Mr. Speaker, I am going to speak in favour of the bill. The need to keep current and competitive with tax changes in other jurisdictions in Canada is a bit of a challenge. In some areas, it can have its share of risk, as well. Was it two years ago that we changed our corporate tax rate upwards? This bill is going to reduce it now, again, as we are keeping pace with the changes in other parts of Canada.

One of the things that we will be looking into as this bill moves into committee is the potential consequence to the NWT in making these changes. While I am speaking in favour of the principle of the bill, Mr. Speaker, there may be other consequences or concerns that will be brought back to the Assembly and into the further debate about this bill. Thank you.

Thank you, Mr. Braden. To the principle of the bill.

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

---Carried

Bill 20 has had second reading and, therefore, stands to a committee. Second reading of bills. Consideration in Committee of the Whole of bills and other matters: Bill 18, committee reports 5, 6 and 7, with Mrs. Groenewegen in the chair.

I will call Committee of the Whole to order. We are considering Bill 18, Appropriation Act. Mr. Menicoche.

Thank you, Madam Chair. The committee wishes to consider the Department of Health and Social Services.

Thank you, Mr. Menicoche. Does the committee agree?

Thank you. We will do that after we take a break. Thank you.

---SHORT RECESS

Okay. I call Committee of the Whole back to order. We're on the Department of Health and Social Services, general comments. On my list I have Mr. Hawkins. I mean, not Mr. Hawkins; Mr. Menicoche. I got you mixed up. Sorry.

Thank you very much, Madam Chair.

Sorry, Mr. Miltenberger. I was getting such pressure to hurry. Mr. Miltenberger, would you like to come into the...I mean, would you like to bring witnesses into the chamber?

Yes, I would, Madam Chair.

Does the committee agree that we should let Mr. Miltenberger bring witnesses into the chamber?

Agreed. Thank you. Sergeant-at-Arms, would you please escort the witnesses to the witness table.

Mr. Miltenberger, would you please go and take your place at the witness table.

Okay. Thank you. I do apologize that we forgot for one moment only. Welcome back, Mr. Murray and Mr. St. Germaine. We'll now proceed with general comments. Mr. Menicoche.

Thank you very much, Madam Chair. Just with respect to the Department of Health and Social Services, another one of the big departments that plays a large part in my constituency, Madam Chair. I've got a very spread out constituency. I've got six communities, four small communities, and quite often -- "often" the key word here, Madam Chair -- is that programs, and guidelines, and policies that work in the larger centres just don't apply in the smaller centres and the smaller populations. Even Fort Simpson, as well, which is my biggest population centre of around 1,200 residents. But constituents get frustrated over guidelines and policies about travelling for medical travel, and having escorts and translation services along with the escort services, especially with the elderly population. That's predominantly the makeup of my constituency, Madam Chair, is that it's largely aboriginal and quite often the elderly and the older people, their southern Slavey dialect is their first language. They're getting increasingly frustrated because they are still going to get attention in the health centres and medical centres and it's still happening that nurses and doctors are asking them questions and they're kind of nodding in compliance, but they're not really understanding, Madam Chair. I think part of it is that when I first came to this Assembly I fought hard to get our cultural awareness programming. I think, primarily, I went through the Department of Health and Social Services first, but I believe it has to be an ongoing program, ongoing cultural awareness training that has to be ongoing perhaps on a yearly basis or for the new employments. It's not only Health and Social Services that the elders are having problems with. But there's a start there and it's just a basic understanding that even though it appears that they're understanding English and acknowledging what they're saying, they're not really doing that. I think it's more politeness, Madam Chair, that the people are agreeing.

As well as another huge event that occurred in my riding over the holidays was that there's a couple young girls in Wrigley that I'm still not quite sure on whether they got misdiagnosed or else there was quite, anyways, Madam Chair, there was quite a delay from an incident that they had to the time they got treatment. I think it was three or four days. Both of these girls were involved in an incident or accident with a snowmobile and they had broken legs, but it wasn't determined until about three days later. That's just something that's not acceptable. Granted, I'm not too sure what the reasoning behind it was, but I'm looking for a proper assessment of what happened there and just to prevent against that type of occurrence again. Even though I disagree with the way it all turned out, but there must be a way to assess a situation, provide a root cause, and then learn from that and move on. People just don't want to see those things happening.

What if it's more severe the next time? Who's going to explain that? That's just what I'd like to say. I don't want to see it get worse or something else, a worse incident happen and somebody gets either misdiagnosed or else put off until the next day type of approach. Quite often that was one of the biggest complaints when I got elected, was that elders were actually being sent home with aspirins thinking that aspirins will cure their ailment, when actually they're really sicker than they thought they were. But this kind of practice is improving, and I continue to speak for it. It's one step forward and two steps back, or whatever. But we still have to keep looking at these and assessing them and finding out root causes and improving service delivery to our constituents, Madam Chair.

Another very important aspect to elderly health care in the Nahendeh riding was the establishment of a dialysis machine in Fort Simpson. I see it's moved further down the capital plan. I don't know what the reasoning for that is, but as our population ages, it becomes more and more important for more and more people to receive the treatment they need from the dialysis machine. In fact, when I first came here, we actually had to move a resident of Simpson over to Yellowknife to be close to treatment for dialysis. In fact, he's still here and I continue to visit him often. But his greatest heartache is that he knows he needs the treatment, he knows he needs the machine, he knows he has to be here, but his greatest malcontent, Madam Chair, is that he talks to me in Slavey and he says sehotii, which, in my language, means "my cousins" and "the people that care for me." I don't see them all the time like I do back home, but when they do come here, his children come see him when they can. They make the effort to drive over here and see him. But it's just people who are stuck here for long periods and I'm not quite sure if we can provide some kind of assistance for families to come see him other than vacation trips. I'm sure there are other areas they can go with their hard-earned vacation money. But if we can provide some type of assistance to bring families here just to be with them...I know that we're extending every effort, as well to get him to our home community and back home for visits, but some of the visit barriers is that the best time to send him home is on a Friday and then back on Sunday. But his treatment is almost daily, so he needs that treatment on a Saturday and his visits are a threat to his health. In fact, the department was gracious enough, I went to them and said let's get this guy home. He hasn't been home for awhile. But when he actually did go home, he just dug right into all the wild food that was presented to him, all the bannock and the breads and the chicken soups and the rabbit soups, but it was just too much for his system and he actually got sick from that. But it's just not being able to have that machine there. If that machine, the dialysis machine was there in this particular case, then, of course, there would be no need to run him back and forth and he can have that care and attention back home in the community of Fort Simpson. So this is what I'm thinking, the reasoning for the movement of that dialysis machine there, Madam Chair.

One other aspect of care for elders is that, I know that the ministry has gone to great lengths to improve their respite care in the communities. It goes a long way with helping our families, helping our elders or helping those in need to stay in their communities. Indeed, too, in the smaller communities, Madam Chair. Quite often it's been brought to my attention that even though our elders are being sent home to the home communities, it's there, too, that they need that respite care, and we just don't have the medical staff or the attention to help spell off the parents or the sons and daughters that are helping the elder maintain a presence and maintaining their house in the community. Because even moving from Nahanni Butte over to Fort Simpson, or Trout Lake to Fort Simpson, that transition

from a very small community to Fort Simpson is great indeed.

It's much like the impact of people from Simpson or Norman Wells having to stay in Yellowknife. I think the main thing is that you're being away from home. However, Madam Chair, just with respite care in the community, I don't know how to do it, but there must be a way we can get specialists into the smaller communities to spell off our families that are taking care of their elders. Quite often the easy way is to get that elder back to Fort Simpson for a couple days. Sometimes that works, but oftentimes, if we can do it, maybe we can send that specialist into the smaller communities, like Jean Marie or Trout Lake, and pay attention to that respite care that's offered in those communities.

Just with that, I'll just close on this note, Madam Chair, and allow the Minister and the ministry to respond to some of the points that I've brought up and how we can continue to improve service delivery to our communities. Thank you.

Thank you, Mr. Menicoche. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, I'd like to acknowledge, firstly, the diligence that the Member from Nahendeh represents his constituents, both by e-mail, but he's also very prolific in terms of bringing the issues through the channels in letter writing. All good issues that we attempt to deal with.

In the issue of the medical travel and the escorts and translation services, for the most part we believe we have a system that functions the way it's supposed to, but there are always the circumstances where things don't work the way they're supposed to, or there may be an escort required where initially maybe it was determined that there wasn't. We attempt to address those, as well. Nahendeh and the Deh Cho have the benefit of having a very good board with a strong CEO and a lot of capable local staff that are very familiar with the concerns. So I acknowledge that there's always going to be a need for us to constantly look at trying to improve the services and address those circumstances where things don't work properly.

We have made a commitment, as well, to the issue of cultural sensitivity and awareness training, and it is an issue that's not only germane to the Member's riding, but it's a circumstance that we want to make sure is addressed adequately and with sensitivity across the whole territory.

The issue of the circumstance in Wrigley with the two young children is one where there's been an initial review done and we are currently getting it reviewed by a third party. We will be reporting back on that circumstance. As the Member indicated, there are many factors at play in that particular circumstance and we want to make sure that we do this carefully, in the right way, so that we can come up with a clear assessment to ensure that whatever didn't work properly does work properly in the future and that we don't necessarily repeat things.

The issue of dialysis is one where there is a plan that we want, not that we want, we recognize that there's a growing need across the North and we are, this year, '06-07, we are going to be putting dialysis into Hay River. In 07-08, coming forward after this budget, there will be built into the budget the resources to set it up in Simpson for the region. We recognize the inconvenience, not only the inconvenience, but the significant stress of having to relocate on a permanent or semi-permanent basis from your community and family has on the individual as well as the families. So we do have a commitment. We're doing this in a staged way, predicated mainly on its availability of resources and trying to live within our means. But the Member has raised a good point and I want to reassure him that it is on our to-do list, as is the issue of midwifery, which he raised earlier, as well.

As well, we have been piloting in Yellowknife the respite care program for social respite for those of families who are taking care of individuals and they may need, from time to time, some support or a break. This current budget addresses the issue of moving that project from a pilot basis to an ongoing program and then, once again in '07-08, we're intending to build resources into the budget to start expanding the program outside of Yellowknife. This will be the continued use of the federal dollars that has been agreed to from our various meetings with the government starting back in 2004. Thank you.

Thank you, Mr. Miltenberger. At this time I'd like to recognize in the visitor's gallery Chief Ron Pierrot. He's also the vice-grand-chief of the Sahtu, and with him Sharon Kakfwi and Richard Epelon. I hope I said your name right. Welcome.

---Applause

Next for general comments for Health and Social Services I have Mr. Ramsay.

Thank you, Madam Chair. I'm glad to see the Minister and his colleagues with him today to discuss the Department of Health and Social Services. I just start off my comments, my general comments, by saying I still am impressed with the level of service that is provided to the majority of residents here in the Northwest Territories and I think the Minister is to be commended for that. I know it's a challenge, especially in the smaller areas, to deliver the service, but I think we do the best that we can. I know here in Yellowknife the health care system is top notch, continues to be top notch and I think the Minister is to be commended for that.

There are a few areas, Madam Chair, that I just wanted to discuss while I've got a chance; some areas, perhaps, that we might be able to improve upon. If I hear any criticism at all here in Yellowknife, it has to do with the emergency room at Stanton and the length of time some people may have to wait there to see somebody, see a doctor. I think that's something, I know the Minister mentioned it in his opening comments to us yesterday that they are working to reduce wait times at Stanton's operating room and in the emergency room. I guess one of the questions I would have is, you know, how are you going to go about reducing wait times in the emergency room and in the operating room? That's the first question I'd have. Thank you, Madam Chair.

Thank you, Mr. Ramsay. Mr. Miltenberger.

Thank you, Madam Chair. Madam Chair, in regard specifically to the operating rooms, we are looking at doing some very basic things in terms of making use of the available space and

reorganizing so there's no down time. In the past, if there were numerous cancellations, we would just wait for the next patient to show up maybe two hours later. So we're looking at how we book people so that there are people on standby that if there's a space that comes up, it's put to use. So we've brought in some human resources, a sergeant major as it were, to help schedule the use of the operating room. If and when demands increase sufficiently, we also have the option that we've already done some work on in terms of a third OR that would give us the ability to do a lot more things, like the dental surgery, and be more responsive in terms of giving the doctors that require operating room time access. So in those two areas those are some of the ways.

I'll speak briefly...