Thank you, Madam Chair. Committee wishes to consider Tabled Document 30-19(2), Main Estimates 2020-2021, with Health and Social Services. Thanks, Madam Chair.

Thank you. Does committee agree?

Thank you, committee. We will take a short recess and resume with the first item.

---SHORT RECESS

We are going to call committee back to order. All right. Committee, we have agreed to consider Tabled Document 30-19(2): Main Estimates 2020-2021. We are doing Health and Social Services. Does the Minister of Health and Social Services have any opening remarks?

Yes, Madam Chair. I am here to present the 2020-2021 Main Estimates for the Department of Health and Social Services. Overall, the department's estimates propose an increase of $26.7 million or 5.4 percent over the 2019-2020 Main Estimates. These estimates support our fiscal objectives to prioritize responsible and strategic spending while matching the modest expected revenue growth over the coming year.

Highlights of these proposed estimates include $15.2 million to address forced growth and $12 million for programs we have partnered on with federal counterparts, through funding agreements. These estimates support the priorities of the 19^th Assembly. We will focus on activities that are already underway to support our mandate and our priorities as a government. Some highlights include:

• our focus on quality and increasing the efficiency and sustainability of health and social services;
• better coordination of services for children and families;
• supports for targeted recruitment plans across the system that address critical nursing shortages;
• increased supports for mental wellness and addictions recovery;
• a focus on helping seniors stay in their homes and communities; and supports for vulnerable populations.

That concludes my opening remarks. Thank you.

Thank you, Minister. Do you wish to bring witnesses into the House?

[Microphone turned off].

Sergeant of Arms will escort the witnesses into the Chamber. Would the Minister please introduce her witnesses?

Madam Chair, with me, Deputy Minister Bruce Cooper and Director of Finance Jeannie Mathison.

All right. Thank you. Committee, we have agreed to forego the general comments. We will proceed to the detail contained in the tabled document. We will defer the departmental summary review, the estimates, and the review of the estimates by activity summary, beginning with administrative and support services, starting on page 166, with information items up to 169. Questions? Comments? Member for Yellowknife North.

Thank you, Madam Chair. I guess just a general question if the Minister could update me of how and any progress we have made on telehealth and kind of what we can see to continue out of the progress we have made due to COVID-19 and if that is expected to be found in this budget or whether there is a supplemental appropriation for a more digital healthcare system coming. Thank you, Madam Chair.

Thank you, Member. Minister.

Madam Chair, the federal government announced some money for virtual care. The department is now looking into accessing. If and where possible it's our best interest to utilize federal funding versus using money out of our budget. Yet, we do recognize the importance of virtual care. We have been practicing it for the last two months. It's important that we continue to do so.

Thank you, Minister. Are there any further comments or questions to this section? Member for Frame Lake.

Thanks, Madam Chair. I notice on page 168, on contributions, that there was some funding provided to the nurses association of the NWT and Nunavut a few years back. I seem to recall that there was going to be some effort towards having one regulatory framework for nursing professionals. Can I just get a bit of an update as to where that work is at? Thanks, Madam Chair.

Thank you, Member. Minister.

I am going to bring this over to my deputy minister, Mr. Cooper, to answer. Thank you.

Thank you, Minister. Mr. Cooper.

Thank you Mr. Cooper. Member for Frame Lake.

Thanks, Madam Chair. That is good to hear and understandably delayed probably as a result of COVID. Is this, dare I say, some sort of almost a co-drafting process, where the associations are involved in drafting the legislation or giving feedback, having an opportunity to review drafts or whatever? How is that working? Thanks, Madam Chair.

Thank you, Member. Minister.

Thank you, Madam Chair. While we are on the topic, I will get Mr. Cooper to answer that, as well.

Thank you, Minister. Mr. Cooper.

Thank you, Mr. Cooper. Member for Frame Lake.

Thanks, Madam Chair. That is good to hear. I think that is the way that we need to approach this. I am glad to hear that that is being done. This is, I guess, the place where health and social services authorities' funding flows through. I have raised this in the past. I am wondering if we are making any progress on some sort of consolidated reporting of features of our integrated system now. The health transformation system was supposed to allow for reporting of things like wait times for key medical services. Look, I understand folks are working flat out in terms of pandemic preparation and all of that, but have we started to make any progress in this consolidated reporting of things like wait times for different kinds of medical services so that the public understands where focus might need to be better made or even us as legislators? Thanks, Madam Chair.

Thank you, Member. Minister.

Madam Chair, in terms of increasing information systems, one of the things the department has done just recently is to incorporate our financial system, SAM. This is something that we are looking at in terms of putting all our systems into one place. We have done it with our financial. We recognize that there is need for improvements in terms of putting all our other systems together. That is something that the department is looking into.

Thank you, Minister. Member for Frame Lake.

Yes, thanks, Madam Chair. That is good to hear, but I have raised this for, I think this is probably about the third or fourth year in a row now. When are we going to be at a point where we can have public reporting of wait times for a variety of medical services? Thanks, Madam Chair.

Thank you, Member. Minister.

Thank you, Madam Chair. The information that we have, we do track wait times in many of the different services that we provide. This is something that the department can look into, because we need to improve wait times for any of the different services that we provide here. There is room for improvement. I understand that, and that is something that we can look at. Thank you.

Thank you, Minister. Member for Frame Lake.

Thanks, Madam Chair. Is there a schedule, though? When could we expect to see public reporting on an annual basis, even, of wait times? Thank you.

Thank you, Member. Minister.

Thank you, Madam Chair. I will turn it over to Mr. Cooper.

Thank you, Minister. Mr. Cooper.

Thank you, Mr. Cooper. Member for Frame Lake.

Yes, thanks, Madam Chair. I would very much like to see that list. Can the Minister confirm that that would be provided? Thanks, Madam Chair.

Thank you, Member. Minister.

Thank you, Madam Chair. Yes, that is something I can provide to the Member. Thank you.

Thank you, Minister. Member for Frame Lake.

Thank you, Madam Chair. I guess one of the other big issues system-wide is recruitment and retention. I'm just wondering if I can hear if we're making any process on recruitment and retention of healthcare professionals across our whole system. Thank you, Madam Chair.

Thank you, Member. Minister.

Thank you, Madam Chair. Recruitment for health professions is one of our priorities in the 19^th Assembly, and this is something our department is looking at doing. As a result of COVID-19, we were able to repatriate a lot of nurses coming back from outside of the Northwest Territories, which is very promising, because we were able to then possibly even keep them. That is something that we are looking at. We need to meet our target. Our Assembly identified a target for the 19^th Assembly, and that is something that we are working at. Thank you.

Thank you, Minister. Member for Deh Cho.

Mahsi, Madam Chair. My questions are related to RNANT/NU, the Registered Nurses Association of the NWT and Nunavut. I am aware that they are a governing body that governs registered nurses or nurse practitioners in the Northwest Territories. That whole body seems to be separate from the whole health department. I know that people before me have filed complaints to them. I think it goes to several other places, too. It could be to the leadership council chairman. It could be going to the department of health, but the majority is funnelled to RNANT/NU.

I even filed a formal complaint for three or four people back in November regarding problems with misdiagnosis, different causes, inappropriate comments to our Dene people. Those were being made in our health centre, but we weren't receiving responses. I asked those other people, too, who filed some back in May of last year, and they said they have never ever once received anything back from anyone to even acknowledge that they received their complaints and stuff like that. I am just wondering: what's the relationship between our health department and this governing body? If you could try to paint me a clear picture of what has happened there, I would appreciate that. Mahsi.

Thank you, Member. Minister.

Thank you, Madam Chair. The complaints process is not straightforward. I'm going to maybe ask Mr. Cooper if he can talk about the process in detail.

Thank you, Minister. Mr. Cooper.

Thank you, Mr. Cooper. Member for Deh Cho.

Mahsi for that. It's still muddied, that whole process, because now we're dealing with an independent body, and a lot of times, when you deal with independent bodies, you're always having problems, because we're not totally regulated by something under the GNWT umbrella. We get answers there, right now. Here, we don't. I believe you guys look after recruitment and retention, and you're sending them over there. You're cutting the ties, type of thing.

We do have a lot of legitimate complaints out there, and we haven't resolved them. Like I said, some were back from May a year ago. We're still here with no answers. There is a big disconnect and a problem there. I would really like the department to look at tightening or strengthening the relationship that you have with this group, in order that we get some timely responses to formal complaints. Right now, we're just not getting anywhere. My community, a year later, we're still up in arms.

I think we may be requesting to meet with the Minister of health in our community in the near future to really discuss this issue with RNANT/NU and a complaint process. We need to do better than that and not just say, "Well, they're a regulatory body. They're on their own." We're hiring the nursing profession in there. Those are just comments on that one.

Recruitment and retention that my colleague brought up there is another one, too, because I know we've had a person or two go through the nursing profession from our small communities now and again. Now, it's just gone by the total wayside. I'm wondering if the GNWT, the department of health, would consider an aggressive recruitment program in high schools and going out to all the small communities to speak to them because I think there could be some very good people in there who would be interested if somebody were there to talk to them about it, maybe an actual nurse, too, to pique their interest, and that may be where our youth might take that up. It's a profession. We've got to get into their faces. I would really like to see that happening. That's just another general comment. Mahsi, Madam Chair.

Thank you, Member for Deh Cho. Minister.

Thank you, Madam Chair. The Member is correct. The recruitment piece is essential. Right now, we're pulling people in from outside the territories and it shouldn't be that way. We should be able to have training here in the Northwest Territories. We have many institutions that we can be able to provide health training. I agree with the Member's comments about having the careers in earlier schools, so that way students can understand that they need certain courses in order to get their grade 12 and carry on into a nursing profession. I agree, and that's something that the department of education, culture, and department of health can have a look at to start to capture students at earlier grades so that they can take the appropriate courses so that they can go right into college for a nursing profession. Thank you.

Thank you, Minister. Are there further comments to this section? Member for Monfwi.

Masi, Madam Chair. I'm looking at page 168, the French language services, $970,000, which stands out. As you know, the population of the Northwest Territories, the majority is Aboriginal-language-speaking people. Is that due to the course of a federal contribution towards the French language services? Is that why it's identified on its own? That would be my first question. Masi.

Thank you, Member. Minister.

Yes, that is correct.

Thank you, Minister. Member for Monfwi.

Masi, Madam Chair. If that's the case, I think we, as a territorial government responsible for Stanton, territorial government needs to push more to identify similar to French language. I know that the French population is aggressive. We need to be aggressive, as well, Aboriginal-language-speaking people in the Northwest Territories, because a majority of our communities speak the language, but it's not identified here on its own. I would like to see that even more. I guess a direction to either the Minister or the department to push that with the federal government. I know the federal government increased Aboriginal language funding to ECE just recently, not too long ago, so they've identified the importance of Aboriginal language. If we can identify that here as part of a line similar to French language services, with identification of funding, that would be very much appreciated. Is the Minister willing to push that from her end with the federal government and her colleagues from Nunavut and the Yukon territory, as well? Masi.

Thank you, Member. Minister.

Thank you. That is absolutely something we should be looking at. The Member did identify that, here in the Northwest Territories, we have the majority of our residents Indigenous, and the language piece is so important. I spoke earlier in the House about the translation and how important that is for patients coming in and to be able to have those services available to them. That is something that we would look at. That's a key part of the services, is to be able to have that language aspect, so that's important. Thank you.

Thank you, Minister. Member.

Masi, Madam Chair. Obviously, whenever we're in session, the federal government is listening to us, looking out for our discussion here. Clearly, this is of importance to the Northwest Territories. We have 11 official languages, and the federal government only recognizes two. We recognize our 11 official languages, and we have to stand firm to say, "These are our own Northwest Territories. We identify nine Aboriginal languages." We need to identify that as part of our budget going forward.

In the previous terms when I was education Minister, I spoke my language to the federal government, and they always put their earpiece on. They had no idea what I was saying, but I was making a point to them, that we do exist, and there are Aboriginal languages out there. I'm glad the Minister is willing to pursue that with the federal minister, but it will take time, but we've done it with ECE. There's been an increase on federal. I don't see why Health and Social Services, I'm sure we can do that, too. It has to take a firm approach from all of us, and I just want to highlight that, Madam Chair. More of a comment, but it's the importance of the language to be identified in the budget. Masi.

Thank you, Member for Monfwi. I will just take that as a comment. Are there further questions to this section? If there are no further questions, please turn to page 167. Health and Social Services, administrative and support services, operations expenditure summary, 2020-2021 Main Estimates, $52,038,000. Does committee agree?

Thank you. We will move to Health and Social Services programs, beginning on page 170, with information up to page 174. Questions? Member for Kam Lake.

Thank you very much, Madam Chair. I have a couple of questions for this page. It's a very expensive page in our book. It's very obvious that health has a lot of fabulous health and social programs, and one of the ones we've heard the most about in the last few years has been the child and family services program. I notice that the increase for the child and family services program in the budget this year is just under half a million dollars. I'm wondering if the Minister can speak to whether or not that is enough money for this program to cover what they would like to achieve with child and family services?

Thank you, Member. Minister.

Thank you, Madam Chair. Right now under the child and family services, we do have the quality improvement plan that we are looking at, and we are also looking at innovative ways to be able to meet what our standards are. We continuously try to improve where we can. If the Member is asking: do we want more money in the budget line item? Of course, we do, if we can. This is where we are at right now with the child and family services. Thank you.

Thank you, Minister. Member.

Thank you, Madam Chair. I would be curious to know if the Minister can speak to what it would cost for them to be able to address the issues raised in the Auditor General's report? Thank you.

Thank you, Madam Chair. That is a big question. We looked at the Auditor General's report, and there were a lot of actions. That is something our department can go back to have a look at. Maybe I'll turn it over to Mr. Cooper.

Thank you, Minister. Mr. Cooper.

Thank you. Member for Kam Lake.

Thank you very much, Madam Chair. I very much believe that child and family services is, given the changes that health and social services wants to implement, a form of preventative care because we've all seen research that says, when you invest in kids, when you invest in families, the benefits that come back to communities and the benefits that come back to your society are huge. I think my colleague from Yellowknife Centre once said, and she can tell me if I'm wrong, but I'm pretty sure, she once said, for every dollar you invest in kids, your return is $13. I believe that was actually from UNICEF that that was pointed out. I definitely think that this is somewhere where we need to put our energy and put our money. My second question is for the family violence line that is in here, that this hasn't changed from the previous year. Does the Minister consider health and social services a lead on family violence prevention? Thank you.

Thank you, Member. Minister.

Thank you, Madam Chair. Earlier today we had our meeting in Cabinet where we talked about family violence and the multi-departmental approach. You're looking Department of Health and Social Services, Department of Justice, and Department of EIA. That is something that our government is looking at because we don't want to be pointing fingers at different departments. Family violence is very important here in the Northwest Territories, and everybody seems to be turning a blind eye and pointing at departments. That is not what this government wants. This government, Madam Chair, wants to be able to have a go-to at a very senior level so that they can work within the departments to be able to take some action. That is where we are at right now. Thank you.

Thank you, Minister. Member.

Thank you very much Madam Chair. Yes, this was a conversation that the Minister of Justice and I had during our last sitting that was cut short. I have let her know that I am coming back around to finish that conversation during this sitting. I appreciate that answer, and I agree that it does need a lead. My next question is in regard to the antipoverty fund and the day shelter fund that is on the next page. Over the course of the last 10 weeks, the day shelter showed up in media quite a bit, and the conversation was around does the day shelter go back to being a day shelter because it turned into an isolation centre over the course of COVID. They supplied MLAs with some research that showed some of the great work that they were doing. My question became: how do all of these levels of care fit together, and who has the oversight of that? I'm wondering if the Department of Health and Social Services does have somebody that looks at levels of care for day shelters or transitional homes, and who has that oversight, and how does that work? Thank you.

Thank you, Member. Minister.

Thank you, Madam Chair. That is a really good question. Here in the Northwest Territories, we a variety of different services that we provide to vulnerable populations, the day shelters, we also have the NWT disabilities; we have a variety of different service providers that we partner with. I think that partnership is key. We, as a department, look to help fund different NGOs here so that they can provide the services where we're not able to. I agree that partnership is ideal and is key to be able to make successful progress.

Thank you, Minister. Member for Kam Lake.

Thank you very much Madam Chair. I absolutely agree that NGOs are crucial in that sense. As you mentioned the NWT Disabilities Council, they end up being the ones actually delivering the programming. My question is: who provides the oversight of all these NGOs? Because sometimes they end up administering the same programs, whereas, really, we could be working together to make sure that we're offering different levels of care throughout our system of partnerships. Thank you.

Thank you, Member. Minister.

Thank you, Madam Chair. That's the key. It's the communication. Although the department does fund a portion of some of these programs, the key is the communication, to be able to get everybody together on an ongoing basis to be able to provide some communication and support is ideal. I don't want to say that department has the official oversight. For us, the key is partnership. Thank you.

Thank you, Minister. Member for Kam Lake.

Thank you very much Madam Chair. I'm just looking at the time, so I'm going to move on from this one a little bit. I'll come back to it with the Minister at a later time. My next question is in regard to the mental health and addictions line item in the budget. Within COVID, we've talked a lot of mental health and addictions and how the increase in need for mental health supports is huge. Does the Minister foresee that line item going up or them coming back for the need for additional monies because of COVID in relation to mental health and addiction?

Thank you, Member. Minister.

Thank you, Madam Chair. We are in a situation now of a pandemic. You look at a lot of the programs that have delayed because we don't have the one-on-one with the mental wellness. We do access a lot of the virtual care, and that is something the department will continue to do as we get through this pandemic. In terms of the mental wellness and addictions, we've been asked from a lot of residents to have more addictions here in the Territories. I can see this as something that we will have to have a look at and get back to the Member, unless, Mr. Cooper, you have anything to add?

Thank you, Minister. Mr. Cooper.

Thank you, Mr. Cooper. I'm going to move on to Member for Thebacha.

Thank you, Madam Chair. I just would like clarification on page 171, community clinics and health centres. That $73,936,000, an increase of probably about 2.5. I just want to see, what does that include, and then I'll ask for another line after that. Is that the health centres in all of the communities?

Thank you. Minister.

Thank you, Madam Chair. The community clinics healthcare, the majority of the budget is going towards the grants and the actual budgets. It's all going to some of the different health authorities is the majority of the community clinics and healthcare centres, so yes.

Thank you, Minister. Member.

Madam Chair, I just want clarification. Community clinics and health centres is the $73,936,000. I need clarification on that. That's everything in the communities outside of Yellowknife; right? Am I correct?

Thank you, Member. Minister.

Thank you, Madam Chair. Let me just find it here. The community clinics and health centres, this funding is for primary care services, which is considered the first level of contact for individuals within the health system. These are going towards the Hay River Health and Social Services Authority; also, some of the other hospitals, the Stanton hospital. Yes, they are going to regional health authorities. Thank you.

Thank you, Minister. Member for Thebacha.

Thank you, Madam Chair. Then there's a line there, hospital services, for $134,607,000. There's an increase in there of about $14 million. That would be the two designated hospitals, which is Inuvik and Stanton. Am I correct, Madam Chair? Just wanted clarification.

Thank you, Member. Minister.

Thank you, Madam Chair. I will ask Ms. Mathison to respond back to that. Thank you.

Thank you, Minister. Ms. Mathison.

Thank you, Ms. Mathison. Member for Thebacha.

I need more clarification, Madam Chair, for the $134,607,000. That includes the Hay River, considered a hospital, the Inuvik hospital, and Stanton, and then I want to see the breakdown. I would like clarification on the breakdown.

Thank you, Member. Minister.