Mr. Speaker, that could be taken into consideration, if it’s felt that that messaging going out from the board itself is not adequate or needs something coming directly from my office. We can work on doing that. Thank you.

Thank you, Mr. Roland. The time for question period has expired; however, I will allow the Member a final supplementary question. Mrs. Groenewegen.

Thank you, Mr. Speaker. If a meeting were to be arranged for for any NTPC employee in Hay River, would the Premier agree to come to Hay River and have a meeting with those employees and the MLAs to discuss, I suppose, what some of the minimum requirements of the government would be with respect to the analysis of the benefits and contributions that NTPC headquarters in Hay River brings to the Northwest Territories? Would the Premier agree to a meeting to be convened for that purpose?

Mr. Speaker I would be prepared to work with the Members on messaging or setting up a meeting or propose a potential meeting. One of the things we would have to look at is what type of information we have available, if they wanted to get into technical stuff, we’d have to look at that through that review. But if it’s to try to address the concerns of the employees within our headquarters staff, we’d be prepared to try to work and set something up around that. Thank you.

Thank you, Mr. Roland. Item 8, written questions. Item 9, returns to written questions. Item 10, replies to opening address. Item 11, replies to the budget address, day four of seven. Item 12, petitions. Item 13, reports of standing and special committees. Item 14, reports of committees on the review of bills. Item 15, tabling of documents. Item 16, notices of motion. Item 17, notices of motion for first reading of bills. Item 18, motions. Item 19, first reading of bills. Item 20, second reading of bills. Item 21, consideration in Committee of the Whole of bills and other

matters: Tabled Document 7-16(3), Ministerial Benefits Policy; Committee Report 2-16(3), Standing Committee on Rules and Procedures Report on Matters Referred to the Committee; Tabled Document 11-16(3), Northwest Territories Main Estimates 2009-2010; Bill 1, An Act to Amend the Historical Resources Act; Bill 3, International Interest in Mobile Aircraft Equipment Act; Bill 4, Public Library Act; Bill 5, Professional Corporations Act; and Bill 7, An Act to Amend the Student Financial Assistance Act, with Mr. Bromley in the chair.

I’d like to call Committee of the Whole to order. We have under consideration: Tabled Document 7-16(3), Committee Report 2-16(3), Tabled Document 11-16(3), Bills 1, 3, 4, 5, and 7. What is the wish of the committee? Mrs. Groenewegen.

Thank you, Mr. Chairman. The wish of the committee today is to proceed with consideration of the budget for the Department of Health and Social Services, of course, starting with the opening comments and see how far we get from there. Thank you.

Okay. Committee agreed?

We’ll take a short break.

---SHORT RECESS

I’ll call Committee of the Whole back to order. Committee, we’ve agreed to consider Tabled Document 11-16(3), NWT main estimates 2009-2010. We’ve specifically agreed to review the Department of Health and Social Services. Minister Lee, would you like to provide opening comments?

Yes, Mr. Chairman, thank you. Mr. Chairman, I am pleased to present the Department of Health and Social Services’ Main Estimates for fiscal year 2009-10.

The department is requesting just over $313 million, an increase of approximately $3 million over last year, which is an increase of just about 1 percent.

Mr. Chairman, the department is committed to effecting significant changes consistent with our Integrated Service Delivery Model, ISDM, including refocusing on health promotion, preventative

services and primary care, improving information management and technology, standardizing processes and lessening our dependence on costly institutional care, and maximizing the efficient use of our health care providers in a way that is congruent with our small population size.

Mr. Chairman, this budget will enhance our approach to primary community care to ensure clients receive appropriate, accessible, effective and quality care at the right time by the most appropriate provider in the most economical way. As the Minister of Finance stated in his budget speech on February 5, 2009, for Department of Health and Social Services, “strengthening prevention programs will be a major focus of our work. Putting more dollars into our health care system is only part of the answer. We can all help reduce health care costs by taking more responsibility for our own health. We need to encourage Northerners to stop smoking, drink less, eat a proper diet and exercise more.

The

government has a role to play, but so do individual Northerners.”

To that end, I will be coming forward with a Minister’s action plan for reforming the way we deliver health and social services in the Northwest Territories. I look forward to discussing this in greater detail with the Standing Committee on Social Programs.

Strategic Initiatives

The department will continue to advance a number of initiatives under the government’s Strategic Initiatives Committees.

Through the Building Our Future Strategic Initiatives, we have five initiatives that are being funded and advanced. They are as follows:

Expanding Programming For Children And Youth

•

An additional $64,000 for In-House Respite

Program for 2009-10, in addition to $224,000 from 2008-09.

•

This

initiative

provides an essential “time-out”

for parents and caregivers of children with special needs.

•

Work has also begun to develop a Framework for Children with Disabilities.

Key non-

government partners as well as other government departments are working together in this framework process.

Encourage Healthy Choices And Address Addictions

•

We are supporting the Healthy Choices

Framework with $350,000 for 2009-10. This investment will fund a health promotion specialist and focus on activities that enhance supports aimed at encouraging health lifestyle choices such as physical activity, healthy eating, being smoke free, and avoiding high risk activities.

•

We are implementing a healthy eating initiative in three Beaufort-Delta communities.

•

To address the mental health and addictions issues for youth we have developed a social marketing, resiliency programming and life skills programming.

•

Immunization is recognized as one of the most cost-effective public health interventions in prevention and control of disease. This year the department will implement the Human Papilloma Virus (HPV) vaccination program in the NWT.

The federal government has

provided a $388,000 vaccine trust for the NWT to implement and fund the program for 2009-10.

•

The successful Don’t Be a Butthead campaign will also continue this year.

Implement Phase II Of The Framework For Action On Family Violence

•

Actions under Phase II of the Framework for Action Against Family Violence has been developed in a cooperative manner with the Coalition Against Family Violence. Phase II will build on the successes of the first phase and focus on expanding services to smaller communities to alleviate further impacts from family violence and prevent family violence by providing treatment to abusers and services to children who witness family violence.

•

Eight hundred thousand dollars has been

allocated for the implementation of phase II.

Strengthen Continuum Of Care

•

The demand for homecare and community

care is growing and there is a need to ensure that the NWT has a sufficient number of workers to meet this demand. To address an identified training gap, we plan to implement an eight-month Nursing Assistant Diploma Program in cooperation with the Dene Nation and Aurora College. This program will train candidates for the position of home support workers and resident care aides.

•

The government will support our residents with dementia through the opening of the Territorial Dementia Facility, which is scheduled for completion in 2009-10; $1.462 million has been allocated in 2009-10 budget for the operating of the facility.

•

The Hay River Supported Living Campus for adults with cognitive and behavioral challenges will address the need for appropriate social contact, life skills programming, behavioural support and personal care needs. This budget includes an additional investment of $538,000 for the operation of this purpose-built campus with day program as it becomes fully operational.

Through the Managing this Land Strategic Initiative, departments of Health and Social Services, Municipal and Community Affairs and Environment and Natural Resources under Protect Territorial Water Initiative will work to increase public education on water issues. We will also undertake a continual release of an annual water quality report, develop a website and materials to assist with public education.

The department’s

contribution to this initiative is $95,000.

Through the Refocusing Government Strategic Initiative we will strengthen service delivery through the successful implementation of the new health information systems. These systems are new tools which would support patient care and safety as well as achieving a more financially sustainable health care system. I would like to highlight the following initiatives and their status:

Interoperable Electronic Health Record, IEHR – Phase 2, implementation, started in 2007-08 and is expected to be completed in 2009-10.

Planning for the Diagnostic Imaging/Picture Archiving and Communication System, better known as DI/PACS, began in 2005-06, implementation activities began in 2007-08 and the planned three-year rollout will be completed in 2010-11. In 2009-10 we will continue the rollout of these systems to community health centres.

Communities that will receive this new technology, computed radiography readers, CRs, in 2009-10 and 2010-11 are:

•

Aklavik

•

Deline

•

Fort Good Hope

•

Fort

Liard

•

Fort

McPherson

•

Fort

Providence

•

Fort

Resolution

•

Fort

Simpson

•

Ulukhaktok

•

Lutselk’e

•

Norman

Wells

•

Paulatuk

•

Behchoko

•

Gameti

•

Sachs

Harbour

•

Tuktoyaktuk

•

Tulita

•

Whati

The order of rollout will be decided in collaboration with the authorities and will depend largely on site readiness and the suitability of the GNWT digital communication network, DCN, in different regions of the Territory.

To ensure efficient and effective access to NWT Rehabilitation Services across the NWT, the Telespeech program has been a priority for the department. Since 2006-07, investments have been made to establish four regional rehabilitation teams across the NWT. Without Telespeech capacity this investment would not achieve its full potential in effective use of resources. The deployment of a total of 15 new or replacement tele-video consultation units, five health centres, 10 schools, will take place in 2009-10. Communities receiving the units include:

•

Norman Wells (school)

•

Deline

(school)

•

Paulatuk (2) (school and health centre)

•

Tulita

(school)

•

Fort Good Hope (school)

•

Inuvik

(school)

•

Tuktoyaktuk

(school)

•

Ulukhaktok

(school)

•

Sachs Harbour (health centre)

•

Tsiigehtchic (health centre)

•

Fort McPherson (2) (school and health centre)

•

Aklavik (2) (school and health centre)

New Program And Initiatives 2009-10

Mr. Chairman, in addition to the above strategic initiatives the department has a number of other initiatives we are working on.

Seniors Action Plan

The department will continue to fund the NWT Seniors’ Society through a contribution agreement. Funds are being used by the NWT Seniors’ Society for the following activities: Seniors’ Information Line, Seniors’ Advisory Council, Seniors Awareness Week, Canada Senior Games and community outreach programs.

Chronic Disease Management

The department, in consultation with key NWT stakeholders, is finalizing the NWT Diabetes Strategy. It is proposed that, upon consultation with the standing committee, this strategy be implemented through a pilot project in two authorities in 2009-10.

Cancer Screening

Cancer is now the leading cause of overall mortality in the NWT. Significant impacts on cancer mortality can be achieved through well-organized evidence-based screening programs to detect cancer at the earliest possible stage when treatment is more likely to be curative. Some types of cancer are on the rise in the NWT, such as those of the large intestine, colorectal, and of the lungs, which are considered for the most part to be preventable. We have increased our cancer screening programs and have implemented a cancer registry.

The

maintenance of the NWT cancer registry is done in partnership with the Alberta Cancer Board, where most NWT residents with cancer receive diagnosis and treatments.

We have expanded our Breast Screening Program to Hay River and an estimated 450 to 500 women will be screened every year.

We are funding

Stanton Territorial Health Authority to test the elements of an organized screening program against colorectal cancer, and we currently have a protocol for conducting testicular cancer screening in the Community Health Nursing Program Well Adult Clinic.

We are also working with Health Canada to implement a screening mammography service in Hay River. This service will be a part of the Territorial Screening Program and will have a common database with Stanton Territorial Health Authority. In Supplementary Appropriation No. 3 we will be seeking to draw down funding from Health Canada’s Patient Wait Times Guarantee Pilot Project Fund to fund this program.

Sexually Transmitted Infections (STI)

Public Health Agency of Canada has provided funding for the hiring of a sexual health coordinator that will work with regions to implement components of the STI Strategy. One hundred thousand dollars from the Pan-Territorial Health Access Fund has also been allocated to develop an STI website and to develop some mass-media public STI education materials in partnership with the other two territories.

Healthy Choices Framework

The department will continue to carry out health promotion and prevention activities including: coordinated programming, interventions and public messaging on physical activity, healthy eating, mental health and addictions, tobacco harm reduction and cessation, injury prevention and high-risk sexual behaviours.

Addictions Initiatives Related To Aftercare

The department will provide $450,000 to establish culturally appropriate community treatment options for youth, along with a targeted media campaign that will highlight and promote community based addiction aftercare services. The intention is to build community-based programming that could include on-the-land treatment and aftercare programming, healing camps and mobile treatment. I look forward to working together with the Members of the House as we focus our resources and change how we do our work in this important area.

Lastly, Mr. Chairman, we have heard loud and clear from Members who brought forward a motion and from the public who may be affected, that changes to the Supplementary Health Benefits Policy requires more work. I would like to take this opportunity to announce changes to the policy will be delayed until April 1, 2010…

---Applause

…in order to facilitate a comprehensive review of the implementation tools necessary to advance the policy’s intent and to undertake full consultation with the Members of the House and stakeholders on the policy’s objectives and implementation.

Mr. Chairman, this concludes my opening remarks and I would be happy to answer questions. Thank you, Mr. Chairman.

Thank you very much, Minister Lee. Would the Minister like to bring witnesses into the House?

Yes, please. Thank you, Mr. Chairman.

Does the committee agree?

Thank you, committee. I will ask the Sergeant-at-Arms to escort the witnesses into the Chamber.

Thank you. Would the Minister please introduce her witnesses?

Thank you, Mr. Chairman. I have with me to my left, Mr. Dana Heide, acting deputy minister of Health and Social Services; to my right is Mr. Derek Elkin, director of finance. Thank you, Mr. Chairman.

Thank you, Minister. I will now open the floor to general comments on the Department of Health and Social Services. We will start with Mr. Abernethy.

Thank you, Mr. Chair. I would like to thank the Minister for her opening remarks. I am just going to start off with where she finished off. I am very happy to hear that the Minister had decided to delay until April 1, 2010, the implementation of the Supplementary Health Benefits Policy. I am also happy that she acknowledged that it requires more work and that she’s going to go out and do full consultation. Clearly that’s what is needed in this case.

We need to get out there; we need to do the financial analysis; we need to talk to the stakeholders that are going to be affected; and we need to get that information from them so that a comprehensive and reasonable policy can be developed. I look forward to working with the Minister on that, as I’m sure many of my colleagues do, and I look forward to seeing how they proceed and go forward.

Not to be answered now, but certainly there’s a question that I’m hoping at some point the Minister will come to the Standing Committee on Social Programs and give us a bit of a timeline and outline on how the department plans to move forward on this. I look forward to that.

A comment I made yesterday with respect to the budget is I see that it’s only a 1 percent increase. Now, that on principle sounds really great. Not a significant growth in this area. But health care traditionally and consistently increases by about 6 percent to 7 percent in most other jurisdictions, and even in the Northwest Territories our forced growth in the government is around 3.5 percent or 3 percent. So when I see a 1 percent increase in the Department of Health, it appears to me to actually be a 2.5 percent or 2 percent decrease. Given the importance of the health services that we provide, I’m not a big fan of seeing a decrease in this department. I’d rather see that typical forced growth 3 percent. But we do need to find some efficiencies within the system to ensure the money we are spending is being spent in a reasonable and responsible way.

In going through the budget I’m still struggling with some of the deficits that we see out there and some of the authority. I know we did a lot of work in the last budget and there was some significant work

done in one of the supps to address some of the shortfalls that they had, and I see we’re still predicting some deficits in that area. I know a lot of work has been done to mitigate some of those challenges in the authorities, but we need to work a lot harder to find efficiencies within the system so that we’re not having any significant deficits in the individual authorities.

Some things that I’d like to have some more information on...Last session we talked a lot about the money that we believe that Nunavut owes us. We provide services through Stanton, which is a territorial authority. We provide a lot of services to residents of Nunavut out of the Kitikmeot region and keep hearing anecdotally, but also practically, that there’s money that technically they owe us that we haven’t been able to get out of them. I’m looking forward to hearing from the Minister and her staff about how the Minister plans to improve that situation, both through the 2009-2010 fiscal year and into the future, to ensure that the services we are providing to Nunavut are in fact being paid for.

I’m sad that there is no reference in this health budget to the milk subsidy. The Members on this side of the House passed a motion with all 11 Members...

---Interjection

Sorry, with 10 Members -- one of them was out. Ten Members passed a motion, on this side of the House, talking about the importance of getting the nutritional supplement known as milk into the bellies of our babies, which is obviously an incredibly important thing to do. I’d like to see...

---Interjection

Pardon? Sorry. I’d like to see a little bit of movement on this, if not in 2009-2010 then in 2010-2011. If nothing else, pilot it in a community to see if it works, to see if we’re improving the health of children in these communities. We need to try. We need to do something. If you don’t want to implement fully, I would like to see it maybe piloted in a couple of communities to see if there is any impact in that area.

I believe it’s in this fiscal year and started last fiscal year, but we know that some of the money that we’re getting from the feds will be sunsetting. The Territorial Health Act and whatnot will be sunsetting at some point. We’re using those dollars for very important things within the health system and I’d like to hear from the department as to whether they’re working with the federal health to find out if we’re going to have access to any of those dollars for future years in order to continue doing some of

the good things we’re doing with nurse practitioners and community health nurses and midwives, all the types of things that we’ve been supporting through there. If that money is gone, I’m worried that we’ll have to cut back on those services. I’d like to hear from the department whether they’re moving forward on trying to get any dollars out of those areas.

Another area -- and I know many others raised Members’ statements to ask questions about this last year -- is the money we’re getting from INAC. Or rather, the unresolved financial issues related to the INAC contribution agreements for aboriginal health services. I’ve heard all sorts of numbers. Millions of dollars, outstanding funds that INAC theoretically owes us. I don’t see much in the way of progress being made in this area.

In health care, as I’ve said before, I’m not super happy to see only 1 percent growth. I’d like to see at least the forced growth levels. If we’re cutting back and we have people who owe us money, I find that a little unfortunate. We should be out there trying to get every penny we can to support the provision of health and social services to the residents of our Territory. Health care is one of the most important services that we can provide and if we’re letting money slip us by, we’re not doing our jobs.

So you’re going to hear this one a lot. I’ll start. Board reform. I’m not 100 percent convinced that rolling health into regional boards where they’re part education and part housing is in the best interest of the people of the Northwest Territories by way of provision of health services. I’m obviously curious on how the Department of Health plans to move forward with the board reform group on rolling health into those areas. I’m concerned that a beast like health -- and it is a beast -- if it rolls into a combined board it might either overpower education and housing or they might lose themselves by way of more support going to education or housing. We need to be cautious that we don’t lose the quality services. And we are providing, yes, there are shortages, yes there are people out there who aren’t getting exactly the services that we say we can provide and want to provide, but I have to tell you, the nurses and the doctors and the allied health professionals we have in the Northwest Territories are some of the best in the world. They’re committed to doing the work. We need to make sure we have the mechanisms in there to support them as well. Every one of them deserves a pat on the back and if we’re rolling them into a joint board, I’m worried that we might lose some of our quality people and might actually do them a disservice by having money flow out of the department rather than into the department. I’m

concerned about board reform. We’ll be talking about that one more, I’m sure.

One other area I’m confused by, and I’d certainly like to hear from the Minister if she could help me understand this, we’ve gone out and pulled money out of the department in order to reinvest by way of the Strategic Investment Committee. However, to me, I always understood those things to be new initiatives; new things that we’re doing in different and exciting ways. New things. Whereas when I look at some of the reinvestments that are occurring in the Department of Health and Social Services, they look to me like things that should have been known, things that should have been understood. We know we’re building a dementia facility. How come the funding and staffing of the dementia facility comes out of the strategic initiative money? I think that should have been more forced growth or new programs, but certainly not out of the strategic investment funds. I would have expected that to be new things that we’re not doing. The same is true for the Hay River assisted living. That money is coming out of the reinvestment dollars, as is the ITE health system. To me those are things we knew were coming, we should have known they were coming, and they probably shouldn’t come out of the strategic initiative money.

The last thing I’d like to just talk about briefly is I’m really happy that you’re building the dementia facility here in Yellowknife. I think it’s great; it’s great for Yellowknife, it’s great for the people of the Northwest Territories. But in talking to my colleagues, it’s becoming increasingly clear that there are challenges in the smaller communities with respect to some of the seniors facilities out there. I was up in Aklavik, God, it might have been almost a year ago now, and we looked at the seniors facility in Aklavik and it looked a little rough, to be quite honest. I’m curious at what point we’re going to start getting on to those seniors facilities to help the elders in those communities. Don’t get me wrong, I’m incredibly happy about the dementia facility here in Yellowknife, but I’m wondering when we’re going to take the next step to start helping those people in the smaller communities. They deserve quality facilities as well.

So overall, I mean, I don’t mean to sound too awfully negative. I think there’s a lot of really good stuff in this budget. I think there are areas that we have to work. Health care is tough. I know that. We need to find the efficiencies within the system. I do like many of the new things you’re doing within the department, and overall I support the budget and I’m excited to get into the detail to talk about a few of those areas where I do have concerns.

Once again, thank you for moving on the supplementary health benefits. I think it’s great. I

look forward to working with you and I look forward to working with the department and all the stakeholders out there in trying to find a Supplementary Health Benefits Program that works for all the residents of the Northwest Territories. Thank you very much for that.

Thank you, Mr. Abernethy. We didn’t actually confirm the protocol. We had gone to a protocol of accumulating general comments before the Minister responds. Is committee still fine with that this time around?