Thank you, Mr. Moses. Minister Abernethy.

Thank you, Mr. Chairman. Medical physicians, family practitioners are actually trained to provide this assessment, as well, so if they’re working with somebody who’s in a medical detox and it’s determined that the person is now fit and they have concluded their medical detox, they can choose to discharge them or offer them other options that might be appropriate for them given their current situation. If they think the person has some psychiatric problems, they can refer them to a psychiatrist.

There are two positons at Stanton by way of example, but we’ve also got distant psychiatry and a number of other programs, locum psychiatrists in the Beaufort-Delta. At the end of the day, I mean, the doctor, as the deputy minister said, will make a ruling based on their knowledge, skills and ability and their knowledge of the programs and services that exist. If anything, one of the things that we do need to do better as a government is make sure that people, including MLAs, including doctors, including nurses, including private citizens are more aware of the programs that we offer and understand we have an expedited referral process, and understand the Matrix programs that are out there, and understand that community counsellors

have a role and have many skills. We all need to get together and promote the message as best we can.

Thank you, Minister Abernethy. Mr. Moses, your time is up.

Committee, we are on page 211, nursing inpatient services, operations expenditure summary, $35.470 million. Does committee agree?

Page 212, nursing inpatient services, grants, contributions and transfers, contributions, $35.470 million. Does committee agree?

Page 215, supplementary health programs, operations expenditure summary, $32.361 million. Ms. Bisaro.

Thanks, Mr. Chair. I have a couple of questions here. I raised it in my opening comments but I want to ask the Minister, and it goes to supplementary health benefits for what we, unfortunately, call the working poor. Those people who are working who do not have their own supplementary health coverage either through their work or they can’t afford to buy it. They’re not indigent. They are working and they wish to continue to work. I’d like to know from the Minister if there are any plans anywhere in this next fiscal year to look at providing supplementary health benefits for this small group of residents. Although they may be small, it’s a gap within our system that has existed for a very long time and needs to be fixed.

Thank you, Ms. Bisaro. Minister Abernethy.

Thank you, Mr. Chair. This wasn’t actually an area that was identified as a priority during the Caucus discussions for the 17th Legislative Assembly. We do have a number of priorities we’re working on and, unfortunately, the department doesn’t have the surge capacity, and there are no positions without assigned duties. Everybody within the department has got a number of assigned duties. The department has some allocation for unanticipated contract work but this, obviously, is minimal. Delivering on the department’s ambitious strategic plan with proposed timelines requires full use of the department’s resources, including our staff, who are our most valuable resource.

Inevitably, new projects arise, and I understand the Members recently have indicated that they would like us to move on supplementary health benefits for the working poor. This is additional work in the department. I think this is something that does need to be done. There was a lot of discussion in the 16th Legislative Assembly, and I still think there’s room

for some significant improvements. We know, based on some estimates that were done, that the projected cost for coverage for the working poor through supplementary health benefits is going to be estimated to be about $4.3 million. That doesn’t mean it doesn’t need to be done and work doesn’t need to be done around this area, but my recommendation is that we include this in our transition planning and make it a priority for the 18th Legislative Assembly.

It’s unfortunate. I’ve heard a lot since we started this session, an awful lot about, well, it wasn’t a priority at the beginning of the 17th so we can’t do anything about it, and that’s starting to wear on me a lot. I appreciate that the department has a lot of work to do and that they are doing a lot of work, and I know that they have staff who are working very hard, and I appreciate that staff are doing good work, and I wish that to be known. But there are an awful lot of things which suddenly seem to be not a priority and there are an awful lot of things which suddenly seem to want to be pushed off to the 18th Assembly, and there are

still a lot of months left in this 17th Assembly. I’m

struggling with the attitude which seems to be getting more and more prevalent that we can’t do it because we’re in the last year and we’ve got to put things off to the 18th .

The figure that the Minister mentioned of some $4 million-plus, that’s not the number that I remember from the working group that went through a very extensive review of supplementary health benefits. I don’t remember that it was that huge a number. It was actually reasonably minimal if I recall. We may be talking apples and oranges when we talk about costs, so I’ll just leave that one at that, but I would hope that, I guess to the Minister but also to all Ministers, that just because it wasn’t identified as a priority doesn’t mean that it shouldn’t be done. I appreciate that the Minister wants to get it done. I appreciate that he’s willing to put a priority on it for transition, but I still think we have residents who are not being treated fairly.

I will ask a question. I will ask a different question. Thank you for indulging me.

I asked this earlier and I’m now on the right page so I am going to ask it again. The air ambulance contract that was recently signed was a very large increase in cost from the previous contract that we had for the air ambulance contract. I guess what I would like to know is at the outset what is it in this new contract, what benefits are we gaining that are worth the $4.5 million or $5 million increase that we are having to bear?

Just going back to the first part of the comment before the question, the $4.3 million estimate was based on the numbers obtained from the NWT Bureau of Statistics by the Supplementary Health Benefits Working Group in

2010, and it’s been updated for new information. But $4.3 million is the estimate, which, as a note, is a significant amount of money in these fiscally challenging times. I do believe, and I think many Members believe, that this is an area that needs some work, and I would like to see that work done, which is why I’d like to make it a priority for the transition document.

With respect to the air ambulance, the providers actually have higher end aircraft that can get into the short runways throughout the Northwest Territories. We have expedited the turnaround time or, rather, the contractors have expedited the turnaround time to some of the smaller communities to two hours from four hours. The current 23-year-old aircrafts will be replaced with four newer ones, more advanced aircraft, all enhanced with dual stretchers so that they can carry more people for increased system efficiencies, improved avionics and systems such as enhanced vision systems that allow pilots to see more clearly in adverse weather conditions such as fog, which is hopefully going to help us reduce those times, and there’s new medical equipment on these airplanes from the old medical equipment that was on them that was getting dated. Significant enhancements in the aircraft as well as the technology on those planes to ensure quicker turnaround for our residents in some of our smaller communities.

I will say also through the Med-Response program, we have actually started to see some sharing of services. The Med-Response, the airplanes are actually able to pick up other people on return flights and actually maximize some of their flight times and get some efficiencies by recognizing that there are other things happening in the territory at the same time. I have some details that I’ll be able to share with committee when we go live with the Med-Response program.

Thanks to the Minister. I’m pleased to hear that we’re getting a little more efficient. Maybe that means we’re going to save money, ha ha. I guess I have to ask, the Minister mentioned new planes and new equipment and so on, and it may be a little crass in this question, but are we paying the contractor to upgrade their equipment? Thank you.

These were all requirements in the RFP to meet modern safety requirements, but also medically responsible requirements in order to provide safe transportation of our residents.

Thanks. One last question in this section and it has to do with the extended health benefits figure. It hasn’t increased, I see, but there was an increase… Actually, it went down from ’13-14 actuals to ’14-15 estimates. It stayed the same in the ’15-16 estimates. It’s my understanding that

that area includes costs for seniors’ health benefits, our seniors are increasing and as our seniors increase we know that there’s going to be a bigger drain on our health system. So I’m surprised to see that there is no change in the estimate from this current budget year to next year. So can I ask why? Thank you.

Thanks. The Member is exactly right. There are increasing numbers of seniors in the Northwest Territories and we are actually projecting increased costs to our already existing budget but we’re in the process of trying to monitor that and figure out what those costs are so that we can project them effectively given that we have a growing population. I imagine at some point, once we get a better grasp of what those future costs are going to be, we will be coming back to the FMB as well as to committee.

Thank you. So the Minister is coming back. I presume he means coming back for a supp, coming back for more money. If we know this now why is it not in the budget? Thank you.

Thank you. At this point I don’t anticipate a supp. I anticipate the department will be coming back through the business planning process for ’16-17. We’ll have a better idea of what those increased costs or future increased costs may be.

That’s okay. Thanks, Mr. Chair.

Thank you. Mr. Bromley.

Thank you, Mr. Chairman. Just a follow-up. We know that seniors are increasing. I know that the Minister has the stats, 6 percent or something. We know that the costs are going to be there. I think that’s typically how the departments adjust their budgets when we know that those costs are going to be there. Why wouldn’t you do that in this case?

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. This is actually the first year that we’ve actually started to see some impact in this particular area. The budgets have always been sufficient. We are starting to see some real pressure, but in order to make a forced growth submission we actually have to have some statistics showing the actual increase of costs over a little bit of time, but until this year we haven’t had those challenges. We’re starting to see it now, so we’re going to make a forced growth case for it.

Thank you. I guess we’ll watch the supps. Just on the medical travel, what’s the explanation for the $3 million decrease previous year and this year and the $5 million increase

between this year and the one year under discussion here?