Thank you, Mr.

Chairman.

Perhaps I should start with some of the comments that the Member for Nahendeh raised. I want to also thank the Member for inviting me to his communities. It was a very busy trip, but it was a really great opportunity for me to visit some of the smaller communities as Minister.

Increasing nursing positions in communities obviously is something that everyone wants, and our communities want doctors in the communities too, but it is not something that we could afford in all places. I have committed to the Member for Nahendeh, and other places, that I will make my best effort to see how we could increase the access to services for small communities wherever we can, even if we can’t have permanent staff live there.

As we move forward and in order for us to face head-on the challenges of the health care costs, we do have to look at innovative ways of how we deliver our services, our staffing model. I think the recommendation by the Standing Committee on Social Programs…. We looked at reorganizing the board structures so that we could have a better, comprehensive implementation plan on all health care professionals. It’s something that gives us a really good basis to work on.

I really look forward to taking some time with my officials when the budget is over and coming up with something for the next business plan cycle where we, as a Legislature, could look at some more details about where we can just increase the physician services, nursing services, midwifery services. Under the limited resources we have — although Health and Social Services has a huge budget — we need to use every cent wisely. Increasing services would require some innovative and transformational changes, and I look forward to having more discussions on that.

With respect to the telephone trouble in Fort Simpson — maybe the deputy minister could give more information — I think that was a very particular issue with NorthwesTel. It wasn’t to do with a 1-800 number. So I’d be happy to follow up on that, or maybe the DM could add to that.

In a lot of communities we were at, cross-cultural training and such…. I think we’re lucky to have the CEO we have in Deh Cho, Kathy Tetso, who has been there for a very long time. She knows, I think, most of the residents and the staff that she has. I know that she has inside knowledge of the people, the communities, the issues, and she was constantly sharing them with me when I was travelling with her. So I’m sure that she makes that a priority with any of the new staff that come on board.

Another thing I had a chance to look at: in visiting communities where the interest and the enthusiasm on the part of the community members to do a lot of things themselves in the communities…. They wanted some information on chronic disease management. They want to know more about how to take care of diabetes situations, or they wanted to work on community wellness. They wanted to work on youth issues, senior issues. I talked to the CEO and the Chair. I asked them to come up with

some of the proposals that we could work on. That’s not grand and it’s not huge, but it’s something that could work on small communities. So I look forward to looking at more of that.

Moving on to Mr. Abernethy’s questions, I’m also going to ask the deputy minister to give you detailed information on the investment of $1.8

million under CHNDP program. We are

definitely committed to increasing and expanding the NP practice in the North. It does take a lot of work in a very multilateral kind of way. Not only do we need to train the NPs, but we need to make sure that they’re placed in the right places, and we also have commitment from all the authorities that they will do everything they can to accommodate the NPs that we train. So I’m going to ask him to do a little bit of detail on the difference between the $1.8 million investment versus some of the reductions we’re making.

On the issue of Telehealth that the Member…. I understand that he’s going to ask more detailed questions on that. I just need to say here that the Department of Health and Social Services…. We have about 130 people in headquarters and about 1,200 people in regions in eight authorities. Most of the position reductions came out of headquarters, and it is up to 12.5 per cent. I think the Members may not have noticed, but it reflects the priority I had as the Minister, and the department, when we were given…. We’re a part of this realignment exercise, and when we went to work on it, I wanted to make sure that if it’s at all possible, we do not affect employees in the front line. And this is the reason why almost all of the positions, except for two, came from headquarters. That’s not to say that we have a lot of fat in headquarters, but it is showing the commitment on the part of myself, as the Minister, to make sure that if at all possible we try to do it to be more effective and efficient and minimize the impact of the reduction exercise in the front line.

So perhaps Mr. Elkin or…. Let me go down the line. We could give you detailed information, without interfering with privacy issues, on the details of which positions are affected.

I just want to comment a little bit on the balanced budget issue. I think if you look at the opening comments, there was a statement that in the past we have had authorities go through their expenditures or come back for supplementary funding later on. This budget introduces a very different way of doing that. I think it’s a good way of doing that. We’re letting the authorities know, up front, what their budget limitations are, and we work from the beginning, starting when this budget is approved, so that we have better control and better ideas about how the expenditures are being made in each authority.

It is a different way of doing that, although officially the authorities have always been required to submit balanced budgets. It’s just that there was a little bit of a practice or a convention that if the cost of expenditure goes above their budget, they could always come back for supplementary funding as long as it’s justified. Whereas in this budget we’re increasing their budget in the base, but there is more understanding and expectation that we will work every day, every month to make sure that our expenditures are in line with our budget.

With respect to affected positions at Stanton that Mr. Abernethy mentioned, I have to tell you once again that there were no other positions affected under this budget reduction exercise other than the Telehealth positions in Stanton and Yellowknife and Inuvik. We have accepted the recommendation, part of the recommendation, of the Standing Committee on Social Programs, and reinstated the Inuvik Telehealth position. But we believe that we have to do our part.

Health and Social Services is the biggest part of the expenditure of the.... Not biggest, but one of the larger ones. If we keep increasing and we don’t do our part in keeping our costs down, that means other departments will have to do more reduction.

With respect to Telehealth positions, we believe firmly now that with the reinstatement of the Inuvik Telehealth position — we do have a headquarters position in Yellowknife — we can still continue to deliver the programs. There are lots of communities in the Territories without a Telehealth coordinator, but both services are still being prepared.

I just want to make an initial comment on that, and I’m sure that as we go forward line by line, we could have more detail back and forth.

The affected position at the OR Room: Mr. Abernethy mentioned earlier that there is a nurse being laid off in OR, and that is not entirely correct. I don’t want to talk specifically to one person, because I want to respect the privacy rights, but I want to just advise the Members that we have done everything we can and the department has done enormous work and put in a Herculean effort to do the realignment exercise and the budgeting exercise without impacting front-line workers in this realignment exercise.

As a balanced-budget issue, we are in the process of working that out. I don’t have all the details on that, but I’m applying similar principles: if at all possible we need to look at structural and transformational changes to the way we are delivering our health and social services so that we minimize the possibility of affecting front-line health and social services workers.

We have not finalized that budget plan yet. The Cabinet will be looking at options, and the Standing

Committee on Social Programs will, I’m sure. I’d be happy to share some of that information with the committee.

I’ll leave it at that. I’m sorry to take so long, but there was a lot to add there. I wonder if the deputy minister could just give a little bit of detail on some of the issues raised.