This is page numbers 857 to 898 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 positions.

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Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

I’d like to call the

committee back to order.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

June 3rd, 2008

The Chair

The Chair David Krutko

At this time I’d like to ask

the Minister of Health to introduce her witnesses.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. To

my left is Deputy Minister of Health and Social Services Mr. Greg Cummings. To my right is Director of Finance Mr. Derek Elkin.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

Thank you, Ms.

Lee.

Welcome, witnesses. General comments. Mr. Hawkins.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you, Mr. Chairman. This is as

good an opportunity as any to bring this up. I notice that the Minister’s opening remarks, with the eight pages…. As highlighted by another Member, it seems to be lacking in recognition or a plan — or, I should say, even further — on addictions. Addictions, as we know, is a very significant problem here. It’s horrible. That’s all I’m going to say. I could probably go on at length about that. The fact is that addictions isn’t highlighted. I’ve

looked through the budget, and of course, we don’t have any specific line item for addictions.

The problem with that, Mr. Chairman, is that just the other day we gave away, through a negotiated deal, our Territorial Treatment Centre, which will now become a training centre. Addiction problems continue to rise at an alarming rate, and treatment for larger challenges, such as cocaine and crack and whatnot, require specialized treatment, yet this budget seems to be lacking that recognition. If it is there, I’d certainly like to know where it is, and I’d certainly like to know why it seems to be missing or why no recognition of this problem is in the Minister’s opening remarks.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

Thank you, Mr. Hawkins.

Ms. Lee.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. I don’t

agree with the Member — the way he puts that. There are programs and services for addiction services. The mental health unit at Stanton is the more acute-care facility for addiction treatment, more intensive care, under the supervision of the medical professionals.

We have mental health addictions specialists and community wellness workers placed in most of the communities. We invest up to almost $1 million to Nats’ejėe K’eh, which is the treatment centre facility in the Hay River Reserve, K’atlodeeche band land. We also provide funding to the Salvation Army, which has a treatment program that is not recognized as much as it should be. We also spend a significant amount of money in counselling here — family counselling services in Yellowknife and all of the territories. I’d be happy to provide the Members with more information.

We work with the Tree of Peace. Yellowknife Health and Social Services provides services for Yellowknife and the North Slave area, but all of the authorities have money allocated for addiction counselling. When we go into the specific item, I’d be happy to point that out to the Member.

Also, with respect to individuals who are looking…. I realize the Member is from Yellowknife and he may be referring to cases in Yellowknife. In my office I get lots of inquiries and calls from people who want to get outside of the NWT treatment services. They’re treated on a case-by-case basis; they’re treated on a confidential basis. I can tell you that anybody who needs assistance is given support and counselling to do that. What I do ask for is that when I get inquiries from a Member who’s asking a question, or the general public, I would like the initiative and action to be taken by the people in question. We follow that up.

I do not agree with the Member that we don’t have enough of that, although it may not be obvious to the Member, and I will be happy to point that out.

As we go forward, the mental health strategy and action plan as a whole is something I want to revisit. I look forward to having those discussions in this fine process.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Well, I disagree with the Minister’s

assertion on that, because quite frankly, we don’t have a specialized program that deals with crack. That’s taking over a number of our areas in the community, and it’s becoming the drug of choice, which is a real shame.

Sending someone to intense treatment in a hospital is not an appropriate use of our hospital. Furthermore, when we describe it as “We send them to the mental health unit,” I wouldn’t typically want to describe someone who has a drug addiction problem and wants to seek treatment as having a mental health problem. I would say that’s someone who has been attracted to a dark side of life, and they can’t shake it and they need some help. I don’t think sending someone to a mental health unit is the appropriate source.

The Minister further asserted that Nats’ejėe K’eh is the treatment centre. I do recognize that, and I’ve spoken in favour and support of that in the past, and I will today. But the fact is that it’s an alcohol, spiritual-based program, and if you’re burdened with the pains of crack addiction, that’s the last place you need to be. You need to be in an intensified treatment centre that focuses on those things. The way the existing program goes now, you have to be sent to Nats’ejėe K’eh, fail and then be further referred out south. Now, I’m not saying that’s the exclusive formula for how that process happens, but that’s the typical formula.

The Minister has suggested that she will get us details and whatnot, but I still have a number of questions outstanding regarding treatment programming and services provided in the Northwest Territories. When I say investment, I’m talking about real investment that provides real programs for people in those areas. The Salvation Army, I understand, offers a program. I know the Tree of Peace offers a program. I understand they’re successful for the levels of what they offer. But they are not the high-intensity

programs

required when you have that addiction. We do not have family-related programs, so when you have a codependency on drugs, we have nothing that focuses on that. We have nothing for children that offers that.

What I’m stressing is we have a number of these addictions. It’s not new to this Minister; it’s not new to this Assembly by any stretch of any imagination. The fact is, as I said today about watching drug dealers take over our community, it’s time this sort of spectator sport ends, from the sense of a bureaucratic approach. I believe to the bottom of my heart that this territory needs a high-intensity

crack-addiction treatment centre to deal with people in that scenario. If we can’t help them with the demons in their life, I don’t know where they have to turn. The problem is, I think, that this government continues to offer a soft “sit around and talk through your problem” process, and the fact is that this requires a high-intensity

situation of treatment.

Sending people to the hospital for addictions is not a reasonable approach. I don’t think it’s fair when we talk about the stress that Stanton itself has. It has been highlighted by other Members about burdening Stanton with office space. It’s not designed that way. In my opinion, Stanton isn’t designed as a treatment centre for people like this. We need a facility that focuses on this. Personally, I really don’t care where it is; I really don’t. If it’s in Sachs Harbour or Resolution, I don’t really care. The fact is this is the type of real investment in people we need to make. I think you’ll hear outstanding support even from people in the Yellowknife community. They don’t care if this is built here; they just want to see it built.

The fact is that people are suffering from this problem. Whether you’re a parent watching your children, whether you’re a spouse watching your partner, whether you’re a child watching your parent, it doesn’t really matter. The fact is that people want solutions to this problem, and I don’t think it’s being met head-on. Money is being given to service organizations to sit there and talk, who I think to some degree are worried about their little “kum ba yah” approach, and having people come in and sit there and talk their way through it. We’re not talking about soft drugs, where people can control themselves or get some support from friends and neighbours to work through the problem. We need real intense treatment, and I think that is the real move on this problem that needs to be done.

As I cited, I don’t see a significant investment in that area. As I even further highlighted the other day, we just gave away, to a large extent, our only treatment centre for this type of thing. That’s not speaking in any negative fashion to the fact that it’s going to actually finally be put to good use. I believe it will have a good use as a training centre, and I think that’s fine. I’m glad to see we’ve stopped heating an empty building for a number of years — which kind of draws into the question of why it sat empty for so long.

My time is running out, and I’m sure I made my point a number of times. Maybe Cabinet’s smiling because they agree with me on the sense that this issue needs to be done. Do I hear they’re finally willing to make that commitment? I’m not sure.

I’m going to leave it at that. I think I’ve made my point a few times. This is a significant issue in my riding downtown; a lot of the citizens have always

highlighted this and they look for leadership from the government.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Mr. Chairman, just briefly, as the

Member pointed out, late in the evening yesterday he thanked the government for the capital projects: a territorial dementia facility and the Yellowknife consolidated clinic. There is no plan to build a treatment centre in Yellowknife. I think we have a lot of good capital projects happening there.

I don’t think there’s anybody in this Assembly qualified to speak about what exact services should be provided to those suffering from crack addiction or some of the major addiction issues. What I was trying to simply point out is that if you talk to anybody who has these addictions and mental health issues, it is bracketed as the same issue. Addictions is part of mental health issues, and there is a spectrum of services you need to provide, right from medical intervention at the most acute stage, which has to be provided by psychiatrists at the hospital, who are qualified medical doctors, down to the program that Byrne Richards provides in Yellowknife, which is called Crackbusters. So it is very important that we have a whole spectrum of services available. A treatment centre is only one component of that.

I want to assure the Member again, and it’s up to the Member if…. I accept the fact that he would never probably agree with anything I present, but it’s not for me to speak; it’s not for me to convince him. He will do with information that he has. But let me tell you, as the Minister of Health and Social Services, that anybody within our system who is suffering from addiction of any kind, who is in need of support and services and counselling — the services are available for them to tap into in every community throughout the Territories. We have the services available in the whole spectrum — for the children, for the youth. It’s not a simple, black-and-white “enter into this door A and everything to do with your issues is going to be taken care of.” That’s not the approach with respect to a very complex area of mental health and addictions.

Another thing I want to talk about with Nats’ejėe K’eh programming is that I was just there visiting as the Minister as well. They organize their programs very much based on the clientele that is in the place at any specific time. I think that it’s very simplistic to suggest they are doing some simple alcohol- and spiritual-counselling thing. They are professionals and they provide services.

Anyway, I just want to say that we focus on individual-based treatment programming and services for those people who walk into our facilities, and we tailor our programming to suit the individual’s needs.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

General comments? Do

we agree we move to detail?

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Some Honourable Members

Agreed.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

Okay, we can turn to

page 6-7, Operations Expenditure Summary. We’ll defer that till later. The first page up is page 6-8, information item, Active Positions. Mr. Abernethy.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair. I see by

looking at this page that 15 positions are being eliminated from headquarters. I was wondering if the Minister could go through the process they followed in order to determine which positions would be eliminated. Of those positions, which ones are currently filled and which ones are vacant?

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

Minister Lee.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

As I indicated yesterday, in

adhering to the realignment exercises that we’ve had to go through, my department placed the most minimal impact on the front-line services as much as possible. That is the reason most of the reductions are within the headquarters, within the Department of Health, not in the authorities.

There are reductions of 17 positions from the department, and that is about 12.5 per cent of the entire workforce of the department. I do have a table here for the Members that I can provide to the Clerk. I can advise the Members that out of the 17 positions, nine positions are vacant, six positions are filled, and five of the six have been placed or other arrangements have been made. There are two positions to be determined, and they are placed in headquarters. They’re not in any of the authorities.

The reason those are to be determined is that our reduction exercise for these positions spans over two years. It starts this year; some of the savings are this year, as I stated in my opening statement. But some of the reductions will be implemented next year because of the planning we need to do with programs and services to make sure our alignment is done in a way that impacts the program delivery at the headquarters level as minimally as possible. Seventeen positions out of 133 is quite large in that context, and we need to make sure we do it the right way. I’d be happy to provide the Member with that table.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Glen Abernethy

Glen Abernethy Great Slave

Yes, I’d like to see that table,

please. In thinking about the positions you’re eliminating, I’m under the understanding that you’re getting rid of a number of positions in your communications

area. How do you see that

impacting the promotion and marketing that that department does with respect to the provision of health care in the Northwest Territories?

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

I want to assure the Member

that in all of these realignment exercises we have not eliminated or taken out entire programs. It is about better using the resources we have, and I think the communications section is a good example of that.

I do want to note that the budget reduction exercise is about choices. As the Premier mentioned in his budget opening address, these are hard choices — to eliminate positions. But the way to do that is to make sure we minimize the impact on the programs and services as much as possible and that we make every effort to make sure our employees affected are given all the opportunities to be reassigned wherever possible.

With respect to the communication section, we will be eliminating a communications officer position, which has been on transfer assignment for a while. We will be eliminating a graphic design area, but we do have resources there, so we could continue to do the web site work and other services. That’s the principle we have applied in all of our realignment exercises.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Glen Abernethy

Glen Abernethy Great Slave

I’ve indicated before that when it

comes to the reduction exercises, I’m less concerned about vacant positions. There are still a number of positions that have incumbents in them.

In my first question, I asked you if you could go into the type of analysis you used in order to figure out which positions were going to be eliminated, what that analysis entailed with respect to the department’s mandate, and all those things. You didn’t really answer the question on what kind of analysis you used, what you used as criteria, and how you dug in and figured out which positions weren’t contributing to the mandate of the department in your selection of those positions you were going to eliminate. If you could go into some more detail as to how you actually chose, that’d be useful.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

I think the Member mentioned

that…. I’m not sure if I would put it that way. I mean, I don’t think a Minister or any official in the department goes into the book and says, “What mandate can we eliminate?” May I just get that reworded?

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Glen Abernethy

Glen Abernethy Great Slave

The Department of Health and

Social Services has a mandate. In reviewing the positions you’re eliminating, how did you determine which ones weren’t contributing to the mandate of the department and, therefore, you were justified in eliminating? I want to know what type of analysis you did in relation to what your mandate is, and how you chose to eliminate specific positions and not adversely affect your mandate.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Mr. Chairman, I think I heard it

right the first time. I don’t agree with the premise

that by eliminating some of these positions we’re suggesting that any of these positions are not contributing to the mandate. I don’t think that’s fair to the positions affected or persons affected. I don’t think that’s the right conclusion to make.

I think, Mr.

Chairman, communications is an

important part of our mandate, as are all other divisions in the department. As I stated earlier — and I’ve said this many a time — what you will see if you look at the positions affected in the department is that we have not eliminated any mandate at all. We have not eliminated any program. What we have done is look, program by program, to see how we could reduce some of the positions and expenditures but still deliver the programs we need to deliver.

I think that with communications, you will see we have a number of positions in that area — Policy, Legislation and Communications; that’s what it used to be called before it was restructured — and that there are a number of people engaged in the communications work and graphics work and advertising work and pamphlet designing and annual report designing and web site designing. There’s a group of people who are doing the work. The best decision to make is to look at what everybody’s responsible for and see how we could do the same job with fewer resources.

If we had choices, we don’t want to do less. So to say we are reducing those positions because they were not contributing to the mandate is not fair to the employees impacted. With respect to all the employees who have been impacted, these are choices we had to make.

I think the Member should keep in mind that when we make these choices, it’s not about, “Do we not appreciate the communications section more? Do we not appreciate some of the other positions that have been impacted?” We had to make an overall department mandate, which is to provide health and social services. I have made the commitment publicly that, as much as possible as the Minister, I do not want to impact front-line workers. We’re talking about nurses, doctors or medical services — a myriad of services that we provide. I think we need to go to a bigger circle about how we make those choices.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Glen Abernethy

Glen Abernethy Great Slave

I’d like to thank the Minister for

putting words in my mouth. I’d prefer it, obviously, if she’d actually listen to what I’m saying.

The department has a mandate. I’m asking you what criteria you were using to ensure that the elimination of specific positions would not adversely affect your mandate. I’m not suggesting they weren’t doing or contributing to the mandate. But changing positions — which were obviously, at some point in the department’s history, put in there

because they contributed to the mandate…. Removing them has an impact. I’m asking you what criteria you used to dig into the department to figure out which position eliminations would have the least impact on that mandate? Clear?

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

I’d just like to remind the

House we can have some civility here and show some respect for each other. All these personal shots across the bow aren’t helping anything. I think we should be civil here. I’d just like to ask that you keep your questions directed to the page we’re on, and also if you can keep your answers short and specific to the point that’s being asked so we can move on.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

I could advise the Member that

the elimination of these positions does not impact, in any way, the department’s ability to follow our mandate and deliver the programs and services we have been given to do. We just have to do them differently.

Main Estimates 2008–2009 Department Of Health And Social Services
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair David Krutko

Next on the list I have

Mr. Bromley and Mr. Hawkins. Mr. Bromley.