Thank you, Mr. Chairman. Earlier

today we were provided with a list of position reductions under Health and Social Services. I just want to be clear. Under Active Positions here there seems to be a loss of eight positions. If the Minister could clarify which positions have been re-profiled in the bigger scheme of things.

Minister Lee.

Thank you, Mr. Chairman. We

have the seven positions that were provided already — FTP policy adviser; graphic design and communications specialist; communications planning specialist; senior adviser, financial planning and analysis; junior financial board analyst; data entry clerk; manager of planning and reporting, impact assessment analyst. Those are the seven position reductions, not eight positions.

No, it didn’t seem quite clear. There

may have been a position missing or something there. Could we clarify that? If we have 15 positions here, two to be determined, and this is headquarters, that’s minus eight. If I read this paper, there are 15. The paper I’m citing is the one. I just want to make sure.

Thank you,

Mr. Hawkins. I believe the eight positions are the first eight listed on the page there. Is that correct, Minister Lee?

Yes, those are the first eight. I

think the other positions are under other tabs.

Thank you, Ms. Lee.

Anything further, Mr. Hawkins?

No, that’s it.

On page 6-16,

Directorate, Active Positions

Department of Health and Social Services,

Activity Summary, Directorate, Active Positions, approved.

Moving on, page 6-17.

Questions? Mr. Hawkins.

Thank you, Mr. Chairman. Under the

third paragraph down we have a section highlighted under the recruitment....

Excuse me,

Mr.

Hawkins. We were still on page 6-17,

Directorate, Active Positions.

Department of Health and Social Services,

Activity Summary, Directorate, Active Positions, approved.

Moving on, 6-18,

Program Delivery Support, Activity Description. Mr. Hawkins.

Thank you, Mr. Chairman, and thank

you, colleagues, for that.

Mr. Chairman, there’s a section under Human Resources, and it talks about recruitment and retention. If I understand it, there’s the difficulty of balancing this out. I’m just trying to find out what the activities are that this would apply to. If I can get some breakdown as to some examples of how they’re reaching out.

Mr. Cummings.

I thank the deputy minister for that

detail. As I understand it, for better or for worse there are nurse practitioners out there on term positions. They haven’t been made permanent, in other words.

That said, I’m under the understanding that this section, through this type of program, goes out to continue to find more potential nurses to become nurse practitioners who we don’t have jobs for. As I understand it, the situation is that you need to be a practising nurse practitioner in order to keep your credentials active and useful. It’s not a question of losing typical RN status. It’s more in the sense of how are we investing. If we continue to pay people to become nurse practitioners when we don’t have positions for them, that’s a concern. If I can get some information as to how they deliver this program for nurse practitioners. How many do they train? What positions exist for this transition from training to practical work?

Minister Lee.

Yesterday I think I touched on

this when I stated, and I want to state again, that the nurse practitioner program is very important to us. As Ms. Bisaro mentioned yesterday, hopefully it’s more than a six-month situation at Stanton. I want to make it clear that what we know happened at Stanton should not be construed as a reflection or any sort of…. It’s hard to explain. It’s a situation that is really internal to the operation of the hospital in that those two positions were put there to be incorporated into the operation. That’s the understanding of all the authorities.

All the authorities are very proactive, and they’re open to hiring as many NPs as possible. We have lots of NPs in the Yellowknife Health Authority; we have an NP placed in Fort McPherson; we have one trained and placed in Fort Resolution. This is the way to go for the future, and you’ll see there is a lot more money being put toward training our nurse practitioners and placing them.

The difficulty a few NP positions at Stanton ran into was with the fact that the hospital setting was not as conducive to accommodating positions in a way that they are able to do in more primary clinic settings, such as the Yellowknife Health or in other regional centres. If we are to continue, and we are going to continue to rely on NP positions to enhance our services and to lessen the burden on the medical practitioners, it’s incumbent on our operators to use these NPs and to incorporate their

work into the practice. It’s not supposed to mean extra services, but it’s a service that would replace some of the nursing positions or take on some of the work that is not typically done by nurses.

I just want to advise the Members here that the situation that happened at Stanton is an anomaly. It should not in any way reflect negatively on the commitment this government has, and that I have as Minister, to continue to pursue and support the NP

program.

Through this program is the

Government of the Northwest Territories paying for the training for RNs to become NPs at a rate at which we cannot fill empty positions? Because they do not exist. If that’s the case, how many do we have in training school? How many have we trained to date? How many openings do we have to provide for these people who have taken this training the territorial government has paid for?

The system as a whole is open

to accepting all of the NPs we train. I could get the information on exactly how many NPs were trained. The situation is that they are meant to be in a primary care setting and we may not be able to have those

NPs exactly where they want them and

in exactly the jobs they want. I think we have to respect the ability of the health authorities to make decisions about where to place those NPs. Those are the things we need to iron out. It needs partnership and collaboration with all of the parties involved, with all the health care professionals that work with the NPs. But so far we have been able to place all the NPs we train.

Moving on, we’re on

page 6-18. Mr. Krutko.

Thank you, Mr. Chair. In regard to the

area of program delivery and services, I think as a government we have tried different things in the past. Some things have worked out, and other things have been problems by way of recruitment, implementation. I’ll use some examples. The midwifery

legislation that was passed — and we

were able to activate that program — seemed to be originating in one community, which is Fort Smith. But to enhance that program to other regions and other communities…. I know my colleague from Deh Cho made reference that it was something that community would like to also consider. I think that’s something communities elsewhere throughout the Territories could probably access. The legislation is there, but it’s not really being implemented to its fullest.

The same thing applies in regard to the mental health positions. We’ve implemented legislation to bring people under the public workforce whereas, before, a lot of these positions, such as alcohol and drug programs, were run out of the communities

that needed them — government employees. Yet we made it so stringent that it’s very ineffective to find people for those positions. The qualifications are so high and so stringent we are having problems attracting and recruiting and, more importantly, training our own people to take on those positions.

I think also in regard to programs we have in this government, we seem to be quick on the draw, passing legislation, establishing these particular legislative authorities to do so, but it’s the implementation side I think we’re lacking in. I think we have to find a way to have the flexibility in the legislation, to realize we’re unique and we have some unique challenges. Through the ways that individuals, either at the regional level or at the territorial level, interpret that legislation, they have to have some flexibility or basic moral understanding of the people, the communities and the regions they’re serving, and work with those NGOs and community organizations to deliver a lot of these programs and services.

I talked about the Tl’oondih

program. They had 200

and something people go through that program. It was unique because it was the first time in Canada, I think, they had a program strictly designed to deal with family issues, to deal with the children, the husbands, the wives, the grandparents and whatnot. It was unique in the sense that a lot of the problems we see in our communities and in our families you can track back decades to residential schools, going back to first contact. I think it’s important that we work with our community and aboriginal organizations to develop programs and services that meet their needs, meet their goals of trying to achieve some of these successes and not put road blocks in their place because we had so much legislative red tape in there.

I’m wondering if there is anything this government is doing by way of reviewing its policies, procedures and legislation, seeing if there are ways we can, not overhaul the system but review the procedures and policies and see if we can make it not as restrictive as it is right now.

Minister Lee.