Masi. Our condolences to the family and to the community, as well. Members' statements. Member for Tu Nedhe-Wiilideh.

Marsi cho, Mr. Speaker. Today I would like to compare some laws in the NWT regarding alcohol and cannabis possession. As we all know, last October marked the legalization of recreational cannabis across Canada. This shift in federal policy has triggered a massive legislative overhaul to all laws pertaining to the purchase, transportation, and possession of cannabis, along with newer penalties for alcohol- and drug-impaired driving.

Mr. Speaker, at this time I believe that we should consider the harmonization of cannabis and alcohol because there exist several key differences in terms of legal limits on purchase, possession, and transportation that encumbers one substance but not the other. Currently, it is cannabis that is more tightly regulated than alcohol, which is only because alcohol prohibition ended sooner than for cannabis and has thus become less restrictive over time. However, from a harm reduction perspective, such restrictions for one substance over the other makes little sense, especially when you consider that the more restricted substance of cannabis is actually less harmful to people than alcohol.

Mr. Speaker, the harmonization of certain policies is nothing new to the NWT. In fact, there already exists some elements of policy harmonization between alcohol and cannabis. For example, the punishments for selling cannabis or alcohol to minors is exactly the same, as is the purchase of either substance from an unlicensed vendor and driving under the influence of either substance, as well.

The point that I am trying to make, Mr. Speaker, is simple. If the government wishes for our citizens to consume legal substances safely, responsibly, and in moderation, then the policy should be more consistent across the board. After all, both cannabis and alcohol already share the same minimum age for purchase, possession, and consumption. Why is it that we have purchase limits on the amount of cannabis, but no limits on how much alcohol one can buy? There is also zero limit to the amount of alcohol anyone can carry in person or transport to their homes. Why are we treating one substance differently than the other?

To be clear, Mr. Speaker, I am not advocating for the deregulation of either cannabis or alcohol. I am merely suggesting that we place them both on an even playing field. Mr. Speaker, I seek unanimous consent to conclude my statement.

---Unanimous consent granted

Marsi cho, Mr. Speaker. If there exist restrictions for one, there should be restrictions for the other. I believe that alcohol should not be sold without limits. There should be limits to prevent bootleggers from buying unlimited amounts of alcohol for illegal resale. According to many in my riding, bootlegging is a booming business. It is more difficult to charge bootleggers because there are no limits on the amount of alcohol that one can possess. Thank you, Mr. Speaker.

Masi. Members' statements. Item 4, returns to oral questions. Item 5, recognition of visitors in the gallery. Member for Hay River North.

Masi. Recognition of visitors in the gallery. Item 6, acknowledgements. Item 7, oral questions. Member for Hay River North.

Thank you, Mr. Speaker. Just a moment ago I spoke about the need for more permanent physicians at the Hay River Health Authority, and I talked about some of the issues, some of the barriers that we are facing, in terms of being able to recruit physicians. There are just a few. I often get complaints about the work environment as well, but I didn't want to delve into that too much.

I have a series of questions for the Minister of Health. My first is: what steps is the Hay River Health Authority, along with the Department of Health, doing to recruit more physicians in Hay River? Is there a strategy? Is there a plan, or are they going to continue to use the same recruitment practices that have had failed results? Can the Minister please elaborate? Thank you, Mr. Speaker.

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker, and I understand the frustration that the residents of Hay River have had. Obviously, we need to do better in Hay River than we have done.

The authority is actually currently developing a new formal recruitment strategy in order to help them find more physicians, hopefully on a permanent basis. A lot of work needs to be done. I think the Member did a great job of articulating some of the things that need to be done. Some of those things are the types of things that they are doing, but I will reach out to the authority and figure out where we are on some of those exact items.

In addition to that, Mr. Speaker, the NWT Health and Social Services Authority is currently recruiting an area medical director who would actually be based in Hay River. This individual would be working in Hay River to serve patients while also being part of the territorial medical staff for the entire territorial health authority. This will help build a relationship, an important relationship, within the system to help address challenges that we know are arising.

They are also working with the territorial authority to understand how we can better coordinate our physicians on staff, potentially looking at options to make Hay River physician staff formally part of the territorial physician staff. This would allow us to benefit from shared resources in a more coordinated, system-wide approach to recruitment and retention, and we are working closely with the territorial authority to help make those steps a reality.

There are a number of things happening. The Member did raise a lot of things that need to be addressed in the Hay River authority, and I will be following up on those as well. Thank you, Mr. Speaker.

As I mentioned, we have a budget for five physicians in Hay River. Maybe we need six. Maybe we need seven, but we are probably never going to get there. Our healthcare system seems to rely on that model, the one that is heavily dependent on physicians. Are there any systematic changes that are being implemented to improve patient care, in light of the fact that it is so difficult to get full-time physicians?

Yes, absolutely. As part of our Cultural Safety Action Plan, the territorial health authority and health system have recently embarked on work to undertake a reform of our primary healthcare services across the Northwest Territories. This work is being led by the territorial authority and the department, with pilot projects happening in the Yellowknife, Fort Smith, Deh Cho, and Tlicho regions.

Just as an example, Mr. Speaker, two of these projects in this reform effort focus on the implementation of integrated care teams. The goal of this team approach is to provide safe, high-quality care that makes the best use of existing resources by creating integrated multidisciplinary care teams, where each member works to their full scope of practice to provide what we hope and we expect will be flexible, responsive primary healthcare and health promotion.

These teams, and this is the exciting part, will have a wide range of providers, including mental health supports built in, different scopes and practices, nurse practitioners, community health nurses, admin staff, all to work as part of a team to provide high-quality primary care to our residents.

I think that the Minister was speaking about what is called the Nuka model, or something based on that. He mentioned that there is a pilot project going on in a few different regions. When can Hay River expect to become part of this pilot project or expect to have the end result of the pilot project fully implemented?

Nuka is a model that is very similar to what we are moving toward here, and we are certainly learning a lot from them, but it will be a made-in-the-North design. The primary healthcare reform is a system-wide initiative. Although our first six demonstration projects don't include Hay River, I want to be clear that Hay River Health and Social Services is participating in the planning and design process to ensure that they are a part of the effort from the very beginning. Although the pilot isn't happening in the community, they are definitely a part.

As we begin to implement integrated care teams in other parts of the Northwest Territories, we will be able to test these new approaches that might work well in Hay River and will likely work well in Hay River. We will certainly be helping with local staff, leadership, and residents to be more active once we start rolling those types of things out in the community.

Primary healthcare reform has been identified as a strategic priority for the Hay River Health and Social Services authority, and we look forward to them being part of our solutions moving forward.

Oral questions. Member for Hay River North.

Thank you, Mr. Speaker. I appreciate the thorough response. If this type of model is implemented, will there need to be staffing changes, like a reduction of staff? A change in staff? New positions? Can the Minister elaborate on that?

We are talking about a new model, and in many of these primary healthcare teams where we've seen, it does involve different types of staff working in different relationships. It doesn't necessarily mean we need to get rid of staff. It doesn't necessarily mean we need to add staff, but it does mean we need to change how they operate and work together and the structure that they provide services in. It could result in some job description changes. Those always have a potential of having some impact on employees, but we have proven that we are quite good at working with our employees to recruit and retain, and especially when they have skillsets that are very, very valuable in the Northwest Territories. Our front line providers clearly fit that, and obviously, we don't want to lose any of our professionals, but we need a system that really meets the need of our residents, and it needs to be designed with outcomes as a priority, and focus on our clients, not on the systems themselves. Thank you, Mr. Speaker.

Masi. Oral questions. Member for Deh Cho.

Thank you, Mr. Speaker. I wanted to thank the Minister of Health and Social Services on his recent visit to Fort Providence. They had a meeting that evening, and I think it was very clear that constituents were concerned about the well-being of elders. It's a known fact that we have an aging population in the NWT, and also Canada. This government has committed itself in terms of creating available beds at a specific date, and including beds, including facilities, and those facilities more likely will provide senior care and specialized care. I wanted to ask the Minister if he could update this House whether we're making progress in meeting those targets? Mahsi.

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker. Just to start off this conversation, I want to be clear that our priority is to help keep seniors in their homes first, their communities, their regions, and then, if they do require high levels of care due to different degrees of acuity, obviously they would need to be going to a long-term care facility. Long-term care facilities are those level four, five facilities where individuals' needs are significant. They need a greater degree of care that can be safely provided in a community. We built long-term care facilities where we also have physician positions located.

Having said that, we know we're 258 long-term care beds short by 2026. In the budget, we have already begun to move forward with long-term care beds in Hay River. We've got plans to move forward with long-term care beds in Inuvik. There are 72 long-term care beds going into the old Stanton, the Legacy Building. We're looking at, at least 30 new beds in Fort Simpson over the next couple of years. A lot of work needs to be done. We're still moving forward with the plan that I believe was presented both at the witness table and others over the years, and we are committed to getting that work done.

What I did not hear is reference to small communities, so that's the question that I have: what are the plans for the Minister and his department in addressing the needs for senior care and elderly care programming and facilities in small communities?

Under the Health and Social Services mandate, our responsibility is for the long-term care facilities. That doesn't mean that there isn't a responsibility for this government to move forward with living units for seniors, which the Housing Corporation has done. Over the last number of years, we have built or are in the process of building five independent living units for seniors throughout the Northwest Territories. I do have to applaud the Housing Corporation. They have worked very well with Health and Social Services to make sure that these new independent-living units for seniors have program space located within, where we have seen elders from the community go to and take advantage of different programs. We have seen that in Liard. We have seen that the in other communities. We will continue to work with the Housing Corporation to identify potential areas that they can explore for independent living. We'll keep working with them on design so that we can continue to evolve to meet the needs of our residents.

I understand that the facility in Fort Providence is being retrofitted and fixed up to meet current need. It's also my understanding that that upgraded facility will also have programming space, so we look forward to getting in there with our homecare teams and others to provide supports to the seniors who are actually utilizing those independent living units.

On top of that, Mr. Speaker, we continue to move forward with our continuing care action plan, and one of the first priorities on that is to do our test piloting of the family and community caregivers, pay caregivers, that we're hoping to roll out as a pilot in the next couple of months.

My other question that I have, I think the Minister made reference to it. The Minister said that they're undertaking pilot projects in terms of delivering, and caretakers, and family care program initiatives across the NWT. Is there a particular region that they're focusing on? Is it specifically for bigger regions, and perhaps not small communities?

When I stood up, I actually knew the answer to that question, and now, I've completely blanked. I know that we're trying to do the family and community caregivers across a wide-range of communities, and small communities, regional centres, but I have completely blanked. I will commit to getting the Member that information.