Thank you, Mr. Chairman. As I said on Friday, I would have a few more comments to go through the opening address and highlight. Mr. Chairman, as I said on Friday, I am very supportive of working towards making our communities more sustainable through environmental investment, but one of the things that I find to date, we still have to realize that we need to find real savings for our cost of living issue. We continue to invest in cost of living initiatives but, as I said on Friday, several businesses all in the end say costs keep increasing. You go to anyone’s power bill, the power bill keeps increasing. The oil bill keeps increasing. Of course, the cost of living makes it very unbearable to live here. I suspect that that is going to be one of the most significant emerging issues going into the next election for this Legislature which is, what has this government done to lower the cost of living? Although there continues to be good investment stewardship and, if anything, as I have said before, I think that may end up being one of the incidental hallmarks of this Legislature where it will be known for is a very green Legislature. It has taken on very positive initiatives to recognize its responsibility and role in the future. But setting that aside, what have we done to address the cost of living? I think ultimately what we keep coming back to is nothing has changed. We just keep shuffling costs around and the cost of living here continues to grow.
Mr. Chairman, although I was listening very closely to the last speaker, I am glad to see we had no tax increases coming forward in this budget. I think that our economy has taken enough of a beating in the last year and I have said before that our corporate taxes will have a difficult time keeping up with our government’s need for spending. I have often said that, and I really do believe this, that we don’t necessarily have a revenue problem, we just have a spending problem. I would often look with high hopes to the program review office that it would find ways to tackle some of our larger spending. If I could take that further, I wish the program review office is more engaging with Members specific to where would we believe an initiative should be targeted and focused in on saving money. I think it is a real policy question on how we fund our programs and see our future. I think there needs to be more value put into that.
There are a couple of other areas that I would like to highlight. Certainly investments in children, youth and families is one. Something that I have heard this summer when I was doing some door knocking is that different people in the constituency talked about junior kindergarten and pre-kindergarten and noticing that it seems to be an emergence on some of the latest trends of what people are having as an expectation of where should education go and how should it be reflected. Long has passed the day where people sort of drop their kids off to someone who provides a day home and probably a very loving day home that is safe and secure, but the parents are starting to demand things such as a little earlier child education than what is being offered out there in an organized sense. I think their expectations are growing. The modern parent these days does not believe that parking your small child in front of the TV calling that day home child care management. A number of constituents have told me that they would like to see some organization evolve into that sort of area. It is not a simple answer. It is just to say now we are going to add junior kindergarten to all schools throughout the Territory. It is not an easy thing. With those things come costs as well as priorities, but it is an emerging issue that I think our government should start examining about what fruits of our labour will deliver positive results.
It is nice that we spend money on tons of programs. We can be here all day talking about them, but ultimately I hear it constantly everywhere I go. Education is the best employment program we have. We should start investing in it as soon as possible. A number of parents have talked to me about on the horizon they would like to see our government start addressing these issues as a future initiative. I don’t think that there is a case where people would assume that it would be there… They ask for it today and it would be there for the next education season for the school year that is, but yet I think it is an emerging issue. People would like to see that the government is focusing in on that direction.
Under stabilizing the health care system, I would like to congratulate the government on moving forward on the downtown clinic in Yellowknife here. I think it will have a significant benefit in a few areas. The first is obviously cost. Rather than having multiple leases throughout other buildings, the government will be able to help focus some of its financial resources into a particular area and, furthermore, doctors will be able to provide more walk-in services for patients. The coordination of those services would probably be a major factor. It would bring the administration of those separate offices together and we augment that with the new benefits of being able to do X-rays there and tests. I think it will be a huge step forward for health services here in this community. I think, in the long term, it will provide excellent value for what we are getting.
I think that is a bold step forward in the way the government has been doing business in the past. I certainly hope this will sort of drive out a model that should be expanded upon for other types of thinking. How can we consolidate services in a manner that makes sense in a particular community? When I emphasize consolidate, I don’t necessarily mean for the community community. I mean within a community to make sure that we are getting good value for money. As I was complaining the other day about my concerns about local housing and moving the housing program back to the housing LHOs, what we have done is stepped away from a service centre or one-stop shop. I think initiatives like that shouldn’t be frowned upon. We should be finding ways to do better business from a service centre of excellence point of view.
To continue under the health file per se, although it is not related to health directly, it is the housing for disabled people. In our community under the LHOs, we don’t have stock of housing or an available stock for people when it comes to families. I know one particular family had been trying to get into housing for some time now and because of the disability, it is easy to find… Their response to me was it is easy for the housing authority to find a place for them to stay, but then it gets into a problem about is it a place that is of quality whereas it is safe. It is built with a person who has a disability in mind. With the aging population wanting to grow a little older and still be a little bit more dependent on their own rather than being put into a sort of centralized institution type service. People want to be able to be independent as long as possible.
But when it comes to family services out there, they are very few and far between. In one particular case now, I think we are paying well in excess of what can be considered a normal market rate in order to house somebody properly. Our housing program by itself, compartmentalizing that point and pushing it aside for a second, is not focused in on enough about trying to get people out onto their own feet, sort of the old helping hand approach. That is one of the big focuses, I think, that is now being hurt by separating the housing component out of the income support, as service centres continue to strive to get people to work harder and to stand up on their own and take advantage of the opportunities before them. Mr. Chairman, I think moving housing back to the local housing authorities was a step backwards.
Mr. Chairman, the big thing that as we all came into this Assembly, we talked about was the big thing that is coming forward on everyone’s mind at the time were things like environment. I want to emphasize that I think the territorial government’s focus is in the right direction, but we always have to keep cost of living in mind. Although we are going to spend a fair bit of money to continue expanding projects, I just want to end on the point that we still have to always keep the fact that the bottom line is always going to matter more than anything else.
We don’t have to look too far than our southern states, that is the United States of course, and see that when people have a choice, they certainly like to do the good stewardship process, but when people’s backs are against the wall, when it comes to being able to put food on the table, they tend to choose the economy over the environment, which, you know, up front is a mistake and over the long term it will be a mistake, but people are forced to do what they need to do. So I would exercise caution to this government by saying the more competitive we can be, the easier it is for people to live here under the conditions that we do survive under, whether it is heating your home or putting food on your table. I mean, those are very important issues and although we would like to do things constantly better, those are primary issues on people’s minds. So, Mr. Chairman, for my opening comments, I will leave it there and, of course, with anything else, I will have questions during page-by-page review. Thank you.
Comments. General comments. With that, we are hearing more general comments as we read, we are going to begin with the Department of Health and Social Services. So at this time I would like to ask the Minister responsible for Health and Social Services if she has any opening comments. Ms. Lee.
Yes, I do, Mr. Chairman. I am pleased to present the Department of Health and Social Services main estimates for fiscal year 2010-2011.
At the outset, I want to identify that our system and the whole of the Canadian health care system is stressed to capacity due to a number of evolving challenges. These include changing demographics of both patients and care providers, rising health care costs especially in pharmaceuticals and technological advances in health care, recruitment and retention challenges, and the increasing prevalence of chronic disease nation-wide.
The current spending rate of our health and social services system is not sustainable. If left unchanged, our ability to provide access to quality, timely and safe services in a way that is affordable for this government will be impacted.
The department’s initiatives under A Foundation for Change are a blueprint for action that faces this challenge head on. Sustainability, as well as wellness and accessibility to health and social services are three pillars of the Foundation for Change. This plan is based on the principle that while sustainability and bending the trend of the health and social services future cost trajectory is our primary focus, system change to reach this must be managed well to ensure service delivery and quality of care are also sustained.
We launched A Foundation for Change with the support of the Members of this House through the Standing Committee on Social Programs and I am committed to continuing to work with the Members as we move forward.
Mr. Speaker, ensuring sustainability and addressing the changes in our health and social services system will not be easy and requires the full support of this Assembly and our stakeholders. It will require support for a planned, managed, multi-year approach to change and a committed focus on long-term sustainability envisioned in the plan.
Under this budget, the department is requesting just over $326 million. This reflects an increase of approximately $13 million or 4.2 percent over last year.
Twenty million of this $326 million is forced growth which includes ratification of the physician contracts for $4.3 million and ratification of the Collective Agreement for approximately $10 million.
I would also like to note federal funding initiative sunsets of $7 million, which includes $5 million for the Territorial Health Access Fund (THAF) and $1.8 million for the Patient Wait Times Guarantee. The Patient Wait Times Guarantee was a federal government initiative and will not be re-established. The department and relevant authorities are looking at options for wait times monitoring and assessment to be provided within existing resources.
We, as a government, are continuing our discussions and lobbying of the federal government to continue THAF funding. It will, however, be some time after the federal budget in early March that we will learn if any THAF funding will continue and under what parameters and time limits. In the meantime, the department and authorities are developing plans for how we can manage without THAF funding or with a reduced amount. I need to be clear this is not something the system can absorb, so we are looking at what we may continue under new models with existing resources and what will end.
This concludes my opening remarks and I would be happy to answer questions. Thank you, Mr. Speaker.
At this time I would like to ask the Minister if she will be bringing in any witnesses. Ms. Lee.
I do have witnesses, Mr. Chairman.
Does the committee agree that Ms. Lee brings in her witnesses?
---Agreed.
Sergeant-at-Arms, escort the witnesses in.
Ms. Lee, for the record, would you introduce your witnesses.
Thank you Mr. Chairman, to my left is Ms. Paddy Meade, deputy minister of Health and Social Services, and to my right is Mr. Derek Elkin, director of finance. Thank you.
Thank you. Welcome, witnesses. General comments for the Department of Health and Social Services.
General comments. Mr. Krutko.
Thank you, Mr. Chair. Yes, Mr. Chairman, I didn’t want to lose my opportunity to talk about the Department of Health and Social Services but, more importantly, the lack of programs and services we see in our small, isolated communities. We seem to be doing a lot to increase large programs and services with regards to the dementia centre, amalgamated clinics, large-scale hospitals, but we haven’t done much by ensuring or improving the quality of health care services in our small communities. I, for one, have been raising this issue prior to division, and if you look at statistics going back prior to 1999 when we had division, when we were one Territory, we received better health care then than we do today. We can actually see the expenditures made in our communities where they had full-slate nurses, where they had their services being provided just by the capital expenditures being spent back then. But yet, every time you build a new clinic, you build the dementia centre, you build a new hospital, those dollars come out of the same pot of money that the smaller communities are depending on for programs and services, and when we continue to say forced growth this and forced growth that, we are the ones that are adding to the problems by increasing more programs and services and taking away those dollars and resources to ensure we have a service provider that provides services across the board to all communities, and not use the excuse, well, sorry, you don’t have the numbers, or you’re not really that important and because you can take a bus or hitchhike or whatever you have to do to get to a hospital, that’s your responsibility.
I’m just wondering, as aboriginal people in northern Canada, should they consider going to the United Nations, or even talk to Doctors without Borders and come to our communities, provide that health care service that this government is not providing. I think it has come to a point in the road in regard to actually saying is there another option to health care services for aboriginal people in those communities that aren’t getting any. I hate to say this, but some communities feel like they’re a third-world country in Canada, especially aboriginal people.
We talk about the health and well-being of our residents. There are people that are struggling in our communities who are cancer patients, who are patients dealing with diabetes, but do not have the ability to go across the street to the health centre and see a nurse. Little things like that make a difference in our small communities. Having the security and knowing that if I don’t feel good or I’m not well, that there is going to be care provided for me in my home community.
There was a big step a number of years ago to implement mental health addiction workers throughout the Northwest Territories to ensure that that was one way of providing some means of services to our 33 communities. But what happened there is you gave it to the policy people in regard to drafting up the criteria and the formula for what type of mental health workers you need and basically the qualifications they’re going to need. They made it so stringent that our local people could not acquire those jobs, which they used to fill prior to the decision to take back to the Department of Health and Social Services and were not able to provide those services in our communities because you couldn’t find the people with those qualifications to move to these isolated communities and know that basically the quality of wellness or community security was not there. You don’t have policing. You don’t have a backup system in regard to a nurse. When you don’t have basic housing in regard to those communities, we continue to be dealing with external or internal pressures to deliver services, but we do nothing by way of finding ways to bring down those pressures so that we can physically see programs and services being delivered in our communities.
Mr. Chairman, I think it’s about time that this government seriously looked at what’s wrong with our health care system. The problem is it’s top heavy. You spend more money on administration by way of operation administration than actually delivering health care on the ground. I think, if anything, that we do have to start reeling in some of those administrative expenditures and put it where it’s needed by way of your front-line workers in communities, on the ground, so there are actually health care providers providing health care in all communities in the Northwest Territories.
More than ever we’re seeing the effects from First Nations’ communities to the health and well-being of communities, regardless of their diets, their diagnoses in regards to more and more cases of diabetes. Simply a lot of that has to do with a change in diet.
We’re seeing a problem now that we’re debating here in the House in regard to caribou. You can’t simply take an aboriginal person or a person who has always, all their lives, depended on that as their main supplement for their diet. You have to realize that people depend on country foods as their main staple for maintaining their health. But what we’re seeing is that it’s harder and harder, and people are struggling to be able to have those fresh caribou or fresh fish or fresh berries that they basically have always depended on as a means of sustaining themselves, and having to deal with store-bought foods and products which have high traces of sugars and whatnot and that are having a direct effect on our aging population.
The other area that I think is important for this government to seriously look at, and I know that it’s been some time since we actually built health care services for seniors by way of improving the seniors facilities in our communities, seniors care homes, and also the level of seniors’ care in regions and communities that can definitely display that there is a high need for seniors’ care in those communities than simply having to send seniors to regional centres and finding ways to retain the seniors in our home communities so that they can be close to family, their friends and, more importantly, communities that they grew up in. I think, as a government, we do have to work with the Housing Corporation and Department of Health and Social Services to find a way to implement that program.
I, for one, feel that this government has to do more to deal with substance abuse. We used to have alcohol and drug treatment centres in the Northwest Territories. We’re seeing the problems with substance abuse. We’re seeing the problems with hardcore drugs, regardless if it’s cocaine, crystal meth, and also the problem in regard to addictions and the effect it’s having on the whole Northwest Territories and not having the options or alternatives that people can turn to and having to send them south for treatment.
There were a lot of federal dollars you mentioned in your budget in regard to federal initiatives, but I think one that hasn’t been mentioned is what’s going to happen in regard to the Aboriginal Healing Foundation funding, which again is ending this fiscal year, and looking at some alternatives to support those organizations that have done some great work in our communities by way of accessing this federal program and federal initiatives, regardless if it’s through Health Canada and whatnot. I think it’s essential that we do have the means and the abilities in our communities to cope with the day-to-day pressures of just dealing with the stresses of living in small communities, but also being unemployed, looking at the social and economic conditions that a lot of communities are in. Again, it’s something that I believe this government has to take ownership of.
One of the areas I hear a lot of in regard to my region is the lack of dental care in the Inuvik region in regard to children who basically are having effects in regard to their dental care. Children who should have braces but aren’t able to because there’s no one in the Inuvik region that can provide them with that expertise. It’s been some time since they filled those positions. But I think dental care is just as important as health care and, if anything, that we do have to ensure that the well-being of the residents is taken care of throughout the Territories. I know that from talking to a lot of parents where a lot of parents are stuck in the position of having to pay their own way to southern dental professionals when dealing with braces and whatnot, and also having to pay the cost of sending their kids either to Yellowknife once a month at their cost. They’re bearing the costs of this, which isn’t cheap. But yet that service should be provided, especially in the major centres to serve the regions, and not have to put the burden on the parents to take care of that cost in which now they’re having to do it for the well-being of their children.
Mr. Chair, in regard to the area of services in communities, I think that we do have to do everything that we can to ensure that we do provide services and not simply say, well, it’s the Minister’s responsibility or department’s responsibility and sort of it’s up to the health boards. Again, for the health board in the riding I represent, it’s going on five or six years that this health board has been running a deficit. It has not been filing any financial statements, has not been showing its public responsibility for accountability by financial accountability to not only this House but the people of the Northwest Territories. If you’re not providing services by way of your responsibility, again, I stated earlier, that the Minister, through ministerial responsibilities, has to either take back that responsibility, take back those dollars and find a different instrument of delivering that service regardless if it’s through an NGO or through another means or through their office to ensure that services are being provided. For me, that’s the biggest concern I have, is that I’ve seen too many good people go to the health centre and find out a couple of days later they’ve passed on because they either waited too long or they were misdiagnosed or they basically were prescribed a drug that they shouldn’t have taken and it has caused death. I think as a government we are responsible to ensure that we do provide health and social services to all residents in the Northwest Territories and ensure that we don’t have these situations where families are grieving over a family member because they weren’t taken care of. Thank you.
Thank you, Mr. Krutko. We’re on general comments. Mr. Jacobson, were you raising your hand? Mr. Jacobson.
Thank you, Mr. Chair. I really want to echo on what Mr. Krutko was saying in regard to misdiagnosis, people not being sent out in time in regard to cancer. In my communities that I represent, we’ve seen a lot of death in regard to cancer because of misdiagnosis and other certain illnesses that our staff is not basically passing along information as simple as travel to getting them down to their hospital appointments in the South.
The last 18 months I think in the communities we’ve been really hit hard with doctors’ visits and not seeing any doctors, no dental. You know, the eye doctor I think you get once a year. It’s really come down in regard to the quality of health care in the communities. It has come down a lot in regard to what we’re used to. I think our Minister and her staff in the Beaufort-Delta should meet in regard to getting a game plan and a go-forward for providing health services in the communities. It’s got to stop in regard to the lack of. It’s easy to sit down here with all these books and papers, but when you’re seeing it firsthand, Sandy, or Ms. Lee, where people are, if not dying, they’re getting sick and being sent away, and for them it’s almost a death sentence in regard to the service that is provided. I don’t mean to put it in those broad terms, but it’s true. I’ve seen a lot of good friends go this year that shouldn’t have been deceased. So it stirs up a lot of issues in regard to the service. I mean, I know you are doing your best, but the Beaufort-Delta has to really start coming onside and providing our communities with the services that we need, and not just sending them into Inuvik. We’ve got to have nurses in the community for proper checkups and day-to-day stuff.
Mr. Krutko has brought up a lot of good issues in regard to that. I won’t mention them, but I think we have to really start working a little bit harder than what we’re doing and go and visit up north. So for me, that’s it, Mr. Chair. I look forward to a page-by-page on this Health and Social Services.
Thank you, Mr. Jacobson. Next on my list is Mr. Menicoche.
Thank you very much, Mr. Chair. I just wanted to speak about Foundation for Change a bit. I know that the Minister brought it up in her opening comments and she’s absolutely correct that it did go to committee. One of the biggest changes for me in the Foundation for Change was looking at community nursing. It’s been something especially high on my agenda for the community of Wrigley. I look forward to seeing that change. I know that it took a long while to get to this stage, lots of barriers to overcome, including return of policing to Wrigley was part of the equation and with the help of my colleagues we are able to at least have some manageability about that. So with the Foundation for Change it’s not only Wrigley, there will be hopefully some increased services. I’ve got six small communities in my riding and we do have aging populations out there and I’d certainly like to see increased care for our residents in all our communities. So I certainly support the planning around the Foundation for Change document, because it does include some resources here in our main estimates.
As well, I just wanted to also bring up that residents continue to be concerned about language, and cultural training should continue to be part of any new staff or even for our long-term staff, at least every couple of years should be at least mandatory training, because our elders are going there and I keep telling people that their language is limited in English and culturally we often say yes. When a nurse or doctor is saying “is everything okay,” they’ll say “yes” or else, “do you want to take these pills,” they’ll say “yes,” because they’re trying to be nice, but they’re not really understanding what’s going on when, in reality, after they leave they’re telling people that they didn’t have an adequate checkup or adequate care, that they were given Tylenol and were turned away. So those are some of the things that I think we must continue to do in the health care system, is to ensure that our elders and our non English-speaking people have the best care available as well, and to make sure that they understand the process and that they understand the system and the technicalities of what’s being taught to them.
Along with language, of course, is the medical terminology training that’s required for our dedicated staff that are translators and interpreters in our health centres and in our hospitals. So that’s continually got to be part of the training system, I believe, Mr. Chair.
A couple of my colleagues spoke about cancer rates and it’s continually a concern and in my communities we’ve got to find a way to address it and see is there a root cause that is going on with increasing cancer rates. There are people in my communities, too, who have lots of people and elders dying recently, and mostly of cancer. I have been looking at doing a Member’s statement later on this week about that. With concerned community members, they do believe there may be a trend. If there is a trend, then there must be a way in our system to help monitor that or confirm it and see if, indeed, there is a root cause. Lots of people are concerned, too, that the root cause may be from many years ago, an incident or chemical; or is it current? That is something that we have to look at and not be afraid of looking at it, Mr. Chairman. We have to have the courage and conviction as a government to see if there is a real trend out there, if there is a real root cause. We will have a real good look at it and not just accept the fact that cancer happens. Sometimes it can be prevented. We know it can be prevented. Then we must have a real good look at it. Those are some of the emerging issues that are coming from my communities. The department has some huge challenges in terms of finding funding and getting their fair share of funding from our government for programs and services that they do deliver.
I think that, despite the forced growth, it is kind of like it has to be done, but I am sure it can be monitored. But at the same time, reduction of any programs and services, especially in the health field, is going to have to be monitored, because we don’t want our people affected and not having our services or the ability to travel. They certainly need that, Mr. Chairman.
That concludes my comments on the opening comments of the Minister. Thank you, Mr. Chairman.
Thank you, Mr. Menicoche. Next on my list is Mrs. Groenewegen.
Thank you, Mr. Chairman. I am going to take a little different tact here when it comes to the Department of Health and Social Services. I think we have a system that can be adjusted, that could do better, I am sure. Every community should have a nurse and everybody should have access.
But overall, in general terms, as a government we are spending $326 million on health and social services for 42,000 people in a remote and often rural part of Canada. It is a very big challenge, but I think for the most part we have a Cadillac version of health and social services here in the Northwest Territories.
One thing that irks me is how many times we have to spend a lot of money to come up with some program, some plan, some doctrine to follow when the things that we need to do in terms of basic services to people is pretty straightforward. I know we get often into a lot of other specialty kinds of care and programming. That is fine, but I guess I have been around for a long time and now we have a Foundation for Change. I remember when I was Minister of Health, it was the Cuff report and we were going to integrate and we were going to come up with areas of specialty in the communities. It just seems like we have always got some expensive little road map in our hands that makes us happy, when in fact the needs of the people in the Northwest Territories are pretty straightforward. But I think we have a lot of professional, caring, concerned, genuinely dedicated people out there in our communities on the front lines, with the exception… And I do not wish to pay any disrespect to Mr. Krutko’s concerns or Mr. Jacobson’s concerns about access to health services in their communities that they represent. I don’t want to pay any disrespect to that, because we are fortunate in larger centres like Hay River and Yellowknife where you can walk into a clinic any time of the day or night and somebody is going to take care of you. But for the most part, there is no one that this government would not fly from the ends of the world to get to Yellowknife or Edmonton or any place where they could receive health care services. I don’t believe that apart from some logistical things, like I said, which my colleagues have referred to, I don’t think that this government is trying to deprive anyone of very high quality services when it comes to their health.
Now, having said that, if I were a health care provider and serving in that area in the Northwest Territories, I think it must be frustrating for them as well, because the fact of the matter is there are a lot of people in the Northwest Territories, a disproportionate amount of people in the Northwest Territories who are involved in activities which are detrimental to their health and to their well-being. They know the things they are doing are detrimental to their health and well-being and yet we send people out.
Mr. Chairman, you didn’t set my timer so I am now out of time. I have only been speaking for two minutes. Not even two minutes; one minute.
Thank you. I don’t often go on and on in Committee of the Whole.
You might have noticed, but this is something I just feel strongly about, so let me say it. A lot of people out there, a disproportionate amount of people are out there in the Northwest Territories are doing things which are detrimental to their health and well-being. They know it. I don’t know how far we as a government can go to stop them from doing it. We can create awareness. We can talk about nutritious foods. We can talk about smoking cessation. We can drop the pop. We can do all of these things, but, at the end of the day, people have a personal responsibility to make a choice about how they live and how they live in relation to their health and well-being.
I’m not pointing fingers at people. I could live more healthy. I can exercise every day. I know that if I exercised every day, I would probably prolong my life. For the sake of my grandchildren, I should probably do that, but I am not doing it so I am talking about myself too. I read all the statistics about working too much, having too much stress, overeating, not exercising. I know all that stuff too, so I am in that guilty boat too, so please don’t think I’m being critical or judgmental here. But if I was a health care professional and I had people coming to see me that said I’m borderline diabetic but I drink 10 cans of pop a day… I mean, just look at the numbers of the amount of soft drinks that we consume in the Northwest Territories. It is in the millions of containers in a year. We know we have this emerging issue with diabetes, but if people still want to drink stuff that has 50 grams of sugar per serving, then what are we going to do as a government?
We can be running after these issues and trying to catch up with the problems but, you know, when I hear people talk about cancer rates, it is no different here than in any other part of the country. I don’t believe the cancer rates are higher than any place else. Somebody said that the elders are dying of cancer. You know what? Everybody dies, and everybody dies of something. Seriously. You have to die of something. You could be just fortunate and just go to sleep one night and not wake up. Generally speaking, everybody dies of something. When you are old, quite often you die. Absolutely.
---Laughter
For sure, you will die. Anyway, I’m not trying to be facetious, but our government is supposed to be the underpinning of a safety net in the area of health and social services. We are there to aid and help people, but we have got to have people who want to help themselves as well.
A lot of the money that we spend is in health and social services. It is really not because of lack of awareness. Some people get sick too, and some people don’t want medical care. Sometimes we say, well, that person didn’t find out they were sick until they went to the health centre. They died two days later. You know what? Some people know they are sick and don’t want to be treated. They do not want to be interfered with. They do not want to go through being taken away from their family. They don’t want to be a part of that. You hear that a lot. I understand that. Some people notice it and they just don’t want to deal with it.
If I was sick, I think I’d want to deal with it, but some people don’t, for whatever reason. I don’t think that we can take all the ails of the Northwest Territories and beat up the Department of Health and Social Services and say we’re not doing enough as a government to try to meet the needs of the people. That is not something that I believe. I know there are glitches. I know there are things that happen sometimes that don’t make sense and in a Territory this small, if we get a situation like that and we have a constituent like that, we have the ability to talk to our MLAs. We go to the Minister. We say, hey, there’s something that’s not working here. There’s something that’s a problem here. Somebody was, somebody fell between the cracks, so to speak. We even get a response to those issues.
So I am not saying the system is perfect. I wish we spent more of our money doing the stuff that we know needs to be done rather than creating books that talk about it and lay out plans. I think everyone knows that I think we spend too much money on that kind of thing. I think we have to put this in the context of a relatively small number of people in a fairly far flung region of the country and we, as a government, are doing the best we can to meet the needs of that diverse and remote population. When you compare what we have to fall back on in the area of health and social services compared to anybody in the world, and I will say anybody in the world, we have got what is attempting to meet the needs of those people.
Again, I say with no disrespect to my colleagues who represent small communities where I would rather be spending money to put nurses and social workers in those small communities than I am to produce another report called Foundation for Change, okay? I want my colleagues to understand that. I want as much money to go to those frontline, basic services as possible, not specialty kind of boutique study things. All those kind of soft things that aren’t at the heart of delivering the services right to the people right on the front lines, we could do better in that area, I believe. But I think the intent is there, the financial commitment is certainly there. What we need, I think, from people to a large extent too, is commitment from people for their individual choices, because I think our medical system is dealing with a lot of people who are doing a disservice to their own health. I think we all have a role to play in addressing that. The government can’t fix all your problems and you can’t go to the doctor after you’ve used and abused yourself your whole life and say fix me, I’m sick, because it just isn’t possible. So that’s all I have to say. Thank you.
Next on the list is Mr. Bromley, Ms. Bisaro, Mr. Yakeleya. Mr. Bromley.
Thank you, Mr. Chair. If there is still time to get this in before we’re done here today... I’m just kidding.
---Laughter
First of all, I wanted to say that I also recognize from the Minister’s comments this is a huge challenge. The costs in many of these areas are going up and some of the areas are beyond our control. I believe we spent about 25 percent of our budget on health and I suspect, based on my rusty knowledge of other jurisdictions, that it’s even been higher in other jurisdictions. Given the challenges that Mrs. Groenewegen has highlighted, that’s some sort of a marker that we’re doing not too badly, but clearly the challenges are rising.
I wanted to mention I really appreciate the support that the department is providing to some of the things like the social services child and family services review. That’s important support and it’s nice to see the consolidated primary care clinic coming to fruition here soon, I believe right about the new fiscal year.
I am concerned about some of the costs that we need to be planning for in terms of delivery that are required if all of the Joint Review Panel’s recommendations are approved by the NEB. I believe there are additional health care services as well as drug and alcohol treatment programs and facilities, et cetera.
Certainly we are facing the same trends in demographics. I am very happy to see the Alzheimer’s facility coming on stream here soon and I am interested in knowing how that will serve the need out there. I don’t know exactly what the capacity is here. I think we will be hearing about that soon and celebrating that facility, but what is the capacity of it in relation to the need that is out there and where are we headed on that given this changing demographics and trends?
The Minister mentioned rising health care costs, especially in pharmaceuticals. We know that in the western jurisdictions, the Premiers have agreed that they should get together and start purchasing drugs to help reduce those costs. That is an opportunity that I hope we are aggressively pursuing. Technological advances in health care, and again, we see amazing amounts of money going out the door for those technological advances. Some of those are real issues, others are things like handling information and so on, and I am starting to wonder how much we need with a population of 42,000. We can’t come up with some system by throwing half the amount of dollars at people instead of new computers and software, if we couldn’t actually make some savings there as well as some other benefits, and chronic disease.
I think many of the things Mrs. Groenewegen mentioned that I had on my list were about prevention, a focus of this Assembly, and I see the role for other departments to be integrated with health and social services here. We are doing some of that. But I think, again, as I mentioned earlier today, there are some real opportunities for integration with ECE programs, Justice, MACA programs, for example, ENR on the environmental side. The Foundation for Change is something we have heard about and we are supportive of and I am looking forward to more discussions on that as it gets initiated and towards full implementation. But we have a record of such new thinking and strategies that have not been brought to full realization in the past and I know there is a nervousness amongst the public that here we go again, sort of thing. I think that there is an opportunity to make some progress on these major issues the Minister has raised, but I want to know that the commitment is there to see it right through to the end so we can realize some of those opportunities.
Finally, of course, the loss of the Territorial Health Access Funding is a big one and I will be interested in hearing how we plan to deal with that. The Minister ended by saying that we will need to choose those programs that will end and those that we choose to go forward with. If we do not get that support in March, what is the process for that and how will the public participate, if they will? I hope there is thinking being done on that. I think it is no surprise that the federal government is in a pretty good deficit situation. It would be nice if this worked out, but it doesn’t hurt to start thinking about that right now early on. I will leave it at that. Thank you.
General comments for Health and Social Services. Ms. Bisaro.
Thank you, Mr. Chairman. I have a number of comments. Many have been mentioned already, but I will re-emphasize them with my own take, I guess.
Initially, I want to say that I totally agree with the Minister’s statement that the current spending of the Health and Social Services system is not sustainable. I’ve had concerns, I think, since I arrived here, that every year the total cost seems to go up. I do hope that over this next year it will be galvanized by the lack of THAF funding if it doesn’t come through, but I hope that the department is going to be looking at all aspects.
I think, as well, and I mentioned in my statement yesterday, I think the program review office is an area that can assist the department in trying to keep the costs down and look for efficiencies and so on. In, I think, the business plan it was mentioned that there’s a continual increase in health costs, particularly in the area of seniors as our general population ages and so on. So I’m interested, when we get to that part, to hear what sorts of plans the department has to try and deal with providing a continuum of care for seniors that isn’t going to break the bank, so to speak.
In terms of the Foundation for Change, I am supportive. I hope it’s not going to be another effort to produce another report. I hope that this is actually looking at how we can change our provision of health care and that we are going to be coming forward with something that we can actually turn around and implement in short order. We haven’t had an update on where that particular reform is going at this point, so I look forward to an update from the Minister of the Social Programs committee, hopefully, at some point in time.
One of the things I wondered in terms of the Foundation for Change is whether or not the board reform initiatives, and there have been some that are flying under the radar for the last little while, but whether or not there is going to be any changes, any board reform relative to health and social service authorities that’s going to have an impact on the budget. I don’t know if any changes have any impact on this upcoming, or if it’s going to be another year or so before we’re going to see that.
In terms of funding, I am extremely concerned about the possibility that the THAF funding won’t be renewed. I think it will be a huge blow. We’ve had some discussions at committee with the Minister previously and have been advised that the department is looking at a plan if that funding doesn’t come through. I would hope that those plans are well underway. I hope it’s not just empty words that, yes, we’re looking at things and they haven’t started yet, because March is not a very long time away. If we don’t have the THAF funding, if it’s not renewed, there are a couple of areas where I think we really need to seriously consider maintaining the service that we have.
I know the business plan talked about expanding midwifery services. Well, I don’t imagine that’s going to happen if we don’t get the THAF funding renewed. We need to maintain the midwifery programs that we currently have and not cut those.
The other area is in terms of nurse practitioners. I think nurse practitioners fit in with our change in thinking and going to primary care and community care. Nurse practitioners, those that we have, must be maintained, in my view.
A couple of things in terms of the budget in general and the business plans: I’m supportive of an increase in respite funding for provision of respite to parents who are caring for children and need the respite. I’m very supportive of the implementation of the Family Violence Action Plan, Phase II. It’s absolutely something that’s necessary. I think phase I and the beginning part of phase II have proven that it is a successful plan and program.
Another large concern for me is the Supplementary Health Benefits Program. We haven’t seen any indication of where that program is going. Presumably work is happening. That’s a huge expense. It adds to our health budget quite a lot. I don’t know that it’s indicated in the budget whether or not changes to the Supplementary Health Benefits Program are reflected in this particular budget. So I’m interested in finding out that when we get there, and also what sort of consultation and what progress there’s been on consultation.
I think that’s it, Mr. Chair. Thank you.
Thank you. Next on the list I have Mr. Yakeleya.
Thank you, Mr. Chair. The territorial health expenditures just run over $325 million per year. The staffing is about 1,257. We have our own health board in the Sahtu, which runs about a $10 million operation. When you look at the numbers here in terms of the amount of dollars that are spent in the Sahtu compared to some of the regions, knowing the Sahtu is deemed as an isolated region with the winter roads only going for three months of the year and a lot of fly-in/fly-out of the services there, when you look at other regions that have some of the communities that are along the all-weather roads, they seem to have the same budget. You’d think that regions that have fly-in/fly-out services, that their budget would somewhat increase in terms of the operations. But we seem to be on par with some of the other regions in terms of them running their health boards. I’m not too sure how funding is allocated in terms of the types of services we have from the different regions. I just noticed that in there and there’s probably a good explanation as to how our funding gets to... I’m just making an observation.
The other one I want to ask the Minister -- and Ms. Bisaro brought it up in her comments -- is the way that the government is going to look at hopefully secure funding to the transfers that have been in our budgets that are going to sunset. These are millions of dollars here, these programs. The federal government has so far indicated that they’re not going to entertain any type of agreement to secure them, and I think there is some discussion as to how do we seek millions of additional dollars to continue with these programs. It just means that there’s a shifting of how we deliver services in the North to our people here in Yellowknife or into our communities. Hopefully the Minister can give us some type of game plan as to what, for sure, she could say in the House, confidently, that we’re going to work on these issues with the federal government in terms of transfers that are going to be sunset. As Ms. Bisaro indicated, March is coming up and that’s something that we really need to look at.
Mr. Chairman, the issue of diabetes has been a growing concern of mine in the region. More and more people are being diagnosed, and more and more people could be possibly looking for some type of test in terms of the condition of their health, namely to see if they are on the brink of becoming a diabetic. For six years, Mr. Chairman, I know health has always been an issue here and it seems that the basic services of diabetes testing and diabetes care is very important to the people in the Sahtu and the service of health care in our smaller communities. We still need to deal with how health care is delivered in our small communities. They made some great strides in improving the services. In the community of Deline they have the telehealth supplies or operations there, but they’re not using it. What’s up with that?
I think that the telehealth was a good thing; however, it’s not being used. Even to put telehealth or something like that along that line in the community of Colville Lake. They don’t have an RCMP. They don’t have social workers. They don’t have a nurse on a regular basis like other communities. You know, people up there need services. They have to feel confident in this government that it’s going to provide these services. They have agreements with our health boards. There are agreements with the communities to provide health care services. They are making some difference in terms of the services, however, in this day and age it’s unacceptable to go to Colville Lake with 134 people and not provide some basic services, such as having a nurse there. You have people who are trained as laypersons with one day training here, one day training there. That doesn’t quite fit the goals of the Health department’s mandate here.
So these are concerns that I know my people want to see, hoping that one day we will see a presence of a nurse in Colville Lake, as I heard other communities like Tsiigehtchic, like their community, or other communities in the Northwest Territories.
We do want to thank the Minister for her Foundation of Change, because that gives us some hope, yet it’s still on paper so we haven’t seen the real work of it. The Foundation of Change does give us hope to see that we can do things differently in the Sahtu towards alcohol and drug programs, the structure and the governance of how do we deliver health in the communities, roles and responsibilities. Mr. Chair, as you have noted many times, there is expertise among people in our communities that can deal with wellness. They may not have a university degree or some western style of training; they have a degree in culture and a degree in how to work with people on the cultural basis. We are not utilizing these people in traditional methods of healing and wellness. We seem to be putting them on a pedestal when we want them, but we don’t want to use them in a formal sense of having these services in our community. We still rely on the psychologists or the medical practitioners.
A lot of people have told me that when they go to the health centres, a lot of the times they’re just given pills and told to go home. So services are not the same as in larger centres, and I know because I live in a community and I’ve experienced that.
So I look forward to this Minister rolling up her sleeves. We’ve got about 20 months left in this Assembly to see what big changes we can do. I will work with the Minister, and I said before in the House that she did a tour with us in the Sahtu and she heard our people speak and she knows what our needs are. So I want to say, Mr. Chair, that I look forward to going through the budget with her, looking to see where we can make some differences in the health care or in the social service area. Even that, we don’t have social services in one of our communities because of the housing. That is unacceptable. However, there’s lots of time to go through in detail and see what this Minister can do to improve some of the care in the Sahtu.
In closing, I wanted to ask the Minister later on in terms of how is she working with the Stanton Health Authority to look at how she can bring aboriginal foods into the hospital. Sixty-five percent of clients are aboriginal people and they survive solely on a lot of aboriginal foods we serve to them, especially caribou. They like that kind of food in the hospitals when they are getting well. So I’ll ask the Minister later on in terms of what her plans are in looking at the Stanton Hospital master plan development. Mahsi.
Next on the list is Mr. Hawkins.
Thank you, Mr. Chairman. I move that we report progress. Thank you.
---Carried
Can I have the report of Committee of the Whole, please, Mr. Krutko.
Thank you, Mr. Speaker. Mr. Speaker, your committee has been considering Tabled Document 62-16(4) and would like to report progress. I move that the report of Committee of the Whole be concurred with.
Thank you, Mr. Krutko. Do we have a seconder? The honourable Member for Monfwi, Mr. Lafferty.
---Carried
Orders of the day for Tuesday, February 2, 2010, 1:30 p.m.:
Prayer
Ministers’ Statements
Members’ Statements
Returns to Oral Questions
Recognition of Visitors in the Gallery
Acknowledgements
Oral Questions
Written Questions
Returns to Written Questions
Replies to Opening Address
Replies to Budget Address (Day 4 of 7)
Petitions
Reports of Standing and Special Committees
Reports of Committees on the Review of Bills
Tabling of Documents
Notices of Motion
Notices of Motion for First Reading of Bills
Motions
First Reading of Bills
Second Reading of Bills
Consideration in Committee of the Whole of Bills and Other Matters
Bill 2, Forgiveness of Debts Act, 2009-2010
Bill 4, An Act to Amend the Child and Family Services Act
Bill 7, An Act to Amend the Summary Conviction Procedures Act
Tabled Document 62-16(4), Northwest Territories Main Estimates, 2010-2011
Minister’s Statement 47-16(4), Transfer of the Public Housing Rental Subsidy
Report of Committee of the Whole
Third Reading of Bills
Orders of the Day
Thank you, Mr. Clerk. Accordingly, this House stands adjourned until Tuesday, February 2nd, at 1:30 p.m.
---ADJOURNMENT
The House adjourned at 5:59 p.m.
