Thank you, Mr. Braden. Mr. Minister.

Thank you, Mr. Chair. Mr. Chair, in my opinion, we will be able to provide the same level of service that the calibre of staff that work on the floor with the kids is available in Hay River. It is available now in Fort Smith and Inuvik. We also invest in training northerners. Yellowknife is not the only jurisdiction or community that has the capacity to look after children; children, many of which, don't come from Yellowknife. The quality of education in Hay River, I would suggest, is as good as it is in Yellowknife. The access to specialist services is the one difference, and it's about 20 minutes or half-an-hour farther away than it is for the children in Yellowknife. So I categorically state, and I have enough experience in this business having run the facilities for a number of years myself, that you can train northerners, that you have very skilled, compassionate, caring people in the communities that can deliver this service under the expert direction provided by Bosco Homes.

So I'll restate that this program will be delivered. It will be delivered very well in Hay River and that's what we're intending to do. Thank you.

Thank you, Mr. Minister. Mr. Braden.

Yes, Mr. Chairman. I'm very familiar with the Minister's confidence, and I share with him the confidence of a large majority of the people who are

needed, and trained and committed to the care of children. But the exception, as the Minister pointed out, is amongst the more sophisticated, if you will, psychological and medical and clinical services. Yes, the Minister is quite right; it is potentially only a half-hour plane ride from Yellowknife, but there's a lot more involved than sort of transporting people back and forth on airplanes.

So let's park that one there. We're hoping and I'm entirely supportive of trying to achieve some repatriation, Madam Chair, and anticipating that we are going to be undertaking more of the cost in order to do this. I look at information that the department supplied in response to a question from me in October of last year, Madam Chair, and the response indicates that for the eight clients or beds that are presently provided for children at the Territorial Treatment Centre, there's a cost assessed here of about $145,000 per year per bed, or per client if all those beds are full. Madam Chair, the letter then indicates that providing specialized services for children that are not available in the NWT, we had 27 clients in care for a cost that amounted to $45,000 per client. So we have $145,000 to deliver a service here with the arrangements as we know it under the TTC, and $45,000 in the South. That is a major, major difference in cost. I'm wondering if the department can give some sort of reconciliation of how the economies of scale are going to shift. I don't want to assume here that I'm an advocate of keeping all these kids in the South, not at all. But there is a $100,000 difference per client of the service between the South and the North. Are we going to be able to reduce that? How much? When, Madam Chair?

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, I don't have the letter before me. Once again, I can only assume that it's an average, because I do know that we spend significant amounts of money down south, as well. It is, on a dollar basis, in most cases cheaper to have children down south, but oftentimes we send children down south because they have a complexity of need that's not able to be met in the North.

I guess the other value that I would suggest is it's hard to put a dollar figure on them when you have children treated in the North, as the value of having them close to home within an environment and culture that they know and that their families can access in a somewhat easier way, but, very clearly, we think there's a value to looking at repatriation. I can only assume that the $45,000 per child is an average. I know that last year we spent down south on children about $4.7 million for a total of 41 children. So those are the stats for '04-05. So it's a very expensive business no matter where you do it. Thank you.

Thank you, Minister Miltenberger. Next on the list, general comments, I have Mr. Villeneuve.

Thank you, Madam Chair. I just want to thank the Minister for his opening comments. I think this year's health budget is basically going to deliver a lot of good changes that people were asking for and have been asking for for a long time.

I just want to mention something about the medical travel concerns that seems like everybody has got an issue with. First off, I know we had the telehealth line and the toll-free nursing line available on a 24-hour basis. I know it's been mentioned to the department before, of whether they're going to establish a medical travel toll-free line that people can phone from anywhere, anytime. It seems to me that every time I'm picking up people from the airport or bringing them to the airport, that people at the airport who don't know who to contact in the government that takes care of travel, and the people that are travelling don't know who they were talking to, because it seems like there's different people at the end of the line all the time. So I'm just wondering, just to alleviate the stress that these patients are going through while travelling, to alleviate the travel stress, is there any review or consultation been done within the department to setting up a medical travel toll-free line?

Thank you, Mr. Villeneuve. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, the Member's correct; this issue has been raised before, and I've just had discussion in the department. But of great importance to us is looking at the system and the exceptions that happen that cause concerns to be raised, or MLAs to be approached so that they have to come either to myself or to the deputy to resolve issues, and we're trying to eliminate those. So as I indicated to the Member from Nunakput, we're constantly trying to improve the service. We know that this is a very critical time in person's lives, when they're on their way for medical treatment, and we tend to hear about the exceptions. We do our best to resolve them. We haven't made a final decision about how we could possibly move ahead on a toll-free medical line. It would be much different than the line we have to phone nurses. This would be talking about very specific circumstances, policy interpretation, sort of online adjudication in trying to sort out the information so that you could, in fact, make that kind of determination which would be very difficult when you're, for example, on the phone with a distraught individual from the Hay River Airport on their way to Edmonton and things haven't fallen into place and it's 4:00 on a Saturday. We tend to respond to these on an emergency basis, and as the best way to deal with those circumstances, and then try to sort out what happened after that, make sure that the immediate need is met, and then we try to adjust to make sure it doesn't happen again. Thank you.

Thank you, Mr. Miltenberger. Mr. Villeneuve.

Thank you, Madam Chair. I'm just having a problem seeing the big problem with having a medical travel toll-free line, and just for the fact that medical travel is basically pretty cut and dried, as far as I can tell. When people get the authorization to travel somewhere, it's just as easy to phone a travel agent and make those arrangements themselves, where as they have the Stanton travel and authority to do that for them. There are many instances where people wind up at the airports with no information on travel arrangements, and the agents at the airport don't have any information themselves and nobody has a number that they can call.

So is there a possibility that we can set up a 1-800 line that people can phone in and the person at the other end of the line will have access to a computer system that I am sure will be able to handle all bookings that Stanton works

with or makes for any individual in the NWT, to find out whether or not their travel has been confirmed, who it's been confirmed with, and by whom and when? If it hasn't been confirmed, the person at the other end of the line or some authorization to issue a ticket, be it over the line, through a credit card or through whatever means that they might have at their disposal. Just something that might be a little more instant than having to go running to the Minister's office every time somebody gets stranded at the airport. I just don't know why that is such a difficult area to build on. We have telehealth lines and nursing lines and we have experts at the end of those. We are just looking for a travel agent at the end of this one, somebody who knows how to make the change, and make the necessary adjustments, and do the necessary billing arrangements and invoicing. Is that something that the department is considering now, or are they just going to research more into why? How is it so difficult? Thank you.

Thank you, Mr. Villeneuve. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, I can appreciate the Member's concern and frustration because it is an issue that, as I have indicated, gets a lot of traffic with MLAs through the Minister of Health's office. The circumstance is as the Member said, it provokes a response and it's not always as cut and dried as it would seem, that's why we end up with these calls that something hasn't worked. What I will commit to the Member to do is we will layout what we are doing, what we are going to do to improve the service. As well, we will come back with our assessment, a specific written assessment on what we think is the validity and the aptitude of using a 1-800 number. Does it make sense? We'll give the Member and this House and the Social Programs committee our best advice. If there is a way to do that, we will give it a serious look. If not, we will be looking at other ways to try to give people some way to get basic information, as the Member indicated, about flights being reserved and confirming travel arrangements. Thank you.

Thank you, Mr. Miltenberger. Mr. Villeneuve.

Thank you, Madam Chair. I am glad I got a commitment from the Minister for that. I look forward to seeing what gets presented to Social Programs.

Still sticking with the medical travel issue, the issue with medical travel escorts has always come to my attention, also. I know the patients themselves don't really have much say in whether they want an escort or not. It's basically up to the nurse practitioner or the community health representative to make the call on the escort and then people are coming here, travelling, they are distraught, they don't know how to handle a lot of the inquiries if the tickets aren't there. I don't think the escort is just there for emotional support, but I think a lot of them help the patients to move along and to carry their luggage and bring them to the hospital and make sure they are eating and everything else. I don't think it's just for some emotional or psychological support, or just to overcome the language barrier are the only reasons an escort should be allowed to travel with the patient. Is there any movement on the department's side to be a little more flexible on the escort rules? Thank you.

Thank you, Mr. Villeneuve. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, the escort provision of the service we provide is geared around a medical determination of whether an escort is required. As the Member indicated, that assessment is made by the doctor, the nurse, or the nurse practitioner who is with the patient. We are working constantly with the authorities and with the various facilities and the staff to make them aware that there is some flexibility required; that a medical escort may include being able to make sure, for example, that there's adequate interpretation services, or that if the person may not be very sick but is infirm and has difficulty walking, those types of assessments and that it is not a rigid assessment. There are always extenuating circumstances. But there has been no move towards going back to what used to be called compassionate travel, which became a prohibitively expensive service. Thank you.

Thank you, Minister Miltenberger. General comments. Ms. Lee.

Thank you, Madam Chair. I just have one question about the new Chalmers Report. I know that the report has come out and the Minister offered to give us a briefing, but we could just not put that on the agenda. I just want to know if this new budget reflects any recommendations coming out of that report. Thank you.

Thank you, Ms. Lee. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, the recommendations in the Chalmers Report haven't been fully assessed and we are working on our response of how we are going to incorporate those. What is in the budget, though, is the third year funding for the Mental Health and Addictions Strategy, which we haven't fully implemented yet pending the outcome of the Chalmers Report, which will give us some flexibility to be able to respond to some of the recommendations. Thank you.

Thank you, Mr. Miltenberger. Ms. Lee.

Thank you, Madam Chair. I think the Social Programs committee will have an opportunity to deal with that, then, because I wasn't sure if it was incorporated here. Sorry. I will look into that later.

Just on the Nurse Practitioner Program, Madam Chair, I just want to comment on this program because I didn't get a chance to do that when I was commenting on all the other things the Minister is working on in health care delivery in Yellowknife and downtown clinics. I have to say that I think that is one addition in the clinics that is working well, and I know that the Minister is planning on spreading that as much as possible, but I would like to know what the level of training is and how that's going along. The question comes up often when we are travelling to communities and talking to Members from outside of Yellowknife, whether or not it is expected that the nurse in charge or senior nurses will be the ones that would be taken away as nurse practitioners, or they would be the better suited candidates to take the Nurse Practitioner Program, which may produce more nurse practitioners,

but it may have the effect of creating a vacancy for senior nurses in communities that are vital. I just want to get a quick update on what the latest is on this Nurse Practitioner Program. Thank you.