Thank you, Mr. Chair. I have a number of opening comments I’d like to make. Then I’ve got a lot of questions I’d like to ask, once we get into the line-by-line.
One of the first barriers I want to start off talking about is recruitment and retention. In the Premier’s opening statements, or Budget Address, he talks a little bit about expanding nurse practitioner training and expanding the Community Health Nurse Development Program. Yet I was under the impression when we reviewed the budget that there are actually reductions in those areas. I believe the Community Health Nurse Development Program is being reduced by four positions. I also believe that the Nurse Practitioner Education Leave Bursary has been eliminated completely. There are also, I believe, reductions to the number of individuals that we’re going to support through things like the Advanced Nurse Mentorship Program.
In the statement he does talk about $1.8 million going to investment in these areas. The Minister’s comments also talk about $1.8 million going into these areas, which I have trouble reconciling, given that there are cuts in these same areas. I believe programs like the Community Health Nurse Development Program are valuable programs that are going to help northern nurses transition from a hospital setting into a community health setting, where we as Northerners are experiencing a significant number of problems finding people and training people and getting them into there. I’m having trouble reconciling the message that we’re getting now as compared to some of the information that we had discussed previously. So when we get into that area, I’m going to have some
specific questions on how you can be reducing yet expanding and enhancing. They don’t seem to work for me.
Another area — and it was mentioned in the Social Programs report — is Telehealth. We hear a lot about changing the way we do business. We also hear a lot about finding ways to increase efficiencies and reduce costs. Our medical travel costs are really going through the roof, yet here we are, cutting one of the programs — or reducing our ability to enhance and deliver a program — that can clearly, if utilized appropriately, reduce some of our costs.
So I am disturbed that we are reducing one of the Telehealth coordinators in Stanton. I’m happy that we’re putting the one back in Inuvik, but I think that doesn’t solve the problem. The Telehealth positions provide an education and a clinical function to help with mental health consults, to help with physiotherapy consults. They help with discharge planning. If someone is being discharged from Stanton before going back to the community, Telehealth has a great opportunity to coordinate a conversation to help with the discharge planning. I really feel that in getting rid of the Telehealth coordinators, we’d be taking away one of our champions.
I hear things; people say things like, you know, we’ll be able to continue to deliver Telehealth; we’ll get the nurses to do it; we’ll get these other people to do it. It takes time and it needs a champion: someone who can get out there and actually provide the education. It’s not as simple as just doing the bookings or managing the equipment when we’re doing a consult. It takes education. It takes someone to get out there and provide training and education to all of those people out there to help them understand the importance and the value of such a program and such a tool.
If it’s being underutilized, I’m suggesting that it’s because we don’t have those champions in place. I’m under the impression that they just hired a consultant or a coordinator in Stanton, and three weeks after she arrived, she got her letter of affected status. It doesn’t make any sense. You can’t say it’s not working when you don’t have anybody in it. Get somebody in there and make them demonstrate how valuable this program and this service can be. I’m going to ask a lot of questions on Telehealth when we get to that section.
It’s been difficult to get a clear picture of the position cuts that the department is talking about. When you get in there, I’m going to be interested in getting from you, the Minister, a copy or a list of all the positions that have been identified for elimination, as well as which positions were filled and which positions were vacant, so we can get a
real sense of the impact on the departments and also the provision of health and social services.
Another area that I’d like to talk about it is that I understand each authority has been given an amount of money, and they’ve been told to live within their means. Given the amount being provided is not necessarily equivalent to the growth that has happened in the last number of years, I’m worried that telling them to live within their means, when you’ve given them meagre growth, is going to result in job cuts. I’ve had individuals from Stanton indicate that they’ve already received affected letter notices. We’ve received no information from the department and from the Minister outlining what the impacts of telling the authorities to live within their means are. I’m worried that it’s going to result in major cuts in the authorities and therefore result in a limitation or a degrading of the quality of services these authorities provide. These authorities are an incredibly important part of our health system, and laying off nurses — laying off any other health care provider — is detrimental to the provision of services.
I understand costs are ballooning in the health system rapidly, but it’s time to actually rethink how we do business. This is something the Premier said right in the beginning: a lot of this exercise we’re going through now is about redefining how we do business, changing direction, and finding better ways to do things and better use of our own money. There are lots of things and lots of opportunities that may exist that will help us spend our money wisely, but they seem to be completely ignored or not even considered.
I’ve had a lot of conversations with a lot of different individuals who have talked about Stanton as an example where our overtime rates resulting from things such as sick leave and annual leave and all of those types of things are ballooning. Every time someone is sick or on annual or away, they have to have somebody come in and do overtime to backfill for them. When they’re gone, because they’re taking lieu time or whatnot for the time that they’ve put in, two more people have had to cover for them. As a result, one sick leave or one lieu time or one annual day actually costs us way more than a simple one-person replacement.
I’ve had individuals talk to me about the fact that it may seem radical, but if we’re actually to increase the number of nurse positions at Stanton so that we build in a redundancy, we would be able to reduce the number of overtime hours being put in. If we reduce the number of overtime rates, we’re actually saving money in the long run. We can actually reduce our costs through redundancy, if we actually create some redundancy and eliminate our use of overtime. Yet when we talk to the department, we get very little response on that, or Stanton gets very little response on that. I think that is seriously
something that is worth consideration. I think that is something that is worth investigation, and I would encourage the department and Stanton to look into that very closely and see if, in fact, they can realize some savings in that way.
I know health care is difficult. I know that it has challenges due to international and national shortages of all levels of health care providers. This suggests to me to that it’s really time. If in no other area, this is definitely one area where we seriously, seriously have to reconsider how we do business. Sticking with the same old way of doing business is not working. The costs are ballooning out of control. We’re frustrating our health care professionals, who are our most valuable asset in the world of health care.
I’ve talked to individuals who have said they’ve applied for nursing jobs at Stanton, and they’re told, “Oh, we’re not looking for anybody, because we’re fully staffed.” Yet they’re still paying out huge quantities of overtime, and it’s costing them more and more and more. Then they stand back and say, “We’re broke. We need $11 million in a supp appropriation so that we can pay our payroll.” Yet they keep paying overtime: more overtime, more overtime, more overtime.
Once again it’s time to seriously look at how we do business. Consider some of these radical approaches, such as built-in redundancy. You will likely find some cost savings and not have to end up laying off staff at Stanton, shutting down the OR at Stanton and telling nurses in the OR, “Your job’s gone; you’re an affected employee” — things that I think we should all be concerned about.
I’m going to end there and let somebody else talk. I’ll have a lot of questions for you as we start going line by line. Thank you very much.