This is page numbers of the Hansard for the 20th Assembly, 1st 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.

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Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Robert Hawkins

Robert Hawkins Yellowknife Centre

Thank you, Mr. Speaker. Mr. Speaker, yes, I too want to acknowledge the champion of health care we have here, my good colleague from the Range Lake riding. I know that I share his passion, and that was kind of why what started with the town hall meeting we had this summer which is to hear the voices of the everyday family, the everyday person, struggling with health care challenges. And I reiterate what I said before a few days ago, not at length, but I want to point out that the building was busting at the seams. We were probably borderline on the fire marshal's load capacity of the building. No one counted, by the way, just to make sure. But the truth be told is we'd never seen such a turnout in Yellowknife at any type of meeting like this. It was amazing. And they were respectful, and they were helpful, and they were telling their stories, their journeys, Mr. Speaker.

But, Mr. Speaker, the challenge, of course, is this, is that what's next? And even people ask me, you know, and my good colleague Mr. Testart, what's next? We tell you these stories, we tell you these concerns and pains, we need something to change. You know, people would describe it the proverbial the train is coming off the track, is it too late? I don't think it's too late. As a matter of fact, I think we don't have -- we couldn't have a better opportunity than now because we're in that point, like we have to collectively start pulling together. So as they say, with tragedy sometimes comes this great opportunity. And here it is, we could turn this around.

Now, again, another example of -- in the sense of a description is, I mean, when things have gotten this way, it wasn't overnight, you know. No one's suggesting chaos and disorder. But what we're suggesting is the fact that it's true, as my other colleague had mentioned, you know, doctors and nurses will tell us they are getting tired of providing advice, skills, professionals who have decades of knowledge, on how to do things better, could make the very difference.

So what is a performance audit, Mr. Speaker? To be crystal clear, both to the Minister, the government, and certainly the media, it's not a witch hunt. It's not in any form. And it shouldn't be contrived or construed in any way it is. It's simply asking are we getting value for money? Is there a better way to do this? Are we doing the things that we should be doing? Can we do them better? That's what it's about. It's about trying to find a path through these challenges. It will be overwhelming. But the auditor general office is free. They have the talent, the skills, the abilities. They have the vision to pull it all together on a song sheet and start focusing on a direction so we can all be singing on the same sheet working towards a better outcome, Mr. Speaker.

Mr. Speaker, we need to show our teams, our teams of professionals, be it administrators, be it support workers at the hospital, be it doctors, you know, nurse practitioners, everyone, that we care so much we're going to go through the system and make sure.

The great thing about the auditor general's office, Mr. Speaker, is they're unfetterred. We'll point them in a direction and say, we want you to find the best way of what's happening here. They don't show up with a prewritten decision on how we're -- and then say, this is how we're going to get there. In other words, they won't determine the outcome until they see where it takes them. And to them, they -- out of very few people, they don't -- not a lot of people have that skill. And the fact that it's outside, it will be them.

Now, I remember -- I'm getting old, so now I'm starting to say I remember, and -- but I remember, we used to have a great hospital administrator, Dennis Cleaver. He was great, he could -- being the best of people, whether it was doctors, admin people knew -- he knew them, they knew him, and he really understood. That's why I was trying to raise the other day -- and to be frank, changing the head of the system it doesn't do anything. We have to get into the morale, into the functions, into the systems. That's why we need, as I said, a Jane Phillipot type who understands the DNA of how everything comes together like a great conductor. And they'll say things like well, I see that it's working, they're doing the best but it's actually not working to an outcome that actually is effective. And hence that's the type of conversation only these types of experts can have.

Mr. Speaker, as this is a motion, as we know, an important motion, and I feel like this is going to be the health care Assembly. We're just going to keep rallying on health care until we not only see change, if not better, we feel change. But I worry about the risk about how much money and we can no longer afford to keep doing things the same way as we do them.

Now, I know, again, this is a motion, and I recognize it is a suggestion to the Assembly, and I don't know what Cabinet's going to do. As a matter of fact -- I mean, I don't know if anybody on this side knows what they're going to do. But I'll -- I won't be the first in the sense of just today, but I'll certainly be the first at least this afternoon and say I hope Cabinet is willing to have a free vote on this particular issue. Because this isn't just fixing my riding, my colleague's riding, my regional ridings. This is affecting everybody's ridings. And I would hope that they would want to be partners in this solution by having that little bit of a thumbprint on this motion by saying I supported it, and I was part of the path to a reinvigored health care system, a renewed health care system, that helps all. Because if we keep going the same way we do, Mr. Speaker -- and I'm going to try to wrap it up here -- you know, we will see cuts that we don't want to have, we will see change that we're forced to make, we will see departments -- not just health, but the ripple effect of this, having to make choices no one wants to make. I don't want to hear the fact that we can't afford a doctor in oncology because we don't have any more money anymore. I don't want to hear those stories. I want to hear that we can provide desperately needed services in the regions. I don't want to hear about the unavailability or the unaffordable of birthing units in Inuvik. This is our chance to be part of that solution before we say it's too late.

So, Mr. Speaker, again, a big fan of Steven Cubby. His saying begin with the end of mine. I think this motion says it. Let's begin hoping we can build a better health care system, and now let's work to achieve that. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Yellowknife Centre. To the motion. Member from Yellowknife North.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Shauna Morgan

Shauna Morgan Yellowknife North

Thank you, Mr. Speaker. Mr. Speaker, I will be supporting this motion. I also want to acknowledge and recognize that this could take a while. This could take about two years, at least, to complete if they do agree, if the auditor -- Office of the Auditor General does agree to conduct an audit. So this will not be a quick fix or an immediate solution. But I think that it is a tool that would be useful in our toolbox in order to improve a system that desperately needs improvement. So I also recognize that an audit -- a performance audit would usually assess performance against the standards and goals and targets that we have established. And one problem is that in our health care system, we seem to have been struggling in many cases to set those explicit standards or goals or targets. One example being nurse/patient ratios at Stanton hospital, and so it might be hard to assess performance against when we don't know what the goals have been that we're trying to set for ourselves. So I would hope that the Office of the Auditor General might be able to point us to, say, more broadly accepted national standards to help evaluate our performance and look at models of rural health care and primary care used in other remote communities in the country.

I understand that in some ways our system is unique, but we're certainly not the first jurisdiction in the world to have rural health care systems and remote communities. And so I think we do need to look to what other standards are out there and how we stack up.

I would also hope that the Office of the Auditor General could provide some insight into why our health authority and Department of Health and Social Services seems to have had so much trouble in being able to create system plans to really step back and look at the bigger picture, to create the plans and the targets, such as for example, a system workforce plan, and what have been the barriers to actually implementing plans like this. Despite many studies and reports and recommendations produced over the years internally, what have been the barriers preventing those things from coming to light and actually being well utilized and implemented.

With regard to staff retention, one thing I would certainly appreciate is a review of our policies around how and when frontline health care employees can take their annual leave ideally with some indication of how our policies and practices compare to other small health care systems and rurally-based health care systems in the country. We cannot surely be the first ones to confront these challenges of how to ensure staff can get the full leave that they're entitled to when we have limited staff and small systems.

I would also appreciate an evaluation of the extent to which exit interviews are implemented, so when staff do decide to leave, the rate at which we're actually conducting the exit interviews and the extent to which the insights gained through those interviews lead to changes to prevent other staff from leaving where possible. I understand that there will always be cases where people need to leave for personal reasons, family reasons, whatever it is. But if we're seeing patterns of preventible reasons that people are leaving, that those could be used to improve the system to improve staff retention.

Now, we've all been talking this week about how we're establishing a new health care system sustainability unit with the limited resources that we do have, and that has a number of years of work ahead. So my hope is that the work of the Office of the Auditor General could dovetail with that work. It could help raise some flags, identify areas for that unit to focus on, and ideally help to make the work of the new health care system sustainability unit more focused and more efficient because, you know, they have a lot of things to try to sift through and understand, a lot of previous documents and data, and so anything that the Office of the Auditor General could do to help point towards things that really raised a lot of questions or concerns might really make the work of that unit more effective.

So with that, I'll just conclude by saying I do support the motion. I'm hopeful that this can help, even though it won't be an immediate or quick fix, and so we do have to continue working on some of the shorter term solutions as well but this could be one of the more medium term -- medium-term steps that we can take to improve the system. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Yellowknife North. To the motion. Member from the Sahtu.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Daniel McNeely

Daniel McNeely Sahtu

Thank you, Mr. Speaker. I too will be supporting this motion. This motion will assist in retaining the services of the auditor general. And as my Members have said, we're not engaging in any witch hunt by any means. The performance review audit will give us tools to improve our current system. We're here to serve the people, and if we can be more efficient in the auditor general's review directly going to the recommendations of the audit on being more efficient in our health care delivery.

Similarly to the private sector, accountants really serve the entrepreneur in being cost efficient. On those principles of providing management skills, we need to produce the tools of recognition through an auditor general's report, and in my view, that'll really help our government to design, recognize, where we can pull up our socks and move ahead more efficiently.

Many of our small communities there, Mr. Speaker, depend solely on health care but limited facilities. That dependency is really on the system that we have now. And if there's room for improvements, I'm willing to participate in any way that I can. In recognition of the need for practitioners and trades in that system of health delivery, we can say to the previous statement I made the other day on working with the department of ECC to promote education. We have beneficiaries in the Sahtu that specialize in nursing and health deliveries. So if we can promote the recruitment and the noble trades position of health care delivery, that was my purpose of initiating that discussion through the statement I made. We need more trades. And in this case, in this motion, will help us recognize that. It also will recognize our weaknesses, and I hope that we as a government will all stand together to help do a review of efficiencies and, more notably, look at the recommendations from the report that's going to be produced. Mahsi, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from the Sahtu. To the motion. Member from Monfwi.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Jane Weyallon Armstrong

Jane Weyallon Armstrong Monfwi

Thank you, Mr. Speaker. Mr. Speaker, I do support -- I support this motion as well. The health care system in the NWT, especially in small communities, needs major improvements. Mr. Speaker, we want living in the small communities -- we want Cadillac services. We've been living with the Ford Focus services for a long time, you know, like, I mean, in the process -- in the process, our people are not getting the treatment they deserve. Some of our people are getting more sicker or misdiagnosed, you know, and we heard so many stories about medical travel too as well, you know, and the problem that it has on our vulnerables and those living with challenges. We heard of their experience. So we need to improve our services, especially in small communities, because we don't even have a medical doctor. Some patients, they wait long to see medical doctors. I mean, in Tlicho region, we're very fortunate because we have a physician that goes to our community, to our other Tlicho communities, but other communities, they don't have that advantage. So this I do support, and I feel for a lot of people living in the small communities that do get missed, a lot of misdiagnosis. We heard from other people about -- some people they have to pay their own way to Yellowknife to get the Cadillac services, which in small communities we lack that. And by the time they get here, for many it's too late. So for that reason, I do support this motion.

And I do support and encourage for more young, Indigenous to get into the health care field. And I hope that -- I know that will help with the recruitment and retention. Our people will stay in our community to deal with our problems with our issues and language, our culture, is not going to be a barrier. If we bring in outside people, there's going to be challenges for them. So I think we need to start focus on training, educating our young people and promoting them, you know, to take nurses and all the other professional fields. Thank you.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Monfwi. To the motion. Member from Tu Nedhe-Wiilideh.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Richard Edjericon

Richard Edjericon Tu Nedhe-Wiilideh

Thank you, Mr. Speaker. Mr. Speaker, I rise to also give support to this motion, the performance audit of the management of the Government of the Northwest Territories Health and Social Services Authority, the last number of years, in the 19th Assembly, there were a lot of issues brought forward in regards to the health system. You know, and my colleagues talked about it a little bit there as well. I got to remind also that when we have a mace here, we talk about the Crown, and we have a treaty, and part of the treaty we have a medicine chest. And the people in our small communities have treaty expect the health care to be a priority for them.

Over the years, I've been bringing issues here to the House on almost every issue you could think of, including medical travel and how it's funded. And to me, that's also another big issue.

My colleagues spoke passionately about the health system and the retentions of the nurses and doctors. And I -- you know, I think this is long overdue. I think it's needed. We should also learn from what happened to me and my community. And for now, Mr. Speaker, I just want to keep it short and sweet, that this motion is something that I'm glad to hear and see and that was brought forward by my colleagues because it hits home when a lot of our members get misdiagnosed, they get sent home to the point some of my colleagues -- I mean, my constituents had babies in the bathtub because they were sent home. And there's no need for that. So this here will look at ways as to how we can improve the system, and I look forward to the recommendations. So, Mr. Speaker, I do support this motion. Thank you.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Tu Nedhe-Wiilideh. To the motion. Member from Mackenzie Delta.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

George Nerysoo

George Nerysoo Mackenzie Delta

Thank you, Mr. Speaker. I too will support this motion based on the concerns during the election. Many constituents brought forth concerns about the health care within the Northwest Territories, within the smaller communities with lack of staff. We put up with these concerns every day. Every day when I'm back home, even when I'm here, I'm getting calls with the concerns saying that, you know, why is this happening? Why is that happening in our -- in this time of the day when we should be advocating and looking after our residents of our communities. Our smaller communities are ones that are suffering more and more travelling. We have elders that are travelling to bigger centres and where they don't know the system and are left alone. We have patients who have medical conditions that can't travel alone, but they too are told that they're denied. And we just need some improvements in the health care system for not just my community but for the whole Northwest Territories. So just to let you know that I will be supporting this motion. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Mackenzie Delta. To the motion. Member from Great Slave.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Kate Reid

Kate Reid Great Slave

Thank you, Mr. Speaker. I too will be supporting this motion for reasons very well outlined by everyone else. It's really troubling to me that probably two-thirds to three-quarters of the requests and feedback I get back in my office every day are about health-related issues, are about staff who feel completely at the end of their rope, and it's very telling to me that people within the government feel scared to have this feedback to an MLA. I really would encourage Cabinet to support this motion if at all possible; however, they usually abstain. But it's really -- it's really a good tool to have in our toolbox as other people have said. It's good to have an external lens on this issue. I also recognize it will take a long time to get results, but I think those results will be exacting so I will be supporting this motion. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Great Slave. To the motion. Member from Hay River North.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

R.J. Simpson

R.J. Simpson Hay River North

Thank you, Mr. Speaker. Cabinet will be abstaining from this out of respect for the independence of the Office of the Auditor General.

I just wanted to say that I agree with much of what I've heard from the Members. I receive complaints about the health care services as well just like every MLA in here. I do want to temper people's expectations. I've seen a number of OAG audits. It doesn't necessarily result in change. It's not a silver bullet. The OAG can come in, identify some issues, and then leave, and then we are looking at some issues that we're aware of without the necessarily the solutions to get at those issues.

What we proposed here is to create a health -- what we have done is create a health care system sustainability unit, so we can actually work right in the health care system. The staff is embedded in the health care system but still independent, able to bring real time information to the decision-makers to help actually do that work.

Another thing I want to mention to the Members as well is that the Office of the Auditor General, the way they work with these performance audits is they look at the policies in place, they look at what you say you're going to be doing, and then they look for documentation to confirm that you're doing what you say you're going to be doing, and that documentation needs to be dug up by somebody. And so that is the staff of the health authority. So the staff that are already burdened with a large workload with increasing, you know, complexities of care, now they have to go and chase down a bunch of documents. And while the Office of the Auditor General puts in a significant amount of time on these audits, thousands of hours, territorial health authority staff will also have to put in a significant amount of time that will take them away from the work that they normally do.

I also want to note that, you know, the Northwest Territories Health and Social Services Authority, it's the primary health care provider in, you know, 27, 28 communities, but we still have the Tlicho Community Services Agency and the Hay River Health and Social Services Agency. So this motion leaves out, you know, a significant part of the health care systems that serve, you know, 5, 6, 7, 8,000 residents in the Northwest Territories. So that's just something else to consider.

With that being said, we're not going to stand in the way of the wishes of the Assembly, but Cabinet will be abstaining. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Mr. Premier. To the motion. Member from Range Lake to conclude discussion.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Kieron Testart

Kieron Testart Range Lake

Thank you, Mr. Speaker. Yes, I will close discussion. So I was contemplating reading at length from Tabled Document 204-20(1), which is the patient survey that the Member for Yellowknife Centre and I brought forward to the House. I'm not going to do that. The document speaks for itself. But I do encourage everyone, in particular our Cabinet colleagues, to read that document and see in their own words what practitioners, members of the public, said in that survey. I think it's valuable to let them tell their own stories, and we'll continue to hear their -- we'll continue to hear those stories and bring them forward. This motion, and the other things that we're working on as a government, aren't going to change -- or are not going to change things overnight; I completely agree, there is no silver bullet.

But the audit that was just tabled in this House not too long ago was the result of a motion that was passed by the last Assembly. So, you know, it does take a while to get there, but I think we can all -- there are lots of lessons that we know we're going to learn from the Stanton renewal audit, you know, and not just were they following policy. Like, we have a very clear set of this is how we can avoid these things in the future, and I think that's -- that's the value of these things. And it shows that the OAG is listening to this Assembly. They're listening to the concerns of the people of the Northwest Territories. They always do. But we're just escalating that and asking them to prioritize this work because it is important. And with all these efforts that the Premier's office is putting towards health care sustainability, the health Minister, hopefully things do align and we're able to assess whether those things have been working and effective because those are policy changes that will now be part of any performance audit that comes forward.

I did want to say that my honourable friend from Yellowknife Centre mentioned that the town hall we had, and it was a pretty tremendous thing to have standing room only and have all these people engaged. Because sometimes Northerners do feel timid or that they can't speak out because they work for government or because they're worried about who's listening or there will be reprisals or they won't get contracts or whatever it happens to be. And it's a dam shame because this is our democracy, and it only works when we're listening to the people we serve.

So I was really pleased to see that. And during that, I made a commitment to bring forward this motion and that's the -- the people who were assembled wanted something like this. They wanted outside eyes taking a look at this. Because, quite frankly, Northerners are fed up, and things need to change. And it will take time. Everything we do will take time. But this puts us on the right course, and I think it's important that when we make a promise to the public, we keep it. So that's my effort today, Mr. Speaker. I look forward to the work of the auditor general. And I thank all my colleagues who have spoke in support of this motion. And I will recognize the commitment of the executive council to prioritize this as well, and we'll have to see -- hopefully everything aligns, and we start to make progress as soon as possible because, like I said, the system is breaking, if not already broken, and we desperately need to fix it. And I will ask for a recorded vote. Thank you, Mr. Speaker.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Thank you, Member from Range Lake. To the motion.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

Some Hon. Members

Question.

Motion 44-20(1): Performance Audit of the Management and Governance of the NTHSSA, Carried
Motions

The Speaker

The Speaker Shane Thompson

Question has been called. Member has asked for a recorded vote. For all those in favour, please stand.

Recorded Vote
Motions

Clerk Of The House Mr. Glen Rutland

The Member for Range Lake. The Member for Inuvik Boot Lake. The Member for Monfwi. The Member for Frame Lake. The Member for Great Slave. The Member for Mackenzie Delta. The Member for Yellowknife North. The Member for Tu Nedhe-Wiilideh. The Member for Sahtu. The Member for Yellowknife Centre.

Recorded Vote
Motions

The Speaker

The Speaker Shane Thompson

All those opposed, please stand. All those abstaining, please stand.

Recorded Vote
Motions

The Speaker

The Speaker Shane Thompson

The Member for Thebacha. The Member for Yellowknife South. The Member for Kam Lake. The Member for Hay River North. The Member for Hay River South. The Member for Inuvik Twin Lakes. The Member for Nunakput.

Recorded Vote
Motions

The Speaker

The Speaker Shane Thompson

Colleagues, all those in favour, 10. Opposed, zero. Abstentions, 7. Motion has carried.

---Carried

Motions. Colleagues, realizing that we've been almost three hours, we need to give our translators a break. We will have a brief recess. Thank you.

---SHORT RECESS

Recorded Vote
Motions

The Speaker

The Speaker Shane Thompson

Colleagues, notices of motion for first reading of bills. First reading of bills. Minister of Environment and Climate Change.