I do appreciate what the Member is saying. The jobs or the positions or the people that are in our communities do serve in two different areas. Economically those are jobs and they have those jobs and those are important to them. Then in terms of care, it is so much more preferable for our people to be taken care of on our own. So I agree with the Member that there is room in our health care system, health and wellness, where we train and we have people in communities to take care of those who need assistance. Largely those are usually elders or they could be people with chronic conditions, they could be young people. We are having people with disabilities in small communities that need to be supported. So

going forward, looking down 20, 30 years from now Canada-wide and in the NWT, not an exception, we need to have our people taking care of our people. That happens as home care support workers, wellness workers, those actually probably would have better economic return.

Our occupancy rate then, what we think of typically from a more acute care setting, because we still don’t have a lot of registered nurses or some of the other care members, they’re usually locums or fly-in staff. I mean, even communities the size of Fort Good Hope, Tulita, Lutselk’e, already we have a lot of nurses that are not locally from there, but I think our planning going forward could have a result that goes hand in hand of providing quality care on one side to our residents who need it and then care providers being from the communities. That’s possible under our long-term care model that we have developed. Thank you.

I believe that you have to look at the economics of the Northwest Territories and see exactly the have and have-not communities. I think one thing that you can clearly illustrate in those statistics or information that’s out there, I think most of our communities we have employment that ranges from 12 to 13 percent of people that make a pretty decent income, and you know who those 12 to 13 percent are. Those are professional providers in our communities. It’s either the nurses, the teachers or the RCMP. That’s the makeup of the 10 or 13 percent of those jobs in our communities.

Now, you have 45 to 55 percent unemployment with people making under $30,000 a year, which is almost 50 percent of your population. Something tells you there’s something wrong with that picture. When you have the large regional centres where you have almost 50 percent of your population making over $100,000 a year, there’s something telling you that this government is stimulating those economies.

Government is an industry, government provides that basic service model as so-called jobs, and for ourselves in our communities that is what we’d like to see this government really focusing on.

I know that you’re going to talk about national standards and everything else, but my view is the Northwest Territories is unique, it’s different, we have regional centres throughout the Northwest Territories, we have cultural distribution of different cultures throughout the Northwest Territories, we have geographical challenges. So I think that we have to be realistic when we do these things.

I do not support the direction this government is going. I strongly feel that you have to really be, when we’re making these capital decisions, what are the social impacts on the rest of the Northwest Territories when we make the decision to establish a long-term care facility, take it out of a small community, and make sure to realize that is going

to have a long-term economic impact throughout the Northwest Territories, just not in those communities that are affected.

I’d like to ask the Minister, I know you mean well when you say you’re looking at home care workers, but those jobs don’t really pay as good as someone who is a caretaker in a long-term care facility or someone who is trained up to ensure you have a community health nurse on staff or the resources to assist those people. I’d like to ask the Minister why this government has not seriously contemplated the previous decisions of this government by looking at the demographic and population needs throughout the Northwest Territories and focus more on the need than the government continuing to grow at the regional centres and forgetting about the rest of the Northwest Territories.

For many, many years now we have not had a long-term care facility in small communities funded. There were long-term care facilities built by the Housing Corporation and I do support what Member Beaulieu said, for example, that we need to work to make those rooms available to our elderly and other people who need those rooms in our communities as assisted living facility, which is what it was meant to do. So I don’t think there’s much change in what we are doing, what we have been doing in the Territories for the last 10 years.

What is different with the recent work that we have done is that the Department of Health, along with DPW, have done a long-term care planning, and the deputy minister can go into more detail on that.

I do understand that the NWT is different and unique and we need to do everything we can to support our local people to take on some of those jobs. We would like to do that. But we need to balance that with the risks and the other factors that we need to adhere to. It’s not something we have an option on. What we need to do is make sure that we can do a lot more to provide support and strengthen our system and resources in small communities so that our people take on those jobs to take care of our own local people, because the demands are just going to get more severe 10, 20, 30 years from now. We need to plan and we need to work harder to build the local resources. They don’t necessarily have to be a 24/7 long-term care facility. We need to do things differently to support our elderly and people who need our care.

Thank you, Ms. Lee. Next on my list I have Mr. Ramsay.

Thank you, Mr. Chairman. Just getting back to the discussion we had earlier on whether or not either one of the Fort Smith or Hay River centres is going to be deemed to be the regional centre. It was a bit confusing for me. Are there not requirements like staffing and programming levels in a community that would

suggest you spend $28 million there? If that is the case, maybe the Minister has stats or figures on what the staffing level is at the facility in Hay River and the one at Fort Smith.

Thank you, Mr. Ramsay. Ms. Lee.

Thank you, Mr. Chairman. The part of planning study would have included the programs that would be offered in these facilities and planning on what the staffing makeup would be. I’d ask the DM to give more information on that.

Ms. Meade.

That’s nice and that’s good to hear, but I’m just again trying to understand. Okay, so currently how many registered nurses and resident doctors are there in Fort Smith and in Hay River? Does the Minister have that information?

Thank you, Mr. Ramsey. Minister Lee.

Thank you, Mr. Chairman. I don’t have that number handy. I think Smith is budgeted for five doctors.

Yes, I don’t think we have the exact numbers of nursing positions there, but we could get back to the Member on that.

Thank you, Minister. Mr. Ramsay.

I want to relate this back to us spending millions and millions of capital dollars. Is it the department’s intention, if we are going to build up these facilities in close proximity to each other, are we going to have a resident doctor or doctors in Fort Smith and Hay River? Is that the intended purposes here? If that’s not the case, then maybe we need to rethink some things here.

Ms. Meade.

I guess that’s my point, is that if you are building up the health care infrastructure in communities like Fort Smith and Hay River, we had better have the horsepower or the manpower to back up the programs and services that residents in those communities are going to be deserving. It doesn’t make a lot of sense to spend $28 million on a facility that you can’t staff and you can’t have programs in. That’s my fear. If the Minister’s confident that spending this money on the facility in Fort Smith is the right thing to do, to me it’s still, I’m not 100 percent sold on this. They’re too close to each other and I don’t understand how they could both serve as Level C communities within an hour and a half by highway. That’s something I’d like the Minister to respond to, whether she’s confident that those two communities we’re going to be able to get staff in there that are going to have programs and take the pressure off Stanton here in Yellowknife.

Ms. Lee.

I see the Member’s points, especially when we’re talking about the overall financial pressure on our system. The fact is that I think we only have three resident doctors outside of Yellowknife in the NWT. We don’t know that it’s going to get better in terms of being able to recruit and retain physicians in communities outside of Yellowknife. Yellowknife has been highly successful in recruiting and retaining doctors.

Now, what we need to do, and the things that we are grappling with in the Department of Health and Social Services is that we need to have a system-wide plan on how we are going to provide services to our residents. What we are building is a facility where likely, probably visiting physicians, mobile teams, nurse practitioners, or any other specialist services can move into any of the B-C level facilities and provide care to our residents so that it will reduce the need for medical travel, will reduce the workload at Stanton so that Stanton can do what it should be doing, that people feel confident that when they go to Hay River or Smith or Simpson or Norman Wells that in combination with technology and the visiting professionals that the service they get there is good, that they can rely on that. This is what we need to build for the future.

I know $28 million seems like a lot of money, but when you’re planning a 20- or 30-year facility, I don’t believe that’s too enormous. The fact is our people expect to be able to get services at least at the regional level and if we have any hope of having a territorial-wide system and avoid everything being done at Stanton, we do need to build some support. Not that I don’t think things should be done at Stanton, but we need to have a hierarchy, so to speak, of health facilities so that we specialize and decentralize at the same time wherever possible. With technology we can do that. With modernization we can do that. In future I see our facilities and programs being delivered in a very multi-faceted and multi-sided way and that’s the future of health care delivery.

Thank you, Ms. Lee. Thank you, Mr. Ramsay. Next on my list I have Mr. Abernethy.

I just want to follow up on some of the questions my colleague Mr. Ramsay was asking. It got a little confusing for me, but to sort of put it into perspective, I was wondering if the Minister could tell me what a Level A health and social services station is responsible for.

Thank you, Mr. Abernethy. Ms. Meade.