Thank you, Madam Chair. As I indicated, in the Canadian Blood Service and the cost, the cost of blood and plasma protein

products is very volatile, so this huge shift is just a matter of two clients only. I think that initially when we were budgeting this, there was one client receiving some blood services. There are a lot of clients receiving blood services, but with this particular plasma protein there is one client receiving it. We got an additional two clients and then the amount went up immensely at that point.

This is something that would be hard to budget. This product keeps the people alive, Madam Chair. They have no option but to continue to receive this product from the Canadian Blood Service or the patients receiving this service would not be able to survive.

Thank you, Mr. Beaulieu. Ms. Bisaro.

Thank you, Mr. Chair. I’ve got a couple of questions on this page. I do want to comment specifically on the cost itemized, the $3.335 million that’s itemized for contributions to the Beaufort-Delta Health and Social Services Authority and Stanton Territorial Health Authority.

I spoke about this in my general comments, but I would like to know at this point, and the Minister kind of gave a bit of an answer previously, that we’re sort of working to fix this, but having been here for four years, I’ve been hearing this for awhile now. I’d like to know, at this point, whether or not I can get any specific comments or specific remarks as to just exactly what we are doing to try and properly fund these two health authorities. Because I think, from what I’m gathering, everybody in this room believes that we’re not properly funding these two health authorities, and what are we doing to get ourselves on the right track so we do fund them properly and we don’t have to move this money around, we don’t have to ask for supplementary amounts of money every year. Thank you.

Thank you, Ms. Bisaro. Just to let the Members know here, we are in health services programs for the $4.79 million. We’re just in that category, so I’ll turn the response over to Minister Beaulieu.

Thank you, Mr. Chairman. There are basically two solutions, two long-term solutions that would address this issue. The first is amending the authority funding to address the structural deficits. This being addressing this with what is happening. Like I indicated previously to some questions was that we have to move some of the costs right now. The budget for some of the costs like a lot of the medical travel and doctors’ services to the Stanton in order to cover it. Right now the health and social services authorities that have the budget do end up sending their individual clients to Stanton. Stanton then picks up the cost for those individuals. In order to make that change we would have to essentially transfer those budgets. Keep the governance structure but just

transfer more of the budget numbers from the other health and social services authorities to Yellowknife.

Also, some of the costs of employee benefits, which was substantially underfunded. Those are specific to the Stanton Health Authority as well.

The other big item that the department can do is reforming the governance to support the operating as one system. It is to bring all of the costs into basically the centre. To have an example would be doctors and possibly nurses, to bring in those costs under one roof. That has opposition, obviously. Right now what’s happening is we are operating a system where the health authorities are bringing locums in in Yellowknife, or the Stanton or YK Health and Social Services Authority is also providing some of the doctors to a couple of the communities, but reforming governance would be more than just having that cost centralized. We could also have the cost of procurement centralized. A lot of the finance and then a lot of the back office, as it is often referred to, can also be moved into a more central system. Now, that doesn’t mean actually relocating these individual employees to Yellowknife. The reform governance would be done in conjunction with the other health and social services authorities. If procurement was centralized, then the operation and the budgeting of that procurement would work under one system, not necessarily in one location. The same with finance. There are efficiencies to be had there, there’s no question about it.

As we go out to the communities we ask the communities what they think of the idea. At the Joint Leadership Council we have some opposition and some in favour, and at the community level, when we went to the Beaufort-Delta we did have some opposition and some in favour of it. Some people thought it was creative, that if we had operated one system that we’d be able to better manage our budgeting and our expenditures.

Thanks to the Minister for the explanation. I heard an awful lot of we can and we could and we might and some things that are recognized that we have to do. There’s a lot of if we do this and if we do that. I guess my question is, we recognize, I think, as Members that there are things that must be done. The Minister has elaborated on quite a number of things that need to be done. For Stanton and for the Beaufort-Delta authorities, we know that their budgets need to be amended and need to be changed. My question was more to are we doing that. What are we doing? When are we going to have it done? I didn’t hear a lot of definite actions in the Minister’s answer.

In terms of reforming governance, you know, of the procurement, the back office administration, a lot of that has been in the works for awhile, I think, and I certainly agree that amending governance is

definitely going to take a bit of work. Not everybody is going to agree right off the bat, but when push comes to shove, if we, as the funder, don’t have the money and we have to create these economies of scale in order to properly fund health authorities, then we may have to make the hard decisions and say this is how it will be. Not all authorities will agree, but at some point in time we have to, as a government and as Members, bite the bullet and make the hard decisions. I’m not so sure that I heard that in the Minister’s answer. I guess I would like to sort of ask the same question again.

I realize there are things that need to be done. The Minister has mentioned a whole bunch of them, but are those things happening now or are they simply things that we want to do at some point in the future? If that’s the case, when are we going to see some major change and some efficiencies in the way we fund these two health authorities? Thank you.

There is a need to do some consultation. Right now, as a department and as senior management to the department, we feel that this is the way to go. We need to reform governance in order to better take control of the costs. However, there is a requirement for a consultation.

I don’t think anybody that is working in the regions with the authorities or MLAs representing various authorities would be too pleased if the department proceeded with reforming governance without doing proper consultation with the health and social services authorities. Health and social services authorities are usually made up of groups of people that come from all of the communities and represent the people and some of the community governments.

We don’t want to rush into this and then have everybody in opposition. We would like to sit down with the authorities and do a proper consultation, to visit them in their home communities and discuss the possibility of trying to reform the governance so that we are trying to take control over the costs. We want to do this. We don’t want to rush into this without consultation. Right now we are at that stage. We have had the initial discussions with some communities. We have had some consultation in Joint Leadership Council.

Madam Chair, I appreciate the need for consultation. I’m glad that that is part of the Minister’s plan, but I’ve been hearing about these potential changes for over a year now. I’m concerned that we’re going to talk ourselves to death and we’re going to be continuing to spend and need infusions of three and four million dollars into these two health authorities for several more years. With some concerted effort, I think, with a bit more concentration on a couple of changes, we

could be saving some money and creating a much more efficient system than what we have now.

I guess I would like to ask the Minister finally, when can we expect to see some kind of change in terms of consultation. How long is it going to go on? When does he expect that we might come to the end of this consultation? Thank you.

Madam Chair, we had hoped to visit all of the communities in our initial meetings at the community. When we go into a community, we meet with the community leaders, the organizations and the Aboriginal organizations, and we also have a public meeting. We’re hoping that we’ll conclude all of the meetings, which I am actually doing myself. So we’re hoping that, weather permitting and everything else, we will complete our community meetings and I guess what we are referring to as a consultation in the community by the end of this summer.

Madam Chair, I have one other question on this page. It has to do with the contribution to the Hay River Health and Social Services Authority for the shortfall and the retirement plan for the employees of that health authority. I can’t remember when, but I am sure it is probably three years ago now that there was some discussion about bringing those employees into the GNWT public service. I realize that their contract for employment is different than what the GNWT’s is. I would like to know whether or not there is any thought about doing that in the near future. The longer we wait, the more it costs us. I think it’s time that we make the change and bring all the employees of all of our health authorities into one union and one contract. Is there any schedule for when this might happen? Thank you.

Thank you, Ms. Bisaro. Mr. Miltenberger.

Thank you, Madam Chair. This item could cost as much as now they say $10 million. It is a significant investment, so where we have a list of our priorities, it doesn’t rank up near the top of all of the things we need to spend that money on. Thank you.

Madam Chair, I just have a quick follow-up. I would ask the Minister to do a true cost-benefit analysis of the cost to have these employees in a different union. Sure, it may be $10 million. I think three years ago it was probably half that. Have we looked at the cost to have employees in a different union with the inability for them to transfer from one authority to another to help out with gaps in another health authority or another hospital?

I think we need to seriously look and evaluate the whole picture, not just the initial cost to pay them out but what are we going to gain in efficiencies. I

think there will be something to be gained. Thank you.

Madam Chair, we will commit to take a look at making sure we are updated in terms of the work we have done and if there is some full-cost accounting factors that we haven’t quantified. But it comes down to, at this particular juncture, just significant ongoing cost to bring them into the system that is prohibiting us from moving forward because of our fiscal circumstance. Thank you.

Thank you, Minister Miltenberger. Next on the list I have Mr. Bromley.

Thank you, Madam Chair. I want to just mention the program to renovate Stanton Territorial Health Authority to contain and remediate the mould issue. I’m happy to see that that has gone forward. To me it really is a reflection of the state of that building, that desperate need to do some work on that building, as is the second item regarding the repairs and modifications to the sterilization steam equipment. I hope the Minister sees it as the same, as some flags.

We have postponed and postponed and postponed renovations to Stanton Territorial Hospital. We are beginning to pay the price. Well, we have been paying the price for quite awhile, obviously. But these are some very serious issues that obviously express themselves in the health of our people.

I just wanted to get an update. I see that the issues of sterilization of equipment are ongoing. We are now 13 or 14 months into this issue. We have spent quite a bit on it. I know there have been other expenditures, I believe. Again, the most important aspect of this is the health of our people. I am wondering, first of all, are we caught up in the backlog that has resulted in surgeries as a result of this. I see we still do have an issue; I believe it’s scaled back quite a bit, but we are going after it. Are we postponing surgeries at this time because of the incurrent situation and the need to separate these two types of sterilization? Thank you.

Thank you, Mr. Bromley. Minister Beaulieu.

Thank you, Madam Chair. I have that information in the briefing note; I don’t have that information here. As I recall, there are two operating rooms that were under the sterilization issue and that one is functioning fully. I think the other one, there are still some issues, but it is able to function to a certain level. I think that they’re able to do about 60 percent of the operations in that operating room, but there are some certain operations that they still can’t do in that one operating room. That’s my understanding at this time, but I can quickly check to see if those numbers are correct.

I appreciate the Minister’s commitment there and I think I’ll hold up on that one and ask that he provide that to us as soon as possible. That would be helpful.

The last one I have on this page is the considerable cost, almost a 50 percent increase to the cost for children in residential care outside the Northwest Territories. This is a very, very sad state to me. The last time we visited this issue was when the Child and Family Services Act was reviewed by the Social Programs committee. At that time we were assured by the department that those numbers were on the decline and great progress was being made. Now we have, as I mentioned, just about a 50 percent increase in costs.

As well, the number of children in care has gone up, or the number of childcare months has gone up and the cost is really ramped up even relative to those figures. So we’re now at well over $7 million. If we’re looking after special needs children here outside of the Northwest Territories… The reason why I kind of harp on this a little bit is because we had some very specific recommendations from the Child and Family Services Committee review to address exactly this sort of thing. One of which was the establishment of the child and family services committees in every community within the Northwest Territories, and we fought hard for and successfully got funding to establish five such committees and the department has failed to establish those here in the tenth month of our 12-month fiscal year.

So I guess what are we doing to address this and do we have no capacity for these children? I assume we have no capacity for these children in the Northwest Territories or we would have them here. But what are we doing to implement the sorts of mechanisms that the review highlighted as being needed to reduce these costs? Thank you.

These clients are children that have needs that require highly specialized daily attention for assessment, treatment, education and support services. The individual children that are in southern placements are there because we don’t have that service available in the NWT. Although the Child and Family Services Committee does deal with children receiving services, and under the whole Foster Care Program or the Child Protection Program we have these children in there in southern treatment or southern placement – some of these children in there in southern placement – it’s not directly associated with the creation of the committee cost. This cost here would be, unless we’re able to provide the treatment, educational and the support services that these particular children need. Even if we had all of the child and family service committees up and running, we would still have these children in these placements until, like the Minister of Finance indicated earlier,

we’re able to build facilities and get staff into the North trained or brought into the North to be able to accommodate the needs of these children here.

On the surgery room, I’m just going to read some of the key messages here that all surgeries have resumed, with the exception of joint replacement surgeries. The processes are in place to ensure that all the best practice guidelines are continued to be met. Higher risk joint surgery is still on hold, pending additional infection control improvements, and that was on the sterilization issue that the Member brought up previously.

I appreciate that information. I did not hear anything about the child and family services prevention programs that we had recognized are needed here. There’s a national case going forward today where one of the workers we had involved in the review, Cindy Blackstock, is sort of leading the charge to take the Government of Canada to court, I believe, on their failure to appropriately fund Aboriginal children across Canada. I want to know that we are doing funding as we should be. There were a number of things that were identified, but funding is obviously only part of it.

We have funding in place. We need people who will go after the best spending of those sorts of things, and I hasten to add that I’ve been in discussions with my colleagues and we acknowledge that we wear some of that responsibility here, because I think these are our communities in all our ridings. So we need to be working with our communities to take advantage of the opportunity.

In this case here, we’ve got funding for five community committees and none of them up and running yet. But I want to know what we’re doing on the prevention side to implement these recommendations in an aggressive way.

I just want to point out that there’s a phenomenon here that we’re seeing repeated: the energy issues. You know, by not investing – and we know the returns are great, the paybacks are great – we’re paying at the other end big time now and it’s taking away other options. The same with the Hay River pension situation, of course. It’s now gone beyond our ability to address that $10 million. Here we have a situation again with child care. So I want to know that we are making good use of these dollars and not letting them slide. So can I get a sure answer that we’re actually going to do that here and get going on the prevention towards ultimately decreasing the escalating cost of looking after children outside of the NWT? Thank you.

The government has given Health and Social Services $470,000 to work on the creation of the Child and Family Services Committee. We think that will go a long ways to the prevention. The Member is right; we haven’t struck any of those committees at this point. We are, as

this is all part of our tours to do consultation in communities. When we went into the Sahtu we looked at and we had an initial meeting with the health and social services authority, and at that time the health and social services authority felt like it was adding another layer of government to the system and thought it was going to just do nothing more than add costs.

After I met with the authority, along with the staff that were travelling with me, it became fairly clear that our intention of creating child and family services was for a good reason. That was that over the long term it would save costs.

The department is going to be offering the Train the Trainer workshops in Beaufort-Delta so that staff have the tools to establish the child and family services committees in the communities.

I think that I was surprised that each of the authorities, there was a plan for each of them, although they didn’t action the stuff yet, that each of them had a plan to try to create as many child and family services committees as possible. We looked at the numbers that I know at the top of my head right now would be in the Sahtu. When I travelled there with the Member for Sahtu we looked at the numbers. We say that two of the communities there may not need child and family services committees but the other three would need them. There was an actual call in the communities for them to be established.

Right now, back in October they delivered some of the workshops referred to as Child and Family Services Committees Train the Trainer Workshops. The authorities were doing them and they were delivering some of the programs in every authority except for the Beaufort-Delta. We’re hoping that by the end of March of this year that we’re going to hire a child and family services committees coordinator, and that individual will be located here, and we’re going to try to give that individual the responsibility to strike as many of these committees as possible. We’re actually working on it.

We’re not ignoring committee recommendations on these at all, it’s just taking some time to look at everything, train the staff and fill the appropriate positions.

Thank you, Mr. Beaulieu. Next on the list I have Mr. Yakeleya.

Thank you, Madam Chair. The Canadian Blood Services that we pay for, has the department looked at how the residents of the Northwest Territories could be part of helping these people that require blood? Is it cheaper or is it more convenient for them to just purchase the blood for these two people in the North than not to bother the rest of us? Because the Canadian Blood Service relies on donors too. Can there be something like

that or is it just doesn’t quite fit the plans for having blood for these people in the North here?