This is page numbers 5663 - 5700 of the Hansard for the 16th Assembly, 5th Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.

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Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Kevin A. Menicoche

Kevin A. Menicoche Nahendeh

Thank you very much, Mr. Chairman. I just wanted to re-raise the issue of medical travel and issues by constituents. I know that the Minister had indicated that they are currently reviewing the guidelines, and many of the issues that cross my desk and what I raise in the issue is not dissimilar than Mr. Beaulieu’s. The few others are some elders that are being medevaced, are being medevaced without an escort with them, especially those that require translation. I have got constituents in my riding that do what they can for the elders and those that are sick and in need, and they often go on these medical travel trips, often for days, sometimes weeks at a time and they are low income or no income. So I have requested over time to allow for at least incidentals, because I know that when they do come to Yellowknife, they are given a place to stay, a place to eat, but at the same time they have no income at all, so I would just like them to review, to allow them for some type of daily incidentals or something.

As well, during the springtime I had an incident where the patient is in the hospital in Yellowknife or in Edmonton for lengthy periods, there is actually a replacement of escort policy, I think it is, I am not quite sure, maybe the Minister can inform me, but I think it is, like, two weeks. But I think in most cases, Mr. Chairman, is that the escort is going with the elder or whoever is sick and they are prepared for only two or three days and when the illness does take a turn for the worse or else it is extended, then the person asks for medical travel so they can go home but medical travel tells them they have to be there for two weeks and they are often without money or unprepared, but that is their rule of thumb, but that is there, flexibility. I don’t know if flexibility or those things must be built in to the review of the Medical Escort Policy, which leads me to the next question, Mr. Chairman.

I know that when I raised these questions in the House, I think in the fall time, the Minister indicated that the policy is being reviewed, so I would just like to know the timing of it and I certainly would like, as a Regular Member, I certainly am not on the Social Programs committee, but I would like to have input into that reviewing of the policy and as it moves forward. So just in terms of timing, when will we be looking at receiving this initiative and how much

work have they done to date, Mr. Chairman? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Mr. Menicoche. Minister Lee.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. The issues that the Member is mentioning here are a part of the review, so we expect to have the review done by the end of this fiscal year and to be able to bring forward to the standing committee for discussion with recommendations following that in April or May. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Kevin A. Menicoche

Kevin A. Menicoche Nahendeh

So the department is working on it and they will review it with the Social Programs committee and it will be at that point that the committee and the Regular Members will have input into the new policy. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Yes, Mr. Chairman.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you. Next on my list for 8-25 is Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

Thank you Mr. Chairman. My first question is, though I recognize we have come a long ways in our extended health benefits discussions and that the grandfathering that was provided in the past has been dropped as of I believe this April, or maybe it has been already, and I am wondering if we know what sort of savings that will provide. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Mr. Bromley. Minister Lee.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. The grandfathering will be dropped as of April 1

st

. So far

the transition is quite smooth. We don’t believe there will be a savings per se, it is more so about consistency and fairness in applying the policy across the board so that we don’t have this class of people that has been grandfathered in perpetuity, which I would think would add more complications. I am going to ask Paddy to give more detail on numbers, if she has them. Thanks.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Minister Lee. Ms. Meade.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Meade

For many of these, they have been asked to see their physician to see if the generic or the drug that is on NIHB can actually accommodate their need. We do know of two rare disease drugs that we won’t be able to change and those are very high-cost drugs. I think there will be some savings but it will only be in the case where the product can move to a generic, and in most cases the list got quite small. I think it is more on a go forward that we start to follow the set formulary, so there will be some costs, but it will be limited. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Ms. Meade. Mr. Bromley.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

Thank you Mr. Chairman. My other question, my second question, is, I think that

the working group and Members agreed to a number of principles and high amongst those principles is making sure that everybody is under the fold somehow to get coverage. What is the plan going forward for providing coverage to those who don’t have coverage now and is that going to be part of the 2011-2012 activity and budget? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Mr. Bromley. Minister Lee.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Thank you, Mr. Chairman. As the Member knows, this is under discussion at committee level and I need to get back to Cabinet for further direction and then dissemination of the information to the public. But as the Member knows, following the two or three-year debate we have had on what was then known as Supplementary Health Benefits Policy, which has now been rescinded and that policy allowed for extension of coverage to what we know as the working poor, but with the rescinding of the policy we are basically back to status quo, subject to some of the changes we are making or we are suggesting that we make that we are under discussion on. So I don’t believe we could make those changes without coming up with a new policy, so any policy changes will have to be part of the next round of discussions, if the next government wants to engage in that. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

I don’t disagree with the Minister and I think it was a solid principle. I know there is a number of ways that have been contemplated for addressing it but I just want to make sure that it is addressed in this coming fiscal year, because I think it was something that everybody did agree to and I think there probably is some coverage, at least for pharmaceuticals out there to help everybody in the Northwest Territories and perhaps that information is getting out there.

On the question of pharmaceuticals, I wonder if the Minister is aware that in the Canadian negotiations with Europe right now for European-North American Free Trade Agreement, they are talking about pharmaceuticals and the estimate is that it will raise pharmaceutical costs by $2.2 billion for Canada. My understanding is that it translates to $2 million in additional costs for the NWT. Is the Minister aware of this? Is she acting to prevent that from happening and avoid those additional pharmaceutical costs? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Sandy Lee

Sandy Lee Range Lake

Yes, Mr. Chairman, I am aware of that issue. It is at a preliminary discussion stage. The federal government has made it clear that they would not be signing something that would have that sort of adverse impact on our government, but I could tell the Member that this is not advanced to a stage where you wouldn’t even get to FPT. If it were to get anywhere near that, it

would be at FPT level. This is just something that is floating around on a global level.

But something in Canada, we have a federation. We have a health care federation. Provincial and territorial governments have a lot to say on how these are implemented. That could not be done without our input. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

Mr. Chairman, I appreciate the Minister’s comments. I assume from that, that obviously she is a participant on that committee and that she would express that sentiment strongly that we would fight. I always think it is progressive to the Minister on my recommendation to the Minister to take it or leave it, would be to write and be on the record right now of the Prime Minister and whoever the Minister is dealing with on these negotiations.

My next question is on the specific issue of macular degeneration. It is an issue that leads to blindness in people. It has come up amongst my constituents. I know there are a number of people, typically the elderly, that experience this disease. There are two forms: one that can be treated and prevent blindness, the other can’t right now. The drugs are changing on this. I know that the new drugs have been accepted by other jurisdictions. Are we on the road to accepting those ourselves? Are we planning to cover that? Beyond that, we have a lot of travel costs on this. Do we have a capability to deliver that service in the North? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Mr. Bromley. Ms. Meade.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Meade

Thank you. The drug used is Lucentis and it is not the drug that has changed, it is the funding. Most jurisdictions were not funding this procedure. A lot of our residents -- not a lot, there are about 30 that were doing this -- were going to Alberta because they were able to go to a clinic where the cost was paid for. So we have just discovered these numbers because Alberta has made a change, put it on their formulary and, therefore, they are not being covered by this clinic. Because we didn’t know and approved the preapproval, it has been hard to find the exact numbers. We are looking at two things. The business case for the cost will be quite significant to add this to the formulary and in particular when you include the medical travel costs. We are also looking at, because the procedure is an injection and requires training and equipment, whether we could actually do that at Stanton. So all of that is being reviewed and we should be able to come forward to the Minister quite soon with that.

This often happens when you have a new use of a drug or a new procedure, that it takes a while in different jurisdictions, add it to their formula over time. But the other issue on this is that if you do it, you actually only approve it for so many injections because it does not treat all people. We didn’t have any control. You would set a stage of three

injections and then see for progress. If there wasn’t, it wouldn’t be an automatic continuation. All of those are being done within the department and also with the medical advisor as to what the actual protocol should be and if we can do it. Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

Mr. Chairman, I appreciate those remarks. I hope we can deal with this fairly straightforwardly and get a consistent message out there to those 30 or so patients.

My last question, Mr. Chairman, is on pharmaceutical expertise within the department. I understand that we have vacancies. There are some challenges there. What are those positions that we have on staff that require the pharmaceutical expertise and where are we in terms of vacancies and getting those positions filled? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Meade

Mr. Chairman, there are no pharmacy positions in the department. The positions that we have had some difficulty with were in Stanton long term. We have been filling that with locums. We do have a longer term locum that -- please be nice to them when you see them because we are trying to make them go from a locum to a term -- that has been filled. There are three hospital pharmacist positions in the full system across the authorities. We also augment so the medical directors and the medical advisor will consult and in the department also, and this is often the case.

You can consult with the pharmacy medical school. The U of A has a pharmacy and the dean there has always historically been quite cooperative and supportive. Recent discussions with the pharmacists, we do have pharmacists on the therapeutic and treatment committee. We are looking at how we can increase the use of the current pharmacies within the... There are 30-some licensed and about 22 practising throughout the whole Territories. I think it is 22 now that we can tap into some of their expertise. The physicians do use them as well.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Ms. Meade. The next person on my list for page 8-25 is Mr. Hawkins.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you, Mr. Chairman. I just wanted to do some follow-up as to a specific concern regarding supplementary health benefits. I understand some changes are being proposed or considered and juggled. I wonder where the public benefits are going to be brought into this from a communication point of view as to some of the changes and the adjustments. As I understand it, there are no big dramatic changes from the existing plan, but, of course, the public is still keenly aware of this particular issue. Does the Minister have any sort of update that she could provide the House? Thank you.

Consideration in Committee of the Whole of Bills and Other Matters
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Glen Abernethy

Thank you, Mr. Hawkins. Minister Lee.