Thank you, Mr. Chairman. Mr. Chair, just in regards to the Minister’s opening comments, I like what she is saying but I didn’t hear anything in regard to what is going to help our small communities. We have health centres which basically are locked up. No one is operating those facilities. We have nurses that show up in our communities maybe three times a year if we are lucky. I think it is important that this government has to do a better job to basically ensure that we have a health care system that is provided in all communities in the Northwest Territories. We have health centres in our communities. We have facilities in place, but yet for one reason or another, I don’t know, it is simply a problem in the Beaufort-Delta region. This issue has been raised in this House time and time again by myself and Mr. Jacobson. I would like to state that I was hoping that the Minister would have been able to make some comments in regard to what we are going to do with the challenges we face in our small communities, especially when it comes to recruiting and retaining health services in those communities.

In regard to Tsiigehtchic, there was a commitment made last fall. There was a nurse there for three months. The nurse basically was willing to stay longer in regard to having a contract obligation from this government. The process took so long that the nurse basically got hired in the Yukon, which basically we lost a nurse from the Northwest Territories to the Yukon. I think that shows us exactly how unresponsive this department is to small communities and our issues.

Another issue I have a real problem with is the Tl'oondih Healing Society and the mental health position in Fort McPherson going on over 10 years. Because of political differences between the health boards and that society, basically the individual had enough and quit and basically moved on. But yet, Mr. Chairman, the Department of Health and Social Services’ remedy to the problem is they will send

someone into Fort McPherson one day a month, for over 850 people. One day a month to provide mental health services to that community, which, again, is totally appalling in this day and age, and then for a health board in Inuvik to be running deficits going on over five years. This year there is an excessive deficit of over $6 million, yet this government doesn’t do a damn thing about it.

When it comes to the Stanton Health Board, that ran a little deficit a number of years ago. The government stepped in, took over, got rid of the board and basically instituted someone to manage that operation by encompassing a financial arrangement looking at the deficit, finding ways to work it through. Yet, Mr. Chairman, I find it awfully hard to encompass a deficit running every year while we don’t have programs and services being delivered in our communities.

I think, for myself, even in the statement that has been read -- I can read between the lines when you talk about community care and perceiving appropriate and accessible and effective quality care -- this is the right time by most appropriate measures, but then the bottom line for me is the most economical way. I think by using that in your statement clearly tells me the dollar at the bottom line and the more people you have in your communities, that is where the money is going to be spent. But for those communities that are basically struggling, I think for most of our small communities I think it was said here today that our communities that have predominant seniors in those communities, those individuals have made that their home, lived out their lives in those communities and they are going to live out the rest of their lives in those communities. I think that we do have to improve the quality and care for our seniors in our communities. One of the fundamental principles of care for seniors is looking at the health and well being of those people to ensure that they do have health care services that they can provide.

Mr. Chair, another area I have a real problem with, and I know we didn’t really touch on it in the Minister’s comments, is the area in regards to child and family services under the act in regard to adoption and also the people in foster care. It has become an epidemic in the Northwest Territories. We have over 600 kids in care. The majority of those children are aboriginal children. I, for one, know that is a cash cow where people are receiving in excess of $2,400 a month tax free to take a kid into care and which, because he can prove the aboriginal child is affected by FAS, this government basically has to enhance the cost to that individual. It is costing us millions of dollars in regard to that care.

When it comes to adoption or basically trying to re-establish that child with their parents, grandparents or family siblings, this government has every excuse in the world why the grandparents are inequitably feasible to take care of that child, or another family member. But yet we are paying people in excess of $2,400 a month to take care of kids in care. I, for one, have a real problem after we went through the residential school nightmare. It is still upon us. Then for this government to get into the same type of mentality in regard to residential schools using a policy of this government, which basically is the same type of heavy-handed tactic that was used by previous governments to take kids and drag them out of their communities, take them away to school for years on end and then basically try, at the end of it all, to reunite them with their families.

Another area I have a concern about is the area of treatment rehabilitation. I know that it is great to have slogans like cool people quit smoking, quit drinking and quit playing cards. Maybe that will solve all of our problems. Well, excuse me. I think the problem is poverty. This government has to wake up to the reality that we do have poverty in the Northwest Territories. We have poverty in small aboriginal communities. We talk about a recession we are in today. Well, aboriginal communities have been in a recession for hundreds of years. I think it is important that we tell this government that deals with that apprehension, that poverty is the problem of a lot of these ailments in regard to alcohol abuse, drug abuse and basically abusive behaviours in our communities. If you were unemployed for years on end, some of it you didn’t have a hope in heck of getting a job or having an opportunity to maintain a lifestyle for yourself, your family and your siblings, and have people take away your children whenever they wanted to, I think you will have a different insight in regard to what the reality of life really is.

Mr. Chair, another issue that we don’t seem to talk about but I think it is only when we get approached by either our constituents or our political masters out there that basically has court services in our communities, especially when patients have cancer and other ailments have come across by way of an accident, and that basically a policy that we have is becoming very stringent. But yet, Mr. Speaker, a lot of community members still would like to have the ability to escort their siblings or grandparents or parents to a hospital, especially the individuals with cancer and other ailments. I think it is important that this government does whatever it can to have a flexible policy, especially for isolated communities and communities who depend on that family unit.

Another issue in regard to this budget and bill that the government has put forward, you don’t make reference to dealing with territorial water issues and

whatnot. But I think, from what I have seen in my riding and over the years with the challenges we had with water issues in THMs in Fort McPherson and H. pylori in Aklavik, where Aklavik has done a community comprehensive review from the University of Alberta to work on a way to find the source of the problem. I believe the problem is dealing with environmental water issues, which are basically airborne or flow downstream from these issues we hear from Fort McMurray and what is happening in regard to Fort Chipewyan and now seeing it happen in a lot of our communities along the river systems. I think that the government cannot just look at the contribution of $95,000. I think it has to do with education. I think it has to do with more studies, testing and research that has to be done to compel individuals to come forward, get tested to see exactly where those ailments are, how many people are affected and what remedy we have to take to try to pinpoint the problem and, more importantly, treat those people who are affected by these ailments.

Mr. Chair, I believe we have to do a better job of working with aboriginal organizations. We have the Tl'oondih Healing Centre above Fort McPherson. That thing has basically been run off federal programs for the last number of years. Now we have a healing centre just outside of Inuvik, and we were all there for a Caucus that we had, and everybody made grand statements and great comments, but this government has to find ways of delivering programs and services so that we can use these facilities and quit building new facilities that we don’t have to.

There are already facilities on the ground that can be used for treatment and healing programs and also even looking at the possibility of management workshops for our health care professionals or people within the system so that they can have a place to go to receive cultural enhancement programs or give them some education about these regions that they are in and be able to promote those programs.

Mr. Chair, again, I will have a lot of questions for the Minister in this area. I feel that we’ve been let down by this department, especially in the area of Inuvik health services. Again, I don’t see anything being too grand to celebrate here. I think, as a government, when you have a health board running deficits going on six years and do nothing about it, I think you have a problem.

Thank you, Mr. Krutko. Moving on to Mr. Hawkins.

Thank you, Mr. Chairman. Mr. Chairman, the issues that I wish to highlight have been broadly raised by previous speakers, but I

would like to highlight a few in particular that are sincere interests.

First and foremost, the shift in the Minister’s position needs to be applauded and recognized in the fact that it’s a representation that government is listening that this needs a full and comprehensive review and we’ll start from there. In my view, that unlatches the chains of bias and predetermined results but yet gives them the spirit and the intent of saying we have some concerns with this policy, they want to go look at it. By listening to the simple point of suggesting that moving it back a date that’s more reasonable, I think, is understated here. The fact is it’s a bold recognition of how important this issue is, so I want to compliment the Minister for doing that. My view is that consultation won’t be rushed in the context of getting to the finish line. Consultation will be brought forward in a reasonable amount of time certainly, but not for an endless amount of time. I want to look at it that way.

Mr. Chairman, just really quickly, I would have liked to have heard something about how the Minister plans to deal with the debt at Stanton and as well, of course, the Beau-Del. I, too, don’t support board reform and I certainly have said for years that I’d like to see Stanton have a board of its own overseeing that. I’m pleased with the progress that the new downtown clinic is coming forward with. I certainly look forward to seeing that open. I think that will take a much needed stress off the system over at Stanton which will allow people to have a great ease of getting treatment for simple things, whether it’s a simple blood test, a quick X-ray, seeing a doctor. I think the other thing about the downtown clinic is it provides the synergy of having all the doctors together and allows more of a sense that if one’s free, they can certainly calculate their time in a more efficient way that we’re...It’s not necessarily putting them on a treadmill, but if somebody walks in off the street and says I need to see a doctor, can I see one today, that option then becomes a reality.

Mr. Chairman, like other Members, I’m concerned with billing with Nunavut, but I also have concerns that I’ve heard that there seems to be internal billing problems with a certain area. I will address that directly with the Minister. As well as, of course, I was hoping for the opening remarks somewhere to mention some highlight about the work that’s been done on the NIHB money, the $100 million that’s outstanding by the federal government.

Some new areas with these, I look forward to questioning the Minister on developing a policy and a program certainly for organ donation. I’ve had some experience with that problem lately with some people in the community and them trying to get

assistance and sometimes the theory works good, but we need a fair bit of work on that area.

Mr. Chairman, talking about synergies, there’s a respiratory therapist position that I believe has been rolled back to half time and when the dementia facility comes up to full speed, you know, it causes me concern that it’s been rolled back at Stanton. But the fact is it may be an important and critical role, or play an important and critical role, sorry, at the Dementia Centre. I would hope that the department, when they roll back or make adjustments to positions, that they’ve taken an eye to the future at the same time, because I think positions like that that have been hit hard for...I think, there wasn’t long enough thought gone out to see where the picture is on our needs and the impact it has.

I’m glad to see the Dementia Centre moving along. I drive that Avens Court loop quite regularly just to see the progress.

I just want to finish off by saying, you know, Mr. Krutko has brought this issue up many times, which is the health centre nursing and I couldn’t agree with him more in the principle that we should be trying as hard as we can to get nurses out into the communities to make sure we can help people there. That would probably take a lot of pressure off our great system.

Mr. Chairman, I’m going to close with an addictions area that I’ve been raising, which is I look for more leadership to the department of coming up with solutions as addictions treatment. I proposed during the October session that they consider investigating coming up with a program for the Gwich’in Wellness Centre outside of Inuvik. I think that would make a good compendium to the many services we offer here in the Northwest Territories. I think it could integrate in such a way that we could still offer treatment in the North, still help support groups that are working well and taking care of our people rather than sending them south. If I may compliment them in an area here, in my closing area, which is there’s recognition that youth options need to be developed for treatment for them. I look forward to seeing a bit more.

Mr. Chairman, I’m going to say that as the budget as a whole, I’m happy with the progress to date. Other than a few specific areas which I’ve highlighted, I’m relatively pleased. If I was to say one thing, the delay on the supplementary health benefits implementation is a significant and bold move and I was glad to see that the Health Minister has listened to the concerns of this side of the House. Thank you, Mr. Chairman.

Thank you, Mr. Hawkins. Moving to Ms. Bisaro.

Thank you, Mr. Chair. There’s not much that has been left unsaid for me. Mr. Abernethy covered most of my points but I will speak to them as well because I think the more times they’re mentioned, perhaps the more it reinforces the position.

At the top I want to also indicate my appreciation for the statement made by the Minister in her opening remarks to the change to the date for the implementation of the Supplementary Health Benefits Program. It’s great to have a motion passed on this side of the House that actually is heeded by the other side of the House. We thank you for that. I only hope that the policy, the intent of this change is not predetermined and that everything will be on the table; means testing and all.

There were a couple things that the Minister mentioned in her remarks that I wanted to highlight and one is that we’re developing a framework for children with disabilities and that’s something that I think is very positive. The other thing is that we’re finalizing an NWT Diabetes Strategy. Certainly, diabetes is a condition in the NWT that is almost an epidemic and is one that really needs to be worked with. I’m very glad to see that we’re going to have a strategy that can be put in place and hopefully will reduce the incidence of this particular disease.

A couple of things in terms of a little more specific stuff in the budget. I, too, am concerned about cost overruns at the Stanton Hospital Authority and the Inuvik Hospital Authority. They have been in deficit positions for many years now and I will be asking the Minister what sort of plans are in place to deal with these particular cost overruns. I know the department’s been working on it but I know that Members are looking for something concrete, so I will have questions in that area later on.

I mentioned in my statement the other day that I’m disappointed about the lack of a milk subsidy in the budget. I’m encouraged by the Minister’s comments today that it apparently is still being considered. I think that’s great. The sooner we can get that in place the better. Again, I want to reiterate that I think to depend upon the commercial Power Subsidy Program for businesses is not going to be in place as soon as we can put a milk subsidy in place. It’s something that needs to be...It’s a program we need to have within a few months’ time, not in a year or two years’ time.

I, too, have concerns about the funding agreement that we have with the federal government relative to insured health benefits. I believe that the Minister has previously told Social Programs committee that that’s being worked on and negotiated and I’ll be looking for an update from the Minister on where that’s at.

There is absolutely no way that this government can continue to absorb the cost for the NIHB program if we are not being funded adequately by the federal government. We either have to reduce the services or we have to get more money from the feds, and it’s something which is creating a real drain on our health budget.

I, too, have difficulty with strategic initiative funds being used to pay for, or being identified for, an operations and maintenance cost, and I am referring to the Dementia Centre and the Hay River...I have totally lost the title, but the Hay River.

---Interjection

Thank you. The Supported Living Facility. Both of those facilities have their operations and maintenance budget identified as a strategic initiative and it is hardly, to me, an initiative. We know both of those buildings are being built and are going to be or are currently completed. I think at the time that we start building any facility, we have to put the operations and maintenance funds into the budget as an ongoing expense.

I am little concerned, as mentioned by a couple of other Members, about the age of some of the buildings in some of the communities for seniors facilities and health centres and so on, and I am wondering when committees and/or Members will have an opportunity for input into the capital plan for ’10-11 for this particular department. Members know within their ridings which buildings need to be replaced and certainly have opinions on which buildings should be targeted in the capital plan, and I think an opportunity for input should be provided and I would like to know when that is.

Again, board reform is an issue for me, I don’t feel that this particular model, as laid out, is one that can work at all. There is not much more I can say, except that this model will not work.

The combining of the Department of Health and Social Services and the Department of Education, both of those are two huge areas, very different areas and one will take over the other or the other will take over the one. Housing, I think, is going to be a very poor second cousin at the bottom of the pile and unlikely to survive, in my estimation. So I really feel that the department should be looking at the effects that the board amalgamation will have on the department itself.

It was stated in one of our committee meetings that each department, as part of board amalgamation should be doing their own analysis, their own evaluation. They should be looking after their own needs, so to speak. So the Department of Health and Social Services should be considering this

board reform only in the light of health and social services. Is it going to benefit the department? Is it going to benefit the clients that take advantage of the programs and services that are offered through this particular department? I don’t think that has been done. That is all I have, Mr. Chair. I will have questions for the Minister as we go through the detail.

Thank you, Ms. Bisaro. The honourable Member for Kam Lake, Mr. Ramsay.

Most of the comments I will just go over them. I have heard a lot of what I was going to say from other Members, so I will try to keep this short.

I guess I wanted to start off with thanking the Minister for delaying the supplementary health benefits changes, or proposed changes, until April 1st of next year. That is a welcome sign that the

Minister and the government actually listened to us. I have said to the Minister that I still don’t understand why this policy would go out the door in the state that it went out, and I think, in my mind, somebody has to be held accountable for that bad policy that went out the door that caused so much frustration and anger in some communities here in the Northwest Territories. We had close to 2,300 signatures from NWT residents end up on the floor of the House. It was a mess, and I don’t want to see that happen again, Mr. Chairman. Like I said, somebody has to be accountable for the mess that that was and that that caused, not to mention the amount of work that it caused Members. We are busy enough as it is, other than having to answer to 20 or 30 e-mails a day from residents who are upset about this. So again, I think that somebody has got to be taken to task for that bad policy that came out. They have had five years to work it, so you have to ask the question: what are they doing there at the Department of Health? I know they have other policies they are working on, but I hope they get this one right the next time and I do look forward to seeing that as it goes forward.

The other thing I wanted to mention is on the issue of board reform. I know we went through the business planning process, and not just the Minister of Health but the other Ministers were reluctant or did not want to answer questions pertaining to the provision of services and programs their departments respectively provide, and now that we are in a public setting those questions are going to come again and not just to you, Ms. Minister, but to the other Ministers. Those questions are going to be here. How are you going to protect the programs and services that are being delivered in education, in housing and health? What are you doing as we move through the budget itself? There will be a

number of questions and I would expect that all Ministers would be able to answer for their own departments, not continue to recite the gospel as it pertains to the Cabinet. I do look forward to having that kind of discussion with the Minister when we get to it.

It was mentioned, you know, there are a number of good things in there. The Dementia Facility, that is a good thing; though I agree with the Members that the planning should have been better. It should have been better planned for the O and M money for the Dementia Facility itself. The consolidated clinic is close to being done. I think this time next year it will be open, and that is a step in the right direction as well. Stanton and the Beau-Del definitely need some attention. We start to sound like a broken record, but we can’t continue to allow these deficits to accrue at both of these authorities and not do anything about it, and sit idly by and approve supp after supp or bailouts for the authorities. I know there is a new CEO at Stanton, and I like to think that the department is taking the deficit in the Beau-Del seriously as well. There are a number of concerns. You have heard from Members that represent constituencies in that area, there are a number of large concerns. If you are not delivering the services, why are you still running up these huge deficits? I don’t know; the two just don’t seem to coincide for me, Mr. Chairman.

Also, I wanted to speak in favour of the Milk Subsidy Program and there were 10 Regular Members that threw their support behind that. I think that where there is a will there is a way, and this is definitely an area that the department needs to be focussing in on. You are always asking us for ideas and opinions on what we think can make a difference in people’s lives and I think starting somewhere with something like a milk subsidy, if it is done and implemented the right way, I don’t think it would be too onerous an administrative task to handle. You can make it more trouble than it is worth, but, like I said, I think there is a way to do it justice and do it right. That is something, like Ms. Bisaro was saying, that should take a few months, not a few years, to get to and I certainly would like the department to spend some time on that.

We always need to keep the interest of the people we represent at heart, and I know our health care system, for all its challenges across the North and the vast distances between communities, I know we do what we can and we do a good job at it. I would commend the Minister and the government. It is a challenge, like some other Members have alluded to, and it is a tough position to be in, but we do the best that we can.

We certainly could be looking at doing some more things. I mentioned in the past about services that

presently are done in Edmonton that we could look at repatriating back to the Northwest Territories, if we had the staff and the expertise here in the NWT to do it. I think it is becoming very costly to have people attend hospitals in Edmonton. Wherever possible we should be trying to keep people in the Northwest Territories to receive care. In some cases, that is not possible, but I think there are some areas, and I have talked about the nursery at Stanton as being one of those areas. Women in the Northwest Territories today who have a baby under I think it is 35 weeks have to have that baby in Edmonton. I don’t think there’s any reason why women shouldn’t be able to have their children here in the Northwest Territories from the 32 to 33 week mark on. If we had the staff and the nursery up and running, that would be the case, but, unfortunately, they have to have their children in Edmonton.

I could go on with a few other things, but I think I’ll stop there. I do have questions as we go through the Department of Health’s budget itself, but for the most part I’m pleased with what I see.

Thank you, Mr. Ramsay. Mr. Beaulieu.

My number one issue in health care, Health and Social Services, continues to be seniors’ care. I think seniors tend to be viewed by all the people in the community almost as the unofficial leaders of the community, and one of the things that really have bothered my community of Fort Resolution. I think for the most part the people in Lutselk’e have been able to keep their seniors at home in their last days. But they, too, have had no options in their community once a senior hits a certain level of health and has to be taken outside the community. If there are some seniors that require more than just basic care -- they could get a little basic care from home care people -- then they pretty well have to be removed from the community.

We have situations like that that are not comfortable for the families. It’s difficult for the senior and very difficult if the senior that is taken out of the community for better care into Yellowknife, Hay River, Fort Smith or whatnot has a spouse that is still able to care for themselves and they’re left behind. It’s a real issue.

I think that the community of Fort Resolution has asked the department to try to come up with some sort of a plan. I don’t think it’s a plan that would indicate they would be taking care of people that have dementia or people that have care to do everything, but individuals in the community that still have some ability to care for themselves with assistance and then providing that type of care. I recognize that there is a cost to that, but at the same time there’s a lot of value to the people and in

my riding to have these seniors remain with the family as long as possible.

I’m still looking for a plan from Health and Social Services to address that issue. I’m looking, like I said, in the community forward to having something done. We’ve had discussions on it and at some point I think we’re not really connecting, because what the community wants and what I’m asking for is less than what the full care that individual needs in their last days that can only be provided by certain professionals is what the department feels the community is looking for, but that may not really be the case. In a lot of cases where one of the local people in Lutselk’e indicated to me that I guess the best term he could come up with individuals that used to take care of the elderly in their dying days in their own homes were Dene nurses. He said you should use that term because that’s a term that they used. They never really used that term, but in the aboriginal language they basically referred to them as that, and these people took care of a lot of people back in the day when transportation wasn’t easy and individuals passed away in their homes.

I think that the department should pay a lot of attention to addictions and the prevention of addictions. The addiction prevention and aftercare seem to have much greater value for money than treatment. So I’m looking forward to some of the stuff in the plan for the prevention of the various addictions and what type of aftercare and what type of support the local workers in the communities would have. Sometimes they’re not in the best location for this type of work and so on, but at the same time I recognize that sometimes there’s a long-term commitment for these individuals who are located in the community. It’s a problem for some community members as far as accessing addictions and mental health counselling and so on. Along that line, I think that communities should have some sort of therapeutic aid or something along those lines that I think I may have mentioned previously. Something where individual therapists would come into a community and they see clients in the community, around the community, around the schools and so on. But we really don’t have anybody to assist them, anybody to coordinate their activities, to keep track of what’s happening when they’re not in and out of there on short spurts. That’s something that at least the community of Fort Resolution and also Lutselk’e would benefit from something like that, if the department went and got some sort of aid for these professionals and therapists that come into the community and see people along the way. There’s no real coordinated approach.

I think the department should look at the Child Protection Act. I don’t really know a whole lot about this act at all. In fact, I don’t think I’ve even read the

act. However, I have seen results of what the act unapplied can do. I have a couple of really serious situations, serious cases in Tu Nedhe where individuals who were taken from their communities at a very young age and today these adults are suffering the consequences of actions taken under that act that was designed to protect them and has completely destroyed their lives. If the act is there to protect someone yet at the end of the day completely destroys their life, there must be something wrong. Maybe it’s the application or maybe it’s where the act comes from, how it’s written, and how people have different needs in the community as far as child protection goes, and different views and so on. That’s just an area I think the department should look at.

Board reform. I, along with the Member for Kam Lake, sit on the board reform with Cabinet and we’ve looked at that. Because of our positions in there we’ve had a lot of opportunity to speak to a lot of different boards and so on. It’s not something that is favourable as it is planned out at this point, but there may be some board reform necessary. I think the one thing that definitely has to happen that cannot happen is the amalgamation of the three departments. I think it should be board reform for health, for housing, and for education in three different streams and leave it that way. That would be something that would be more acceptable.

I, too, will put in a plug for the Milk Subsidy Program. I think that’s something that will benefit the small communities where milk is very expensive. In fact, I heard a person from Lutselk’e talking about that and the Healthy Food Program, that they had on this morning on CBC.

Thank you, Mr. Beaulieu. Mr. Menicoche.

As we’re about to deliberate the health budget I just want to reiterate many of the concerns that come from my constituency of Nahendeh. First I’ll just mention that during my Member’s statement I mentioned the nursing station in Wrigley. Myself, the community and all the residents went through great effort to get the RCMP established with a full understanding that once that was in place, the nursing can be reinstated in Wrigley. The safety of the nursing station there was of primary concern. So we went through all this routing and achieved, through much effort and work, getting the RCMP. Now we’re looking at getting the nursing back.

This community is poised to be one of the impacted communities, should there be a pipeline, and working towards that. But right now it’s the community that’s without services and it’s very much needed. It felt very left out by government when it comes to providing professional services.

We do have monthly visits and commitments for health coverage during freeze-up and break-up, which is lasting longer and longer now. It’s averaging just in excess of a month now.

But over the course of time, in my five years as MLA representing Wrigley, occasionally we come across a nurse that’s willing to work in a small community; someone who is ready and willing to be there. But because of the way the budget is structured, they couldn’t put that nurse there at all. People who want to move to small communities...And professionals do exist. They’re willing to commit for long periods of time. I believe we should take those opportunities when they come. Once again, I’ll be raising this issue with the department and doing the budget deliberations here in Committee of the Whole.

I just wanted to speak about some of the other concerns that come from the other communities of Nahendeh. The Minister toured with me in May of last year and she heard many of those concerns. During the monthly visits a lot of the concerns are that if there’s inclement weather or else a visit is missed, they felt that it actually extends the period between their health being taken care of. I’ll just share that with the Minister, as well, and I would just like to ask the department that should there be a missed day, that immediately and as soon as we can to get the doctor back there.

One of the recent concerns from the community of Trout Lake was that it’s a very small community and the community members did not understand why they had to have an appointment when the doctor is there. I can see if the doctor wanted to see certain people, but what is happening is our elders who don’t have a good command of the English language are going to the nursing station, sitting there, wanting to be seen either for their aches and pains, but the staff are saying, well, you didn’t have an appointment, so see you later. Why do I want to book an appointment for next month? It’s today I’m aching. So some of those sensitivities I believe have to be in our system. They’ve got to be there. We’ve got to have the flexibility. I don’t know if timing is an issue, but we have to take that extra hour to see an extra couple individuals, if that’s what it takes. That speaks to us being the caring and attentive providers of the service to our communities and to our people.

Also, there are businesspeople that have a good command of the aboriginal language -- South Slavey in my case -- who are often asked to be escorts for our elders. What’s going on is that they’re putting potential wage-earning opportunities aside and work opportunities to travel with these elders, and they’re coming here with little or no money. I know that we’re providing them space and

providing them food, but it really doesn’t make sense that they have no spending money. They’re here with an elder for three or four days. I don’t know; it’s just not manageable. We need some kind of...I don’t know how we’re going to do it. I don’t think they’re asking for a per diem, but probably something along the line of incidentals to help them out. It doesn’t have to be universal. If we put in some kind of...If we reviewed it and looked at it, if we do it for smaller communities and their people, particularly the community of Fort Liard. There are a couple of individuals that are often the go-to people to travel with the elders. They have many elders and so that happens quite a bit. They’re often asked to assist and, being good-hearted, they do. But at the same time they’re in Yellowknife for four or five days with little or no money at all. We don’t want to lose their goodwill or their service, too. I believe that somehow we should support them while they provide this valuable service to us, because they are providing translation services.

Our translators in our health centres I believe should be adequately supported and offered continued training so that they can update their skills and learn medical terminologies that will be beneficial to them in their jobs. This also helps create, as well, a little bit of a business for people that can provide aboriginal language services. So with those translators I believe they have to be supported only because people continue to be concerned about misdiagnosis, because our elders are going there and they’re going there for probably serious things, but once again they’re continuing to be given aspirin. I don’t know if they’re wrongly diagnosed or misdiagnosed, but real or imagined I believe it’s a concern of our people and our constituents and that this must be treated seriously. Our people deserve the best care.

When someone comes in I believe they should be checked over properly and not to be put off until the next day, because everybody has busy lives and if they miss a scheduled visit, then chances are they won’t come back. The reason they’re going to the health centres during that day and during that specific time is because they are concerned about their health, and to be dismissed is not a good feeling at all. Or else to be given a bottle of aspirin or something is just not...Once again, our health centre is not being viewed as caring for the people.

Mind you, I do have to give a pat on the back, too, that we’re doing our best at those times. But like I said, it’s largely our non-English speaking aboriginals who don’t have a good command of the English language are the ones being affected the most. It goes through everything. Even glasses. I always say that. Our elders always concur. They always say “eh-heh,” which means yes. Sometimes I believe that because of their nature, when they

even do an eye test, it kind of skews the way the person is doing the exam. When they get their glasses, they are largely non- confrontational, our seniors and if the prescription is too strong or too weak, they are not going to say anything. They just move closer to the TV or something like that. But it is up to us. We are the providers. I believe we should take the time and the opportunity to provide the best services there are. I think one of the ways that we can do that is...and I have always been a strong provider of cross-cultural training and I believe that should be continued. I know that we do it. I don’t know how often we do it, but I would stress to the Minister that something should be on an annual basis. It doesn’t mean that the same people have to be taking the same courses, but I do know that their staff turnover will largely benefit from cross-cultural training when they are working in the small communities and the aboriginal communities. It will benefit not only them but the people we do serve. This is one small way. If we continue that, I believe it will help improve our services. Thank you, Mr. Chairman. I have no further comments.

Thank you, Mr. Menicoche. Mr. Yakeleya.

The comments by other Members, what I heard today, are somewhat on the same line as my comments, so I’m not going to go too far into having similar types of comments here.

I would thank the Minister for putting together a very difficult budget and plan for the Northwest Territories. Certainly there are so many needs out there that sometimes we would want more for our regions because of the services that we see when we go to different parts of the Northwest Territories. Sometimes I would get into thinking, why not have that in the Sahtu region or that type of service in the Sahtu region. Mr. Chair, only once I started to understand the processes, the expenditures and the amount of services that are going to each of the regions I started to realize some of our services that we desperately want to see in the Sahtu, I think that will come into play in time.

I think the issue here is how to implement the dollars that you do have available for the Sahtu region in terms of implementing it in a way that makes sense to us in the Sahtu amongst our people in terms of how to take care of the elderly that want to stay home, that could be staying home. But sometimes medical services just because, or because the patient needs 24-hour care, that patient should be sent to Inuvik, Yellowknife or Behchoko where they have that type of service. Is it possible with this department to say, can we do something in the native ground that we would like to keep our elderly people home?

There are 3,650 seniors over 60 in the Northwest Territories. In the Sahtu, there are 241 who are 60 years and over. Is it possible in some way that we can provide some of our services with the existing funding that we have and propose to have in our region working with our health board to keep our seniors home as much as possible? I understand there is no type of facility right now. I haven’t seen any type of plans or indication of looking at a facility like the Aven Manor centre or the Behchoko Elders’ Facility in the plans for our region.

I am looking at creative ways that the department can look at how we keep our seniors home, with improving care, training, hiring on additional workers to have people in the communities. I am looking at places like the Aven Manor centre where we have people from our region in that centre. Certainly Aven Manor has done a good job in terms of providing care for them, but the elders that I spoke to, elders who have lived there and have gone on, their only wish was, it would be nice to have a place like this in the Sahtu. The late Paul Baton said that to me. We could have a place like this in the Sahtu. That is something I look forward to this department, to see if they can become creative and do what they can.

Mr. Chair, the hospitals and facilities review report came out. Another report came out. Again I am going to be questioning the Minister as to recommendations of the report and get feedback she’s gotten and what kind of consultation has happened in terms of the facilities and hospitals review.

Certainly I am going to still continue advocating that the Sahtu certainly would like to see a regional wellness health centre in our region. There are a lot of arguments for it. I will probably get good rationale why it is not happening from the department, but I would like to see somewhere that we do some serious planning, as other facilities have seen upgrades and renovations and new facilities are on the books to happen in Yellowknife or any other centres.

I was in the last government where I supported the Dementia Centre because there was a real need in the Northwest Territories. The department, previous colleagues talked about the need for a dementia centre and I agreed with them. I think that because the space that we have in the hospital here is filled we need a place in the Northwest Territories to have special care for these special people. I ask no more or no less for the Sahtu people in terms of having a regional wellness centre in our region. I won’t go further into details to why we need one in our region, but I am going to continue pushing for the Minister to go to bat for us at the Cabinet table to capital infrastructures with the senior

management to see if you can put something in the books for us. I know it takes a long time to get things on paper in the book, but I am asking. I am not too sure how to go, but I want to ask that from the Minister.

There are many other issues there that, Mr. Chair, I think the Minister needs our support in terms of working with the federal government on funding by the non-insured health benefits. I know our government through different discussions are having their struggles and their challenges dealing with the federal government in terms of money owed to us. I think, and I hope, that the Minister can come forward. How do we deal with this deficit that we have with the Department of Indian and Northern Affairs on the billing issue? Shame on them for trying to offload those on our department and our government. I look forward to if the Minister is ever going to come forward with the discussion paper, a paper maybe from her colleagues and the Cabinet, saying that this is how we are going to deal with the federal government issue, because we can no longer continue to carry a disputed number because that’s affecting us in our communities. That’s something that I look forward to from this Minister. In terms of her leadership, how do we deal with the federal government? Do we need to get the chiefs on side? Do we need to organize with the other aboriginal governments? I look forward to those and seeing if anything comes about in terms of how we resolve that.

Mr. Chair, the one issue that I would like to commend the Minister on is that she’s implemented some programs that I agree with in terms of how it’s going to impact our people in the Sahtu and the Northwest Territories. I think the Minister needs to look at how we support our small communities and health centres, upgrading our health centres, helping our aboriginal CHRs -- most of them are in my small communities -- in terms of the proper medical training. I’d like to see Colville Lake become a health centre. Right now it’s a health station. I’d like to see Colville Lake become a health centre and have more people in that community get some proper training, as we do with any other medical field in the Northwest Territories. I hope to see that Colville Lake gets some attention in terms of becoming a health centre, rather than just being labelled a health station.

I have some more questions for the Minister, but overall I’m pleased with what she’s doing. I think there’s room for some good discussions. Thank you.

Thank you, Mr. Yakeleya. Mr. Bromley.

I’d like to respond to the Minister’s remarks here with some general

comments and I’d like to start by just saying I greatly welcome her announcement regarding the supplementary health benefits. As all of us in the House, I think this has been the hottest item that I’ve received feedback from constituents on and the response that the Minister has offered is totally appropriate and very welcome. I’m looking forward to participating in that process.

Reference is made to maximizing efficient use of our health care providers in a way that is congruent with our small population size. I’ll look forward to hearing further what that means. I welcomed the Finance Minister’s statement on strengthening prevention programs and that they will be a major focus of our work. The Minister of Health made reference to that. I totally support that approach. Of course, one brief word on the milk subsidy, that would be appropriate there, but there are many good programs that we can see happening. I am also intrigued with the Minister’s action plan on reforming the way we deliver health and social services in the Northwest Territories and the opportunity to discuss this with the Standing Committee on Social Programs. It sounds like an intriguing document. I’m wondering if the program review office was involved at all or whether this is within the context of board reform and so on. Regardless, I think a community approach, community involvement, a community perspective in delivering programs is going to be key. I’ll look to that. I think the comments we heard from my colleague, Mr. Menicoche, are relevant there.

Again, I’m just highlighting a few things that I’m happy to see and anxious to get more details. The mental health and addictions issues we’ve heard about before. Social marketing, resiliency programming and life skills programming -- very glad to see that. I’m assuming they’re going ahead. I see they’re developed, but no statement has been made about putting those programs in place. I am assuming that that’s going ahead.

We’ve heard about how our seniors will continue to build and become a significantly large proportion of our population, so some attention to them is clearly needed; some increasing attention. I think there’s some indication that this is happening here. The programs that are being implemented now, the Hay River Supported Living Campus and so on are, I think, already proving to be of interest to our people.

Just wanted to mention that phase two of the program on family violence, Framework for Action, I’m very happy to see the funds dedicated to that program.

The new annual water quality report, again, I will be welcoming. I’d like to see what that might be covering. Is there federal involvement in that? I

know there are other departments likely to be involved in that. I think the Minister indicated that. Further details to be discussed there.

Chronic disease management, Diabetes Strategy...Again, is this our first strategy? I wonder. We definitely need one and we need to get it implemented. We are following the predicted increase, I understand, in the incidence and potential for diabetes. I know there was a decision to cut a dedicated person in Inuvik last year with, apparently, the understanding that existing positions could take on that work. Anyway, I will be very much looking forward to the details of that strategy and seeing that gets in place.

Again, cancer screening was highlighted and, yes, as the leading cause of our mortality, there are some really good screening programs, I know, happening now on that. We’ve learned a lot over time. That, combined with milk to prevent cancer, of course, vitamin D, and so has some opportunities for some synergy.

Sexually transmitted infections have got a lot of press lately. Not a lot of cases involved but the trend is obviously of concern. I think some resources in that direction are wise.

The community-based addiction aftercare services, again that’s something we’ve been talking about for a while and I’m happy to see some resources dedicated to that, and particularly to the extent that they can include the on-the-land treatment and healing camp approach. I think that for a lot of our people that’s a real opportunity for some holistic healing that can be substantive and get at the underlying issues.

A number of people have mentioned the added focus needed on small communities getting our stations staffed up. That’s been highlighted since this Assembly began and I have to say that that’s something I’d really like to see focused on and some solutions in place.

Some of the funding issues, I also support those comments. We’ve talked about the rate of increase in costs and so on and the federal role and failure to come to the table on some of those issues. That needs to continue to be a focus and hopefully get some resolution happening there.

Finally, I just want to mention the recreational position that was cut to half-time last year. That’s still proving to be a trial for people working at Stanton and it’s a key position in terms of focusing the efforts on recreation, an important part of healing in the hospital and for bringing other volunteers, effective and dedicated volunteers, to the table. I’m hoping with the efficiencies we’ve seen here we might be able to bump that back up

at some point soon here to a full-time position in response to those pleas for help.

Not to belabour many of the things that have been mentioned already, I think I’ll leave it at that, Mr. Chair, and look forward to the detail. Thank you.

Thank you, Mr. Bromley. Mr. Jacobson.

All of my colleagues brought up a lot of good points. From our small communities we do have major problems with our health, with our doctor visits. It’s good to see in the opening comments, Ms. Minister, with the electronic health record or diagnostic imaging going into all four of my communities, which we really need. We’re having to remove people from the community to go get an X-ray.

Again, getting back to the doctors’ visits, the elders in my communities are being sent out to see the doctor and if they’re ill enough, they have to stay in the hospital. The last couple of weeks I had an elder pass away from pneumonia -- sent home too early. Trying to deal with that with the family members is really tough. In our small communities our elders never see a doctor sometimes for two or three months, if not longer. The health system in our ridings -- myself, Mr. Krutko -- is not up to par with Yellowknife where if you want to see a doctor, you make an appointment and you see him in the next couple of days. If it’s an emergency, you’ll get to see him within a couple hours. Back home, the nursing station will give you Tylenol and send you home. That’s not right.

Over the next couple of weeks I’m going to be bringing forward our elders facility in Ulukhaktok. I’m going to bring a motion into the House. My elders in Ulukhaktok want to take care of our own and we want to bring our elders home instead of having to send them to long-term care in Inuvik or Aklavik; both good facilities but they want to be close to the community and their families. A lot of little problems we’ve been having are elders with arthritis and stuff like that. I have an elder in Tuktoyaktuk who’s been having a lot of problems trying to get treatment, wanting to drive to Inuvik himself. Just the way he’s been treated in the community health centre, it’s not right. I really think this should be looked into.

In our community of Paulatuk, in our community visits, myself and the Minister heard many issues in regard to mental health workers, psychiatrist to be brought into the community, which we really need. The community said that loud and clear on our visit, so I hope something is being done with that.

The cancer screening, in my riding it’s either too late or you’re trying to prevent and -- how can I say

-- basically if you’re diagnosed with cancer in my riding, it’s just like getting a death penalty. You can prevent the cancer in regard to the treatment that...There is no treatment. I mean, it’s too late. You can’t catch it at the start. You’re really lucky if you do. The screening for cancer, there’s none. How many people could we have saved since I’ve been an MLA down here? How many people died with cancer in our communities? Something’s got to be done with that. I really hope that the Minister is willing to get more doctors, more locums or whoever, just to provide the service that’s required in the smaller communities, because we’re treated like second-class citizens sometimes in the smaller communities of Paulatuk and Sachs. Having to be sent out, it’s not right.

Just to close up, on the board reform, it’s not a good thing. I’m not going to be supporting that supplementary health. You might as well just get rid of it because we’re just wasting our time on it. April 1st isn’t go to go anyway. I’m not supportive of that.

Again, thanks for your time.

Thank you, Mr. Jacobson. As that was the last Member on my list, we’ll go to Minister Lee to respond to Members’ comments. Minister Lee.

Thank you, Mr. Chairman. There were a lot of issues that had been brought up. I think most Members have indicated that they will be asking more specific questions as we go through the review. I will try, Mr. Chairman, to just highlight some of the more commonly raised issues, if I may.

With respect to the review of the changes on the supplementary health, I just want to state again that I will be coming forward to the Standing Committee on Social Programs with a timeline and outline and some of the framework for the review. I expect that we will do that when this session is over, if that’s okay. The officials are working on that so that we can have a document starting point and to get the input from the standing committee, and then after that we can move forward with public consultation and more of a back and forth information exchange. I think the past two months have shown that not only we hear from the public, but then there’s information the public will benefit from having as well. I look forward to that situation in that work.

With respect to deficits in our authorities, I just wanted to advise the Members that our health authorities are doing much better this year financially than last year. They are doing much better even than the last detailed report we had back in the second quarter. We are approaching...I think we just got the third quarter results back. All the authorities were asked to balance their budget this year and they had to take on some mitigation

measures, and that recreational therapy position is one of the examples. Last year our accumulated deficit system wide was about $9 million; that’s taking on all the deficits minus surplus. This year we are looking at about $700,000 deficit as a system. Stanton is looking at about $2.2 million deficit this year and the Beaufort-Delta is looking at $91,000 in deficit. Those are projections. We don’t know what’s going to happen at the end of March right down to the penny, but I think it demonstrates that some of the mitigation measures have worked. It hasn’t been without difficulties, because in the health system we need every position and every program. But I think by the hard work that the authorities and their officials have done, we’ve been able to balance and get better numbers doing some hard work but not seriously affecting negatively the programs that we do offer.

Another issue that I would like to speak on is with respect to...(inaudible)...funding renewal. I just want to advise the Members that the Minister of Health from Nunavut, and the Yukon and myself met with Minister Aglukkaq at the beginning of the month, in January, and we had a very good, lengthy meeting, much to the chagrin of all the staff there. We had a very nice northern Ministers’ meeting for about an hour and a half and it was nice to speak to a Health Minister who knew a lot not only about the North, but exactly how...(inaudible)...funding renewal works. We understand that she has to work through the challenges within the federal system, but we are working closely to see how she can help us with renewing that funding; because I think we all understand how crucial that is. It’s about $10 million funding to our budget and we need every dollar and every funding program. We will continue to work on that.

With respect to the programs for small communities on the issue of capital projects and facilities and health care and other facilities, capital projects will be reviewed during the capital planning process. I look forward to having more discussions on that. On providing nursing services and additional services in small communities, the Minister’s action plan, that I hope to come to defend in the Standing Committee on Social Programs, will address that question and others. Because I have learned in my role as the Minister of Health and Social Services that the template that we are following is the ISDM, model, which works well and has worked well for many number of years. But what I am trying to do with the Minister’s action plan is to sort of make a super ISDM- plus, because there is some lack of flexibility in the ISDM in that it states very clearly that for a community of certain size you can have a certain level of staffing. I think that there is not enough flexibility there and I want to build in special needs for some of the communities. Obviously the issues about nursing coverage in Wrigley and

Tsiigehtchic are the most often heard and that is the kind of thing that I want to discuss with the Standing Committee on Social Programs. It is a plan as we move forward. It is a plan about how we could look at our health and social services system differently. It is a completely new action plan that we, the department and myself, have worked on for the last eight weeks. It is not directly related to the board reform work, but I think it is an opportunity to discuss some of these issues. We work to plan for the next business plan cycle.

Tl'oondih Healing Society, I am happy to advise the Members that we have an agreement. I have been working with the Beaufort-Delta authority on this for many months now. The Beaufort-Delta Health and Social Services Authority is willing to work with the community and provide the funding to the community, the council of Fort McPherson, directly, where they could hire their own person to provide a counselling service so that they don’t have to have somebody coming from Inuvik and that there would be some flexibility on the programs they can provide There are so many issues here at Stanton.

On the billing issues with Nunavut, we are working on finalizing an agreement with Nunavut where we will have…I learned when I came into this office that there was not a formal agreement on how Nunavut will pay us for the services we provide and how much each service is worth; not all of it anyway. We have an agreement on that where we are expecting to finalize that. We also have had to agree that some of the outstanding amount could not be collected, so we may have to write that off.

The Stanton Territorial Health Authority has gone through some changes in management, but I think they are very stable now. Everybody is staffed. They have a new CEO there. I have not had a chance to get a direct report from the acting PA, who is sitting next to me, with Stanton, because the new CEO there just started about eight weeks ago. I look forward to listening and getting a report from her about some of the things that she wants to do for the Stanton authority and I think her expertise and experience could help us in working through the system.

I just want to…There are so many notes here. I am going to have to just wait until I get all these questions asked back and I will answer those questions. Thank you, Mr. Chairman.

Thank you, Minister Lee. I have nobody else on my list. Does the committee agree that there are no further general comments?

Does the committee agree that we proceed to detail?