This is page numbers 3723 – 3762 of the Hansard for the 17th Assembly, 5th 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.

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 Robert Bouchard

Thank you, Mr. Moses. Next on my list I have Mr. Nadli.

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

Michael Nadli

Michael Nadli Deh Cho

Thank you, Mr. Chair. I have a few comments, at least five points I want to raise, just to highlight.

First of all, I think this department is the biggest department and, of course, the most challenged

because you are dealing with very core, primary issues related to the health and well-being of people. Obviously, it comes to how programs and services are carried out and delivered. At the receiving end of the services the government provides are people, people who live in large centres, regional centres, cities, but for the most part in small and remote communities.

That being said, there are major initiatives that have come across in Fort Providence, at least, one of four communities that I represent, is the new health centre. I know the foundation is complete and things are steaming forward. There’s a reprieve at this time and I understand contrition is likely to begin in the new fiscal year.

In small communities we’re challenged with infrastructure and buildings that can be available that can be converted and provide a service to another sector of the population, whether it's youth or elderly care programs. So I hope there is a dialogue that has been done with the local communities in terms of looking at some options on how the old health centre can be procured and its fate decided at some point. I encourage the department, if there is dialogue going on, to maintain that dialogue. Don’t discount the people at the local level. For the most part, we’re challenged to find buildings to house programs and services and offices.

The other point I wanted to make is in terms of the regional health boards. I know there are some cost-saving measures. This is the biggest department and has the biggest budget. It carries the highest expenditures, so we have to look at ways of curbing expenditures and, at the same time, being very efficient with what we have and make the best use of it. That’s the price of democracy, ensuring people from the regional centres and communities do have input and continue to at least have a major say in how programs and services are delivered in regions and communities.

That being said, if indeed we go down the path of restructuring boards, what we’re basically doing in this government is walking away for a template of a regional model that could serve as the basis of self-government when First Nations go down the line of achieving the status of making their own decisions.

That point being made, seniors, in terms of their care, is a growing concern. Most seniors want to continue living in their homes for as long as they can. Either themselves, if they are independent enough, or with their children and grandchildren. Sometimes policies don’t consider that. We have to be mindful that we have different cultures and different expectations, and at the same time, we have an obligation to service the needs of people. Once again, if there is a possibility of looking at the fate of the old health centre in Fort Providence and converting it into a long-term care facility for seniors

as our population of elders grow in most communities, then by all means, let’s explore the possibility.

The other point that I wanted to make is I think this government has been a major precedence, it has responded, it’s doing something. With the on-the-land program, I think the government has responded and it’s good. What it tells me and the people in the communities is that we have developed a culturally appropriate model to address the addictions problems in our communities, whether it’s drugs or alcohol. We are trying to at least create a system so that people can make decisions for themselves in terms of making a choice of living a healthy and well lifestyle.

I think that’s a major precedent that we’ve set for ourselves. I‘m hoping at some point there will be advances to ensure we invoke practices such as allowing traditional foods in hospitals for elders. I think that’s the next step in developing culturally appropriate programs and services.

The other point I want to want to make is with Nats'ejee K'eh Treatment Centre. I think it was widely known that there was a lot of disappointment and disbelief in terms of the only addictions centre in the NWT. We’ve kind of repositioned the priorities in advancing the on-the-land programs. There again, I don’t know what’s going to happen with that building. I know there’s been some discussion with the local First Nation in terms of the use of the building and ensuring that it’s available, whether it’s for programs and services, and not just abandoned but put to the best use by local people of the K’atlodeeche First Nation.

The other point in the same instance is this government, of course, has made advances, again how great leadership in establishing the Anne Buggins Wellness Centre. That was a great achievement and I was very pleased to see that. They had a very nice ceremony. From what I see there, it’s an establishment of the GNWT working to wrangle their jurisdictions of layers of policies and procedures that sometimes become a hindrance in delivering quality programs and services to people on the reserve. I encourage the department to continue advancing to ensure that we determine very good programs and services delivered on the reserve. I think that’s doable and I encourage the department to keep on working with the communities.

Those are just some of my comments today. I am reminded of the statement I made today on child poverty. That’s a very strong hindrance in trying to promote advancement and well-being of children. It’s a big issue that a big portion of our population is stagnant. It’s not growing; it’s not declining. I think as we look to the future, our children are our future and we need to do our best to ensure we have programs and services available to families so they

succeed either in education or advancement of careers and making their homes in the NWT.

Those are just some of the points I had, Mr. Chair. Mahsi.

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 Robert Bouchard

Thank you, Mr. Nadli. Next on my list is 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. Chair. My comments are in no particular order and I would like to thank the Minister and his staff for being here.

The department, in my mind, has a huge responsibility. They’ve got a huge section of our total territorial budget. By and large, I think the department is doing a pretty good job. Certainly there are wishes from Members for the department to do more but, you know, when push comes to shove, we kind of all would like to have more.

That said, there are some priorities which I feel are priorities to me and also to some other Members on this side of the House that aren’t getting the attention I think they should, and by attention I mean financial attention. I know the staff are working very hard to do what they can, but you can only go so far with what money you have.

So, some of these are reflective of my priorities. Some of them are just general comments on the department, as a whole.

I know the department is working towards a change in the governance and our system of authorities. I think it’s something which is overdue and I commend the Minister and the department for taking what I see as action at this point. It has been talked about for quite a long time and I’m glad to see that I think we’re going to be moving forward in the near future on making some concrete changes. We have been making changes in terms of sort of operational activities, but we need to talk about how we are governing our health system. We’ve been talking about it, but we need to actually make some changes to our system and I think we’ll find efficiencies if we do that both in terms of PYs, but also in terms of actual dollars.

The Minister has said a number of times to Members in committee and outside of committee that early childhood development is a high priority for the department. I’m hugely supportive of that and I think the early development instrument results, although they were preliminary results, but we’ve had those in the last couple of months and those are very indicative of the attention that we need to pay to our zero to three-year-olds. It’s my belief that we should be putting more money than what’s in the budget into child and family resource centres. If not centres, because we’ve had two and I don’t know if we’ve had a chance to evaluate them, but certainly on paper they look to me like they’re the best way to go, but if we’re not going to be putting money into that particular program or activity, then we need to put it into another activity. I

just don’t think that this budget reflects as much emphasis and as much spending on our zero to three and zero to four-year-olds as it should.

The Minister tabled an updated Mental Health and Addictions Action Plan just within the last week or so I think. I’m glad to see that there has been some recognition of some of the activities that have taken place and some of the other plans that have been put in place in that there’s a change to the Mental Health and Addictions Plan which came out last year sometime. I would hope that all the plans that the government is dealing with not just within Health but that all departments would do the same thing, that an action plan doesn’t come out and then sit there stagnant for five years. They should be a living document, much like a strategic plan.

I note in the Minister’s opening remarks that $3.2 million will address a base deficiency in Stanton’s medical travel budget. This has been an issue for many years and I would just like confirmation from the Minister that this is an ongoing $3 million that is going to be addressing the deficiency in the medical travel budget, but at the same time, I thought I had heard noises that medical travel and the costs for medical travel was going to be moved to the department. So, I’m a little confused if this $3 million is being added to Stanton’s budget or if medical travel is going to be at the department level.

Right after that the Minister said $5.2 million has been added to the budget to address increased costs for residential placements outside of the NWT, and that again has been a cost which we have been funding by supplementary appropriations, certainly as long as I’ve been here, and I would like confirmation that this has been added to the base and that we will be better budgeting for the costs for our residential placements outside of the NWT in the future. That’s what it sounds like, but I’m just not sure of it.

The other thing with medical travel and somebody mentioned that we’re reviewing the policy and absolutely we need to review the policy. I think the Minister mentioned the Med-Response, and the Med-Response system, I think, is going to assist in some efficiencies with medical travel. I certainly hope so. I’d appreciate confirmation on that. I’d also like to know when the Med-Response system is going to take effect. I don’t believe the Minister mentioned when Med-Response is going to take flight.

The Midwifery Program, I’m very glad to see that there’s money in the budget for this program. I am disappointed, however, that during last year’s budget deliberations there was money added to the budget for midwifery to advance the Midwifery Program and that didn’t happen. I presume that that money lapsed. Members on this side of the House felt that we wanted to get midwifery in Hay River

sooner than what the department was planning. We also wanted to get it started in Inuvik sooner than what the department was planning. So I was really disappointed that that didn’t happen. I presume it was a capacity issue with the department, but I would hope and I’m not sure exactly when we’re expecting to have a midwife or a Midwifery Program in action in Inuvik, but I’d appreciate confirmation of when.

The Minister has advised us that the department is working on assessing our long-term care needs and I have a particular interest because of the long-term care facility which exists here in my community in Yellowknife. The Aven Centre is looking at an expansion and I know the Minister has said that the capacity at Avens will be considered in conjunction with the long-term care needs right across the territory. So there is a report coming, I understand. It’s been coming for quite some time. I’d appreciate knowing from the Minister when we can expect that report. As has been mentioned by a couple of Members already, seniors are an ever growing part of our population and I think as is pointed out in the Aven’s proposal, which the Minister has seen, the need for long-term care beds for seniors and for care for seniors, whether it’s acute care or not, it’s huge.

The need for enhanced and identified services, and generally mental health services related to wellness courts, the needs for services for wellness courts I don’t think has been totally identified by the department. I know that the recognition is there that we need to have those services in order for wellness courts to go ahead, but I think the department should be putting more emphasis on making sure those services are in place so the wellness courts can basically get going. We’ve been talking about this, again, for a very long time.

There’s no mention in the Minister’s opening remarks about the child and family service committees. I know that’s been a really difficult program to get going, I would just be interested in knowing whether or not that program has been kind of put off to one side because it has been so difficult.

The Anti-Poverty Strategy was mentioned and I am very supportive of the work that the Minister has done on the Anti-Poverty Strategy. He has involved people outside of government, he’s involved many aspects of our community outside of government and it’s proven to have produced us a pretty good document, and they’re working on the action plan right now. I think my biggest concern with the Anti-Poverty Strategy is that I don’t know that that strategy and the action plan that’s being developed is going to look at the difficulties and the impediments that policies across government create for people who are in poverty and/or particularly assessing income assistance and other

programs. In my mind, in order for us to actually have the Anti-Poverty Strategy work, we have to make sure that we don’t have policies that are working at cross-purposes to each other. We’ve talked about this before, but I’m not so sure that the government has taken it on as an issue that is extremely important.

Lastly, I want to make a comment about deficits for a couple of our health authorities, particularly the Beau-Del and Stanton. I guess there’s been, again, a lot of talk about sort of how to fix it and if we are going to fix it. So I would appreciate knowing from the Minister at some point what his plans are to try and make sure that we fund authorities appropriately so that they’re not in deficit because, in general, I think they’re in deficit because we aren’t funding them properly.

I have the same concern about my own local Yellowknife Health and Social Services Authority. Their deficit is not nearly as large as Stanton, for instance, but they’re still operating in a deficit and the Minister needs to do something to look at all of our authorities, and maybe the governance will change things, but we have to look at all our authorities and make sure we fund them properly so they aren’t operating in a deficit.

I see my time now is up so I am now done. Thank you, Mr. 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 Robert Bouchard

Thank you, Ms. Bisaro. Next on my list I have Mr. Bromley.

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

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Chair. There’s certainly a little overlap. I know the Minister is hearing that, so I’ll try not to repeat too much. This department is up 8 percent in budget and that’s the reality, but it is a high increase this year. Although I do note, as I think it’s been noted, that the Territorial Health System Sustainability Initiative funding came in after this budget was drafted, so I’ll be looking for an update when we get into detail. Just a heads up there.

I notice in the directorate that it’s up 25 percent over two years, which is not typical of the rest of the divisions. On closer examination, a lot of it is compensation, but again that didn’t happen with the other divisions, so I will have questions on that. I also note that there’s a modest contribution to the Anti-Poverty Strategy, which is a smaller proportion of that increase.

The ECD, early childhood development, obviously needs extremely strong partnership and collaboration between Health and Social Services and ECE, but I’d like the Minister to know that I do support the suggestion that Health and Social Services should take the lead role, especially for the zero to three category of early childhood development, recognizing that it depends on big efforts on both departments and real collaboration. I think the problem is that ECE is so overwhelmingly

domineered by their education commitments, and perhaps rightfully so, that it tends to distort the absolutely essential, the absolute requirement that we bring this focus as the topmost priority in our ECD work to zero to three, and I know there are lots of things starting to happen and that have been happening. I think this is not a new recognition, but we do need a renewed emphasis.

I am very pleased, as I know others are, with the establishment of the Aboriginal health and community wellness division, and I’m looking forward to a positive start with that work on mental health and addictions. Again, the Minister knows my and committee’s view that mental health or a wellness court can really be one of the most effective things that we can do to address one of the most serious and costly sets of cases that we deal with for many reasons, and I won’t drearily go over them again here, that we must deal with. Again, we’ve been at it. Let’s really get going on this. What we’ve heard to date is too modest. It’s not acceptable, so we’re looking for better effort there.

There is some reorganization, perhaps, that will be coming down the pipe. We really do need to clarify and simplify our lines of authority to seek consistent direction and emphasis, the things that you would expect from a leader, and I think the department needs to provide that in the management of this huge health system. I’m not totally knowledgeable on this. I know it’s early days and the Minister is working hard on this effort. I’m supportive to the degree that I am aware of it and know anything about it. It seems like we’re going in a good direction there now and I urge the Minister to continue with that development and implementation.

Some concerns, I know that the department has not fulfilled the direction provided by the House in, for example, areas where we have provided specific resources in the past, and the examples that come to mind, as we’ve heard, are ECD and midwifery. I did hear the Minister’s reference to starting work in the Beau-Del. That’s very positive and that would catch him up, as the Minister can do that, this fiscal year that’s coming up and complete the Hay River work. I think there would be a little catch-up happening there and I’d be very happy to see that.

The last thing, long-term care beds. We are doing things in this area, but I know the Minister is aware that we need a lot more. We’ve heard ad infinitum that our age structure is changing demographics. Perhaps we’ll hear more about the plan to address that and come up with a well thought out, comprehensive plan. I was disappointed to hear that Avens is backing off on their efforts, because I think one of the worst areas will certainly be Yellowknife where people tend to migrate to when they have particular needs. I hope that will be

recognized in the plan and that the Minister will get busy on this. I’d hate to see us 5 or 10 years down the road seeing a lot of seniors suffer because we haven’t done the work to get that in place.

I think we’ll get into the details here. I’ll leave it at that. I’m not expecting the Minister to respond to a lot of these, because I know they will be coming up in detail, but I did want to bring them up because I think they’re important enough to be repeated.

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. Bromley. Again, moving with general comments, I have Mr. Blake.

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

Frederick Blake Jr.

Frederick Blake Jr. Mackenzie Delta

Thank you, Mr. Chair. I just have a few comments and concerns to raise with the Minister. First off, it’s been about two years now that through the department we’ve had a commitment to implement the Beaufort-Delta health board back up in the Beaufort-Delta region, and the residents up there are still waiting for a voice from the community to represent them. That’s really lacking up in the region. Although a lot of services are improving, the residents still would like a voice on the board. I think all we need to do is do a bit more training in the financial area. That’s where a lot of the past board members felt that there was really no education for the board members in that area. I think that simple little training that if we apply it to those board members, whoever they may be in the future. I’m really looking forward to that and I hope by the end of our term that we could have this board in place.

Also, I’d like to commend the department on the improvements with the medical escorts over the last couple of years. A lot of the elders that are travelling had a lot of difficulty, especially travelling to Edmonton. Many of them have gone there for the first time and they don’t know where to go even in the airport. It’s really stressful on them, especially if they’re dealing with major issues like cancer and other life-threatening issues. It’s added stress. I’m glad to hear that the department is offering counselling to those that are affected by that.

Next, a lot of concern in the Beaufort-Delta riding that we need a health care facility, whether it’s in Aklavik or Fort McPherson. Fort McPherson is larger and has a larger population of elders in that community. In my riding alone we have 350 elders that are over the age of 60. That’s a clear demand there. Inuvik has a small facility that could hold, I believe, roughly 20 people or so. This is going to be needed in the future, and I highly recommend that we put it in Fort McPherson because they do have a full-time road that’s accessible, which I believe would cut costs.

Also, nursing in Tsiigehtchic, as I mentioned, it’s been just a few years back that we did have a full-time nurse there, 10 years or so, but if we could do it then, we could do it now, and there’s a clear demand there as well.

Also, for the positions that are in the budget for Fort McPherson and Aklavik for nursing, I highly recommend that we fill those positions and willing the work of the department to do that. If it’s not possible to fill those positions, maybe we could transfer them to Tsiigehtchic and that would make things a lot better.

Those are just a few comments that I had, Mr. Chairman, and I look forward to the response. 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 Daryl Dolynny

Thank you, Mr. Blake. Moving on with general comments, I have Mr. Yakeleya.

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

Norman Yakeleya

Norman Yakeleya Sahtu

Thank you, Mr. Chair. I want to make my comments to the Minister and I want to thank the Minister and his colleagues for the continuous efforts and push towards the new wellness centre in the Sahtu and the territorial long-term care facility and the exciting news about putting the training program and what we need to do to get that operational, off the ground and put forward to having some sort of ceremony, maybe this summer, to kick-start the excitement, and the previous Minister also was involved with that. I want to thank the department for their efforts to take my questions as I nag you through the system, because it is exciting and we want to make sure that it stays in the books and I thank the government for making those commitments.

In saying that, I would like to follow through this venue here, another venue that the Tulita health centre has been in the planning books. I know there is one last piece of detail that we have to look at before we start looking for money for the Tulita wellness centre. I am just calling the Metis right now in Tulita, because that is where the letter went, to see where things are at. I know that there was a meeting set up to see what we have to do to maintain that piece of infrastructure on the books, given all our other infrastructures that we wish to have. I wanted to thank the Minister for keeping that also on the radar here.

Mr. Chair, I do want to say that the issue that I talked somewhat to the Minister on not too much, but one that I brought to his attention is that we have elders that fly out of our small communities. They come down to Yellowknife or Edmonton for medical services and the way the airline operates and the timing is not conducive to some of our elders. The ones I am speaking about are ones in wheelchairs or walkers, or are fairly old and fragile. Because of the airline schedule, sometimes these elders have to stay at the Norman Wells Airport for an extended period of time. I was asking if the departments operations and maintenance can look at an elder who has cancer goes for treatment or elders who are with walkers or disabled, that they could be put in a place where they can rest. Work with the health centre in Norman Wells so they can

have a place where they can rest, have something to eat, have some tea, watch some TV maybe, but not just stay at the Norman Wells Airport for two or three or four hours. We are young, so we can handle it, right Minister? So, we look out for most of the elderly people. That is what I would like to look at and go to. It is not going to be all the time, it is when these elders have to come to Norman Wells to catch a flight south. That is what I am asking for. I have run into some incidents where some of our elders have been staying at the airport for five hours. I am not too sure if they ate or had any tea or they were looked after. It makes me sad to see how we treat them, so I asked the Minister if he would put a little effort into looking at something like that, where he could make it work. It would be on a case-by-case basis. Just so that elders that have cancer, they could go to a place, so I ask for some civility, I guess, to see what we can do there.

In Tulita we have people over 60 years of age. There are 74 of them, according to my stats here. In Deline we have 54; Colville Lake, 16; Fort Good Hope we have 64, and in Norman Wells we have 85 people who are 60 and over.

In doing my homework here, these elders that I listed off, in Colville Lake 94 percent of people consume food from the land. In Good Hope and Deline, 77 percent; in Tulita, 79 percent; in Norman Wells, 29 percent. I say this for a reason, Mr. Chairman, because of these high percentages of numbers where our people consume food from the land, so that goes to the point I want to talk about. I want to talk about food that is offered in our health centres.

In Stanton Hospital, I know the Minister is working on that. In any facility now that we have elders in, like the Aven Manor, or up in Inuvik, or Simpson maybe, in our hospitals, these elders grew up from eating food on the land. There is a health benefit also to it. I know you have the Aboriginal wellness council going pretty strong and pretty forceful, and I like to see where the Aboriginal patients have a direct access to getting food from the land served to them by our government. It should be representative, just like we have a policy where we have employees representing the population. So if there’s 65 percent Aboriginal people, we should have at least 65 percent of Aboriginal foods in the hospitals, not 5 percent or 10 percent or whatever. Boiling fish is good, fish broth is good, ducks, geese, beaver, rats, they have to have all that food. That is what they grew up on, so we cannot deny them that. I wanted to raise that with the Minister to bring those numbers up. I do want to say to the Minister, I really, really support the Aboriginal Wellness Initiative, the directive, the on-the-land healing programs, all those good things that are going to plant the seed now. It is good that the department is listening now, we have dedicated money to those initiatives. For 10 years I have been

saying this, now we are finally starting to see. Now let’s give that a chance, let’s give it a whirl and see what we can do for our people.

I want to say to the Minister that the medical travel certainly needs to be something that is revamped and looked at for our people. I also want to say, on the same thing, medical travel has done some things that have helped my people also. I am not going to be too hard on them because they have done some things that I think have helped me, as a Member, in getting my people back home. So it is not all criticizing the system or the people in there, it is just what we have set up.

The issue that I want to raise, and the Minister certainly heard it from three of us a couple of days ago, is on increasing the nurse presence in our small communities. Without nurses, we don’t have any nursing in our communities and there are nine communities in the Northwest Territories. I look forward to a discussion paper, something that will say this is how or when we will want to get these communities on to the same level of health care as the rest of the communities in the Northwest Territories.

The challenge, and I know the Minister is up for a challenge, actually he has had some pretty good programs when he was working in it some time ago. I think that’s what I want to do too. Work hard for us. The budget is pretty good in the health field here and I certainly hope we have some further discussions on the federal government’s announcement on having money come to the Northwest Territories and how we’re going to use that money. That’s all I have to say, Mr. Chair. 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 Daryl Dolynny

Thank you, Mr. Yakeleya. Moving on with general comments, I have 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

Thank you, Mr. Chairman. I’m just going to use this opportunity to highlight a few areas of general concern. Of course, I’d certainly like to see ourselves do a little more in the treatment area. I’m not sure that the Minister’s Forum, in my view, was their forum panel, and certainly research done on addictions and whatnot was the approach I would have liked to have seen. They have come up with some recommendations, but like anything, it’s all about implementation and how we follow through. There was a commitment in there, the observation of making a treatment centre available or treatment spots available in the North and South and I have yet to see them emerge, so I certainly look forward to the application of that and not sort of the two-step dance away from accountability, so we’ll have to see that.

You know, you don’t have to go very far in this city for people to call upon the government, asking yet again where are these treatment centres that they want their government to commit to. Ironically,

accountability is a funny thing. It seems to be a difficult thing to put our finger on around here, because this is what the public wants but yet the government finds new ways to avoid it. I certainly hope this is coming to an end, at least the excuses, that is, because, quite frankly, the constituents and the people of the Territories deserve the follow through on these types of initiatives that they’re asking for. I mean, if the people are asking for them, I find it odd that the government cannot respond to that need. Yet again they use their many, many people studies and resources to deny the public what they are truly looking for.

The homeless problem continues to be an issue. I often hear this brought up at regular discussions when I’m out visiting folks. People would like to see more initiatives on this. This isn’t just a Yellowknife problem. I think Yellowknife certainly has its own problems with it specifically, but what I think needs to be done more so by the government and certainly by the Department of Health is to find money for programs, for regional centres. The reason I say that is when we are presented anecdotal evidence, we find a very low percent of the people attending these opportunities for people who are homeless. What we find is the vast majority of these folks really belong and are from the communities and regional areas and they want to go home, but of course, if you ask them where they’re from, then they’ll say that there’s nothing there for them to go to. That continues to be a fundamental issue that I’d like to see addressed as an emerging focus and a problem that needs some real help and heavy lifting. If we had more money invested into homeless centres in regional areas, people would be able to be more connected with their regions and certainly their families. I would say those interties are so important they could help us down the road with other issues.

I won’t be spending any time at this particular second, but I do look forward to asking about position vacancy in every area I get a chance. I’m going to be asking about funded positions and unfunded positions and certainly how we fund them. I mean, let’s get to the bottom of some of these things and why are we running positions in existence that aren’t funded, so why aren’t we asking for the money to fund them.

At the same token, this money doesn’t fall… I think it was so eloquently quoted today that they don’t just show up because of pixie dust. I’m not sure what fairy is dropping that funding off. But that said, that money has to be coming from somewhere. Hence, that now leads into the next point of saying I certainly look forward to the updates on each regional health authority to find out what their current deficit is, how are they addressing these things, what are their plans and their focus. I’d like to know things about the establishment of the boards and why don’t we have boards in certain

areas. I think there are lots of good questions about those particular areas and I’m sure we’ll hear lots of good answers. I am certainly optimistic we’ll hear those answers.

One of the issues I continue to raise, and I will continue to raise in speaking of deficits when it comes to health authorities, is the doctors’ pay, which I think is such an embarrassment of this government to put these doctors’ costs on these health authorities, which truly should be a departmental cost. This is very frustrating to watch that these authorities have to carry these things. For example, Yellowknife Health and Social Services Authority has to carry the doctors and they have to send them out, they have to find overtime, they have to do training time. I mean, just the headaches alone. If this government was proactive, not reactive, we would place these doctors all sorts of we’ll call it from an accountability framework point of view and they would make them financially accountable at the department. I think ultimately that would take some of the stress off the authorities. When we look at and wonder where some of the money is coming forward to pay for these things, they have two choices: find it somewhere within, which means they either, you know the old saying, steal from Peter to pay Paul, or, of course, they run without and that means they run with a position that’s empty, reallocate. Who knows how they get through their budget year? I mean, sometimes we just don’t know. Hence we end up with authorities with deficits. Frankly, I’ve never once really heard a good excuse why and I don’t think anyone believes it.

I think moving doctor pay to the department could go a long way in solving that. I don’t know of any MLA that wouldn’t support an initiative if we had a crisis that needed support. I mean, I know a couple of years we’ve had different sorts of fallouts of problems that have come forward and we know when it’s important and, by golly, if it’s important, bring it to the Legislative Assembly and don’t be afraid to ask for money. If it’s meaningful, we’ll support it and if it’s not meaningful and important, well, then you’ll get your answer.

As was probably mentioned by my colleagues, we continue to have the call of the naturopaths wanting to be regulated. I’m not sure if my other colleagues mentioned it today, but it’s certainly worth mentioning because it’s something that needs to be looked at. I’ve even received an e-mail, and I think MLA Bisaro spoke about it yesterday or the day before, that they want to extend their authority to be able to do some stuff. I’ve heard cases where naturopaths want to prescribe therapy but they have to go through a doctor and then they have to get a doctor to sign off on certain elements of we’ll call it the investigation process and then that doctor takes responsibility. But some of the naturopaths are very credited and credible, very insightful and

very capable, and we should be asking ourselves why aren’t we using this resource for what it is. Yet again the public speaks. Yet again the government falls deaf to the cries of the people. It’s frustrating to watch.

It’s days like this, you know, I wish we were a typical party system because we could throw those folks out of Cabinet because they’re not answering to the needs of the public, but we’re not a typical party system and nobody is accountable to these things, because they always just blame it on the last government and no one is around to take those responsibilities.

I’ve asked for suntan beds to be legislated. Although this is a small issue, it’s an important one. I think if we were wise, we’d certainly be going down that path.

Let me continue to reaffirm – I’m not sure if my colleagues have mentioned this one – the importance of midwifery and the expansion of it. It has turned down to a dull roar on this particular issue right and I think what’s happened here is the need for the service has sort of gone to a whisper. Yes, it’s important, but I think people have given up on it because they just see our government dragging our heels on this. It’s a service people want, a service people definitely need, a service we can certainly divert out of our typical normal process of needing a doctor in a standard healthy case.

Again, another demonstration of the needs and the direction and the wants of the people are, well, quite frankly, being ignored. The government always finds money for subsidies of their projects, but when the public comes forward very strongly and says they want something, it just seems like you cannot garner any attention of the government. I often wonder what you do. We continue to raise the issue and they just continue to chuckle and say, don’t worry; we’ve got money for our projects and our ideas in Cabinet but just no money for the people’s ideas. I wish we could exercise more authority.

The last area I’d like to highlight, although I can’t specifically say where the project is now, but I would certainly make special note that the project over at Aven Manor is still on the horizon, although I don’t think it’s on the front burner of activity of development. I think there’s still a continued underutilized resource there. There’s energy behind the board, there’s optimism behind the organization, and certainly there’s land and resources and a partnership that I think isn’t being embraced the way it could be. I like the fact and I love going to the Aven’s area where you see seniors active and enjoying life and being part of it. I think it’s a phenomenal community that I would like to see personally that we develop in other regions in the Northwest Territories. I don’t know

why we can’t have more of these things. It all starts with some vision and some support. Whether it’s housing or it’s health or it’s a partnership thereof in some manner or some form, I think it’s a real missed opportunity that we’re not developing these types of things.

Again, I said this and I mean this. I can’t speak to the present state of that project and expansion that they want to do over there. It may be on the back burner, but the problem is we need some support from this government. Of course, they will say that they don’t have any money, which when it’s a Member’s idea, of course, they don’t have any money. I’d be shocked if they ever said yes. But that said, it’s something that I would hope the Department of Health would be finding and helping advocate for and certainly working with them to leverage new opportunities and partners with everyone else.

Just a few random thoughts with health and I will have more. Like I said, I will be asking, when appropriate, some questions regarding position staff, money, funding, where it is and why it isn’t there, et cetera. We will be there. 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 Daryl Dolynny

Thank you, Mr. Hawkins. Moving on with general comments, I have Mr. Bouchard.

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

Robert Bouchard

Robert Bouchard Hay River North

Thank you, Mr. Chair. Obviously a very important budget, the Department of Health. It’s the biggest budget we have, $391 million, just about $392 million.

I guess, in no particular order, some of my colleagues mentioned some of these issues, but obviously I want to mention them again.

Midwifery, obviously I’m pleased to see that in the budget for Hay River. I know we were talking about the implementation last year. I’m definitely looking for assistance in that area to help people be able to put Hay River, Northwest Territories, back on their birth certificates. It is definitely an issue I have been pushing since I got elected. I think midwifery is going to be an option for some of those people out there, not the answer to everybody. Only certain people meet those requirements or feel that comfort level in midwifery, but I am definitely excited about the project. It’s maybe not just a birthing issue but also an option for ladies before they give birth and after they give birth. It’s definitely an asset in the community that we’re looking forward to having.

Along with that, the constant demand or questions about filling positions of doctors in Hay River continues to be an issue. I know the department has been talking about trying to do more with centralization of doctors, helping our authority to place doctors in the community. I look forward to keep working at that. I think we had one success and she seems to really like it in Hay River. I’m

hoping that it’s a selling feature for doctors to come in the future.

The next topic I want to talk about is medical travel. Obviously it’s a big dollar item for the department. There always seems to be issues with people for medical travel, whether they are eligible to travel, whether they can fly direct. More recently, I just had a senior talk to me about wanting to fly direct to Hay River from Edmonton, but was given a little bit of a run-around from the department because the costs are cheaper to go through Yellowknife through some other commercial airlines. I definitely have a concern in that area. We should be trying to make it convenient, especially for seniors that don’t want to have to wait in the airport and in Yellowknife here for five or six hours at a time. I think we should be looking at convenience for elders, obviously. With that, though, our seniors are very accommodating. That senior actually indicated to me that he was very pleased with the staff at Larga House. They need to be commended. They do a great job.

The next item that I wanted to talk about the Department of Health is obviously the new health facility that is being built in Hay River. We are excited for that. Construction seems to be going well. Obviously, we had concerns about the extended care beds. The department has shown us that it is in their capital budgets to come forward, but I guess we still have some more questions and some more issues with the new facility. It doesn’t quite have enough room for all the offices that we currently have in our existing facility, so office space will be definitely an issue coming forward once that facility is up and running. Along those lines of that extended care, like I mentioned in my Member’s statement this week, about actually assessing what we need as a community.

My colleagues talked about it a couple of times these last couple of days, as well, that our population is aging. Hay River is a central location. We tend to have some seniors move to Hay River just for the convenience, it’s a regional centre, some of their family is there. What the demands are for the community is something that we want to assess while we’re doing this upgrade – what are the demands, how many seniors are we going to have in five, 10 or 20 years – so we are planning for the future and some of the efficiencies that we can be doing if those demands are increasing, which we know they are.

I would also like to talk about community wellness. Obviously, it is a big uptake from the community of Hay River. I know that our Metis and a lot of people have been working on it, given a lot of comfort to the community as far as some of those people have been involved in and have thought they were disengaged from the department. It’s definitely been an asset to the community. I think people are

feeling a little bit more comfort that they have a say in what’s happening in some of those areas.

Obviously drug and alcohol is still an issue for our territory. It holds us back a lot. There are a lot of expenses that we spend because of drug and alcohol. It slows down economic development. It does a lot of factors. Obviously we are concerned with the closure in Nats’ejee K’eh. Those jobs were not in my riding, but those jobs definitely affected Hay River. The majority of those people lived in Hay River. We definitely had some concerns about how that rolled out and how that was presented to us at the 11th hour after the decision had been

made. We know that it is a great asset of a facility and we need to find an effective use of that facility and replace some of those jobs, I’m hoping.

Obviously we don’t have a health board anymore, but we definitely feel that there’s a need for an advisory type of board, an advisory board where people can give feedback. We have one public administrator that deals with community concerns, complaints, but I think we have a variety of people in the community that would like to give feedback. I think if you had an advisory board where even with Hay River being regionalized, even if there was funding available for regional type of information or feedback. But that being said, we also need to recognize that Hay River is a regional centre. Along with that, some funding would be an asset.

Those are some of the basic information that we’ve been dealing with over the last couple of years with health. I thought I’d mention them as a general statement. I’m sure we will have more questions in the detail. Thank you, Mr. 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 Daryl Dolynny

Thank you, Mr. Bouchard. General comments. Mrs. Groenewegen.

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

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Chairman. I’m not really a big general comment kind of person in Committee of the Whole, but I just wanted to make a few comments on Health and Social Services. It’s a big department, it’s a tough department and I have to say that I am pleased with the general direction that the leadership and the department are taking things. I see some innovative things. I wish there was more that we could do to inspire people to be more caring about and taking personal responsibility for some of the challenges that we face. As a government, we try to fix things and sometimes I think we have to find a balance between trying to fix things and maybe getting on the front end and try to prevent things and try to denormalize things such as the degree to which people consume alcohol and are involved in other destructive behaviours. That’s always the balance, that’s always the struggle. But overall, whether it’s medical, social, the leadership that the department is providing on these fronts I am generally happy with and as we had in committee the other day, one of the leaders on the front line overseeing the

Community Wellness Initiative, these are good things. As my colleague Mr. Bouchard said, we need to give communities a say in what they feel are the things that will make the most impact for them in achieving wellness.

So a long ways to go. Like I said, a challenging, big department, it covers so many areas, but I think we have, as a government, devoted a lot of resources to this area and we hope to have good results as a result of those investments. We’ll carry on with making our comments and having our input where applicable. Thank you, Mr. Chairman.

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, Mrs. Groenewegen. General comments. Okay, we’ll allow the Minister an opportunity to reply. Minister Abernethy.

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

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Mr. Chair, and thanks to all the Members for their comments and thoughts.

There are a number of areas that the Members brought up that there was some clear cross-over. So I’ll attempt to address as many of the questions as I can with my comments and if I do miss any, please remind me in detail and I’ll make sure to answer them at that time.

MLA Dolynny started off talking about some of the challenges and indicating that there’s room for improvement and, quite frankly, I agree, absolutely. We need to have a system focused on better health, better care and a better future for all of our residents in the Northwest Territories. Since I’ve become the Minister of Health and Social Services, I’ve had a lot of discussions with the senior management of the department. For me and for the department, our top priority is to improve care and services of NWT residents. For me, every decision that we make with respect to our system has to focus on what is best for the patient, or what is best for the client. That’s the premise that I and the department are moving forward as we are bringing forward decisions, but also discussions with our colleagues.

There’s no question that the system needs to be accountable and responsive to the needs of communities and regions, and that’s all communities in the Northwest Territories and all regions. Roles and accountability must be clearly defined. In my opinion, at present, they’re not.

Regions must be adequately resourced to meet the service demands in a timely fashion. I heard this several times about resourcing the authorities properly with every authority running a deficit. Clearly, they’re not.

Our current model does not offer enough flexibility to respond to significant changes in service demands across the Northwest Territories. Moreover, there’s no consistency in the current formula for distribution of resources across the

Northwest Territories. We heard that from the Auditor General.

The system needs to be compatible with emerging Aboriginal self-government aspirations and we don’t want to build more silos. We have eight silos in the Northwest Territories. We don’t have a health care system, we have eight health care systems and they don’t always work really well together. Where they do work together it’s not by design, it’s by good will of the incredible people that we have working in the system, not by design.

We need to come up with a system that gives our residents seamless, competent, quality care. It must be client and patient focused. Clearly, communications throughout must be improved and this includes follow-up and after-care.

We need more focus on prevention. I know the Members of this House have talked an awful lot about prevention, and working with Members, we have put additional dollars into prevention over the last couple of years. The allocation of resources must meet and be reflective of community realities and community needs, and our regions must retain the ability to deliver programs and services in a manner that meets the unique needs of their respective catchment areas.

Who is best to help us figure out what services to deliver in a community like Deline other than the people from Deline? We need to make sure that we have a mechanism that gives us an opportunity to hear the voices of our residents.

There must be a balance between traditional western medicine as well as traditional healing practices, and all of our programs need to be delivered in a culturally sensitive manner that engages our clients and our patients, once again, focusing on our clients and our patients. All of this has to be done in a system that is sustainable. We all know the fiscal reality of the Government of the Northwest Territories. We’ve got to find $20 million this fiscal year and we’ve got to find $10 million more next fiscal year just so that we can deliver the programs that we’re committing to here today.

Collaborative shared services and governance reform are not centralization, and I’m throwing that out today because I know that some people think that. I just want to be clear that it’s not centralization. We want to build a system that is both simple and able to make best uses of the resources to meet the needs of our citizens regardless of where they live in the Northwest Territories.

We’re not talking about saving money here. We’re talking about finding ways to utilize in the most effective, responsive way that will give the best results for our clients and our residents and will help us control the rapidly escalating cost of health care in the Northwest Territories. We are not alone.

The cost of health care across Canada is escalating rapidly and if we don’t change the way we do business, we will price ourselves right out of the ability to provide anything. So we have to be conscious and aware of the cost and we feel we can provide better health, better care and a better future without rapidly or unrealistically increasing the funds. But it does mean that we do have to do things in a different way.

As I’ve said, we want to focus on the patient, we want to focus on the residents, we want to support residents. We know we have to have a voice, and this goes to comments made by Mr. Menicoche, Mr. Blake and Mr. Bouchard about getting some of these authorities in some capacity back up and running because we want to make sure that we have an opportunity to make sure that the people’s voices are heard with the respective delivery of their care. We have to do that. There is no question.

So going back to Mr. Dolynny’s point, yes, we’re not meeting the needs of the people of the Northwest Territories. Yes, absolutely, without question we can do better and we can do better with the resources we have at hand. Now we are going to have to do an awful lot of work, and I look forward to working with committee, with Members and with residents of the Northwest Territories as we move forward and redesign this system so that it meets the needs of our patients and clients, while at the same time allowing meaningful input from the program delivery at the community and regional levels. It doesn’t mean we’re not doing anything, it means we’re doing an awful lot.

There are a number of things that we’re doing already, and we’re talking about a collaborative shared services model and I have discussed this with Members in the types of things we’re doing. Finding ways to share IT services, finding ways to have a territorial-wide physician pool, or a territorial physician staff. We are talking about Med-Response that’s available at the territorial level. We’re talking about territorial purchasing and these things are happening right now. We are making headway on these things right now. Unfortunately, we do know we’ll hit a point with those where we can only go so far without making some structural change and I will certainly be having conversations with everybody on that as we approach that.

In the meantime, I am continuing to have dialogue with committee. I am going to communities and meeting with regional leadership and community residents to talk about our system here in the Northwest Territories and getting feedback from them on how we can make it better.

Mr. Dolynny talked about some of the reports that we have and how they are sporadic, and I agree. Five years seems pretty excessive but, unfortunately, many of our statistics rely on federal

databases. This is unfortunate and it is not where we want to be. We are looking at making improvements, but some of those improvements are going to require us making headway on some of the things I talked to previously, but also technology. EMR, by way of example, will help us get timely statistics so that we know what true population trends are now as opposed to five years from now. We’ll have more timely access to data, more up-to-date data once we roll the system out and start putting the data in. I agree completely, and we are working to address that.

A number of Members have raised the issues around the aging population. We have an aging population. I think it was Member Yakeleya who actually gave us some of the numbers of the individuals, the seniors in his riding and how those numbers are going up. It’s reality and we have to be prepared to deal with it. We have just completed and distributed to Members the continuing care review. That went out yesterday. That is going to help us form and inform the Aging in Place Strategy that we will be bringing to Members for discussion, or at least distributing to Members and arranging some opportunity for discussion by the end of March. We know we need to do more. We know we need to be prepared for the increased number of seniors that are coming into the Northwest Territories.

Going back… I don’t mean to jump around. I apologize. Going back to some of the governance thing, and for a number of Members mentioned this, is the lack of consistency in the provision of health and social services across the Northwest Territories. Yes, you’re right; there is and we need to fix it. Absolutely, without question. We need to have some standards of care. It’s very difficult to have standards of care where we have eight separate silos that make their own decisions with respect to how they’re going to interpret GNWT regs and policies. We know we need to move forward and we need to improve this. We have hired, I’m happy to say, a chief clinical advisor who is a medical professional, a long-time Northerner, and is going to be able to provide us some real solid advice and guidance on the development of clinical standards which will be applicable across the Northwest Territories once we get to a more unified system here in the Northwest Territories.

There was conversation by a number of Members about quality assurance. Mr. Menicoche talked about an individual being misdiagnosed several times. This is something we never want to hear. This is something that obviously really undermines our system as whole, and we need to improve this. This goes back to the clinical guidelines, territorial and clinical guidelines we’re talking about, but it also highlights another challenge that we face, which is quality assurance in the Northwest Territories for the provision of health and social

services in the Northwest Territories. Each authority is responsible for their own quality assurance, so it’s very siloed and it doesn’t look at a system as a whole, it looks at a particular location or region. This is something else that we need to fix, and if we go to a more streamlined, unified health and social services system instead of what we have now, we’ll be able to provide quality assurance across the system, and the nice thing is if a quality assurance person in the Deh Cho retires, leaves and is unavailable, we will have other professionals that they can go to get the supports they need. With these things we will be able to have better results for those individuals in communities like Wrigley who happen to break their leg.

A number of Members talked about more nursing in some of the small communities, and I hear you. I hear you loud and clear. Yesterday in the House I talked about the ISDM, and I have directed the department to go back and do a bit of an audit of the – audit is not the right word – but a review of the ISDM with respect to provision of services in the smaller isolated communities, and we will be working with committee. We will meet with committee. We will bring that assessment forward so that we can have an informed discussion and try to come up with some creative solutions for the provision of services in those small communities.

A lot of Members talked about THSSI. I’m going to leave that one until the end.

Mr. Moses talked about the Mental Health Act and his frustration with the number of counsellors that we have in the Northwest Territories, especially the lack of counsellors in the small communities. With our Mental Health and Addictions Action Plan that came out recently, we’re trying to find, better yet, we’re trying to offer our residents options. In the Northwest Territories now, we have access to four treatment facilities in southern Canada. We have expedited the referral process so clients can get into, or rather, be approved for going to these facilities within a 24-hour period. Yes, sometimes it takes them a bit longer to get into the facility, they may not want to travel when the opportunity comes, they may not be exactly ready, but the referral could be approved within 24 hours. This is significant.

Now, we also have four facilities. We’ve got two in Calgary, one for men, one for women. We’ve got Poundmaker’s and we’ve got Edgewood in BC. We can get our residents into these programs to receive high calibre services and programming in a very timely way with minimal, minimal wait times. There are much better services than we had when we were basically working on one treatment facility here in the Northwest Territories, and we do this at a really reasonable rate. These four facilities, with the beds that we have access to, which is far greater than what we had before, is about 750 to

800 plus thousand dollars a year. We couldn’t run a treatment facility in the Northwest Territories and guarantee the high calibre of programming that we’re getting for those dollars at this time. It doesn’t mean we aren’t interested in a treatment facility in the North, but it means we’ve got a long way to go, and we have to do some additional work, and work with communities, Aboriginal governments, community governments to see what options may exist.

We’re also exploring the mobile treatment. Yes, we did say that we wanted to have something to pilot this year. That did not work out. This fiscal year, I mean. That did not work out. But Poundmaker’s has indicated that they are very interested in working with us, they’re just not available until after March 31st .

We’re also moving forward with on-the-land programming, and I think this was a clear message from the people. I know that it has been suggested that we don’t listen to the people, and Cabinet doesn’t care about the people, and frankly, I find that insulting, but we do listen to the people and we do listen to the residents of the Northwest Territories, and we heard clearly, without question or equivocation, that people want on-the-land programming. We’re doing it. We’re putting it in. We’re going to pilot it. We’ve asked for more money so that we can do more of it, and we’re looking forward to the success of those programs. Now our residents in the Northwest Territories, compared to two years ago, have an option of four treatment facilities providing a variety of programming, high calibre programming. We’re going to have mobile treatment; we’re going to have on-the-land programming. We continue to have community counsellors and mental health addictions workers, and we have a relationship with a number of NGOs who are helping us provide services. Is more needed? Yes, and we will continue to find solutions and work with our partners to find solutions.

ECD, and Mr. Moses brought up some dental issues. In 2013-14, the fiscal year that we’re in right now, we do have some THSSI dollars available that we’re using to help us come up with a plan. Through THSSI we got some money to lead a Pan-Territorial Oral Health Initiative focused on reducing the reliance on the health care system to deal with dental extractions by improving oral health and reducing cavities, strengthening community level access to services, and training and recruiting additional service providers. This money lapses, or rather, expires on March 31st . Although the feds

have announced some money, it is not THSSI. I just want to be clear that the money they have announced is not THSSI. This ends. By March 31st we intend to have a plan and Oral Health Strategy that will look at dental services and oral health promotion and prevention with an emphasis on children and youth in the Northwest Territories, and

we hope to have that strategy done shortly after we complete the Pan-Territorial Oral Health Initiative review.

Work is being done. We need to, obviously, find ways to do this. There are some challenges there. One of the challenges we have in that particular area, and it’s super frustrating to me, is that we actually have no more professionals being developed in this country to fill our dental therapist positions in the Northwest Territories. That school program actually started here in Fort Smith years and years and years ago and then it moved to Saskatchewan and it was recently cancelled. There are no new dental therapists coming into the system, and I find that frustrating and frightening.

---Interjection

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

Glen Abernethy

Glen Abernethy Great Slave

By the dental therapists that we do have, yes.

Child and Family Services Act, Mr. Moses brought this up and I think a number of the other Members did bring this up as well. An Auditor General report is coming forward shortly. I haven’t seen it, the system works in such a way that I don’t actually see it until basically the same time you do, but I have heard anecdotally that it is going to be rough. We look forward to seeing the report and coming up with solutions to address the issues that are outlined in it.

A number of Members have talked about traditional foods and this is one I would love to say yes to, but unfortunately, we know bringing foods into a facility comes with its own challenges and we will continue to have discussions with people in the facilities to see what options exist, but it is challenging. I know it sounds like it should be something that is easy but it is not, because there is actually a number of regulations that limit what we can prepare commercially in our kitchens. We recognize the desire and we will continue to work forward and try to address that.

Mr. Nadli talked about the health centre and the option to use the building, the current health centre, for other purposes. Obviously, we are always interested in something like that. The Department of Health and Social Services, once we open the new health facility, will surplus that building unless there are any other uses that we have for it, which we don’t believe is the case at the time, and it will go through the normal distribution process and Public Works and Services has that well laid out, so the community will certainly have an opportunity to discuss the use of that facility in the future.

Mr. Nadli did talk about regional health boards and I think that I have talked about the need for moving forward with some change and improving the system. I think Mr. Nadli – and I apologize if I am getting this wrong – had a concern about not losing

the voice of the people, and we share that desire, to make sure that the voice is heard.

Mr. Nadli also talked about seniors and I have talked a little bit about our continuing care and how we are going to move forward with the Aging in Place Strategy, which we will certainly have more discussions with committee.

A number of the Members mentioned Nats'ejee K'eh. Yes, the facility shut down. We do need to find a use for that facility. I have had an opportunity to talk to the chief from the Hay River Reserve about the facility and about options for usages and we are exploring some usages that will give us some really positive results for the community, but also the Northwest Territories. Nothing has been decided. I am still talking to committee about that as well as to the community, but we are looking for some immediate use for that facility.

A number of Members talked about an Avens expansion. I have had a number of meetings with the board of directors at Avens, also the staff have been meeting with Avens. I know it was suggested by a Member that we don’t necessarily care about what is happening at Avens and that we aren’t engaging them, that is not the case. We are actively involved with them and we are exploring mutually beneficial opportunities, and there are a number of them that we are discussing. They are not necessarily asking us to fund the construction, I think they have come up with some solutions that will allow them to move forward without our involvement, but it will mean more programming and we will have to find more ways to support that. We are working with Avens, we are working with them on a regular basis, trying to find solutions and discussing mutually beneficial opportunities. Some of this will be, obviously, issues that will come up in an aging place.

Ms. Bisaro talked a little bit about the Anti-Poverty Strategy, and I thank her for her kind comments. This is something the Premier committed to and the departments have been working together on, our response, rather, to the framework that was put together by the working group that consisted of non-government organizations, community governments, Aboriginal governments, but I hear the Member say that she is looking for ways to see if there is any opportunity that we can look at where government policies create barriers or challenges. This is something that I can say the social envelope committee of Cabinet has been discussing and we recognize, and I know Mr. Bromley has brought it up many, many times before, and we hear you and we’re trying to find ways to get past some of this. One of the ways is the integrated case management pilot. We feel that this is an opportunity to look at some of the areas that might be butting heads, to see what we can do to improve

services. There are more. We recognize that, but we have to start somewhere.

Ms. Bisaro wasn’t the only one and I know I’ve talked a little bit about the deficits. The deficits are real. We have authorities all purchasing things in their own ways. We have authorities with different accounting systems. We have authorities that are set up who aren’t on EMR, who have different computer systems, there’s no tie-in. All those things create inefficiencies, plus we also have a high demand from our residents. The costs are high. We have to find a way to better understand the needs financially and a better way to flow it into the system so that it makes sense, but this year we are running deficits once again.

Mr. Bromley talked about why there was such a large increase in the directorate. I will just throw it out real quickly. This is where we put the anti-poverty section of the Department of Health and Social Services. We’ve hired the clinical advisor and a number of other things. Mr. Bromley wants us to take a lead on ECD. I would say we are working collaboratively together with Education, Culture and Employment and with respect to the four categories or the four action items out of the 22 that are health-specific, most of them deal with zero to three, so we are taking a lead in that area. But we are working together and it has to be collaborative. People keep handing me notes and I’m running out of time.

I can keep going; I mean, there are a lot of things missing. Do you want me to keep going? I’ll keep going until someone says I will rise and report progress. How does that sound?

Mr. Bromley also talked about wellness courts and work is being done on the wellness courts and it is continuing to move forward. There is money in the budget this year for an integrated case management pilot which is going to be a key component of the moving forward with the wellness courts. Once again, there was conversation about lines of authority. We are talking about governance, and I will continue to work with committee.

It was suggested that we did not fulfill the direction of the House with respect to ECD and midwifery. I’m not sure what the Member was referring to by not fulfilling our direction with respect to ECD. We are doing incredibly good work there.

Midwifery, we didn’t make as much progress as we had wanted, but I can tell you today that we are shortly going to be going out for competition for the midwives in Hay River. We are hoping to actually expedite it. We were planning to back it from the opening of the facility to give enough time for people to provide programs and services so it would line up nicely with delivery or the opening of the new facility, but we are going to do some minor renovations in the old facility that will allow us to do that before. We are hoping to hire somebody in

short order so that we can get those midwifery services. All the clinical governance guideline work has been done, so we are pretty close to being ready to go there.

Mr. Blake talked about medical escorts and medical travel. We are reviewing the Medical Travel Policy. I have shared the timeline with committee on when that work is going to get done. We will continue to move forward with that. I will continue to work with committee. I like what Mr. Yakeleya had to say about we have to have a sympathetic system that recognizes that people that are having layovers in a community like Norman Wells, that putting someone on crutches or in a wheelchair and leaving them in an airport for five to six hours may not be the most reasonable thing or fair or sympathetic. I take his point and we will work on that.

Sorry, Norman, you’re going to have to ask me some questions.

We talked about naturopaths yesterday. It has been suggested that when it comes to naturopaths, the people’s wishes are falling on deaf ears. That is just frankly not true. Naturopaths, I have moved them up on the list as far as regulation. They are fourth on the list. I have a meeting with the naturopaths in the next couple of weeks to talk about their concerns. They are being heard and we will work with them.

Doctors’ pay, we are going with the Territorial Physicians Staffing Model through the collaborative shared services area.

Just for the record, we don’t always ignore Members. In fact, I’d say we never ignore Members. By way of an example, it has been suggested that we have ignored Members. Just a really small example, one of the Members in this House brought forward an idea that we have to put some regulations around suntanning beds. We did that. Absolutely we did that. In March 2013, after the Member brought it up, we put regulations on beds. People under 19 can’t use them and we have shared all this information with all the nine facilities that provide tanning in the Northwest Territories and they all hang signing up that we have provided. So we do listen to Members and we do respond to Members’ desires.

I think I’m on Jane and…I mean Mr. Bouchard and Mrs. Groenewegen. I’m almost done. You know what? I think I’ve actually addressed all the issues of Mr. Bouchard and Mrs. Groenewegen, so I’ll stop. How does that sound?

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. Abernethy, for your enthusiasm in responding to general comments. Noting the clock, committee, I will now rise and report progress. I’d like to thank our witnesses for today. Ms. DeLancey and Ms. Mathison, thank you for joining us. Sergeant-at-

Arms, if you could please escort the witnesses out of the Chamber. Again, I’d like to thank the Minister. Thank you.

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, Mr. Dolynny.

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

Daryl Dolynny

Daryl Dolynny Range Lake

Thank you, Mr. Speaker. Your committee has been considering Tabled Document 22-17(5), Northwest Territories Main Estimates 2014-2015, and would like to report progress. Mr. Speaker, I move that the report of Committee of the Whole be concurred with. Thank you.

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

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Dolynny. Do I have a seconder? Mr. Lafferty.

---Carried

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

Orders of the Day
Orders of the Day

Principal Clerk, Corporate And Interparliamentary Affairs (Ms. Bennett)

Thank you, Mr. Speaker. Orders of the day for Thursday, February 20, 2014, at 1:30 p.m.:

1. Prayer

2. Ministers’

Statements

3. Members’

Statements

4. Reports of Standing and Special Committees

5. Returns to Oral Questions

6. Recognition of Visitors in the Gallery

7. Acknowledgements

8. Oral

Questions

9. Written

Questions

10. Returns to Written Questions

11. Replies to Opening Address

12. Petitions

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

18. Motion 11-17(5),

19. First Reading of Bills

20. Second Reading of Bills

- Bill 8, Write-off of Debts Act, 2013-2014

- Bill 9, Forgiveness of Debts Act, 2013-2014

21. Consideration in Committee of the Whole of

Bills and Other Matters

- Tabled Document 4-17(5), Northwest

Territories Electoral Boundaries Commission 2013 Final Report

- Tabled Document 22-17(5), Northwest

Territories Main Estimates 2014-2015

- Bill 5, An Act to Amend the Motor Vehicles Act

22. Report of Committee of the Whole

23. Third Reading of Bills

24. Orders of the Day

Orders of the Day
Orders of the Day

The Speaker

The Speaker Jackie Jacobson

Thank you, Madam Clerk. Accordingly, this House stands adjourned until Thursday, February 20th , at 1:30 p.m.

---ADJOURNMENT

The House adjourned at 6:04 p.m.