Thank you, Mr. Speaker. I would like to thank the mover and seconder for bringing this motion to the floor for this important conversation around medical travel. I clearly hear the Members as well as I clearly hear the residents of the Northwest Territories.
Medical travel is an essential component of our health care system, one that affects each and every one of us, every resident, at some point in their lives. As a result, it’s a subject about which many people feel quite passionate, as we’ve heard today, and hold incredibly strong opinions. We all want to know that support is there to ensure that we can access service when needed.
Frequently our residents are forced to access health care services in difficult situations, often when they’re ill or they’re in pain and they’re facing difficult diagnosis, when both parents are needed to support the treatment of young children or when our elders, who may not be fluent in English or familiar with the city they’re going to, need help getting around. At these times we want to know that our loved ones are not alone, and as a system we want to be compassionate, but the reality is that we need to balance that compassion with affordability because medical travel is a major cost pressure for our system.
Last year we spent $16 million to provide this service and about one-third of that went to cover non-medical escorts. Our medical travel budget is routinely overspent. Utilization rates are slowly increasing as we face an increase in chronic disease and our ability to contain these costs is impeded by uncontrollable factors like rising airfares. Another pressure is that the federal funding that we have counted on for many years to help us in this area is declining and will cease to exist completely after next fiscal year.
As a government, we strive to find a balance between supporting our residents and keeping our system affordable. This isn’t always easy, especially when we are faced with other competing pressures like demands for improved mental health and addictions services. The changes proposed in the motion, to provide guidance on the situations in which patients should have access to a non-medical escort, are almost identical to what is in the policy today. Our current policy clearly spells out criteria for approval of a non-medical escort that mirror very closely what is proposed in the motion. The challenge is not drafting policy guidelines; the challenge lies in the application and interpretation of those guidelines.
The Medical Travel Policy requires the referring health care provider to make the recommendation whether a patient or a client meets the criteria to be eligible for a non-medical escort. Determining when a patient`s physical limitations or need for an interpreter mean an escort demands careful consideration of many factors, including the nature of the medical condition, the duration of the required travel and whether the final destination is Yellowknife, Inuvik, Edmonton or elsewhere, the patient’s previous experience and personal desires, to name just a few. This is a judgment that is best made by a health care provider in consultation with the patient and the patient’s family members.
I frequently receive appeals from Members of this Assembly or the public who feel that they require a non-medical escort and ask me to intervene in the decision-making process or to overrule the recommendation of their health care provider. Mr. Speaker, let me state clearly that I have not, and I will not, second-guess the advice of health care practitioners in our system. None of us wants a system where decisions about access to medically necessary services are based on politics. This would undermine the public trust in the fairness and equity of our system and would not be consistent with the principles of the Canada Health Act.
Mr. Speaker, I’ll close by saying I recognize that our Medical Travel Program is not perfect. As Members of this House are aware, the department is working with Stanton Health and Social Services to improve the program. We have just completed consultation with stakeholders across the Northwest Territories on how to improve our policy around non-medical escorts. We recently put in an appeal process for anyone who doesn’t agree with a decision made under the policy. That’s a new resource that we have and I believe that the improvements the Members are seeking with this motion are already in process, and for that reason, and in addition to it being a recommendation to Cabinet, Cabinet will be abstaining.
I would just like to point out one additional thing, Mr. Speaker, and it’s one concern I have with this particular motion that’s in front of us. While I recognize that motions are recommendations and aren’t necessarily binding, it is obviously common convention that a government doesn’t make decisions for future governments. With respect to this motion in front of us today, upon dissolution all requests for documents and responses actually die in the life of this government. So this is actually recommending that the next government do something which will die on the floor. But I would like to say, even though the motion dies on the floor and the requirement for a response dies with the dissolution of this government, I want to give the Members an indication that the department is working on this file and they’ve heard you clearly and they know that we need to make improvements in medical travel, and the next government, I hope they’re as passionate about medical travel as the Members are in this House. Maybe this motion will be brought forward again so that there can be an appropriate response, but the department is working on this and is committed to getting it right. Thank you, Mr. Speaker.