Thank you, Mr. Chairman. I can assure you that the current, newly appointed chief medical health officer is qualified and has the credentials to undertake that position. She is from the Northwest Territories. She is from Aklavik. She is one of the very few aboriginal doctors in the country. She is Gwich’in, I believe.

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She is committed to working to advocate for healthier living and she is very enthusiastic. She understands, and I understand also, that we need to support her. Dr. Andre Corriveau has been part of this discussion. He has committed to work with us. He has chosen to move to a different area from having practiced here for a long time, but he still loves the North and he’s committed to making sure that work continues. We have made sure that there is a good transition process in place so that Dr. Orlaw will continue to be supported. I do support this appointment.

Thank you, Mr. Chairman. It wasn’t coined in any phrase as criticism to the present person and it should not be defined; no one should assume that was the definition of my question in any manner. My question is really more based around the context of are we going to work towards raising the standard. If you look across Canada, whatever terminology they use for the chief medical officers, they use various terminologies, but it comes down to the same types of things. A post-graduate degree in community health or a master’s degree in public health are critical elements to that type of position anywhere else.

Of course, this doctor’s qualified. That’s not the issue. The doctor’s qualified by being a doctor. That’s right now, as I understand it, what’s required in this position. So it’s not a question of can they do the job at this time. But I’m just recognizing that other regions, and pretty much virtually all regions across Canada, have a little bit of a higher standard. I’m asking what the department is doing to work with this candidate to obtain these types of credentials, such as more skills in the area of public health or in community medicine. We shouldn’t be worrying about how low the bar is. We should always be having targets not just for today, but for tomorrow and down the road; trying to work for bigger and better.

My question is not a criticism. It’s a question of are we working towards that type of credential and are we working with the present candidate in this position towards those types of positions.

She is qualified to be in this position. She is a practising doctor. She is currently undertaking her master’s program. She is three-quarters of the way done in getting her master’s in public health. I see this position as somebody who speaks with confidence and expresses energy and enthusiasm to the public about how to take care of their health. When there are some important public concerns, health concerns, that they will speak with authority and give comfort to the people that we have an institution and body that is looking after the public health. I am satisfied that she has what it takes to do this job. Obviously, for any person walking into this kind of position...Dr. Andre Corriveau left huge shoes to fill for anybody stepping into that position. I am committed and the department is committed to support Dr. Orlaw to be successful in this position, but she has all of the qualifications and credentials to begin this appointment. Thank you.

Mr. Chairman, again, it is not about is this candidate qualified. I think that goes without saying. She is a doctor and one of the requirements to be in this position is to be a doctor. That is not the issue whatsoever. The issue is moving forward on the credentials of this type of position to ensure that whoever gets this position going forward has a master’s degree in public health. I am elated to hear that, I think the Minister said that she is three-quarters of the way through her master’s degree in public health. That is great. That is well and good. That also speaks to what would be considered regular or normal credentials throughout the rest of Canada in this type of position. Community health medicine is another area that is considered to be an equal in the context. I am only talking about the actual position, not the person whatsoever. I certainly don’t mean to imply, if anyone is trying to read between my words, that it is anything else. It is not. It is strictly about the type of position and are we moving towards demanding more out of this position going forward in the future. Thank you.

Thank you, Mr. Hawkins. I would appreciate it if we would stick to the discussion about the position rather than bringing in a particular incumbent. Minister Lee.

Thank you, Mr. Chairman. I don’t think I really have any more to add. There is no lowering of standards in any way. I think I have answered the question. Thank you.

Thank you, Minister Lee. I am not positive if you answered the question that was posed but, Mr. Hawkins.

Thank you, Mr. Chairman. Neither am I. So I will try this way. Going forward in the future, is there any chance the Department of Health will look at re-evaluating the NWT chief medical officer position in requiring that part of their responsibilities to get qualified for this type of position is they need to have a background in public health, which would be a master’s degree in public health or a post-graduate degree in community health medicine? Is that something that the Minister could look at going forward in this position? Thank you.

My understanding is that that is not a requirement. It is a requirement…There are various backgrounds, education and practical experience that one could bring to this position. I don’t know what else to say. We have somebody who is qualified to do this job. We will support her to be a success. Thank you.

Thank you, Minister Lee. I think that was a clear no. Mr. Hawkins.

The issue I am raising here is across Canada. The credentials I have noted are considered a typical standard for this type of position. We do not require, at this time, that standard, although this is a recognizable standard throughout Canada and, again, in that type of position. I am wondering if the Minister sees that as something worth noting in going forward that, in the NWT chief medical officer type of position, they should require that type of thing other than just be a regular doctor. Believe me, doctors are not regular when I say it that way. Could the Minister look at that perspective and in a comparable way to the rest of positions that are filled throughout Canada? Thank you.

Thank you, Mr. Hawkins. I think that question has been asked several times, but I will give the Minister one more chance to answer it. Hopefully we can move on. Minister Lee.

Mr. Chairman, I understand what the Member is asking. Will the public health medical officer be required to have a master’s in public health or community health? What I am saying is that is not required. Doctor Corriveau didn’t have a master’s, for example. I don’t want to talk about individuals, but what I am saying is this position is a certain position. We need to hire somebody who could do the job. We have hired somebody who could do the job -- I think that is the important part -- and somebody who has the credentials required. Thank you.

Thank you, Minister Lee. I understand that to mean the department is not going to reassess the qualifications required for this job and try and align it with other jurisdictions. You are happy with what you have now. Thank you. We will be moving on. Mr. Krutko.

Thank you, Mr. Krutko. I would like to just bring up the fact that some of these things come…Really, we have specific headings like community programs that would be more appropriate for this. I will let the Minister respond, but please keep that in mind. Thank you.

Thank you, Mr. Chairman. Yes, I do agree with the Member in that we need to build some flexibility so that we have communities who have more say and control over how we deliver our Mental Health and Addictions Program. We spend about $7 million a year providing these services and I want to state that there is room there for those with master’s and specialized training in a more formal setting, but we should not have a situation where we do not have flexibility to build in other types of healing and counselling programs that communities are desperately asking for.

I am committed to revisiting our Mental Health and Addictions Program and see what changes could be built in. I don’t think that is in any way saying that we are somehow downgrading standards. I think that is a very dangerous situation. Job descriptions and qualifications are written by some people with certain perspectives. One perspective is not always right. We need to be able to bring in all kinds of educational background, practical experience, underground experience, understanding of what the communities are, what the people’s needs are, and we need to have them all working together so these problems are not one way either.

I am really interested and excited about the possibility of revisiting our Mental Health and Addictions Program. Thank you.

Mr. Chairman, I will be blunt. The health care system in the Northwest Territories has taken a major shift. The shift of health care in the Northwest Territories is now becoming a large urban, regional-based health care by way of dementia centres, care facilities, hospitals. You name it, they have it. But when it comes to the small communities who basically are striving just to get the basics, there is no consideration for those small communities. You give us all the excuses in the world why you can’t deliver health care in small communities, but yet you can find the money to build dementia centres, build $1.5 million there ongoing and yet you can’t even find a nurse for a small community. For me, that is a total cop-out by way of the government, who basically administers health care service for a few in light of the program services for people that basically are just trying to ask for the basics. Yet you don’t give us the basics because you are saying, sorry, recruitment or retention, we can’t find people to go into your communities because all the nurses, doctors and people that are specialized in those areas want to stay in those larger urban centres.

This problem was not a problem a number of years ago where we were part of the Northwest Territories and Nunavut. After division, this problem is definitely out there. Because we continue to put a lot of capital investment into those larger centres, it is taking away those dollars that could have been spent to improve on the recruitment and retention and providing the health care systems, the long-term care facilities and those types of facilities for our communities so that those people don’t have to leave our communities for health services and that they can be diagnosed and administered at the local health care clinic or local nursing station. The way the system is being set up, all we are doing is referring people from our communities to a larger centre and then to southern Canada because that is where the facilities are. Because we made that shift, it is now about time the government took a 130-degree turn here and look at the community challenges we face and deal with those issues separately from the issues in regard to running these larger facilities.

Are there any plans in regard to reviewing the care, the facilities we have in the Northwest Territories and also not give me the argument, sorry, Tsiigehtchic only has 170 people, we are not going to put two nurses in there because somebody in Inuvik is afraid you might have to leave the community. I would like to know what the Minister is going to do to restructure that system. So now you are delivering services to 33 communities, not five or six.

I think it is important to note that there are lots of small communities in the Territories with nurses and other professionals who work in those, especially in terms of mental health and addictions. Out of $7 million we spend, we have 80 people working in the system and only about a quarter of them are required to have formal education. Now, I know we have particular situations in Fort McPherson and Tsiigehtchic that have been really long and outstanding. Beaufort-Delta Authority has less flexibility than other authorities to accommodate some of the requests that I have been trying to get through. The Member has been getting through, so we need to work through that.

I have said about at least 10 times I think in the last week, or maybe more times in the many sessions before this. I have said that to the Member in private and in public. I am committed to looking at the mental health addictions delivery system as well as our community capacity in small communities. I have told the Member and I am saying again that the way to do it is revisit the ISDM model, because the ISDM model specifies specifically that if you have a certain number of people in your certain community, this is the staffing you get. I am saying I am going to revisit that. We need to come up with the ISDM-plus, where we don’t just look at population, but we look at unique situations of communities. We are looking at Wrigley and Tsiigehtchic particularly. Thank you.

Thank you, Minister Lee. Moving on, we have Mr. Yakeleya.

Thank you, Mr. Chairman. The primary delivery support is very key in terms of my questions to the Minister in terms of the Colville Lake health stage in terms of the service that they receive. I want to ask the Minister, in working with the Sahtu Regional Health Authority in terms of improving the health delivery programs in Colville Lake through the community, I know there were issues there with the health centre in terms of the training. There is some progress in terms of training our two workers there in terms of the delivery of aspirins to higher degrees of pills, but it still needs more support.

Also with the social services with the community itself in terms of long-term care planning and helping with the elders in that community. In terms of the program delivery support in Colville Lake, is the department working with the health boards in providing them with the adequate support and funding to move the status of the health station into a heath centre in Colville Lake? For a number of years since I have been an MLA, it has been an ongoing issue in Colville Lake. Their mental wellness worker comes from Fort Good Hope. A couple of other services come from Norman Wells

into Colville Lake. I have talked to the workers. God bless their hearts who work in Colville Lake, in terms of the inadequate facility there. They can only do so much and they are certainly in need for upgrading that facility. This is where it is truly key, Mr. Chairman, in terms of what the Minister’s response is to me. How do we start defusing some of the questions that I have been questioning the Minister on in terms of the equality of certain standards of our health stations, health centres in the Northwest Territories? This issue must be one that will be coming up over and over again. I will ask the Minister, what is she going to say here that would give some level of comfort to the people of Colville Lake?

I think we are talking about two things here, the programming at the Colville Lake health station as well as perhaps the physical infrastructure there. I have to say I am not aware of…I haven’t looked at this issue lately. I know that the Member raised this a couple of times, I think, last summer. I am willing to look at what we have in Colville Lake again in terms of infrastructure and the programming there.

I have to say that I am committed to the ISDM model as well as mental health and addictions programming. I do agree, and I am telling the Member for Sahtu also that I am committed to reviewing that. I have to say, though, that we are not going to be able to have everything in every community in all of the Territories. Just the way that there are lots of programs that we are delivering and in Yellowknife that we need to visit and see if we could continue to deliver those services or is it better that we get some services from other jurisdictions. We need to look at the entire system and the Minister’s action plan is looking at that. We need to make sure that there’s no duplication in our service delivery.

I am committed to strengthening services that we provide in small communities but it would be misleading for me to say that Colville Lake will have the same services as Yellowknife, for example. I think we do need to make sure that we raise the bar for the smaller communities. Thank you.

Thank you, Minister Lee. Mr. Yakeleya.

I thank the Minister for her answers. Certainly the people of Colville Lake have certainly heard it loud and clear that they are not to expect the same type of services like they have in Yellowknife. That’s a fair given, but they do deserve quality health care in their community by properly training those hard workers who work at the health station. That at least, in this day and age, in that health station there should be some proper

facilities, supplies, materials. That has been noted and our health board should be supported.

Colville Lake still operates on a slop-pail system in this day and age. Why isn’t something done in terms of that type of facility? That’s where I get very passionate, Mr. Chair, of the equality of some of our health centres. When I start seeing the number of dollars, and the Minister is correct, that there is time for some infrastructure discussions at different times, but that’s been noted in our small communities that some of our infrastructure has not had the attention as to other issues here that we see in the books that infrastructure has been committed to. Members have noted that around the table, so I don’t want to get into that, but that’s what people in Colville Lake are looking forward to and our health board is looking to fight for.

That’s where it’s very important in terms of the program delivery. I know the Minister is going to consider this. She has given me some very good answers in terms of the questions I’ve raised with her in terms of a new regional wellness centre in the Sahtu. She’s told me and I’ve said that’s fair enough. I want to register at this time here some of the wishes and needs in the Sahtu, but specifically some of the programs we have in the community. I’m very encouraged to hear the Minister talk about reviewing some of the programs that are already on the books that would fit our community. Mainly our population in the small communities, a high number of culturally aboriginal people, except the community of Norman Wells where there are lots of Imperial Oil workers and other government workers. Even that centre of Norman Wells is busting at the seams in terms of programs. I just want to register with the Minister that I think it’s very important that we start making some changes and having some serious discussions so that we can see that we’ll make a difference. I talk for a lot of the small communities, Colville Lake.

We should start looking at some of the quality of the programs being delivered in other centres. I’m not going to go into that any further, Mr. Chairman. I think she knows well things don’t change and these type of discussions will happen again in the future. I think we should look at these small communities like Colville Lake that do not have centres or even health stations. We should really think about those community members. If we don’t say anything, no one’s going to speak for them. That’s where I feel passion for the elders and for people who have suffered, who’ve been misdiagnosed either for the eyes or any kind of health sickness. We should really look at that and say we’ve got to do something more. There are lots of communities who are in that field, so I think we need to pay attention to those communities and bring up that standard of health care through program delivery as in this budget here.

I know the infrastructure plan would happen later on. I want to register that. I go back and live with those issues and I live with my people and I know what it’s like day in and day out. We certainly would like to have some services in our regions. Especially in those communities that don’t even have a health centre, they have health stations. We need to, again, remind the Minister of the priorities of the people. She’s got to do a balancing act and sometimes the balancing aspect for us in our communities do not see it as being very fair. That’s what I get very passionate about, about this issue here. Mr. Chair, I think I want to leave it at that.