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

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

We were initially responding to the third item down on program delivery details on 8-17. We thought we were responding to health services administration so, yes, we were responding to a different item the first time when we talked about $1.4 million for salaries. We were talking about that item. I just for a minute thought that we were still talking about that line item, but now we’ve moved to the bottom one and that’s what we’re responding to now.

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

Robert Hawkins

Robert Hawkins Yellowknife Centre

Okay. No problem. I understand accidents happen. No, I was always speaking to HSS authorities administration. Maybe, for the record, if we could get the breakdown of exactly what that is. Let’s start with that. Let’s start with the full breakdown in some detail.

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. Hawkins. And you’re referencing $15.588 million? Mr. Hawkins.

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

Robert Hawkins

Robert Hawkins Yellowknife Centre

That’s correct, Madam Chair. I believe that’s the only item, financial item that’s attributed, but that said, maybe the Minister can clarify if there’s more as well. 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

Thank you. I’m just trying to clarify. 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. To read the fine print I have to remove my glasses. The $15.588 million, I could give the breakdown of the authorities first of all. Starting with Beaufort, $3.3 million, roughly; Deh Cho, $1.4 million; Fort Smith, $1.4 million; Hay River, $2.6 million; Sahtu, $1.2 million; Stanton, $2.6 million; Tlicho, $900,000; YK, $2 million. This is for executive, corporate board trustees, planning and development, quality assurance, risk management, internal audit, finance, human resource system support, communications, material management and volunteer services.

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

Robert Hawkins

Robert Hawkins Yellowknife Centre

Okay. That’s the type of detail that was very helpful. Thank you very much.

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

Next on my list is Mr. Moses.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Madam Chair. Just for some clarification here. I didn’t really want to get into all the super detail about the Midwifery Program, but responses that I’ve been hearing from the Minister this afternoon have really got me concerned, actually. My first question, he mentioned earlier, and I could go to Hansard for clarification, but just for the record, I want to ask the Minister of Health and Social Services, when he made reference earlier to looking at a territorial model as the model that he was looking at implementing, can he confirm that under his leadership that he was confirming that he wanted to implement the territorial model out of Yellowknife?

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. Moses. 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. We were looking to put the territorial midwifery program in place three fiscal years from now, so we are discussing, assuming that the mains that we’re talking about now is 2013-14, so 2014-15 of the next phase and then 2015-16 would be the regional. The expansion for Yellowknife would be in year 2016-17. I guess it would not be in this government but we would hope to have all of the funding approved and the program moving through the system if we stay with that schedule.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

Also for clarification, the Minister had mentioned managing risks, and he made reference to it on more than one occasion. I just want to get clarity on what the Minister means when he says managing risks. In terms of the Midwifery Program, residents of the NWT, the report, all the stakeholders made a recommendation that the community-based model is the most recommended model that we should be moving forward with. They didn’t ask for a consultant. They asked for a community-based model. I want to know what these risks are that the Minister is talking about.

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 risk that I am referring to, the management risk that I am referring to was the involvement of physicians. We have a Midwifery Program in place that, as I indicated, would involve physicians as well. Some of the risks associated with childbirth are considered to be risky, so we just wanted to ensure that we had the support of the physicians in order to manage the risk surrounding childbirth. That’s what I was referring to when I said we were trying to manage the risks by engaging the physicians.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

There are just so many areas that I can continue on. Managing risk. The Midwifery Program is put in place to help a lady when she finds out that she’s pregnant. It helps support her through her pregnancy so that she gets the counselling that she needs, she gets the support, she gets the alcohol and drug treatment, healthy pregnancies. If midwifery is not there to give the support, especially for single mothers, then the high

stress level of flying to Yellowknife from the small communities and spending all the time here to give birth without the support of a midwife in the community, the cost to the government as well.

There was a question about costs. It’s in the report. I think on average it was somewhere around $12,500 for perinatal care, and the highest cost was in Ulukhaktok for about $16,000. Managing risks, we can manage risks during the birth, but we can do a lot of preventative and supportive work nine months leading up to the day of the birth.

Other questions here. In terms of legislation, in the report it says the NWT government passed the Midwifery Professions Act in 2005. If this Minister wants to update these regulations, there’s probably going to be a cost to change the act. There’s going to be also, following regulations – the midwifery professions general regulations, prescription and regulation of drugs and other substances regulations, and the screening and diagnostic test regulations – there are going to be added costs to that.

Can I get confirmation on whether that legislation is going to need to be revised, or reviewed and amended, as well as all the regulations? And does the Minister believe there’s going to be a cost to changing those as well?

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

We don’t see any need to change the act. If he’s referring to the cost of changing the act, then no, we don’t see any cost.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

How about the regulations? The Minister said he was going to change some of the standards earlier, in the discussions earlier today. I think that is going to have an effect on regulations. And when it has an effect on regulations, there’s going to be something in there that’s going to have an effect on the act. I just want to get confirmation if the Minister feels there’s going to be also some changes needed to be put to those regulations.

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

We’re not anticipating that change. We were going to change the standards. Maybe we could have further clarification. We weren’t thinking of changing the act or regulations but putting in territorial standards and other standards around education and so on. Perhaps I could get the deputy minister to provide some detail on what we consider or think the cost would be around that change.

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 Daryl Dolynny

Thank you, 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

Debbie Delancey

Thank you, Mr. Chairman. I’m not a practitioner, so I can only go so far. My understanding is that the act is relatively recent, would not need to be updated. The regulations are also timely. The act does provide for the Minister to approve a framework of practice. My understanding is that when we talk about standards, we do not have an updated framework of practice.

The Member has noted that there was some work done in 2005 but that it may not be current with standards nationally, it needs to be updated. That is the work that we are talking about when we talk about establishing this consultant position that would initially do some of that developmental work and then would have on an ongoing basis a training mentorship and oversight role.

When we talk about risk management, we’re talking in large part about being able to monitor midwives. I understand, from a professional perspective only a midwife can monitor or audit the practice of another midwife. So we need to have somewhere in our system the capacity to do that on an ongoing basis.

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 Daryl Dolynny

Thank you, Ms. DeLancey. Mr. Moses.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

Two really quick things before my time runs out here. In terms of doing more consultation, the co-ordinator position there, I just want to, for the record, mention the groups that were consulted initially. There were 31 participants throughout the NWT as well as national organizations from the communities, as well, also a topical expert. Actually, I won’t even get into it. Hopefully the Minister does know who they are as it is in the report.

For the record, can the Minister let me know what the total costs of all the consultations – all the costs to get this report done in terms of consultation and hiring staff – what was the total cost to the government to put this report through that he seems like he doesn’t want to put any action to?

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 Daryl Dolynny

Thank you, Mr. Moses. Mr. 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, Mr. Chairman. We don’t have that information here with us today.

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 Daryl Dolynny

Thank you, Mr. Beaulieu. Mr. Moses, your time is up. I know you had a second question. If you want, I could put you back on the list. Moving on with questioning I have Ms. Bisaro.

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

Wendy Bisaro

Wendy Bisaro Frame Lake

Thank you, Mr. Chairman. Just a couple other questions on this page. One has to do with – and it was briefly mentioned I think when either the Minister or the DM talked about governance and change – there has been talk about centralizing the administration of the authorities. I didn’t quite understand where things were at with regard to that centralization of the administration for authorities. I gather it’s in the works. When might we expect that is going to be finalized? Is that another four- or five-year project?