This is page numbers 5611 – 5653 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

Glen Abernethy

Glen Abernethy Great Slave

Thank you, Madam Chair. As I indicated yesterday, a significant portion of the system funding within the Department of Health and Social Services is actually for the authorities. So, recognizing that the authorities report on criteria and categories that were created by CIHI and the department didn’t, we have moved to a system where our reporting system that’s in front of you now mirrors what’s coming from the authorities and is consistent with CIHI, and this is one of the categories that existed. In previous budgets these dollars would have been in one of the sections where it said “transfers to authorities” and was a whack of cash but not a lot of detail. We feel that this system actually gives Members as well as the public more details into some of the specific areas that are actually where dollars are being spent within the system. So, it’s a matter of reporting in a consistent way between the authorities to the department and giving the Members the information they need so that they can ask the questions that I think are quite relevant.

When it comes to out-of-territory hospitals and physicians outside the Northwest Territories, this covers services that are actually occurring for our residents outside of the Northwest Territories. We’ve heard a lot of talk about this in previous budget discussions where we’ve come for supp funding or whatnot for our residents who are receiving services outside of the Northwest Territories and we have an obligation to pay. That’s basically what these are and it’s based on service agreements but we’ve also got reciprocal billing agreements with every jurisdiction in the country.

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

Daryl Dolynny

Daryl Dolynny Range Lake

We know that the Department of Health has, under contract, nursing care or, I guess, nursing helper services in some of the jurisdictions down south, especially at the University of Alberta Hospital, where these individuals help patients who are brought down from the Northwest Territories who are in need of help to explain what’s happening to them, making sure that they’re coordinated with loved ones, et cetera. Where does that budget fit into here with respect to that service we provide?

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

That actually falls under the out-of-territory hospitals expenses.

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

Daryl Dolynny

Daryl Dolynny Range Lake

What would the budget be for that service?

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

I don’t have the specific details. I will commit to getting that information for the Member, but it’s my understanding that it’s about $300,000, but I’ll get the exact number for our Member and committee.

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

Daryl Dolynny

Daryl Dolynny Range Lake

I’ll take the Minister up on his offer there.

Now, with respect to that service delivery, as indicated earlier, there was some discrepancy in terms of when these nurses were available on call. There were hurdles in our system, and the Minister is very much aware of this. It happened to one of my residents here, where these nurses are basically Monday to Friday, nine to five, and we all know that emergencies and medevacs are 24 hours a day, seven days a week.

Has the department mitigated that philosophy of just a Monday to Friday availability of service and do we have this now, indeed, as a 24-hour service for those patients who are medevaced and who need that assistance when they arrive in Edmonton?

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

We do see this as a challenge and it is something that we want to fix. I agree with what the Member is saying. We actually have begun negotiations some time ago with the Government of Alberta in order to increase the amount of coverage that is being provided by these northern support nurses that happen to be in Alberta. Unfortunately, those negotiations have temporarily ceased as Alberta is going full forward into their budget process as well. We anticipate those discussions will continue once their budget is concluded.

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

Daryl Dolynny

Daryl Dolynny Range Lake

I’m encouraged by what I’m hearing and I’m hoping that the Minister will notify Members and committee if and when we have that as a 24 hour service for our residents.

Statistics that were given to us last year indicated that the no-show rate for family physicians was a whopping 13.8 percent. That means 13.8 residents out of 100 were missing their family doctor visits. I see here speciality clinics are now a separate category, and with speciality clinics it usually goes hand in hand with a lot more expensive services. Do we know what our no-show rates are for our speciality clinics?

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

The Member is correct; the speciality clinics portion is mostly the speciality clinics located out of Stanton. Stanton does track that information but I just don’t have it at my fingertips, so I will commit to getting it to the Member in committee.

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

Daryl Dolynny

Daryl Dolynny Range Lake

I’ll accept that offer from the Minister. The number, aside in terms of what that percentage is, is notwithstanding and we’ll get that number later as promised. The question is we know that there’s a cost to no-show rates. What is the department doing specifically to the speciality clinics in order to mitigate and lessen the burden on our health care system on narrowing the gap of no-show rates?

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

February 17th, 2015

Glen Abernethy

Glen Abernethy Great Slave

I agree with the Member. There is a significant cost to no-show rates both in productivity as well as frustration for those individuals who are on waiting lists. To talk about some of the detailed work that is being done, I will go to the deputy.

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 Jane Groenewegen

Thank you, Mr. Abernethy. Deputy Minister DeLancey.

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

Delancey

Stanton has done a lot of work on this and we’ve had many discussions with them. One of the issues with no-show rates is there are a number of factors. It’s not always just that somebody fails to show. What we’ve determined is that some of the reasons there are no-show rates at the speciality clinics and at Stanton have to do with people being ill, with weather delays, with, again, because we have some communication challenges among our eight authorities with people not getting the information, as well as people coming to town and then having concerns or second thoughts or needing support. There is no one solution that will address no-show rates. Stanton is trying to do more in terms of better communication to make sure that patients are aware, have their travel, know when they have to be here, make sure that they’re getting calls ahead of time to remind them to make sure that all the advance work is done. But it’s not something that always evidenced is noncompliance or where it’s really appropriate to have a punitive response. It’s a pretty complex issue. Stanton is putting a number of things in place to try to reduce the no-show rates.

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 Jane Groenewegen

Thank you, Ms. DeLancey. Mr. Dolynny.

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

Daryl Dolynny

Daryl Dolynny Range Lake

Thank you, Madam Chair. I understand it’s a daunting task, but I think in terms of no-show rates, I only need to lean in to make reference to my own personal dentist. I can tell you that I get no less than two or three reminders within 24 hours of my appointment, and I would feel very bad if I missed that appointment. I’m not sure if we’re doing that at the same level as we probably could be, as simple as notifying people of an appointment. To that, I’ll get a response, but I’d like to make reference to a great idea I heard from you, Madam Chair, that you brought into the House probably about two years ago. I love the idea where if you miss an appointment such as a specialty clinic or a specialty service, even a regular family physician clinic, that we submit a phantom bill to the

patient and say, look, you know what, we’re sorry you missed this appointment; however, this cost taxpayers X dollars. It would somewhat shame the patient to make them understand that there was a huge cost implication. But quite frankly, I think the message would be loud and clear and I don’t think you’d have to do that service for very long before people would realize it. Again, I’m trying to lower the number of no-shows. I’m trying to save the department money so they can spend that on other programs, so to those questions.

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 Jane Groenewegen

Thank you, Mr. Dolynny. 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

Actually, Stanton already did consider this. They explored it and there were a couple concerns that they raised. Number one, it’s not particularly culturally sensitive. It also doesn’t really articulate or recognize the fact that sometimes people are missing appointments for reasons beyond their control such as medical travel, flight delays. A lot of the people utilizing the speciality clinic are coming in from other communities to receive those services. Also, in a time of fiscal restraint and being prudent with our dollars, there is also a cost to it, a cost that has to come from somewhere, and Stanton would have to take that from program delivery, so they chose not to move forward with that.

They are looking at ways to find better communication. As the Member said, I mean, I get the calls from the dentist too. I don’t ever miss dentist appointments, and I might have missed a doctor’s appointment or two in my life. I appreciate the calls. I know many people do. They’re obviously looking for ways to enhance their ability to communicate with residents, recognizing that not all the residents are in Yellowknife, not all the residents have cell phones, some of them don’t even have e-mails. It can be complicated but we’re trying to rectify it.

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 Jane Groenewegen

Thank you, Mr. Abernethy. Next on the list I have Mr. Moses.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Madam Chair. Just following up in some of the areas that Mr. Dolynny was speaking to in terms of services outside the NWT. Has a study been done or do we have data showing what our most frequent visits are or services that are being provided from Alberta, for instance, to our residents? In terms of cost efficiency, do we have the opportunity to see where we’re spending all those dollars and rather than continue to spend those dollars and send our services down south, that it would be more appropriate if we purchased a piece of equipment and take it somewhere, say, centrally located as here in Yellowknife? Do we have the data to kind of confirm that’s something that we should be doing?

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 Jane Groenewegen

Thank you, Mr. Moses. 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, Madam Chair. I’m really happy the Member has actually brought that up. Our chief clinical advisor has actually started doing that work already and it will help us do exactly what the Member is saying. If we find that we have repeat business going down for one particular procedure, it may prove to be far more efficient for us to do that procedure here in the Northwest Territories. There have been some procedures that we have been able to bring some locums in to do in the Northwest Territories to help us reduce costs just based on that type of information.

I hear a lot of people talk about MRIs. How many people are we sending out for MRIs on a regular basis, and when are we going to hit that magic point where it’s actually more appropriate for us to have an MRI machine here in the Northwest Territories than fly them out? We might be there but we don’t know until we have concluded. She says we’re not there. I still say we might be there but we won’t know until this analysis is fully done. But when we do cross that line, that’s the data that’s going to help us say yes, it’s time for machine X to be located here in the Northwest Territories. Apparently, it’s not MRIs just yet, but we’ve got to be approaching that line.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

I’m glad to hear that that analysis is being undertaken and I think that there will be cost savings and also in terms of time for the patient, rather than have to go all the way down to Edmonton that they can actually come to Yellowknife. I know we got an e-mail not too long ago from the Minister in terms of a sonographer, in terms of breaking down in Inuvik and the amount of ultrasounds that patients might need was about four or five a week. Any update on that? I know in the e-mail it had mentioned that there is a shortage across Canada, but is there an update on when that’s going to be rectified? 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 Robert Bouchard

Thank you, Mr. Moses. Mr. 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, Madam… Holy cow! Thank you, Mr. Chair. You’re so different. When did that happen?

I can’t even remember what I was going to say. We don’t really have an update. I’ll get that information for the Member. I know we’re moving some of our people around, you know, to help backfill where possible and we’re looking at doing some staffing, but we don’t have a full answer for that. I’ll get that information for the Member.

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

Alfred Moses

Alfred Moses Inuvik Boot Lake

I think the next question that I have in line deals with the ambulatory care services. On a couple of occasions during my term, we have had

infants that were born in the Beaufort-Delta in the Inuvik Regional Hospital that were born with jaundice. I’ve asked twice in this House about BiliBlankets. I believe they only have one at the Inuvik Hospital. Should two babies that are born with jaundice happen to be born at the same time, one will be able to get the phototherapy that they need with the blanket, but the other one we’d have to send out on a medevac and those are thousands and thousands of dollars if compared to if we just purchased another blanket.

Can I get an update on whether or not the department has taken any action on this or, in fact, maybe you have an inventory on how many BiliBlankets we have throughout the Northwest Territories. Thank you, Mr. Chair.