It’s my understanding that Level A is a health station with no nurse. It’s my understanding that a Level B is a community health centre, which does have nurses but is more specific to providing services in that community. It’s my understanding that a Level B-C facility is a regional health and social services centre, which does have regional outreach responsibility to Level A and B communities. It’s my understanding that a Level C is also a regional health and social services centre but with a greater degree of diagnostic capabilities and some additional services, which is, I think, the point that my colleague Mr. Ramsay was trying to get at, is when you look at a map, you’ve got only two Level C facilities in the Northwest Territories and they’re both in the South Slave. In fact, they’re right next door to each other. If you think about regional outreach, which is what I understand a Level C is supposed to have, clearly Hay River is going to get outreach from Fort Res and Hay River Reserve and Enterprise and Kakisa, but I’m not sure what regional outreach Fort Smith is going to get. So we spent all this money renovating and fixing this facility in Fort Smith, adding some additional capacity, and I’m hearing you talk about additional capacity, but by the definition provided by the department, it must have regional outreach to be a Level C facility. So if there’s no regional responsibility for this particular health centre, I’m curious why we have two Level C facilities.

I hear the deputy minister saying, oh, well, we’re going to add all these services. Who are the clients? Where are the clients coming from? Are they coming from all over the Northwest Territories? Is this going to be a place where we can bring people from anywhere in the Northwest Territories to? Can we bring somebody from Fort Res here? Can we bring somebody from Deline here? Can we bring somebody from Paulatuk here for the services that are apparently being expanded in Fort Smith? How do we justify two Level C facilities right next door to each other? That’s, I think, the point that my colleague Mr. Ramsay was trying to get at, and I didn’t really hear an answer as to the justification for two Level C facilities next door to each other.

Thank you, Mr. Abernethy. Ms. Meade.

For clarity, the answer is yes, we’re going to be bringing people from any community and every community in the Northwest Territories to Fort Smith and Hay River as the need exists and as programs are available. I think it’s a simple yes or no answer. These two facilities are going to be used for everywhere in the Northwest Territories. Is that right? Yes or no. No explanations. Yes or no works for me.

Thank you. Next I have Mrs. Groenewegen.

Thank you. I wasn’t going to speak to this, but I need to jump in here.

I understand the rationale of the questioning of my colleagues; however, Fort Smith and Hay River, first of all, are not right next door to each other. They may both be in the South Slave, but we’re really stretching it to say an hour and a half. You’d have to be driving about 150 miles an hour to get there in an hour and a half.

As far as being back up or taking pressure off of Stanton, it’s a flight of about 30 minutes to get between Hay River and Yellowknife and it’s probably a flight of about 50 minutes between Fort Smith and Yellowknife, so I suppose you could make an argument for all three hospitals would kind of be right next door to each other. Most people who are seeking medical attention are not probably driving. Most of the people who come to Yellowknife, for example, for medical attention are flying over here and it’s about a half-hour flight.

As to the order in which and the magnitude of the capital projects that are on the books for Fort Smith and Hay River, these two projects were, for lack of a better way of saying it, neck and neck for a long time in which one would go first and what kind of planning needed to be conducted, what kind of

groundwork needed to be laid for these projects going ahead. Hay River is the second largest community in the Northwest Territories. It does have a service area surrounding it. When we talk about Hay River’s population, we have to include the Hay River Reserve, Enterprise, Kakisa, Fort Providence, Fort Resolution to the other direction, to the east. It is a centre for some degree of commerce and services and makes a lot of sense, in my opinion, for medical services.

Whether or not Hay River has been able to recruit and retain and whether Fort Smith has been able to recruit and retain resident physicians is also a bit of a red herring. The fact is there is enough interest from locum physicians to fill these positions. Maybe it is not ideal and it’s certainly probably not the most cost effective for the department, but the services are there, the locums are there, the people can be treated, examined, hospitalized in their own community. We’re hoping that the ability to recruit and retain physicians will improve as medical institutions have increased the number of seats they have available and as we still are in this long pulling out of the reduced number of seats for physicians in Canada. That was a bad mistake and we’re still paying the price for it. We’re hoping that as time goes on, that the situation is going to be improved.

As I said, Hay River has a population of around 4,000 and a service area of closer to 8,000 to 10,000, and a facility like what is proposed, I think, will also go some ways towards facilitating, as the Minister said, the locums, the specialists, the itinerant teams that will come in and deliver services in the communities. You still have to have a facility to operate out of and, hopefully in the long run, doctors who will want to practice medicine there and have a hospital to do it in.

I don’t think the government wants to pay to have everybody from Hay River transported to Yellowknife everytime they require the services of a specialist or a procedure like a colonoscopy or a mammogram or a… You know, all of these services and specialists clinics that are all now currently operated out of the hospital that’s there. I don’t think the government wants to start to quantify the cost of bringing a population the size of Hay River and the needs of a community the size of Hay River to Yellowknife for service, or to Fort Smith, for that matter, if you want to talk about them being close by each other.

I can’t explain the rationale. I mean, that’s not my job to explain the rationale for two facilities, one in Fort Smith and one in Hay River, but I know that the one in Fort Smith did make significant progress on their planning and was able to get started on that.

I can tell you that we are looking forward to the Level C facility in Hay River as well. It has been on the books for a long time, practically as long as I

have been an MLA. We will make sure it gets used. I don’t know what my question is. Thank you.

Thank you, Mrs. Groenewegen. Committee, we are on page 6-6, the Department of Health and Social Services. Mr. Krutko.

Thank you, Mr. Chairman. I would just like to get clarification from the Minister in regards to when we go through the briefing for this particular department. It came to our attention that there was information that was being provided that the long-term care facility in Norman Wells will replace the Joe Greenland Centre in Aklavik. I would just like clarification from the Minister. Is that the case?

Thank you, Mr. Krutko. Minister Lee.

Mr. Chairman, we have already established that that is not the best way to describe that project. Long-term care facility and wellness centre being built in Norman Wells stands on its own. Thank you.

Mr. Chairman, I would like to ask the Minister what is the plan for the Joe Greenland Centre in light of this new information to establish these long-term care facilities elsewhere in the Northwest Territories. More importantly, what is the transitional plan in place for the residents of the Joe Greenland Centre? More importantly, the status of the employers, the individuals who work there so that we can give them some comfort that there will be a transitional period that they will transition out, that basically there will be more research and development done to really look at the potential of the facility which served the Northwest Territories for some 40 years. I would like to know exactly what is the transitional plan for this facility in the Department of Health and Social Services.

Thank you, Mr. Krutko. Mr. Krutko, I am going to ask that we hold off on that until we get to community health programs, if you will and stick with this. It starts to get a little bit into program. So, committee, if we can just confirm on page 6-6, the health services programs, activity summary, infrastructure investment summary, total infrastructure investment summary, $15.491. Does committee agree?

Thank you, committee. Mr. Krutko.

Thank you, Mr. Chairman. The information that I’m talking off of was information that was provided on the particular line item which is before us, which is the Norman Wells Health Centre and long-term care facility, which basically clearly stipulates that long-term care facility was going to be to replace the Joe Greenland Centre

from the information that we received in the briefing that was given to us. So that documentation is the department’s documentation and it is dealing with that particular capital item that is presently before us. Thank you.

Thank you, Mr. Krutko. It is clearly related, Mr. Krutko. I am going to allow that question here. Minister Lee.

Thank you, Mr. Chairman. As I already stated, the regional health centre/wellness centre/long-term care in Norman Wells stands on its own. It is the only region in the Territories without a Level C care facility for all the reasons that the deputy minister mentioned. The 48 repatriation rule that is under effect from Alberta facilities, the surge capacity, the need for us to use technology more and to have facilities in place where our local travelling specialized staff could go to different places and provide services, we just don’t have that in the Norman Wells facility.

That facility, I think, was built in the ‘60s. It is really a mobile home. They really cannot provide the kind of services that they need to do in that region. That project stands on its own.

Joe Greenland Centre will remain the way it has been for what it was meant to be, which is assisted living facility for elders, and the Housing Corporation has agreed to renovate the facility and to create additional capacity and additional bed spaces for elders in Aklavik that are desperately needed.

We will be able to use the money still to enhance the home care services in Aklavik and I believe that would provide opportunities for elders to be provided in the communities. Thank you.

Mr. Chairman, for the sake of progress, I will agree to ask my question on the next page.

Thank you, committee. Part of Health and Social Services, activity summary, health services programs, infrastructure investment summary, total infrastructure investment summary, $15.491. Agreed?

Thank you. We will move to community health programs, pages 6-8 through 6-10. Mr. Beaulieu.

Thank you, Mr. Chairman. I just wanted to discuss a little bit with the Minister and ask the Minister questions on long-term care and what seems to be the general philosophy of the department to regionalize long-term care.

As indicated by my colleague Mr. Krutko many times in this room and in committee, we talked about the need for the communities to care for their elderly, their seniors, and most of us are affected. I

don’t want to get into a long story, Mr. Chairman, but at one point, when things were a lot simpler, the elders and the seniors got to stay in their communities in what was referred to as a senior citizens home that was owned by the NWT Housing Corporation, and a service was provided by Health and Social Services in kind of like a variety of scope sort of setting where there were some people that needed more care than others. When some seniors needed more care than others, that care was provided to that senior. We had provided service through that system as a government to people in wheelchairs, to people who were in fact even to a point where people were bedridden. That allowed the communities to retain their elderly in their last days.

Now, when the policy changed and Health and Social Services withdrew from some of those smaller centres, smaller senior citizens homes that didn’t have enough beds to warrant that type of base expenditure, it left some of these homes empty. I know this is a capital discussion. I am going to get to capital. I am wondering if the Minister looked at the feasibility of putting some capital into some of the homes that at one time did provide long-term care. I am specifically referring to Our Great Elders Facility in Fort Resolution. Has the Minister looked at putting some capital into that home to make it possible for the people that are in long-term care from Fort Resolution in Hay River or Fort Smith to repatriate those people into the community and allow, too, the variety of programs that they used to care for those elders in their last days, if that was something that the Minister would consider or if that is something that the department has considered to date. Thank you.

Thank you Mr. Beaulieu. Minister Lee.