Thank you, Madam Chair. I move that this committee strongly recommends that the funding identified for the territorial midwifery clinical coordinator position be re-profiled and directed towards community program delivery initiatives.
Thank you, Mr. Dolynny. A motion is on the floor. To the motion. Mr. Dolynny.
Thank you, Madam Chair. I appreciate the ability to present this motion today to Committee of the Whole. I don’t want to spend a lot of time reviewing a lot of the items that were covered today. There was a lot of passion in this House with respect to midwifery. I do want to say, for the record, that I’ve had a long and promising affair, I guess, with midwifery in a way that most people don’t have. I mean that in the kindest sense. It’s late at night.
---Laughter
This is a Harlequin romance.
I was brought in early on in the infancy stages of the Midwifery Program and was part of the consulting team to put together the legislation for midwifery. I have a very long cardinal relationship with them in terms of understanding their needs and their scope of practice, their ethics and standards that they govern themselves by. They are quite a dynamic group of individuals, and over the years I have been very appreciative, having witnessed going through the process. These people are very, very value-added to our health care system.
It has been talked about in here that we want to look at developing territorial standards in relation to what we already have, and community standards. I think many of us have a hard time grasping that whole concept. We’ve got some very strong community-based programming right now that has done very, very well for us. I think Members here, as general public, really want to see the continuance of the community-based programs. Not to undermine the territorial aspects that the Minister is referring to, just that we do have a good program in place that we need to move quicker along the pathway that was clearly laid out in the March 2012 midwifery report.
The Minister also references the fact that there has been very little consultation. I, again, want to quote this on the fact that the March 2012 report was a compilation of many hours, many stakeholders to which the review and findings were tabled. That was with the collaboration of doctors, communities and stakeholders. To say that there was no consultation, that we’ve got a creative consultation process for a territorial model at this stage, really doesn’t bode well, especially with the fact that this has already been in place for a number of years.
I know the Minister has indicated he doesn’t want to rush into this. We do admire the stewardship of the Minister; however, there is a difference between not rushing into it and taking a snail’s pace to implement it. I believe the Members here are very adamant in our resolve to push this agenda not according to the department staff wants and wishes but to the wishes and needs of the community and the Northwest Territories. We’re hoping the department will understand and heed the wishes of committee and also heed the wishes of the Northwest Territories.
I could go at great lengths to support the re-profiling of this money but we’ve heard many of these arguments this evening already, so I will refrain from continuing with the same. With that, I am hoping we will get support for this motion.
Thank you, Mr. Dolynny. To the motion.
Question.
Question has been called.
---Carried
Page 8-23, Health and Social Services, activity summary, health services programs, operations expenditure summary, $198.582 million.
Agreed.
Page 8-24, Health and Social Services, activity summary, health services programs, grants and contributions, grants, $40,000, contributions, $152.528 million, total grants and contributions, $152.568 million. Mr. Yakeleya.
Thank you, Madam Chair. I wanted to ask the Minister when his department will begin bringing forward plans to staff health centres or nursing stations that are without nurses in communities. How many communities does the Northwest Territories have without nurses at their health centres?
Thank you, Mr. Yakeleya. Mr. Beaulieu.
Thank you, Madam Chair. This will be part of our clinical services plan which we earlier talked about having completed the review of the Integrated Service Delivery Model. We expect to have a plan by August 2013.
I look forward to the plan the Minister is working on and how we move this plan forward. How many communities are without a nurse stationed at their health centres?
We have eight communities that don’t have nursing services at this time.
So I look forward to this Minister moving with his other colleagues and looking at where these dollars are going to be spent for the upcoming years. We have eight communities. I hope the Minister can forward me a list later on as to which communities do not have health nurses actually in the community, so that we can look at some proper staffing of these communities with some of these basic essential needs such as the health nurses in our communities. In the same line I will be asking questions to the Minister of Justice on communities that do not have RCMP, what type of plans are in place to work towards filling these communities with some of these basic necessities that we expect today.
Long gone are the days when it was okay, but now with today’s standards it is not okay at this time in the year 2013. I just want to reiterate that the Minister is going to come sometime in August 2013 and I’m looking forward to some concrete plans where these eight communities would start to see nurses in their communities and not to be serviced by other communities on a one week per month date. I just wanted to let the Minister know I’m going to be looking forward to that and put him on notice that I will be doing some work for him.
I will commit to bringing our plan to the committee. As soon as we receive our plan on the clinical services for the communities, I will bring the plan to the committee.
Under medical equipment under $50,000, the funding for the minor medical equipment purchases, I wanted to thank the Minister of Health. One time when he went to Colville Lake, that certainly helped us with a dental chair. I believe it was Mr. Miltenberger who was the Minister of Health at that time. These simple things in our health centres that we have medical equipment that sometimes gets overlooked. Certainly, now the people in Colville Lake talk about that incident where the Minister had to come to the health centre to look at some of the equipment that we have there. They were second hand or hand-me-downs from other larger centres. The health equipment in our smaller communities certainly goes a long way towards medical care in some of the centres that we have. I look forward, again, to the Minister making some improvements in some of the smaller communities where even a kit for testing diabetes in health centres are some of the places that are certainly lacking in some of these basic medical equipment. I just want to again let the Minister know that whatever can help us in our small communities, we appreciate it. More of a comment.
We have allocated $13,000 to the Sahtu Health and Social Services for equipment under $50,000. In addition to that, the department has $3.1 million in the capital budget for minor medical equipment.
Thank you, Mr. Beaulieu. Page 8-24, Health and Social Services, activity summary, health services programs, grants and contributions, grants, $40,000, contributions, $152.528 million, total grants and contributions, $152.568 million. Mr. Bromley.
Thank you, Madam Chair. Just on hospital services, it seems like we’re really towing the line, and maybe even decreasing the budgets over time, for hospital services. Obviously, I think we are providing more services, the more medical procedures and so on.
I’m particularly concerned at Stanton where, as the years go by, we realize how poorly designed the hospital is for modern health care delivery in a hospital situation, how bad that is. So I can’t believe that we’re really delivering better care with this stagnant or declining budget. I’m sure we are gaining some efficiencies. Can I have the Minister just comment on this situation? Are our hospitals really getting by on less and providing the same services or are we giving up more services or some services despite covering a broader diversity of services?
Thank you, Mr. Bromley. Mr. Beaulieu.
Thank you, Madam Chair. The way the budget is laid out, if you’re comparing with the actuals, it looks like the budget has decreased, but if you compare with the mains, then you can see that there is a gradual increase. The reason the actuals are high is we have bumped up their budget on the redistribution of funding between all of the health and social services authorities, including Stanton. Some of the authorities that had deficits, we had moved money. We had an agreement with all of the authorities that we would move money around. This was the reason it shows as a bit of a bump up to $87 million in actuals for 2011-2012. If you come back to the mains or even the revised mains for 2012-2013 compared to 2013-2014 there is a slight increase.
Thanks to the Minister for those comments. I take his point there. My concern remains for Stanton. As the Minister knows, we had a tour of Stanton not so long ago, a matter of days or a couple weeks. I think there are some real obvious difficulties there. I guess I’m asking, how are we handling that situation and how is it not reflected in this when it’s clear that there’s a very inefficient delivery of health services at Stanton. Our needs are increasing. I think it was something like 20,000 when it was designed for 10,000 visits and it’s actually handling 20,000 visits now. If I could get some comments from the Minister on how we’re dealing with that situation. Thank you.
Thank you. We recognize that Stanton was not designed to handle the volume of visits, the volume of patients that they currently face. That is why we’re going through the planning and going through the capital budget to come back to the House to make some renovations, possible additions and reallocations of space in Stanton.
As far as this budget goes and the $84 million, the budget moving from the revised mains to what we have here as the mains, there’s a difference of $3.36 million and I would say that a large portion of that has been allocated to Stanton. Thank you.
Thank you, Mr. Beaulieu. On page 8-24 then, health services programs, grants and contributions, grants, $40,000, contributions, total contributions, $152.528 million.
Agreed.
Sorry; I didn’t read that line. Total grants and contributions, $152.568 million.
Agreed.
Thank you. Moving on to page 8-27, supplementary health programs, operations expenditure summary, $26.730 million. Ms. Bisaro.
Thanks, Madam Chair. I just have one question here with regard to the cost to us as a government for… We have many of our residents who are covered under the federal Supplementary Health Benefits Program, the NIHB program, and it’s always a mystery to me whether or not we top up the NIHB payments to us, whether we provide a service which costs us more than what we get back from the federal government and I’m thinking particularly of travel costs. So I’d like to know from the Minister whether or not this budget includes any funding, any expenses, which are an expense to this government to top up the NIHB coverage from the federal government. Thank you.
Thank you, Ms. Bisaro. Minister Beaulieu.
Thank you, Madam Chair. No, we don’t pay anything over and above what services are provided by them, the money that’s provided by them to cover medical costs. They pay us in addition to that an administrative fee to administer that NIHB.
Thanks to the Minister. I don’t know if this is a valid example or not, but I did hear somewhere that if NIHB only covers road travel from Yellowknife to Edmonton for a particular procedure, I would presume that we would not send the patient by road, we would send the patient on an airplane and are we then losing or gaining money with the cost from the feds based on road. Thank you.
Thank you. We are not familiar with any type of difference in what they would cover for travel and what we bill back. So when we bill back, when we have an NIHB client that travels, we bill back the actual to NIHB.
Thank you, Mr. Beaulieu. Next I have Mr. Dolynny.
Thank you, Madam Chair. The question I have for the Minister or deputy minister is: When was the last time that the department has done a full review of the Supplementary Health Care Program in terms of criteria and eligibility for payment for whether it’s appliances, prosthetics, drugs, medical expenses? Thank you, Madam Chair.
Thank you, Mr. Dolynny. Minister Beaulieu.
Thank you, Madam Chair. I don’t have that information on the date, but we think that review had occurred in 2007, but we can check to confirm that.
Thank you. Can the department indicate whether or not we’ve got systems in place to have formal reviews done in supplementary health programs on a frequent basis or is this basically an on-demand request from the department when need be? Thank you.
Thank you. The department does not have a regular cycle for reviewing supplementary health benefits.
Thank you. The purpose for my questions here is to show savings in design, and the Minister is fully aware that I have talked to him and I’ve talked to his department many times regarding the opportunities of savings within the framework of the Supplementary Health Care Benefits Program. It’s unfortunate that a lot of the recommendations and a lot of the opportunities for savings have yet to be looked at or implemented. Again, my question is: Is that savings in design, and if we have not looked at this since, as the Minister indicated, potentially 2007, would the department commit within the life of this Assembly to do a full audit or a full review of the Supplementary Health Care Program to find ways to save money? Thank you.
Thank you. We will attempt to get to that review when we’ve completed the other reviews that are in the books now. We’re hoping that we’re able to complete the essential reviews that we had talked about on the other items that we’ve discussed here today. So if we’ve completed those reviews, then we will begin this review. I’m not sure that I can commit to completing a review within the next two and a half years, but we will attempt to do that.
Thank you, Mr. Beaulieu. Next I have Mr. Hawkins.
Thank you, Madam Chair. On this particular section I’m just wondering, quite often the territorial government has been well known for providing more services than it covers and there’s always been a dispute between the feds about what billable services can be reimbursed. This is the right section, I assume, for that detail. and if it is, just in case, then how far is the gap or what are we in delay of payments, because it’s always been quite a known subject that we’ve been behind on NIHB return payments owed by the feds. So let’s start with that. Thank you.
Thank you, Mr. Hawkins. Minister Beaulieu.
Thank you, Madam Chair. There is no gap and no delay.
Thank you. So the Minister is saying that all our services that we pay under the NIHB program are completely paid up to date by the federal government and there has been no dispute on our funds and allocations of that? Thank you.
