This is page numbers 2083 - 2120 of the Hansard for the 19th Assembly, 2nd Session. The original version can be accessed on the Legislative Assembly's website or by contacting the Legislative Assembly Library. The word of the day was health.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Speaker. No. Just to add to that, I appreciate that, and I think that many of the Members who serve in this House would like information on that, based on what resources are available because I think, to achieve your community wellness plan, it does not matter to a community member what funding pot it comes from, just the fact that they have access to services that are needed for the wellness, the overall wellness, of their community. Thank you.

Julie Green

Julie Green Yellowknife Centre

Yes, thank you, Mr. Speaker. I will take that as a comment.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Oral questions. Member for Frame Lake.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

Merci, Monsieur le President. My question is for the Minister of Health and Social Services. In my statement, I referred to the conditions described in the Health and Social Services System 2019-2020 Annual Report. The report portrays some very mixed results here in the NWT, where we still seem to be lagging behind many other Canadian jurisdictions. Can the Minister describe for us how this tracking of some indicators feeds into planning and delivery of healthcare programs and services, particularly around mental health and addictions? Mahsi, Mr. Speaker.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Frame Lake. Minister of Health and Social Services.

Julie Green

Julie Green Yellowknife Centre

Thank you, Mr. Speaker. The department uses monitoring of indicators as an ongoing means to both provide program oversight and to provide planning in all areas, including mental health and addictions. Some of the things we look at include usage rates, wait times, common presenting concerns, topics of prevention and promotion efforts and that kind of thing to get a feel for what is going on. The data that is obtained is used to monitor performance and also adherence to the program mandate: does the data show that the program is properly focused and delivering the services for which it was intended? We also find from the data that we are able to track trends and ultimately move that into system planning and professional development and staffing needs, so that our staff is up to date.

One of the areas in which we've had a lot of success and which I mentioned earlier today is stepped care. This is an approach where we overhauled the Community Counselling Program and decided that, instead of making a client a series of appointments over weeks or months, we would make appointments available on the same day so that there would be no waiting list. If you need an appointment, you could go and get an appointment. The waiting list or a long wait time would not be a barrier to being seen. This is the kind of innovation that was put forward in the mental wellness and addictions recovery plan and which we have now implemented, so that is an overview of how the data and the planning fit together. Thank you.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

I want to thank the Minister for that. I know that she loves evidence and she loves making decisions based on evidence, so I appreciate that. Some of the more recent statistics during the ongoing pandemic paint a rather bleak picture of substance abuse, predominantly alcohol abuse, and overall health, mental health, and hospitalizations, family violence, child neglect. In June 2019, the Department of Health and Social Services released the mental wellness and addictions recovery action plan that the Minister referenced. Can the Minister tell us how this action plan is being adjusted to take into account findings of social conditions during the pandemic?

Julie Green

Julie Green Yellowknife Centre

The current mental wellness and addictions recovery plan expires next month, so there is no point, at this point, to try to bring new actions into it. Instead, what we're doing at this point is we are looking at other ways to capture information and trends, as I mentioned before, and bring those into the everyday operation of the department. The Member referenced the social indicators that were produced for the first three months of the pandemic. It's my understanding that the department is getting ready to produce another of those reports. The thing about that first report is that it only covered three months, and so it wasn't a long enough set of indicators to really make firm policy decisions on. The intention is to continue repeating these social indicators over time, so that we get a good grasp of what needs to be done on a priority basis next.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

I want to thank the Minister for that. As this year's budget address points out, though, 30 percent of GNWT operation spending is devoted to health and social programs and services, and in the budget that is proposed for next year, it is going to go up another $75 million. The Minister of Finance said the current expenditure pattern is unsustainable and that a plan was being developed to stabilize health and social services costs. I am quite concerned about what that plan is going to look like, and I don't want it to lead to a reduction in Health and Social Services programs. Can the Minister of Health and Social Services describe what is going on with this sustainability plan for the Northwest Territories Health and Social Services Authority and tell us when it's going to be available to the public?

Julie Green

Julie Green Yellowknife Centre

There is no question that the Health and Social Services system is under enormous financial pressure. The accumulated deficit is $120.7 million. That is within the health authorities, the NTHSSA, the Hay River HSSA, and the Tlicho Community Services Agency. Sustainability is a very complex problem and, as the Member says, the place to start is not by cutting, but rather to look at what the drivers of spending are and what the value is we get out of that spending. This is really the core of the government renewal initiative, which my colleague the Minister of Finance has talked about, and also within the sustainability plan. What is going to happen is that there will be a dedicated group of three or four staff who will engage in looking at the detail of what we're spending money on and what value we're getting for that money and whether there are ways to reorganize ourselves to spend less money on those particular things.

I'm sure the Member is aware that fiscal sustainability is a problem in healthcare systems all across Canada and has been the subject of federal negotiations for an increase to the Canada Health Transfer, which we in the North don't get. We get our money through the FFT. However, we share this problem that they have. What we are going to do is look at, as I mentioned, internal costs containment, operation review in quality improvement, and the funding and service level so that we can get a grip on what we're spending and why we're spending it. This is not a public plan; this is an operational plan. We have offered to brief the Standing Committee on Social Development on a confidential basis about this plan and to answer questions that they have about that, and that offer still stands.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Final supplementary. Member for Frame Lake.

Kevin O'Reilly

Kevin O'Reilly Frame Lake

Merci, Monsieur le President. I want to thank the Minister for that, and I look forward to getting that briefing, but I still think it should be made public somehow. In discussing ongoing wellness and mental health needs with some community leaders, there doesn't seem to be enough resources at the local level for planning and service delivery. Can the Minister describe what resources and services are available to communities for local solutions to mental health and addictions? Mahsi, Mr. Speaker.

Julie Green

Julie Green Yellowknife Centre

We are now in year three of four of the children and youth care counselling program, which is a joint initiative with the Department of Education, Culture and Employment, and those counsellors are in place throughout Yellowknife and north to the Beaufort Sea. The last area that will be brought online is the South Slave. We have the Community Counselling Program, which is available in 19 communities, and then available in different ways such as telephone, virtual, and occasional visits to the remaining communities. We have the dedicated funds of on-the-land healing, peer support and suicide prevention. We have access to facility-based addictions treatment. We have a lot of programs and a lot of variety at our disposal. We're looking forward to having the results of the addictions recovery survey to get the on-the-ground look about whether the supports we are offering are those that are most needed at this point. Could we do things differently? Of course we could, but we do now have a pretty robust set of programs in place and we are interested in hearing from the public about what else they need. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Oral questions. Item 8, written questions. Oh, oral questions. Member for Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Sorry, Mr. Speaker. I was going to share some time with my colleagues, but I'm not going to let some time stay on the clock. My questions today are for the Minister of Health and Social Services. I am wondering if the Minister of Health and Social Services can let us know how many people Stanton can serve through medical detox at one time. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Kam Lake. It seems like a theme day here. Minister of Health and Social Services.

Julie Green

Julie Green Yellowknife Centre

I'd like to direct this question to the Minister of Lands. Just kidding. Sorry about the heart attack, Minister.

---Laughter

Mr. Speaker, there are no dedicated rooms for detox at Stanton. The rooms are made available as they are needed and they are made available to people who need medical management while they are withdrawing. For some people, that's a very important step. Withdrawal can be fatal if it's not managed properly. Other requests for medical detox are assessed one at a time. As I mentioned earlier in response to another question, most people actually do not need a medical detox. The vast majority of people do not need it, but there are some people who are very alcohol dependent for whom life and death really depends on a proper detox. Thank you.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

If somebody presents at a health centre or a hospital, rather, in another community and wants to go through a medical detox process or if the nursing staff knows that this is somebody who would require medical detox, will that person be medevaced to Yellowknife in order to go through their medical detox here, or would they be able to stay in their home community to do that?

Julie Green

Julie Green Yellowknife Centre

It could go either way, depending on the judgment of the nurse whom the patient sees. It may be necessary, depending on the level of alcohol dependency, to bring that person into Stanton, or they may be able to stay in their own community. I will just say again that the vast majority of people do not need the facilities at Stanton for detox, so it would really be however it's decided on a case-by-case basis.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

I have had numerous conversations with constituents who have gone through different portions of treatment for addiction within the Northwest Territories and also outside of the Northwest Territories. One thing that has come up multiple times is the issue of every doctor in the territory not being able to refer somebody for an in-patient treatment facility. I am wondering if this is something that Health and Social Services is looking to change so that, regardless of the doctor who somebody sees, they are able to receive a referral for an in-patient facility.

Julie Green

Julie Green Yellowknife Centre

I need to investigate that further before I can give a proper answer.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Final supplementary. Member for Kam Lake.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Speaker. I appreciate that. My next question for the Minister is in regard to protocols of care for people when they present at the emergency department within the Stanton Territorial Hospital. I am wondering if there are protocols for after-care for people once they do arrive at Stanton Territorial Hospital emergency with mental health challenges and if there is a protocol for either the attending physician or the attending healthcare staff or potentially people within primary care to then reach out to that person and to provide follow-up care. Thank you.

Julie Green

Julie Green Yellowknife Centre

There is a medical social worker, at least one, maybe two, at Stanton Territorial Hospital, and they do discharge-planning with people who are leaving the hospital with all kinds of health needs, including mental health needs. The idea of the discharge-planning is to connect that person who is leaving the hospital with other supports that he might need or she might need, whether that is counselling, family physician, or other types of medical and counselling services that are relevant to them. They recommend it; whether the person decides to take that up is really up to them. When we are talking about adults here, the health system does not hound them to attend appointments. They make appointments for them. They may be reminded that they have those appointments. Of course, it's our hope that they obtain the care that they need, but at the end of the day, we can only set everything up; we cannot enforce it. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Oral questions. Member for Kam Lake.