Thank you, Mr. Speaker. Today I’d like to follow up on some questions that were being posed here in the Legislature last week on midwifery. I want to say in my preamble that I was very glad to hear the Minister of Health and Social Services not agreeing with everything that was being suggested about midwifery, and using words like “common sense” and “basically pushing back” a little bit on this theory that midwifery is the panacea of birthing opportunities in the Northwest Territories.

Being from a community where there are currently no resident physicians, certainly the desire of people to have their children in their home community is real, and I understand that. I had three kids. I had them all in Hay River not two blocks from where I lived at the time, and that is wonderful when those children can be born there. I think we are deluding ourselves if we think that midwifery in and of itself is the answer to all of that.

I’d like to ask the Minister, even after midwifery is in place, will people who are having a first child, a high-risk pregnancy, will they still need the conventional medical services in order to birth?

Thank you, Mrs. Groenewegen. The honourable Minister of Health and Social Services, Mr. Beaulieu.

Thank you, Mr. Speaker. Yes, that service will still be available and needed. Midwifery will not replace that. Midwifery will be a complementary practice.

So it will be a complementary service and it will be optional. People could still have their choice of being in a hospital and going through child delivery in what I’ll call kind of a more conventional sense. Midwifery is an optional, additional, supplementary service that will be operated. I keep hearing people say let’s roll it out, let’s roll it out faster. I don’t want to see it roll out and then have to roll up because we didn’t lay the necessary groundwork. There seems to be some confusion about protocol, about best practices, about liability, about all of the issues that need to be addressed and the backup and support. There seems to be a lot of question out there about where we’re at with the model. Now, we know that it’s been happening in Fort Smith for a long time, but maybe the Minister could bring some clarity to the kind of groundwork that needs to be laid before this service can be rolled out in a community like Hay River.

Just to make it simple, I think one of the key things is developing midwifery regulations. The thing with it is to ensure that the model would work effectively and would be beneficial to the region. Once the health centre is built, Hay River is going to be like a small regional operation as opposed to just a community operation like it is in Fort Smith. That is why we are rolling it out in that fashion. The next step after that would be a larger regional operation, or people grabbing midwife services in Inuvik would be coming from further away, so the visits are different and the care is different. It’s going to be that type of service.

So then one of the questions that begs to be answered and I’m hearing in various places is: If we have to have midwifery regulations in place first, how is it then that Fort Smith has operated with midwives and midwifery services for all the years that it has, but when it comes to Hay River we have to create new regulations? I’m not saying that we don’t, I just want people to understand why that’s necessary.

The regulations being developed for Hay River, again, would be a regulation that’s developed so that the midwife services are delivered on a regional basis but not the full regional basis. We are trying to, as we’re getting the new hospital and health centre in Hay

River, then we’re going to roll midwifery services into that facility and there will be more regulations developed in order to do a regional and, ultimately, a territorial one that will be based out of Yellowknife. That is the reason that we’re rolling it out in that way.

Thank you, Mr. Beaulieu. Final supplementary, Mrs. Groenewegen.

Thank you, Mr. Speaker. One of the foundational pieces to expanding midwifery services in the Northwest Territories is going to be the engagement of a midwifery consultant. Perhaps the Minister, for our benefit, could also explain what the role of that consultant’s position will be.

At this point we are thinking of approaching the midwives that are in Fort Smith to talk to us about how the program functions in Fort Smith. Right now the midwives have been doing deliveries in Fort Smith for the last several years, I think since 2005 when those regulations were developed for the community of Fort Smith. Now that they have doctors in Fort Smith, how that will change and how the system will work with doctors and how the system would work without doctors. The role of the midwives would be to give us the on-the-ground information on what works and what does not work. We’re hoping to use the current midwives to do that.

Thank you, Mr. Beaulieu. The honourable Member for Hay River North, Mr. Bouchard.

Thank you, Mr. Bouchard. The honourable Minister of Health and Social Services, Mr. Beaulieu.

Thank you, Mr. Speaker. Once the determination has been made that we will add this bariatric care or obesity or in the whole area of those being overweight to the insured services and how we deal with obesity into insured services, then we will make a decision on when and how we will go through the process. Part of the process would be if an insured service is added, then it will be more cost. Once that determination is made by the Medical Association and by the department that bariatric services will be added,

then we will come back to the House for more money to carry out that service.

I appreciate the Minister’s answer, but in that answer there’s no indication of any kind of timeline. Are we expecting to see this in a month? Three months? Are we expecting to see it in the fall? Or are we going to deal with it in another Assembly?

I don’t want to be throwing out dates guessing at these things. All I can say is that bariatric surgery is on the agenda for the team of individuals or the committee that has the NWT Medical Association and the department on it looking at the system now. I’m hoping that it doesn’t take years to come out with something. However long it does take, it would be once we’ve decided that this would be an insured service in the system, then we come back through the regular business planning process. However long it takes for us to add this and get this approved through the business planning process, considering all the other pressures on the system, then we will have a better idea of when this can be approved. It may be in the next business cycle. If it’s in the next business cycle, it will be a year from now.

I appreciate the timeline there. I’d also like to ask the Minister if, to speed the process up, they have looked at any other jurisdictions such as Alberta and Quebec who are funding some of these types of surgeries.

I don’t have that information, but I’m assuming that when we move into any area that may have already been covered by other jurisdictions that we do look at best practices. If we haven’t looked at best practices, then I’ll ask the committee to look at best practices in this area.

Thank you, Mr. Beaulieu. Final supplementary, Mr. Bouchard.

Thank you, Mr. Speaker. I have no further questions but I do look forward to seeing that happen sooner than later.

Thank you, Mr. Bouchard. The honourable Member for Range Lake, Mr. Dolynny.

Thank you, Mr. Speaker. I rise once again as a follow-up on my Member’s statement earlier today on last week’s devastating deadly highway crash north of Fort Providence. Again, our hearts do go out to the families involved.

As in my last question with the Minister of Health and Social Services, my questions will not deal directly with the accident itself as it is still under RCMP investigation. However, they will deal with

the level of first responder care, patient immobilization and highway medical transport in the NWT. My questions today are for the Minister of Municipal and Community Affairs.

Can the Minister of Municipal and Community Affairs indicate 33 communities in the NWT have proper ambulance or a van ambulance that has all the safety standards to secure, immobilize and transport victims in the event of a highway accident?

Thank you, Mr. Dolynny. The Minister of Municipal and Community Affairs, Mr. McLeod.

Thank you, Mr. Speaker. I’m not sure of the exact number; however, I would assume that in places like Yellowknife and Hay River and those on the highway system with properly trained first responders would have ambulance services.