Thank you, Madam Chair. I want to make a couple of general comments. I wanted to begin by highlighting that one sector of the population is vulnerable as we consider them and that’s the aging population of the elders that live throughout the NWT. Just having at least a perspective for where elders exist in communities. For the most part, they’ve lived a life, perhaps a long life, being accomplished in terms of a career, various work and various experiences. They have seen many changes. They’ve also, at the same time, seen their children grow up and now they’re experiencing their grandchildren grow up. Those are the golden years. Those are the years that are supposed to be stress-free, comfortable life, almost sailing, I guess, in a wondrous state. But the reality is that we don’t have a situation like that up north. The elders, for the most part, are living in communities in terms of trying to maintain their own home. Sometimes they’re struggling with the cost of living. They’re living on a fixed income. At the same time, the circumstances are that they have their grandchildren to take care of. It’s just the way it is in communities.
I wanted to begin by saying that because I think that there has to be some attention drawn to that reality and we need to deal with it, whether it’s at the local level, whether it’s at the regional level or coming from headquarters, but it’s a real issue that
I think has to be addressed throughout this department.
At the other spectrum of the population that’s vulnerable are the sick people that remain in hospitals because we simply don’t have the facilities. There could be a need for special care and we don’t have it. The other option is we send them down south to be separated from their families or their siblings or their relatives, and we just don’t have those specialized care facilities up here in the North. So we have to house them, perhaps in a hospital, and try to do the best we can. That’s a challenge that we face.
There’s still a need for us to try to maintain at least the basic services that we’ve been carrying this far. You know, the diabetes program, because diabetes is one area that really, for some reason, affects Northerners, especially First Nations people. Sadly, you see some people that lose their limbs because the awareness is not there or the services of care and prevention are not there. The reality is that some people are just simply in a circumstance where they find that they’re at the end of the road and they have to take drastic measures like amputating, perhaps their limbs, because there’s just neglect.
Other areas like mental health and addictions, it’s sad that that whole issue still remains a big issue. It confronts us on a daily scale and it’s a matter that we need to accept, it’s a reality and we cannot deny that it exists. We can’t live in denial. We have to admit that it’s part of living, but at the same time it’s a matter that we seriously have to try to address the best that we can.
An unfortunate reality, too, is that we don’t have a treatment centre in existence and we’re trying to come up with programs such as the on-the-land programs. We need to take steps to ensure that those are succeeding as best as we can.
Another area that I wanted to highlight is the Home Care Program. Why I say that is because we have an aging population where most elders want to remain in their community or their homes. I thought the Home Care Program at some point would see a mixture of local people that can qualify to work with elders through the health care system at the local level. At the same time, they also have perhaps a person from the outside, or local that decides to become a registered nurse, or a nurse practitioner that is well experienced. They can work with local people and operate as a unit and work within the community to provide health care services to the elderly and the sick people that make the choice to be home. If we could achieve that, then it’s almost an effort of filling at least some parts of decentralization where we have a program that could be set up. You have local people, you have registered professionals or registered nurses that work with the local people and you’re delivering a
program at the local level. For me, that’s almost like an element of decentralization. I’m kind of disappointed that we haven’t highlighted perhaps a program as much as we should and could.
In that same breath, too, with the onset of some new facilities and infrastructure in my riding, we still have this idea of trying to decide the fate of old infrastructure, like the old health care centre in Fort Providence needs to be decided. We don’t know what’s going to happen to that, but the bigger opportunity that I found was that from taking a perspective that we have a new building, you know, we’re going to move out of the old building. What I thought would be interesting is trying to do things differently. One example is to enhance the Home Care Program, but the unfortunate signals right now are that the status quo is going to be the same. We’re going to basically do the same as we’ve done for a long time and nothing is going to change. We’ll just have a new building.
There are some remaining concerns that health care could be delivered in the smaller communities. There’s been an effort in trying to deliver these programs where people live, especially elders, and there have been discussions in terms of trying to bring the health care services as close to the people as we can, and if it’s in the small communities, we need to work with the local leadership in trying to make that possible.
There’s been discussion in terms of governance in terms of perhaps moving to a centralized model of trying to amalgamate and try to pull things together. I see the rationale in terms of cost efficiencies through trying to make things more manageable, more economical, more financially frugal so that we have more resources. I think we need to be reminded, especially with a majority of First Nations that are on the receiving end of programs and services related to health, but the fundamental block in all of this is the fiduciary obligations of First Nations that do receive health care services from the government. The original relationship was between First Nations and the Government of Canada, and as responsibilities are taken on, there has been an effort to devolve responsibilities to territories, to provinces, and in this instance here in the North we have some First Nations groups trying to negotiate self-government regimes and models so that they can make decisions by themselves.
At the same time, and parallel to that, the system that we have is founded on that, that the fundamental relationship of First Nations and the Government of Canada has changed fundamentally so that those programs and services are delivered now by the GNWT. How that’s going to change in terms of if we come to a centralized model of health delivery, I don’t know, and perhaps that’s something that you need to maybe discuss at some point and contemplate in terms of how it is that we
will try not to affect any constitutional obligations that we have to First Nations. Mahsi.