This is page numbers 3403 - 3440 of the Hansard for the 16th Assembly, 4th 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

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

Sandy Lee

Sandy Lee Range Lake

That provision of handi-vans to communities in the way that the Member described it is not currently a Health and Social Services program or I don't believe a program under any government department. The Member has raised this and also the Member from Hay River South raised this and I have heard the need for this in some other communities as well. We, as a Legislature, could talk about making that as a policy and set the guidelines as to how that would work, but as it sits now transportation of that nature is being done by community governments. I believe where those services are available they're being done either by municipal government or by community groups. So that's where it stands now and I agree with the Member there is not a policy on that. We don't have program funding for that and in order to do that, not only do we have to come up with separate funding but also we need to look at some of the policy work about doing that. Thank you, Mr. Chairman.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

The Chair

The Chair David Krutko

Next on the list I have Mr. Ramsay.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

David Ramsay

David Ramsay Kam Lake

Thank you, Mr. Chairman. I would request the committee's indulgence to go back to page 6-4. My apologies; I had to step out when we were on that page.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

The Chair

The Chair David Krutko

Does committee agree we go back to page 6-4?

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

Some Hon. Members

Agreed.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

The Chair

The Chair David Krutko

Mr. Ramsay.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

David Ramsay

David Ramsay Kam Lake

Thank you, Mr. Chairman. I understand my colleague Mr. Abernethy had a number of questions in the area of the Stanton Master Development Plan and the status of Stanton Territorial Hospital and I wanted to ask some questions again about that master plan. I guess I haven't gotten a level of satisfaction on why that plan appeared in subsequent capital plans to the tune of 60-some million dollars at times and last year disappeared from the capital plan. Again, it's nowhere to be found in this capital plan and I fail to understand how a department and the hospital could receive a technical assessment report that was done in 2004 that called into question a number of the building systems, code requirements and things of that nature, and we need some substantial capital dollars to be spent at that hospital.

Here we are and the government hasn't got that hospital on its capital plan. The Minister talks about it being back in the planning process and developing a plan, but, from where I sit, the department's had seven years and counting to come forward with a workable plan. To say that whoever was planning it came forward with this grandiose $250 million plan, well that's the government's responsibility to take those people who were planning that and go back to the drawing board. I don't think it takes seven years to do that. If you go back to 2004 it's been five years.

I'd like to know who is planning this Stanton Master Development Plan and exactly where it's at and whether or not we can expect to see the Stanton Master Development Plan come back in some form or another before the life of this government is over in two years. I just haven't gotten any reassurance from the Minister that that's going to happen. She wants us to work with her. I'm wondering what do we have to do to make that happen, Mr. Chairman. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

The Chair

The Chair David Krutko

Ms. Meade

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3433

Meade

Thank you, Mr. Chair. Thank you again for the question. First of all, we are in the throes of planning. We are working very closely with Stanton and the physicians. The issue is Stanton is a territorial hospital; what services need to be in there, what services should or shouldn't the Territories be looking at outside of the jurisdiction and what services could be moved to the community. Some progress has already been made on that. For example, moving out to the Dementia Centre, setting up a primary care and looking at what services can be used. Stanton's design will also be designed around the use of further supports out to the small regions. So the use of electronic health records, TeleSpeech and telehealth helps physicians and other specialists in Stanton to provide services and support to those regions, to those other authorities and communities so that services will not need to come in to Stanton, but this is a work in progress.

The landscape has also changed very quickly and recently in health care, so now any master plan has to consider major issues like infection control, laboratory access, which has happened in the last couple of years in Canada. That's very different than the technical assessment, and I'll speak to that piece in a moment.

So the plan that came forward, certainly -- and my Minister has spoken to this previously -- did not address both the current and future needs and a master plan cannot just be about the building design. It has to be driven and lead and designed around the program services, as well as patient flow and maximizing efficient use of the existing envelope as we do any rehabilitation. It will be a very complex renovation of any facility, given that it's an acute care facility, and we have to be able to stage this. So some work is already done as far as moving some services and realigning them, and the department is working with the authorities on that as well as being supported by our colleagues in other departments.

The technical assessment actually was also from 2004. It is separate to the master plan. That is an assessment of the major components and systems of the facility, not unique to the Stanton Hospital. That work, then, was done over the last five years inclusive of money that's pending, I believe $2 plus million in the current fiscal, for some completions in the major systems and components. So the master plan will drive what type of facility and how we can best use the existing envelope around what services need to be and what Stanton needs to be delivering in the future. In any hospital, look at a master service delivery, it's very complex because of the number of decision-makers and providers. So physicians, the nursing staff, how you actually maximize and use your ORs and your emergency all becomes a piece of that.

I believe that it was committed earlier that this was a piece of work we intend to have finished over the course of the next two years, but as we are moving ahead and those programs are starting to move out and it does fit with the Minister's initiative around the Foundation for Change. Thank you, Mr. Chairman.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

David Ramsay

David Ramsay Kam Lake

We had, at the committee level, I'm not a member of the Social Programs committee, but we had an opportunity to have the Minister before the Social Programs committee I believe it was close to a year ago and the issue was raised about the capital plan and why the Stanton Master Development Plan wasn't there. The Minister at the time stated that she would do her best to get it into the capital plan and it's not there. I understand what the deputy minister is saying, but I want to know -- let's say it doesn't come forward in two years -- ultimately who is going to be held responsible for that plan not materializing, because, like I said, it's been seven years.

I mean, things change. It's a moving target in health care, things change every day. So if we keep waiting, there's going to be new technologies coming forward, there's going to be new innovative ways of doing things, there's going to be new service delivery models eventually. I mean, we'll never have something nailed down if we keep saying, well, things are moving, things are changing. Of course they're changing, but what we need to do is get a major infusion of capital dollars into that hospital?

I want to know today who we can hold responsible if it doesn't happen. Is it the Minister? Who is actually working on this plan? I'd like to be clear on that. Who is working on the plan today? I said this in the House the other day: if the department and the authority cannot get the work done that's required, let's bring somebody else in to help them get the work done, whether that's Public Works and Services or somebody else. If they need the horsepower, let's bring that in and let's get this done and I'd like to see it happen by the end of the life of this government, Mr. Chairman. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

The Chair

The Chair David Krutko

Minister of Finance.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Chairman. In an earlier response to the Member from Great Slave, I committed, based on the question, that within the life of this Assembly, Stanton would be ready to be moved back into the capital planning process. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

David Ramsay

David Ramsay Kam Lake

So I guess the Minister of Finance is going to take it on himself that this will be back in the capital plan. .Again, I'd like to hear from the Minister or the deputy minister who exactly is responsible. Is it the authority, the department and how that works and who is actually developing the plan and is it going to be back in the capital plan again next year, Mr. Chairman? Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

The Chair

The Chair David Krutko

Ms. Meade.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

Meade

Thank you, Mr. Chair. Obviously eager to answer this one. As the deputy minister of Health I'm responsible to work with the authorities, Public Works and anyone else required, the physicians, to establish and bring forward for my Minister the plan on time and that would be a part of my accountabilities. Thank you, Mr. Chair.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3434

David Ramsay

David Ramsay Kam Lake

I guess all I can say is I look forward to that happening. It hasn't happened to date. So again, I'm going to hold my tongue. I just want to see it happen and I've told the Minister this. We need to work together and we need to get this back in the capital plan. I can't make that any more clear.

A couple of other things, too, I want to talk about and maybe this is part of the Master Development Plan, but the space utilization at that hospital and having administrative staff located predominantly on the third floor, we had talked previously about moving some of those administrative staff out of the hospital. It is a hospital, not an office building. We've actually gone to converting some patient lounges into offices and I think that kind of thing has to stop and we need to have the hospital be a hospital, not an office building. Again, I don't know the comment for the Minister. What are the plans long term for the administrative staff located in that hospital? Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

Meade

So absolutely all the use of the facility and what services should be included in the facility are part of the master plan. I think we do need to move services out of there and maximize it is an acute, whether that's the ambulatory and outpatient or some of the other services and we maximize that out. I think there is a plan, actually, to consider how they can move some of the administration and maximize that, but all of that service delivery inclusive of administrative and provider support will be in the master service program delivery that will design and guide the function of the plan.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

The Chair

The Chair David Krutko

We're on page 6-4, health services program. Mr. Ramsay.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

David Ramsay

David Ramsay Kam Lake

Thank you, Mr. Chairman. By the sounds of it, the deputy minister talks of a plan and I know there's been a tremendous amount of work done already, there's got to be the foundation of this Master Development Plan somewhere. I mean, we've spent money on it in years past, so there's got to be something there.

A couple of other questions, the Master Development Plan, will it include a discussion around the medical clinic, the Stanton Medical Clinic that's currently located outside of the hospital next to McDonalds? Is that part of the discussion as well, the clinical services that are provided? I know we're going to this walk-in clinic downtown in the consolidated clinic, but these are services that are provided outside of that venue, obviously, and I'm wondering what the future of that is going to be. Because I've talked to staff there, they're working in cramped quarters, they're overcrowded, they need more space to run the programs that they have there and we need more space there. I'm just wondering if I could get a comment from the Minister or the deputy minister on that. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

Meade

First of all, all services have to be looked at under the umbrella of the NWT system. So we can't just look at Stanton alone, we have to look at Stanton in the context of the community as well as the other communities and what services best fit in which infrastructure, but, more importantly, what services are best going to support the patient flow through the system. So redesign of any and renovation of any infrastructure or looking at space has to look at the context of how each piece fits in the system design. We are looking at the role of specialists and specialist clinics and how those can best be suited.

The other issue is we have to define the program. So, for example, a provider may be licensed to do a specialty, but the decision is who decides on how much and how broad that is. Orthopedic surgery can be A to Z. It is not always a high quality, safe or necessary to provide the full service in some places. So when we are looking at programs, we are looking at the full gamut of programs and that will design the space. I understand they are tight, I think there are also efficiency measures and lean measures of health care delivery that can be looked at, and that will be included in our master review of service delivery and the subsequent master plans. Thank you Mr. Chairman.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

David Ramsay

David Ramsay Kam Lake

I am just wondering if the deputy minister could elaborate a little bit on the master plan for service delivery. It is the first I have heard of that. I know there is a Master Development Plan for Stanton, but I haven't heard of this master plan for service delivery and what that might encompass. I would like to hear a little bit more about that. Thank you, Mr. Chairman.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

Meade

I have to apologize, Mr. Chairman, I am in transition. I have been told I can only use my newbie card for another week but I do get my language mixed up from my old world. What I am referring to on the service delivery is under the Foundation for Change that was referenced by both the Minister of Finance and my Minister previously. We are looking at the right service, the type of service and how we are going to deliver that. That is what I am referring to and I apologize for mixing my language and my places, but I know I am here today. Thank you.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

The Chair

The Chair David Krutko

Thank you Ms. Meade. If we can move forward on this one. Page 6-4, Health and Social Services, activity summary, health services programs, infrastructure and investment summary, $4.174 million.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

Some Hon. Members

Agreed.

Consideration In Committee Of The Whole Of Bills And Other Matters
Consideration In Committee Of The Whole Of Bills And Other Matters

Page 3435

The Chair

The Chair David Krutko

Moving forward to community health programs, Health and Social Services, activity summary, health services programs, infrastructure and investment summary, total infrastructure investment summary, $800,000.