Thank you, Madam Chair. Madam Chair, I don't disagree with the Member. I would suggest, however, or respectfully point out, that we have about a 25 percent vacancy rate, which is very high. But it also indicates that we are staffed up 75 percent and we're managing to provide coverage on the other 25. We're going to have a graduating class of our first-time degree'd nurses, which is a process that's taken years to put into place. We've gone from relative ground zero with the nursing program over a relatively short period of time, to start turning out northern graduates. We have, or have had in the last year or so, 15 nurse practitioners in training that have started to come out of the door with their qualifications. That is a good investment. We're building those folks into the system and we're tying them into all the other allied health professions that we have with the midwives and the doctors that we've added. Our big measurement of success is going to be if we can break the cycle of dependence on agency nurses and see the vacancy rate start to diminish, in my opinion. Thank you.

Thank you, Mr. Miltenberger. Mr. Ramsay.

Thank you, Madam Chair. I thank the Minister for that. There are certainly many issues at play here and I'd really like to know why nurses and why health care professionals are leaving in the numbers that they're leaving the territory in. They come here for a little while and they leave. I think we have to try to find out what the real problems are. Why are we losing nurses? Why are they coming here for a short period of time, turning around and leaving? Why do we lose nurses that have been here for a number of years? Why do they go south? Why do they seek other opportunities? What is it that we're missing here? I think that's the key component to this and I think the department has a problem on their hands. If the vacancy rate is 25 percent, as the Minister stated, we have to try to find out what's wrong. To me, I think conducting exit surveys on every health care professional that leaves the territory might get us some kind of indication on what that problem is and how we might be able to remedy it. I think the sooner that this type of work starts, the better off we'll be. I'd like to ask the Minister if he can direct his department to start questioning nurses that are leaving the North, other health care professionals that are leaving the North, tendering their resignations, moving on, why are they leaving? I think that's the big thing. So we have to start asking ourselves why are they leaving. Thank you, Madam Chair.

Thank you, Mr. Ramsay. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, the Member raises a good point that

is part of doing business, which is the matter of exit interviews. However, it hasn't been done with consistency across the system. Now that we're going to be having a coordinated, consolidated HR presence and function, then we will now be able to do this as a matter of course, and the issues the Member raises are good ones. We know that training was very important to nurses. We know that in the smaller communities the issue of the rent, and the remuneration, and the recognition of the challenges of living in the more isolated communities are issues that are there. They were struggling to deal with given the fact that all health professionals are part, with the exception of doctors, are part of the UNW bargaining unit and part of the Hay classification system, which poses its own unique challenges in that regard. Thank you.

Thank you, Mr. Miltenberger. Next I have Mr. Menicoche.

Thank you very much, Madam Chair. I'm quite interested in some of the program delivery support mechanisms as provided by the Department of Health and Social Services. I've spoken to them several times in this House, as well as during our opening comments with respect to deliberating Health and Social Service's budget here. Just like my honourable colleague Mr. Ramsay speaking about many employees having like one foot out the door kind of approach to living and working in the North, and I'm not too sure why that's there. Maybe there's some uncertainty. It would probably be prudent enough, I don't know, I would say to at least conduct some kind of interviews, or even exit interviews, with the people that are leaving. I'm not too sure of the standard practice in the department to conduct exit interviews, but at the time when we need to track nursing and get them up in the North, and even to the smaller communities, it would be appropriate to find out what would have made them stay longer just to help design a better retention and recruitment policy.

Some of the things I spoke about often are even like the community of Wrigley who really wants professional attention from nurses and doctors, even looking at activities like a rotation system into the communities for short periods of time. Even making it an option perhaps for some of our new nurses that are graduating, because I've paid great attention to the dialogue, as well, the Minister and the Honourable Mr. McLeod from Inuvik, their discussions this morning when they were talking about graduation rates and how do we keep our youth in the North, even get them into the communities. So this is one of the ways of doing it, is I would suggest rotate them in perhaps with some of their peers into the smaller communities because, granted, certainly the way of delivering services and having the help delivered in the communities is different when it's a very small community; especially if there's language barriers there, as well.

Part of the cultural aspect of our aboriginal people is there is a lot of trust involved and once you gain that trust, then I'm sure it will make the job easier for our health professionals that are trying to get out there, but it's getting out there on a consistent basis is what I hear often, too. They're coming in, but they're only in for a couple of hours and people are saying, well, why don't they stay longer, or even plan for an overnight visit. Some of those things go a long ways, you know, in that they're willing to be part of a community, that they're willing to pay attention to us. I think that's all it is, is just the ability for our health professionals to be there and to pay attention to our people. It goes a long ways in that sense.

Of interest to me, as well, too, was Minister Bell was in the news earlier today talking about looking at some alternative ways of getting policing into the communities. That helps the nursing profession too because that's always a concern that I relay to the communities. Yes they want a nurse, but in order to get a nurse you have to get your police, but you can't get your one police, you've got to get your two police. Even that's not good enough; you have to get 2.5 police because you need somebody to spell them off in between. So it seems like a huge bureaucracy problem. But in the end, all the people want, Madam Chair, is just to be taken care of and protected as well, and just to have their ailments taken care of and looked at. In the end they want security; they want that service there all the time.

In fact, there was an incident this winter in one of the communities that I represent where it was felt that proper care wasn't given. I brought that up with the Minister, as well, and I think part of the incident there is what's the root cause of that? Has the department looked into this situation and found out the root cause of why the proper care and attention wasn't given? Just by exploring those root causes and doing the exit interviews, I think the department will find it very, very beneficial in creating proper programming, more current methods and it will help with the recruitment and retention of the professionals that we want in the North.

Just touching on a few other programming issues that I guess caught some attention is that as the communities I represent, they're small communities so often our people are travelling for their medical needs either to Fort Simpson or to Yellowknife. They're often saying, well, the translators or else family members are sometimes deemed, I don't know who does it, but sometimes somebody deems those family members or translators, they're not allowing them to go even though they have a translation problem. It just goes back to what I spoke about initially when I was first elected, was that the elders appear, they really do appear that they're understanding because you're talking with them, they're nodding and they're saying uh huh and uh huh, but culturally it's a polite thing. That doesn't mean that they're understanding very technical explanations and instructions because going through airports, you know, it's quite stressing. You talk to about 30 people before you finally get into a taxi, and to someone that doesn't have a good command of the English language, that can be very, very stressful. In fact, often they get stranded. They just get stuck at the airport, and that's happened on more than one occasion to constituents of mine.

So I don't know who's been making the judgement calls, but there's got to be a better way of doing it to say, yes, you know, that person really does need that translating and it's not just somebody wanting to go on a trip to Simpson or wanting to go on a trip to Yellowknife, because often that's the focus. But the focus should be on the client, not on who is going travel with them to provide assistance.

Quite often, too, the clients are travelling and they've got no contact information with them. There was a case in the fall time where the client was travelling from Yellowknife back to Fort Simpson. Due to difficulties and missing connections, that person was actually at the Fort Simpson

airport in excess of two hours; no contact information, nobody to phone. Quite often I think that we should provide a listing of phone numbers or contact information if you run into difficulties while en route from your community. Often it's on the weekend so it's not during the weekdays where these things occur. So that would help because I know that even in Fort Simpson and in Liard, there's people designated as on-call personnel. So if their numbers were given, then at least the clients could call to their home base and find out how to get assistance, instead of just sheer luck.

In fact, last fall there was a taxi driver that showed up at the airport for some other reason and he noticed that there was an elder sitting there and he said, well, how long have you been here, and that kind of stuff. But I'm grateful for that taxi driver for being there and understanding that language was a barrier and that he'd been there for in excess of two hours and bringing him to town and trying to get attention for that person. In fact, even the cab fare, right? That was like $20 and who's going to pay for that, right? But in this instance, the cab driver didn't worry about that for the moment. The main thing was to take care of our people and that should be our focus all the time, is that we should be taking care of our people, Madam Chair. So for the regional and community services we could always use improvements. That's one of the things that I think will help out, but the main thing is I think that we have to keep applying ourselves and looking at innovative ways of which to provide professional services like policing and nursing in our communities for extended periods.

With that, Madam Chair. I'd like to hear the Minister's comments on some of those ideas. Mahsi cho.

Thank you, Mr. Menicoche. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, we, as well, share the same concern about the quality of care and the standards that that care is provided. I think, for the most part, the system we have tends to work fairly effectively, but to be sure, as the Member has pointed out, and others have pointed out, and we find out through phone calls to our office and such, there are times when things don't work as they're supposed to.

On the issue of contact information, that is a good, common sense, simple suggestion and I'll commit here that we'll make sure that in every airport, if it doesn't already exist, we will have contact information for those travelling of who to call either in Yellowknife or in the community where the airport is.

In terms of the service or trying to improve the service, we're continuing to invest, as the Member may know from discussion in this House. In this budget, there's funding for additional nurse practitioners to go into the regions to provide more support to the communities. We've got two for the Deh Cho, two for the Tlicho, two more for the Sahtu, and two more for Inuvik with their function to be able to go to the communities and provide better support than currently exists. We also have the public health units which have been funded, and we're working hard with the Deh Cho, the Sahtu and the Tlicho to get those units up and running. Those are three positions each where I think they're about $900,000 per unit. As well, we've also announced that we're going to make a significant investment in the rehabilitation teams that will allow greater service to the regions and communities and that's going to be staged in over the next number of years.

The issue of medical travel is a very sensitive one and I recognize that one, as the Member has indicated. We try to ensure that it's done carefully There's medical decisions made, but the issue of making sure that elders aren't inconvenienced or disadvantaged is one that we continually try to pay attention to. Whenever specific circumstances arise, we try to address it, as well as try to make sure that people are as sensitive as possible to the circumstances of the people travelling, which gets back to another suggestion that the Member made, I think it was last year, which was the whole issue of cultural awareness training and being sensitive to these issues, especially if you have a population of health professionals that may be fairly mobile and not aware of some of the circumstances that they are working in. That, as well, we hope will contribute to greater effectiveness in how the work is done. Thank you.

Thank you, Mr. Miltenberger. Next I have, well, just to remind Members, we're on page 6-23, program delivery support, the description's on 6-22, if we could keep to that page, thank you. Ms. Lee is next.

Thank you, Madam Chair. Just a couple of things. One is to do with the Home Care Program and not necessarily for Yellowknife, although I'm a big supporter of this program and I think it's a great program that needs to keep on going. What I do want to speak to is with respect to home care positions in small communities.

In our pre-budget tour, and I don't want to mention any communities or names because I don't want to get any employee in trouble, but I was quite startled to find out that, in fact, there is a half-time position in small communities. I can understand how some communities are so small that they may not be able to have full-time home care, but surely there's a lot of programs being provided by this government in similar areas of social services per se, or health and social services. I just think having a part-time person, or just somebody being a half PY, does not provide the kind of job security necessary for that person to really get committed to a position. Even if this person was from that small community and this person will be there for a long time, this is a person that the whole elders or everybody who is in need of anything relies on, and obviously this person was working a lot more than part-time hours. I'd like to ask the government to undertake a review of the manpower that they have, or the womanpower that they have, in their communities and see if they could somehow combine the work there of related fields to make sure that wherever possible, that all of these positions are full-time. Because I think that full-time positions, unless, of course, somebody wants to work part-time, but in most cases where this person was quite young, very ambitious, she's gone through three to five years of training and she desperately wanted to work full-time, but there was just not enough work there, but not enough budget money, but I'm sure there's enough work there for her to be full-time. So I'd like this department to undertake a review of some of the conditions in small communities and what part-time positions they have, and whether or not they are like similar programs that they could combine to make it into a full-time position. It could be half social work and half home care for somebody; half-time nurse and half home care or something so that

the persons could be employed as full-time wherever possible.

The second issue that I want to address also is something that's already been addressed a number of times in this House. That's with respect to recruitment and retention of health care professionals with specific emphasis for retention. I think that we would go a long way in addressing our health care professional shortage if we could just keep what we have, and I'm not sure if the government is doing enough to keep people who have moved here, or who are from here, who have been trained into positions. I don't know if we're doing enough to keep them in the field and in the North. I think the Minister is aware of some questions I've posed to his office about people that are under the Maximizing Northern Employment Program where northern born, northern trained health care professionals are being left to wonder year after year whether they will be able to get a full-time job, even though there's a lot of need for health care professionals and people trained in that area.

So as long as I have been here, there have been questions asked about doing exit surveys. I was watching the Olympics over the weekend and there was a commercial by Johnson and Johnson, and Mr. Johnson, one of the Johnsons, was on TV saying the reason why they are the best company in the world, or one of the best, is because they ask their customers about products they make and the only way you can improve and know whether you are producing products that work for people, and whether or not you are satisfying their needs, and whether you're performing well, is by asking the customers. For the life of me, I don't understand why we cannot have an exit survey. Make it mandatory. The Minister could make that a policy right now. Some people may be leaving for all the good reasons. They may have to transfer for family reasons; they may be leaving the field or whatever; but there might be some other information there that might be helpful to improving our retention programs for us to learn more about what we're not doing well in, or what we could improve on, especially for Stanton Hospital.

I have to tell you, I've said before that I'm getting the sense that the human resource issue there is not as challenging as it had been years back, but I think the challenge is still there. I still do get phone calls from staff there from all different departments at all different levels about human resource issues. I could say that I get more calls about human resource issues out of that hospital than anywhere else. Perhaps we had that issue with the North Slave Correctional Centre and this government addressed that by having a special project person, reviewing the issues and one of the things they did was to do a survey. I remember being briefed on that survey about employee satisfaction and what's happening and just learning from the employees themselves about what's going on. I don't understand why we can't apply the same thing to Stanton Hospital. I'd like to ask the Minister if he would conduct a survey at the hospital and report to the Social Programs committee about what the findings are, and whether he would institute an exit survey requirement, a mandatory exit survey to all of the health care professionals. Thank you.

Thank you, Ms. Lee. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, if I can just go through the list that I've been making here. In regards to the issue of positions and half-time positions, or part-time positions, we will, as part of the business planning process for 2007-08, work with the authorities to make sure that we make every effort to have these positions as fully occupied as possible and, where it makes sense, possibly combining them.

In regards to the health professionals, as I indicated to Mr. Ramsay, exit interviews are a human resource practice. It hasn't been very consistently applied. It's our hope and plan, now that we're becoming better organized, that that will become a standard part of the separation process with employees, keeping in mind that it's an optional one, that they can't be forced to do that. As well, we've already, as part of our facilities review with the work that's going into the facilities review, have committed to doing more work with doctors, better assessment. As well, flowing from that, we recognized that we have to do more work with nurses in terms of the actual work that's there, the needs that are in the various facilities and information from the practitioners themselves. So I'll commit to the Member, as the chair of the Social Programs Committee, that when that information is finalized and ready, we will add that to our list of briefings that we will offer to the committee for their review and feedback. Thank you.

Thank you, Mr. Miltenberger. Ms. Lee.

Thank you, Madam Chair. I think I would like to get some more commitment from the Minister, especially about the exit interview. I do appreciate that you can't force people to write about why they are leaving, but I think given the level of shortage of health care professionals and the money that we do spend on recruiting these people, I think we can't afford not to know why these people are leaving when they do leave. It seems to me that it's the best way to find out what we can do better or maybe we are doing just fine. I mean, this is a way to find out. I understand that human resources is just being amalgamated, but we're coming to almost a year-and-a-half left of this Assembly and I do need to see something more concrete. So could I get the Minister to make a commitment to undertake a survey of the Stanton Hospital prior to the next business plan session this fall and have some results for us to look at? Thank you.

Thank you, Ms. Lee. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, we will report back on the vacancy rates and the exit interviews that were done. As well, we've already undertaken, and we have work underway, to look at the issue of nursing, not just in Stanton, but across the system. I'll just restate my commitment to report back on those findings, as well. Thank you.

Thank you, Mr. Miltenberger. From page 6-23, program delivery support, operations expenditure summary, $26.822 million. Mr. Yakeleya.

Just for clarification, I wanted to ask the Minister on this senior's facility in Deline. When could they expect to see it open? I guess there's a joint effort, as you mentioned, Minister, between yourself and the

Housing Corporation and the community of Deline, and a motion was passed by the leadership in Deline to accept the recommendations by your report in terms of turning that facility into a centre for wellness workers and social workers. So I just wanted to ask the Minister in terms of this facility. He did talk about two phases and I guess I wanted to ask them when can they expect to see this facility open. It's been dragging on for how many years now. I just want to get some commitment from the Minister in terms of when would this facility be open.

Thank you, Mr. Yakeleya. Mr. Miltenberger.

Thank you, Madam Chair. It's our hope and plan, as the deputy indicated, that there would be two phases and if we can get things worked out with the Housing Corporation that the first phase would allow the facility that's currently unused to be used by late summer.

Thank you, Mr. Miltenberger. Mr. Yakeleya.

Should that work out good with the Housing Corporation, late summer, I mean I guess I'm concerned because I guess I'm asking the Minister if he could commit to sit down with the Housing Corporation and say like this date we're going to have this open. You know, the winter road is opened up until the end of March and now we're missing an opportunity. So that's what the people wanted more in Deline, is that we seem to be dragging it on and we're just dragging it on. So we're just hoping right now to sit down with the Housing Corporation. I'm not too sure if the Minister understands what I'm trying to get at in terms of having this facility open. Thank you, Madam Chair.

Thank you, Mr. Yakeleya. Mr. Miltenberger.