Thank you, Mr. Hawkins. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, first I'd like to assure this House, in as strong as possible terms, that there's no way that we would ever use health programs and services as a shell game or as chess pieces. We have a very high level of service that we provide and we're committed to doing that, but we're committed, very clearly, to moving forward in a careful systematic way that recognizes that Stanton is a key piece and part of a broader system. Madam Chair, we have invested, in previous years, $1.3 million. We're investing over $1 million this year, and in subsequent years there will be more invested. We have money in the budget for an emergency, as well, and we're bringing forward the consolidated clinics. So we're trying to look at this in a comprehensive way that recognizes that these are all linked. If we're going to do system improvements, you can't look at any one facility in isolation.

In regards to the doctors, Madam Chair, the resources we have committed in the past are there for doctors, that we are constantly recruiting, that we are committed to providing those services not only here in Stanton and in Yellowknife or Health and Social Services, but in Inuvik and in Hay River. We've got doctors' positions funded for the Sahtu, Tlicho, as well as additional support for the Dehcho, as well as all the other services, though, the doctors are critical players in the health care system. We are also trying to design the system, as I indicated earlier, for example, with the clinic in Yellowknife, to give the doctors a greater ability to see patients more effectively by giving them capacity to do basic testing, better waiting rooms so that there is no waiting, better scheduling systems so we don't lose patients because they don't show up and the doctors don't have a patient waiting to see them. So this is an issue, but doctors are consummate professionals and dedicated to their craft and we're working with them to ensure that we have a strong system. We're putting in nurse practitioners, as well. We're going to be looking at the other end to upgrade licensed practical nurses to, as well, provide greater support. Thank you.

Thank you, Mr. Miltenberger. Next on the list I have Mr. Braden.

Thank you, Madam Chair. In the last couple of years, arguably the aspect of health delivery that has plagued our system the most and all the rest of Canada is the shortage of skilled professionals, doctors, nurses and allied health care professionals. Madam Chair, of late, it seems to have been less of an issue, at least in my telephone and my e-mail and I think less in the media too, but I guess I don't want to take that as a signal that we're over this problem. It's been described as a long-term issue for all of Canada, training up and recruiting more nurses and doctors. I'm wondering if the Minister or Mr. Murray could give us a bit of a snapshot. How are we doing? Are we managing to settle down on this persistent shortage of professionals ready to live and work in the NWT? Madam Chair.

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, the Member was accurate in his assessment that this is a long-term problem that goes back, it's genesis has been assessed to go back to the early '90s where there were some significant miss-assessments made in terms of the need for professionals, and we have put a significant amount of resources when it comes to doctors to fund positions. We have at least half-a-dozen northern students in medical school right now working towards their MD, as well as the other specialties that they will eventually go on to take. We are also moving to a four-year degree Nursing Program and the first 24 graduates of the four-year program will come through the system this spring, which will give us a much-needed boost of trained resources because, for the last 18 months as we switch from a two-year diploma to a four-year program, there has been a very small number of graduates, but now we're over that transition period. We have about 15 nurse practitioners that are currently being trained in the system, as well, that are going to come out with a level of skill that's going to be higher, or they're going to be qualified, ready to do business. The nurse practitioners are going to bring a higher level of skill into the field. As I've indicated, we're doing initial work on trying to upgrade the LPNs, but it's a constant challenge to recruit. For example, I know some of the other professions, audiologists, speech pathologists, OT folks and we are constantly working to compete and to recruit. It's something that we anticipate we're going to be doing across the board. We also talked earlier about the need to look at a competitive nature of our remuneration packages at all levels on an ongoing basis so that, in fact, we can deal with that particular issue, as well. But it is one where we're going to be at this with vigilance and diligence for the years to come. Thank you.

Thank you, Mr. Miltenberger. At this time I'll have to recognize the fact that we do not have quorum in the House and I'll have to ring the bell. So I will give you your time again from the start, Mr. Braden.

---Ringing of the Bells

Thank you. Mr. Braden, under general comments you have the floor.

That was on the record. That was not Mr. Braden speaking, Madam Chair. It was somebody else.

Madam Chair, could the Minister, with regard to his description of the various professions, advise how we are increasing and expanding our ability to grow our own workforce, and that is the very best kind of solution.

I guess what I am trying to do is get a quantitative idea of at least the degree of severity. Are we at 20 percent below our ideal capacity of registered nurses? Is there any kind of data like that? If it is not readily available, we can defer on that question, Madam Chair. Thank you.

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. Right now, for allied health professions, which include audiologists, dental therapists, laboratory technicians, nutritionists and such, we have about a 22 percent vacancy rate. For social workers, we have about a 23 percent vacancy rate. For nurses, I believe it is somewhat worse right now. It is 27 percent. I would point out, Madam Chair, as well, that all of this information we shared with committee. Thank you.

Thank you. Mr. Braden.

So all things given, Madam Chair, are we making headway on this trend? Are we seeing things going the right way? By and large, are they static? Are they going the wrong way? How are we doing? Thank you, Madam Chair.

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, we, by necessity, are optimistic that we are going to stay on this issue and look at filling the vacancies, recognizing some of the factors both locally, nationally and internationally that are affecting us. Very clearly, we do have some serious challenges. We have significant challenges for nursing, for example, in small communities. I talked earlier in the House about some of the options we are looking at in terms of trying to set up our own northern float pool where we can invest the resources here so we don't have to pay the very stiff rates that we are charged by agency nurses. We are working with the college to look at the recruitment issues when it comes to social workers, to deal with and try to improve enrolments and get more northern social workers in the field to fill the vacancies we have there, as well.

We are trying to track and setting up processes to work with all of the students that we have in the Northwest Territories that are going out to school that are going to be taking courses in colleges, be it for pharmacy, radiology or lab technicians, so that we can, in fact, connect up with them and encourage them and make them job offers to come back to the Northwest Territories. Thank you.

Thank you, Mr. Miltenberger. Mr. Braden.

Thank you, Madam Chair. One aspect related to this that I have some experience with in a couple of constituency situations is that, in the Nursing

Program, while we have worked hard to build up the capacity through Aurora College to give nursing students the basics, there is also a professional requirement that when they go into the workforce, there is the capacity in our hospitals and our clinics to guide them through various aspects of their training. If I understand it correctly, this is what is called preceptorship. It has become at least a perception that I have, Madam Chair, is that we have a bit of a bottleneck or maybe a major bottleneck in our system in that we do not have enough professionals or activity going on in our hospitals to be able to take the number of graduates and put them to work in our own hospitals. One constituent of mine has found that she has had to leave the NWT because, while she was trained up here, there was just not the capacity or the wherewithal to put her to work here.

Is that a correct perception of how we are doing in this particular area? Do we have a bottleneck in our hospitals and clinics in terms of bringing our nurse trainees onto staff and into the workforce, Madam Chair?

Thank you, Mr. Braden. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, in Stanton and the other facilities requiring nurses, as well as the many community health centres, we have capacity to take. We need every nurse that we can graduate. We have set up or are trying to set up the processes for mentorships to do the preceptorship to give them the extra additional experience they need to be able to go out. Working in hospitals is one thing. Getting to work in community centres where they are doing a tremendous amount in terms of independent nursing, we are working on that. The issue is convincing a lot of the nurse graduates to be prepared to move outside of the larger centres. Clearly, Stanton will take, as well as Inuvik, Fort Smith and Hay River, the nurse graduates. If there are gaps in our system in the ability to do that, it is not because we don't have the capacity, but if there are things we should be doing that we are not, then we will move to address those. Very clearly, we are spending millions to train the nurses. The whole key is to keep them in the North and in our northern facilities.

Madam Chair, with your indulgence, I would ask the deputy to speak a bit further and give a little more detail on this issue. Thank you.

Thank you, Mr. Miltenberger. Mr. Murray.

Thank you, Mr. Murray. Next on the list I have Mr. Ramsay.

Thank you, Madam Chair. Picking up on where Mr. Braden left off, I have a few questions in regard to human resources. First of all, the questions are specifically regarding nurses. I know I have a written question in to the Minister and his staff on what the rate of locum nurses in the Northwest Territories is, where we are getting them from and how much money we are spending on them. As the Minister knows, I am a big fan of training our own people to work in health care and health care professions. I think the Northern Nursing Program, and now it is changed to the four-year program, but I think something like that has really been a success story here in the Northwest Territories. I would encourage any more funding or help that can be put in that area to try to train our own people to work in our hospitals and our health centres to be undertaken.

What I don't completely understand, and that is why I want some historic information on this, is why are we bringing more locum nurses into the Northwest Territories today? This is seven or eight years after the start of the Northern Nursing Program. Are we paying more today on locum nurses than we did pre-development of the Northern Nursing Program? I think that is a question that I would like to have answered. I would be interested in seeing the historical data on the locum nurses and how much money the government is spending on them. That is just something I look forward to seeing. I am glad Mr. Braden was talking about that.

The other thing I wanted to touch on is human resources related. A number of employees were taken out of Stanton hospital and relocated to the corporate human resource services. I don't know the exact number of employees that that was, but I have heard the deputy minister, and the Minister spoke of it. There is $6 million inside the budget of the Health and Social Services to deal with HR functions and the fact that they are looking at actual expansion of that. I am not saying that is a bad thing. What I am trying to get at is I am not a big fan of duplication, as many Members will know. If we have taken employees out and put them at corporate human resource services, what are they being tasked with? Are they still looking after Health and Social Services employees, or are they doing different jobs now and they are being replaced inside the Health and Social Services? I am just trying to understand how that all works. Are we just moving people out and bringing new people in to deal with HR concerns with Health and Social Services? Thank you, Madam Chair.

Thank you, Mr. Ramsay. Mr. Miltenberger.