Thank you, Madam Chair. I’d like to welcome the Minister and the Department of Health here today. In preparation for today I had to look back almost 364 days ago as to what I said on this department back then, and back then the Minister was in power in his position for 232 days. So, it was more of a reflection of a short period in office and I tried to recant and re-evaluate some of the overarching issues of the day and apply them to now, which is around 597 days later in office, as to
where we’ve gone with this department. In that respect, I’ll try to make comparisons within that year and how we’re looking forward. So, today my comments will be general in nature and won’t require any type of response.
Back then I did mention that we were in a very unique position to reposition our Department of Health, given the nature and the gravity of the situation within our responsiveness and our effectiveness at delivering the quality care that we could do. Now, granted, by all accounts our accessing of health care in the Northwest Territories and the quality of that care is generally comparable to the rest of Canada. So I think, in essence, we’ve got to give some good marks with respect to the delivery. With that, I want to make sure that is loud and clear.
But to note, still to this day, after as many days as we’ve been here as Members of the Legislative Assembly and given some of us here with unique perspectives who sit on the standing committee who actually evaluate health and put health pretty high on what we do on a daily basis. We’re still, to this day, not doing well in certain key categories. There are still some real disparities between how Aboriginal people are dealt with and non-Aboriginal people are dealt with, still today. Even given everything we’re trying to do that’s positive and we still rank among the highest in Canada for smoking rates, binge drinking and suicide, and I have not seen those statistics go down during this term. When it comes to chronic diseases such as diabetes and cancers, many of these are on the rise and some of the statistics that we’re having brought to us for the Northwest Territories put us in a position where we should be asking why the numbers are so high and what are we doing to bring those numbers down. On top of that, our hospital admissions for preventable illnesses, we’re still the third highest in Canada and that ranking to three years ago is still as valid as it is today. Our injury rates are still 10 times the national average.
So when I look at these key determinants, I’m asking myself where have we gone as a government, where do we go with the Department of Health? Now I know that there are many, many challenges that we face in the Northwest Territories that are hurdles to deliver this quality of care that we’re all trying to achieve. For example, we have probably as much competition to recruit and retain our professionals as any other jurisdiction in Canada, but I think we’re doing a relatively good job. Could we do better? I think we can, but I think for the most part we’re not doing too bad, but we still have to face those challenges.
We still have the rising costs of drugs to deal with and we’ve been waiting for this pharmaceutical strategy, which was being deemed as kind of a panacea of a catch-all to deal with this. But yet,
without seeing any type of framework on the table that we can take publicly, it makes it very difficult to see the resolve in that thinking.
Of course, our technology that we have in the Northwest Territories, albeit when we open up new hospitals we put new technology in these new hospitals, these new health centres. But as a general rule, our technology is aging and you have to replace that technology at a rate to which it keeps up with the disease and preventative illness that we’re seeing. I still think we’re going to be hitting a crux in the road here sooner than later for some of our smaller health centres and some of our regional hospitals that require a much needed upgrade in medical equipment and I don’t believe the money is there or will be there when the time comes.
Finally, we do have a lot of health and social challenges associated with our aging population. Let’s face it, none of us are getting younger, we’re all getting older and that’s just a fact of life. I look at it from not only as a legislator in this room, I look at this as even a health care professional myself and I try to evaluate what are we doing in concrete terms dealing with our aging population. I still don’t see that silver lining. Of course, there haves been reports out there. I’ve read the action plans and some of these initiatives, but it’s almost throwing rice at a freight train. This entity is coming full on, we know those age categories are going to hit us soon, and yet it seems we’re still not dealing with the issue and the root cause of what we’re doing to make those significant investment and changes in the future.
Notwithstanding, I know that the Minister is working feverishly hard, trying to create a new governance model for the delivery of care and I don’t want to get into details about that just before committee. I have been supportive, I’ve publicly been supportive and I will continue to be supportive because I think it is a good thing that the Minister and department are embarking on. However, I don’t believe, again, I don’t believe that is the catch-all that is going to correct all our woes when it comes to making things better. I still think there are going to be cracks in our system because we’re not prepared to look at some of those areas while we’re trying to change governance. I’m still, to this day, not understanding why it is that our accounting systems differ in our authorities that we have in our system. Now, I know through a governance system this should be in line, but the question is why did we allow it to get to that level and why couldn’t we have fixed it?
I don’t think we’re dedicating the right quality and risk management to these different authorities so that we’re standardizing our delivery of care across the board. Now again, a single governance model should correct that. But I need to see the workings, the different levers of this in action before we get to
that stage, and that is still a missing determinant as we move forward.
Again, when it comes to reporting, if you can’t measure what you deliver, then how are you supposed to make change? Again, we’re told the governance model should make reporting standards a lot more efficient and effective, but yet we’re still missing a number of these determinants for whatever reason. We don’t have the numbers; we don’t have large enough numbers to report on. So we’ve got to come up with almost a made-in-the-North program where we’re actually looking at those health care determinants to evaluate how effective our delivery is and how effective that we’re able to maintain standards equal or on par to the rest of Canada. It shouldn’t be a nicety. This should be a right. Every Northerner should have the same right as any other Canadian, and I’m not quite sure we’re there. I know we’re making effort. I don’t want to give the illusion that the department is on their heels or dragging their heels on it, but we’re still not there.
When I started this position a number of years ago, it was funny because I look at our budget and back then we were spending 26 percent or 26 cents of our budget dollar on health, given the full budget. When you look at national averages, most provincial jurisdictions are spending up to 40 cents, or 40 percent of their budget on health. Every key economist in Canada four years ago clearly indicated with the rising age of population growth and the pressures of population growth and expenditures, that every jurisdiction in Canada would see budgets around 50 percent of their dollars spent on health. Three years later I’m looking at our budget and I’m thinking, you know what – this is the first time where I’ll say, “you know what” – we’re not spending enough. This is not true for every department I talk to, but for this particular department, although we’re seeing a $14.9 million increase of 3.8 percent, I’ll agree with that. We’ve got to spend more money on health. We’re not there. The current budget right now, if you look at my quick calculation, about 25 percent. So in three years we’ve actually regressed by almost a percent in terms of total budget, overall budget we spend on health. Again, as I said, that’s nowhere near national average, which is close to 40 percent, and nowhere near the predictable average of 50 percent.
Now I know we’ve got Cabinet Ministers over there going well, Daryl, you know, we spend all this money in housing and everything else. So if you add up all the things we do from income assistance, we do 50 percent of our budget in health. We have to compare apples to apples when we deal with that from across the system. Again, I don’t believe we’re there.
So, the observations that I have here are mostly just comments. I will have more specifics as we get into detail. I just want to leave you with this and leave the department with this. I mean, I applaud the work that’s being done, given the minimal amount of finances that we give this department. I’m impressed that you’re able to deliver the quality of care, given the limited resources that I think health receives as a general rule. Now, I’m not saying this is impoverished, but I’m seeing that if we were able to give this department a little bit more money in the future, and I’m hoping we can. I’m thinking we can do some great things because, at the end of the day, it’s about people, it’s about quality of life and it’s about the delivery of a promise, and that promise is good health. Thank you.