Thank you, Mr. Roland. Mr. Ramsay.

Thank you, Mr. Chair. That is good. The base review is going to be conducted at Stanton, but is there also going to be a base review done in the Beaufort-Delta and the Sahtu as well? Again, it is a systemic problem here. It is one that recurs over and over again. If boards are unable to manage what they have, then there has to be a reason for that. Is it mismanagement? Is it underfunding? What would the Minister attribute the chronic deficit situation seen in the Beaufort-Delta, the Sahtu and here at Stanton too? Thank you, Mr. Chair.

Thank you, Mr. Ramsay. Mr. Roland.

Thank you, Mr. Chair. Mr. Chair, it fluctuates from year to year. For example, southern placements where we have patients going to southern facilities, that being in Alberta or other jurisdictions, as health care is driven by the health of our constituents and people of the North. You could have one case where the procedures required are very expensive and the time out could be long in duration. That could significantly impact our out-of-territory costs. That is one of the areas. As well, if we have more clients stationed out in the South for longer terms, that does add up to the cost, as well as some of the forced growth items when it comes to just the utility and operations of our facilities in the North is another area. With what we are doing now, the base review process is established now. We will use it with Stanton and that will be used with every health authority as well. That is going to be the model we will use, the tool that we will use to look at our expenditure patterns and work to fixing the areas that need to be fixed. If we are finding areas of over-expenditures, then they would have to be justified as well. Thank you.

Thank you, Mr. Roland. Mr. Ramsay.

Thank you, Mr. Chair. Just to wrap this up, again, I know we talked about this at length now, but, to me, if we don't send the message out there that it is not okay to run up huge deficits and come back to the Legislative Assembly to have us rubberstamp basically saying it is okay. You can run up a $7 million deficit. It is okay. We are just going to rubberstamp it and approve it anyway. I don't think that is the message that I want to get out there. I think these health operations in the regions have to be run effectively and they have to be managed effectively. They have to be funded effectively and judging by the deficits that have been allowed to accrue, that is not happening, for whatever reason. It is not being looked after properly, Mr. Chair. So I think it is a big problem. I think the Minister understands what I am trying to say here. It shouldn't happen. In a perfect world, I guess, it wouldn't happen. But how do we get the message out there to the Beaufort-Delta and to Stanton that this just can't happen? Maybe it is the department that is the problem. I am not sure. Maybe there has to be some kind of investigation with the department to try to figure out why this is happening. Are they underfunding Stanton? Are they underfunding the Beaufort-Delta? Are the Beaufort-Delta and Stanton being mismanaged? Those are questions we have to ask ourselves every time we are asked to rubberstamp this case $3.5 million and $1.6 million in the Beaufort-Delta. It adds up. Like I said, it is over $10 million in the past little while. We should be paying attention to this. We spend 30 percent of our budget on health care. It is something we should pay close attention to. We should try to monitor it properly. This isn't good monitoring, in my book, Mr. Chair. Again, we are just forced to accept the deficit and pay it. That is it.

Thank you, Mr. Ramsay. Mr. Roland.

Thank you, Mr. Chair. Mr. Chair, the process is we start right from square one. For example, as the Department of Health and Social Services builds its budget, it goes to all the health authorities and they submit a budget for the upcoming year. Those budgets are based somewhat on the actuals they had in the previous year with some estimates of what the potential may be on certain areas. If the population has grown, if they have seen an example of certain sicknesses at different times of the year, that has an impact on their budget. Some of it is built on estimates. Those, in all worlds, are not the perfect tool. At times we find that those estimates are not agreed to either by the Department of Health and Social Services or by FMB itself, where the direction has gone back to re-look at the numbers and prove up some of those figures.

The question ultimately I guess comes down to the fact that, in our relationship, the Department of Health and Social Services builds the budget, works with authorities, brings that budget into the whole process where we review every department's budget, we build it on that, come forward with that. But at the same time, when it comes to the variance reports, getting the background and the quarterly reports as to where expenditures are happening, if authorities aren't quick in responding, that puts us behind the ball in trying to get the information appropriately. What you see here is not just a matter of rubberstamping. There has been significant work done by FMBS and the Department of Health and Social Services, trying to come to grips of why the numbers fluctuate as much as they do. That is why, for example, the base review has been established. I would be happy to share the terms of the base review with Members. I will provide that information to Members so that Members will see what is going to be undertaken as we proceed with this. Thank you.

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

Thank you, Mr. Chair. I have a question under 2007-08 new initiative for $100,000 for delivery of ground ambulance and highway rescue services. It is on page 14, just before the hospital federal health care funding priorities. I know that this is something that has been in the works for a while because there is unclear jurisdiction and responsibilities with respect to this and lack of consistent rules about who is responsible for paying for ground ambulance and highway rescue services. I know there has been a study done on this to figure out what to do between Health and Social Services and MACA, but I wasn't aware that the new initiative will be by way of developing a legislative framework. I thought that there was some money being made available for the

communities to tap into. Although that program is not available for cities like Yellowknife, which is a problem, but it is a first step anyway in trying to get some infrastructure set up for that. I would like to ask the Minister for more information on what this $100,000 is for and how that fits into the more general, larger framework of this initiative. Thank you.

Thank you, Ms. Lee. Mr. Roland.

Thank you, Mr. Chair. Mr. Chair, the report that was done on the ambulance and highway rescue, what you see here is the first phase of it. The $100,000 is the Department of Health and Social Services' piece. That is working on creating the legislation. Municipal and Community Affairs has $200,000 that is available to communities that are delivering their own ambulance services at this time. There were a number of options in the final report, five of them to be exact. One, for example, was option one which was the status quo, no changes, let everybody do what they are doing. Option 1(a) was status quo with some minor enhancements. Option 2 was the status quo with GNWT legislation, and option 3 was GNWT legislates and delivers ground ambulance and highway rescue services. Option 4 was GNWT legislates ground ambulance and highway rescue services and contracts services for the private sector. What the Department of Health and Social Services and Municipal and Community Affairs are working towards is option 3. So we are looking at the first stages of dealing with those communities that provide that service on their own. There are a number of communities that it is delivered through health authorities. So that is being left as it is. The Department of Health and Social Services is working on creation of the legislation that is required to begin to occupy that field. Thank you.

Thank you, Mr. Roland. Ms. Lee.

So would that legislation then work for all the communities? So the GNWT will legislate themselves into this responsibility, basically.

Thank you, Ms. Lee. Mr. Roland.

Thank you, Mr. Chair. Yes, right now there is a void there in legislation. That is why it is in a number of areas where different groups are offering the service. So we will create the legislation and then occupy the field. Thank you.

Thank you, Mr. Roland. Ms. Lee.

Thank you. Just to be clear then, this is for the drafting of the law. How long will that take to bring forward? Thank you.

Thank you, Ms. Lee. Mr. Roland.

Thank you, Mr. Chair. Mr. Chair, the department is planning to begin this work in this upcoming year and returning to the business planning process for 2008-2011 to try to come up with how we would fit in there. It was initially over a three-year period to come in with the legislation and how we were going to implement. We have been directed to try to cut that down to bring this up to speed sooner rather than later. Thank you.

Thank you, Mr. Roland. Mr. McLeod.

Thank you, Madam Chair. I notice under the Health Services Program, Dialysis Program in the Stanton Territorial Hospital for $96,000. Are there any plans to bring the Dialysis Program up to the Beaufort-Delta? We don't have it right now. My understanding is that we may need it soon. Are there any plans to start investing some money into the Dialysis Program for the Beaufort-Delta?

Thank you, Mr. McLeod. Mr. Roland.

Thank you, Madam Chair. Madam Chair, as we would work with the authorities, if they were requesting areas of forced growth, if they had patients that needed the service, they would begin through their budget planning exercise along with the Department of Health and Social Services. Right now, there is a program laid out. I don't have that with me at this point, but we will provide that to Members as to where we have communities slated on the business plan as we proceed or the Department of Health and Social Services proceeds. I will have that information provided to the Members. Thank you.