Thank you, Mr. Menicoche. With that, we’ll ask the Minister of

Health and Social Services if he has witnesses he’d like to bring into the House.

Yes, I do, Mr. Chair.

Thank you, Minister Beaulieu. Does the committee agree?

Thank you. If I can get the Sergeant-at-Arms to bring the witnesses into the House, please.

Minister Beaulieu, would you like to introduce your witnesses to the Members here, please?

Yes, Mr. Chairman. To my right I have the deputy minister, Debbie DeLancey, Health and Social Services. To my left I have the assistant deputy minister, Mr. Derek Elkin, Health and Social Services.

Thank you, Minister Beaulieu. Ms. DeLancey, Mr. Elkin, welcome back to the House. Glad to see you here today.

Committee, we last left with the opening address and we were going to go into general comments to the opening address for the Department of Health and Social Services. With that, we’ll be asking Members to go consecutively and the Minister will, hopefully, reply as an aggregate response. With opening general comments, I look to the committee. Ms. Bisaro.

Thank you, Mr. Chair. I have a number of comments in no particular order. Some of them are related to the Minister’s opening comments, some of them are not, so I might jump around a little bit. Bear with me.

In the Minister’s remarks yesterday he mentioned that the department is continuing to take advantage of eHealth, and I think that that’s absolutely the way to go. I’m really glad that we are embarked on that path and that we are continuing to go down that path, but I wonder how many communities we are in at this point, in terms of eHealth. How many are up and fully running and whether or not we are going to achieve full, efficient use of our telehealth and our eHealth capabilities in the near future.

The Minister then mentioned the Child and Family Services Act review that was done by the 16

th Assembly Standing Committee on Social Programs. A major recommendation from that review was the establishment of child and family services committees in communities. I know the department has been struggling to try and get communities to take advantage of the funding that’s available to establish these communities, and I would like to know from the Minister where things are at, whether or not there’s been any progress. I think there were a few stumbling blocks.

I’d also like to use this opportunity to highlight to communities that establishing your own child and

family services committee enables you to do your own assistance with interventions at a community level as opposed to having it done from Yellowknife, so to speak, by social workers who are coming in from afar. It’s a valuable tool, I think, and gives the power to the communities to deal with children at risk and children who might, perhaps, be apprehended if some intervention is not made.

The Minister mentioned a planning study for Stanton Territorial Hospital. I think it’s recognized and well known that Stanton is aging, is an aged building at this point. It definitely needs to be expanded and revamped and brought up into the 21

st Century. I need to know from the department,

and it goes a bit beyond the department, I think – and involves the whole of the government – how we are going to manage the huge cost that Stanton is going to be on this government. The Finance Minister has said an upward limit of perhaps $400 million. It’s a huge amount of money and I need to know from the Minister, apart from the planning study, how are we going to get this done.

I will have some questions when we get to discussion of health and social services authorities. The Minister’s statement is that current funding levels are insufficient to continue providing programs and services at current levels. I agree with that. We can’t just make that statement and not have a plan to deal with it, so I will have some questions when we come to that section of the budget.

The Minister mentioned, as well, the department intends to streamline governance of the system. I am in support of that philosophy. I think there are many ways that we can increase the efficiency in our health and social services system. I think, dealing with boards and agencies, making them somewhat smaller, and one of the things that’s mentioned is shared services, I totally agree with that approach. I think it is the right way to go. But I am concerned about the lack of input that residents have into their local hospital boards.

Stanton Hospital has not had a board for many years now, over 10 years, I think. The Beau-Del recently lost their board. I don’t know if we have any authority that now… Well, Yellowknife Health and Social Services Authority has a board. But where’s the opportunity for me, as a resident in my community, to have input into my hospital? Yes, it’s a territorial hospital, but I live in this community and it’s my hospital. I’m concerned about some of the governance intentions. I would like to get some explanations when we come to that section as well.

The Minister talked about modernizing our Medical Travel Policy and absolutely I agree. It is a very old document. That policy was written I don’t know how many years ago, but it does need to be updated, for sure. There hasn’t been an opportunity for Members to have any input into sort of how this

policy is going to be revised. I gather it is in the works, but I will have some questions in terms of what the intent is when we come to that section.

I am really pleased to see the section on services available to elders to help them remain in their homes as long as possible. That is a valid goal, in my mind. I think we want to keep people in their homes. If we can provide home care or if we can provide other services to our elders that allow them to stay out of our institutions, everybody is happier. It costs us less money in the long run. I think the people are happier to be in their home than they are to be in an institution. I totally support that avenue. I would hope that we are looking at taking the money we might have put into institutions, not building those institutions, but putting them into programs that are going to assist people to stay in their homes.

Part of that, similar to that but a little bit different, in my mind, is the supports that are needed for people who require assisted living, people who need to be living independently but are challenged in a number of different ways.

We do not have adequate infrastructure, whether it be homes or whether it be institutions, but we are well below the level of infrastructure that we need in order to accommodate all of our residents who need to have assisted independent living. I see nothing in the budget which looks at that and says we have to do something about it. I have a major concern in that area.

The Mental Health and Additions Action Plan, I am really pleased to hear the Minister say that it is going to be tabled soon. I look forward to it. Members have seen a bit of an advance copy. We will have questions for the Minister on it at the appropriate time. The Minister says that it’s going to define steps that they can take as a government over the next three years. My initial concern, when I read that, is that three years is not long enough. I think in terms of the Mental Health and Addictions Plan, we need to be looking 10 years down the road, even 20 years down the road. This is a fairly short-term plan. I would hope that we would also be looking at this as immediate, but where is our medium and where is our long-term plan for mental health and addictions? I don’t think that’s there.

I did note in the budget on this, on the department summary, that there is an increase in the budget from the main estimates of 2011-12 budget year, but there is a decrease in this year’s mains from the revised estimates in the 2011-12 year. I wonder whether or not that $10 million less that we are starting with this year is going to mean that we have to drop programs and services, and if there is an explanation for that, I would love to hear it.

I do have concerns about our health and social services authorities that some of them are constantly operating in a deficit position. I will have

some questions when we come to that section of the budget.

Part of the funding for this budget is federal funding, THSSI money and that will expire in another year and a half to two years, from my understanding. I guess I want to know from the Minister what the plan is to… How are we going to replace that money so that we can continue to provide the programs and services that THSSI funding is currently providing?

I’m disappointed that there doesn’t seem to be any money in this budget for Family Violence Action Plan phase 3. There are a number of recommendations that have been made. Nineteen recommendations have been made by the Coalition Against Family Violence. I don’t see any direct reference to that in this budget.

Lastly, I just need to comment on supplementary health benefits, Metis health benefits, after the very large kafuffle in the 16

th Assembly when changes

were proposed and then withdrawn. There were some recommendations to the department to put in place some sort of administrative changes that were going to create efficiencies and hopefully reduce the cost of supplementary health and Metis health benefits to the department. I don’t know whether or not some of those have been done, so I will have some questions when we get to that section as well.

I do have other questions, but that is kind of an overview. I am done. Thank you, Mr. Chairman.

Thank you, Ms. Bisaro. We have the honourable Member for Hay River North, Mr. Bouchard.

Thank you, Mr. Chairman. This is one of the bigger departments and one of the ones that has been a very big interest to myself and the community of Hay River. I think one of the things that we would like to see is a little more in the community as far as providing health services. It’s one of the larger centres. We would like to see some of the services that are provided in other communities provided for Hay River.

Obviously on the forefront are doctors. We are still looking to locate permanent doctors in Hay River. The department is continuing to work with their authority, but it still should be a priority to get a group or a team of doctors into Hay River. I think there is great cost-savings to the Government of the Northwest Territories to work on this and to establish this team so that medical travel back and forth from Hay River to Yellowknife doesn’t have to be a continual issue.

One of the biggest areas of concern is the current funding that the Hay River authority receives and some of the flexibility and the lack of a team of permanent doctors there. The community is looking to see if we can implement more nurse

practitioners. Now that the review for midwifery is completed, implement that and maybe offer that type of service to the community of Hay River so that, again, people don’t have to travel to communities such as Hay River or travel to Yellowknife and southern destinations to have their children. There is also, along with that, the cost to the families and friends that only have to wait until the child is born to come back to the community to greet them. I think it is a very big part of the essential services that Hay River is looking to get.

Also in the Department of Health is the addictions treatment. I think this is a big factor in the Northwest Territories. It affects a lot of departments. It affects the economy. It affects justice. The number of addictions affecting the economy and the general public as a whole is great. I think we need to invest money in there to reduce as many addictions as we can, because it is tearing our communities apart.

As one of my colleagues indicated, I think the community of Hay River is also looking to get some sort of input into the health system. We don’t have a health board. The community has no direct input into how the community’s health care system is being operated. There are some small issues that have been there for awhile and continue to raise their heads and continue not to be dealt with, I guess. I think if we had a board or a sounding board for the community to express those concerns, they may be dealt with a little quicker.

One of the other areas of concern is obviously the new health care centre. It is something we are looking forward to. However, the long-term beds that are not in the current health care facility are a big concern to the community. Obviously, it is a big issue to a lot of people there and to a lot of seniors. Not only do we have a high demand in those long-term beds, but in our other facilities for the long-term seniors’ care is in high demand. We have wait lists there. We have people that are beyond the capability of staying at home that are looking to get into these facilities, but there are wait lists. We don’t know when those wait lists are going to be filled. It could be six months. It could be two years. We don’t know.

Those are a few of the major issues that I know the community of Hay River is having with health and some of the health issues. Those are my opening comments. Thank you.

Thank you, Mr. Bouchard. We have the honourable Member for Inuvik Boot Lake, Mr. Moses.

Thank you, Mr. Chair. First off I just want to welcome the Minister and his staff here and just let him know that I do appreciate the hard work and the dedication that this department has to the health and well-being in providing the services and programs to the people of the Northwest Territories.

I do know it’s a challenge. With all the challenges that we face in the remote communities and the high cost of living that we have in the Northwest Territories as well, you try to do the best with what you have.

That said, there are challenges and there are concerns that I bring from my constituents of the community of Inuvik, but also from the territory as a whole. In one of my previous jobs, I had the opportunity to travel to every community in the Northwest Territories and regardless of what the job was, I’d always make it a thing to do and go visit the health care centres and just do a little quick tour, introduce myself to the nurses and see what challenges they were facing. Now that I’m in this position, we can start addressing some of those issues and offering our support to the Minister and his department.

Some of the comments that the Minister had made yesterday, I just wanted to highlight a couple of things. Doing some good work. One of the things that was mentioned was providing speech and language therapy to children in the community schools. I know it’s very high, I’m not sure what the stats are, but they are exceeding what is probably expected. So there’s a lot of work going in there. That said, it allows us to look at other departments on how we can start putting efforts and money and resources into early childhood development, and I’m not talking kindergarten, Grade 1; we’re looking at zero to three, zero to four, right up to the ages of six, seven, eight. When they get to kindergarten, we can’t forget that those are critical years in their lives and the sooner we start, the better results we will continue to see.

I’m glad to see that there’s the Mental Health and Addictions Plan. What I hope to see in that is the long-term plans and also immediate action on what has been said in previous reports, reports that go back however long. We’re going to consult and continue discussions when we already know some of the main obstacles, main challenges that are right in our face, right on our front doorstep. Yet we’re going to continue to consult. We need action on those, immediate action for critical problems that we face right now in the Northwest Territories. Then, as we continue, we can develop a longer strategy looking at somewhere like a 10-year-plan. I know we’ve had a couple discussions here with some of the other departments where they develop a 10-year plan. It would be nice to have this department follow suit with such a critical area. As we know, mental health and addictions are our biggest cost-driver in the Department of Health and Social Services.

Prevention and promotion. We could deal with a lot of problems. It is a priority of this government. However, when I look through the budget plan, I do see a decrease in prevention and promotion and I

think that needs to be addressed. We need to find better dollars where we can educate the people of the Northwest Territories and create awareness on some of the issues that impact us. This is where it starts, right here at our budget planning and our business planning.

As our seniors population increases and gets older, I do see status quo in the budget where no monies have changed, but each year we’re getting a higher increase of population. To make it worse, there was that two-year period, maybe even more, where a lot of our seniors had to wait for hip replacement therapy, joint replacement therapy. So in those two years their health declined and now there’s going to be increased costs of rehabilitation services to get our seniors back into living an independent lifestyle. For those that we fail to do that for, we’re going to need more funding into long-term care centres as these injuries which might have a longer lasting effect where they can’t live independently at home. This just continues spiraling downward. It has an impact on the family, an impact on the homes, on the communities as well.

I see that there’s also a decrease in the population health budget, which I wasn’t very pleased to see, as they do a lot of the community work in terms of evaluating programs, getting out to the communities and some of our programs that we see at the regional community level. Once we get into detail, I’ll get into more questions regarding that and maybe ask why decisions were made to take money out of such critical programs that allow our people to live healthy lifestyles.

There’s also the concern of the deficits that we have in two of our regional health authorities, how we impact that when we have good authorities who are doing good work, but making a policy where because they’re doing a good job, we’re taking monies from them and putting it into the regional centres. Obviously, the regional health authority that I’m from in Inuvik, it does get affected and we do have a deficit, and I appreciate that we get the money from other regional health authorities, but it doesn’t allow those regional health authorities to flourish, to continue to do better programs for their regions. There’s got to be a better way to manage those.

I’ll just make a comment that I know we did have discussions earlier in this government with the Minister and his staff to create a Beaufort-Delta regional advisory committee for our health authority. It wouldn’t be a board, but it would be an advisory committee where they’d give some direction or discuss our major issues and that would get representation from the community levels. As much as I represent our region, I’m also here representing the territory as a whole, and that needs to be reflected in Fort Smith, Fort Simpson, the Sahtu, North Slave and here in Yellowknife, as

well, and it can’t be just directed to one community. How we find that out, how we do that, that’s something we have to discuss. It’s a territorial initiative that we’ve got to continue to move on.

The Family Violence Act, Ms. Bisaro discussed that earlier, but it is a growing concern in our communities and there needs to be something done to address that. We can go through phase 1, phase 2, make some good momentum, but we cannot shelve phase 3. We’ve got to make sure that all the work that’s been done by previous governments, previous leaders, previous staff does not fall on the wayside and that we continue to take their work and move forward.

I’d like to say I was glad to see that there was also the funding for $36 million to fund facilities in their replacements and their renovations. As we go forward with the building planning, that the buildings and the way they’re planned accommodates what we need: detox centre, detox rooms, psychiatric spaces, long-term care facilities and it’s not just for patients.

Another one that’s addressed, and where we’ve had the report and have had discussions with constituents as well as very interested and concerned members in the Northwest Territories, is the Midwifery Program. The sooner the better that we could get that on, we would take some pressure off of our physicians, but it also gives families, expectant mothers a great opportunity to have a healthy birth from conception to birth and show them the support that they need, especially in our small communities. That’s where they don’t always get a chance to see physicians or be able to attend certain programs.

Like I said, I do appreciate the hard work that this department does, based on the challenges, the high cost of living, the facilities, the lack of physicians in some of the communities. I appreciate the hard work that they’re doing and the dedication that they have. The reality is we do have challenges and we’ve got to work on addressing those.

I appreciate that the Minister and his staff for coming and listening to what we’re going to have to say today. Thank you, Mr. Chair.

Thank you, Mr. Moses. Moving on with general comments, we’ve got the Member for Weledeh, Mr. Bromley.

Thank you, Mr. Chair. Thank you for the opportunity to present to the Minister and his staff here today. I have to say that expanding the eHealth is one thing that caught my attention. We had talked about that, we have made some progress, but I’m wondering what are the limitations here and how are we addressing them. We have been talking about this for years now. In discussions earlier today with the Mental Health Commission of Canada, it was also raised as an

important element in addressing mental health issues across the North. I know the Minister is aware of that and I will be interested in how that’s being incorporated into the expansion in our effective use of eHealth.

The funding to support the budget includes funding to support the establishment of child and family services committees. I’m very happy to see that. Obviously, last year we also included funding and I don’t believe there were any committees established. My question on that is: Is the new funding additional? Will we now establish the committees we meant to last year and didn’t, plus the new ones we had hoped we would be doing annually to do the catch-up that’s required here? We’ve invested a lot of money into that work, made recommendations, and I was glad to see the House support that work last year but disappointed in what was achieved.

The capital planning study for the Stanton Territorial Hospital is obviously very critical for this territorial facility. I know this is a multi-stage process, but my question there is: Will we see recommendations for actual work to begin, recognizing that it likely won’t be the full plan or anything and that this is a highly complex undertaking? We are fortunate in having a very solid, long-lived building as a base to work on, but it does have serious limitations in its organization relative to the effective delivery of services. We want to get going on that. We recognize that costs will only go up. I think we’ve been waiting over a decade now for this. It’s been pushed back and pushed back. I’m glad to see that work is happening. Will it result in something recognizing that planning will go on? Can we get started on some improvements that are desperately needed in that facility?

There are many needs in this department for the improvement of efficiency and sustainability. One of these, one amongst many, is the drug cost issue. I know that provinces across Canada are getting together. I’d like to know that we are part of that and we will be enjoying some of the benefits with what that process has to offer.

Connecting patients through services in the timeliest manner. One of our serious costs, I think about 12 percent of our appointments made for outpatients are missed, and for operations and so on. That’s a serious hit to the system, it’s well known. The Minister talks about modernizing our Medical Travel Policy and the full potential of electronic communications. I’ve made suggestions on that. There are mechanisms used by the provinces for just such things. The latest example I sent was the example from New Brunswick of registering vehicles. It’s just a digital communication that goes out there automatically and we need to come up with that and start plugging that cost.

The Mental Health and Addictions Action Plan. I certainly look forward to having a good look at that. Again, I will be looking for a commitment to prevention, as well as addressing the current situations with strong community involvement. I also want to see us meeting our responsibilities rather than shuffling our responsibilities off onto communities. I will be looking forward to reviewing that document.

The Mental Health and Addictions Forum. I appreciate the opportunity to nominate individuals to that. I hope, and I’m sure, there will be a good group of people in that forum to provide advice. There is sort of a happy coincidence right now with the national strategy that’s coming out from the Mental Health Commission. I think we want to follow up on any opportunities for collaboration there. I also have to say that I hope the Minister will also, besides the forum, listen a little bit to committee members who make a real effort to be in touch with our constituents on these issues, and they have brought many of those issues to the table along with recommendations to address them.

Lastly, I’ll leave the rest to detail here. Maybe second last here. Prevention is mentioned a few times throughout the Minister’s introductory remarks, which I really appreciate. To quote, “prevention is the most effective way.” I can’t agree more. I’m saying to the Minister: Where is the Mental Health Court? Where are the new early childhood development programs for the early years? Clearly a health responsibility. Where is the integrated case management promised now for several years?

Now, actually my final comment is, I appreciate the ongoing effort and challenge of medical travel, but we need to get that working. The most basic administrative process is in Blue Cross coverage and reimbursements. It simply revolves on a wheel. The shepherding of patients through the medical travel process in an effective way so that they’re not missing appointments and so that efficient travel appointments are lined up and they see their doctors. It’s not happening. Providing timely results to travelling patients, these things are all what I call yo-yo issues. They keep coming back. We take them to the Minister, the department works to get them resolved, and on a case-by-case basis they might, but back they come again, identical. I really am looking for some work at a fundamental level. I know the Minister is aware of this and has expressed – and actually past Ministers have too. I really hope solutions can be found, again recognizing the complexity and the huge amount of medical travel that we deal with to provide the good services that we do to our people.

I do hear, when it comes right down to treatment, I hear very few complaints amongst our population. There might be complaints getting there, but when

they do get treatment, it’s very good treatment and I wanted to pass that on to the Minister. I’ll leave it at that.

Thank you, Mr. Bromley. Moving on to the Member for Deh Cho, Mr. Nadli.

Thank you, Mr. Chairman. I think, generally speaking, my concerns are more weighted on health issues. For the most part I can recall very distinctly that we made it very clear in terms of trying to promote through the Department of Health and Social Services, a very strong emphasis on preventative steps so that we promote the idea to the public that we need to try and encourage our people to live healthy and wellness lifestyles so that at least down the road we don’t have to bear the consequences of some things that we have undertaken as habits. I think the general understanding was that yes, indeed, we will try to undertake some preventative steps so that we do encourage the people to live healthier lifestyles and lesson the burden on the health care system down the road.

If there’s anything that stands out for me, it’s just over the course of the last summer I think we all came to realize just how volatile sometimes the drug industry is and our reliance on it, especially for people who are really in a circumstance where they’re relying on it for their life. We’ve gone through that experience where there were some place restrictions on certain kinds of medications that affected patients. Sometimes going through the experience, more likely patients are very weird. They want to be assured that measures and systems are in place to ensure that there is a contingency plan out there so that people are encouraged and they are reassured that yes, indeed, those services will not be interrupted.

If there’s anything I should also mention, it’s just, here in the North, we’re very dependent on the natural resource industry. Especially mining. More likely down the road we’ll have more activity related to oil and gas development. That’s almost industrial activities that will more likely determine that we’ll have an increase in the industrial workforce. We all try to promote safety and awareness, but at the same time, there’s always the likelihood of people sustaining injuries that are very serious in nature. Sometimes they have people that, unfortunately, result in serious brain injuries and they have some irreversible damages to their motor abilities. Unfortunately, it could be that we’re not in a position to provide special care, but I feel strongly that at some point in our future, we need to seriously give it some thought and consideration to ensure that we do have a plan of some kind to provide services to people that would need them in those circumstances.

Another area that I think everybody is more likely affected by in one way or another is the cancer rates. It again goes down to preventative steps, but I feel that more likely the system is in place to ensure that we do everything that we can to detect cancer at the earliest stage. It’s so sad and so often that people are in a predicament where cancer is caught at the late or fatal stages, and I think we need to do more so, detection, more practices, so that at least we provide the service that’s really needed in communities. Especially in small communities.

If the department, at some point, would be in the position to consider assisting communities that are closely situated to the highway, especially in my home community of Fort Providence, more likely we will see the eventual completion of the Deh Cho Bridge and we’ll more likely have an elevated increase of traffic. I know we do have first responders in the local community. We have a volunteer firefighter brigade, and we’re almost equivalent to an ambulance, but we’re short of having the qualified people there. My thinking is that maybe the department has to, at some point, maybe work with the community to look at maybe providing first responders, whether it’s ambulance or medic people who can be ready to provide that service. For that matter, I think efforts need to be made again to maybe, as a discussion piece at least, analyze whether it’s doable to look at having a system in place so that we have real-time responses and we can communicate on a real-time basis. That’s cellular service. Whether the department would encourage an establishment of cellular service in Fort Providence, because we have an increased amount of traffic not only of vehicles but of people who boat and hunt. It would be encouraging or reassuring that there’s a system out there like that.

In terms of social services, I think there’s been discussion towards the development of a mental health strategy. I think it’s something that we need to push forward on. We need to ensure that all levels, including community levels, are heavily engaged in terms of trying to bring people together to look at creating some best ideas and best practices. Just building up on the strengths for some communities that have gone down the path before, to the point of almost developing community wellness strategies in terms of how it is they want to undertake to address the alcohol and drug issues. Mainly that’s one of the most prominent problems that we have. To see whether there can be an entry program in terms of how to ready people to go into treatment. After they come out, how do we support them? It’s so critical at that stage that people come out of treatment and they need that support. We need to ensure that we have a system in place that is workable and successful.

The other point too is, on that same nature, we had a very strong effort, an ongoing effort, I would like to think, in terms of acknowledging the residential school experiences that we’ve all, in one way or another, been affected by. We need to see if there could be some cooperative efforts in terms of at least providing the ongoing services for people that still feel the effects of those experiences. We need to ensure that we have a helping hand, that we are there to help them, to acknowledge and put into perspective their experiences that sometimes were good and sometimes were bad.

I think, for the most part, those were my general comments. I think those were some of the key things that I felt the constituents that I serve most feel strongly about, and those are just points that I wanted to raise at this time.

Thank you, Mr. Nadli. We’ll move on with the Member for Nahendeh, Mr. Menicoche.

Thank you very much, Mr. Chair. Just a chance at some opening comments on a couple of key issues for the community of Fort Simpson right now. The Minister talks about investing health care facilities. I know that Stanton requires huge investments, but also planning studies have been scheduled for the community of Fort Simpson Health Centre. It is on their list of critical infrastructure and I’d like to see it progress forward as well. I know it will be challenging to meet the fiscal constraints, but at the same time, government knows that that infrastructure has to be replaced and reconstructed. I just want to say that, certainly, it’s a concern to the community of Fort Simpson and the residents, that their health centre maintains a level of service, so it needs these capital investments and I look to the department’s plan in moving forward the replacement of the Fort Simpson Health Centre.

As well, I spoke in the House the other day during question period about the return of nursing services staff to Wrigley. I wasn’t really satisfied with the Minister’s answers and the department’s strategy for the community of Wrigley in returning nursing services there. I went on at length about how I will be moving this forward and how having the RCMP was part and parcel of the package, so I went and got the RCMP, the dedicated resources for the community of Wrigley. We’re just working towards somehow finding the detachment building for the community of Wrigley so the RCMP can be housed in Wrigley. But at the same time, I never did get the same level of commitment from the Department of Health to return nursing services to Wrigley. I would say that, of course, I think they have one dedicated nurse. Perhaps the Minister can correct me on that, but I think there’s one dedicated nurse to provide for the needs of the community of Wrigley.

All those make a little bit of a difference, but at the same time, restoring the services to the community of Wrigley is their priority. They often feel that they’re left out and neglected by a government that never hears them, and it’s no wonder why. We do the best that we can to, or I do the best I can to represent my constituents, and at the same time, every time the Ministers and government says no, that no is coming from me as well. We all have to work together to meet the needs of our small and remote communities. I know Mr. Minister has been giving me some fangled formula population ratio kind of thing, but that’s not what I’m interested in. What I’m interested in is serving the needs of our people in our small and remote communities. Thank you.

Thank you, Mr. Menicoche. Moving on to the Member for Mackenzie Delta, Mr. Blake.

Thank you, Mr. Chair. I’d like to raise a few concerns that I have with what’s before us. Many a time we’ve brought up the need for a nurse in the community of Tsiigehtchic and all the small communities. It’s something that we struggle with. Many a time the residents in the smaller communities are put in situations where they have to respond to these situations and I don’t think it’s fair to our residents. I think it’s very important that this government put in place, in all the communities, a nurse.

As an interim, one thing, we don’t have a long-term care facility in the Mackenzie Delta, which is Fort McPherson, Aklavik and Tsiigehtchic. I do realize they have one in Inuvik, but it’s just not adequate for the residents of the Mackenzie Delta. One thing that we can do in the interim is increase the amount of home care workers in Fort McPherson and Tsiigehtchic. Right now there’s just a part-time position in Tsiigehtchic, and Fort McPherson only has one person who deals with a large amount of elders in the community.

Just to get back to the nurse, I want to give an example. I think it was about a year and a half ago now, we had a situation in the community where someone broke their leg. We were fortunate we had two nurses on hand who were actually just in the community at the time, but because we don’t have a nurse in the community of Tsiigehtchic, you can’t have things like morphine on hand, and this person had to deal with the pain for at least two hours before we got him medevaced out of the community. I think we really need to address these major concerns, and hopefully within the next year we can focus on those. Thank you.

Thank you, Mr. Blake. Moving on to the Member for the Sahtu, Mr. Yakeleya.

Thank you, Mr. Chair. The Minister is challenged with many, many challenges.

Of course, our system is bulging at the seams with all the needs that we want in the communities that we face. As my colleague talked about Tsiigehtchic, it’s no different than talking about Colville Lake. It’s the same situation. It’s a different town, different time, and situations like that. The Health department is doing its best to get into the community from time to time and be there longer than a couple hours or a couple days. Thank God we have some pretty dedicated people that just need to deal with the situation at hand, and those are our community health representatives that, with the limited amount of training they have, they do the best they can until a nurse or a doctor gets into that community.

I want to say to the Minister that our system is highly diversified by a number of communities, the population and the cost of delivering health care into our communities. It’s quite complex in some manner and sometimes that puts a lot of stress onto our nurses in the community, our doctors, even to our people here.

When the Minister made a presentation to us in April, our residents are not doing too well, like in other jurisdictions. The Minister provided us with some key indicators of our population, such as the smoking rates. They’re pretty high in the Northwest Territories. Addiction rates are pretty high, obesity and healthy eating. When we look at that picture, we’re not doing too good compared to other provinces or even Canada as a whole. That means that when we’re not doing too good health-wise, it costs us more to look after our health. The Minister is challenged with that with the budget that they have and the cost of the aging population going up. It costs more now to look after the aging, because we want our elders and seniors back in our communities, or we have to send them out to Yellowknife here where sometimes they come to the Dementia Centre. It takes money out of the system to look after them. We have some opportunities to see where we could improve on our efficiencies and our sustainability and to look at how we do cost management of this issue here.

One of the things that the Minister has talked about is the government system. He is meeting with the leaders to look at this issue. I applaud the Minister, because he did say that this will not take away from the Sahtu authority or some control on our health issue. We’re looking at some things where we could do things together and put some money where it’s needed. The money where it is needed, the Minister has acknowledged that the top priority throughout the North is addictions and mental health issues. That’s what he said to us in April. That is the top priority. I want to ask about this business plan. What are we doing about the addictions and the mental health issues in the Northwest Territories?

The Minister had taken a trip with me in the Sahtu. We looked at the cancer issues in Fort Good Hope, and the Minister had talked about this work here and not only in Good Hope but in other communities that also have a high rate of cancer. We want to look at the early screening program of cancer. Right now we are catching them at the latest stage where it is too late. There are people already, as I speak, that are impacted and affected with cancer in the Sahtu. We need to have some support for the survivors of cancer for the families. Good Hope talked about this. When they come back to their communities, we need to work with the families with the grieving issue. There’s a lot of sorrow in our communities. Kids especially carry the sorrow for a long time, even adults. We are not properly processing our grief. It stays within us. Even that causes other medical health problems for us, but especially for children. I’m looking for support for that.

The Minister is also tackling the issue of electronic telehealth. That policy could be one factor that could cut down some costs in our health care system. We want to see where that is strengthened and improved.

The Minister and I, when we went to Deline, they talked about palliative care service in that community. They want the elders back in that community. We have nine elders right now that have come out of the Sahtu that are in Yellowknife. The same thing with Inuvik, places that we need to bring them back and let the Minister, working with his colleagues, look at getting the long-term care facility in the Sahtu underway. The Minister answered some questions of mine last week here. We are looking forward to having that facility up and running and bringing our elders back. Too many of our elders have died outside the community. That’s not good for our people. Deline I know has asked if they will look at the potential of some of those units opening so they can have some of the elders being brought back to the community so they can die among their people. That’s what they want.

I know in Norman Wells and Tulita there is going to be possibly an impact of resource development. We need some help in many areas to see where the department can come and work with the communities and with the Sahtu Health Board. I already talked about the dental services. That’s something that I really look forward to the Minister to see how we can get a proper dental program going in the Sahtu. Too many people are leaving with an abscessed tooth, fly here and Inuvik and getting their teeth pulled and getting fixed. It’s too dangerous. We need to get some proper dental service in the Sahtu.

This is the last of my comments here. The Minister has also talked about the doctors and the nurses and how we work with those. We have a solution

made in the North. It’s called a Nurse Practitioners Program. I want to see if we can continue to support this program. These nurse practitioners are graduating. I’m not too sure if there are jobs waiting for them. If not, we should be having jobs waiting for them. We just had a class graduate. I want to know how many nurse practitioners have a job, and how many left the Northwest Territories or are they staying around here waiting for a job. Is this program going to be on again next year? This is one of our solutions that we have here. These nurse practitioners work in the North. They help us and are a valuable service to our health system.

I want to close off by asking the Minister, through some of this business plan, where do we look at the community health centre. I know they had some funding in the community to do some planning for a new health centre, amongst other projects that the Northwest Territories is going to be dealing with. The community health planning centre money was somewhere in there. I want to see where it’s at. It will have to line up with the other projects that we have already for the North here. We have to come to that decision when we deal with it.

All in all, I do want to say to the Minister I really appreciate himself and his staff coming to the Sahtu, and listening to the people and making some commitments to our people in the community. I look forward to going through the business plans with him this afternoon. Thank you, Mr. Chairman.

Thank you, Mr. Yakeleya. Concluding general comments we have the honourable Member for Yellowknife Centre, Mr. Hawkins.

Thank you, Mr. Chairman. There are just a couple of areas that I would like to highlight. It will be no surprise to the Minister.

The budget itself I’ve had a chance to go through. It’s pretty much the same as it usually is. I have no general concerns about that, but what I will use the chance to do is highlight that, first off, I appreciate the help that the Minister’s office provides my office. I am very grateful for it. The Department of Health, in my experience, is probably one of the most challenging departments to run, so I’m glad we have Deputy Minister DeLancey there as the pilot to the captain of the SS Beaulieu ship running that while it is certainly an overwhelming one.

The reason I want to make sure that they get the accolades on the record is because quite often it is an unsung job that happens that the Department of Health and the folks don’t get the recognition they should. It is often coined or joked about as that the department of pain and suffering, because it is just so difficult and challenging. They don’t get the recognition.

The issue I want to highlight today is the addictions and the downtown day shelter, which certainly I am

sure is no surprise to anyone at the table as they all bow their head. Quite frankly, I still don’t believe we are doing enough in the way of addiction. I look forward to some actual results being committed in this term.

It wasn’t just an election issue last fall. This is an issue in this town that is deeply rooted in the desire for success. People want addiction challenged. They want it uprooted. They want it gone. Are they fooled by a treatment centre being the be-all and end-all? No one is fooled in thinking that, but the fact is there is a strong belief in Yellowknife, as well as in the communities, that we need to take a harder stance and certainly come up with more new and innovative ways.

I support my colleagues who want things such as on-the-land programs. I don’t disagree with that. But when you come to hard drugs, those programs on the land just don’t seem to address those needs of hard drugs.

I don’t have the time today to go on at length about that, but it is well recognized and understood that someone who has a crystal meth problem, or a crack problem or whatnot, needs the treatment and medical support to be provided in a region that is able to do that. An on-line program is inappropriate for that. I have often said that I believe we have room for both types of philosophies. It makes sense. It’s just a matter of how we balance out the philosophy and which one we implement.

The downtown day shelter I think, by and large, has not been the success I had hoped for. At the time I was advocating for opportunities for folks who needed somewhere to go during the day, it was seen and perceived as such a great idea that we could help people help themselves. First off it started with the issue of there’s no public washroom or nowhere to go during the day, and the emergence of the shelter itself was sort of, I’ll call it a solution to that problem but, unfortunately, all it’s done is it’s brought the problem together and it’s actually made it worse in that community area in the downtown. The neighbours are, not directly but in a metaphor type of way, constantly being attacked by a barrage of problems and it’s a challenge.

I spoke to a person, who works right across from the day shelter last week, and although I’d known about this problem for some time, he talked about being attacked by a swarm of folks that just came out of the shelter right after it closed at 7:00. I’ve talked to some parents, one particularly who had mentioned how they saw someone flashing folks at the shelter and yet this continues with a blind eye.

I’ve talked about the fact that people are openly using, whether its drugs or alcohol, that it just seems to have the appearance that no one seems to want to step in and say this is not the right

behavior. I mean, fundamentally this not behavior that we should be pulling a blind eye to.

Mr. Chairman, the idealism of the downtown shelter I saw was all built around the components of, okay, let’s give them somewhere to go, but let’s not waste this opportunity before us. Now that we have them here, what are we going to do? Quite frankly, I don’t think we’ve done anything with them other than open up the door. What it’s done is allow bad behavior to continue to grow and it’s grown exponentially.

I’ve had constituents who live in that area, right next to it, have talked about the fact that they shouldn’t, nor should anyone, but they shouldn’t be able to open up their window, look out their window and see people fornicating just across the street. Quite frankly, they’re upset by that behavior. I’m uncomfortable using that phrase in this Assembly. I’m not uncomfortable saying it out loud and the fact is, it’s not really an appropriate context to be talking about in the House, and I challenge myself by putting it out there and saying that, but we have to lay the facts on the table.

I think part of the problem – and I haven’t shied away from this difficult challenge – is the management of this downtown day shelter and I worry that there has been no effort, really, to build any type of working relationship with the community. There was one call back in January about let’s have a community discussion and, of course, it just showed up and the conversation went around the table once and then went flat. There was a pitch with a potential of saying well, let’s create a working group, and then of course that fizzled right after that and never showed up again.

So, fundamentally, the Department of Health has to ask themselves… I mean, are they a partner in the success or failure of this downtown day shelter? I fear that they’ve not only become a partner, but certainly a steward or a witness to the failure of it. I think the principle exists for good reason. I think the partners that we pick to work with have not produced any potential. Is it our fault or is it their fault? I’m using strong words today, but the fact is by not putting the right mechanisms in there or the right reasons in there, I mean, that should be a place of hope, but it frustrates me that it has not turned into a place of hope. That’s what the community felt and I get tired of telling neighbours personally, and I get tired of telling business no, no, this is a place that will help them over the longer haul. Everyone says anyone who criticizes, it’s just a nimble argument, not in my backyard. Well, quite frankly, it’s not when you can stand there and I’ve witnessed it myself. I’ve gone into the day shelter. I’ve stood outside it and watched people drink on the picnic table parked outside. I mean, no one is doing anything and I’ve had staff complain, but then the staff get in trouble if they complain there. The

staff are probably worried about their jobs. They should be supported by the network of the agency that runs it, and they should be supported by the GNWT that sponsors it, and I don’t think we’ve taken the approach that the citizens deserve.

Mr. Chairman, the fact is I think we’re letting an opportunity slip through our fingers. We’ve just dug into the ground, grabbed a handful of sand, it’s just slipping through. We have such potential to offer people there. I mean, we could be sending social workers down there every single day. Yes, I am well aware that there are sometimes agencies that do pop down there, but we could be having health clinics there, we could be having job clinics there, we could have substance abuse clinics there. I mean, we could have a real focus on asking ourselves why do we want them there. It was more than just trying to get them out of the mall or off the street. It was more about trying to remind them that hope can happen and here it is.

This ties nicely into the homeless problem, and I don’t mean nicely because I enjoy that reality, but the fact is we’re talking about an interrelated problem. Some of these people really need hope again, and I support my colleague Mr. Moses about wanting opportunities outside into the regions. If we had homeless shelters in the regions, whether they’re in Fort Simpson, Fort Smith, Norman Wells and Inuvik, I mean, some of this problem wouldn’t be a problem because people would be back where there are support mechanisms called their family.

So what we have here are a group of dynamics that aren’t getting support from any family members. They have no way of getting home. They have no way of building relationships outside of their little nexus that they work in and yet it continues to be a spiral. There isn’t hope if you go to the shelter. It’s actually quite depressing. So families, with their young children, walk by that and they see it, they see what it is, everyday people, good people, all backgrounds, it doesn’t matter who they are or what ethnicity walk by there and they feel uncomfortable walking by there. Why? Because it’s turned into a very large disappointment. It’s something I care and still want to advocate for, but it’s hard looking into the families’ eyes who live there, it’s hard looking into the eyes of the businesspeople who say we want to invest here, when that’s what they look at. There’s no potential, and hope, if anything, has been lost.

So, Mr. Chairman, as time ticks away on me through my opportunity to talk, I’ll say time seems to be ticking away on those folks and I really hope the department deals with the addictions problem seriously.

As I said, I support an addictions centre, we need a treatment centre, I agree with on the land in its own circumstance and I think we need to take a harder, stronger approach on how we administer the

downtown day shelter as we are the partner of partners in that situation. Thank you, Mr. Chair.