This is page numbers 4111 - 4162 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 know.

Julie Green

Julie Green Yellowknife Centre

Yes, thank you, Mr. Speaker. And I'd like to thank the Member for the question. Of course we're all the concerned about the high rates of cancer, including colorectal cancer, that occur in the NWT.

I want to make a distinction to start with between screening and diagnosis. We actually have a colorectal cancer screening committee, and they've recently started work in the Deh Cho by providing what are called FIT kits to households so that they can use that to provide a sample which would be screened for colorectal cancer. The health centres cannot provide diagnosis. The public health nurse, or the community health nurses who are there of course see patients, evaluate their complaints, take note of whether it's a continued complaint, and then they would refer the patient to a higher level of care, whether that's a visiting physician or a nurse practitioner, and from there, there could be additional referrals to a specialist. So the situation for Fort Providence, the Member's primary community, would fall into that area. Thank you.

Ronald Bonnetrouge

Ronald Bonnetrouge Deh Cho

Mahsi, Mr. Speaker. Mahsi to the Minister for that answer. She did reference at some point there referring to a specialist, but I just want the Minister to be aware that I brought it up previously and with the present case of this Deline elder, they'd been to the health centre more than once and the community, it's been four or five times. And -- and I'm wondering if the Minister can acknowledge at what point would a patient be referred to a specialist for their ailment? Mahsi.

Julie Green

Julie Green Yellowknife Centre

Yes, thank you, Mr. Speaker. Mr. Speaker, the referral onwards for diagnosis is provided by a healthcare professional. In the case of small health centres, that would be a community health nurse. If it's an emergency, the telehealth system is available for the community health nurse to call the Stanton emergency room and speak to a physician there. And then, as I say, when the visiting doctor comes, it's possible for that person to make a referral for a diagnosis. So those are the different ways that that's handled by medical health professionals who are working in the local community setting with the assistance of people who may be a phone call away through telehealth. Thank you.

Ronald Bonnetrouge

Ronald Bonnetrouge Deh Cho

Mahsi, Mr. Speaker. Mahsi to the Minister for that. I don't think my question was really answered because I've been stating that there's many residents probably up and down the territory that go to centres for an ailment, and like four or five times. And perhaps by the fifth time, they're being medevaced out. And it's at that point. So getting where -- we're missing something within the health centre, the diagnosis there.

Can the Minister advise that the department has any evaluations, evaluation processes in place to determine if small health centres nursing staff will require other training screening for cancer and other chronic diseases? Mahsi.

Julie Green

Julie Green Yellowknife Centre

Yes, thank you, Mr. Speaker. Mr. Speaker, the community health nurses adhere to clinical practice guidelines for breast, cervical, and colorectal cancer. They will assess for symptoms and taking into account family history, age, risk factors, and other circumstances. And once again, this would be for screening.

So this is to -- not to make a diagnosis but to -- on a general basis, offer people the opportunity to be screened in or out of the risk of cancer based on their health indicators. Nurses are offered frequent professional development opportunities and we do have, as I mentioned previously, a colorectal cancer screening program. So this program would be well known to the nurses and used by them to deal with this particular type of cancer, which is one of the most prevalent in the NWT.

As I mentioned at the beginning, in the Deh Cho region the Member can look forward to seeing communication from the Department of Health and Social Services about screening for colorectal cancer. And I certainly encourage everyone to take advantage of that opportunity. It's free of charge and in your own home. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Final supplementary, Member for Deh Cho.

Question 1050-19(2): Small Community Cancer Screening
Oral Questions

March 29th, 2022

Page 4117

Ronald Bonnetrouge

Ronald Bonnetrouge Deh Cho

Mahsi, Mr. Speaker, and mahsi to the Minister for that answer. I think she's answered my question, but I really wanted to stress that even though you say that nurses do ongoing training, I don't know we as the public here, but and I keep saying and I said it many times since I've gotten to the Assembly in 2019 that there's many times -- I hate using the word "misdiagnosis" but that's the only one that I can use that a lot of people been there and I'm saying it again. Like, they've been there four to five times. And I don't want to get into specifics of what happened to those people at this time, but it's serious in our small communities and this elder from Deline, you must have read the story too, he's been there numerous times. He was sent there with just a Tylenol. You know, and that screening processes. What and it's not determined on site, you know, they go to Yellowknife where there's actually CT scan machine that can determine stuff like this that we don't have in the small communities, and I'd really like the Minister and her department to start working on better processes of diagnosis a lot of the unknown ailments which can lead to serious, serious illness and even death. Mahsi.

Julie Green

Julie Green Yellowknife Centre

Yes, thank you, Mr. Speaker. Mr. Speaker, it's not possible for me to comment on individual patient's cases because of privacy considerations. I just will go back again to the difference between screening and diagnosis. Screening can happen in the small health centres for colorectal cancer, cervical cancer. But you need to have no symptoms in order to be screened. You just need to show up. The diagnosis would happen in Yellowknife or further afield maybe in Edmonton.

I would say to the Member that the Department of Health and Social Services has a patient experience questionnaire available at this time to capture the experience of people who have used our services and gauge their satisfaction with them. So there are, I'm told, paper copies available at the health centres. It's also available online. And I would recommend that anyone who has received health services in the last year, whether they were satisfied with the service or not, complete the patient questionnaire so we can learn how we can do better with our services. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

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

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Speaker. Mr. Speaker, my questions today are for the Minister of Education, Culture and Employment.

I'm hearing from constituents that day home providers are unable to see the contracts that they are going to be expected to sign to take part in the new federal childcare agreement before they are expected to sign them. I'm wondering if the Minister can speak to whether or not this is accurate and if ECE is willing to ensure that all providers have the information they need to feel comfortable signing onto this childcare agreement, including see the contract before being expected to sign it? Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Kam Lake. Minister responsible for Education, Culture and Employment.

R.J. Simpson

R.J. Simpson Hay River North

Thank you, Mr. Speaker. Well, we would never expect anyone to sign a contract that they haven't seen.

There's been a number of meetings between ECE officials and childcare providers, whether that's day home or childcare centres, and there has been a number of documents provided to childcare providers, and those documents contain all of the information that is contained in the actual contribution agreement. It's a contribution agreement, not a contract. So I just wanted to clarify that as well because childcare providers can have contracts with parents, but they would have a contribution agreement with ECE. And if the information that is being provided, which is the same as what's in the contribution agreement, isn't sufficient, we're happy to show a template of the contribution agreement as well with the understanding that it wouldn't be filled in with the actual numbers as those are dependant upon the situation of that particular day home, and that's the whole point of the -- the work beforehand. So if that's a hurdle, it's not much of one because we're more than happy to share that information. Thank you.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you very much, Mr. Speaker. Mr. Speaker, I appreciate that commitment from the Minister.

My second question is that the cost of living has gone up everywhere, including the cost of fuel and food as of late. As such, some businesses are having to increase the cost of their services. And so I'm wondering if the Minister can speak to what are the rules around increasing the cost of childcare now that the average rates have been set in the Northwest Territories. Thank you.

R.J. Simpson

R.J. Simpson Hay River North

Thank you, Mr. Speaker. So in our agreement with the federal government, we've agreed to use the funding from them to reduce the cost of childcare by on average 50 percent. And we understand that the cost of childcare varies depending on what people are charging. There is a number built into the federal agreement which -- so we can handle a 2.3 percent increase and not have to take from any other pots of money. The timing is not great right now because as the Member mentioned, the price of everything is going up. We're seeing, you know, inflation like we haven't seen before. So what we are willing to do is work with childcare providers to ensure that if they're proposing an increase above that 2.3 percent, that it is something that is justifiable. And while I say that, I'll preface it by saying that most childcare providers are, you know, only putting forward increases that are justifiable. There have been some instances where we've seen, you know, increases of 20, 30 percent proposed for this month, even retroactive a month, and it's -- you know, it coincides with this new money that's flowing -- that's supposed to be flowing to parents. And so if we have a childcare provider increasing their rates by 30 percent when we're trying to reduce rates by 50 percent, that causes some problems because that will take money away from some of the other efforts that we need to put forth, such as increasing wages for early learning and childcare providers. So we want to ensure that parents are getting this money in their pocket, and we want to ensure that the childcare providers are not being unduly burdened. So we are providing them with additional funding because we understand there's additional reporting. And the 2.3 percent increase is seen as reasonable, and we -- you know, we believe that most operators are charging what they need to charge at any given time. And there are increases that businesses need to make along the way but when we're talking about 20, 30 percent increases, there are definitely some questions and we likely can't accommodate those types of increases, and we don't want parents to have to pay those increases as well. Thank you.

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you, Mr. Speaker. Mr. Speaker, some people have been informed that the average for the cost of day homes or childcare in the Northwest Territories was determined using a zero dollar figure for providers who do not charge because of alternate federal funding contributions. I'm wondering if the Minister can speak to whether or not this is accurate and how the average cost of NWT childcare was reached? Thank you.

R.J. Simpson

R.J. Simpson Hay River North

Thank you, Mr. Speaker. And so we are looking to reduce the cost of childcare by 50 percent on average. And so what that average is, is the average of all childcare providers who charge for childcare. So we do not factor in all of the hundreds of childcare spaces that are available free of cost, many provided by Indigenous governments in smaller communities. The average that we're looking to reduce by 50 percent is based only on childcare providers that actually charge money. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

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

Caitlin Cleveland

Caitlin Cleveland Kam Lake

Thank you, Mr. Speaker. Mr. Speaker, I'm wondering if a licensed day home chooses not to opt in to this new childcare agreement, if a parent can switch their child to a new licensed childcare provider and still receive the retroactive subsidy from their new childcare provider. Thank you.

R.J. Simpson

R.J. Simpson Hay River North

Thank you, Mr. Speaker. And no, the money that flows from the Government of Canada through the Government of the Northwest Territories through the childcare provider to the parent has to be flowed from the childcare provider who actually provided the services to the parent. So it can't be a different operator. If you've had your child in childcare for three months, from January, February, March with one provider, it has to be that provider who is flowing the funding to you. And we've had a lot of success. We have most people signed on to this, most providers. For some people, it's taking a bit longer. And, you know, I think we'll get there. There are some instances where perhaps information needs to be explained in different ways, but I'm confident that the vast majority of childcare providers will have signed on and that parents will be receiving these refunds. Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Minister. Oral questions. Member for Great Slave.

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Speaker. Mr. Speaker, my questions are for the Minister of Finance as the Minister responsible for the public sector. I have questions in regards to the labour market supplement that was offered to the Union of Northern Workers.

Given that there is a labour shortage across our healthcare positions, what was the rationale for only including the frontline RNs and medical lab technicians in the proposed labour market supplement? Is the department planning at looking at other healthcare positions for a labour market supplement and if so, what are the timelines on that? Thank you.

The Speaker

The Speaker Frederick Blake Jr.

Thank you, Member for Great Slave. Minister responsible for Finance.

Caroline Wawzonek

Caroline Wawzonek Yellowknife South

Thank you, Mr. Speaker. Mr. Speaker, the labour market supplement was a policy tool that was developed, firstly, in consultation with the union.

In terms of what choice was made around which workers or which specific positions would first be -- would have the opportunity to utilize this policy, that was a choice made by the Department of Health and Social Services who was applying that policy. So there's a number of factors that are within the policy as to what types of positions should -- should qualify for what is an exceptional -- an exceptional tool, an exceptional that's being used to enhance costs -- or rather, to salaries and recruitment through the use of an enhancement, of enhanced pay. So that's why it was quite specific is because this was a segment that, in our view and in the view of the Department of Health and Social Services when it came forward, they had the evidence to support that these were positions that were difficult to recruit for, that they had tried to recruit for, that they weren't able to recruit for consistently. And, you know, again I won't go through all the elements of the policy that are there as to whether or not it -- we will be expanding or whether the Department of Health and Social Services will be expanding to other specific positions. Mr. Speaker, that will ultimately be a determination that they'll have to make looking at what's happening with the recruitment and retention processes and then bring that forward to -- to the Financial Management Board for consideration. Thank you, Mr. Speaker.

Katrina Nokleby

Katrina Nokleby Great Slave

Thank you, Mr. Speaker. Yeah, well given that we've had a shortage of health care workers enough -- and this has been going on for long enough that it was one of the things that we did include in one of our priorities, can the Minister explain why the union wasn't approached sooner to negotiate the labour market supplement?

It's my understanding it was pretty much a give or -- you know, take it or leave it type scenario with not any room for negotiation. So why was the government not more proactive here versus reactive? Thank you, Mr. Speaker.

Caroline Wawzonek

Caroline Wawzonek Yellowknife South

Thank you, Mr. Speaker. Mr. Speaker, the union was engaged, I believe, back in the fall -- I believe in September, in fact, with respect to this labour market supplement in terms of its design, and then there was a process of going through to determine which positions to which this -- the supplement policy would properly apply.

But, Mr. Speaker, the health recruitment unit that now exists, and was developed both by Department of Finance and Health and Social Services, that's something that's been in the works obviously in response to the fact that there's been challenges in our healthcare and this is part of the mandate. That's been in the works for some time. It's looking not only at the salaries and compensation but at the totality of what the workplace situation is like.

You know, one of the elements that's considered in the supplement is whether or not the position itself is still at the top of the pay range compared to other jurisdictions in Canada. And in general, our health care workers continue to be high in the pay range and yet we still struggle. So we want to make sure that we're looking at the totality of what's happening in the workplace, morale issues, you know, workplace safety issues, whether it's the timing of the shifts, so on and so forth, Mr. Speaker. And so for that reason, it's more than just a labour market supplement and it's -- it's a process that's going to have to continue to go on but it is already well underway, and I'm again confident that we're going to continue to find good solutions as we move forward. Thank you, Mr. Speaker.