Thank you, Mr. Speaker. I have a return to oral question asked by Mr. Krutko on September 25, on cancer studies in the MacKenzie Delta. On September 25, 1998, you expressed concern over high cancer rates in the Mackenzie Delta and you asked me what studies have been done and where they are.

The Government of the Northwest Territories, through the Department of Health and Social Services, maintains a Cancer Registry under the Disease Registries Act. It is a legal duty of health professionals in the NWT to report every newly diagnosed case of cancer to the registry.

Information gathered in the Cancer Registry is reviewed annually and reports are produced periodically. The analyses are usually published in EpiNorth, our epidemiological newsletter. Data is also regularly provided back to health and social services boards upon request.

Cancer rates in the NWT, although rising, still remain lower than the rest of Canada. This is also true of the Mackenzie Delta region. The types of cancer which are on the rise include lung cancer, strongly linked to high rates of tobacco smoking, and cancer of the large intestine and rectum, associated with dietary changes away from traditional foods towards those that are fried, high in saturated fats, and low in fibre, vitamins and trace minerals.

The perception that cancer rates are high in many NWT communities relates to the following:

-cancer rates were traditionally quite low among aboriginal people and the rise in the past two or three decades has been noticeable;

-cancer is a disease associated with aging; as the numbers of elders increase, so do the numbers of people with cancer; and,

-people with cancer are also more "visible" in small communities as compared with large centres; proportionally more people are aware or touched by each new case of cancer.

The department is quite concerned about this issue. In collaboration with aboriginal partners, a project is currently underway to develop a communications package to facilitate discussions about cancer at the community and regional levels. A workshop was held in Yellowknife on October 14-15, 1998. It was coordinated by the Dene Nation and included participation from regional stakeholders. Once a communications package has been developed, it will be provided to the Inuvik Regional Health and Social Services Board for use at the community level in your region. Thank you.

Thank you, Mr. Speaker. I am pleased to announce that last Thursday, the Financial Management Board approved inclusion of $1.55 million in capital funding in the 1998/99 Supplementary Appropriation No. 3, for the Department of Health and Social Services.

Included in this funding is:

- a $500,000 contribution to the Stanton Regional Hospital Board to assist in the acquisition of a CAT scanner;

- $300,000 for furnishings and equipment for the soon to be completed health centre in Gjoa Haven; and,

- $750,000 for contributions to boards to address urgent minor capital requirements that could not be funded this year.

Mr. Speaker, the Stanton Regional Health Board, through its foundation, has been pursuing the acquisition of a CAT scanner for some time. Today, we are happy to announce this government's contribution which will bring this pursuit closer to realization. The Stanton Regional Hospital Foundation was

established to help meet the funding needs for medical equipment at Stanton Regional Hospital. Several pieces of equipment have been identified as being required. The CAT scanner, which is a very important diagnostic tool, is at the top of the list. I urge all Members of this House and the general public to generously support the efforts of the Stanton Regional Hospital Foundation in their continuing quest to raise additional funding for medical equipment. As Members may know, a CAT scanner is a system that reconstructs cross sectional images of the human body. The acquisition of the scanner and the establishment of a CAT Scanning Program will support and enhance the Diagnostic Imaging Program for the Stanton region. This will provide more effective diagnosis and treatment for residents in the region and will decrease the need for invasive diagnostic procedures.

In summary, Mr. Speaker, the proposed CAT Scan service will support NWT health care practitioners in providing a higher quality service:

- by assisting in patient diagnosis and treatment;

- by facilitating better decision making about southern referrals; and,

- by allowing practitioners to maintain professional skill levels.

Practitioners' support is a key ingredient in recruiting and retaining health professionals in the north, and many specialists rely on the availability of CAT Scan technology. Mr. Speaker, with respect to the second item of newly approved capital funding, I am pleased to say that the new health centre in Gjoa Haven, which will replace the present facility, is nearing completion.

In the past, the expectation has been that the necessary furnishings and equipment in an existing facility could be transferred to a new facility. Therefore, the department has not included furnishing and equipment for replacement projects in their budget. However, given the environment of fiscal restraint, the department has been unable to maintain an active minor capital replacement program. As a consequence, the equipment in the existing Gjoa Haven facility is in very poor shape, and a significant portion needs to be replaced. The recently approved funding will allow for this replacement.

Mr. Speaker, each year the minor capital requests that the department receives from boards far exceed available funding. Requests typically exceed funding by $2 million or more. Knowing this, boards only bring forward their most critical needs. The department is attempting to address this chronic shortfall and minor capital through the business plan. However, there are significant critical needs that need to be addressed now.

Mr. Speaker, aging facilities and equipment continue to place pressure on the health and social services system to maintain essential assets. The financial resources currently available to maintain the existing infrastructure have been and continue to be, insufficient to meet urgent requirements of the boards.

Included in these urgent requirements are items such as:

- medical equipment including dialysis machines, fetal monitors, infant warmers;

- other equipment such as hospital beds and stretches;

- upgraded phone systems and workstations in community facilities;

- renovations to facilities such as painting and replacing carpeting; and,

- vehicle replacements.

These capital purchases will ensure that quality programs and services can continue to be delivered. Capital equipment and facilities that are rapidly nearing the end of their useful and sometimes safe life, if not replaced or renovated, will cause the shutting down of programs and could even mean the closing of facilities. These purchases will also address fire and other safety code issues. Mr. Speaker, we all know that fiscal restraint of the past few years has had a major impact on our ability to provide quality health and social services. However, I am pleased to say that this government has demonstrated its willingness to recognize and address these difficulties by approving funding for these urgent capital requirements. Thank you, Mr. Speaker.

--Applause

Yes, the Minister of Finance is correct except to state that also that because of the fact that Stanton would be getting this significant investment, the Kitikmeot would be a getting a significant investment out of the total $1.55 million appropriations. For the basis of the $750,000 that we would try to focus on the other boards that had not received any capital allocations, in recognizing their needs on a priority basis. The only way that Stanton or the Kitikmeot would receive any additional funds is if it was deemed to be a highest priority because of safety or health reasons. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I have a list, like I had indicated, that $2 million plus from all the boards. The department has it and like I said, depending on the priorities within that $2 million, because we only have $750,000 to allocate now, so the CEOs and the department will sit down and go over those lists once again and see what are the most urgent requirements and fund it based on that. Thank you.

Mr. Chairman, what happens on an annual basis , all boards put in their capital submissions of an urgent nature and historically it is running from $2 million plus. The department has not had the capability to finance all the needs. This $750,000 for the minor and small capital projects will be going through the whole process of being re-evaluated by the CEOs in conjunction with the department and funded accordingly, based on those priorities. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, yes, the plan is that the NWT recruitment and retention plan, that resources are for the Northwest Territories, as I had indicated in respect to the locum relief pool, that is, right now, to be based in Yellowknife. Some of the resources of headquarters, of course, are in Yellowknife and there will be some that will be moved to Iqaluit, depending on what the base funding split is for the recruitment and retention plan. As it stands now, it is at headquarters and the distribution, for example, I used the professional development fund that goes to all boards, no matter where they may be, because there is staff in every community throughout the Northwest Territories. Thank you, Mr. Chairman.

Thank you, Mr. Chairman. Mr. Chairman, if the honourable Member is speaking in respect to the locum relief pool, that is exactly what the Minister of Finance has outlined, in respect of there is no targeted community where those individuals are going to go. It is going to be on an as-required basis and determined by health care professionals. It certainly not going to be a political exercise of, well this community needs it more than this one. A decision will be made by health care professionals where the needs are, Mr. Chairman. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, I do not particularly have the answer to that today. I believe that is fair to say there are all sorts of discussions ongoing right now between the Nunavut Interim Commissioner Office and our government on shared services. We are aware of that, in particular in the area of health. I do not think it has got down to the level of detail in respect to something like this locum pool that we are just in the process of establishing. I can see there is a possibility of having shared resources, but I cannot speak to that today, at this moment. Thank you.

Thank you, Mr. Chairman. Mr. Chairman, the intent is there be one pool available to all boards. Thank you.