Debates of February 14, 2011 (day 38)

I have to go back to the opening principle of this budget, which is we do not have a whole lot of new initiatives. So we do not have anything new, I don’t think, than what was there before.

Having said that, the Dehcho Health and Social Services Authority is working on a traditional healing project. We are looking to see what... It’s a study on how to apply some of the traditional practices into modern medicine. It’s not to replace modern medicine but to make more traditional healing practices compatible to modern medicine. We expect that will be done shortly and we need to look for ways to apply that across the other authorities. It’s something I’ve been speaking on with the Joint Leadership Committee and the other chairs. We have different projects going on. We have traditional healing work going on in the Deh Cho and then we have some of the child protection work that are more sensitive to Aboriginal culture and Aboriginal practices in the Tlicho that we want to share across the board. That’s where we are with that topic. But it will require some investments, as well, to apply that across the board.

Again this is a stated objective of the department, so I’m assuming there is an intent to work in this area. There are some things happening, obviously, which I’m happy to hear about. If there’s a plan in place, I think we can usually make better progress. I think experience has shown with a good plan in place than without one in place. I’m just raising that issue. I’ll leave it at that.

Thank you, Mr. Bromley. No question, more of a comment. Would the Minister like to make a response?

Thank you, Mr. Chairman. I would not disagree with that. I just want to note that Foundation for Change action plan has a number of priorities and objectives. It’s a three-year plan and there are some areas where we are able to fund it, but we have made it clear from the beginning that those are planned, those are what we want to do, subject to finding resources.

Thank you, Ms. Lee. We are on page 8-29. Next on my list for page 8-29 is Mr. Hawkins.

Thank you, Mr. Chairman. I’m not asking to go back, but I will provide some explanation on page 8-28. It explains what the programs are that enable individuals with special living requirements to stay in their homes, yada yada yada. I’m just curious specifically on page 8-29 how much is attributed to that specific budget line item. How is that further broken out?

Thank you, Mr. Hawkins. Ms. Lee.

Thank you, Mr. Chairman. Could we get the Member to restate that question? Page 8-29 and he was talking about persons needing assistance to live at home? I’m not sure; if he could give us more information, we could answer that.

Thank you, Ms. Lee. For clarity, Mr. Hawkins.

Thank you. Pointing to page 8-28, the last bullet. Programs to enable individuals with special living requirements, yada yada yada.

Thank you, Mr. Hawkins. Ms. Lee, he’s asking for a financial breakdown for that bullet, I believe.

Thank you, Mr. Chairman. That speaks to various programs that we have within the department which is funded to authorities to assist our residents who need special support. In Yellowknife we deliver that program through Yellowknife Health and Social Services Authority who funds to YACL and YWCA and other homes and facilities. Is the Member asking for a specific dollar amount for that or is that program criteria that he’s looking for?

I’m looking for the program funding. So in other words, the dollar amount. If the dollar amount, how is that particularly... How would that line item be broken out? It’s easy to say $5 million, but what does that actually interpret? Does it break off from there into further programming? Thank you.

That program is broken into different authorities and different programs. We will have to undertake to get that. We don’t have specific amounts that attach to that bullet. That bullet is a statement of programs and services we do provide. Thank you.

I’ll take the commitment on providing the breakout of how that statement is met through funding and how that’s budgeted under what titles. Thank you.

Thank you. We will get it to the Member. Thank you.

Thank you, Minister Lee. We’re on 8-29. Next on my list, Mr. Ramsay.

Thank you, Mr. Chairman. Try as I might, I was going to try to stretch things out a little bit and get some questions in on 29, but I’m going to seek unanimous consent of committee to go back to 8-21 just for a few seconds. Thank you.

The Member would like to return to page 8-21. Does committee agree?

Agreed.

Okay. We’ll go back to page 8-21. Mr. Ramsay.

Thank you, Mr. Chairman. I just wanted to follow up with some of the questions my colleague Mr. Bromley had and I know Mr. Abernethy had earlier during this session. It gets back to graduating nurses and the possibility of them gaining employment in some of our smaller communities where services are desperately needed. I just wanted to get some assurances from the Minister that the Community Health Nursing Program is going to be maintained. The reason I say so is because in letters that graduating students this year in the Northern Nursing Program... They received a letter in January indicating that funding was available for the Grad Placement Program for 2011 but it didn’t say anything about future years. Also, if you look at the academic calendar for Aurora College, there’s no indication that the Community Health Nursing Program is going to be run in 2011-12. I just want to get some assurances from the Minister today that that program will actually, in fact, be run, and how are we going to get some of the northern nursing grad students into that program and out into the communities working in the small communities. Thank you.

Thank you, Mr. Ramsay. Minister Lee.

Thank you. I’m going to invite my deputy minister to add details, if she feels they’re needed.

I think we’re mixing up a whole bunch of programs here. First of all, I want to say, because I received an e-mail from a student who was I think offended, maybe she was, that I was suggesting... She thought that I was suggesting that a graduate out of a Nursing Program from Aurora College is not ready to be a nurse. That’s not in any way what I meant. I think what we’re talking about is being practice ready. In any profession, whether you’re an engineer, lawyer, doctor, nurse or whatever, you learn certain things from school, but the practice at the community level or a hospital setting or public health or home care are a little different and we need to make sure that we support them through that. Of course, the nurses that graduate out of Aurora College are qualified to be a nurse. There is no question about that.

We facilitate our nursing grads through a Graduate Employment Program and our government is committed to facilitate them so that we recruit and retain as many of those grads to work in our communities in the North as much as possible. They’re going to be asked to give a preference of communities but they may not get to work exactly where they had asked for. But we are committed to hiring them anywhere in the Northwest Territories.

Community nurses, CHN is one program, but if given the right support and resources and mentoring we may be able to accommodate new grads into different authorities. That’s just everyday work that the department is engaged in.

The other thing we should keep in mind is that what Aurora College provides has to be in line with what the health care system needs. We provide funding to HR and ECE to deliver these programs, but I think it is totally acceptable and expected that we review these programs to make sure that people we train are in line with what jobs are required. As I said earlier, the Foundation for Change action plan has a vision for more home care workers and home support workers and resident aide workers. Those are really good community-based jobs and counselling programs. There are lots of human resource needs that we need to marry up between the Department of Health and Social Services and Aurora College.

We’re also aware that in the next three years we’re going to be graduating about 70 to 80 nurses. I think it’s reasonable to think that maybe we have tapped off on the number of nurses that we can hire and then we need to look at other programming. We’re saying, my deputy minister and Education and Aurora College, we’re going to review all of our training programs and see where, not all, but the programs that we are providing with our own money and make sure that we’re training the people we need.

I’m sorry for the long answer but I think it is important. We are looking at all aspects and we are committed to funding to 2012 and we need to work on where go from here with those training programs. Thank you.

Mr. Chairman, I know the Minister gave me a long answer, but it really didn’t answer the question that I had. That is, where is the CHN program, the Community Health Nurse Program at Aurora College in 2011-12? It’s not there. It’s not on the academic calendar. I’m trying to understand why it’s not there when the Minister is stating all the good reasons why it should be. That’s the issue that I’m bringing up, Mr. Chairman.

The Minister says she didn’t mean to say that northern nursing grads weren’t trained enough to get out of the program and into jobs. She might not have meant to say that, but that’s what she said. That’s why they’re offended. Because the Minister said, “I don’t think they’d be able to apply for a job from the website.” That’s offensive. That’s a program from the University of Victoria. A reputable, reputable school. The answer the Minister provided me the other day where she talked about the 11 grads last year, there were two of them that got jobs on their own. They didn’t go through the Graduate Placement Program, even though I think the Minister thought that 11 of them did. They didn’t. Two of them got jobs on their own. And you know what? Nursing graduates from universities across the country apply on jobs that are posted on websites across this country and get jobs. That happens, Mr. Chairman. Again, I think it was offensive what the Minister said the other day in regard to our northern nursing students and I think she owes them an apology, at the very least.

Again, I want to ask the Minister where is the Community Health Nursing Program. Why is it not on the academic calendar? I really, really want to know that. Why isn’t it on the academic calendar for 2011-12 at Aurora College? Thank you.

With all due respect, he is completely misinterpreting what I said about the website. Mr. Chairman, my answer was the grads coming out of Aurora College don’t need to go and respond to ads for nursing positions because we have a program that we are working with them, which is the Northern Graduate Employment Program. That has been set up for HR and so we have a separate path to facilitate them because we do want to work with them and we want to recruit and retain them. The question was why aren’t the jobs on the website so that they can apply, and my answer was they don’t necessarily have to do that, not that they can’t. Not that they can’t be qualified for the jobs. I think it’s important for this House to tell the grads that we appreciate you, that we are glad that you have gone through the Nursing Program for four years and we are here for you to work with you. I want to commit again that I told them and I wrote the e-mail back to the student to say that I have asked my officials and HR and health authority people to go there to talk to them so that they can have their questions answered.

CHN program is still there, but it is fully subscribed. We have people there already. We are not able to bring in any more new people at the moment, which is another reason why we need to review all of our HR training for health and social services. Thank you.

Mr. Chairman, I don’t want to belabour the point here, but Wednesday, February 9, 2011, page 19 unedited Hansard quote from the Minister: “They wouldn’t be, I don’t think, ready to apply to a job that is available on the website right away.” Those are her direct words from Hansard on Wednesday. Again, I think that is offensive. It is offensive to individuals who spent four years, and we made it a four-year degree program. That is an offensive line.

Like I said, the Minister, at the very least, owes an apology to those grads, some of whom won’t need the Graduate Replacement Program. I am not sure if the Minister understands that. They have practicums. They have been there for four years. They can walk into some positions and they should be able to apply on some positions. That was my point the other day.

Again, Mr. Chairman, I really am struggling to understand. I know the Minister says there are programs fully subscribed but where is it for 2011-12? It is not there. That is my point. It is not in the academic calendar. Who is going to be providing the program? Nobody. Where is it? It is not anywhere to be found, Mr. Chairman. Thanks.

Mr. Chairman, I don’t think it precludes any grads from Aurora College to apply if they want to. I think they noticed that there are not enough of them posted to apply. I want to let the Members know that we worked in the last year to put the students through the Graduate Employment Program and many of them were direct appointed. Those jobs were not advertised.

Mr. Chairman, I think our records show that the government is committed and it is incumbent on the students to work with us so that we could help them be placed into positions. There is a process and there are rules to follow. I understand that some of them are discouraged because the jobs are not on the website and we were simply trying to tell them that we are going to work with them within our system to maximize the opportunities that they have different paths than somebody walking into the Territories looking for nursing job might be faced with.

Second thing, CHN program, like I stated, is fully subscribed. The money was overspent so we were not able to bring any more grads into that. We are putting through the people that are involved in that program on their year two and we are going to continue to do that and see that program through. But CHN program has to be reviewed like every other HR program we have with respect to health and social services. Thank you.

Thank you, Minister. Next on my list is Mr. Hawkins.

Thank you, Mr. Chairman. I guess if we are on page 8-21, I would like to take the opportunity to ask another question under program delivery details. Medical equipment under $50,000 appears that the department is budgeting. It looks like a consistent budget just under a million dollars. Would the Minister help me understand this particular amount? Is it money spent under the departmental sort of as a broad spending initiative or is it actually money that is filtered down into the authorities and spent, well, for running the authorities? Is it department money or is it money further transferred to the authorities? Thank you.

Thank you, Mr. Hawkins. Minister Lee.

Mr. Chairman, that item is for the department. It is for evergreening. Thank you.

Mr. Chairman, that is fine. If it is just evergreening, are we talking about office equipment? It says medical supply. That is fine. I just wanted to make sure it wasn’t...

Seeing how I have the mike, can the Minister provide me some, maybe, examples of what they would define as medical equipment under this evergreening process? Are we talking about beds? Are we talking about those specific programmings? Thank you.

Mr. Chairman, we are not talking about office equipment. We are talking about medical equipment and it could be all kinds of medical things, but not beds, but small medical equipment.

Mr. Chairman, I appreciate that clarification. One of the criticisms I have heard from some vendors out there is that they are not able to compete in a fair and open manner. The reason I was asking is this authority money, they are pointing particularly at authorities to be specific but they are also referring to the headquarters potentially as being a problem in this particular area, where they are either sole sourcing or just going south and, of course, contracts are written in such a way that it really comes down to one vendor can only supply knowing full well that, of course, medical supplies that are a very specialized product whereas if you offer a Phillips product and only one vendor is being granted the rights to sell Phillips in the Northwest Territories, I guess that is a funny way of really writing a sole-source contract. Of course, the department, I am not in a position to say rightly or wrongly, but of course the department then refuses any other option from anyone trying to compete to provide a low-cost alternative.

Mr. Chairman, does the department have any types of substantiation that they can show that they are spending about a million dollars on northern vendors, giving them the opportunity? Are they able to demonstrate that these contracts for supplying medical equipment under $50,000, whether they be competitive or sole-source? Thank you.

Mr. Chairman, I believe the Member brought up that issue with respect to Beaufort-Delta and we had explained and we followed up on the Member’s request. We follow all of the purchasing rules. We have to follow the contract guidelines. We have to follow the northern preference purchasing policies. We follow all of that. Mr. Chairman, I don’t think that issue is alive. That was brought up way back when and I believe it was resolved. Thank you.

Mr. Chairman, I did follow that particular issue up. In essence, take my word for it, really, was a short answer to the long letter or long reply. I am asking if the Minister is very confident that they view this and they are able to stand by it, then it should be no trouble providing some factual detail. That was the follow-up information that I asked for some time ago, perhaps maybe a month ago or more. I have yet to receive it. It is difficult getting back to people when they ask these questions and then you disappear for such a lengthy time or what the Minister says is basically they follow the rules. In essence, it shouldn’t be that difficult to provide. Will the Minister provide that material and detail of those types of breakdown? The Department of Health has provided this information in the past, so I know it is viable. When Minister Miltenberger was Minister of Health at the time, I had requested that level of detail and the authorities quickly complied and certainly the department quickly complied with that request. Thank you.

Mr. Chairman, I am not aware of a request that he has made that we haven’t responded to on this topic. I know he brought it up about Beaufort-Delta and we followed up in writing. I could tell you, Mr. Chairman, that the purchasing of medical equipment has been done through public tender. There are some standardized, mostly public tender or standing offer agreements in one case, but mostly all public tender. It follows the guidelines. All the northern businesses are allowed to bid on them. There are some standards that the authorities require and a lot of purchasing is done through Stanton Territorial Health Authority, who also purchases for Sahtu as a contractual arrangement. Thank you.

Can the Minister provide that breakdown to demonstrate that? Thank you.

Yes, we could do that.

Just changing subjects but in a somewhat related manner, the Minister has mentioned that, I guess it sounds as if it is the department or Stanton that purchases items on behalf of other authorities, does the Minister’s office support any type of mark-up if it is Stanton, by way of example purchasing medical equipment and then selling it to an authority, do they support any type of mark-up on any particular product that is resold? Thank you.

Of course not. What we are talking about is Stanton Territorial Health Authority being a $100 million organization, give or take a few. Sahtu is a $10 million organization. They have been around for five or six years. So it is authorities working together and they do the buying activities with Stanton. So if you are going out to order, I don’t know, birthing beds, it is better if Sahtu just buys one and if, say, Stanton bought ten and one of them is for Sahtu, they don’t have to go through the whole new tendering and contract procedure. But I don’t think Stanton is charging extra money to Sahtu to do that. It is just neighbours working together, which we should do more of.

So the Minister is confirming that there is no administration fee or service fee whatsoever, in any form or other name, hereafter being charged. Is that what she is saying clearly in the House? Thank you.

Well, an administration fee is different than a mark-up. Thank you.

Alright. Same question; let’s just insert the work administration fee. Thank you.

I don’t know if there is an administration fee. I know that Stanton provides this service for Sahtu, so I could undertake to do that, but I am thinking that his meaning is does Sahtu have to pay more to get it through Stanton, and clearly that is not the case. Thank you.

The Minister almost said she would look into it. That is my question. Would the Minister confirm that if an authority is purchasing through Stanton, that they are not being charged a service fee, an administration fee or a mark-up fee? And feel free to find another like-minded semantic style of word to replace administration fee or service fee, but a fee is a fee in some form or another and I am curious, are they charging them just to help bulk purchasing or is there a hidden cost there somewhere that is being passed through to the authorities. If she would do some research and confirm that, it would be appreciated. Thank you.

I don’t know where the Member is going with this; I don’t know what his point is. The Sahtu Health Authority gets... They have their budget to run programs. There is some cross-work that happens between the authorities. Stanton might ask Sahtu to pay for some of the staffing time, but I would like to know what the Member is getting at. Thank you.

Thank you, Minister. Time is expended for this question, but I could put you back on the list, if you wish, Mr. Hawkins. Next on the list is Mr. Abernethy.