Moving on to page 8-23, activity summary, health services programs. Mr. Hawkins.

Thank you, Mr. Chairman. Mr. Chairman, under the health services programs and certainly under the centre area specifically, I would like to know of any updates that the Minister can provide regarding the downtown clinic and, of course, the Dementia Centre, finding out where they are on schedule dates of openings and things like that. Thank you.

Thank you, Minister Hawkins. Minister Lee.

Thank you, Mr. Chairman. As far as I know and the latest information I have as late as last week is that the Territorial Dementia Centre is on time and on budget. It projects to open in November of 2009 or finish construction in 2009 and start staffing. The downtown consolidated clinic is on time and on budget as well. I think right now they are designing the space for the area and there should be more public announcements on how that is going to look. Thank you.

Thanks for that answer. What does on time mean in the context of when will the downtown clinic open or I should say it this way: when it is scheduled to open? Thank you.

I believe the tender went out to design the space last fall. They should be doing renovation work this spring and summer. The consolidated clinic is supposed to open in the spring of 2010. Thank you.

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

Mr. Chairman, my questions are in regards to the NWT health centres. It talks about the first contact care through the system of health care centres located throughout the Northwest Territories. Again it comes back to the question of a lot of money that we spend on these centres but yet we are not fully recruiting or staffing up these facilities. I would like to ask the Minister, does she know how many of these health centres are not fully functional by way of having nurses and that in those health centres throughout the Northwest Territories?

Thank you, Mr, Krutko. Minister Lee.

Mr. Chairman, all of our health centres, stations and health cabinets have health and social services staff working in them. In any given time there are vacancies, and not all facilities have doctors or nurses but they all provide some level of service. Thank you.

I don’t think the Minister got the question. How many of them have functional centres by way of nurses and doctors in those health centres? Tsiigehtchic does not have a nurse in the health centre. You have a health centre, yes, but how many of them have professional people providing health care services in those communities and not just saying that, well, you have the community health nurse. That is different than actually having a nurse or a doctor in that community. We are spending a lot of money in the area of medevacs in our communities. In Tsiigehtchic alone, 151 cases cost $105,000. Is that because they don’t have a nurse that they have to leave the community which is a medical medevac cost? In regards to the community, you have some...

For me, it is just a question of the cost that this government is spending in those different areas. I would like to ask again. I know Wrigley is in the same boat as Tsiigehtchic. Colville Lake is in the same boat, so are the smaller communities that don’t have those services, but in here you make the statement that this program is to provide a system of health care centres located throughout the Northwest Territories to be the first contact for those residents. I would like to know how many of them are fully staffed like any other health centre in the Territories and not give us a list of the ones that aren’t.

The statement is simply saying that our residents come through primary care services as a first contact. The first contact could be with a doctor, a nurse, or hopefully not

with the doctor because you pay them a lot more than other health care professionals. A nurse or a community health rep or whoever is in that front line service.

I understand the Member’s question. I don’t have a profile of what each health centre or health station or hospital has. I would have to undertake to get that for the Member. Also, Mr. Chairman, I don’t think we could say that where there is no nurse, you get more medevacs, because a case can be made that when there is a nurse there are more medevacs too. Sometimes a new nurse going into a small community would rather choose to send people for further diagnoses and treatment than if there was no nurse there. We know of anecdotal situations where that does happen. You get a new doctor into a facility; sometimes they refer more cases. I am simply saying that we can’t say that a lack of a nurse or doctor…It is just not a straightforward calculation. But I would be happy to undertake to provide the Member with the human resource staffing we have in each of the facilities. Thank you.

Mr. Chairman, the Minister knows from her trip to Tsiigehtchic that without a nurse in the community, there is no service. People are having to physically find their own way to Inuvik to deal with the medical attention. Those people are not even part of this survey. To tell me that, well, because you don’t have a nurse in the community means there are less medevacs or less people going to the hospital. If anything, there are more people going to the Inuvik Hospital on their own paying out of their own pocket to get the services they require. You have heard it yourself in the meeting in Tsiigehtchic. Even the former chief told you himself the incident he had where he fell off the roof and basically had to pay his own way down to Inuvik. He was hurt and whatnot, and yet he made his way to the hospital in Inuvik. He called Fort McPherson. Nobody came. He called to see if there was a shuttle. He had to pay his own way to Inuvik by taxi, which was $300. For you to say that, because you don’t have a nurse in the community, that means there are less medevacs. If anything, you’d think that without having services there, you won’t have that. With that, I would just like to ask the Minister, just on what you stated, are there actually analyses that state what you said to be true?

Mr. Chairman, just for the record, I did not say that if there is no nurse, there is less medical travel or medevacs or if there is a nurse there is more. I am saying there is not necessarily a direct correlation.

Now, Mr. Chairman, I understand -- and I don’t know how many times I could say this -- the Member’s concern about lack of permanent nurses

in Tsiigehtchic. It doesn’t mean that Tsiigehtchic is not getting health care service. I understand the Member feels it is inadequate. I am not going to debate that, but Tsiigehtchic does get nursing coverage. They do not have a permanent nurse there. I understand that. But Beaufort-Delta sends a nurse to the community. They get nursing coverage I believe two or three days a week. I understand the Member is saying it is not adequate, but it is not correct to say that Tsiigehtchic does not have health care services because they do have a homecare support worker. They have a community health rep and they do have a visiting nurse. I am not saying that there is no need for more there, but it is not correct to say they don’t have a health care service. Thank you.

Thank you, Mr. Chairman. Can the Minister give us a breakdown in regards to the NWT health centres for $27.456 million so we could see where those expenditures are made? Thank you.

We have only a breakdown for the authorities.

Mr. Chair, in regards to the funding that does go to the health authorities, the reason they get the money is to provide permanent care in regards to health care facilities throughout the Northwest Territories. The money that they get is not for their little caddy but it is for communities to run health centres. You should have a breakdown of what they’re doing with that money that they get to basically operate and maintain health centres in our communities. Do you have a breakdown of that? If not, maybe get your department to pull that together.

Mr. Chairman, I believe we provided the Member with that last September. I will be happy to provide that again.

Mr. Chairman, we do have health authorities in the Territories and they are block funded. The authorities do have the flexibility on how they move their money around to provide the services. Also, the Member knows, and I’ll repeat this again, and the Member knows this from having been here, on their ISDM model, a community of Tsiigehtchic does not necessarily get a nurse. I have said to the Member that as a new Minister I am willing to revisit

that. I’ve said this I think at least 12 times in the last week. Thank you.

Thank you for that, Mr. Chair. In regard to your ISDM model, I think that you definitely have to admit that it just does not work for small communities. I think that to make the comment that while health care service is not guaranteed, if anything, all we have to do is provide the service. By providing a service, sending a health nurse in once a month or a mental health worker into the community once a month and a doctor, if you’re lucky, once a month, is not health care services. I mean, you pull that off here in Yellowknife, basically you’ll have a riot on your hands. Yet, you expect people in small communities to have to put up with that. I would like to ask the Minister how soon will the review be done in regard to the ISDM so that we can allow some flexibility for small communities.

Thank you, Mr. Chairman. I’ve written to the chairperson of the Standing Committee on Social Programs last week asking for a time with the standing committee to have a briefing on the Minister’s action plan. Thank you.

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

Mr. Chair, I’m wondering if the Stanton Territorial Hospital emergency has bumped up its security. That was raised last year as a concern and I think the long-term is for the primary care clinic, which I think is to be ready a year and a half or so from now, will relieve some of the pressure on the emergency ward. But I’m wondering if, in the meantime, we’ve bumped up security there to meet the serious concern expressed by both the staff and the community. Thank you.