Thank you, Ms. Meade. Mr. Ramsay.

I appreciate the response from the deputy minister. I guess, from my perspective, especially the Beaufort-Delta and Stanton are in such dire straits financially, running up big deficits at those two authorities, my fear is that when you throw this on top of everything else, it has the potential to send them spiralling again further into a deficit situation. I’d like to see the department budgeting for… And these are costs that I don’t think would be too hard to even guess at what your costs are going to be. Your costs are going to go up. If you have to repatriate people within 48 hours, it’s going to have an impact, like I said, all the way through the system. Whether that’s 4 percent, 5 percent, who knows? I’m not going to throw a guess out there but it is going to cost you more money.

I guess the thing I’d like to get at, Mr. Chairman, is how are we budgeting for it? We know it’s coming. How are we budgeting for it? Or, like I said, are we just going to wait and just let it happen, let the deficits keep accruing at the authorities and deal with it later? Is that how we’re budgeting for these changes? Thank you.

Thank you, Mr. Ramsay. Minister Lee.

We need to consider separate factors from what the Member has suggested. What he’s saying is we should be able to neatly budget what the costs will be and have better control, although that’s one definition of control.

The second thing is, are you just going to spend and spend and spend and not have control? In health care we need a third factor, which is what we’ve been saying all along, that we are working within the system to be ready to respond to manage our resources wisely, but there is no way you are going to have a budget that is going to anticipate, predict and neatly categorize that we are going to have a 3 percent increase, 4 percent increase or a 5 percent increase. That is not possible. One person could walk in tomorrow and need a blood transfusion and that is a $600,000 item. It may not happen, but it could happen. We could have a major... Cost control in that way in health care is not possible.

I know the Member would like us to have a budget prediction, be able to forecast everything, but that is not possible because we respond to the demands of the people. When they need their procedures, they get them. We pay for them. If they need medical travel, they get them. If they need an MRI, they get them. If they need a CT or if they need their knees or hips replaced, we do them. We don’t know how many people are going to need them.

What we could do is we respond as a system to make sure that we use our resources wisely. Even with the Edmonton situation at the airport or the 48-hour rapid repatriation, our system is responding by

working our resources wisely and communicating better. But the health care budget is not like the transportation budget or even the education budget where you can see the trend of population at schools. Thank you.

Mr. Chairman, I guess I will just disagree with what the Minister is saying because I think going forward we know the new rules of engagement with the Government of Alberta. We know it is going to cost us more money. Why isn’t there a corresponding increase in the operations and the maintenance of the authorities and the department to address those concerns? That is the question that I have. We know it is coming. It is going to hit us squarely in the pocketbook. How come we are not budgeting for it? That is my beef, Mr. Chairman. Thank you.

Thank you, Mr. Ramsay. That is more of a comment, not a real question. We are on page 8-21. I have a list of speakers, but I believe those are for 8-24. Is there anyone who would like to make comments on 8-21? Okay. Ms. Bisaro.

Thank you, Mr. Chairman. I have a couple of questions here. We talked, I guess it was just yesterday. It feels like a week ago when we talked about the deficits in the Beau-Del Health and Social Services Authority and the Stanton Health Authority. I wonder if the Minister could advise whether or not there is a debt reduction plan for each of those health and social services authorities to deal with their debt and their deficit. Thank you.

Thank you, Ms. Bisaro. Minister Lee.

Mr. Chairman, no, we do not have a debt reduction plan for each authority because we do not consider this debt as being an authority debt. We have been saying that for three years. We consider this as a system debt. We are making systematic changes through Foundation for Change. We believe that we need to make systematic changes to make sure that each authority has the right budget, that they do things without duplication, that they are a better transition of services and patients across the authorities.

Right now we have some authorities that are having a surplus and some that are in deficit, but we don’t consider them a deficit of that authority. This is why I have had my deputy minister speak at every occasion about things that she is doing to change the system. These are all interconnected. Foundation for Change is interconnected. Getting some money for the relief staffing cost is inter-related. Getting money for technology is inter-related to dealing with this deficit situation, so it is a complex multi-faceted way of managing the health care system. So, no, I have no intention of sending a direction to Stanton and say you are in deficit for $5 million as of this fiscal year and I expect to clear

the budget, because the understanding of our system is that they can’t do that. I can’t do that. We have to respond as a system. Thank you.

Mr. Chairman, I guess it begs the question to the Minister: if it is a system debt and it has been three years that they have been trying to rework the system debt, how come we haven’t seen any change in the various health authorities? Why are they still working with budgets which are obviously unworkable? They are obviously underfunded.

The Minister referenced a number of things that the department is doing. I support all of those things, but I guess I am wondering why we aren’t seeing some effect of the changes that are happening, the efficiencies that are being found, the reworking of programs and services between authorities. Why is that not reflected in the budgets at least to a certain extent? Thank you.

Mr. Chairman, it is reflected in the budget to a certain extent. We have improved in our medical travel component of Stanton Territorial Health Authority, for example. This year’s deficit is less than last year’s. It is reflected. I need to get the DM to give a little bit more detail on how our deficit picture has changed as a system. Thank you.

Ms. Meade.

Thank you, Ms. Meade. Ms. Bisaro.

Mr. Chairman, thanks for the comments. I don’t doubt that there has been progress. I guess I am just looking to see that that progress is reflected in the various authorities’ budgets. I think I heard the deputy minister say that there has been some.

I did want to ask, as well, about the client navigator position. My understanding from previous information, I believe, is that the client navigator position is going to be dropped in this budget. I have a concern. I’d like to know a couple of things. Just what is the job of the client navigator, and the second part is that I understand it’s going to be delivered through the single-window service centre, which I believe is being set up by the Department of ECE, I think, or maybe it’s the Executive, but I have concerns about how a client navigator for health can deliver services through a single-window service centre in various communities. So if I could get a definition of the job and then how that job is going to be done through the single-window service centres. Thank you.

Thank you, Ms. Bisaro. Ms. Meade.

Thanks for that explanation on the client navigator.

I just have one quick question. The Minister made a statement this week about Drop the Pop and I wondered if I could get an explanation from her, or a bit of an elaboration on whether or not this program will also target energy drinks, which I think are probably even more evil than pop is. Thank you.

Thank you, Ms. Bisaro. Minister Lee.

Thank you, Mr. Chairman. It is not part of the Drop the Pop program right now, but we are reviewing that within the plan, including that in the future. Thank you.

Thank you, Minister Lee. Next on my list for page 8-21 is Mr. Hawkins.

Thank you, Mr. Chairman. On page 8-21 I just wanted to follow up with a couple of questions I noted under physicians inside the NWT and, as well, sort of cost to our health service centres. One of the particular issues I’ve noticed, and I’ve talked to the Minister and deputy minister, is the cost to health centres in how they distribute or reallocate funds; namely doctors’ cost and if we have a particular case where a health centre, or I should call it a health authority, where they are unable to find a doctor, they have excess funds sitting around, but they’re not allowed to hire NPs in the interim to fill some of those needs and gaps created. I raised that specific issue to the deputy minister one day in the building here and I’m wondering what headway have they made in that particular case. So as I understand it, doctor money is prescribed specifically to hire a doctor, but if you can’t hire a doctor in that particular authority for that particular hospital, the doctor money sits there and that therein lies the problem. Thank you.

Thank you, Mr. Hawkins. Ms. Meade.