Thank you, Mr. Bromley. We’ll turn our attention to Minister of Finance, Mr. Miltenberger.

Thank you, Mr. Chairman. I will make it on the record here that we will provide that information. We will be monitoring closely the system designed with checks and balances to ensure compliance and a high level of implementation. We will commit to share that with committee now and on an ongoing basis.

Thank you, Minister Miltenberger, for that clarification. Mr. Bromley.

Thank you, Mr. Chair. Thank you to the Minister for that. I would like to know how many GNWT personnel are we letting go as a result of this project and do we have any indication of how many of them will be picked up by the new provider. Is it possible to get a breakdown of those according to the various areas? I know there is building maintenance and so on by a very committed bunch of staff there, part of our GNWT staff that we’re losing. Thank you, Mr. Chair.

Thank you, Mr. Bromley. Minister Abernethy.

Thank you, Mr. Chair. It’s projected to be nine positions that may be affected by this. I will not give the names and the specifics at this point because we want to give the CEO at Stanton the opportunity to talk to the staff and make sure they are fully informed before we release their position which will, in fact, identify the individuals. It is nine facilities maintenance staff. BHP will be taking over the facility’s maintenance of the project effective 2018 when the facility officially opens.

So there is no other staff, just the maintenance staff. It will be all GNWT staff that will be taken over, just for confirmation. Thank you.

That is correct. There are positions in the facility today that are contract staff, whe

ther it’s laundry services or food services,

dietary. Those are going to be part of BHP’s facilities management and building management in the future, but they are not GNWT staff. Only nine GNWT positions will be impacted.

I would like to add, Mr. Chair, that this is a significantly larger facility than the one we have available to us today, and we actually anticipate, in order to provide the full scope of services that are going to be in that building, requiring additional positions just like we needed additional positions in Hay River and other facilities when we’ve constructed them, there will be a number of new positions created as a result of this build.

Thank you, Minister Abernethy. Mr. Bromley, if you want to be put back on the list, just let me know. Getting back to questions on pages 38 and 39 on administrative and support services, I have Mr. Bouchard.

Thank you, Mr. Chair. I do have some questions about the Stanton Project as well. Obviously, there is a bit of a balancing here. We, obviously, as Regular Members, had an opportunity to walk through Stanton, and there is definitely a need for improvement to the facility, and talking to some of the contractors that were bidding on it and were talking about bidding on it, a stand-alone building is probably more efficient and a more effective way to do this project.

I guess the difficulty comes in the fact that in the communities in the regions we kind of often see that and say, okay, well, Yellowknife’s getting a b

igger health centre. I know it’s a territorial facility,

and I appreciate that, but I guess some of the difficulty that I’m hearing is what’s going to be done with the old hospital. My understanding was that when we build our new facilities, we build them for the health care only, and then our own facilities, I’ll use Hay River as an example, we’re going to use our old medical clinic for office space. I was thinking, in Stanton’s case we’d be building a hospital just for the essentials, using the old hospital probably for the administration, just like we’re planning to do in Hay River with the medical clinic, but it seems like we’re doing a bigger project than that, which is difficult for us who are continuing to look for things in the regions.

I understand

we’re building a new hospital, but it’s

going to be a “have your cake and eat it too” scenario where there’s a double whammy. You’re getting a new hospital and you’re getting a new upgraded facility in the community. There are probably some needs for that somewhere, but from a regional perspective, people are always looking at that and obviously criticizing it.

I know Mr. Bromley was asking those questions, and the Minister was talking about staffing, and obviously we have an issue in Hay River about our staffing. We originally started asking for 33 new positions, went down to 21 and then come back and we are about to be given a lesser amount. Before we get too far down the road, we should actually have some of those numbers of the staffing that a brand new $350 million building is going to add for staffing. I’m assuming that Stanton is probably similar to the new Hay River Health Centre where things are separated and you already need separate staff, so the numbers will maybe be different. In Hay River we’re seeing a scenario where the ER and patient care are separate right now, where they were together before, so we’re seeing that type of increase for that at that facility. But we should know that going into Stanton right

now. We should be doing some of those operational assessments right now so that Regular Members can understand the pressures that we’re going to see in that health care.

The other question that I have, and I see the portable ultrasounds are in two areas in this budget and I’m not so much concerned about ultrasounds, but I’m just talking about equipment. I know in the South Slave we have a situation where we have a lot of people travelling from Fort Smith to Hay River and a lot of them are taking cabs and a lot of them are travelling there, and even some of those people in Fort Smith are talking about moving to Hay River because they’re on a dialysis system. I know Fort Smith used to have dialysis. I don’t know if it’s an operations thing or we got it and they didn’t, we took it from there or…

W

hy can’t we run two dialysis systems in the South

Slave? We’re spending a whole bunch of money transporting people, forcing people who are on dialysis, who are ill, to travel three times a week. It’s probably costing us an arm and a leg. It’s definitely affecting the care and concern of the public because those people are actually talking about moving to a community where they’re getting that service.

I think we need to look at that as far as getting dialysis back in Smith for the residents of those communities.

Obviously,

we

appreciate

the

economic driver with those people coming into the community, but it’s getting to a point where it’s beyond that and beyond just a small economic driver. It’s actually affecting people’s lives. If we could look into that p

rocess, I think that’s definitely

a difficulty we have.

I’ll just wait for the Minister’s answer on that.

Thank you, Mr. Bouchard. Minister Abernethy.

Thank you, Mr. Chair. A lot of questions there. Just to be clear, the RFP for Stanton was prepared to ensure the broadest potential options for bidders to develop the most affordable and efficient proposal. The procurement process that we went through does not limit the redevelopment solutions. A full range of proposals were considered for Stanton, including renovation of the existing building and provision of a completely new hospital. A new build proposal was considered, provided that the proposed solution did not include demolition of the existing hospital, and addressed the GNWT’s requirements with respect to

the

future

development

and

long-term

maintenance.

The BHP proposal included an opportunity to repurpose the existing Stanton Hospital at no cost and no risk to the GNWT. The developer in the BHP proposal assumes a 30-year commercial redevelopment marketing and tenancy for the

redevelopment of this old hospital under a separate lease agreement with the GNWT. The GNWT will retain ownership of the facility, land and parking at the end of the 30 years. The agreement to lease includes revenue sharing with the GNWT over the 30-year life and also provides limits to ensure that any redevelopment is not incompatible with the delivery of health care services from the overall Stanton site. All security for the redevelopment is being provided by the developer’s project company.

At the end of the day, when we were initially looking at the redevelopment of Stanton, we recognized that the bones of that building, the existing Stanton Building, are still good and there’s still an opportunity for the building. But, as I indicated, the RFP process was such that it allowed for options. The option that is before us came and it was the best proposal as far as efficiency, value for money, and it is the proposal that we’d be moving forward with.

I hear you on the staffing. The building is larger and it will require some additional staff. But as we are seeing with all expansions in all program delivery areas, there’s the “I wish I had,” there’s the “I would like to have,” “it would be nice to have,” “I need,” and that is what actually is required in order to ensure that we don’t go backwards. We look at those numbers. We try to assess those numbers, program areas. This isn’t about program expansion, so we’ve got to make sure that we’re not putting in positions in light of this incredibly tight fiscal environment that are expansion services but required to meet needs.

We are doing the thorough analysis of Stanton and future Stanton, recognizing that the building has room for growth over the years dependent on changes in populations, changes in demographics, all those types of things. So some positions might come later, but we anticipate there will be some positions that are going to be needed right out of the gate. We’re doing that work to make sure that we can present a case that will be accepted by the future Assembly to support additional required physicians in that facility.

With respect to portable equipment, the ones on this particular page are related to the evergreening of equipment that has basically reached the end of its useful lifecycle. But I do hear the Member on his desire for two dialysis units in the South Slave. I will say that the Fort Smith facility, when it was built and designed, there is a room where a dialysis unit could be placed, and we are always monitoring and always evaluating to see when and if it’s going to be appropriate to move a dialysis unit back to Fort Smith. There will need to be a certain level of demand in order to justify positions and the intense training that dialysis nurses have to undergo. A nurse from a regular unit untrained cannot provide dialysis, so we need to make sure that there’s

nursing coverage to meet the expectations of our clients, which requires a certain number of clients to make it h

appen. It’s probably going to have to be a

couple nurses. A dialysis unit is not one nurse and it can’t run with one nurse.

Keeping all those complications and difficulties in mind, we look at our numbers. I hope we never get to a position where we meet those numbers in Fort Smith, but it could happen, and we are prepared to go that direction if and when we reach those numbers. In the meantime, we have to work with the residents who are affected, whether they’re going to Yellowknife or whether they’re going to Hay River, to find solutions that work for them for their health and well-being, recognizing that being a distance from dialysis can prove difficult.

I think I answered all the questions.

I think the extended care unit is a good example. We do learn from past mistakes and there is, on the next page, a request for money to build the extended care unit here in Yellowknife that would ensure we don’t run into the same problem we ran into in Hay River.

Coming back to the management of the new building, the management of the old building will be taken over by BHP. They are responsible for leasehold improvements and tenant management. We don’t have a cost related to any construction in that building. We do have an opportunity, depending on the tenants who are brought in, to have some revenue sharing on that. However, if we choose to utilize some of that room for our programs and services, there will be a discounted rate or discounted rent that we might have to pay. So, there might be some future cost to leasing those buildings.

As far as the upgrades, that is on the facility maintainers and managers which will be BHP. Was there another question?

Thank you, Minister Abernethy. Carrying on with questions on pages 38 and 39, administrative and support services, Mr. Moses.

Thank you, Mr. Chair. I just want to make a couple of comments. In the past I’ve made comments about some medical equipment. I think I’ve asked questions and made some statements in the House about when this department purchases new equipment, they send a lot of patients down south

for

specialized

care,

specialized

appointments or checkups. I am trying to remember back, but I think the Minister mentioned that they were already in the process of looking at how many appointments where we sent people down south and the cost-effectiveness of it and whether or not there’s a trend for dialysis or cancer treatment or some other area. Since you are creating a new stand-alone hospital, maybe we should get an update, and if he recognizes any of these trends, maybe we could start doing those kinds of appointments here in Yellowknife, at the very least, rather than sending our patients down south. Thank you, Mr. Chair.

Thank you, Mr. Moses. Minister Abernethy.

Thank you, Mr. Chair. We are always looking at the numbers and the costs of sending people south versus finding ways to keep them here in the North. We are doing ongoing analysis. We haven’t been able to identify anything appropriate as an immediate move to the Northwest Territories at this point in time. But in the construction and design of Stanton, we didn’t want to limit ourselves in the future. So there is room within the proposed build that would fit something like an MRI, as an example. In the plan of the new building, there is a section that is designated for where we put the addition on to house an MRI should we reach that point. We may well reach that point. The numbers are changing all the time and some day we might reach it, but we’re not there yet.

We have an immediate need to expand things like dialysis here in Yellowknife where there is a significant number of residents who require dialysis. We are working with the Stanton Foundation. I would like to applaud the Stanton Foundation, who is currently out fundraising for our new dialysis machines that could be put in this new hospital. When that happens, we will have to seek some operating dollars. We are on top of trying to monitor trends to ensure we have the ability to provide acute care services for all residents of the Northwest Territories.

In terms of the medical equipment, it kind of goes to what my colleague Mr. Bouchard

mentioned as well. We do get a lot of medical travel, which has also been a topic of hot discussion in the House. Whether or not we can put some equipment into the regions, for instance, seeing what we might be able to get up in Inuvik. With the cost of travel and adding an escort on to that, the costs doubled bringing people down, whether it’s a first appointment or follow-up or checkup appointments. Maybe it’s a possibility to see what inventory we have in the communities and if we can start putting that type of equipment in the communities. Thank you, Mr. Chair.

The line the Member is referring to is the medical equipment biomedical evergreening. Much of this can be quite small, Mr. Chair. Some of it is small machines, some larger machines. Some of it is diagnostic machines and some are more complex. We are always looking for ways to bring the services as close to our residents as possible. We have to acknowledge that it’s not just machines but specialty expertise, specialty employees who come to us who have particular training who sometimes have to come to these machines. It’s a little difficult to talk about this category with respect to machines because the nature of these machines is so varied, so significant, but we are always looking for ways to bring these services closer.

You will note that there is a portable ultrasound on this page and that is intended to go to Inuvik and help improve some of the X-ray services they are providing up there.

That is leading into my next question with the portable ultrasound machines in Inuvik, Simpson and Smith. It seems like it’s a very important piece of equipment in terms of detecting any kind of disease or disorders that can be life threatening.

Can the Minister tell me how many communities have these portable ultrasound machines and why we’re not getting them into more of the communities, especially the regional centres? On top of that, do we have people staffed and trained to operate these machines? Thank you, Mr. Chair.

The portable ultrasounds is in response to a policy that was put forward in 2006 by the Canadian Association of Emergency Physicians. There are new national standards for emergency rooms and these portable ultrasounds will be going into emergency rooms. We’ve already got the one we need here in Yellowknife and we’re looking at Inuvik, Fort Smith, Simpson

– Was it Simpson? – Hay River, my

apologies, to be in

– you’re right, Simpson – the

emergency units. They do require some specialty training that we’re not in a position to ensure that our community health nurses throughout the Northwest Territories have, so they won’t be going into the community health centres at this point.

Just looking at some of our regional centres, does Hay River also have one and does Norman Wells have one? Do these regional centres have the staff trained to utilize these portable ultrasound machines? Thank you.

There will be one in Hay River. It’s incorporated into the new build as part of the plan there. There will be one in that community. At this time there isn’t one scheduled or planned to be in Norman Wells, given the nature and degree or scope of that particular facility.