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.