This is page numbers 2093 – 2142 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

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

Mr. Chair, my next question has to do with the pharmaceutical costs. I know seniors are going up something like 8 or 9 percent a year in the Northwest Territories and we are known to use a lot of drugs, apparently. The costs are going up. I know the Minister has been working hard to try and find out what we can do in the area of pharmaceutical costs.

Is there anything yet achieved or where are we at in our work towards trying to achieve some cost efficiencies with bulk purchasing or whatever? I know there have been a couple of things happen with just a couple of drugs at a federal or national level that have gained us significant savings. Thank you.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Tom Beaulieu

Tom Beaulieu Tu Nedhe

Mr. Chairman, the cost, just to provide some information, has gradually increased from 2007, about $3.6 million, to in 2011-12 about $4.1 million. In addition to that, I’ll have the deputy minister provide some details on the work we’re doing in the Pharmaceutical Management Strategy.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Minister Beaulieu. Ms. DeLancey.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Debbie Delancey

Thank you, Mr. Chair. We did provide a briefing to the Standing Committee on Social Programs not long ago. We’re still in the early stages, although we have put a number of pieces in place. We did have an initial report done by Alberta Blue Cross on considerations for developing a pharmaceutical strategy. We have done some work with Alberta Blue Cross in terms of implementing changes to how our programs are administered, but we’re really at the early stages of putting together the components of a

pharmaceutical strategy. Some of the things we know we need to look at are catastrophic drug coverage, expensive drugs, and the possible review of our formulary. Right now we use the NIHB formulary. We are working with other provinces and territories under the Council of the Federation initiative to look at generic drug pricing.

A key priority on our work plan this year is to do what the Member is talking about, which is looking at potential for cost savings. Part of that will come through common procurement and bulk purchasing, and I did talk earlier about how all of our authorities have agreed that moving to common procurement has to be a priority under our back office initiative, so we’re putting a work plan in place for that. We are also going to be working this year to do a more detailed analysis, drilling down into the potential for other cost-saving potential and how we acquire pharmaceuticals.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Ms. DeLancey. Mr. Bromley.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Bob Bromley

Bob Bromley Weledeh

I think this is a big topic, but there’s obviously a very rich area for ongoing work here and I think I’m going to leave it at that rather than drill down into this, and I’m sure we’ll be visiting in committee about this further. I will leave it at that. That’s all I have on this page.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Bromley. Page 8-27, Health and Social Services, activity summary, supplementary health programs, operations expenditure, $26.730 million. Does committee agree?

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Some Hon. Members

Agreed.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you. Page 8-28, Health and Social Services, activity summary. Mr. Hawkins.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you, Mr. Chairman. If I was to look for a line on medical travel, is this the only funding source area that I would search out or is it listed in any other line somewhere within the government?

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Mr. Hawkins. For that we’ll go to Minister Beaulieu.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Tom Beaulieu

Tom Beaulieu Tu Nedhe

Thank you, Mr. Chairman. We have some details here that I would maybe have the deputy minister just read the cost detail for the other areas like the revenues that come in to pay for medical travel and also the THSSI, I suppose.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Minister Beaulieu. Ms. DeLancey.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Debbie Delancey

Thank you, Mr. Chair. This is the main line item in the budget for medical travel. There is another just over $500,000 under hospital services which also relates to medical travel. What’s important to note, though, is that this is not our full budget for medical travel. This is the full

amount that we vote, but Stanton Hospital, that runs the Medical Travel Program, gets an additional $12.7 million in revenues so that their full budget for medical travel is about $29 million. There is a shortfall. They are predicting a shortfall in that amount of about $2.3 million for this year.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

The Chair

The Chair Daryl Dolynny

Thank you, Ms. DeLancey. Mr. Hawkins.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

I appreciate that answer and, certainly, the forthrightness of it. Where does the additional money come out of? Can I get some help in the description of, sort of, connecting the dots? I mean, it must come from somewhere.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Debbie Delancey

The additional funding comes from third parties, so for example, costs that we recover from the Non-Insured Health Benefits program, costs that we recover from third-party insurance providers through our EHB program, out-of-territory residents' recoveries, recoveries from the RCMP, WCB and other private sources.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you for that. Just adding a little further, so is it safe to say that… Sorry. Would it be correct to say that medical travel, then, is on budget for core cost and should we be including third-party cost in its normal line budget? If the taxpayers of the Northwest Territories asked the simple question does normal medical travel under the cost of our programs we offer as a government service, are we on budget or are we within budget, is that a fair statement to make?

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Debbie Delancey

The other portion of the budget that’s realized through revenues is included in the main estimates on the revenues page. We do show anticipated revenues, and of course, that’s based on historical trends, so we do our best guess at estimating that. It’s fair to say that it is reflected in the budget under the revenues.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

I appreciate the reminder of where that money comes into the system and then add it to the $16 million, which brings us to the rough total of the whole program of being about $29 million. I’m, I guess, really talking about the question of for what we’re responsible. Are we within the normal budget threshold of what we’re responsible for as a government? I’m going to ask, can we separate the third-party responsibility for a second, because it seems as if that is an actual cost, and I do have a separate question for that one.

If a little kid is out playing, trips, breaks his leg and has to fly to Edmonton, that would be our cost. If it’s an RCMP member who did something and it fell under their insurance, that would be a separate cost. I’m really asking, is our responsibility under our budget, are we on the threshold of normal budget programming or over, under or within a normal tolerance?

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Tom Beaulieu

Tom Beaulieu Tu Nedhe

We are underfunded for the medical travel of about $5 million.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you to the Minister. The next question I have is about the third-party gap. Under the third-party gap – and I appreciate the deputy minister’s detail and highlight how she clarified some of that – do we find we get short-changed on any of that and, if so, could someone from the department, through the Minister obviously, provide that level of detail, what we’re left on the hook for.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Tom Beaulieu

Tom Beaulieu Tu Nedhe

We are not aware of any shortfalls anywhere in the third-party billing.

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Robert Hawkins

Robert Hawkins Yellowknife Centre

Alright. Now, does this medical travel benefit here, adding all those numbers up, is that only reflective of what’s transferred over to Stanton or is that also in consideration to what’s farmed out to the authorities? When an individual authority needs to charge something to the medical travel budget before it gets on to the Stanton Territorial travel budget, would that be the global budget or is there a separate budget line item for all the authorities?

Committee Motion 7-17(4): Reprofiling Midwifery Coordination Funds In Community Programs, Carried
Consideration in Committee of the Whole of Bills and Other Matters

Tom Beaulieu

Tom Beaulieu Tu Nedhe

That’s the entire budget, the global budget for the whole system.