Mr. Chairman, I think some of the initiatives are as a result of seeing where the patient flow and where the needs are. That has to come up as to what is the real issue and what is causing the deficits. I think there has been lots of attempt at deficit but it wasn’t from a full system change. To look at the Beaufort-Delta Authority in isolation of what they are picking up from other authorities and also the economies of scale and ways of doing business. As the PA for both of those large ones, I can tell you that there are ongoing budget reviews and looks at how we can plan to reduce the debt or manage within the budget the increased pressures on those health systems.

One of the things, for example, that the Beaufort-Delta was looking at was lab costs to see that, in fact, it was a lack of discipline in the Sahtu that actually was driving the lab costs and spent the budget. So now we are looking at how we actually streamline and get medical directors involved in monitoring repetitive lab costs throughout the whole system.

I think that you see less about a full deficit reduction as more as bending the curve on these things initially. We are also looking at what should be the right budgets in those different authorities as we change the patient flow.

Things are coming at us very quickly as we started this work. We didn’t know about the Alberta pressures, the issues around how we could do some special programs ourselves.

To implement change and to deal with efficiencies has also taken some education and some understanding at the authority level and at the key provider and stakeholder level, for them to buy in and see their own role in efficiencies. I think we are starting to see that. While it has taken some time, for example, at Stanton, we are with both coming forward on critical funding areas that hadn’t been identified before through supp funding through support by the Financial Management Board, but we are also starting to see a reduction in the overall deficit at Stanton. That is with increased pressure and increased use of their specialists, ORs and beds.

I think the bigger issue is you are starting to see a system change. This is something that all of the health systems are struggling with in Canada, but getting a handle on it as a system and really drilling down to where can we start to make the change and what is going to have public support and understanding has taken some time and will continue. I think we have made great progress in the last couple of years.