Thank you, Mr. Yakeleya. Mr. Blake.

Thank you, Mr. Speaker. I’d also like to thank Mr. Yakeleya for bringing this motion forward.

Many of our residents who do travel down as an escort from our communities, many of these communities are faced with 35 percent unemployment rates. So, many residents don’t have any part-time or full-time positions. There are many challenges, especially for long periods of time, two, three or four weeks at a time. More and more people are faced with many medical issues and they have to stay in Edmonton or other cities down south for long periods of time. As time goes on, they need toiletries and sometimes they get tired of the food in the hospital or other places. They need to have a different type of meal.

I see the challenges and I’ve also seen escorts and there are many challenges. Luckily, some communities can fundraise for people who are down there. This government needs to have something in place so people can access a little extra funds. Thank you, Mr. Speaker.

Thank you, Mr. Blake. To the motion. Mr. Bouchard.

Thank you, Mr. Speaker. I will be voting in favour of this motion. It does bode a lot of questions and brings up a lot of issues we have with medical travel. Obviously, there are a lot of financial pressures with medical travel. The budgets are growing on a steady basis and this would include some more pressure to that. One of the

things I indicated on why I would support this is if it was done on a hardship basis. People would have to prove that there’s a need. There has to be a hardship. I wouldn’t want to see us doing this with every medical travel situation, but if families or people or escorts who require some sort of financial help, we do it on a case-by-case basis and we look at the hardship, this is something we may want to implement.

I look forward to hearing the government’s reply to this motion. Yes, I will support it. The concern I have is we are dealing with hardship cases and not every medical escort. Thank you, Mr. Speaker.

Thank you, Mr. Bouchard. To the motion. Mr. Dolynny.

Thank you, Mr. Speaker. I would like to say thank you to the mover and the seconder, Mr. Yakeleya and Mr. Blake, for bringing this forward. They bring up a very important topic. This is a topic that has been brought forward not only by us but the Auditor General of Canada has said, time and time again, get your ducks in order and figure this out. So I’m glad we are talking about it today.

This is a very complex animal, Mr. Speaker. It’s a pretty expensive part of our budget. As the motion we have before you, the spirit and intent is very noble and I do admire where we’re going with this, but I want to talk about some of the precedent setting this could create here for our government. I think we are on a little bit of a slippery slope should we continue in this vein. Let me explain for a second.

As it is right now, we know there are reasonable expenses, out-of-pocket expenses that are covered already within the plan. Could they be more robust? Absolutely. I think we can look at enhancing some of the current out-of-pocket expenses and make them a little bit more valid and value-added. As we heard from Mr. Bouchard, hardship, as it’s mentioned in one of the whereases, needs to be addressed and I think that is important. But I think we need to look at more patient-assisted travel scenarios, so that would come under that term of reference. If that’s the case, I would suggest that this would have to be almost income tested to make sure that that hardship is quantifiable here.

We have to look at some other areas, too, in order to address some of the issues within this motion. We would have to talk about those areas where it says in some communities where they have a hard time finding escorts, we have to actually make our programs themselves a bit more robust, especially in places at destination points such as in Edmonton. You know, by having better bonded medical placements there that are available 24 hours a day, seven days a week. As it is right now, we do have some dedicated nurses that are on government payroll to assist patients when they

arrive; however, as I found out through unfortunate circumstances, some of these paid employees only work Monday to Friday. We know very well that when people land, it’s not only a Monday to Friday landing. You can be landing at night; you can be landing on the weekend. The Minister knows that. I know we’re trying to make great strides to make that work better, but I think it’s important that we address that.

The other thing, too, a lot of jurisdictions look at, is they look at these one-on-one they call it patient sky nurse. These are nurses that could be in the communities that can actually be escorted down with the patient; they stay with the patient until they’re through security, and then they return back to the community. This would also address those communities that are looking for nurses. Here’s an opportunity – and I hope the Minister is listening – where we could have these nurses, these sky nurses that are actually on call in communities, living and providing a duality of services.

So, really what this motion is asking is to compensate escorts for their time, which I translate, let’s compensate them for their wages. I believe this is hitting a precedent that I’m very, very… I’m a bit nervous. I’ll be totally honest; I’m a bit nervous with this motion.

Again, I agree with the spirit and intent. It identifies a need; it identifies something that we have to do. But given the way it’s formulated, the way we’re basically giving a direction to this government to take more away from a department, which we know clearly well does not have the funds and resources to do this at a large scale, we can barely keep the doors open. To ask this government to now top up wages and provide wages, I don’t know, Mr. Speaker. It’s precedent setting, to which I would have a hard time probably agreeing to this motion. Thank you.

Thank you, Mr. Dolynny. To the motion, Ms. Bisaro.

Thank you, Mr. Speaker. I’m going to echo some comments which have already been stated by my colleagues. I, as well, appreciate the intent of the motion and the rationale for bringing it forward.

I can support the recommendation that we look at this issue. I am, as well, concerned by the fact that the motion is asking that we compensate medical and non-medical travel escorts for their time. If we were to compensate any escort for the wages that they are losing, we could be in, I think, very serious financial difficulty.

One of my colleagues has mentioned that perhaps we ought to be looking at evaluating on a hardship basis or evaluating income to a certain extent, and I think that’s something that has to be seriously

considered when the department looks at this issue.

I think it’s not totally clear in here – it’s not in the operative clause anyway – but I think this should really only apply to extended absences or extended periods of time that a patient has to be out and a patient requires an escort for that extended period of time.

We have a system right now where many patients, if they go to Edmonton, for instance, do have a place to stay where there is some support for them. Both patients and escorts are pretty well compensated in terms of their day-to-day necessities. They have accommodation; they are compensated for meals or else their meals are provided; transportation is provided. So, you know, we’re really only talking about compensating people for their time, and I’m having a very difficult time believing that our programs should be doing that, that I should be compensated for my wage when I’m there as an escort.

I think one of the things that I am feeling quite good about is that the Minister has said in the last couple of days that we are definitely looking at the Medical Travel Policy, albeit it’s been a long time we’ve been looking at it. I hope we get some definitive recommendations soon. But I am somewhat heartened by the fact that the Minister has said that he will be looking particularly at the escort policy in the very near future, and that was the issue of the RFP that I queried him on the other day.

The only other sort of issue that isn’t covered here – and I guess this would be the non-medical escorts – but very often the patients require a translator when they go out. If we have someone who is unilingual and who has to be in Edmonton or Calgary or some other place outside of the NWT for a month at a time, they are going to need a translator. Perhaps we ought to have a system in place to cover translators.

Like some of my colleagues, I am considerably conflicted. There are a lot of ramifications for the theory of this recommendation. Again, I support the concept. I think perhaps I may have to abstain, but I will not vote against it. Thank you.

Thank you, Ms. Bisaro. To the motion, Mr. Moses.

Thank you, Mr. Speaker. This motion was one of really good discussion and debate in terms of whether or not we want to compensate non-medical escorts.

As you already know, we go through the budget session and we see the costs that are associated with medical travel, and they are very high and that’s one of the areas that we’re already exhausting a lot of our financial resources on medical travel and trying to find ways that we can

mitigate that and still provide the services to residents of the Northwest Territories.

Aside from that, if you look at all the work that this government and committees have been working with the Department of Health and Social Services and the Anti-Poverty Strategy and acts that we’ve implemented, we’re putting a lot of work on the Department of Health and Social Services and this is another one that’s just going to add to the workload. In some cases, who knows if we have the adequate resources, human and financial, in the Department of Health to put another work caseload on to our already exhausted staff which do a lot of good work.

Other areas I thought why I would not support this motion are things such as how it’s going to affect income assistance. We had one Member who talked about the unemployment rates in the communities, so that means we might have people on income assistance. So if they get compensated, they’re going to have to record that. It’s going to affect the amount of income that they get on income assistance and it might also affect what they have to pay in housing rates, their monthly housing rates that they have to claim on their monthly reports.

We do have boarding homes here in Yellowknife and in Edmonton that do provide adequate services. They provide meals and transportation for these escorts to get in there.

As Ms. Bisaro mentioned, one concern was extended periods of time. If we have medical escorts that are going to be away for, say, a week or two weeks, then maybe we should look at something in that area.

However, I looked at things that might have convinced me not to support the motion, but in recent case files, recent concerns came to my constituency office from not only Inuvik but residents of the Northwest Territories. There are some big concerns on the Medical Travel Policy. I know that we’re reviewing that right now, and I think this motion is timely in that, if we are able to find something that might be adequate enough to give some type of compensation for our low-income families, maybe some of them aren’t on income support and some of them are living with elders, with their families at home. They don’t have the adequate finances to go down and buy the simple things, that I guess some of us might take for granted, while they are away from their home life. Some individuals might be a single sibling in the family and they’d have to take time off to escort a loved one down and, as a result, might have to take leave without pay and there’s no compensation there.

The big one that has recently come into my situation was an emergency trip in terms of a family member going down. The family felt that they

needed to be there with the family member. They went down at their own costs. They even got a letter of recommendation that the client needed an escort under the medication and the surgical process that they went under, and yet even with the letter of recommendation for an escort the family still didn’t get compensation and didn’t get reimbursed for all the costs associated with them coming down, and even when the individual got released from the hospital, they had to pay for their own hotel and accommodations because they weren’t ready to fly. Under certain circumstances like that where it does become an emergency and families in Inuvik, for example, we just decreased the northern living allowance, we have high fuel costs, and when certain things like this happen and family members who are worried for the family member’s life have to go down to Edmonton because sometimes we don’t have the services up here to provide those surgical procedures. Even though some of these families do get physicians to write that letter of recommendation for an escort, sometimes that just doesn’t get reimbursed and they’re stuck paying thousands of dollars in bills.

With that said, I’d like to see some type of program in place to address this. I will be supporting the motion even though I do understand all the hardships and all the work that the department is going through. Plus, I understand that we are going through a review, and if we can get something done before we get that review in place then I think it will be perfect timing and something that we can incorporate into this policy review. Thank you, Mr. Speaker, and I do thank all the Members that are supporting this and talking to the motion here.

Thank you, Mr. Moses. Mr. Menicoche.

Thank you very much, Mr. Speaker. I’m rising today and I will be supporting the motion. I think the intent of the motion is, look, we’ve got an issue here. We’d like to address some of it, and for me, it’s about long-term stays. It’s about emergencies, and often some of the emergencies that I see are that the escorts coming here with the medical client, they’re expected to be two days, but they find more health issues and they actually end up in Edmonton for weeks at a time and the escort is travelling with them ill prepared. It’s often the family member, a cousin, that the only reason he’s going is because he’s in between work and he’s got no income, and then he’s in Yellowknife and/or Edmonton for weeks at a time with little or no income at all.

I certainly do see a need. I don’t know if it’s paying them. I don’t believe it’s income, but I think we have, when you’re an employee for the government, you do have a little bit of incidentals that they use for travelling. I think it’s something like that that’s important for them, because when

they’re down, they want to buy toothpaste, hair brushes, if there’s enough there. It’s just other personal items that they may need. For me, it’s not about paying them. For me, it’s about there’s an issue here. We’ve got people that travel long ways and they’re not ready for it. They don’t have enough income.

As well as I think it is a timely motion because we are reviewing medical travel and perhaps there can be a new category developed and I think that’s all the motion asked for, is let’s devise another system. There’s a gap here that’s being raised by Mr. Yakeleya and Mr. Blake with their motion and I see that gap too. I see it in my work as an MLA. A lot of our medical travel, as well, is from our employees and escorts, but that’s a totally different thing that I see from our elders and our people that are not a government employee that are travelling. Most often it’s cousins because they’re speaking the language and they’re travelling with them to explain what exactly is happening and they’re often stuck for weeks at a time. I see a gap there. With that, once again, I will be supporting the motion.

Thank you, Mr. Menicoche. To the motion. Mr. Hawkins.

Thank you, Mr. Speaker. I think this whole issue really boils down to something very simple as saying this: We don’t want to cause any further strain to this family’s economic situation, and furthermore, we don’t want to provide any extensive financial hardships to the person who has volunteered or, in some cases, doesn’t really have a choice. They have to go as the medical escort. If you weigh and balance the great strain being a medical escort can cause – and I’m talking about the pocketbook or the financial hardship that can be created by this situation – it causes one to say, well, we don’t want to find ways to discourage them for being there in a time that they need to be there. In a short version, what type of ripple effects have we caused or difficult challenges have we created for these people who have made the choice to step in? When people need to be there for their family or loved ones or their friends in a time of circumstances, we don’t want to be thinking about the tough choices they need to make, which is do they have to quit their job, can they afford to go, will going for one day, two days, one week, one month, who knows what type of impact this will have on those families. If you happen to be the person who draws the short straw and has to go, do you have pay and benefits programming that will help and support you? If you’re in between jobs, what kind of circumstance does that put you in?

I think where I can support this is, I’m going to, well, before I say that, where I can support this, really, ultimately it has to balance out what is reasonable, what our government can afford and what makes sense. When MLA Dolynny talks about financial

compensation, how far and where does it go, it does make sense to consider that, but by the same token, when I hear Member Yakeleya or Member Menicoche talk about this in the sense of the hardship that this creates, it causes me to be really concerned about the impact on the individual who is trying to do the right thing.

I will support a review of this. I will support an assessment of some recommendations brought forward to a committee and I want us to cost them out to understand what we are agreeing or not necessarily agreeing to. Before we make any step forward, I think the first important thing is to understand what problem are we grappling with, and I think that’s a reasonable expectation. The department has all the numbers of people who have gone out on medical travel. They know how long they’ve gone out, and we can do a simple assessment through that. Now, I don’t think that that’s 10 minutes worth of work. I know that. Actually, I probably think it’s an extensive amount of work to sit down and calculate this, but I think it’s time we have this conversation, because this is a conversation we’ve been having behind closed doors since I was elected in 2003. People have stepped up and they find it really hurts them. They say, geez, I shouldn’t have gone with my relative. I shouldn’t have been there because I can’t afford it. That’s the type of conversation I think we need to have. We need to have the right information and it’s timely.

I think this is a good step forward on the discussion, the conversation, and I certainly welcome the evaluation of what this really means. As such, I think it stands to say there’s no problem in supporting the motion the way it’s crafted, and once we have that review and evaluation and those recommendations, then we can take our next steps forward as they make sense for our financial ability, because we just can’t afford everything, but let’s at least know what we’re talking about with that detail.

Thank you, Mr. Hawkins. To the motion. Mr. Bromley.

Thank you, Mr. Speaker. I also appreciate the Members bringing this forward. I believe that, actually, for a relatively small number of people there should be some consideration for compensation here. Unfortunately, the ask as stated refers to all those who escort, and I think quite a number of Members and certainly I had reservations about it being that broad. Nevertheless, there is undoubtedly an issue here for those family members and especially the breadwinners that must take time off, as we’ve heard from others, for extended leave to escort and accompany family members or unilingual patients that need this particular support and, again, for a long period of time. I would mention that there are also sometimes benefits that escorts enjoy. An

opportunity to visit family members at a distant place and opportunity for shopping and so on, so there is the opportunity for some benefits, but for those that are on extended leave, those benefits start to fade.

I recognize and emphasize that the dollars for actual medical care are probably the priority, and I support all those who have concerns that we don’t want significant dollars removed from providing medical care to be directed towards this, so that needs to be a consideration. I’m sure it will. We’re always talking about balance here. I do not support the removal of significant health care dollars, as I mentioned, to pay for medical escorts generally, but then there are, of course, exceptions. To the extent that this motion recognizes and accommodates these concerns, I support the intent here, but as it is written, “compensating medical and non-medical escorts for their time,” it is much too broad and the concerns I’ve noted are not captured. So, on that basis I will be abstaining. Mahsi.

Thank you, Mr. Bromley. To the motion, Mr. Nadli.

Thank you, Mr. Speaker. I’m rising to support the motion in terms of the intent and spirit. I realize that there are some details that need to be worked out, but I can imagine in terms of the intent and purpose of this motion is that the primary concern is our elders. If our elders are sick then they have to be brought to Yellowknife or Edmonton. Just the thought of them being alone, being unilingual, not able to communicate in another language. They have very specific dietary needs and preferences. Of course culture is always a big impediment in terms of understanding elders, especially First Nation elders.

The other spectrum is having children that have to be brought to either Yellowknife or Edmonton for their special needs. Again, circumstances, I think that’s when you have to have escorts accompanying the patients that have to go to Yellowknife or Edmonton.

The other point that I wanted to make, usually in these kind of circumstances, if someone falls ill within a family it’s usually direct family members or parents that deal with matters like this. But if it’s a special case and the patient has to be brought down to Edmonton, say, for cancer-related treatment, it takes a heavy toll on the family, especially if families don’t have the opportunity to be on a wage economy, have a full-time job and sometimes it becomes stressful for the family, it becomes divisive in terms of who is going to accompany their grandpa or their granddaughter to Edmonton. Sometimes those decisions can’t be made because people don’t have the monies and they don’t have the proper resources to go down there and be with their family.

Sometimes, because our relatives can’t help us, there are instances where families turn to communities. In particular in Fort Providence I understand there’s a compassionate fund that is there that people try to assist families, but in some instances that becomes a burden to the community organizations as well.

I think the intent of this motion is to try to support families that require it, at the same time trying to be considerate in terms of culturally appropriate care. I don’t think we want a system that’s very indifferent and very impersonal, a very tunnel vision system. I think we have to have a system of government that’s very understanding towards systems of people that are human and have real needs. I think this motion speaks to that, so I will be supporting this motion. Mahsi.

Thank you, Mr. Nadli. To the motion, Mrs. Groenewegen.

Thank you, Mr. Speaker. I appreciate the spirit and intent of the motion. It is interesting. Like Mr. Dolynny, I have some issues with the final now therefore. It talks about paying medical escorts, both medical and non-medical escorts, and it talks about paying people for their time and it sounds like paying for their time when they’re perhaps going to be away accompanying someone for a long period of time.

Right now I believe what we have for people who are medical escorts is we have travel, we have per diems for food, we have per diems for accommodation, we do have a lot of financial support out there for medical escorts. This is talking about medical escorts, but what I’ve heard Members talking about here today is something quite different. We’re talking about families, full families that want to go and support a loved one that’s ill or something and that’s quite different than a medical escort. So this whole discussion here, if you actually analyze it, is a little convoluted. It sounds like everybody is talking about something different. I’m being honest and the other thing we’re doing is we are, even by discussing this motion and bringing it forward – with all due respect to Mr. Yakeleya – we are raising an expectation in the public that we can actually afford to do this. We’re putting an expectation out there. We’re saying, oh well, let’s just look at it, let’s just study it. We probably, you know, in the end will determine we can’t afford to do it, but let’s do the right thing and let’s get the department to look at it. You know what, in all responsibility as legislators and all the demands that there are, we can ask the Department of Health to go and look at this, but I hope we aren’t creating the expectation out there in the public that this is actually doable on the level that’s been referred to here today.

Like I said, we do have monetary supports out there for medical escorts now, travel to get them there, a

place to stay, we’ve got boarding homes, escorts can stay with the patient in the boarding home. I’m just listing off some of the supports we already have out there.

I just want to draw one other analogy here, which kind of puts this in perspective. I know people, Northerners, long-time Northerners who have been diagnosed with cancer who work for the Government of the Northwest Territories and can’t even get enough time off work. Like, their leave doesn’t even…and we’re talking about the escorts’ monetary compensation, what about the person that’s sick? What about the person in the hospital who doesn’t have insurance or some kind of insurance coverage? What about their wages and what about the fact that they no longer have an income when they become ill and they’re in a hospital for a short term or a long time and become incapacitated in some way? I mean the actual patient. Do you folks hear what I’m saying? The actual patient. I mean, some of the best paying jobs in the North don’t have enough coverage, insurance coverage to allow those people enough time off work to even get the treatment that they need for cancer, but we’re talking about compensating the person who’s going as a medical escort.

These are all demands. They all need to be put into perspective and if it makes people happy for us to look at this, then let’s look at that, but let’s surely inventory and articulate all the supports that are there because I don’t want this motion to create the illusion that we aren’t doing anything for people who do require an escort, medical or otherwise. So I’ll go along with this. To not go along with it would be seemingly now to be the Grinch, but I guess in time I think we all know sitting on this side of the House that are bringing forward this motion that this comes back with a big price tag on it. You’re going to look at forfeiting something else in order to do this. I mean, let’s be honest.

So I’ll support looking at it. I hope the department can come up with something, but like I said, they need to clearly articulate what we already do for people. If we need to accompany someone and this whole other issue of compassionate travel and whole families and all that kind of stuff and let’s also just look at the irony in fact that the person that’s sick, that they’re getting compensated for their wages. Thank you.

Thank you, Mrs. Groenewegen. To the motion. Mr. Abernethy.

Thank you, Mr. Speaker. We appreciate the concerns that are raised with respect to the Medical Travel Policy and there’s no question that the Medical Travel Policy needs to be reviewed. In fact, we are currently doing that. One of the areas that we are looking at is the per diem rates that we provide to residents of the Northwest Territories who happen to be on

medical travel. But there are many different situations when an individual may be eligible for per diem and may not be eligible for per diem. For instance, if an individual goes south for an extended stay, we try to get them into one of our government-approved boarding homes where the meals and the accommodation and transportation to and from the health facilities and all those types of things are fully paid for and compensated. But if there is no space available, we do provide our residents with a per diem rate. That per diem rate hasn’t changed in an extended period of time and that is one of the things that we clearly need to update and will be reviewed as part of the review of the Medical Travel Policy.

At the end of the day, I agree with what many Members have said, but at the same time we do have to be fiscally responsible. Money is an issue and when we look at the motion that’s provided to us today, it talks about devising a system of compensating medical and non-medical travel escorts for their time, which is basically compensating them for lost salaries and already we spend tens of millions of dollars on medical travel and I hear every day, find a way to control the cost of medical travel, find a way to control the costs of medical travel.

I have had an opportunity to travel to many communities to talk to residents both in the larger communities like Yellowknife and the smaller communities and hear their concern around medical travel and the administration of medical travel.

We will work with Members, we will work with residents of the Northwest Territories and we will work with stakeholders to make sure that we have the best Medical Travel Policy, but given the wording that is presented here in front of us today with respect to paying people for their time, we don’t have the financial resources to do that to support this motion. It would actually drive us deep, deep into a financial hole.

So we will not be able to support this motion at this time, but I will commit to doing the review of the per diem rates and I will commit to bringing the Medical Travel Policy back to committee and back to the residents of the Northwest Territories to continue the important dialogue around escorts, appeal processes and other important issues that have been raised, but we can’t support the motion as written. Thank you, Mr. Speaker.

Thank you, Mr. Abernethy. Mr. Miltenberger.

Thank you, Mr. Speaker. I would like speak quickly to the motion and to our responsibility as legislators and our commitment and obligation to the broad, overall fiscal plan for the Government of the Northwest Territories.

The motion is clear, even though I’ve heard everyone who is supporting it has a different interpretation. It doesn’t mean paying people, it doesn’t mean giving money for toothbrushes, it will only be restricted to people who don’t have work and have to get compensated for their wages, but it doesn’t mean cousins, families and those people who aren’t working. There is a whole range of interpretation to this motion, but the motion is clear. The motion says compensate people for their time. I would suggest to you that this is indeed a slippery slope. If you are going to compensate person X and person Y is not working but they’re going to go, then it’s going to be what is it about me that is not worthy of getting the same compensation for my time? My time is worth something. It will be a door that once you open it, it will be open for everybody. It’s going to cost us a lot of money.

I think there is a review underway that we should look at and it makes good political discussion, but there is a real concern. People listening out there are going to think we are going to come up with a whole bunch of money we don’t have.

At the same time, we pass the budgets in here and we know that we are going to be trying to remove $30 million to try to balance our books as we move forward and pay for a whole agenda that we have already laid out before us. There was debate in this House, let’s drop the PTR back to 10 to 1, 20 million bucks. Let’s give the school board $50,000, two or three million dollars. At the same time, we know we’re going through forced growth exercises to maintain the budget, to maintain our fiscal standing, to keep ourselves in good fiscal condition.

So you can’t just look at this in isolation. You can’t look at this and forget about what we’ve asked for just in the previous questions about junior kindergarten or forget about some of the other demands that have been made upon the government, upon us, this Legislature, in previous sittings.

While it may be well intentioned, we always worry about program creep. In my mind, this would be more like program leap. It would be fiscally unsustainable. Further to the comments by my colleague from the ministry of Health, this has significant implications and we should just give the study its chance to do its work. There have been commitments made, but I don’t fully support this. So we won’t be voting in favour, as my colleague said.