Thank you Minister. Thank you, witnesses. Sergeant-at- Arms, please escort the witnesses out of the Chamber.

Committee has agreed to consider Bill 44, An Act to Amend the Hospital Insurance and Health and Social Services Administration Act. I will go to the Minister responsible for the bill to introduce, if he has any introductory remarks. Mr. Abernethy.

Thank you, Mr. Chair. I’m pleased to be here to discuss Bill 44, An Act to Amend the Hospital Insurance and Health and Social Services Administration Act.

I appreciate the questions and concerns raised by community members and health and social services providers during public meetings hosted by the Standing Committee on Social Programs throughout the Northwest Territories.

The primary purpose of Bill 44 is to allow for the transformation of the health and social services system so that it can work as one system. This will be achieved by amalgamating all the health and social services authorities into a single territorial authority. While our role is obviously to move towards a single territorial authority, I want employees of Hay River Health and Social Services to know and be assured that we have heard their concerns and that this bill will allow us to bring Hay River into the territorial authority at a later date. The

department clearly respects those providing health and social services to the public and we will not infringe on the rights of workers, or their bargaining agents.

The development of this bill has been the result of a significant time and effort by the department and contribution of the members of the Standing Committee on Social Programs and the public have helped to strengthen and clarify this bill to make it a better bill. If passed, this bill would be a great accomplishment for the 17th Legislative Assembly.

Mr. Chair, I would be happy to answer any questions that Members may have.

Thank you, Mr. Abernethy. I will go to the chair of the Standing Committee on Social Programs, the committee that considered the bill, for opening comments. Mr. Moses.

Thank you, Mr. Chair. On behalf of the Standing Committee on Social Programs, I know that we appreciated the work and the collaboration with the Minister, his department and staff on Bill 44 and we appreciate the Minister bringing this bill forward before the 17th Legislative

Assembly. It was pretty good in terms of consultation. We did hit nine communities for stakeholders during the day and then had public reviews in the evenings. We do agree that it would help address some of the inefficiencies throughout our health authorities throughout the Northwest Territories. As we get into the report, we will have more general comments towards the bill. Thank you.

Thank you, Mr. Moses. Minister, do you have witnesses to bring into the House?

I do, Mr. Chair.

Thank you, Mr. Abernethy. Sergeant-at-Arms, would you please escort the witnesses into the Chamber.

Thank you. Mr. Abernethy. Could I get you to please introduce your witnesses for the record?

Thank you, Mr. Chair. On my right is Ms. Debbie DeLancey, deputy minister of Health and Social Services; on my left is Mr. Thomas Druyan, legislative counsel responsible for drafting this piece of legislation.

Thank you, Mr. Abernethy. Committee, I will open the floor to general comments on Bill 44. Mr. Dolynny.

Thank you, Mr. Chair. I would like to echo the words of our chairman, Mr. Moses. This was a very thought-out piece of legislation and I do want to applaud this and it is hard sometimes for Members to do this publically. I do want to applaud the hard work, I believe, this department has gone through on preparing the public, and I will say the

public in its large sense, on this piece of legislation coming forward.

It made the work of committee a lot easier. A lot of stakeholders from across the North who we talked to had a very good appreciation of what I would consider a very good understanding of what this meant, albeit I would have suggested in the future that we provided more of a visual representation of what this model will look like. I do encourage the department to maybe continue to burn that torch on really providing a visual representation of what this new model will entail, once it starts to unfold and come into line. Again, good work on behalf of the government and the department in preparing the committee for doing the due diligence that we have to do.

Without going into a lot of the detail, I know the committee has issued the report, the report has been tabled and we did go clause by clause and I think a lot of Members did speak to it. I just want to echo some of the key areas which I still believe need mentioning here. I know that the transitional provisions for Hay River employees did consume a lot of our attention, especially when we were in Hay River. A lot of the employees did show up. In fact, I didn’t do the percentage but I believe around 95 percent of the room that came out, which was fairly substantive at the Ptarmigan Inn, were employees of the Hay River local. I think the key words that I got out of it as a Member, in consultation with the public, was they wanted some form of peace of mind.

I think what came out of a lot of comments was that they were looking for that peace of mind within the legislation that would enshrine the government, that they would go bargaining in good faith moving forward but, more importantly, that the pensions and seniority were to be kept whole. I want to echo that again. Again, I can’t pre-empt what negotiations may look like in the years to come, but I am hoping that because it is now enshrined in Hansard, that this will indeed be the guiding weigh point for the department, for the negotiating teams, because I believe this act sets the prompts. The promise is now in law that we will be bargaining in good faith and that we will make sure that the public and the Hay River residents who are involved with the changes of the health authorities will be kept whole.

The other area is the area of critical incidents. I do applaud the Minister with agreeing with the committee’s recommendation that the Assembly, through way of motion, was able to initiate a critical incident investigation through the department and through the Minister. We believe this is a foundational step and a foundational piece of better legislation which allows the political process to intervene in the event that families come forward and are looking for closure. I think we have actually

heeded to that call and I do commend the department for agreeing to that amendment.

The other area that I want to talk about is… Sorry, Mr. Chair, just one second here. My fault, I had a note and I am looking for it here.

For the sake of time, Mr. Chair, I hit the two highlights, so for that I will not consume any more of committee’s time. Those are the two big ones that I had here. Thank you.

Thank you, Mr. Dolynny. General comments. Ms. Bisaro.

Thank you, Mr. Chair. I have some comments that I made the other night but would like to repeat them. At the outset, I want to say that this bill, not quite as long time in coming as Bill 37 but this one has been a long time in the works. I want to commend the work of the Minister to get out and speak to regional health authorities, speaking to regional Aboriginal governments and explain the concept that he was trying to put through and make sure that people really understood the concept before we got to this point of looking at a bill. I think that groundwork went a long way to what we found when we did our consultations in the communities, and that was general acceptance and general positive remarks about this bill and that moving to one authority was going to be a good thing. I think that without that sort of legwork done prior to bringing this forward as a bill, we would have had a much more difficult time.

I want to echo Mr. Dolynny’s comments about the concerns of the staff at the Hay River Health and Social Services Authority. It was very clear to us when we had our hearing in Hay River that they were extremely concerned about their jobs, about their positions, their seniority, their pensions, any and everything in and around their employment. They certainly felt that there was no security for them with this amalgamation. With the amendment that we brought forward from committee and that was concurred with by the Minister, I think that sense of comfort is now in the bill and I think those employees should be able to feel comforted that they are not going to be walked all over and they are not going to get left behind.

I wanted to mention, as well, the critical incidents section. I know there were several things which committee felt were important. One of them which Mr. Dolynny has mentioned and that was that an incident could be referred by motion of the Legislative Assembly, but in addition, we made a motion that expanded and sort of better described who could request a critical incident, so patients or relatives of patients, someone working at an authority. That was, as well, a positive change to the bill.

There were amendments to the Minister’s powers. There were a couple of sections where the Minister

had powers that committee considered to be extremely broad and the Minister accepted amendments to change the bill a little bit, so the Minister still has a lot of power but he doesn’t have power over everything and everyone and everywhere. We were a little concerned about that language.

As has been mentioned, there was, I think it was mentioned, but there was a great deal of collaboration in getting this bill to where it is today, as well, on the part of both sides, the Standing Committee on Social Programs but also the Minister and staff, also the legal representatives on both sides. A lot of work goes on behind the scenes to get motions to where they can be acceptable to both sides and then there is a lot of understanding and a lot of back and forth and it certainly makes for better legislation.

I hope that is something that is going to become a bit of a way of doing business in the future. I think it does give us better legislation in the end. It is perhaps, more work, but the objective, in my mind, is when a piece of legislation comes forward we want the best piece of legislation we can produce, and I think collaboration gives us a better one than if we don’t.

A couple of comments I wanted to make from our hearings. I heard in a number of communities that there was concern that with the amalgamation of all health authorities into one that regional voices would not be heard. They spoke quite strongly to the effect that in order for their voice to be heard they needed to have someone representing them who understood the health system, who understood patients, who was not going to be on the board simply to be on the board, but was going to be there to be a good representative and to be a good voice for the community.

Lastly, there are concerns, my own concern. I’m not sure if it was all of committee, but I am unsure how certain regional authorities are going to remain as a management authority, the other ones are going to be advisory authorities or advisory boards. It’s unclear to me, and I think the Minister needs to work on this through implementation. It’s unclear to me how a management board will remain a management board when we have one territorial management board, and I think it’s something that can be worked out. Mr. Dolynny referenced sort of how things are going to work and what the diagram is going to look like, and that’s an example of what things are going to look like when implementation comes along. It just needs to be worked on and it needs to be clarified, and everybody needs to know what the future is going to hold.

That’s what I had in terms of comments that I wanted to make, Mr. Chair. I just want to reiterate, again, that I think this is a good piece of work and I would like to express my thanks to people on all

sides and in all capacities for the work that was done on this bill. Thank you.

Thank you, Ms. Bisaro. Continuing on general comments for Bill 44 I have the chair, Mr. Moses.

Thank you, Mr. Chair. I just want to express my appreciation for the work that was done. I think it was great that both the department and the community did reach out to a number of stakeholders, and we did get a lot of submissions coming in even before we went on our little road trip there. As I mentioned, we had nine communities and got a lot of really good feedback. I just wanted to mention there, as well, that I think this is the first time that a committee has taken two significant bills that are going to affect the way that we do our business in the Northwest Territories on the road simultaneously. What was great about it was if members of the public came out to talk about Bill 47, they learned about Bill 44 and they were able to give feedback on Bill 44 and vice versa. So when some members came out specifically for one thing they thought this was a great idea, but they made some comments that were concerning.

The first little area that I’d like to discuss is just in terms of the structure. I know that in some of our regional authorities that we do have public administrators, and I think what I heard most of all was the support for these regional advisory councils that are going to be able to provide supports to provide suggestions, comments at the regional level and that communities are going to start having a voice now at the regional level, which will eventually come to the territorial board of management, which would give impact into this territorial health plan that we’re looking at creating through our chairs from the regions that sit on this board.

As Ms. Bisaro said, we did hear from a lot of the general public that said they need to have people that are on the ground, the front-line workers, the community advocates that know the issues, know the concerns. We need them on the board rather than just an NGO head person or somebody that’s head of the Aboriginal government that can give concrete, quality information. I think the Minister possibly also heard that. A lot of people were really happy that in the bill with the regional advisory committees that the Minister would work with the communities in finding that person and suggesting it.

You heard already about the critical incidents, and what we thought was a great step forward and a very proactive step forward was the motion coming from the Legislative Assembly into looking at those investigations and that was great.

In terms of this bill, we heard a lot of really good feedback, and one thing, taking two types of bills, especially this one, you hear of the challenges, the

barriers and the other issues that come up in terms of the health system. For instance, when we were in Deline we talked about how we can address some health concerns, and people said, “Well, we can try to address them in Deline, but we don’t have the services,” and we heard that from a lot of the smaller communities. So, I think it brought up other areas of programs and services. Obviously, the human resources, the health professionals throughout the regions, the lack thereof and having one territorial health issue, I think, is going to address some of the human resources as well as the financial implications of how we move forward.

Just before I finish off here on general comments, I also just want to make a point that we did hear loud and clear from the Hay River Health and Social Services about all their concerns. I think it was a very good dialogue as one of our bigger community presentations from the community members. I think at the end of that we came out with a good conclusion that they needed that peace of mind and needed something in this bill that’s going to address that moving forward. I think the discussions that committee had with the Minister and the back and forth in bringing the motions forward was great. I appreciate the department and their staff for addressing those nine motions that we brought forward and concurring with them. It shows, as has been stated in this House, how consensus government works when we’re creating bills and making sure that we create the best bill possible.

Just before I finish off, I would like to thank some of the other Members who aren’t on the Standing Committee on Social Programs who joined us at the public hearings, sat at the table with us and addressed some of the concerns that their constituents had and also helping us get the word out there to get people to these meetings.

So with that, I think we’ve got a good piece of legislation here. Thank you.

Thank you, Mr. Moses. Continuing on with general comments I have Mr. Bouchard.

Thank you, Mr. Chair. I just want to make a couple of quick comments. Obviously, this bill is very important to Hay River. Hay River is the anomaly in the process. Our employees are not GNWT employees and that became a big issue with this bill, and obviously I’d like to commend the Minister and his staff for getting us as much information there so that we give some comfort to those people, I guess. The question is still out there about how it’s going to look when it’s all said and done, but I think the department is committed to that process and committed to communicating with the staff at the Hay River Health Authority.

Obviously, some of them are still tandem on how it’s going to work, how they will be affected for

leave. Even as of last week I ran into some people and they were still asking me questions on how they thought it was going to work. I said, “Well, I think the details have to be worked out still.” But I know when it did get tense there for the first little while, the Minister provided me with a bunch of information that I could provide to the employees, to the union to reassure them that this is the process. We had a constituency meeting that basically got held up by all these concerned citizens. Obviously, we were able to give them the information.

So I think moving forward we obviously want to keep an eye on how this goes, and obviously the union and the employees will tell us how they feel about the new process once they become GNWT employees.

In general, I think some of the other issues that are out there, and I think people are in support of, is this new health authority will give areas like Hay River an ability to have more context by creating feedback, ways of communicating with the public. Right now we have just the public administrator, but I think through some of these councils and the regional representation we’re going to be able to get some of that feedback from multiple users, and it’s not just feedback to the public administrator. If you didn’t know that public administrator or you didn’t feel comfortable communicating with them, there are other avenues now with this authority. I think that has been something that Hay River has been asking for, so I think they are really supportive of that.

Those are just my general comments. I’d like to thank the committee that did all the work. Obviously, they travelled around with a couple of bills. I was able to help them out in Hay River to make sure everybody showed up, but that wasn’t a tough sell with people being concerned about where they were. Again, the Minister came down for a separate meeting to talk to the employees right at the hospital, so I think most of their concerns have been alleviated for now until we start working out the details with their union and how all that stuff works out. The proof will be in the pudding on that, I guess, but we need this bill to move forward in order for that to happen.

Thank you, Mr. Bouchard. General comments, Bill 44. Ms. Bisaro.

Thank you, Ms. Bisaro. Committee, we have a motion on the floor. The motion is in order and is not debatable. The motion is carried.

---Carried

Committee, general comments. We’ll allow the Minister the opportunity to reply to general comments. Minister.

Thank you, Mr. Chair. This is one of the aspects of consensus government that I really like. The department went out and did a bunch of work and did consultations around the Northwest Territories on how to improve the health and social services system with a focus on the client, and we drafted a bill based on all that consultation. Then the Members got a hold of the bill and they went back out and they did some consultation and they offered amendments and motions that actually, I believe, truly have made this a stronger and better bill. For instance, the Members have talked about the need to enhance the bill in areas around critical incidents and ministerial power, and I concurred with those motions because I believe they added strength to this bill and made it a better bill.

I know that there are still questions out there. We have put together a team consisting of staff, members, professionals from across the territory from all of the existing health and social services to help us do the implementation planning, and we have got commitment from all the authorities. There is some question about the one authority that will remain outside, the Tlicho, how are they going to be incorporated in. Ms. Bisaro asked, “How is it going to work when you have an advisory board and a management board?” With the Tlicho, we’ve been working closely with the leadership in the community and the leadership in the TCSA who have agreed that we will develop some administrative protocols that will allow us to work together in a seamless way to ensure that, although they may have a slightly separate legislative base, they can still work together and be part of this collaborative integrative team, with respect to the advisory boards.

The Members have heard the same thing that I have heard, that we want to make sure that we have the right people on these boards who can offer significant input, value and guidance moving forward so that our residents get the best health, best care, best future possible.

I had a recent meeting with Aboriginal governments and organizations across the Northwest Territories to talk about how we’re going to set these up, and I heard exactly the same things. Get the right people, make sure they have some knowledge, make sure that they can bring value to those boards so that we can get real, meaningful, solid advice, and then those chairs, the chairs of those advisory boards,

as the Members know, will be the chairs or the members of the territorial board. Some people have said, as Ms. Bisaro pointed out, “We don’t want to lose our regional voice.” In this model, in fact, the regional voice, I think, will be stronger because the regions will have a voice at a territorial level to a degree that they’ve never had before and communities will have a voice at a regional level. It’s really building from where our people are, really building from where the constituents are, where the residents are, where the patients are. This system really truly is focused on the patient and providing the best services that we can.

Every one of the Members has mentioned Hay River, and I believe there’s a reason for that. As Mr. Bouchard pointed out, Hay River is a bit of an anomaly, and it has always been our intent to conclude a meaningful process of negotiation with the Public Service Alliance of Canada and the Union of Northern Workers with regard to the collective bargaining process for Hay River Health and Social Services Authority. When the committee came forward with a motion to add some wording to provide some clarity and certainty to our employees, our valuable front-line workers and the members of the Hay River authority, we agreed wholeheartedly. The motion really laid out what we’re intending to do but provided a whole lot more clarity than we originally had in the bill, so I truly appreciate the advice that we got from committee to make that stronger.

In my mind, the motion added some certainty to this process, and it will enable this system transformation to proceed while negotiations are ongoing with the union and the employees of Hay River. Ultimately, what we want is one system. We would love to see Hay River come in, but we’ve got to negotiate a fair and reasonable deal. I believe that’s what the employees want, I believe that’s what the union wants, and I believe that is what we want, and working together with a focus on providing the best services we can with the focus on the client, I believe we can get there.

We’re looking forward to doing that work. This isn’t the end of the work. We have put together, as I indicated, a large team of professionals and front-line individuals and leaders from the authorities who are actively engaged in this fulsome transformation, and we will be coming to committee to provide updates as appropriate. I look forward to continuing to work with committee as we move forward with this important transformational change with a focus on, once again, the clients, our residents, our people, because we all want better health, we want a better future, we want the best care.

Thank you, Minister Abernethy. Is committee prepared to do clause by clause?

Thank you, committee. Does committee also agree that we can consider clauses in groups of 10?