Hearing none, we’ll move to detail. Minister, would you like to bring in witnesses? Yes, you would. I’ll ask the Sergeant-at-Arms if he could escort the witnesses into the House. Mahsi.
Minister, please introduce your witnesses.
Thank you, Mr. Chairman. To my left is Paddy Meade, deputy minister of Health and Social Services; to my right is Mr. Derek Elkin, director of finance; and to my far right is Mr. Dana Heide, assistant deputy minister of operations. Thank you, Mr. Chairman.
Thank you, Minister. Colleagues, we are on the Department of Health and Social Services. The operations expenditure summary on page 8-7, I’d like to request agreement that we defer that until after the detail and begin on page 8-8 with the Department of Health and Social Services, infrastructure investment summary. This is an information item. Does committee agree?
Agreed.
Moving to page 8-9, Health and Social Services, information item again, revenue summary. Agreed?
Agreed.
Moving to 8-10, Health and Social Services, information item, active positions summary. Agreed?
Agreed.
Thank you. Moving to page 8-11, Health and Social Services, information item, active positions, health and social services authorities. Agreed?
Agreed.
Thank you, committee. Moving to page 8-13, Health and Social Services, activity summary, directorate, operations expenditure summary, $7.678 million. Comments? Seeing no comments, committee agree?
Agreed.
Page 8-14, Health and Social Services, activity summary, directorate, grants and contributions, contributions, $35,000. Mr. Yakeleya.
I have a question for clarification. I want to ask the Minister, Mr. Chair, if the Tlicho cultural coordinator, is this part of their self-government arrangements in regards to this position. Thank you.
Thank you, Mr. Yakeleya. Minister Lee.
Thank you, Mr. Chairman. We don’t have that information. I’ll have to undertake to get that. Thank you.
Thank you, Minister. Mr. Yakeleya.
Thank you. I’ll wait until the Minister gets the information back to me.
Thank you for that, Mr. Yakeleya. So, committee, we’re on page 8-14. Ms. Bisaro.
Thank you, Mr. Chair. I beg your indulgence and ask if we can return to page 8-13.
We can do that. Does committee agree?
Agreed.
Page 8-13. We have Health and Social Services, activity summary. Ms. Bisaro.
Thank you, Mr. Chair. I did wonder on this page under details of other expenses, the purchased services has increased considerably from ‘10-11 revised estimates for ‘11-12. I just wondered if I could get an explanation as to why, please.
Thank you, Ms. Bisaro. I’d like to call on Mr. Elkin.
There’s an increase of $1.1 million under purchased services primarily due to the THSSI funding for Foundation for Change. That was approved in the October session.
Thanks for the explanation. It does go back to a pet peeve of mine, which I’ve been harping on since I got here. We’re being asked to approve $1.1 million basically without any kind of other information. So could I get a breakdown, please, of what the $1.1 million of THSSI funding is being used for? Thank you.
Thank you. The $1.1 million in ‘11-12 is made up of $100,000 for a Territorial Chronic Disease Management Strategy; funding for the Health Information Act of $100,000; a review of territorial midwifery practice, $75,000; $300,000 toward the territorial support network; and $547,000 related to a number of reviews that are being undertaken in the current fiscal year to implement next year.
I appreciate the breakdown. I’m struggling to understand. We’ve got, I don’t know, one review for sure which was itemized and then at the end it was a number of reviews. I know that this funding is sunsetting at the end of March of 2012 and I appreciate that federal funding has to end sometime, but I am sort of struggling with what some of this funding is being used for and I wondered two things: what is the territorial support network, and which reviews. Mr. Elkin mentioned a number of reviews. I wonder if he could tell me what those reviews are. Thank you.
Thank you, Ms. Bisaro. Ms. Meade.
Thank you. The Territorial Service Support Network is the work that was presented through the health dialogues and also to standing committee. This is the work with Dr. Affleck and a couple of other physicians, myself, two CEOs, around how we can best use physician and nurse practitioner resources virtually to support both the physicians in small communities, but more importantly, the nurse in charge. So it’s moving out our resources for a 24-hour on-call hook up through technology. We were calling it many things, we’ve landed on a support network because we’re also going to connect a lot of our medevac coordination and dispatch through that. So that’s work being done now with that group.
On the other types of reviews or works in progress there was an issue to further scale down medical travel, medical travel really being clinical decision-making and how we do a better handoff with clinical decisions that relate to travel. Governance and accountability has several components. That’s really around their accountabilities on money to standards both within the authorities as well as some of the key providers and the beginnings of the pharma strategy because of the capacity in the department and to be able to link up with some of the other jurisdictions, larger jurisdictions on generic pricing and other issues that would be in a pharma strategy. Thank you.
Thank you, Deputy Minister Meade. I believe one of the earlier names we covered that under was the Community Call Coverage System. Thank you for that clarification. Ms. Bisaro.
Thank you, Mr. Chair, and thanks for that clarification as well. I did wonder in terms of the medical travel review and I certainly support an evaluation of sort of the clinical decisions and how we do that, but it’s my understanding that the Program Review Office is also undertaking to look at medical travel and efficiencies there. I wondered if these two reviews are being done in conjunction. Thank you.
Thank you, Ms. Bisaro. Deputy Minister Meade.
Thank you. We did work with the Program Review Office. There was an initial review done that actually started to identify where some of the key points are. It’s a very complex area and the first review actually looked at it as a travel issue. We quickly realized that it’s much more about clinical handoff in case management, coordinated case management. So we have several pieces doing that review with the Program Review Office being an initial part of it and now we’re going further. We’re also connecting this with referrals, standards around referrals. So the medical directors have come up with a process around specialist referrals and all of that connects. So we’ve built on the first part of the review with the program office, and this will take us to those next levels. Thank you.
Thank you, Ms. Meade. Committee, once again, we’re on page 8-13, Health and Social Services, activity summary, directorate, operations expenditure summary, $7.678 million. Agreed.
Agreed.
Thank you. Page 8-14, Health and Social Services, activity summary, directorate, contributions, $35,000. Agreed?
Agreed.
Page 8-15, Health and Social Services, information item, directorate, active positions. Agreed?
Agreed.
Page 8-17. Mr. Abernethy.
Thank you, Mr. Chairman. I see this is the division that has health human resources. Could the Minister please tell me how much of the $34.32 million is allocated to the health human resources division?
Thank you, Mr. Abernethy. Ms. Meade.
Thank you, Mr. Chairman. We don’t have a division in the department. With the transfer to Human Resources, both department and health authority resources went into the corporate service. We do have a small budget that is jointly maintained; things like the Bursary Program. Of that $34.2 million, the actual resources for that is just over $4,000. Four million. Sorry; $4 million. My apologies.
So that $4 million is, I guess, co-managed by HR and Health and Social Services and is responsible for programs such as CHN development, our med school bursaries, our nursing bursaries. Could the Minister tell me: have we eliminated any of our bursaries in this division over the last year? For instance, do we still provide physician bursaries? Do we still have a community health nurse development bursary? Are we still providing all of the nursing bursaries? Have any of the bursaries that we provide or have provided in that section been eliminated?
They haven’t been eliminated but that budget was significantly over budget two years ago and we had to reassess how the alignment was. We did have to manage the budget down to within the actual operating budget. So they haven’t been eliminated, but it was a budget that was significantly overspent the last few years and we’re trying to manage within the fiscal allotment. We are having ongoing discussions around the priorities and how we can make sure that the programs like the CHN, that are so valuable out in the communities, continue to be fully funded and prescribed.
On the medical bursaries for physicians, we’re having conversations with the medical directors not to reduce the amount but to manage it so that if you go on for a specialist, then -- if in fact it’s a specialty that could be used in the NWT; a thoracic surgeon isn’t someone that the NWT is going to recruit back -- how do we align the bursary to the types of physicians that we need to recruit and retain in the North.
So just for clarity, I heard that none of the bursaries have been eliminated but they may not be utilized particularly due to budget reasons. If the deputy minister could confirm that.
The other thing that I’m curious about or, rather, I would like the department to provide, is: I’d like the department to provide a list or summary over the last or probably since the duration of the bursaries -- they haven’t been around that long -- showing how much we’ve paid out, how much return of service was owed to the GNWT in all categories: nurses, social workers, physicians. How much return of services owed, how much has been collected, how much has not been returned? I know that a significant number of people have graduated and gone to work and didn’t necessarily come back to the Northwest Territories. I’d like a bit of an assessment as to how much return we got.
Also for confirmation, could the Minister and/or deputy minister confirm that the Community Health Nurse Program will definitely have intake in the 2011-2012 year?
Thank you, Mr. Abernethy. Ms. Lee.
Thank you. We will undertake to provide the Member with all the answers to the questions he raised.
