This was discussed yesterday as well. Just to be clear again, GNWT provides insured health services to all residents whether they are aboriginal, non-aboriginal or eligible for reimbursement from DIAND or not. I think the Member is talking about the DIAND funding, not NIHB funding because NIHB is the program that we administer on behalf of the federal government. It is the NIHB that pays for that, but the cap we have is with respect to the money that DIAND provides for insured services to Indians and Inuit in the Northwest Territories and all over Canada. They have imposed a 2 percent cap on that.

Lately, because all of the fees have gone up, we feel that the money we are spending is about $40 million. We are paying about $25 million, so there is a $15 million gap each year.

Thank you, Minister Lee. Next on my list is Mrs. Groenewegen.

Thank you, Mrs. Groenewegen. Minister Lee.

Thank you, Mr. Chairman. This is part of the health renewal money under Prime Minister Martin. That was announced back in 2003, where three northern Premiers walked out to get this deal. The implementation took another year or two, so we are on our last year of five-year funding whereby the federal government has provided $150 million for all three territories. There are different components to it, but we have been able to use that money to train and hire nurse practitioners. There is money going to medical travel. There is money spent on midwifery programming. There are all kinds of good things that have been done as a result of this funding. It works out to about $10 million yearly for the GNWT. The headquarters of this administration is in Whitehorse. This is coming due. It is going to expire next fiscal year. Sorry; year 2009-10.

As I discussed yesterday, northern Health Ministers including myself met with Minister Aglukkaq on January 8th . They had about an hour and a half

meeting. It was a very good meeting in that probably very rarely we are meeting with federal counterparts and you don’t have to explain who you are and what this program is. In fact, she was more senior of all three of us, so she is well aware of the difference that this funding has made. We have agreed to have our staff work together to do necessary evaluations so that we can help her move this program forward.

Now, I have to tell you, we don’t have any commitments from the federal government that they are going to renew this, but they are very well aware that we need to have a really good indication that this will be renewed by the beginning of the next business cycle for the federal government, which is this spring. So we have asked Minister Aglukkaq to please let us know where they are going with this funding.

I just wanted to be assured that there were communications and negotiations underway to hopefully confirm the continuation of this funding; and if you have to walk out of a meeting or anything or throw a tantrum, it worked last time, then go for it. Thank you.

Thank you, Mrs. Groenewegen. Questions will move to the next person on my list. Mr. Krutko.

Thank you, Mr. Chairman. Mr. Chair, just following up on the Minister’s response to my question, I have been here for going on 14 years and I think I heard every Minister since then give the same comment that you’re just giving saying: Oh, it’s going to be taken care of and the

issue is going to be solved, even. Talk to your colleagues who were former Ministers of Health and you can go through the archives and you will probably get a stack of paper three feet high on this issue.

I think that for you to state it here on record that this problem is going to be taken care of by snapping their fingers, I am sorry. That is wishful thinking. For me, unless I actually see a warm body sitting in the seat of the mental health office in Fort McPherson providing day-to-day services and having someone drive up from Inuvik or flying from Inuvik once a month and then fly back to Inuvik the same evening or drive back to Inuvik the same evening, that is not health care services.

The same thing applies in regard to other taxi services that are being provided to communities in the Beaufort-Delta. I heard my colleague from Nunakput mention this morning that elderly patients basically are having to be told, well, you either come into the health centre and get your name on the list and we will put you down when the doctor comes in once a month. Basically if you are on the list you get in. If you are not on the list, sorry, you have to wait until next month. To me, that is not health care services.

I think we have to find a system that works for small communities, in isolated communities and First Nation communities. The quality of health care for First Nations people in the Northwest Territories is below par when it comes to the statistics that show that aboriginal health is deteriorating compared to the rest of the non-aboriginal population in Northwest Territories. To me, that is a grim statistic that we shouldn’t be proud of. It shows it right across Canada.

I think if you start looking at the increase of cancer cases in our communities, diabetes and other ailments, that could be prevented by good health care, preventative health care measures in communities, having a nurse in a community, having a mental health worker in a community, having home care services, having people there that come home with cancer saying, sorry, there is nothing we can do; go home. But having care for them, aftercare, so that when they get home there are people there to take care of these people.

I get calls from people quite regularly. I got a call just a couple days ago from a young lady that her mom just passed away with cancer a couple of months ago. Now her dad has cancer and is dying. Basically she is taking care of him and she has three kids. She is trying to get help from income support to support them in food, and keep the lights on, and keep the home, but they won’t help her. She is calling me and I’m talking to the chief. We are trying to find ways around assisting people that

have these ailments in our communities and find a system that really works. That has got dysfunctional to a point where they have to start calling the chief and MLA to solve these problems. There is no need for that.

I think, as a government, we cannot allow bureaucracies, either health boards or whatnot, to justify their existence by going into deficits every year and not providing services to communities. For myself, I am frustrated with this issue, because we shouldn’t have to talk about it here in the Legislative Assembly every time there is an issue.

As the Minister of Health, I hoped that you would take this issue seriously, like the Minister of Justice did with policing. I think that, as a health care provider, these services are services that aboriginal people are fighting for and that is why they want self-government, because this government couldn’t do any worse than what we are doing here today.

I would like to ask the Minister exactly when can you guarantee me that there will be a hot, warm, cozy body in Fort McPherson providing mental health care services so people can walk into an office, know that there will be somebody there that will basically provide them that service, and also that there will be the expenditure that you mentioned? You mentioned $75,000. I was just looking through my notes here. McPherson could provide mental health services with $185,000, so I would like to know how you came up with a number of $75,000. But looking at the government information I got from you, it says that you spent $185,000 on mental health services in Fort McPherson.

Thank you, Mr. Krutko. Ms. Lee.

Mr. Chairman, I agree with the Member. In my travels as a Member as well as a Minister, we do need to enhance services in communities. I am not sure if I could guarantee him, though, we are going to have a warm, cozy, -- I can’t remember -- live body in Fort McPherson to do mental health and addiction. But I just wanted to tell the Member again that I have an agreement from the Beaufort-Delta Health and Social Services Authority that they will give a contribution to the Fort McPherson local government. I don’t know exactly the name of the band council or the leadership in Fort McPherson. That money that used to go to Tl’oondih Healing Society so that they could hire a warm, cozy, live body to provide mental health and addiction services for their people. I have also been hearing from communities who would like to do their own programming to help with some of the grieving and some of the other issues that have arisen out of Fort McPherson.

The reason why I said $75,000 is because that is the money that used to go to Tl’oondih Healing Society. Now there is more money allocated to Fort McPherson and some of those positions and money are being used and provided for in Fort McPherson.

With respect to nursing coverage in Tsiigehtchic, I am willing to provide him with the same sort of commitment that was made by the Minister of Justice, because we do want to work in the same way. I understand that the Member is sceptical because it has taken me a long time to get that commitment from Beaufort-Delta Health and Social Services Authority for that mental health money. I am working on proposals to enhance nursing coverage in Tsiigehtchic and whether it be having somebody come over from Fort McPherson or having a permanent presence in Tsiigehtchic, I am working on that. Thank you, Mr. Chairman.

Mr. Chairman, until I actually see it in writing, see it for myself, that there actually will be a person in that position, then I will believe it. As a Minister -- and Ministers that have made this same commitment time after time -- it is not appropriate to basically say, well, we will give a bunch of money to someone, because that was the issue that we are not able to fill that position in Fort McPherson, because Inuvik demanded that these people have to have a degree in psychology and be a psychiatrist before he can fill that position. There is no need to have a psychiatrist in that community in regard to mental health.

I think the criteria for the program is so restrictive that is why you have so many vacancies in a lot of First Nations communities and communities throughout the Northwest Territories, because you cannot find the qualified individual with those types of credentials. I think that is the problem that you faced in regard to this issue. In regard to the Minister knowingly removing all of these positions, to the tune of $2 million or something in which we twisted your arm and got you to reinstate it, like in most issues we have to do around here. Again, to reinstate those mental health positions, I think you should do justice to those people and the individuals who have taken training, have the credentials to provide the services. They might not have a bachelor’s degree, but they have the certification to provide that type of service.

I would like to ask the Minister in regard to the positions in Tsiigehtchic, McPherson or the communities I represent, or other communities for that matter, will they seriously look at the decertification of those programs so that we can actually find people to fill those vacancies or vacant positions throughout the Northwest Territories and also ensure that the communities have control of those dollars, that the dollars go directly to

community from the Department of Health and Social Services and an agreement be signed between headquarters and hamlet communities and bypass the divisional board? As far as I am concerned, that is where the hiccup is. I would like to ask the Minister if she would make that commitment.

I am making the commitment. I will put that in writing to the Member that the Beaufort-Delta Health and Social Services Authority will transfer that money to the community government of Fort McPherson to do their own wellness and community mental health and wellness work.

Mr. Chairman, I agree with the Member to a certain extent; that there is not enough flexibility in the way we deliver mental health and addiction services. There is a need for people with specific qualifications including master’s program, where necessary. The way that the programs are delivered now, there’s not enough flexibility. Flexibility to hire somebody without a master’s program would be helpful to the community. This is why I like the idea when Beaufort-Delta Health and Social Services Authority as well as the acting deputy minister suggested to me that we could work to transfer that money to the community governments so that they could hire their own person and they don’t have to require somebody to have a master’s education.

Now, we do have those people in place if the community needs that. But I have heard also from the community of Fort McPherson that they would like to be able to have some options to provide community healing and wellness programming. We are saying we will do that. We are doing exactly what the Member is saying, that the communities should have more say on how this program is being delivered.

On a larger picture I want to advise the Member in the House that the Minister’s action plan that I was talking about will address -- and we will have an opportunity to talk about this -- about how we could revisit mental health and addictions programming and how we could address enhancing some of the services in communities that are not as available under the ISDM model, because it’s a very clearly designed program and we want to do ISDM-plus under that Minister’s action plan. Thank you, Mr. Chairman.

Thank you, Minister Lee. Next on my list is Mr. Hawkins.

Mr. Chairman, in the last question the Minister answered for me, it was my view that it wasn’t answered fully, which was the strategy to

recoup some of that $100 million outstanding to the territorial government. Thank you.

Thank you, Mr. Hawkins. Minister Lee.

On that issue, the former Minister of Health and Social Services wrote to Minister Strahl in 2007. I wrote to Minister Strahl in 2008. We had agreed that we will have our respective representatives get together. The deputy minister of Health and Social Services met with our DIAND counterpart in August of last year, but I have to say that we have not been able to convince the federal government to remove that 2 percent cap on the reimbursement. It should be noted here that this 2 percent cap policy that the federal government has applies to every government in Canada, and the NWT is only a very small part of this entire funding that the federal government provides for insured services for Indian and Inuit. They seem to be quite reluctant to lift that 2 percent cap. Thank you, Mr. Chairman.

Yes, it may be a small issue for the federal government, but it’s a significant issue, in my view, to our government. Would the Minister consider the option of working with the Department of Justice to take the federal government to court on this issue for settlement? Thank you.

I believe the government is always willing to look at all options and we will look into all options. I think it should be noted that it is not quite correct to say that this is money owed to us from the federal government. I think that it should be very clearly understood that the federal government provides transfer payments for every resident in the Territories, whether they’re aboriginal, non aboriginal or whatever. Then they also provide CHT funding. The extra money that we get from DIAND on insured services for Indian and Inuit are extra on top of that, and what they’re saying is they are going to put a 2 percent cap on that and they are saying that they are paying some of that from the transfer payment. It’s not like we have accounts receivable that says the federal government owes $150 million. As far as the federal government is concerned, this is not a dispute. They are saying they are going to pay us a 2 percent cap every year. Thank you.

Well, I would take a different approach from this. If treaty obligations cause us to only be able to afford, through the transfer payment, 65 percent of the actual, which means 35 percent of the actual is still outstanding, I would see this as a negotiable position to start working from, which is they are avoiding their obligations based on those principles. Therefore, we’re doing our citizens at large a disservice. Could we not define that as a workable position to start to recognize?

Perhaps if this Legislature took the opinion that we would proceed legally, that might get the attention of the federal government on the outstanding dollar.

It’s been my understanding that the federal government always pretends they are not responsible, let’s it accumulate, then pay a little off, bring the balance down. I’m concerned that no one is bringing this, really, to the attention of the federal government in the context of other than a letter. I suggest that it’s probably time that we start taking a significant position. On a side perspective, that is, what do we have to lose in that regard if we put our legal system to work, that we have in our Department of Justice, on this file and say, look, we want this money and we feel it’s due? Who are we really offending? At the end of the day, to them it’s just business. To us, it’s business, but the problem is if we’re not funded properly, it’s going to start affecting our citizens. My view is that it will have a ripple effect on the remainder of our health care coverage we provide through this whole department and our system. I would, once again, suggest that this Minister could seriously take a look at a legal position and challenging the federal government, serving them with notice that this is the way we wish to proceed rather than just a letter, can we talk. Thank you.

Thank you, Mr. Hawkins. Before we move to the Minister, I’d like to recognize Crystal Lennie from Inuvik in the gallery. Minister Lee.

I should have added that beyond communicating in writing, Premier Roland as well as previous Premiers, the Minister of Finance and myself, have brought this issue forward to every Minister and Prime Minister we’ve had a chance to talk to. I’ve had a meeting on this with former Minister of Health Tony Clement. We’re using all avenues to express our concerns in this area. Obviously, a legal option is always there, but for me, and I think for most people, a legal option is always a last resort. I think you want to do everything you can to try to resolve the issue by talking and negotiating and putting on pressure, which we are doing. Thank you, Mr. Chairman.

And what gains have we made from talking about this issue for the last three years? Thank you.

In the time I’ve been here we have had the DIAND officials agree to have our officials meet. That’s progress.

I would like the official record to note I laughed very hard on that reply from the Minister. Is that considered our best position and an acceptable position from the Minister of Health? Thank you.