This is page numbers 6757 – 6826 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.

Topics

Motion 50-17(5): Medical Travel Policy, Carried
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Moses. To the motion, Mr. Bromley.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

Bob Bromley

Bob Bromley Weledeh

Thank you, Mr. Speaker. I will be supporting the motion and I’d like to offer comments that might be classified or categorized as tentative support.

The motion calls for immediately introducing a policy change to ensure access to non-medical escorts for the patients with particular issues. Then again on the last furthermore that the government produce the report to these recommended actions for consideration by the House by February 2016, that’s almost five months from now. We know that this is being worked on since 2011. So I think that’s a healthy opportunity to help the interim or the new government to do its work and provide its response.

We did begin this work in the 16th Assembly and we’re somewhat frustrated that we didn’t make more progress there. It’s gone for the life of this Assembly and I know that the department is actively working on it. This is the message: please get it done.

Consistently applied is the second ask here. That’s something that I think everybody in the House can support and I certainly do.

The mechanism, calling for a mechanism for monitoring and evaluation, again, that’s a no-brainer. We need to do that with all of our policies, and this one in particular, as already noted by my colleagues, is a very significant policy for our residents and a very expensive policy. So we need to make sure that we stretch our dollars as much as we can. I know, in fact, that we have done a considerable amount of work on the Medical Travel Policy. We are working on this 24/7, on-call process, where doctors can be reached 24/7 by a community nurse. We know that we’re working on getting Electronic Medical Records in place so there’s accurate and ready information on patients to help assess their situation. We’ve established Telehealth with equipment and skills in every community in the Northwest Territories so we can create images of patients in their community immediately and with immediate results, and through our IT they can be transferred to the appropriate doctor or professional, again, for immediate consideration and evaluation. All those things should be helpful.

So, finally, I guess, I would note, I think it’s already been noted very straightforwardly, the more dollars we put into this the less dollars there will be for actual health care, so it’s a fine balance and there will always be a tension. It’s not an easy one to do but I think, you know, we’ve been at this for five years at least and we should be able to see some vast improvements. I’d like to see that summarized in place and presented to committee by February of ’16, as called for in this motion. I’ll be supporting it, and thanks to the mover and seconder. Mahsi.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Bromley. Mr. Menicoche, to the motion.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

Kevin A. Menicoche

Kevin A. Menicoche Nahendeh

Thank you very much, Mr. Speaker. I rise today, I’ll be supporting that motion. One of the things is that Members on this side of the House have been awaiting the review of the Medical Travel Policy and I’m sure the Minister will have heard that during his travels to all our constituencies that people raise concerns about medical travel. Even though this motion is quite specific and it may seem costly and expensive, but it’s just about that frustration of our people moving around and it’s another symbol that Members on this side of the House cannot wait for that review. But I think for me it only serves to let government know we’ve got to get this work done. We all know elections are coming and I’m sure that all the Members who will be running again as MLAs will certainly hear medical travel being heard.

Once again, the motion calls for three months’ time to start working on it. I know the bureaucracy is not running for re-election, so I would just let them know as they continue to work on the medical travel review that this particular portion be included as well. Thank you, Mr. Speaker.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Menicoche. To the motion. Mr. Abernethy.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

Glen Abernethy

Glen Abernethy Great Slave

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.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. To the motion. Mrs. Groenewegen.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

Jane Groenewegen

Jane Groenewegen Hay River South

Thank you, Mr. Speaker. I’ll be abstaining from voting on the motion for a couple of reasons. Number one, the work that’s outlined in here is already underway. We’ve already been briefed in Standing Committee on Social Programs on the review of the Medical Travel Policy. So, reference to the Auditor General and the report and all that, it’s already happening.

To the issue of us determining who should get a non-medical escort, it’s taking that decision out of the hands of the medical professionals and I don’t think that’s our role. So I’ll be abstaining from voting on the motion. Thank you, Mr. Speaker.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mrs. Groenewegen. To the motion. Mr. Yakeleya, closing remarks.

Motion 50-17(5): Medical Travel Policy, Carried
Motions

Norman Yakeleya

Norman Yakeleya Sahtu

Thank you, colleagues, for allowing this motion to be brought forward and have your views on it. I certainly know that this motion here, as Mr. Abernethy so eloquently laid out, is going to die. This motion may die here in this Assembly but this issue is still alive and will be still alive in our communities, with our elders that come and talk to us. I have a list of people who have e-mailed me on their experience with the Medical Travel Policy. It may sound that there’s not an issue, but in our small communities and our larger centres, regional centres, it’s an issue, so I hope that our constituents are listening all across the North.

We have a communication gap, big time, with the Medical Travel Policy. I want to let them know that since 2011, four years ago, the Auditor General – the Auditor General – stated clearly, “We’ve got a problem here.” It’s only now, at the dying end of this Assembly, that the Minister is saying we’re going to fix it, be patient with us. For one thousand four hundred some-odd days we had to let people go through this and…(inaudible)…their experiences, especially the elders. Shame on this government for allowing senior people, elders…and I witnessed personally elders in our community travelling without an escort. Shame on them. Shame on them. Our most precious persons in our community.

You know what? This motion says to the government we’re not going to take it. Give some flexibility to our people in the health centre. We’re not asking them. But there should be some common sense questions, common sense questions by the health practitioners, and some of them are not always nice people. I know that.

I’m really wanting to thank the people here to look at this issue here. People have cancer. They need to have someone to look after them, to care. That’s just common sense.

I know that there are lots of dollars spent on it. But we’re in the Sahtu. We’ve got to fly. We don’t have these large centres where we can just jump in a car and go and drive over there with a bunch of family members. Come on. Build us a highway and then maybe.

But I want to say that this motion is passionate, and I want to say that I look forward to the next government and this government looking forward to seeing what we can do to change it. We’ve got to change it now. There aren’t many elders left in our regions here.

Thank you, Mr. Speaker, and I ask for a recorded vote.

Recorded Vote
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. The Member has asked for a recorded vote. All those in favour, please stand. Madam Clerk.

Recorded Vote
Motions

Committee Clerk Trainee (Mrs. Mager)

Mr. Yakeleya, Mr. Menicoche, Mr. Blake, Mr. Dolynny, Mr. Bouchard, Mr. Nadli, Mr. Hawkins, Mr. Moses, Mr. Bromley.

Recorded Vote
Motions

The Speaker

The Speaker Jackie Jacobson

All those opposed, please stand. All those abstaining, please stand.

Recorded Vote
Motions

Committee Clerk Trainee (Mrs. Mager)

Mr. Abernethy, Mr. Miltenberger, Mr. McLeod - Yellowknife South, Mr. Lafferty, Mr. Ramsay, Mr. McLeod - Inuvik Twin Lakes, Mrs. Groenewegen, Ms. Bisaro.

Recorded Vote
Motions

The Speaker

The Speaker Jackie Jacobson

Thank you, Madam Clerk. In favour, nine; opposed, zero; abstentions, nine. The motion is carried.

---Carried

Item 18, first reading of bills. Mr. Miltenberger.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
First Reading of Bills

Michael Miltenberger

Michael Miltenberger Thebacha

Thank you, Mr. Speaker. I move, seconded by the honourable Member for Great Slave Lake, that Bill 72, Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016, be read for the first time.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
First Reading of Bills

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Miltenberger. The motion is in order. To the motion.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
First Reading of Bills

Some Hon. Members

Question.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
First Reading of Bills

The Speaker

The Speaker Jackie Jacobson

Question has been called. The motion is carried.

---Carried

Bill 72 has had first reading.

Item 19, second reading of bills. Mr. Miltenberger.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
Second Reading of Bills

Michael Miltenberger

Michael Miltenberger Thebacha

Mr. Speaker, I move, seconded by the honourable Member for Great Slave Lake, that Bill 72, Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016, be read for the second time.

This bill makes necessary supplementary appropriations for operations expenditures for the Government of the Northwest Territories for the 2015-2016 fiscal year.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
Second Reading of Bills

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Miltenberger. The motion is in order. To the principle of the bill.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
Second Reading of Bills

Some Hon. Members

Question.

Bill 72: Supplementary Appropriation Act (Operations Expenditures), No. 2, 2015-2016
Second Reading of Bills

The Speaker

The Speaker Jackie Jacobson

Question has been called. The motion is carried.

---Carried

Bill 72 has had second reading.

By the authority given to me as Speaker by Motion 10-17(5), I hereby authorize the House to sit beyond the daily hour of adjournment to consider business before the House.

Item 20, consideration in Committee of the Whole of bills and other Matters: Bill 54, An Act to Amend the Forest Management Act; Bill 55, Mental Health Act; Minister’s Statement 221-17(5), Sessional Statement; Committee Report 25-17(5), Report on the Review of Bill 55: Mental Health Act, with Mrs. Groenewegen in the chair.

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

I’d like to call Committee of the Whole to order. What is the wish of the committee today? Ms. Bisaro.

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

Wendy Bisaro

Wendy Bisaro Frame Lake

Thank you, Madam Chair. We would like to deal with Bill 55, Mental Health Act, and Committee Report 25-17(5), Report on the Review of Bill 55, Mental Health Act.