

---Carried

I will now rise and report progress. Thank you.

Can I have the report of Committee of the Whole? Mrs. Groenewegen.

Thank you, Mr. Speaker. Mr. Speaker, your committee has been considering Bill 16, Northwest Territories Business Development and Investment Corporation Act; Bill 19, Appropriation Act, 2005-2006; and, Committee Report 11-15(3), and would like to report that Bill 16 is ready for third reading. Mr. Speaker, I move that the report of Committee of the Whole be concurred with. Thank you, Mr. Speaker.

Thank you, Mrs. Groenewegen. The motion is in order. Do we have a seconder? The honourable Member for Inuvik Twin Lakes, Mr. McLeod.

All those in favour? Opposed? The motion is carried.

---Carried

Item 22, third reading of bills. The honourable Minister of Justice, Mr. Dent.

Thank you, Mr. Speaker. Mr. Speaker, I move, seconded by the honourable Member for Weledeh, that Bill 18, An Act to Amend the Territorial

Court Act, be read for the third time. Thank you, Mr. Speaker.

Thank you, Mr. Dent. To the motion.

Question is being called. All those in favour? All those opposed? The motion is carried.

---Carried

Bill 18 has had third reading. Item 22, third reading of bills. Mr. Clerk, order of the day.

Thank you, Mr. Clerk. Accordingly, this House stands adjourned until February 17, 2005, at 1:30 p.m.

---ADJOURNMENT

The House adjourned at 7:11 p.m.