This is page numbers 2063 – 2092 of the Hansard for the 17th Assembly, 4th 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.

Topics

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

Tom Beaulieu

Tom Beaulieu Tu Nedhe

The evaluation process is very critical in the RFP. The evaluation is going to give us a very clear indication of where the medevacs are coming from. If the Member from the Sahtu is accurate in his thinking, then, yes, many of the issues resulting from perhaps unrestricted alcohol sales and many people, just many people, period, in the area as a result of resource development, then it is possible that many of the medevacs will originate out of the Sahtu communities. That would be in the evaluation.

When we put out the RFP, I think there’s an indication in the RFP as some background information, as the response is being made that this is background information that can be given to companies, that companies want to know where the majority of the medevacs are coming from, whether they’re coming out of Yellowknife because half the population is here, or the majority of them are coming from outside of Yellowknife.

The other point is it is not a tender, so it’s not based on cost. The cost implications in the RFP are weighted. There’s a weight to the cost, but it’s not the determining factor. It’s weighed just like anything else, and we’re trying to structure our RFP to try to provide the best, safest service to the patients.

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 Wendy Bisaro

Thank you, Mr. Beaulieu. Mr. Yakeleya, your time is up. I’ll put you back on the list, if you wish. Next on my list is Mr. Dolynny.

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

Daryl Dolynny

Daryl Dolynny Range Lake

Thank you, Madam Chair. Again, welcome to the Minister and the health team here.

I’ve got two broad topics within the area of the directorate here. I’ll start with the first one here. Just to set the lay of the land to the question, we’ve got three health boards that have been dissolved over the years that are run by public administrators. That’s Stanton, Hay River and Inuvik. What’s interesting is that through our budget dialogues, the back and forth that I have seen in the last 16 months, there have been many areas where we talked about barriers to accountability when it comes to the delivery of service to our health authorities. There have been issues in information sharing. There have been issues in risk management, efficiency, the consistency of the delivery of clinical practices, the consistency of delivery of patient care or the seamless patient care. We’ve even seen competition for professional staff within the NWT within all of these health authorities.

On top of that, it was clear and evident through the Auditor General’s report of 2011, which clearly indicated that we had contribution agreements to all these health authorities, we had very few performance agreements to the same tune, which caused a lot of issues for the Auditor General of Canada, and I think it caused a lot of concerns for the Standing Committee on Social Programs.

Given what I’ve just indicated, can the Minister indicate what the future long-term goal, the structure, the governance structure for the NWT health system is?

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 Wendy Bisaro

Thank you, Mr. Dolynny. Minister Beaulieu.

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

Tom Beaulieu

Tom Beaulieu Tu Nedhe

Thank you, Madam Chair. The future long-term goal of the health structure, if we’re talking about structure as in personnel, physician services, other health services in the territory, we are hoping that we have a system that is where we have physicians that are available equally to all residents of the Northwest Territories. That’s ultimately our objective.

Now, we’re probably going to have a lot of difficulty providing medical services, as in physician services, on a full-time basis to all communities. That’s going to be something that we’re probably never going to achieve, and that is because of the lower populations in some of the communities. But we will use the Integrated Service Delivery Model to determine what type of service has to be on the ground in which community.

In order for us to do that, we need to look at the governance, and the governance of how we utilize the physicians in the Northwest Territories. The objective, again, is to try to provide physicians as close to the people as possible. That, at the end of the day, is going to save on things like medical travel.

Right now, our work has netted us some results, and we know that there are five new doctors in Inuvik, two new doctors in Fort Smith, and we’re continuing to work with the NWT Medical Association to do something about providing doctors into Hay River. In Hay River, it is an opportune time now, with a new health centre being built there. We are working with the new president of the NWT Medical Association to talk about putting, perhaps, some residents into Hay River that would be Hay River doctors. Whether they lived in Hay River or Yellowknife, that would be determined.

Essentially, at the end of the day, we hope to have a pool of territorial doctors, whether they be in Fort Smith, Norman Wells, Inuvik, Hay River or Yellowknife. An example is of the two doctors in Fort Smith, one of them comes to the Stanton Hospital and works here on a regular basis as well. We are not necessarily always saying that we’re going to put all the doctors here and they’re going to work everywhere else. It could be a variety of ways that we would look at providing physician services to communities. That being one of the key changes that I see in the future for the Territories, that we’re going to be able to provide physician services regionally that will go out to the communities on a scheduled basis, based on the Integrated Service Delivery Model. Thank you.

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

Daryl Dolynny

Daryl Dolynny Range Lake

Madam Chair, I appreciate the Minister sharing views regarding the physician services and a bit of a glimpse of a renewed Integrated Service Model. However, I believe my question was a bit more at a higher level of governance. If I can use the term loosely, board reform or the new landscape of how the delivery of our health care will look in the future, given the fact that we’ve had, as I indicated earlier, a lot of barriers to accountability. These were clearly notified by the Auditor General of Canada, to which I believe does deserve the right lens and the appropriate intervention to make sure that we are as efficient as possible, as the Minister said, with physician services.

I am going to leave that question because I’m assuming we’re going to probably get a very similar response if I ask the question again. So I’ll leave that for another rainy day.

My second component regarding the directorate in terms of governance, is the annual reporting. My question has to do with the timeliness of the reports. We’ve seen, in the past, reporting from the Department of Health and Social Services has been very sparse at times. We have even seen the fact that a lot of the health authorities have been noncompliant. Just for the record, the Financial Administration Act clearly indicates that health authorities are bound by the act to report on an annual basis to show what their performance is to the people of the Northwest Territories.

Can the Minister give the committee here some indication? Because they are part of the directorate, this falls under the responsibility of strategic direction of this area that we are in. Can we get some indication, has this been a focus with the Minister, and can we see improvements in this area this year and for the remainder of the 17thAssembly? Thank you.

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

Tom Beaulieu

Tom Beaulieu Tu Nedhe

Madam Chair, this response needs to have a lot of detail in it because of things that we’re doing. So I’m going to ask the deputy minister to provide a detailed response on this whole question, and perhaps the director of finance may also add to the response. I’ll ask the deputy minister to start off the response.

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 Wendy Bisaro

Thanks, Mr. Beaulieu. Ms. DeLancey.

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

Delancey

Thank you, Madam Chair. For the most part, we believe that the health and social services authorities have met their legislative requirements for reporting. We have a number of legislative reporting requirements for the system. The department is required to table an annual report, under the Medical Care Act, which has been done most years except there were two years missed in the last 10 years, 2008-09 and 2010-11. The department has a strategic plan which commits to annual reporting and we did table a report last fall in the Legislative Assembly which provides a progress report on the status of every measure in the strategic plan.

Health and social services authorities are required to report to the Minister on an annual basis, which they do. As well, they have a number of financial reporting requirements to the department, including quarterly variance reports. Our contribution agreements with the health and social services authorities do include a fair amount of financial detail, in order to start complying with the recommendations from the Auditor General that we move towards broader performance agreements. For this year’s contribution agreements in 2012-13, we have requested authorities to provide a significant amount of additional details specifically on issues like number of ER visits, numbers of no-shows and numbers of medical travel events, which have not previously been reported. Again, in response to the Auditor General recommendations, we have, through a request for proposals process, retained consultants who are working right now on developing a set of system-wide performance indicators that every authority will be required to report on. We expect to have that work done by this August. Thank you, Madam Chair.

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 Wendy Bisaro

Thank you, Ms. DeLancey. Mr. Dolynny.

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

Daryl Dolynny

Daryl Dolynny Range Lake

Thank you, Madam Chair. I appreciate the response. It sounds like we are working towards that end goal. For the record, are we able to say with a degree of confidence that all of the performance agreements with the health authorities will be in place 100 percent within this fiscal year? Thank you.

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

Delancey

The answer is no. We do not think that we can finalize the move towards complete broad-based performance agreements until we have finished the updating of the Integrated Service Delivery Model, which will then allow us to move to update our funding model.

Right now our funding model for authorities is based on historical precedent rather than some kind of a formula allocation basis. As we finish the updated Integrated Service Delivery Model, as we get the system-wide indicators recommendations from our consultants, which, as I said, won’t be until the middle of next fiscal year, we will draw that together and move towards full-fledged performance agreements.

As I said, for this fiscal year we’ve tried to expand the reporting requirements on the authorities. In the 2013-14 contribution agreements, we will cast a broader net and require some additional reporting, but we won’t have made the shift to full performance agreements until the 2014-15 fiscal year. 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 Wendy Bisaro

Thanks, Ms. DeLancey. Noting the clock, Members, I will call a halt for today and I will rise and report progress. Sergeant-at-Arms, will you please escort the witnesses from the Chamber. Thank you, witnesses, for your attendance.

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

The Speaker

The Speaker Jackie Jacobson

It’s good to see everybody happy.

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

An Hon. Member

It’s good to see you.

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

The Speaker

The Speaker Jackie Jacobson

I’m happy to see you, too.

---Laughter

Report of Committee of the Whole
Report of Committee of the Whole

The Speaker

The Speaker Jackie Jacobson

Can I have the report of Committee of the Whole, please, Ms. Bisaro.

Report of Committee of the Whole
Report of Committee of the Whole

Wendy Bisaro

Wendy Bisaro Frame Lake

Thank you, Mr. Speaker. Mr. Speaker, your committee has been considering Tabled Document 9-17(4), NWT Main Estimates, 2013-2014, and would like to report progress. Mr. Speaker, I move that the report of Committee of the Whole be concurred with. Thank you, Mr. Speaker.

Report of Committee of the Whole
Report of Committee of the Whole

The Speaker

The Speaker Jackie Jacobson

Thank you, Ms. Bisaro. A motion is on the floor. Do we have a seconder? The seconder is Mr. Bromley.

---Carried

Report of Committee of the Whole
Report of Committee of the Whole

The Speaker

The Speaker Jackie Jacobson

Item 22, third reading of bills. Mr. Clerk, orders of the day.

Orders of the Day
Orders of the Day

February 22nd, 2013

Clerk Of The House Clerk Of The House

Orders of the day for Monday, February 25, 2013, 1:30 p.m.:

1. Prayer

2. Ministers’ Statements

3. Members’ Statements

4. Returns to Oral Questions

5. Recognition of Visitors in the Gallery

6. Acknowledgements

7. Oral Questions

8. Written Questions

9. Returns to Written Questions

10. Replies to Opening Address

11. Petitions

12. Report of Standing and Special Committees

13. Reports of Committees on the Review of Bills

14. Tabling of Documents

15. Notices of Motion

16. Notices of Motion for First Reading of Bills

17. Motions

● Motion 4-17(4), Federal Support for Sahtu Jobs and Economic Growth

18. First Reading of Bills

● Bill 2, An Act to Amend the Territorial Parks Act

19. Second Reading of Bills

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

● Tabled Document 9-17(4), NWT Main Estimates, 2013-2014

● Bill 1, Tlicho Statutes Amendment Act

21. Report of Committee of the Whole

22. Third Reading of Bills

23. Orders of the Day

Orders of the Day
Orders of the Day

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Clerk. Accordingly, this House stands adjourned until Monday, February 25th, at 1:30 p.m.

---ADJOURNMENT

The House adjourned at 2:03 p.m.