Mr. Chairman, it is going up by $6.5 million: $2.4 million as related to Collective Agreement increase for that year; $1.8 million is for Stanton and Beau-Del to fund their benefits from 17 percent up to 23 percent because they are a 24/7 operation; as well, another $800,000 roughly for Beau-Del for relief costing. Stanton previously received that in the previous budget. There is also some various contract increases across all authorities, about $500,000, and $400,000 for additional staff at the medical daycare unit at Stanton. There is also $790,000 related to the Territorial Health Sustainability Initiative going to authorities as well.

Mr. Chairman, it is funding for relief in call back of nurses in the hospital which is not core funded in their base salary.

This relates to how we are funded. We are funded by the position, so we are not provided the call-back money when a nurse is called back, because on a 24-hour operation, you can’t run the position vacant. This isn’t about agency nurses. This is the backfill when someone is called in, and under the agreement there are ways that is done and what they are paid for. That was never funded, so we came forward and asked for that balancing and that is what you see.

Yes, it will now be part of the core funding.

The physician resources that are outside of the Territory are not the physicians that we are bringing in as a specialty. It is anytime someone goes south and they are seen by a physician or they’re in Edmonton, and they’re all

fee-for-service. So all of those are billing codes that come as per the reciprocal billing. That’s very different than nurse locums, which I believe we were asked earlier for trying to find to the best of our ability how much we’ve been spending on the use of locums. They are different.

The work of the Territorial Support Network, or the TSN, is very much in the design phase. This is a very complex, new way of doing business. We’re looking at doing this maximizing the equipment that we have, maximizing the resources. So there’s a committee that meets twice weekly. We do have some research funding, it looks like, from Health Canada, because we have to evaluate and do research as we come along. That model is still very much in its infancy development and then we hope to take that both to medical directors and the joint leadership and management committees. It will have to have a lot of the tires kicked as to implementation and how we’ll implement this slowly. I think as we have that model further developed, we’ll be able to do more costing. It’s very exciting work. I can tell you that the physicians, nurses and authority leads that are involved in this work are very enthusiastic and working very hard, but it is very preliminary at this stage.

We’re certainly already maximizing, to the best of our ability, the use of the technology and the existing physician and nurse practitioner resources as far as the use of specialists that are

now available to the other authorities and the review of everything from lab tests to X-ray results. We are continually challenging ourselves on the use of telehealth and that equipment. But the Territorial Service Network will be extremely complex. There is controversy amongst physicians. If I am a locum physician, part of my interest in coming here is I can make a lot of money on call. If I’m a physician who wants to come here -- and I’m talking about outside of Yellowknife -- and I want to come here, one of the deterrents is that I don’t want to be on call every second night or have a solo practice. We’re looking at how we actually move dispatch and clinic dispatch into our medevacs. We’re being pushed by this because of the pressures from other jurisdictions as well as our own complexities. We’re already doing as much as we can. I’m talking about a real change of delivery model that will take buy-in from all the providers and while we have seen some pieces of this... Australia’s medevac, some of the STARS ambulance use of dispatch, we’re borrowing all of that, we’ve just got interest from Ottawa on what’s called The Best Brains to come and help us share some of this because this has not been done in Canada before. We’re looking at Labrador and how they’re utilizing on call with physicians and nurse practitioners. We’re not using what we have now, but this really will be something that has not been done in Canada and certainly we want to make sure before we roll it out, that we’re not having unintended consequences. Even talking about what will initially be in the mix and how that impacts simple things like the calls to ER, who’s going to answer and how we marry that up with dispatch to a medevac, it actually is extremely complex to get it right. So we’re not not doing it, but that core piece is pretty complex.