Debates of June 5th, 2008

This is page numbers 899 to 954 of the Hansard for the 16th Assembly, 2nd Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.

Topics

Oral Questions

Prayer

Speaker’s Ruling

Minister’s Statement 53-16(2) Drive Alive: Summer Safety Initiatives

Minister’s Statement 54-16(2) Protected Area Strategy

Inuvialuit Final Agreement 25th Anniversary

Early Entry To Kindergarten Programs

Inuvialuit Final Agreement 25th Anniversary

Elimination Of Business Incentive Policy

Guidelines For Seismic Lines

Inuvialuit Final Agreement 25th Anniversary

Cabinet Communications

Acknowledgement Of Crystal Milligan

Kam Lake Access Road

High Cost Of Living In Small Communities

Proposed Elimination Of Deh Cho Youth Worker Position

Inuvialuit Final Agreement 25th Anniversary

Recognition of Visitors in the Gallery

Question 263-16(2) Early Entry To Kindergarten Programs

Question 264-16(2) Renewal Of Mining Company Land Use Leases

Question 265-16(2) Guidelines For Seismic Lines

Question 266-16(2) High Cost Of Living In Small Communities

Question 267-16(2) Teaching Position Vacancies In Beaufort-Delta Region

Question 268-16(2) Access To Gravel Sources For Aklavik

Question 269-16(2) Kam Lake Access Road

Question 270-16(2) Elimination Of Business Incentive Policy

Question 271-16(2) Seniors’ Supplementary Benefit

Question 272-16(2) Employment For Summer Students

Question 273-16(2) Protected Areas Strategy

Question 274-16(2) Elimination Of Business Incentive Policy

Question 275-16(2) Elimination Of Business Incentive Policy

Consideration in Committee of the Whole of Bills and Other Matters

Main Estimates 2008–2009 Department Of Health And Social Services

Committee Motion 29-16(2) To Reinstate Stanton Hospital Telehealth Coordinator Position And Associated Contribution Funding For A Total Amount Of $210,000, Health And Social Services, Program Delivery Support (Committee Motion Carried)

Committee Motion 30-16(2) To Defer Further Consideration Of The Operations Expenditures, Department Of Health And Social Services (Committee Motion Carried)

Committee Motion 31-16(2) To Defer Further Consideration Of Infrastructure Acquisition Plan, Department Of Health And Social Services (Committee Motion Carried)

Main Estimates 2008–2009 Department Of Human Resources

Report of Committee of the Whole

Orders of the Day

Sandy Lee Range Lake

I think the Member is aware I am committed to working as hard as I can, as the Minister of Health and Social Services, to maintain

the access to services and increase it wherever possible. We are constantly juggling that all the time.

think the shortage of nurses in smaller

communities is not necessarily about dollars, either. We have communities like Behchoko

which is

located right outside of a centre that has everything, and we still have a hard time recruiting and retaining health care professionals. It’s a constant challenge. It’s a national and international issue.

I have indicated to the Members in the House, during the time I’ve been a Minister, that I am working on looking at that issue in more detail. I am excited about the challenge. I constantly talk to my officials about that, about how can we re-look at the staffing model we have for nurses, doctors and other health care providers to see how we could increase the access to communities with the resources we have. I feel that is possible. I think there has to be something we can do about there being 24 family doctors in Yellowknife and none in Inuvik region at a given time under certain circumstances.

I think the proposal that Minister Miltenberger has in refocusing government, where we will be re-looking at the Health and Social Services board.... These are not cost-saving measures; these are measures to re-look at how we are delivering our health and social services and other programs, to see how to do better with the resources we have.

I’m mindful of the fact that the Premier and Cabinet are totally committed to being fiscally responsible. Going forward, we have to be vigilant in the way we spend our health care dollars and every other dollar. I see it as an opportunity for us to look at new ways of doing that.

I have to tell the Member that I have not got that full plan. I am hoping for, and working toward having, that plan for the next business-plan cycle. I look forward to having more discussions on that.

The Chair Bob Bromley

Thank you,

Minister Lee. Mr. Hawkins.

Robert Hawkins Yellowknife Centre

Thank you, Mr. Chairman. Earlier some questions were asked about potential layoffs at Stanton Hospital, and I was just curious; the answer didn’t come forward. I’m just wondering about the Minister’s commitment on that. Quite clearly, the question simply is: as we move forward, are there any layoffs coming forward at Stanton?

The Chair Bob Bromley

Thank you,

Mr. Hawkins. Minister Lee.

Sandy Lee Range Lake

Thank you, Mr. Chairman. I don’t have that information. Final decisions have not been made.

Robert Hawkins Yellowknife Centre

Thank you for that. Who makes that final decision? You said that no decision’s been made and you’re waiting for a final decision. So who provides the guidance to make that decision?

Sandy Lee Range Lake

The authorities are required, and they have always been required, to submit a balanced budget. They have given us those balanced budgets. They're under consideration and there have not been any final decisions made as to what’s going to be going forward.

Robert Hawkins Yellowknife Centre

What do you do in a case when an authority provides a balanced budget but does not fulfill on that commitment?

Sandy Lee Range Lake

In the past, oftentimes, even in Stanton — if my memory serves me correctly, between 1999 and 2003 — the authority has had a deficit. The practice has been that there is a combination of requiring the authority to try to come up with the money in the following year to balance the budget, and the authority has been able to do that. I’m talking specifically to Stanton, for about three years after that, and then they had more deficits after that.

My answer to the Member is that authorities have the flexibility. They are block funded. They run lots of different programs, of different sizes, whether you’re comparing Stanton to Deh Cho or Sahtu. Often, they make internal decisions about their financial status.

On occasion, as was mentioned earlier, Stanton has been given some extra cash. Beaufort-Delta was given extra cash on two occasions. We have Deh Cho Health Authority, which is running a surplus because they are not able to fill most of the positions. These are all different characteristics.

Robert Hawkins Yellowknife Centre

Who is responsible for that deficit?

Sandy Lee Range Lake

I do not know the answer to that. I would think the authorities are responsible for the deficit.

Robert Hawkins Yellowknife Centre

Would the Minister commit to seeking ultimate clarity as to who is ultimately responsible if there is a deficit?

Sandy Lee Range Lake

The authorities are responsible for the deficit.

Robert Hawkins Yellowknife Centre

Is that a guess? Or has she just been informed through her staff?

Sandy Lee Range Lake

Categorically, the answer is firm, 100 per cent yes: the authorities are responsible for the deficit.

Robert Hawkins Yellowknife Centre

Thank you. When we have a deficit, how long do you have to allow an authority to carry a deficit before the department acts?

Sandy Lee Range Lake

Technically, these authorities are legal entities. Many of them are run with the oversight of boards, and boards have rules to make decisions about their organizations. Where there are no boards, there are public administrators.

So deficits are the responsibility of the authorities, and authorities could, tomorrow, make decisions to balance their books. Now, we’re talking about health care and so, obviously, what impacts our citizens in their health care programs affects us. On many occasions government, through FMB, has provided extra funding, and we work with the authorities to get all kinds of third-party funding from the federal government. But ultimately the financial status of the authorities, and the way they run their programs, are the responsibility of the authority.

Robert Hawkins Yellowknife Centre

So how long does an authority have to run into deficit before something is addressed?

The Chair Bob Bromley

Thank you. Ms. Lee. Mr. Cummings.

Cummings

Thank you, Mr.

Chair. If an

authority is running a deficit, the expectation is that in the year following the year in which the deficit was incurred, they will provide a deficit recovery strategy to the Department of Health and Social Services.

Robert Hawkins Yellowknife Centre

What are the expectations of that deficit strategy?

Sandy Lee Range Lake

Sorry, Mr.

Chairman. I don’t

understand the Member’s question. Could he elaborate on that question?

The Chair Bob Bromley

Clarification,

Mr. Hawkins.

Robert Hawkins Yellowknife Centre

Well, Mr. Chairman, I didn't say “stay in debt,” because it’s obvious there must be an expectation. There seems to be a continuation of allowing the debt to grow. My expectation normally would be — what is the expectation to get out of debt? One would think that would be the obvious question and there would be an answer to that. We’re not seeing that so I’m leaving it open, because I’d like to know what the expectation is from this deficit plan.

Sandy Lee Range Lake

I honestly do not understand that question. What are the expectations on the deficit? I’ve stated the deficit is the responsibility of the authority. Authorities have power and authority through their boards, their CEOs, to make decisions to balance that book.

In the past, because of the importance of health care and social services, obviously the decisions they made and the impact of that is relevant to us. We have pardoned that, but I think that asking

questions about what the expectations is not.... I don’t understand that question.

Debates of June 5th, 2008

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