Thank you, Mr. Speaker.

Mr. Speaker, I have a Return to Written Question Number 8-20(1) asked by the Member from Great Slave on October 30th, 2024, regarding improving fertility and family planning supports in the Northwest Territories.

The Member for Great Slave asked what additional resources are required to begin tracking prenatal screenings so the GNWT can collect data on individuals struggling with infertility.

Prenatal screenings are undertaken as part of care during pregnancy so this would not be an avenue to collect data on individuals struggling with infertility. The Health and Social Services system does not explicitly track infertility because the metrics to measure infertility are complex in that it's generally accepted that difficulty conceiving becomes infertility only after a full year of actively trying to conceive. Once a person has tried to conceive for at least a year or six months if they are over 35 years of age, there are multiple procedures both partners must go through to determine if there are underlying medical conditions that could be responsible for the inability to conceive. The process of diagnosing an underlying medical condition is covered under the NWT Health Care Plan.

Where the cause of the infertility is not readily known and a resident wishes to request further investigation, the request may be submitted to the Department's Health Services Administration office. Health Services Administration reviews the specifics of each case. This process, referred to as 'prior approval', is used in situations where the treatment may be outside the Health and Social Services system's usual referral pathway or when circumstances warrant further examination.

If no underlying medical condition is determined, the diagnosis may be infertility. Currently, there is no plan to add additional data tracking specific to infertility to the system. The focus of the Health and Social Services system remains the delivery of quality insured health services.

The Member asked what additional resources or processes are required to allow patients to self-report their usage of IVF supports for the purposes of data collection to better understand territorial demand for IVF.

There is no plan or system capacity to create a mechanism for NT residents to self-report their usage of IVF supports.

The Member asked what additional resources would allow the Department of Health and Social Services to better track the number of IVF referrals to fertility clinics provided to Northwest Territories residents each year.

Once the individual has received a diagnosis of infertility, there are no further insured services available under the NWT Health Care Plan. At this point, individuals may make private inquiries for further consultation. There are no formal referrals to IVF clinics. A primary care physician may make a recommendation, however, because IVF is not an insured service and there is no reciprocal billing or formal referral pathway to access IVF services, there is no tracking. Currently, there is no plan or system capacity to begin tracking informal recommendations to IVF clinics.

The Member asked if the Department could provide a comprehensive list of fertility-related issues which could allow for medical travel supports for residents, in comparison to other jurisdictions.

Fertility-related investigations vary from person to person and there is no comprehensive list of fertility-related issues that could allow for medical travel supports for residents. Rather, medical travel supports are available to access services related to the investigation of underlying medical conditions that may be causing infertility. The investigation of underlying medical conditions may include things like semen analysis, pelvic ultrasound, and other gynecological procedures. Once preliminary investigations are complete and the patient has experienced 12 months of infertility or, if over 35 years of age, 6 months of infertility, a referral to a specialist may be made for further investigation of underlying medical conditions.

Medical travel supports are in place to assist NWT residents with costs associated with accessing insured health services. If the health service is insured under the NWT Health Care Plan, it is eligible for medical travel supports. In comparison to other jurisdictions, the NWT has one of the most generous medical travel benefits in Canada. For example, the Travel Assistance Program provided by the Government of British Columbia consists of a discount to ferry costs only. The Government of Ontario provides medical travel supports through the Northern Health Travel Grant that reimburses travel costs based on a rate of 41 cents per kilometer with a 100-kilometer deductible of each trip. Also, there is no coverage for any other expenses. This Grant is limited to residents in the northern part of Ontario. Thank you, Mr. Speaker.

Mr. Speaker, I have a Return to Written Question 9-20(1) asked by the Member for Yellowknife Centre on October 31st, 2024, regarding the staffing of doctor and specialist positions within the Northwest Territories Health and Social Services Authority.

Later today, at the appropriate time, I will table a document titled Physician Vacancy Information by Position.

The Physician Vacancy information provided in this document outlines all staff physician positions including family physicians and specialists, their location, whether these positions are full-time equivalent or part-time, and the vacancy status of each position type as of September 30, 2024. When positions are vacant, every effort is made to have them filled with locum physicians.

Currently, physician vacancy data does not retain length of vacancy, however, some specialist positions have been vacant for five to 10 years. These positions may be vacant due to a variety of factors which include a mix of practice intensity, pay level, and lack of interest in working in smaller communities. Thank you, Mr. Speaker.

Mr. Speaker, I have a Return to Written Question Number 10-20(1) asked by the Member for Tu Nedhe-Wiilideh on November 1st, 2024, regarding complaints in the health care system.

The Member asked for the annual number of complaints made over the last five years regarding the conduct of regulated health or social services professionals, specifically nurses, employed by the Government of the Northwest Territories.

The Department of Health and Social Services, or the Department, does not receive complaints for registered nurses, as these health professions are regulated by the College and Association of Nurses of the Northwest Territories and Nunavut which is commonly referred to as CANNN.

CANNN has provided a summary of complaints received over the last five years:

• in 2019 they received 15 complaints;

• in 2020 - 30 complaints;

• in 2021 - 43 complaints;

• in 2022 - 17 complaints; and,

• in 2023 - 34 complaints.

It is important to note that prior to 2024, CANNN did not track complaints by territory. Additionally, CANNN has informed us that most complaints received are made by colleagues and employers.

The Professional Licensing Office is the regulatory authority for health and social service professionals that are regulated by the Department of Health and Social

Services in the Northwest Territories. From January 1, 2019, to November 1, 2024, the Professional Licensing Office received 22 complaints.

Complaints received by the Professional Licensing Office are separate from complaints received by the Northwest Territories Health and Social Services Authority, who receives complaints through the Office of Client Experience. The Office of Client Experience is accessible to all residents and guests accessing care and services in the Northwest Territories, including through the Hay River Health and Social Services Authority and the Tlicho Community Services Agency.

The Office of Client Experience offers a single point of contact for clients seeking support in accessing and navigating the Health and Social Services system or wishing to share their experiences.

Between January 16, 2023, to December 1, 2024, they received 1,564 requests for service; 878 of those were complaints. Approximately 60% of all requests came from residents who identified as either First Nations, Inuit, or Métis.

The Member also asked the number of Human Resource investigations that occurred because of complaints made to either the Northwest Territories Health and Social Services Authority or to CANNN concerning the conduct of regulated health or social services professionals, for each of the last five years.

There have not been any human resource investigations conducted by the Northwest Territories Health and Social Services Authority stemming from complaints, in the last five years. The Department does not have information on investigations conducted by CANNN.

The Member asked about the number of critical incident investigations conducted in our health system each year, over the last five years.

The Northwest Territories Health and Social Services Authority has had a Quality Assurance Framework in place since 2022. Since that time, there have been a total of 17 critical incident investigations conducted:

• 4 in 2022,

• 8 in 2023, and,

• 5 in 2024.

It is important to note that several of the critical investigations may still be in progress and the type of quality assurance activity may change pending the outcome of the review process.

The Member also asked the number of Indigenous investigators involved in conducting investigations in the health system.

I am unable to provide a specific number because the Department does not collect demographic information, such as the ethnic background, of investigators conducting investigations within the health system. Thank you, Mr. Speaker.

Mr. Speaker, I have a Return to Written Question Number 11-20(1) asked by the Member for Range Lake on November 1st, 2024, regarding ground search and rescue.

The Member requested the Minister confirm how the contract for this work was awarded and what the final cost of the contract was to undertake a review of search and rescue in the NWT.

A public request for proposals was advertised with a closing date of June 30, 2021. There were no bids received; therefore, the Department of Justice proceeded with a sole source contract with MNP. The final cost of the contract was $95, 000, which was funded by Public Safety Canada through its Search and Rescue New Initiatives Fund.

The Member also requested the Department of Justice provide an official response to each recommendation of the report, including comprehensive details on the implementation of each accepted recommendation.

The Government of the Northwest Territories is not prepared to adopt the recommendations in the report at this time given current capacity and financial considerations. Later today, at the appropriate time, I will table a document which provides a recommendation by recommendation summary. The report was a valuable exercise to have undertaken as it has improved understanding of the assets in communities and identified areas for improvement. Search and rescue in the Northwest Territories is a shared responsibility due in part to our vast land size and small remote communities with limited resources.

The GNWT will continue with its current approach for search and rescue in the NWT in partnership with the Royal Canadian Mounted Police, community governments and the many search and rescue organizations across the territory.

The Member also asked if the Department of Justice could provide statistics on the frequency of ground search and rescue operations over the last ten years.

Data collection regarding the frequency of ground search and rescue operations over the last ten years has not been consistent. Search and rescue responsibility is a patchwork of government, non-governmental organizations, military, Coast Guard and community-based resources and efforts. There is no central repository for these agencies to feed data into, and no designated organization or policy to follow regarding who collects this data.

The role of the RCMP is to provide incident command support. Search and rescue is not within the mandate of the RCMP; therefore, members do not receive this specific and highly technical training. As such, RCMP data on search and rescue operations is limited and does not provide a full picture of all operations undertaken in the NWT. RCMP ‘G' Division's internal reporting includes both land based and marine based responses as follows for the past eight years: 2017 - 52; 2018 - 48; 2019 - 50; 2020 - 20; 2021 - 27; 2022 - 21; 2023 - 23; and 2024 - 24 as of November.

Lastly, the Member asked if the Department of Justice could provide the expenses required for ground search and rescue incidents over the last ten years.

There has been no cost tracking and there is no analysis available related to overall search and rescue efforts in the Territory over the last ten years. The mandate for search and rescue is heavily reliant on community-based participation and efforts related to this area are largely undertaken on an in-kind and volunteer basis. RCMP reporting on costs they have incurred over the last five years related to ground search and rescues average $109,372 per year.

The Department of Municipal and Community Affairs administers contributions under the Community-Organized Searches Policy, which may provide a contribution of up to $10,000 to a community government. This is specific to a search for missing person or persons organized and conducted by a community government prior to, or following, a public search. Community organized searches may include recovery operations. On average, MACA receives one request per year for this funding. Thank you, Mr. Speaker.

Mr. Speaker, I have a Return to Written Question Number 12-20(1) asked by the Member for Yellowknife Centre on November 1st, 2024, regarding the cost of living.

It is recognized that the Northwest Territories is a high-cost jurisdiction - the territory's remoteness, climate and small population mean that baseline costs for goods and services are high, compared to other jurisdictions. With this, the Government of the Northwest Territories pursues programs and measures to help alleviate cost-of-living pressures faced by Northerners where, as a public government, we are able to do so in a fiscally responsible and sustainable way.

The Government of the Northwest Territories has, over the years, implemented targeted cost of-living relief measures to support residents. Such initiatives include increasing income support benefits, enhancements to the Senior Home Heating Subsidy in 2024, as well as maintaining the Senior Citizens and Disabled Persons Property Tax Relief Program. Additionally, work has been done to enhance food security through building local agriculture and commercial fishery sectors, as well as the development of territorial meat inspection regulations to promote the availability of locally harvested and affordable food.

The GNWT also expanded the regional Cost of Living Offset, introducing geographic zones to ensure residents in areas with higher heating costs, such as the Beaufort Delta, receive greater support. This is in addition to support for emergency situations, such as regional support offered most recently in Norman Wells for home heating fuel subsidies. Other measures the Government of the Northwest Territories has taken to support Norman Wells, as well as the Sahtu and Beaufort Delta regions, include providing emergency funding to help businesses, Indigenous governments and community governments offset transportation costs for essential goods, and providing a subsidy to the NTPC to shield all residents from electricity rate increase due to higher diesel costs.

To address rising costs, the government has also indexed the minimum wage to inflation and wage changes, ensuring that residents' incomes better align with increasing expenses.

Given the inflationary pressures, including increasing costs related to food and fuel, that are beyond the government's control, it is important that the government focus on sustainable solutions rather than implementing measures like price controls or fuel tax cuts, which could harm the economy or reduce revenues needed for essential programs.

Continued advocacy and progress on strategic infrastructure projects such as enhancing communication and transportation networks, improving redundancy through initiatives like the Mackenzie Valley Highway and Taltson Hydro Expansion, and the recent completion of the Inuvik to Tuktoyaktuk fibre line extension, remain key priorities of this government. These efforts, alongside increasing housing availability, aim to address structural factors contributing to high living costs and provide meaningful support to residents across the territory. The GNWT has been working alongside Indigenous governments to strengthen the impact of our advocacy and explore all possible investment opportunities for the North.

I will table later today additional details regarding programs and measures to support residents of the Northwest Territories. Thank you, Mr. Speaker.