Health Services

Programs, Activity Summary, Operations Expenditure Summary: $175.476 million. Ms. Bisaro.

Thank you, Mr. Chair. I wanted to ask a question relative to the fees and payments listed under Details of Other Expenses. There is an

increase in other expenses from the Revised Estimates last year to this year of almost $4 million. The Fees and Payments have risen $2.5 million or so. I wondered if I could get an explanation of the reason for the increase and, secondly, what the fees and payments are generally used for.

Minister of Health, Ms. Lee.

Thank you, Mr. Chairman. The fees and payments are for out-of-Territories hospitals, out-of-Territories physicians, out-of-Territories hospitals transfer of Canadian Blood Services to Stanton. Those are hospital and health services out of the Territories. The budget amount for the increases is $3 million for out-of-Territories hospitals; $1.2 million for out-of-Territories physicians; and $4.6 million for out-of-Territories hospitals, where we have seen a 30 per cent increase in the rates the southern hospitals charge us.

I thought I heard numbers of about $7 million in increase there, but the fees and payments have only gone up about $2.5 million. I’m a little confused. Could I get an explanation, please.

May I get Mr. Elkin to clarify?

Mr. Elkin.

Thank you,

Ms. Bisaro — Minister Lee. Oh, the other way around? How about I do it completely the other way around, then? Thank you, Mr. Elkin. Ms. Bisaro.

Thank you, Mr. Chair, and I thank Mr. Elkin for the explanation. It certainly helps. I just have to repeat we’re comparing apples and oranges, and it makes life a little difficult.

Thank you,

Ms. Bisaro. Mr. Bromley.

Thank you, Mr. Chair. I raised some issues in general comments and am following up for some more specific feedback from the Minister on emergency care provisions.

A number of people, often with 30 years’ experience in emergency services in our hospitals, are raising the issue of the need for security in those places. As our world gets more and more into drugs and cocktails of drugs, there are some very dire situations. We’re extremely vulnerable in this way, and this needs to be resolved. I’m wondering

what the Minister is doing to address that. That surely must have been profiled with her already.

Minister Lee.

Thank you, Mr. Chairman. I do understand and appreciate that these are issues the Member has brought to our attention. We have forwarded them to Stanton Territorial Hospital. I do understand they have security clearances there. At least after hours they have security guards there. It’s an issue I’m prepared to have a fuller discussion with the public administrator about when we next meet. We’re trying to meet quite regularly for the next few weeks.

I would encourage that discussion, of course. I know there are sometimes security people there, but they’re not really trained. They’re essentially doormen. I think there’s some real services and expertise needed to handle fairly large and emotional people.

Following up further on emergency care, another issue that has come up with medical staff is that there are no longer clerks on in the evening and the night-time hours. Especially on weekends when they’re very busy, the nurses and doctors end up doing the administrative work at a time when they really should be looking after people. I think this has been raised with the Minister. I’m wondering if she’s had discussions — I suppose it would be, again, with the public administrator. I’d appreciate comments on that.

On that issue, I think we need to look at the Yellowknife consolidated clinic. In this budget it’s a capital item. Now that the DPW has recommended — and it’s in the books as the lease option — lease improvements, the tender will go out when the budget is passed. The expected opening time is October of ’09.

That is relevant, because the emergency unit of Stanton is not being used for what it was designed for. It was supposed to be for an emergency in a hospital. But as the Member is well aware, as is anybody who lives in Yellowknife and those who use services from out of Yellowknife, we are accustomed to going to that emergency unit for everything. With the consolidated clinic, what we hope to do is expand the hours of services so that we will have a clinic open there from 8 o’clock in the morning until midnight, if at all possible. People will know to go there, so the emergency unit at the hospital will be used only for hospital emergencies.

The new place will be furnished and fitted and designed to handle those emergency issues. I think the proper use and proper design will go a long way in addressing the security issues and staffing issues and administration issues.

I did catch the Minister’s reference that when the budget is approved, the contract will go out. Just kidding there.

I’m very supportive of the consolidated clinic. I understand the reasoning the Minister has provided there, and I’m anxious for that to be in place. I hope the Minister will look to dealing with the situation in other ways in the short term, between now and October of ’09 or whenever that clinic is in place.

Moving on to another subject here, I’d like to just mention the health care cards. There are 42,000 people, roughly, in the Northwest Territories and 44,000 cards out there. Of course, just issuing and administering those cards costs dollars. If the additional 2,000 are used, the costs would be greater, and there’d be pressure on our systems and so on. I’m wondering if the Minister has come up with a solution that’s reflected in the budget here today, and what’s being done on that situation.

I don’t believe there is a particular or a specific increase to address that situation. It’s part of the operation. There is a scheduled renewal of cards next year, and implementation is going forward with that. Since questions about the number of cards versus the population have been raised, the health insurance administration office in Inuvik has been working with the Audit Bureau to go through all the records to see if there are any anomalies. We have been able to reconcile the numbers quite substantially. I don’t have that information with me, but I would be happy to provide that info. We don’t expect that there will be extra money needed to do that work.

One last point on community nurses. We’ve had a number of vacant positions, and some that have been vacant for a long time. Obviously, people then need to travel and so on, so the downstream costs are significant. Is there a plan to address those long-standing issues?

The nursing shortage, obviously, as well as shortages of other health care professionals, is something I am charged with and working on constantly every day, as the Minister, of course. I could report to the Member that we have improved the vacancy situation in many communities. We have increased the casual nurse pools NWT-wide. We have, as of the latest figures, 422 registered casual nurses who work in communities, which has allowed us to decrease the agency nurses situation. And with the last stats I saw, I believe we have been able to decrease some of the vacant positions in our communities.

Thank you, Minister Lee. Mr. Beaulieu.

Minister Lee.

I do not have a concrete plan that I could report to the Member on right now.

I had the privilege of visiting the Member’s community about a week before the session. We have been preoccupied with sessional business, but I want to tell the Member that I found the visit very informative, and I got full appreciation of the community’s desire to not only keep their elders in the community of Resolution but to make the elders’ community facility a vibrant and functioning place. I was able to meet a lot of different community groups who seemed to tell me the same thing but in different ways and on different issues. I think we need to look at a lot of different factors. I am very interested in working with the Member and the community to see what is the best, optimal way of providing the services to elders there.

So hopefully, within a short time of being out of session, when I have time to really concretely work it out, I’d be happy to come and talk to the Member.