Thank you, Madam Chair. The Member is correct that this money is for 50 percent of the 2005-2006 numbers, both the accumulated side and the ongoing deficit. Stanton is projecting a $6.9 million deficit for the 2006-2007 fiscal year. As I stated, we are working with them around that, as we do with other health authorities. The reason you see these other numbers broken out as they are, they are over and above the normal processes that are used and are not part of, well, the first one, the $732,000 the Member has identified is a result of a re-evaluation that resulted from a number of appeals and that's why it's outside the normal process and budgeting that we would do. As well as the 563. Thank you, Madam Chair.

Thank you, Mr. Roland. Mr. Ramsay.

Thank you, Madam Chair. I guess if I heard the Finance Minister correctly, the hospital is currently today in about $13 million of red ink. I think that alone sends shivers down my spine. I just want to know what the game plan is from the government to address the deficit at Stanton. Why is the big question, are we here today dealing in a supplementary appropriation trying to get half of one year's accumulated deficit at that facility? I think it's shameful. Actually, I think it's shameful too that Members of this House didn't know. I don't know why it wasn't in the mains last year. Why wasn't that information in the mains last year? Can the Minister answer that question? Thank you.

Thank you, Mr. Ramsay. Mr. Roland.

Thank you, Madam Chair. Madam Chair, when health authorities bring their budget plans forward to the Department of Health and Social Services, there's work that's done at that level and then the Department of Health and Social Services will bring in their requests for additional funding and FMB would review those and agree or disagree with some of that, all based on the numbers we have available over the total government. We've allowed a process over a number of years that, surpluses that were there, health boards could keep their surpluses, but we expected at the same time if they were in a deficit position that they would have to manage their way out of it. That's where the negotiations process or discussions go on between the authority and the health or the department and then the department to FMB. So some of the increase that you would see in the business plan process, some of that could be allocated to the fact that there was agreement on some of the numbers, but not all of the numbers. Again, that's the process that is used to date. The number that I used is the number for 2006-2007 is an estimate. Again, when they were asked to put this together they had to do some calculations of what might be seen at the end of the fiscal year. I state, there is a good working relationship now in coming to a better grip with this between Stanton, the Department of Health and Social Services and our involvement from the FMBS. Thank you.

Thank you, Mr. Roland. Mr. Ramsay.

Thank you, Madam Chair. The time that this deficit was rung up there was a public administrator in place at Stanton hospital. There was a direct line between that hospital and the Department of Health and Social Services. It wasn't like an authority. Why wasn't that information contained in the business plans last year or the mains last year? Why is it here today? That's the fundamental question, Madam Chair.

Thank you, Mr. Ramsay. Mr. Roland.

Thank you, Madam Chair. Madam Chair, as I stated, through our business planning process each department would bring their requests for additional funding and the Department of Health and Social Services would have brought its request to the table. It would have been evaluated on the same criteria as any other department and just because a health board has a deficit, doesn't mean it's going to automatically get its full amount put back into the budget. As I stated, the program that's been put in place, if a health board has or authority has a surplus we allow them to keep that surplus for ongoing potential growth pressures that they may feel. That is also coffered in areas where they can't just move that money all the way around. But it's also understood that if there is a deficit, that they're going to have to work their way through that deficit. The government overall in the past has got involved in other health authorities and facilities in the past when it was substantiated, that there was an ongoing growth pressure that wasn't just a blip in one year. That's part of why you see things delayed as they are. We expect again that a review that's going on will help us determine whether in fact there may be some ongoing underfunding of some areas or if in fact there need to be some changes in the way program delivery is happening. Thank you.

Thank you, Mr. Roland. Mr. Ramsay.

Thank you, Madam Chair. I think the big thing, the fear factor for me in all of this is now the department is going to go back to that hospital and as a result of the chronic underfunding that's taken place there over the past few years, it's going to go back there and demand that they make some tough decisions because of that underfunding, which is going to put even more pressure and more strain on the employees that work there and also on the public who use that facility. I think it's just an appalling thing to allow to happen, Madam Chair. Again, I'm not sure, I'm going to go back and double check on the recording or the reporting of numbers because personally I'm not 100 percent sure on which FAM directive it is or which part of the FAA it is, but given the fact that Stanton was operated with a public administrator, I do believe there is a responsibility of Department of Health and Social Services to report that deficit to this House. Not two years later, but in the year that the deficit was accrued and that happened in 2005-2006. Madam Chair, I am going to double check on that just to make sure that everything is aboveboard. Thank you.

Thank you, Mr. Ramsay. I didn't really hear a question there. Does the Minister want to respond to that?

Thank you, Madam Chair. As the process is laid out, departments can come forward

requesting more funding for their operations and its reviewed. At times things are approved, at times they're sent back or told to come back after they've had a full year of operations to substantiate fully their cost areas. This process would be used for any health authority, not just the Stanton facility. Thank you.

Thank you. Before I go on to Mr. Braden and Ms. Lee, I would like to draw Members' attention in the visitors gallery to Mr. Darrell Beaulieu, who is the chair of the Business Development Investment Corporation, and also Pawan Chugh, who is the CEO for the BDIC. Welcome to the Chamber.

---Applause

Mr. Braden.

Thank you, Madam Chair. I don't think I'm going to bring anything new to the debate our colleague from Kam Lake has not already put on the table other than to underscore and emphasize my concern. As a member of the Standing Committee on Social Programs, Madam Chair, this kind of situation was not brought to our attention. Not to ask for the approval to fill in the gaps, but in the sense of keeping us appraised and advised of what is going on out there in these organizations that are under the watch of the department and are included in the oversight that our standing committees have. That is what is missing from this component. Madam Chair, when we are not informed of something, how can we deal with it in an informed manner? How can we set the priorities and decide on where efforts and energy and resources should go? Now we are presented, as Mr. Ramsay has pointed out, at least a $6 million problem here depending on...Oh, $13 million now, $13 million depending on how you do the math. This is not really how our relationship should work between departments, between the government, between committees, between MLAs. I again just want to underscore that we're taken by surprise with this and it limits the scope and ability of me to do my job when I'm not at least advised of what is going on. It's a big job here. The department, the administrators and the new advisory committee that's been put together for the Stanton organization have got a big job ahead of them. I hope that they can find some ways around it that won't impact the type of service that we've come to expect from Stanton. I would certainly hope that committees and MLAs will be kept advised and able to assist with getting out from under this situation. I don't have a question, Madam Chair.

Thank you, Mr. Braden. Next I have Ms. Lee.

Thank you, Madam Chair. I have to say that I too am very concerned about the Stanton deficit situation and I think that we have a responsibility here to find out what is going on and try to fix the situation. Madam Chair, I have to say that as chair of Standing Committee on Social Programs we were not aware of the deficit that has been accruing with respect to this operation. It appears that from the information given to us, that deficit has been mounting for a number of years, since 1996, with the last year being the worst. I would think they're probably accumulating a deficit as we speak. We have no way of knowing whether it's because their demands for service are larger than the money that we are paying, and if that is the case then we need to address that.

We also have information that suggests that the supplies and purchased service costs were underfunded and I'd like to know why that was the case. Given all the issues that we're hearing in terms of the moral issues and the hiring issues, whether they be new nurses or experienced nurses, medical staff, it really breaks my heart that the Stanton hospital, which I believe is such an important hospital and one that has been a leader in the health care delivery here in the Territories, that it is under constant pressure. It's obviously under financial pressure and it's under human resource pressure, for whatever reason, and I'm not convinced that this government and the department and the Minister have a handle on what's going on. This has been going on a very long time.

I could tell you that I'm surmising from the information here that we are somehow underfunding that, but on the other side I have to tell you that I have had former staff of the hospital that come to tell me that there is money probably not being used as efficiently as possible in terms of acquiring equipment. The entire maintenance section have had issues brought about that.

I see that financial review of the hospital was done, but I'm wondering if it's not time for us to do an operational review of that hospital. Because you know, with respect to human resource management, we minimized that inquiry to the human resource management review alone. But I'm saying this not to target anyone and I know that the CEO at the hospital is new and all of these issues were occurring way before her time there. So I want to make it clear that when I'm speaking here about the issues and problems that we must face head on, I'm not attributing that to her at all. But I think for the government, this is an important health care facility and we must find out what is going on and we must address that. If it's about underfunding, we need to find a way to fund it. If it's misuse of money, not misuse of money, but mismanagement of resources there, we need to know and we need to know why. I don't think that's out of the question based on some of what I've heard. I'm not going to be able to verify that because I don't know the insides of that. The only way I could know that is to have somebody go in there and find out what's going on. This is a huge issue and I'm interested in hearing from the Minister how we could address this in a positive way so that we don't have this happening years in the future. Thank you, Mr. Chairman.

Thank you, Ms. Lee. Mr. Roland.

Thank you, Mr. Chairman. Mr. Chairman, as we've seen across the country, funding a health care is not an exact science of what different issues have come up from time to time. Stanton isn't the only authority that's under pressure from human resources or cost drivers. We've seen provinces and other Territories, as well as our territory over the years have to do some significant adjustments to the way funding flows and what gets funded to what level. I believe committee was provided information of the history from 1995-1996 right up to 2005-2006, and Stanton has gone through a number of cycles of surplus and deficit situations as things occurred. The main contributor to where we are today and dealing with the amount established today are in six main areas. That would be the underfunding or unfunded increases in supplies and purchased services, medical and surgical supplies, drugs, laundry, housekeeping, the relief staff funding deficiency, employee benefits funding

deficiency, physicians program funding deficiency, and the Nunavut billing recovery gap, and that's the timeliness of when we get paid back for services provided to Nunavut residents. As well as pointed out the one issue of unfunded high utilization of the maternity issue. Thank you.

Thank you, Mr. Roland. Ms. Lee.

Thank you, Mr. Chairman. I have the same information that the Minister just read out, but none of that tells us how that happened. It's just a one-time overuse or one-time underfunding. Is there an assurance, if that's the case, that this is not going to repeat next year? We went from $508,000 or almost $509,000 surplus in 2004-05 to $2.7 million deficit this year. There is quite a substantial accumulated deficit. Rather than just limiting it to the number we had in front of us and just approving the supplementary appropriation, I would be more interested in finding out more about how it happened and how we go about making sure it doesn't happen again. I would be interested in any information the Minister could provide as to how that is so. Thank you.

Thank you, Ms. Lee. Mr. Roland.

Thank you, Mr. Chairman. Mr. Chairman, as I stated earlier, FMBS is now directly involved with the Department of Health and Social Services along with Stanton coming up with reasons as to why and what the numbers are looking like and where there are trends that are more than trends and reality of cost over drivers that have to be addressed. As I stated earlier, some of it can be possibly attributed to underfunding of certain sectors and that's some of the fix we are looking at. As well, as Minister of Health and Social Services, I am doing a zero-based review of a number of our facilities and the way they provide services as well. Thank you.

Thank you, Mr. Minister. Ms. Lee.