Thank you, Mr. Bromley. The Minister of Health, Mr. Abernethy.

Thank you, Mr. Speaker. Unfortunately, the position in Fort Smith is still not filled. We’ve attempted to go out and recruit that position a number of times and every recruitment activity has proved unsuccessful. We are intending to fill the position and we continue to go out and recruit and we hope that we do find somebody to fill that position in short order.

At the same time, we have filled the two positions in Hay River. That program has started. They’ve already started meeting with clients and we anticipate that the midwives in Hay River could be facilitating a birth in the community as soon as this month. Thank you.

Thanks to the Minister. The Minister also indicated last session that the Department of Health and Social Services was consulting with the people in the Inuvik/Beaufort-Delta region, gathering their thoughts about the Midwifery Program. The Minister related that there were a number of challenges and concerns, but he was working through those with the Beau-Del authority.

Can he explain or tell the House when the Midwifery Program in the Beau-Del will be implemented? Mahsi.

We have had some preliminary meetings with staff in the Beaufort-Delta who have been involved in this type of program or who might be involved in birthing services at this time. As the Member has indicated, there have been some challenges raised with the delivery of midwifery services in the Beaufort-Delta. To that end, we are looking at envisioning how we are approaching midwifery services in the Beaufort-Delta.

Originally when we came forward, there was a multi-part plan which included set up midwifery services in Hay River, move midwifery services to Beaufort-Delta and then move forward with a territorial program here in Yellowknife. We’re

looking at re-envisioning that model and tweaking it a little bit. I had sent the Standing Committee on Social Programs some details about moving forward with a modified plan so we could get a greater degree of midwifery services in the Northwest Territories. Thank you, Mr. Speaker.

Thanks again to the Minister. On May 6, 2011, the Minister temporarily suspended the successful but understaffed Midwifery Program in Yellowknife, Ndilo and Detah. Rather than choosing to staff the program appropriately, the Minister of the day simply suspended the program, leaving half of our residents in the Northwest Territories with no Midwifery Program at all. After four years, this suspension seems to have become a permanent cancellation.

When will the Minister fulfill the promise and reinstate, in an improved format, the highly valued and much missed Midwifery Program for Yellowknife, Ndilo and Detah? Mahsi.

Just for clarity, the Midwifery Program that was in Yellowknife was never funded. It actually never had core dollars to fund that program. It was funding the authority had taken out of other programs in order to create midwifery services.

I’m still committed to midwifery services, I always have been, which is one of the reasons we are looking at re-envisioning how we roll out midwifery services over the next couple of years.

As I indicated, we had planned to move forward with Beaufort-Delta. Things look like they might be changing. There have been some alternate proposals submitted to us on how to deliver services to the Beaufort-Delta, including one position that could be a nurse practitioner to be an educator, mentor for community health nurses and support them as well as support the physicians who happen to be located in the community.

What we would like to do is move forward with a territorial model based out of Yellowknife beginning planning in 2015-16 so we could have a full rollout in 2016-17 and midwifery services. We envision it as being a multi-part program, the territorial program, and it would be reasonable to locate that program out of Yellowknife in order to enable a broader scope of services to the women who may utilize those services.

It would also be a program that could support all communities throughout the Northwest Territories by providing expertise, guidance to community health nurses who happen to be involved with the pre- and postnatal services throughout the Northwest Territories.

The second part would actually be supporting birthing in Yellowknife for individuals who wish to have midwifery support in Yellowknife. So, a multi-part program. I have sent a letter outlining this

opportunity to the Standing Committee on Social Programs, and before we move in that direction I am looking forward to their feedback and support. Thank you, Mr. Speaker.

Thank you, Mr. Abernethy. Final, short supplementary, Mr. Bromley.

Thank you, Mr. Speaker. Thanks to the Minister. I appreciate that. I look forward to that getting in place with the timing you’ve given us. Over the years, while this has been going on actual Midwifery Program positions have languished unfulfilled, as the Minister knows.

My final question is: What did we do with the hundreds of thousands of unspent midwifery salary dollars approved by this Assembly for the introduction and staffing of midwifery programs across the NWT? Mahsi.

We did actually create a midwifery coordinator position in the department that unfortunately has gone through the revolving door as well, been filled, then vacant, then filled, then vacant. That position is a key position and a lot of the funds have gone to support the planning and operational design as well as consultation in communities and whatnot. So a significant number of things were done.

There aren’t hundreds upon hundreds of thousands of dollars that have lapsed, but we are in a position, changing direction and moving forward with this new model, we may have an opportunity to utilize funds in a different way. Thank you, Mr. Speaker.

Thank you, Mr. Abernethy. The honourable Member for Hay River South, Mrs. Groenewegen.

Thank you, Mr. Speaker. I would like to follow up on Mr. Bromley’s questions about midwifery. There are communities in the Northwest Territories outside Yellowknife that have had no birthing options for parents. As a result of that, people have to leave their community at their own expense, or distance themselves from their spouse, from perhaps their other children to depart the communities, the regional centres at least three weeks in advance of having a child.

The midwifery services in Hay River, which now the chief positions are staffed which is wonderful news for Hay River because other than midwifery the only other option is to go to Yellowknife or go someplace down south to have a child or baby.

Would midwifery in those communities where there are no other options to have a baby born in the community, would those not be a priority for midwifery services before places like Yellowknife

where there are actually existing options? Thank you, Mr. Speaker.

Thank you, Mrs. Groenewegen. The honourable Minister of Health and Social Services, Mr. Abernethy.

Thank you, Mr. Speaker. One of the challenges we face around midwifery and providing birthing services in communities outside of Fort Smith, Hay River, Yellowknife and Beaufort-Delta, Inuvik in particular, is that we need to make sure the facilities are appropriate, that individuals can receive the proper diagnostic and specialist obstetric or services such as C-section. Most of our communities don’t have the capacity to provide that type of service. So we need to make sure we focus our attention where we can actually provide birthing services.

What we’re talking about now is pushing midwifery services out and supporting community health nurses in the communities so they can provide many aspects of what midwives do, which is a lot of the postnatal and prenatal services, which will actually lead to healthier babies, healthier births and healthier pregnancies. Thank you, Mr. Speaker.

The Minister indicated that the support and supervision and administration for the Midwifery Program across the Northwest Territories would be operated out of Yellowknife.

I’d like to ask the Minister what is the rationalization for having that located in Yellowknife and why could that not also be located in a regional centre where there are already midwifery services which that administrative position would be overseeing. Thank you.

No final decision has been made. We are open to any discussion, but I would say at this time it is envisioned that a territorial program will be based in Yellowknife as this will enable a broader scope of women with certain risk factors to assess midwifery care for at least a portion of their care through the easy access to diagnostic services, specialist obstetrics, as well as for ability for immediate access to C-sections and other emergency procedures if needed. Thank you, Mr. Speaker.

Again I have to ask the question, if all of those services are already available in the territorial capital, the support of other physicians, the ability for emergency surgery, if those are already services available here in Yellowknife to women who are giving birth, does it not make sense and can there be, please, a rationalization for why the focus for midwifery as well needs to be in Yellowknife? Why could that not be outside of Yellowknife, the oversight for that program, where there are no options but to come to the capital?

You’ve already got it all concentrated here in the capital. I still haven’t heard what the rationalization is for having the oversight for this in the capital. Thank you.

As I indicated previously, the territorial model’s primary goal is to support the knowledge and skill capacity of community health nurses through continued interaction and direct clinical support with midwives. This will benefit all NWT communities by raising the standard of community maternity care. This is one of the primary goals of a territorial program. There’s also the secondary benefit of being able to provide some midwifery support to residents of Yellowknife who choose to access those types of services.

The fact is, at the end of the day, if a patient is at risk, if there are any severe concerns about the birth, they will be coming into a community like Yellowknife or Inuvik anyway, even if midwifery services are provided in a community like Fort Smith or Hay River. High-risk patients still come to those two centres. So we need to focus out of where these high-end services exist just in case we do have to bring individuals in. We also want to push out to communities and support community health nurses.

As a territorial program, I think there’s some value for it to be in Yellowknife. It does provide us the opportunity to provide some midwifery services to a large population in Yellowknife as well. Thank you, Mr. Speaker.

Thank you, Mr. Abernethy. Member for Yellowknife Centre, Mr. Hawkins.

Thank you, Mr. Hawkins. Minister of Environment and Natural Resources, Mr. Miltenberger.

Thank you, Mr. Speaker. We will soon be before the House with our budget for the year, and we’d be happy to have that discussion in that forum if the Member would

apply his fingers to the keyboard and lay out with clarity and detail the specifics of what he’s proposing. We will, of course, seriously take a look at it in that regard, as well, or through the appropriate committee of MLAs, special committees that are in place to deal with issues such as that. Either one of those forums, either or all would be where we’d be prepared to have that discussion with the Member. Thank you.

I think most of us can agree here that with the operation of a house, a lot of money is devoted to heating it. Heat loss is a major contributor to poor energy efficiency if a house isn’t well insulated, the doors aren’t good and the windows don’t withstand the needs for cold weather here.

Is there a reason why doors, windows and exterior insulation aren’t part of the energy efficiency rebate program, which could go a long way to help Northerners heat their houses in a more efficient way? We spend a lot of time worrying about wood stoves, boilers, furnaces, toilets and lightbulbs, but these would certainly give Northerners a bigger bang for their pocketbook in the sense of better quality and certainly help them along the way to do these types of things that are necessary.

The involvement of the territorial government in energy efficiency conservation, all the areas of retrofitting houses, making sure we’re using proper appliances, hot water heaters, wood stoves, LED lightbulbs, those types of things, are part of a process. We’d have to look at the money. If we’re going to be providing rebates or incentives, is it to renovations, is it going to be if you’re building a half-million dollar house? We’d have to put in a certain percentage to encourage you to go to R-40 in the walls, R-60 or 65 in the roof. There’s some discussion to be had, there’s costs to be looked at, is it needs based? So, there are a lot of things.

It’s a fairly potentially big-ticket item, but we’ve been working our way there because we’ve been spending a lot of money on developing biomass strategies, solar strategies, we’ve invested considerably in converting our own buildings and those types of things and putting in a significant amount of money to help people convert to biomass. So, capacity is one issue, the Member’s raised it now in this House, and maybe the time is now to have that discussion. Thank you.

Would the Minister be willing to take this initiative back to the department for a review on what would it take to establish this type of program to include the energy efficiency element of doors, windows and insulation? Thank you.