Thank you, Madam Chair. We are very close to having the land tenure sorted out with ANSI and we’re very close. They didn’t want to proceed on dealing with the land tenure issue until the project was substantially complete. So this is what we’ve done. We’ve completed the facility as of August 2012, this past August the unit was considered to be final and, therefore, we’ve moved with the Aboriginal and Northern Affairs Canada in the process of finalizing land tenure and we are at the very final stage where we’re expecting to have that resolved very soon. I can’t give the exact date, unfortunately, but we’ve been moving forward on this.

I’d like to thank the Minister for that response. It gives me a sense in terms of where the problem may lie. It is a fundamental issue in terms of the land and the jurisdiction.

I know there have been some discussions in trying to bring the service to the ground level. There have been some talks with the two health authorities, including the Deh Cho and the Hay River Health Authority. Where is that at and are we going to see an alignment of this initiative along with the move to try to sort out the land issue and to ultimately have the health centre operable? At what point can we expect or the reserve residents expect the health centre to be open?

Thank you. We have had the two CEOs from Deh Cho Health and Social Services and the CEO of the Hay River Health and Social Services discussing how they’re going to be able to provide a service to the people on the reserve using that health centre. So the plan is that we’re going to be most likely using the medical services out of Hay River to come across and provide service on the reserve. So right now it’s just sorting out some of the details.

I mean, as soon as the land tenure is done, that place will be operational. We’re just going to sort out the details and then between the two CEOs they’re going to come up with a plan and remembering that this involves an Integrated Service Delivery Model. So we would look at what services can be provided right out of that health centre and so that individuals don’t have to go from the reserve across to Hay River, especially a 15-kilometre drive in the summer months to see the medical clinic when maybe there will be a doctor in Hay River one day a week or one day every two weeks, maybe a nurse practitioner a few days a week, a registered nurse and so on and so forth. So we were going to try to find the right integrated service that’s needed, the right medical services that are needed for Hay River and we’re going to try to put those services in that building using the staff at the Hay River Health and Social Services.

I just wanted to ask about the land tenure. Are those discussions primarily with Health and Social Services and the First Nations? Is the federal government involved with those discussions and at what point would there be an agreement?

Thank you. The actual discussions are between Municipal and Community Affairs, Public Works and ourselves with the federal government.

Thank you. The point that I think that I wanted to inquire about is what level of discussions have been happening with the federal government to ensure that they’re part of these discussions. Because what could happen is that as you path out, at least to wrangle through the jurisdictional layers and to get to the ground level to ensure that the health centre is operable, perhaps you could be setting a template for perhaps other departments to work cooperatively and collaboratively with the reserve.

We don’t have the detail of the level of discussion between officials for the GNWT and the federal government through ANSI, the federal government, Aboriginal Affairs. So we can provide that information to the membership or to this Member. It shouldn’t be difficult to pull that information together. We can pull that information and provide that to the Member.

Thank you. This is perhaps my final question. Can we expect the health centre to be open by the new fiscal year?

Thank you. We’re expecting the health centre to be open early in the new fiscal year, early.

Thank you, Minister Beaulieu. Next on my list… First of all let’s recap where we are. We’re on Health and Social Services, directorate, operations expenditure summary, $8.599 million. Next I have Ms. Bisaro.

Thank you, Madam Chair. I have a number of questions on this page. I wanted to start off with looking at the federal funding that we have, which is due to expire in a year’s time, give or take. The information that we have currently indicates that much of the federal funding is being used for supplementing, I guess, our medical staff, doctors, nurse practitioners and the other large piece is supplementing our medical travel.

I mentioned in my comments the other day that I’m quite concerned with the fact that we haven’t yet got an extension of this federal funding. I appreciate the fact that the department is working on it, but I’d like to ask the Minister specifically about the money, federal money that we have, which is used to supplement physician services and supplement nurse practitioners. I think it’s also used to supplement nurses in small communities as well to a certain extent.

So I’d like to know from the Minister, he mentioned yesterday that while if we lose the money we’re just going to have to find it. I’d like to know from the Minister if we don’t have a bit of a better plan than just sort of a wing and a prayer and hoping that we’re going to get this money and if we don’t, well, then we’ll look at things at that time. What kind of a plan do we have in place to deal with the programs which are now, in terms of physician services and nurse practitioners and other programs within those sorts of provision of medical services, what plan do we have to keep those programs going when we lose federal funding?

Thank you, Ms. Bisaro. Mr. Beaulieu.

Thank you, Madam Chair. Our first plan A is to try and retain the THSSI funding. We are on the schedule of the federal Minister, and when the federal Minister wishes to discuss the plan or the furtherance of the THSSI funding with us, then at that time we will have that discussion. If there is no discussion and the money is sunsetted or lapsed, then we will need to come back to the Legislative Assembly to fill the gaps. We really don’t think it’s an option to reduce medical travel by that amount. We really don’t think it’s an option to lay off six nurse practitioners. We really don’t think it’s an option to reduce physician funding in Stanton.

I’m glad to hear the Minister say that it’s not an option to reduce physician support and nurse practitioners and that we will continue to fund those. I also sincerely hope that we will get an extension of this federal funding, because we desperately need it in order to provide the proper physician and nursing support that we need for our hospitals and health centres.

With regard to medical travel, it’s been mentioned by many Members and with regard to the amount of money that we currently put in to medical travel from our federal funding, it’s a large amount. What plan – and the Minister’s talked about a review of the Medical Travel Policy – exists specifically to medical travel to either (a) reduce the costs of our medical travel, or (b) find another revenue source to supplement the medical travel costs that we endure?

Just off the top of my head, a lot of the prevention work will reduce medical travel. Electronic medical records will reduce medical travel. E-health also will reduce medical travel. The TSN, I think we have a different name for that now, Territorial Support Network, where there’s a doctor on call who is able to assist people in remote communities through the telehealth system. Those items are intended to reduce the cost of medical travel. Otherwise we’re back to, without THSSI funding, the increase in the Canada Health Transfer will probably end up filling the gaps in 2014-2015.

Thanks to the Minister. The Minister mentioned a number of things that the department is hopeful will create a reduction in the cost of our medical travel. Could I get an indication from the department as to how much money we are, how much federal money is going into medical travel at this point and can I get an indication of what kind of cost savings the Minister is talking about when he mentions the programs that he mentioned.

The federal portion of medical travel is $3.2 million. There are many factors that are involved in reducing medical travel costs. Inflation is an issue. Any contracts within the medical travel system could also be an issue, depending on how much we’re able to sign contracts for, such as medevac, ground services and so on. These are things that are very difficult to predict. Also, the usage of some of the systems that are made available, how effective they are at using the system. The electronic system is designed to reduce this and, actually, mainly designed to provide a better service to the people. It’s difficult to really say. We do things this way because we can see that it should save, but costs seem to go up. Maybe we can contain the costs. That would be something that may be the best we could hope for. The thought is this would save some travel money.

I appreciate the Minister’s point that things change and we can’t predict everything. I realize that contract amounts change, inflation has an impact, but I’m troubled by the way this is presented in that we think we’re going to save money because it looks like we should. I would hope that the Minister, I’m going to ask the Minister, does the department not have a better method of deciding what changes we’re going to make? It sounds to me like, well, this looks like a pretty good idea so let’s just try this one. Surely the Minister should be able to, and the department should be able to, estimate, give or take a certain amount of money, the savings that will be generated by any one of the things that he mentioned relative to medical travel. That’s what I’m looking for, is a general estimate of cost savings relative to this $3.2 million which we’re now using of federal money.

The other point I want to make is, I didn’t hear anything in the Minister’s response to indicate that there’s going to be an evaluation of the changes that we have put in place, or that we are going to be putting in place, to determine whether or not these changes are helping us to reduce costs in medical travel. To those two things: an estimate of savings, is that at all possible from the department, and is the department doing an evaluation of the changes they’ve put in place to determine if they’re good or bad?

We will definitely be evaluating the systems that we employ. We think that an essential part of introducing new systems. We don’t have estimates but we are trying to move forward on these things. Some of our activities we’re trying to move forward on. We’re told to stop evaluating and move forward. If we don’t evaluate and move forward, we’re told we’re not evaluating. So here are some of the decisions that we’re making. We’re moving forward on this because we think that the system, without a thorough analysis on whether or not this system is going to save money and exactly how much money it’s going to save, we’re moving forward because common sense tells us this type of thing, keeping people close to home and not having to fly people to Yellowknife for a doctor to examine the individual for something that could be very minor, it may be painful but it could be minor, so this electronic… An example is even transferring digital images to the Stanton Hospital has seen a flattening or containment of some of the costs in medical travel. We suspect that this is something that is going to save money in the future. We’ll see as we move forward.

Thank you, Mr. Beaulieu. Next on my list is Mr. Yakeleya.

Thank you, Madam Chair. I want to ask the Minister somewhat in line with Ms. Bisaro’s question and earlier with Mr. Dolynny’s question. It has to do with medical travel and, specifically, I want to ask the Minister with regard to medevacs in our region.

I know there was some discussion about that with our regional people and the timing. I know the money is a real big issue. We’re always balancing the service of a saving a life versus what it costs for the medevac contracts. I know I’ve been speaking with the airline operator in Sahtu and looking at how we can best save a person’s life and looking at the medevac services with the Department of Health and Social Services, if they are looking at, soon, decentralization of the medevac services. It was done at one time, a report was done, it came back with the best service by the central, one location. I’m looking at the medevacs to see if that would be decentralized to the Inuvik, Sahtu, here and in the South Slave area, if that would make sense.

I don’t think it would take very much to get the operators of the airline companies to sit down and see how they could help each other out with a backup plan to their backup plan on aircrafts. We know that this issue is dear to our hearts and stuff, too, and I think something could be coming good out of this type of discussion. It’s something I want to ask the Minister if he’s willing to look at decentralizing the medevac services into our regions in the Northwest Territories.

Thank you, Mr. Yakeleya. Mr. Beaulieu.

We are going to be putting an RFP out for medevac services. This spring we are starting the evaluation of the service that we currently have. The detailed information we get from the current medevac services is going to give us the information that we need to draft an RFP that’s going to be able to provide the best service to the patients possible. The RFP would not indicate that we need a decentralized model, that you have to have a plane in Norman Wells or you have to have a plane in Inuvik. It’s not going to request that kind of detail. It’s going to request that the best service possible be provided within the call for RFP. The companies would then determine whether or not putting a plane in a place like Norman Wells or Inuvik or someplace outside of Yellowknife, assuming they have more than one plane, that if they would put a plane there they would be able to provide the safest, best medical service to patients in the NWT, period. So it would be based on that that we would evaluate the RFP.

There are companies that do believe that something closer to the centre of the Northwest Territories needs to be a plan on the ground. That way you can get into more communities that are further away from Yellowknife a lot quicker. When we look at the RFP we will be thinking that it’s going to provide the best service possible for the patients.

Madam Chair, the Minister has highlighted a critical point for us in the Sahtu. As the Minister of ITI and I have noted, the activity in the Tulita and Norman Wells area is very busy with oil and gas activity, and more and more people are coming into our area. With the lifting of the unrestricted liquor sales, it just adds to the issue of services in health care.

Medevac is one that is dearly held to our hearts because that’s our lifeline outside to services in Yellowknife or in Edmonton. We don’t have the luxury of an all-weather road yet. Hopefully that will be some time down the future. That’s something that the Minister has spoken on, the reality. With the RFP coming out based on doing that evaluation of what is the best way to provide the best services for our patients, that’s key for me.

One of the things in the background is the dollar signs, the money. You gave us the numbers of what it costs to fly in to our communities and what it costs to fly out of our communities. I want to ask the Minister what times are we looking at when the evaluation will be done and then when the RFP would come out, roughly.

There are people within the airline companies that want to work together. They don’t have to compete; they can work together. I know that’s true. I heard them this morning say that we don’t have to compete against anyone. We can work together on this. That’s what we’re looking at because we just don’t want one company to have everything and the rest of the companies are saying, well, what about us. These airline companies want to work together, and I think we can do it. I think that’s what I’m looking for.

In the Sahtu we have some good companies, and in Inuvik and in Yellowknife here or in the Deh Cho. We have good companies that could help each other out here. That’s all I’m asking for, is to give us a fair chance and let’s work together in the North because there are not very much of us to get this work, and we’re all Northerners. We all live here, and pilots are one of the most respected professions in life because they fly in all types of weather.

The key here – I liked what the Minister said – is the best service for our patients. That’s key for us in the Sahtu where there is no other transportation. Other than our short period of winter roads and boats in the summer, we fly.