For Fort Resolution, I understand that the mental health worker there is employed by the band office. Yellowknife Health and Social Services, which administers the program for Resolution, provides funding to the band and the band hires. I understand that that person is paid at a lower level than would be the situation for a comparable level of employee — same job — in another community, like Lutselk’e. But I do understand that the department does provide training for that. We have to work with the band office and the Yellowknife Health and Social Services Authority to see how we could come up with a solution to work that out. It’s one we have to continue to work on.

Just the last area, I suppose. I’m just wondering if the department would be looking into the whole home care area. When the Minister and I did travel into Fort Resolution, the community had talked about home care. A lot of the community members talked about home care and maybe improving the service of home care, changing the mandate of the people who are doing the home care in Res and Lutselk’e. The community there would like to see more staff added to home care.

I was wondering if the department had some sort of plan to examine the whole home care program, weighing the benefits of that against maybe individuals who would otherwise — without the little bit of assistance living comfortably — either be displaced from their homes or cost more money medically into the future if home care support were to be reduced or not changed, or if the home care program were not up to speed with the needs in the community — the various needs and so on.

My question for the Minister is: has she and her department looked at the home care program for increased support to the small communities?

As I said earlier, the home care program NWT-wide is an important component of service delivery, especially if we want to focus on keeping our elders and other people who are in need of health and social services in the communities. I think Fort Resolution is luckier than other communities in that they do have a complement of home care workers who have been given training and have gone through the training.

I do appreciate, having visited the community, that we need to do more work on that. It’s work we need to do in every other community, because home care programming in some communities is relatively new. It will take continued effort for the community to know exactly what the home care worker’s job is — that they’re formalized, that they’re trained — and that there’s buy-in and communication between the community and the home care workers. I understand the community advocate position is right now being reinstated.

Through that person, whoever the new person is, and with the Yellowknife Health and Social Services Authority, I do commit to the Member that we will work and give support necessary to make sure the program is rendered and provides the services people need.

I have given my commitment to the Member that I will undertake to do that and work with the Member to get more.... It will be a

back-and-forth exercise on what the Member has in mind in terms of the objectives he wants to achieve. I think it should be noted that currently, as of May 2008, there are 625 children in care, and only 37 of them are in southern places. Over 420 are in their own homes with some kind of agreement — a voluntary service agreement, which is an agreement between Social Services and parents to improve the situation that has caused them to be in care or extended families.

I appreciate that we need community involvement. That’s why the legislation was changed in the last Assembly to allow Plan of Care committees to be set up in communities. That’s a vehicle for the communities and community people to be involved. If there are other community people who want to be involved, that’s always a good thing.

I think, though, we should also be mindful of the fact…. The fact we need to consider is that the top protection matters are highly legalized, still, in all of the provinces in Canada. The test is always the best interests of the child. It’s highly regulated and legalized, and there are step-by-steps these health professional workers must follow. They operate independently from even the legislators; we cannot interfere in that. But respecting that, obviously I am open to working with the Member to see how best we could incorporate the desires and interests on the part of the community to be involved in this process.

Thank you, Minister Lee. Mr. Abernethy.

Thank you, Mr. Chair. This is the largest part of the Department of Health and Social Services; this is the part of the budget that actually flows all the money to all the different authorities. Just in comment to the actual budget document itself, I know the Main Estimates are prepared in a certain way, but it would be nice to actually see the breakdown of the authorities in this document. I know that’s probably not going to happen, but as far as digging in and trying to get details, there’s nothing in here on the authorities, which is really too bad considering it’s where most of the money is going.

This leads me, obviously, into my line of questioning. We know the vast majority of the money is going to the authorities, which is probably where it should be going — the front-hand delivery, the delivery part of the department. But I understand, in looking at this, that we see only about a 3 per cent increase, and we know the national average for growth in healthcare is 6, 7, 8 per cent, depending on where you’re going. It’s certainly a lot higher than 3 per cent. I understand the need to turn around and rein in our spending and cap our growth, but I wonder if such a radical switch in health is going to be healthy for the health

system. It’s like driving down the highway at 100 kilometres per hour and turning 90 degrees without skidding. It might be better to take a bit more of a gradual turn on this one and get to our 3 per cent growth over the next couple of years rather than trying to nail it all in the first year and causing a whole lot of difficulties.

Having said that, you’re doing it; you’re going to do what you’re going to do. You’re going to cap it at 3 per cent, and we’re going to see where the chips land. There’s no detail in here. Can you tell me — let’s pick Stanton as an example — as a result of forcing them to maintain growth at 3 per cent, what programs and services are expected to be cut within Stanton Territorial Health Authority?

Thank you,

Mr. Abernethy. Ms. Lee.

Thank you, Mr. Chairman. I think the Member should be aware that while I appreciate his comments, it’s been an accepted practice — actually it’s a rule — that every year the health authorities have to submit a balanced budget to the Minister. There is nothing new there. The practice is the same this year. The growth projections are capped, and the authorities have been asked to live with 3 per cent growth. Final decisions have not been made about how that is going to be implemented or how that is going to be broken out, so I do not have that information right now to give to the Member.

Oddly enough, I completely understand what a balanced budget is, and I completely understand what forced growth is. I know that the authorities get their budgets and are told to bring in a balanced budget, which includes forced growth. I also know that — with Stanton as an example — it never seems to happen. There always seem to be major overruns, and an $11 million supp this year is an example. Quite possibly it means you’ve never budgeted those authorities appropriately and they were always underfunded, always driven into the hole, which means they weren’t funded properly. This year, you’re only giving 3 per cent, which is pretty normal but isn’t realistic, necessarily. What I’m asking is: what’s being cut out at Stanton as a result of this direction?

Mr.

Chairman, no decisions

have been made about what is being cut or not.

On the street, obviously, we’re hearing a lot of stuff about things being cut at Stanton. We’re hearing about some nursing jobs. We’re hearing about some jobs in OR. We’re hearing about some programs. I know I’m going to get the name of this program wrong, but I’m going to throw it out there anyway. I believe this is a women’s program — or something like that — that

provides services on a territorial level. That has been tagged as something that can be deleted at Stanton. Can you verify that any of these are, in fact, on the block?

I don’t think it would be proper for me to verify rumours or what’s on the street, but I am aware there have been media reports by the president of the UNW local at Stanton suggesting that the nurse practitioners’ positions were part of the budget cuts, that the Northern Women’s Health Program was part of the budget cut. I have tried to correct that information on every occasion I could. Those are staff funding, of which the Member is very well aware from his past employment experience. Those were time-specific programs. All of those are reinstated.

The Northern Women’s Health Program is part of the new positions being created with staff funding. Those NP positions are ones we’ve had lengthy discussions on. We have made it clear to all of the authorities that we encourage them to work with us to incorporate these NP positions wherever possible. There’s no question that, given that health care costs rise higher than 3 per cent, we have to look at every penny and every program to see how we could live within our balanced budget and minimize the impact on program and service delivery. That’s been my mantra in budgeting the department budget as well as the authorities’ budget. I am in the process of reviewing that, and there have not been any final decisions made in that regard for any of the authorities.

During the 2008–2009 fiscal year, are there going to be any staff cuts at Stanton as a result of these budget reductions across the territory? What are the realities of the budget? Are there going to be cuts at Stanton during this fiscal year?

Mr.

Chairman, I repeat my

answer. The final decisions have not been made. We know that the health care costs rise higher than 3 per cent. They’re being asked to work within the balanced-budget scenario. I know all of the authorities have worked to put a budget together. Their final decisions have not been made, so I cannot answer the Member in any more detail.

Let me try it in a different way. Are cuts at Stanton a possibility? Are job cuts at Stanton a possibility as a result of the budget reduction exercise going on in the GNWT right now?

Mr. Chairman, my understanding of the Stanton operation is that they are in charge of administrating 53 programs, with about 80-something per cent of funding from the territorial government and the remaining from outside revenues, including a big receivable from Nunavut.

They’re block funded by the territorial government, and there is a lot of flexibility on how they could manage those 53 programs: a lot more than, I believe, some of the other places.

I think it may be true that there would be a good strong case to be made that they may need to get some rebasing, or they may be able to reorganize their programs and services and minimize the possibility of reduction. That is the work that the public administrator and the CEO are involved in and that I’m involved in somewhat. So I cannot tell the Member right now whether there will be cuts or not.

Given that you clearly understand the value of health care; given that you clearly understand the importance of nurses, social workers, PT/OT, doctors and physicians; and given that you clearly understand the challenges they face on a daily basis and that the staffing number is already low enough at Stanton as it is — which affects the quality of care — would the Minister commit to no job cuts at Stanton as a result of this budget-cutting and reduction exercise going on in the GNWT at the current time?.

I am not the administrator of the hospital. I don’t run the hospital. They run 53 programs. Obviously all of the money appropriation decisions are made here. The Member knows I work very closely with the Standing Committee on Social Programs, especially in regard to Stanton issues. I’ve kept them fully apprised of the human resource plan issue, the public administrative issue and the zero-based review issue. I’d be fully committed to coming back to the Standing Committee on Social Programs to brief the committee as we go forward. But it would not be reasonable and fair for me to be asked to answer that sort of question. I think the Member knows that, because he’s smiling.

Thank you, Ms. Lee. Mr. Ramsay.

Mr. Chairman, I want to ask some questions, too, about Stanton. I asked the Minister yesterday about unfunded positions and unfunded programs. I’m wondering if she could tell me: who has the authority to institute unfunded positions and programs? Is it the authority? How do we end up still on the hook for paying for those unfunded positions and unfunded programs?

Minister Lee.

I’m not a human resource expert. I’ve never run a government department. And I’m not now; I’m not suggesting that.

The departments, especially health authorities, are block funded. They get money to run some programs they’re assigned to, then there is

flexibility within to deliver those programs. They sometimes use vacancy money to create an unfunded position where it’s needed. They operate accordingly. Where there is a suitable level of vacancy, they’re able to carry those off. I understand it is an accepted practice within operations like that.

It speaks again to the accountability factor. I know it was spoken of earlier, and we’ve had some discussions in the House earlier in this session about the $11.5 million that’s built up in deficit at Stanton and the fact that it’s been done before. I wouldn’t be surprised if it’s done again. It’s just like taking an eraser and erasing that $11.5 million. To me, that’s not good enough. It absolutely isn’t good enough.

Somebody has to be accountable. Whether it’s you, Ms. Minister, or the management at the hospital or the department or somebody at the Department of Health and Social Services, somebody has got to be responsible for budgeting the authorities. If they’re chronically underfunded, let us know. These are our front-line health care providers. They need to have the resources to run.

When you spoke earlier of them coming forward and it’s an accepted practice to hand in a balanced budget, that’s one of the biggest jokes I’ve ever heard if we allow them to build up these multi-million-dollar deficits. The budget they hand into the department is not worth the paper it’s written on, Mr. Chairman. Now we have a situation at that hospital where FMBS has been paying the payroll for the last six and a half months. That’s $26 million.

I’d like to ask the Minister: where is this amount going to be budgeted for?