Committee members believe there are cases where the boards have been too strict in interpreting the Medical Travel Policy. Residents of small communities do not have the same access to the health care systems as residents of urban centres. If they do not agree with the diagnosis of health care professionals in their home communities or if they want a second opinion, they have no choice but to travel outside their community.

However, if the health care professional will not authorize medical travel for the patient to go to another centre, the patient has no choice but to cover all those costs themselves. Even if the patient's complaint or concern is borne out at this other facility, the regional health board will not reimburse the patient due to the lack of a medical referral.

This is unfair. Committee members realize that the health care providers in the communities do the best they can with the resources they have, but they can make misdiagnoses. Everywhere else in Canada patients can easily get a second opinion. Unfortunately, in some of our communities this cannot be done without leaving the community and bearing considerable expense. There needs to be some common sense applied to the interpretation of the Medical Travel Policy.

Members believe that there has to be a second opinion or "escape clause" in the Medical Travel Policy. If the patient does not agree with the diagnosis of the health care professional in their home community and travel to another community and receives immediate treatment, the patient should be eligible for compensation. Members also would like to see an appeal mechanism that allows the patient to appeal the decision of the board to the Minister.

Members were pleased to note that the Minister agreed that there might be circumstances that would warrant the repayment of medical travel expenses and that she was willing to examine the Medical Travel Policy. Members look forward to further discussion with the Minister on this issue in the near future.

On a related note, committee members believe that the department and boards must monitor medical travel costs in each community to ensure that they do not eclipse the costs of placing a doctor in the community. This is an issue that is of particular concern to the residents of Rae-Edzo.

Committee members acknowledge the trend in self-government negotiations for First Nations and their partners to want responsibility for the social service delivery component and preferring to leave the medical responsibility with the boards. The major consideration being that, all participants in self-government negotiations realize that they have to work together to ensure continued service delivery to the residents that we all serve.

It will be a time of major change in the structure of how we deliver programs and services and there is a need for extensive consultation on the part of the department and other service providers.

Committee members believe that we have to do this right. Everyone's primary concern should be the health and safety of our residents. The change must not be allowed to jeopardize the health and safety of our residents.

It is noted that some regions have indicated a preference for a community services board model. Whichever model of health and social service delivery that is chosen by each community or region, it is important that there is an audit function within the system to ensure that program dollars are being spent correctly and that the health and well-being of residents are not being compromised.

In particular, it will be important for the departments that are funding community or regional service boards to provide monitoring and program advice to the boards and for these departments to co-operate with each other.

Committee members also believe that it is important that there be full and adequate consultation between all parties as the process evolves.

Thank you, Mr. Chairman.

Human Resources and the Recruitment and Retention Strategy

The standing committee noted that the Stanton Regional Board was the only board whose information was contained in the PeopleSoft supplementary position information. Members wonder whether the committee will have opportunity to review information for other boards in the near future.

Unlike other departments which provided information on affirmative action statistics within the department, the Department of Health and Social Services did not include statistics in their business plan. Even though the department believes that this is a responsibility of the Financial Management Board Secretariat, there is still a clear role for the department in presenting this information to the committee during the business plan review.

Other than the affirmative action component of the Recruitment and Retention Plan, there is no clear affirmative action plan for the rest of the department. Members of the committee understand that the bulk of employees involved in healthcare in the Northwest Territories are board employees and that a representative workforce is being worked towards that level. Members would appreciate being advised of affirmative action statistics for the department and boards in the next business plan.

Members are concerned that the department is not doing an adequate job in promoting the results of the Recruitment and Retention Plan. Other than being advised by the Minister and her officials that the health and social service system is no longer in crisis, Members have nothing tangible to justify their continued support of the Recruitment and Retention Plan.

Recruiting trips to Europe, the high cost of hiring short-term staff through employment agencies and lapsed funds, make it hard for committee members to justify the plan at the community level. The public and the members need visible indicators, such as affordable housing for health and social service workers, to prove that the plan is working.

Members are aware of the requirement for registered nurses to upgrade to a bachelor degree. Members of the committee believe strongly that the department must incorporate this requirement into the recruitment and retention strategy. There are nurses who are long-term residents or who have made the commitment to the North, that may not be able to practice in the future if this upgrading is not addressed. The Northwest Territories has enough problems recruiting nurses without compounding the situation by failing to deal with the requirement to upgrade nursing qualifications.

Recommendation 1

The Standing Committee on Social Programs recommends that the Minister direct the department to examine the number of nurses practicing in the Northwest Territories that will be required to upgrade their qualifications to a Bachelor degree;

And further, that the Minister develop a strategy as part of the Recruitment and Retention Plan to deal with this upgrading requirement.

Thank you, Mr. Speaker. Mr. Speaker, my statement today concerns difficulties being faced by businesses situated on the Hay River Dene Reserve.

Mr. Speaker, the Hay River Dene Reserve is a separate community from the town of Hay River. However, when it comes to the application of the Business Incentive Policy, with respect to the Government of the Northwest Territories tendering practices, it would appear that they are the same community.

Specifically, this means that the Hay River Dene Reserve businesses do not benefit from local preference or Government of the NWT contracts bid out for services on the reserve. However, Mr. Speaker, the town of Hay River itself recognizes that the reserve is a separate community. It requires those businesses based on the reserve to have a non-resident business license when they do business in the town of Hay River.

Mr. Speaker, the Government of the NWT should be encouraging businesses to grow and prosper on the reserve by applying a local preference policy to resident reserve business when they issue public tenders. In such a matter, they will create business opportunity, employment growth, and investment on the Hay River Dene Reserve.

Mr. Speaker, residents and business owners on the Hay River Reserve also find it difficult to access funds available through the Business Development Fund and the Business Credit Corporation. The town of Hay River is the second largest community in the North. They enjoy the luxury of many types of businesses and services.

Mr. Speaker, the criteria to access business development funding does not allow for market disruption, but what this interprets to is that the reserve cannot start up any businesses that compete with any business that exists in the town of Hay River.

Mr. Speaker, the lack of banking services on the reserve when the difficulties that the banking sector has with providing funding to on-reserve businesses make it especially important that the Government of the NWT provide financial alternatives.

Mr. Speaker, the Department of Resources, Wildlife and Economic Development should play a major supporting role regarding development on the reserve. It should start by listening to the concerns of the residents and the leaders of the community, and translate what it hears into a committed plan of action that will foster and sustain economic development for the Hay River Dene Reserve. Thank you.

-- Applause

Getting all the plans from the communities in my riding, I looked at them and they are nowhere near what came from the regions to the Department of Municipal and Community Affairs, and what is on the capital plan here. Recognizing there were a lot of cuts, and I do not expect everything to make it to this budget, but I feel that the communities are being misled. They are spending, in some cases, two or three days working on capital plans and it is not reaching this level.

I would like to know if that is not the intent, if the Minister would provide that direction to the regions?

Yes, I have a question regarding the process the Minister has referred to. I would like to ask the Minister, I know the program officers go into the communities and they set up a capital plan for five years and they try to prioritize all the different capital items in the plan.

I am concerned, and this is where my question comes in, is the regional staff expected to take that plan and revise it, before submission to headquarters here in Yellowknife?

Thank you, Mr. Chairman. I am glad to hear the Minister will consider creating such a position, or dedicating one position to work with the communities and regions. I would like to ask if he would consider presenting that concept to the meeting in Hay River. From what I hear, there has been some good stuff coming out of these meetings. I think that is something that should be presented to them to see what the response is.

Thank you. My comments are along the same lines. My concern is more so with organization. Granted that a lot of money is raised by Sport North, you do not see a lot of it being filtered down into the communities. The benefits are generally going to the larger centres. When you start to look at why, you could see that the larger centres are much better organized and have a lot more organized sports and committees and groups, and organizations. When you look at the Sport North budget going to the elite athletes, and it shows that it is going to the larger communities. They work to get it. Having said that, you look at the smaller communities that do not seem able to access the programs and the dollars from Sport North, and you will find that most of them are not organized. That is what seems to be lacking in this whole picture. I do not want to point the finger at Sport North and say they are doing a bad job. They are actually doing a very good job of fundraising, but the regions in the communities cannot seem to access the dollars. I think they need some assistance. Some of the regions who are organized and have regional sport groups are starting to draw down on these dollars. I think that all the regions should be setting up that way.

There seems to be a lot of people in the Department of Municipal and Community Affairs that dedicate a lot of time to Sport North. I would like to know if the Minister would consider dedicating one position in his organization, maybe program advisors, who would work strictly on developing regional sport organizations in the regions and work with the small communities.

I wanted to ask the Minister, in light of all the taxes and the frustration in the communities that I am hearing from the chief and members of the council and the mayor and the council, they would like to consider a block land transfer. I pose that question at some point, to transferring those lands over to IAB lands for treaty and status Dene. Would that be something that the Minister would entertain?