Thank you, Mr. Krutko. I did not hear a question there but, Minister Lee.
Thank you, Mr. Chairman. I’ll take the Member’s point, but I think it is really hard to get an accurate comparison to take one part out of the government’s budget, say from 1986 or something, and compare it to ours unless we used the same indicators. So I just want to say, modern medicine and health care have changed so we need to know what is included there. People in Tsiigehtchic, they are connected to roads which is different than some of the other communities in the Territories who are not connected by the road and they still get fly-in nursing service.
Mr. Chairman, I understand his objective, which is to enhance nursing coverage and other health care coverage, and actually services to a small community like Tsiigehtchic. I understand that. I want to tell him that I am committed to work with him to do that. I am glad that he said that a nursing service doesn’t have to be 100 percent nurses, because you understand that a community could need a lot of things. They need a wellness worker, they need a mental health and addictions person, maybe they need a community organizer. We understand that we can’t have six, seven, eight, nine, 10, perhaps, people doing all of it separately in a small town, but that is exactly what Foundation for Change is trying to do. We are trying to find efficiencies as a system, because we believe there is a better way to address, a better way in which we spend our health care and social services dollars, so that we could refocus on the communities and do community wellness work and say, okay, what does a community like Fort McPherson or Tsiigehtchic need, and have a dialogue with the community.
If you look at the Foundation for Change plan, that is part of our plan, because we understand more and more that we are going to have less nurses and doctors and other people there to recruit, but that doesn’t mean that our people don’t need that service. So we need to find ways to see how we can serve our communities better. That is part of our plan and, in the meantime, we are continuing to work on how to enhance nursing coverage and try to create a team of providers in a community like Tsiigehtchic, and that is our plan. Thank you.
It doesn’t seem like I am getting anywhere with this Minister, so I might as well just move a motion and get it over with and see where it is at. Mr. Chairman, I would like to move a motion.
Thank you, Mr. Krutko. I understand you have a motion to move. Please proceed.
COMMITTEE MOTION 19-16(4):
ESTABLISHMENT OF A FULL-TIME NURSING POSITION IN TSIIGEHTCHIC,
CARRIED
Thank you, Mr. Chairman. I move that the committee strongly recommend that the Department of Health and Social Services take immediate action to establish a full-time nurse in the charter community of Tsiigehtchic. Thank you Mr. Chairman.
Thank you, Mr. Krutko. The motion is being distributed. Next I will call for those who wish to speak to the motion. Mr. Krutko, would you like to speak to the motion?
Thank you, Mr. Chairman. The reason I am making this motion is, like I stated, this issue has come up year after year. It has come up at assemblies, it has come up in this House and I basically feel that this government has an obligation to provide secure services for communities. Among the essential services we depend on is health care and I think that we, as government, have to find ways of ensuring that those services are being provided fully, not part time or basically provided at random because of breakup and freeze-up.
I, for one, feel that this issue is almost touching on the grounds of the Charter of Rights and Freedoms and under the Health Act of Canada. The Health Act of Canada makes it clear, you have to provide health care services as a health care provider and that means in communities that basically require that service.
So I would just like to ask my colleagues for support on this motion. I know I’ve raised this several times, but this government has to do more to find ways of ensuring that those services are there for small communities, like I stated. From the information that I have, I provided to other Members, we are getting expenditures by way of service expenditures in the smaller communities than what we were prior to division. We were better off then than we are today and with less people and more money, you’d think we would be able to do more and ensure those programs and services are being provided.
I believe that we have to ensure that the people, regardless of where they are, have at least some basic functioning service being provided in those communities. Health care is key to the health and well-being of the residents of those communities. I think this government has to do everything it can and we keep using the argument, well, sorry, you don’t have the numbers, you don’t have the facilities, you don’t have this, you don’t have that. Well, if we don’t start doing it, we’ll never have any of that stuff.
So I think it’s important to provide these communities full health care services and so if there is a will, there’s a way. I know the Minister made a comment that if we are committed to doing what we say to improve the quality of life in communities, let’s do it. Don’t just say it for the sake of saying it. Let’s improve the quality of life in communities by providing services that are adequate to the function of those communities, especially health care being a core program for community health and the residents of Tsiigehtchic. Thank you, Mr. Chair.
Thank you, Mr. Krutko. To the motion. Minister Lee. No comments?
Question.
Question is being called.
---Carried
Committee, we are on page 8-17. Agreed?
Agreed.
Page 8-18, activity summary, program delivery support, grants and contributions, contributions, $15.039 million. Mr. Yakeleya.
Mr. Chair, the telehealth coordinators were funded by the authority agencies. I was just doing some checking and I know my regional health centres, all the communities have telehealth technology. In terms of the coordinators and operations of telehealth, it would greatly be appreciated that at these four health centres and health station, Colville Lake, that if this telehealth would be used for the people. Is this something that the coordinators are going to work on? I am not too sure of their job descriptions in terms of ensuring that...if I’m right. I do apologize. They talked about telespeech in 14 sites. I made an error here. I know for sure that Deline has telehealth. I can talk clearly on Deline. Any of the other communities in the Sahtu, I am not aware of them having telehealth services. I want to ensure that this is not delayed any longer.
Thank you, Mr. Yakeleya. Minister Lee.
I’m going to try to tackle this and if there is any technical backup, my DM can jump in.
Mr. Chairman, first of all, telehealth and telespeech, we’re not talking about two different projects. It really is a communication machine. It’s about delivering health care and related services like speech therapy through a TV screen connected to a service provider, whether it be a speech language therapist or a radiologist or even a physician. It is a distance health care delivery method. I can tell you that, I know for a fact, I saw with my own eyes new machines sitting in Deline, Good Hope, even Colville Lake. Actually, I think they’re looking for… It’s a beautiful, big, huge flat screen with mobile legs but, you know, the important part of this machine is what’s on the screen and how you bring the services together.
We don’t envision that this is the kind of thing where you need to have a separate coordinator in every health...(inaudible)...in order to deliver this program. It’s about incorporating this new tool into our health centres and health clinics, and how much we deliver through that would depend on the support and training and coordination that would have to go into each of the clinics. So that’s the picture of that right now. I’m going to ask the DM to just add one more thing there. Thank you.
Thank you, Minister. Ms. Meade.
So it is about using technology, but the Minister is correct in what the end application is. In Deline, when I checked this morning, and of course the rollout is being phased in so not all communities are on the same time, and this is why they’re using the coordinators across the system. These are not full-time positions in an area. It’s around the change management better used. But in Deline, you’ve used it so far for an OBGYN consult, you’ve used it for mental health and addictions counselling, there have been some consults with a couple of specialists and there’s been group counselling. That’s just what I remember from an e-mail this morning when we checked from yesterday. Have we used it fully yet everywhere? No. That’s part of the coordinator’s job, is not just about the equipment, but to help us with the change management and how we can continue to use all of this technology further and further so the outcome being the best care for patients and more connection with specialists or other providers as they need it. This, again, gets back to enhancing community delivery so people don’t have to keep moving to come in to see specialists. They can be supported in their own community this way. Thank you.
Thank you, Ms. Meade. Mr. Yakeleya.
Thank you, Mr. Chair. Mr. Chair, I would ask the Minister if she could provide to me a summary on the telehealth in terms of where that’s going in terms of the operations in the Sahtu. I know there’s telehealth speech in 14 sites and all the five communities in the Sahtu are going to be supported through that. The telehealth coordinators, if these machines are in use and they’re going to be used in other communities it will be much appreciated from this MLA in terms of knowing that we certainly can cut down on having our people get on these aircrafts to fly to other locations to be checked in the hospitals. So I want to know if I can get some information from the department in terms of some sort of a status update and plans going forward on the telehealth issue. If she wants to include the telehealth speech, that would be much appreciated, Mr. Chair.
The other one I wanted to ask is in regard to this page here, the primary community service funding for the seniors 1-800 line. They had the seniors advisory council, the Canadian National Institute for the Blind, NWT Council for Persons with Disabilities, Senior Games and Rick Hansen Man in Motion. The seniors feel that they certainly need our support and I know that they are doing a lot of good work. I want to ask from this Minister as she’s responsible for the seniors also, in terms of recommendations that the Seniors’ Society had on the implementation of those recommendations. From my recollection of these recommendations, I’m not too sure if we had a status report as to where this department is in terms of implementing these recommendations that these seniors put together some time ago.
Thank you, Mr. Yakeleya. I suspect there would be others interested in the regional updates on the telehealth and telespeech too, but… Ms. Lee.
Mr. Chairman, we launched that in a big way, I believe, last fall. So I would be happy to give an update to all the Members as to where we are on that and looking forward as to where we see going for the next year or so.
With respect to the support for seniors, as the Members are aware, the funding for the Senior Games came out of THAF funding and that funding is expiring. The NWT Seniors’ Society has submitted a proposal on how they would like to work with the government on providing support to seniors and creating an opportunity for the seniors to do healthy living. So we’re in the process of reviewing that and we will be making an announcement on that. Thank you.
My last comment would be directed to the Minister regarding the seniors in terms of future discussions. I know the seniors have been very active in a lot of the business of the GNWT. I make reference to the elders in the Sahtu region and the seniors in terms of their relationship to this government. Has this Minister, in terms of meeting with the seniors as her duties as the Minister responsible for seniors, had some discussions with the seniors?
Seniors can be elevated almost to another level of authority such as a secretariat for the seniors. Right now they’re an advisory council. There is funding all over in different areas for the seniors. MACA has funding. Housing has funding for seniors. Different departments have funding and the Minister tries to draw everything to them and say, okay, this is the responsibly of the seniors. However, has that type of discussion with the NWT seniors been introduced with this Minister in terms of that type level of authority, more establishing a permanent spot in the government with the seniors? That’s it for my questions.
I can advise you that I have, on a number of occasions, been invited by the NWT Seniors’ Society and I have met with them. We share a meal and we, sort of, have a roundtable and they tell me all the things that they want me to work on in terms of seniors’ issues. The NWT Seniors’ Society has membership. The board of directors has membership from all regions of the Territories. They did bring up the issue of a seniors secretariat and they have told us and, in fact, they have written to us to say that they understand that the resources are limited. They understand that to create an infrastructure, a junior department of seniors, would involve money, and, if they had their choice, they would like those dollars to go to seniors programming rather than a secretariat. They have communicated that to me. So that is their position on that issue. Thank you.
Thank you, Minister Lee. Next I have Mr. Hawkins.
Thank you, Mr. Chairman. Mr. Chairman, just following up on the issues raised under the telehealth, understanding that we have 14 of the units out there, could I get some detail as to how many of the units have service operators and what type of training those individual service operators receive? Thank you.
Thank you, Mr. Hawkins. I’ll call on Deputy Minister Meade.
Thank you. Actually, this is pretty basic equipment and once the initial training is done, as far as turning the machinery on and making it available, you don’t need to have on-the-ground actual users. They’re supported by the department. They’re supported both virtually through the connectivity of the system, but also through Help Desk and things that we set up. So it’s not about providers, it’s about the front-end training and then the ongoing monitoring around how else we can use it. Is there enough uptake? What are the training needs and the changed management needs really so providers are comfortable? It is not about on-the-ground once you have it up and operational on the initial training which we are providing through the department, I should add, and supported again also nationally through organizations like Infowave funded by the federal government.
Mr. Chairman, does the Minister know how many of the 14 units are used and how often these 14 telehealth units are used? Furthermore, whom are they used by? Are they used just by Health or are they used by other departments in some conjunction agreement?
Thank you, Mr. Hawkins. Minister Lee.
Mr. Chairman, as we indicated before, this is relatively new and it is being used in different ways by different authorities. It all depends on the service requirements, the interest even on the part of the people on the ground. I have visited different centres where, for Inuvik for example, they couldn’t say enough about this machine and how much it has helped them. The picture is quite buried all across. It is like any time you introduce a new technology into your service delivery, the uptake and the use is different depending on the regions and the places. I don’t have updated information on exactly what the use is on that, but we will obviously be monitoring and evaluate to make sure that device and that tool is used as much as possible. Thank you.
Mr. Chairman, I am wondering if the Minister knows which two units have been in use the longest. I am referring to outside the Stanton Territorial Hospital. What type of services have primarily been focused in on and how many hours were they in use? Thank you.
Thank you, Mr. Hawkins. Ms. Meade.
I think, first of all, it would be fair to say that I don’t believe that the Health Net that we have so far begun to roll out is used to its maximum. The potential for its use is only just being recognized by our providers and collectively at the CEO table. The providers, in particular some of our physicians, nurse practitioners and community nurses, are very keen on being able to explore this. So the general thing that you see with most telehealth rollouts across Canada are telespeech, some tele-psychiatry where it is done on a consult basis of a case, child welfare case management. Those are the types of things early.
Where you start to move is when you start to do actual treatment. So group therapy, individual therapy, we are starting to explore that in a few areas.
Uses are just beginning. What we do is actually look at uptake. It is quite a drilling down and it is technical spot checks to see. Trying to get the information to be able to make it translated beyond the technology is a bit of a stretch. I think that is fair to say that we are moving it out as quickly as we can and we are moving to change management, but we think we have only just begun to see how much more we can use this equipment.
My recent discussions with emergency physicians at Stanton, we think that actually the on-call physician and start to do consults to some of our community nurses. This was an application not envisioned when we started to roll this out and how the on-call physician system can be linked.
I think it is better to say this will become more and more a critical component of our future delivery, so I am not answering the Member’s questions as far as how many hours so far because we haven’t even begun to envision how many hours we actually could start to use this as we get our culture and our providers trained up and understanding the potential.
Where we have locum physicians coming from other jurisdictions that have full eHealth systems, they are very excited and they are actually helping us introduce the other applications that we can use this for. A big one in Hay River where the Minister was there to announce eHealth was right there and then we had the first time where the labs and the X-rays were read with the specialist on one end in Stanton and the consult happening through Edmonton and right back to Hay River. The patient got good, immediate, in time, quality care without any transport. Thank you.
Mr. Chairman, I didn’t really hear much about how they have been used and how many hours they have been used. I would also like to reiterate that question in that context as well as what specific services have we noticed a trend emerging from our usage on this type of product. Thank you.
Thank you, Mr. Hawkins. Minister Lee.
Mr. Chairman, I understand his question. I don’t think we can get him that level of detail, in that I don’t think that right now we are keeping, okay, how many hours are we using this. The tools are out there. We are trying to provide the support and training so that more people will use it. As I stated earlier, we will be evaluating and monitoring this program and we will give an update and promise that to MLA Yakeleya too. I will give him a profile of where the machines are right now, where we are going to get more out of and what kind of services are being provided through these tools. Thank you.
I thank the Minister for that answer. Would that also include some updates as to where the status of training of individuals would be on that particular list? In other words, if all 14 units are farmed out, are all regions that have received this equipment that they have someone trained and qualified in order to be able to run the unit? Furthermore, would information be available to cite that we have people on board to help deal with problems so they can work with our informatics teams to make sure these things are up and running, that type of information? In other words, do we have qualified people to run these things? Would that be part of your information package?
Yes, Mr. Chairman. I can say we have qualified people running this. I will make a commitment to give him more information on how the services are delivered, where they are, what they are being used for and how the training needs are met. Thank you.
Thank you, Minister. Thank you, Mr. Hawkins. I have next on the list Mr. Krutko.
Thank you, Mr. Chairman. If I can, I wanted to talk about the orthodontist physician in Inuvik. I am wondering if it is okay to do it under this page or should we go back to page 8-16?
Thank you, Mr. Krutko. I think it would be appropriate to go back to page 8-17 for that. For that, I will need unanimous consent of committee. Do I have unanimous consent to go back to page 8-17?
---Unanimous consent granted.
So be it, Mr. Krutko. Page 8-17.
Thank you, Mr. Chairman. Thank you, colleagues. An issue that has come to my attention, especially for residents out of Inuvik and the Beaufort-Delta region, apparently they won’t have an orthodontist in Inuvik. Apparently there are a lot of children who require dental care, braces and whatnot. Without having an orthodontist in the region, a lot of them are having to expend a lot of their own dollars to fly their children to Yellowknife so that they can be seen by an orthodontist here in Yellowknife. As a department which is responsible for primary care, especially in the different regions, especially dental, it is important especially for younger people. I ran into a lady at Wal-Mart, in which her son was with her. Apparently his jaw is locked up because he didn’t see an orthodontist for so long that he has problems eating now. When it comes to that situation, I think that we do have to do everything we can to ensure that the orthodontists and those types of providers are provided in those regions so the parents don’t have to bear that extra cost of having to go elsewhere. So I’d just like to ask the Minister in regard to the orthodontist position in Inuvik: what’s the department doing to try and ensure that they make sure these programs are being delivered, especially when it comes to oral health and dealing with the orthodontist position for Inuvik? Thank you.
Thank you, Mr. Krutko. Minister Lee.
Thank you, Mr. Chairman. I know the Member is good, but I don’t know how he got dental care into primary care, but, anyway, I’d be happy to answer him with the information. This dental issue in general comes up everywhere I travel. It is a big issue for our community people, but it’s important for people to know that dental care is not a responsibility of the GNWT. It is not an insured service. It is the federal government that provides dental care to our aboriginal peoples. The non-aboriginal people in the Territories, they get dental coverage by their own insurance. Dental care is not part of health care.
Now, the GNWT does provide support to dental services in our regions. The problem we’ve been having is almost every authority, and that includes Inuvik, have had difficulties getting a contractor to provide dental service in Inuvik and the Member is right that there have been some parents with young children who need orthodontic services and other dental services and they’ve not been able to get them for the last little bit. I’m happy to note that a new contract has been signed and we do have new dental services being provided in Inuvik. So hopefully the lady that he was talking to at Wal-Mart and some other people that have been contacting us will be able to be processed as soon as possible. Thank you.
Thank you, Minister Lee. I think the window we had into this was through the oral health provision under this directorate division. Anything further, Mr. Krutko?
I’d just like to thank the Minister for that and I think that news maybe should go out by way of a press release, because I think there’s a lot of other people out there that would like to hear that announcement and know that action is being taken in this area. So maybe you’ve got a good news story tomorrow. Thank you.
Thank you, Mr. Krutko. Committee, we started on page 8-17. I find that we’re still there. Activity summary, program delivery support, operations expenditure summary, $31.936 million. Does committee agree?
Agreed.
Thank you, committee. Page 8-18, activity summary, program delivery support, grants and contributions, contributions, $15.039 million. Agreed?
Agreed.
