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.


David Ramsay

David Ramsay Kam Lake

Thank you, Mr. Speaker. I wish to table the following three documents, entitled “GNWT Contracts over $5,000 Report for the Fiscal Year Ending March 31, 2015,” “NWT Business Development and Investment Corporation 2014-2015 Annual Report” and “NWT Business Development and Investment Corporation 2015-2016 Corporate Plan.” Thank you, Mr. Speaker.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Ramsay. Mr. Abernethy.

Glen Abernethy

Glen Abernethy Great Slave

Mr. Speaker, I wish to table the following document, entitled “Annual Report of the Director of Child and Family Services 2014-2015.” Thank you, Mr. Speaker.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Abernethy. Mr. Yakeleya.

Norman Yakeleya

Norman Yakeleya Sahtu

Mr. Speaker, I wish to table the Report of the Special Committee on Transition Matters, “Passing the Mace: Recommendations to the 18th Legislative Assembly,” dated October 2015.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. Mr. Yakeleya.

Norman Yakeleya

Norman Yakeleya Sahtu

Mr. Speaker, I would also like to table a CBC News report on the Province of Manitoba lowering food prices in remote northern Manitoba communities.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. I wish to table 2015 Northwest Territories Human Rights Act Comprehensive Review.

As well, I wish to table the document entitled “Moving Forward - Implementing the Recommendations of the 2015 Comprehensive Review of Human Rights in the Northwest Territories, An Implementation Plan for Changes recommending an independent comprehensive review in the Northwest Territories Human Rights Act.

Item 15, notices of motion. Item 16, notices of motion for first reading of bills. Item 17, motions. Mr. Yakeleya.

Norman Yakeleya

Norman Yakeleya Sahtu

Thank you, Mr. Speaker. I have a motion. WHEREAS the Office of the Auditor General, in its 2011 report to the Government of the Northwest Territories, clearly indicated that the Medical Travel Policy is inconsistently applied;

AND WHEREAS the Office of the Auditor General, in its 2011 report to the Government of the Northwest Territories, clearly indicated that there is no sound mechanism in place for monitoring and evaluating the Medical Travel Policy;

AND WHEREAS the Government of the Northwest Territories has had more than four years to respond to the Auditor General’s report;

AND WHEREAS there are communication gaps between regional health centres and Stanton Territorial Hospital;

AND WHEREAS residents of small communities have, from time to time, experienced difficulty accessing the Medical Travel Program;

AND WHEREAS patients with impaired mobility or cognitive ability, life-threatening conditions, such as cancer, or language barriers, should generally have access to non-medical escorts;

NOW THEREFORE I MOVE, seconded by the honourable Member for Yellowknife Centre, that this Legislative Assembly strongly recommends that the Department of Health and Social Services immediately introduce a policy change to ensure access to non-medical escorts for patients with impaired mobility or cognitive ability, life-threatening conditions, such as cancer, or language barriers;

AND FURTHER, that the Department of Health and Social Services ensure that the Medical Travel Program is consistently applied across all regions of the Northwest Territories;

Thank you, Mr. Speaker.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. Motion is in order. To the motion. Mr. Yakeleya.

Norman Yakeleya

Norman Yakeleya Sahtu

Thank you, Mr. Speaker.

AND FURTHER, that the Department of Health and Social Services ensure that a mechanism is in place for monitoring and evaluating the Medical Travel Program;

AND FURTHERMORE, that the government produce a response to these recommended actions for consideration by the House by February 2016.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. Motion is in order. To the motion. Mr. Yakeleya.

Norman Yakeleya

Norman Yakeleya Sahtu

Thank you, Mr. Speaker. I’m going to make it right to the point here. I want to thank the honourable Member for Yellowknife Centre for seconding this motion.

This motion is to let the government know that there is a huge hole in our Medical Travel Policy. The Minister indicated, through his press release with the staff, that there is a policy that needs to be looked at. As a matter of fact, the Minister has stated, February 7, 2014, from Hansard, and I’m asking him questions: “We have a Medical Travel Policy. We want to have a Medical Travel Policy that is hassle-free for all our patients.” That’s a good goal. That’s a good one.

I want to state to the Minister that the Auditor General, in 2011, clearly indicated that this Medical Travel Policy is inconsistent and not applied evenly across the board. There are no sound mechanisms in place for monitoring and evaluating the Medical Travel Policy and that the government has four years to work on the report by the Auditor General. They are all clear examples that I had written down in this document from residents from the Northwest Territories between the regional health centres and Stanton Territorial Hospital. There are communication gaps to where this person in my region came to Stanton, had chest pains, he was actually having a heart attack. They didn’t know why he was at the Stanton Hospital. That’s just one example; there are many more.

Also, the small communities do not have a link of an all-weather road, so from time to time, these incidents my people have experienced difficulty with accessing the Medical Travel Policy. Things are a little different, you know, it’s not all the same. So I want to let this government know that when there are people who are really in need to be escorted for the head injuries, back injuries or life-threatening conditions such as cancers or, you know, even when I was leaving back to Norman Wells, once I came down to the hospital to get checked out. There was an old lady from Deline. She was sitting there and I asked the young person next to her father-in-law why she was down here. She said, “The Health brought her down here. She does not understand or speak English. I had to come down to get her, and get her back to Deline.” So, language barriers are a real big one for my region, my community and other communities.

I’m saying that with the flexibility that they should have some generality asking questions to the health to have these medical escorts. So, this motion strongly recommends this government to introduce a policy so that there is an avenue to look at non-medical escorts for patients in these types of life-threatening conditions, language barriers, where you know from common sense that this person needs a non-medical escort, a family member should be asked.

There are lots of conditions and I want to tell the government that I look forward to their revision of the policy, but it’s seven months away, you know, and we have to look at how we can do things better for our people who are in the small communities who need medical support.

I heard, through the discussions of drafting this motion from our committee on this side, there are a number of ways that could be looked at to sustain our costs in regards to this policy, so I would like to let this government know that we certainly want to improve our patients’ experience, because right now a lot of them don’t have a good experience. The Minister knows, and we know, that his department is working on things like this, but we also need to know to have some real good flexibility that creates as good a program that we could, in fact, stand up quickly and honestly and say we are improving our patients’ experience and helping this government here.

I want to thank the Members for allowing me, at this late stage of the government and our life here, at this time of day, to have this motion come forward, and I want to know that we, on this side, are listening to people who are having these difficulties with the Medical Travel Policy. Thank you, Mr. Speaker.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Yakeleya. To the motion. Now to the seconder of the motion to speak, Mr. Hawkins.

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you, Mr. Speaker. I appreciate the motion brought forward by my good colleague Mr. Norman Yakeleya, the MLA for Sahtu, and I think it’s very timely. It’s not just a personal experience he’s gone through. These are experiences we are hearing time and time again. Some of the challenges have been brought to my attention, even as of late, and it’s unfortunate, sometimes an experience like what Mr. Yakeleya had personally, all of a sudden it becomes a lightning rod for people all of a sudden to wake up and go, “Hey, wait a minute, that’s happened to me,” or these are the types of things where, you know, the northern culture has been, whereas people have kept to themselves and sort of accepted sort of sometimes the bumpy road and just said, “Well, I’ll put up with it. I’ll put up with it.”

But this issue is on the radar right now and it’s got people phoning in. Recently, I’ve spoken to a constituent, in particular about the medical travel issue and their experience through it, and certainly their family and relatives and the trials and tribulations that they’ve been challenged with and, you know, I mean, the motion speaks loud and clear itself, but I’ll speak to some of the areas they drew up for concern. I know these are areas that are being worked on. I shouldn’t be remiss on that; I need to emphasize that. I know medical travel is complicated. It’s never been an easy beast to wrestle down and solve and it’s one of those things that it’s very expensive. Let us not kid ourselves that medical travel is certainly an amazing benefit, but it’s an important one and represents the values and type of people we are and we feel it’s that important and this is why we need to do a good job. If we’ve committed to do this process then we’re obligated to do a decent job, and that’s the gap right there where I think we expose for fault or failure or liability, whereas in the system itself it has agreed this is what we’re going to do.

It’s funny, that type of commitment is kind of dangerous because when folks finally get through the medical travel gauntlet of approval, whereas their doctor made recommendations and they finally agree that, yes, everybody’s agreed that you require medical travel, even in non-emergency situations, but it’s the same in emergency situations as well. Then it’s, like, what do you do. The family waits. The patient waits. Whether they’re waiting by themselves or waiting to find out approval from their escort, connecting the dots seems to be an issue, and I don’t know how that could be done better. I don’t know if we have to hire a super A-type personality to get in there and put sticky notes and come up with these processes and spreadsheets. I don’t know what the right solution is. The Department of Health is a huge department. I’m sure they can find someone who has great ideas how to link these things, but linking folks through this process has been really a problem.

When you have someone that’s approved for medical travel, how do you link the escort? How do people know what they’re doing, where they’re going and what time to be there? I mean, I’ve heard many horror stories about how people have believed that they were supposed to be on that plane and they get there and there’s no plane ticket sitting there waiting for them. They didn’t get cab fare to that airport so they pay out of their pocket. They get there and then they’re told there’s no plane ticket there. Then they don’t know who to call when they’re panicking. When you’re sick it may, frankly, be an unfortunate experience. If you’re super deathly ill or you’re trying to be the hero through being the escort helping that person who’s going through this terrible experience, people are under a very difficult challenge at that time emotionally, they’re stressed, and all of a sudden now they don’t have plane tickets, they don’t know who to call. It certainly isn’t Ghostbusters.

But the fact is they are stressed. We need, I don’t know if it’s a simple pamphlet that once you’re approved they hand it to you and say, how do you connect these dots? Any problem, you call this phone number and this person has the authority to delegate a solution. I don’t know where it’s going.

But just to continue on, I don’t have a lot of the issues here that I’m going to tie committee time up with here, but there is very little follow-up. For example, if you’re someone from a small community, which happens regularly that English isn’t you’re first language. I mean, this shouldn’t be a shock to our system. It shouldn’t be a shock to anybody in this area of the Assembly. There’s the language problem. Then, of course, there’s just the connection on how you tie everything together, and certainly, there’s not a follow-up process either to make sure that, hey, did it work, how do we make it better.

I mean, sometimes they call those the 360 process where people make phone calls, who are from the system, obviously, find out, hey, did it work, what could we do better, how do we, as Stephen Covey would say, sharpen the sword. You know, you’ve just got to keep working on the system, tirelessly trying to make it better and better.

Again, I recognize and respect that the people there work on this thing every day, and I recognize that it’s complicated each and every day that they’re working on, but these are people working in ideal situations and when you’re on medical travel or trying to get medical travel, you’re not in an ideal situation. If you’re in a place, as I said at the start, you don’t know who to call, where to go, when to be there, and all of a sudden it starts to have a ripple effect. It just makes the whole experience such an incredible burden that it’s great frustration.

I’m happy we have the motion here before us, and I think, really, what it’s saying is we can find ways to do it better, and I certainly look forward to the department finding ways to make this work better. There may never be a perfect solution, but as I said earlier, I’m sure we’ve got someone who could consider things like how do we connect, as I said, people to their processes better, how do we do follow-ups, how do we ensure that the quality assurance programming on the medical travel is there and make sure people understand exactly what they need to do, where to go, and certainly where to go if you have trouble.

That’s all I’m going to say. I think that it’s an important motion. Again, I want to thank Mr. Yakeleya, and the opportunity to second is certainly an important one and a privilege to work with my colleague on this initiative.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Hawkins. To the motion. Mr. Blake.

Frederick Blake Jr.

Frederick Blake Jr. Mackenzie Delta

Thank you, Mr. Speaker. I will be supporting the motion here today. I’m sure there are some challenges, but as the Member just mentioned, we’ve come a long way in medical travel in the last year and a half here. I’ve done a couple statements on this issue. We’re still having little issues with medical travel, elders that get approved for medical travel but when they go to the health centre the people that are working there basically tell them, oh, you’re okay, you don’t need an escort. I mean, that has to stop. If they’re authorized to take an escort, we need to ensure that their escort goes with them. That’s an issue I have here today.

As I mentioned, the department is doing a far better job than they were two years ago, and I’d like to commend them on that. Keep up the good work. Maybe it’s just in my riding. I’m not sure. I’m just kidding.

As I mentioned to the Minister, they’re doing far better than they were a while back. Keep that up and I hope that it only improves more in the next few years.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Blake. To the motion. Mr. Dolynny.

Daryl Dolynny

Daryl Dolynny Range Lake

Thank you, Mr. Speaker. I rise in support of this motion, and I’d like to thank Mr. Yakeleya and Mr. Hawkins for bringing it forward.

First and foremost, we’re very thankful that the mover of this motion is here with us. We know he suffered a very traumatic injury and sustained injury, as well as his family. So on behalf of the Assembly, I want to make sure that we wish him well and much healing for him and his family.

It’s only when you go through yourself the trials and tribulations of pain, of injury, you can actually assess whether or not our health system is actually working for the people it serves. It’s a testament to our system. It’s a testament to the work of men and women who work for us.

I want to say, first and foremost, I’ve worked alongside the medical community for over two decades and we’ve got some great people who work in our health facilities and in our travel area, who do the booking and who work at health centres. I want them not to read into this as something that they’re doing wrong. It’s something that we can do better. I think I want to make that perfectly clear. We have made strides in medical travel but have we made the leaps and bounds to make sure that we’re actually there for the people we serve.

This motion has evolved tremendously over the last couple of days as this motion was discussed in the committee. We were looking at basically a no-ask policy first, and quite frankly, it didn’t garner the support of members, and we could see why. It would be too problematic. But it’s something to consider down the road.

I’m glad that the mover of the motion brought it to us today with more cognitive… He talks about impaired mobility and cognitive ability. Those are key attributes to which we need to be very cognizant. Because, as we heard earlier, everyone in this room, we hope, is of sound mind and body today. As I say, we hope. But when you’re in pain and you’re not firing on all cylinders, everything is magnified tenfold. You’re not able to think clearly. You’re not able to make that decision. You’re not able to make a phone call. You’re not able to hold a bag or even walk up a flight of stairs to get on a plane or take your bag off the rail. You’re not able to do those things, so having an escort, really, in essence, is a key attribute to the healing process. For whatever reason, this motion talks about very specifics in nature which I like, and I think we need to give consideration where consideration is due.

As well, it’s very pertinent for us to note that we’ve waited a very long time. When I say we, residents of the Northwest Territories, Members of this House, committee, and of course, the Auditor General of Canada. He’s still waiting too. He’s asked this government to act accordingly. The government of the day said, yup, we’ll do that. We’ll get on it and we’ll have it done by a certain date, and that’s actually documented for everyone to see. Well, of course, we’ve gone past that date. We’ve gone past that date many times. It’s unearthly to still hear stories to this day, and I can tell you, as a Member who has to listen to a patient or a constituent come in, the moment we know it’s an issue of medical travel, we all know we’re going to be there for a while. It’s not one issue that falls off the rails when it comes to medical travel. It’s a story, and it’s usually a cascade, it’s a myriad of issues, one after the other, to which you’re here as a Member and you try to help.

Now, of course, we put tools in place. We’ve got system navigators, and that’s a great move that the department did. But as I said, when you’re sitting there listening to a patient go through their story about what happened to them, you feel for that person. You go, geez, why couldn’t we have done something better? So this is one of those motions where it says why couldn’t we have done something better, why should we not do something to improve?

So, I really appreciate the motion for what it is. This is a very subtle nudge to the Minister to say you know what, don’t leave it on the backbench. Let’s tackle this issue. We know the Minister has approached committee. We know the Minister has talked about the bigger plans. I’m sure today he’ll share some specific details about where they’re going with medical travel and I’m hoping the public is able to understand where we’re going, should we get there sooner.

The motion talks about getting back to us in February of 2016. Hopefully, some of us are here, but I’m encouraging the Minister and the department, let’s not wait until February 2016. There are certain things we can do now. That’s what this motion says. Let’s do it now. We’ve been waiting years. Years.

So I want to leave you with this, I can go on at length with this because this is definitely up my alley, but I want to leave you with this here: You don’t get what you wish for, you get what you work for, and clearly we haven’t worked enough on this one. Thank you.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Dolynny. To the motion. Mr. Nadli.

Michael Nadli

Michael Nadli Deh Cho

Thank you, Mr. Speaker. I’d like to thank the mover and the seconder for putting forward this motion. I support this motion.

One of the things that I kind of thought about, and hopefully this never happens, or perhaps maybe it actually has happened, is that the thought of an elder who has to be transported from another community and that elder is unilingual and is brought to a foreign place and that elder is left to their own vices, to fend for themselves to talk their way into a cab and to get to the hospital. You know, I would never want to see a circumstance like that, especially with an elder from a small community. Hopefully it doesn’t happen.

This motion ensures that likely in the future that those situations will not happen. That a lot of the policies and initiatives that this government puts forth we need to be culturally sensitive in terms of understanding the culture of businesspeople. At the same time, there are things that are needed, especially for elders, and this motion basically presents that.

So, with that, I support this motion. Mahsi.

The Speaker

The Speaker Jackie Jacobson

Thank you, Mr. Nadli. To the motion. Ms. Bisaro.

Wendy Bisaro

Wendy Bisaro Frame Lake

Thank you, Mr. Speaker. My comments will be brief. I appreciate the mover and the seconder for bringing the motion forward. As a member of the Standing Committee on Social Programs, I was party to an update from the department last month on what they are doing in regard to the Medical Travel Policy. As I understand it and remember from that update, they are in the process of developing recommendations around non-medical escorts. So my preference is to wait for that recommendation and that work to come from the department.

I agree with most of what is in the suggested motion, but I can’t say that I agree with absolutely everything. One of the conditions that is being suggested for a non-medical escort gives me some pause. I do agree, certainly, with consistent application of any policy, that’s an absolute, and I do agree with monitoring and evaluation of any policy, in this case the Medical Travel Policy.

So that said, I do not wish to vote against the motion, but I will be abstaining. Thank you.

The Speaker

The Speaker Jackie Jacobson

Thank you, Ms. Bisaro. To the motion. Mr. Moses.

Alfred Moses

Alfred Moses Inuvik Boot Lake

Thank you, Mr. Speaker. I’d like to thank the Members for bringing this motion forward. Medical travel is a big issue throughout the Northwest Territories, and as my colleague mentioned, standing committee did get a briefing last month as well as on Monday, October 5. The Minister did table a document, NWT Medical Travel Program, Patient Escort Supports Report on What We’ve Heard and it is mentioned that they are working on their recommendations that were developed out of that report.

We all know that medical travel, as we go through our business plans, averages out to over $30 million a year. Now the escort portion is over $5 million and when we break it down that’s over 13,000 medical travel patients every year. So we’ve got to find ways to do things better that can cut our costs, whether it’s providing more services to the regions, or ensuring that people get the proper treatment when they do go out, because I’m sure a lot of these costs are travel that’s repeated over and over.

With the report, I know there have been some concerns and some discussions talked about staff turnover as well as capacity issues in the regions and there’s nothing that we can do about that. All we can do is continue to provide support and try to help our patients get the right programs, the right treatment, the right services that they need. I know there’s been an appeals process that has been discussed and that the department is working on it. I know, as I mentioned at the onset of my comments, that this is something that we’ve been working on for the life of this government.

What else we’ve been hearing is that some cases, when it’s not approved, people are just paying for their own escorts and that is something that needs to be addressed, whether it’s an afterwards appeal process to get remuneration on the hotel, airfare costs, per diems for people who need assistance. So the first part of the motion that was brought before us in the House, I do believe it’s being worked on. During our presentation to standing committee, as well, if you look at the document that was tabled on Monday, it says they are working on a lot of recommendations in there. Whether this motion will speed up the process, as I mentioned there are capacity issues, staff turnover, that’s going to reflect that.

The second part of the motion here is to apply throughout all the regions, and recently over the summer we passed Bill 44, the Health Administrations Act, that’s going to assist in transformation throughout the Northwest Territories. They’re going to provide better services to regions that are having some of those issues with medical travel, as well as all health and social service concerns in terms of services and programs provided to residents. However, due to the fact that this medical travel concern is something that we’ve been talking about, the Auditor General has brought it up and standing committee is trying to stay on top of it, among the many other emerging priorities throughout the life of this government. I will support the motion just on the fact that it is still important and I’ve got to show my support of the importance that medical travel and the escorts for our most vulnerable, our youth, our elders and those who are described in the motion.

I do understand and I do think that the department is working on it right now. There are challenges. Whether or not this motion is going to speed up the process, I have to have faith in our departments and when the governance and system transformation comes through I think it’s also going to reflect on the services that are lacking in some of our regions that don’t have these services currently.

So I thank the mover and the seconder for bringing the motion forward and I will support it based on the fact that it is an important issue and we’ve got to protect our residents of the Northwest Territories. Thank you.