I appreciate that, because I’ve heard it a couple times from local residents as well as residents from the small communities. Not just Inuvik but right across the Northwest Territories. I think we have to make sure we have an adequate supply should this happen.

Just moving forward, I was speaking with a physician on the plane ride coming back to Yellowknife and he was talking about this TED Talks and where this physician was talking about the use of remote technology. When we talk about ambulatory care services, a lot of it is very time sensitive, and actually trying to get into communities, whether it’s a blizzard or some of our remote communities maybe up in the coastal regions and with the work on the Mackenzie Valley Fibre Optic Link, has any work been done in terms of a study to look at how we can use the Mackenzie Valley Fibre Optic Link in terms of remote technology? In the TED Talks they talked about using robotics in medicine, so being able to perform not surgeries but performing medical procedures, or giving advice to some of our communities that might not have any nurses but have health care workers that might be able to do the services that are time sensitive and whether a medevac can get in there or not. Is there a study being done to see

what kind of equipment we might need in some of these small, remote communities, especially now that this Fibre Optic Link will be up and running in 2016? If we get a planning study now, then it’s something that we can work on. It would cut down on travel costs, cut down on medevacs and also possibly save lives. Thank you, Mr. Chairman.

We’re quite excited about the Mackenzie Valley Fibre Optic Link. We believe it’s going to help enhance the services that we already have, and our first focus is to make sure that the tools that we have in place – EMR imaging, lab services – that we currently try to provide over the Internet are enhanced as a first priority and make sure we get maximum benefit out of those programs that we have. We also believe it’s going to support and help us with things like telehealth because we’ll have a better link and better time, better connection.

We also know and we’ve had an opportunity to look at some of the technology that’s in place in Alaska, which is really quite amazing. There are some really interesting things, and we continue to be in touch with Alaska. That would be our second priority after we make sure we’re getting maximum benefit out of our existing things.

But I will say that the doctors in the Northwest Territories are an amazing bunch of people and they really appreciate technology. I promise this literally every day they approach somebody and say, hey, this is something new. We try to incorporate as much as possible and where reasonable. Some of it’s beyond our current fiscal means and we will find a way; some of it is rather inexpensive and we can begin work on those things right away. So we continue to be open-minded and it’s for opportunities as they’re presented to us.

Thank you, Minister. Committee, we’re on page 193, ambulatory care services, operations expenditure summary, $60.154 million. Agreed?

Page 194, ambulatory care services, grants, contributions and transfers, $22.813 million. Agreed?

Page 197, community health programs, operations expenditure summary, $144.418 million. Ms. Bisaro.

Thank you, Mr. Chair. I have a couple questions here. I mentioned in my opening comments that I’m concerned about provision for seniors and the services and programs that we have for seniors. The department has produced at least one document about continuing care. I can’t remember the title now, of course it escapes me,

but one of them was referenced I think at some point by the Minister as not being an action plan, which leads me to believe there is an action plan either coming or that there is one.

So in terms of services for seniors and continuing care for seniors, how we’re going to deal with our seniors, how we’re going to look after our seniors, is there an action plan for continuing care for seniors, and if so, is it made public? Thank you.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Mr. Chair. Seniors are an incredibly important part of our population. The aging population is a growing population here in the Northwest Territories, and we want to make sure that we’re there for them as much as possible and we’re providing supports for them as much as possible. We have our framework, which is Our Elders, Our Communities, which focuses on a number of pillars. We’re working on separate action items and action plans on a number of pillars, including an action plan around a facilities review identifying how we’re going to move forward with facilities here in the Northwest Territories over the next number of years. There are also actions and an action plan around palliative care as well as home care enhancement as well as supporting our seniors in our communities to stay in their communities as long as they can. So, there are a number of things happening.

We have a good relationship with the Seniors’ Society. We meet with them on a regular basis to ensure that they’re involved and providing input and insight into actions as we move forward. We provide a significant amount of money to the NWT Seniors’ Society so that they can undertake actions on their own, which we’re always excited to partner with them on those. So, there’s a number of things we’re doing to support seniors.

Thanks to the Minister. These issues or these pillars that the department is working on, can I get some sense of when they might be completed, when committee might have a chance to look at them and give some feedback? Thank you.

Mr. Chair, for the specific detail on the action items and what’s happening, when we hope to have some of them available, I will go to the deputy minister for that detail.

Thank you, Minister. Deputy Minister DeLancey.

Thanks, Mr. Chair. Thanks to the deputy minister. I didn’t hear a time frame in there. I can understand why one wasn’t given. There’s a lot of work going on and I imagine they’re probably not quite too sure exactly what day it’s going to be finished. I will ask for a time frame if it’s possible and accept the answer if it’s not possible. I understand that.

I’d like to ask a question about chronic care, particularly about diabetes. It is one of the biggest chronic illnesses that we have to contend with, I guess, as a territory. I always get confused on this, but my understanding is that there was a diabetes clinic that was being held in Yellowknife and that was discontinued. What is in place now, whether it’s in Yellowknife or whether it’s in other communities, but what’s in place for people with diabetes to get educated, to basically be treated and learn how they have to handle their disease to get them to get to a point where they’re not a drain on our system? What do we have? Thank you.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Mr. Chair. As far as time frames are concerned, a number of the items that the deputy described are actually well in progress. Some of them have actually been concluded and others are going to take a bit more time. I will get the department to put together some estimates on timelines for the ones that are outstanding but also articulate which ones have already been done and which ones are currently in progress. I will get that to the Members as soon as I can.

The Stanton diabetes education program had a territorial focus and it was delivered in Stanton. The program did some visiting to communities and provided some other clinics. In 2011 the decision was made to transition the program to Yellowknife Health and Social Services as the work was more consistent with the primary care approach. In 2012-13 the Yellowknife Primary Care Clinic implemented some drop-in clinics around this particular area, and diabetes education programs provide services such as workshops. They do drop-in clinics. They do scheduled appointments. They provide some cooking workshops as well as fitness sessions in Yellowknife. Client services include foot care, which I know is a very popular program, as well as some motivational counselling to individuals who happen to have diabetes. The program is run by a team that includes an internist from Stanton, a primary care physician, an NP and an LPN and a dietitian. The program for Yellowknife is still there. It’s at Yellowknife instead of Stanton.

Do you have something else, Mr. Abernethy?

Thanks, Mr. Chair. I do want to just articulate quickly that Yellowknife is not the only place where this diabetes program has been going on. Hay River, Fort Smith and Inuvik offer a targeted diabetes education and care program through their authorities by teams of educators that include nurses, nurse practitioners, dietitians and physicians. The Tlicho Community Services Agency, in partnership with the Tlicho Government, is training local diabetes educators to work with their nurse practitioner who will work directly with people diagnosed with diabetes to learn how to manage their disease.

Funding from the Canadian Partnership Against Cancer has allowed us to adapt our BETTER project approach, which is a great program, and their tools for doctors and nurses and CHRs as well to work with patients to identify their risk and learn self-management techniques for a range of chronic conditions which do include diabetes. So there are a number of things that are happening in the area of diabetes.

I would like to go a little further and say that there are gaps. We know there are gaps. The lack of a territorial program, in my opinion, is a gap. The Joint Leadership Council and the authority CEOs have already identified this as a top priority. Once we actually move forward to a single system here in the Northwest Territories, we’re developing a territory-wide program to meet the needs of our residents and our people rather than fragmented approaches. Hopefully, we’ll be in a position where we can pool some funding to develop something that really meets the needs of our people across the entire territory. But at this point I would say the lack of consistency and regularity is certainly a gap and it’s a problem that we would like to address once we move to one authority.

Thank you, Minister. Next on my list I have Mr. Blake.

Thank you, Mr. Chair. I have three topics I’d like to talk to today. First under health centres, I know it’s an ongoing issue in Tsiigehtchic. If they can’t have a nurse, they’d like a licenced practical nurse there or some specialist in that community on a full-time basis. Many times, during the weekends especially, we get emergencies. It’s left up to our residents to respond to the majority or pretty much all of these incidents. So we are really putting our own residents in our community at risk here, having to deal with a lot of traumatic issues at times here.

Moving forward, we did get commitments in the past to have a licenced practical nurse in the community. I don’t see any policy or guidelines that are holding us back. Why can’t we do this as a pilot project? Thank you, Mr. Chair.

Thank you, Mr. Blake. Minister Abernethy.

Thanks, Mr. Chair. I have indicated that I’d be happy to go to Tsiigehtchic and have a conversation with the leadership to determine truly what it is that they are specifically asking for and what it is that they think will meet their needs. There are lots of potential options. We ask the question of what can an LPN do within their limited scope of practice, and an LPN scope of practice is significantly less, or it can be significantly less than an RN. What is it we are trying to accomplish? We have looked at other models from other jurisdictions like Alaska where they’ve taken local people and provided them with significant training so they can provide some services, get local people for local work, which is something we’ve heard constantly throughout the Northwest Territories. Let’s find ways to employ our people in our communities. There are opportunities, possibly a high level first responder might be more appropriate than a nurse or an LP in a community like Tsiigehtchic, recognizing that we have regular nurse visits on a weekly basis and for some periods

of time they do stay for extended periods of time. I would like to have an opportunity to go in with my staff and have a detailed conversation with the community on what it is exactly they’re looking for and how we can best meet their needs, not committing that it will be an LPN or an RN because that may not be the position that benefits the community the most, but we will have that conversation.