Another section, division, whatnot, responsibility under the program delivery support is information services division. There’s been a lot of talk about e-health and EMRs, DI/PACS and all the great programs that are out there, all the great technology that’s out there to help us provide health services in a more streamlined manner. I understand that bandwidth has been a significant issue in getting these fantastic technologies into our small communities. These things, in my opinion, could help us reduce potential medical travel if we have ability for physicians to use this technology to help treat in the communities. What is this department doing with respect to lobbying or encouraging Public Works and Services to help create bandwidth or expand bandwidth throughout the Territories, for communities in particular, as it relates to these types of technologies?
As the Member stated, this is a very important area and it will become more important as we move forward. NWT actually is at the forefront of rolling out programs and using the information technology. We are sort of a model student under Canada Infoway funding and being able to tap into those.
As the Member stated, bandwidth is a problem, it is a challenge in the NWT, as it is for the rest of the country. We do appreciate the support of the standing committee and the enthusiasm they’ve shown. Our department works with other departments and DPW and Education as we plan as a government on how we cope with what will, you know, most certainly be more and more increased demand for bandwidth. My deputy minister and staff are part of the working group that works on that issue.
Thanks to the Minister for that. We obviously share the same desire to get these particular systems up and running, but as the Minister you have a unique seat at a table in this government where you can really put pressure on your colleagues, the Ministers, to put some greater attention to expanding bandwidth up the valley into our communities so that we can really utilize these technologies that exist. There are so many advantages here to help us reduce medical travel costs, to increase services to the communities, to overall, you know, I mean, if we’re talking Foundation for Change -- and there has been a lot of Foundation for Change -- I think this is something that should fit as a critical aspect to Foundation for Change for helping to improve services in the communities. So as the Minister sitting at that unique table with six of your ministerial colleagues, what are you doing, what can you do to create a greater awareness in your ministerial colleagues so that we can get some movement on this and get some extended or increased bandwidth? Which isn’t just good for Health and Social Services, it’s good for education, it’s good for anybody providing services in the community, but there’s definite benefit for health. What are you doing? What are you doing to make sure that bandwidth is a priority?
As the Member stated, this is an issue that is very much alive among our Cabinet. It is an issue of discussion. This is the reason why we have a Deputy Ministers’ Steering Committee set up. That’s where we have directed for the officials who work on the technical side of the increasing demands of this program and Health is making their case on absolute necessity into expanding investments in this area so that we can continue to increase the accessibility of health care programming and service delivery in small communities. There is a steering committee set up to work on that and it’s very much a live issue for all of the Cabinet Ministers.
Thanks to the Minister for that response. I guess I got just a quick comment and that’s, I think, going to be directed to the Minister of Finance, the Minister of Health, the Minister of Education, Culture and Employment, as well as the Minister of Public Works and Services. Clearly, bandwidth is an issue of ultimate importance as far as reducing our future costs and I’d like to see this Cabinet making more progress on extending bandwidth within the communities, especially up and down the valley. If we can put these technologies that health has access to, we’re going to improve services, have a greater control over costs, and ultimately that’s good for all the people of the Northwest Territories. So to all of those with some decision-making power: get some more bandwidth up our valley and to our small communities in the Northwest Territories.
Next on my list is Mr. Yakeleya.
Certainly, Mr. Chairman, I agree with the Member for speaking in support of the bandwidth. Certainly we would see it beneficial in our communities and to lend our support to see this government put some resources that would eliminate some of the headaches that we have in our smaller health centres in terms of providing efficient health care to our residents in the Sahtu and other communities that certainly would benefit from an e-health care system. If you could work closely with your Cabinet colleagues.
I want to ask the Minister in terms of working with our health boards. It’s about three years now that my community in Tulita and Sahtu that’s been working on every different angle to have a social worker in my community. Somehow we seem to not get to that resolution. There are always numerous excuses not to have a social worker there. It seems that we are regressing in terms of the goals of what’s stated in the program delivery support. I want to ask the Minister how much longer our community has to wait until we actually get a social worker in our community to serve the people there. If they say lack of housing or culture sensitivity or any of those excuses we’ve heard before, it’s going to raise my temperature here. I just want to know why we can’t get a social worker in our community. Break through those barriers, break through those excuses. If you want to work with us, work with us.
I want to ask the Minister again, we went to Tulita, we had a good meeting, but that was it. I go back there and there’s no social worker there. I went and talked with the health board, they gave me the reasons why they’re not having one there. But we’re not serving our people. We’re just satisfying the system here. The people want, at the end of the day, to see a social worker in Tulita. Let’s see how serious this department, this government is in terms of getting some of these resources in the communities where it’s needed.
I want to, I guess, maybe challenge the Minister and her department, hopefully by the end of this government we’ll have a social worker in Tulita. I want to ask the Minister in that sense.
Thank you, Mr. Yakeleya. Ms. Lee.
Thank you, not only as the Minister of Health and Social Services but as his colleague and what I consider to be his friend, I would not want to do anything to raise his heart rate or temperature.
Seriously, on the social worker situation, the last I was aware of it from our visits, there were some personal things like, the Member mentioned housing, but I believe one of the workers were in a relationship with somebody in Norman Wells. We live in a small town where personal backgrounds could determine where one who’s hired could decide to leave and such. What I would like to do is, I haven’t had the update on that social worker situation in Sahtu since our visit. I believe we did get back to the Member on that information but I don’t have the most recent update. I will undertake to look at that because I haven’t had that brought up to me in the last while. The positions are there. I know all authorities try their hardest to keep the positions occupied and to have the people on the ground as much as possible. Sometimes just life predetermines some of the decisions of our workers, which we need to respect as well.
Mr. Chairman, the response from the Minister, I’m having a hard time accepting it. I know that’s part of life, I guess, when you get into a relationship. You know, the husband or the wife wants to move here or stay there. However, I don’t know if that’s one of the requirements of this government here or this department here hiring social workers or our nurses. I mean, that’s part of life. I hope the Minister will be big enough to see that the whole community needs one of our workers in that community and to tell the community of Tulita because of our social worker is now in a relationship, so it’s pretty hard for this social worker now to be away from their spouse. Well, that really doesn’t give much weight in terms of not serving over 500 people, or 400 people.
I just want to ask the Minister if she can have a little more heart than that and to look at the big picture here in terms of serving our people’s needs in this area here, because right now it shows very little heart in her answers. I want to ask again, put the challenge there to the Minister and the fine staff that she’s leading, in terms of making something work for our community.
It’s been three years, Mr. Chair, and we’ve got seven more months in this term here. After that it will be four years that we don’t have a social worker in our community. People are not really feeling confident, I guess, in some of the areas that we do. I think that I need to push the health board and push the Minister’s staff to provide better action plans to have a social worker in our community. It’s something that we need to show.
I want to ask the Minister if she’s up to the challenge to put somebody physically in Tulita. I want to make that known to the House here, that after awhile I tend to say, well, I don’t know if I should bring it up anymore because it doesn’t seem to go anywhere. I’m always hearing reasons why we don’t have it.
Again, I know the resources out there are tight and the challenges are difficult. However, that’s why we’re in this position: to make things happen and to serve people in our communities. I hear social workers, from time to time when I travel in the Sahtu, off the record, that talk to me, and some of them are pretty tired, but they don’t want to say too much because they don’t want to get in trouble. They tell me that we certainly need somebody dedicated in our communities. They are working really hard and they are hardworking people but we need to do more. We need to do something quick to help our communities.
This is only one issue under the chapter here. I want to ask the Minister again if she would provide some concrete direction to our health board and for the person to be located into the community of Tulita. There are other areas in the Sahtu. I have five communities she needs to work with and this is only one community. I’ve got four more and my time is running out so I’ll have to use some other time to look at some of the issues elsewhere. Thank you, Mr. Chair.
Thank you, Mr. Yakeleya. To the issue of more heart, Minister Lee.
Thank you, Mr. Chairman. I’d like to put for the record that this Minister does have a heart, and three and a half years of being the Minister of Health did not lessen that power of the heart. I don’t think we could do this job without feeling for what our people go through.
Mr. Chairman, I was just commenting on the latest information that I remember having about some of the challenges we have with social workers’ positions in the Sahtu, and I just want to put, for the record, that the department and the authorities are committed to having our workforce on the ground. For a community as big as that, we would have positions in Tulita allocated.
From time to time we do run into some of the challenges that are beyond our control and I was just simply stating the latest information. I don’t know what the most recent update is on the social worker position in Tulita because I haven’t talked to the Member recently on that. I will undertake to get an update on where we are with getting the social worker down to Tulita. Thank you.
Thank you, Minister Lee. Next on my list is Mr. Ramsay.
Thank you, Mr. Chairman. I’ve got a couple of questions on 8-13. I’m just wondering if we could just go back there for a brief second. Thank you.
Does committee agree that we go back to page 8-13?
Agreed.
Mr. Ramsay.
Thank you, Mr. Chairman. I just wanted to ask the Minister to what extent is the department involved in giving financial advice to the authorities and I’d like to know what shape that advice takes. Thank you.
Thank you, Mr. Ramsay. Minister Lee.
Thank you, Mr. Chairman. I can tell you that we are intimately involved with giving financial advice and interaction with the authority. I think a large part of the time that the director of finance sitting next to me is spent on working on financial issues. As well, this government and this Cabinet directed the department and the authorities to provide detailed financial information, more detailed than ever before, and, lastly, we have undertaken a step where we have now a financial contribution agreement with authorities that lays out in detail the financial expectations of each authority. Thank you.
I thank the Minister for that. I’m wondering if the Minister could provide to the House copies of the correspondence between the department and the authorities as related to the financial standing in the authorities and what the advice would be in written form that was communicated from the department to the authorities. I’d like to see that in writing, Mr. Chairman.
I would be happy to do that, but could the Member help us with a little bit more detail on what kind of information he’s looking for, because I hope that he can appreciate that there are lots of people spending a lot of time talking to authorities about financial information. Could I ask for some more detail on exactly what he’s looking for? Thank you.
What I’d be looking for is written communication from the department to the authorities, especially the authorities that are in deficit situations. I’d like to get a better idea of what the department is telling the authorities in written communication between the department and the authorities. That’s what I’m looking for. Specific to deficits and financial management at the authority level, and that’s communication coming directly from the department to the authorities. I don’t know if I can make it much more clear than that, Mr. Chairman. That’s what I’m looking for. Thank you.
I will undertake to provide him with the first package and then go from there. Thank you.
Under the policy, the division provides leadership and services in policy, legislation and regulation, and, as well, for the licensing of a number of health professions. I’m just wondering, under the scope of practice for health professions in the Northwest Territories, are we up to date on all of our scope of practice for all health professionals in the Northwest Territories today? Thank you.
Thank you, Mr. Ramsay. Deputy Minister Meade.
With respect to policies saying that we want all providers to work to their full scope of practice, then that would be there, but this is actually a practice challenge, not just here but in all Health departments across the country. We are clarifying what the scope of practice is of a physician nurse practitioner. When you have a nurse practitioner, what is the scope of practice with a regular nurse? We are trying to introduce PMs. I could say yes as far as the policy and the standard, but in practice we are still struggling with the full scope of practice. It is an ongoing change management issue. It also is significant as to whether you have a sole practice or whether you have other providers. I think it is better to say that this is still a work in progress and one that we continue to push and monitor and certainly have the key authorities really champion this, as well, with us.
Mr. Chairman, if I am to understand correctly, if we are still working on proper scope of practice for health professionals in the Northwest Territories and we don’t have those concluded or done to a certain extent, I am just wondering, doesn’t that open the Government of the Northwest Territories and the department up to liability. I am thinking malpractice. I am thinking something goes wrong and when you are dealing with health care, there are a lot of things that can go wrong. I would think that this is a huge risk for us not having this work done. I am just wondering if we have any time frame on when that work might get done. In my mind, that is a huge liability that that work is not done. Thank you.
Mr. Chairman, to clarify my last statement, in fact, from a policy perspective, this work is done. The standards are there and the professional practice standards are there. My comments were actually trying to encourage providers to work to their full scope of practice. They usually tend to not work and not worry about the... And certainly it is a liability issue if you don’t have that or if people don’t exceed their scope of professional practice. That is not the case. I am trying to encourage broader, through change management with the authorities, that they work to their full scope of practice. But as far as what the policy and where the procedures are, well, we don’t have all of the potential professions under the legislation. What we do have in practice and the scope of practice is defined.
Mr. Chairman, I guess I am a little bit confused. On the department’s website I don’t see a defined scope of practice for all health professionals in the Northwest Territories. It might be in policy somewhere, but where is the definition for every health professional in the Northwest Territories? Where is the definition for their scope of practice on the department’s website? I don’t see it there, Mr. Chairman. Maybe I am missing something here. Where would I locate that? Thank you.
A lot of those are actually defined by the profession itself, as far as the scope of practice between a pharmacist or a nurse, those types of things. If you are talking about our umbrella legislation around the health professions, then we have not got all in that legislation. That is a piece that we are working on, but those that we have, the scope of practice is defined. I think the best thing to do is follow up through the Minister’s office to provide what we have on the practice that we have currently.
Mr. Chairman, I look forward to more information on that. Again, I don’t know how we have come this far since the federal government devolved responsibility for health here in the Northwest Territories. We still don’t have that work all concluded. It is troublesome, I guess, to put it in a word.
I also wanted to, while I have a minute and 28 seconds left, comment on my colleague Mr. Yakeleya’s concern over the lack of a social worker in Tulita. I think that is appalling that there is not a social worker there and there hasn’t been one there for three and a half years. All the Minister can say is, well, circumstances and this and that, but, yes, we can understand if it was six months or maybe even a year that a community goes without a social worker, but we are talking three and a half years that that community has been without a social worker. I think we have a huge problem there, Mr. Chairman, that we have to take seriously. People will understand, like I said. Things happen, people move and things change, but the bottom line is that the community has been without a social worker for three and a half years. Somebody has to be held accountable for that situation, keeping itself there for that length of time. It is ridiculous, Mr. Chairman. Thank you.
Thank you, Mr. Ramsay. I just want to point out your last comment had to do with page 8-17. We were on page 8-13. Just to complete that again, Health and Social Services, activity summary, directorate, operations expenditure summary, $7.678 million. That is on page 8-13. Does committee agree?
Agreed.
Thank you, committee. We will return now to 8-17. I believe I have Mr. Abernethy. Sorry. Mr. Menicoche.
Thank you, Mr. Chairman. I just wanted to get a comment on something new that the federal government is doing or when it comes to the Metis health benefits. They are actually changing the definition of the Metis in the federal government system. I am wondering if the Minister and her department is aware of that and, if so, how much of an impact it would have on our health budget and how it will affect the delivery of our services to our Metis membership out there in the Northwest Territories, Mr. Chairman. Thank you.
Thank you, Mr. Menicoche. Minister Lee. Ms. Meade.
Thank you, Mr. Chairman. We are aware, although this issue is more with DIAND and the conversation has not come formally to the federal/provincial health deputies. It would be too early to tell whether in fact there will be any implications. I would suggest that, given that their stand traditionally has been that that is a role provincially for health funding, or been the jurisdictions that there may not be an impact, but we will certainly watch it closely and I assume it will come to the deputies of Health to review for impacts. Thank you.
Given the large population of Metis people in the Northwest Territories, I believe the Health ministry should do what we can to keep us informed as well as all Regular Members and not only our Social Programs committee, because sometimes the federal government does that, they do one level of change and it affects, like the deputy minister said, all the way up to health funding agreements and that kind of stuff if they are changing the definition of who is a Metis and who is not. It will certainly affect the numbers if it comes to implementation from the federal level. Maybe if they get a comment on keeping MLAs informed and the proper committees informed, as well, with regard to this issue.
Thank you, Mr. Menicoche. Minister Lee.
Mr. Chairman, I could assure the Members that we are on the lookout for things like that. Had there been something that would have been more concrete, I would be sending the information well in advance. As the DM mentioned, this is something we are monitoring. I will report the progress to the Members as they become available. Thank you.
Mr. Chairman, I will thank the Minister for going that extra effort and keep us in the loop as the situation develops. It is just any situation, certainly, I do have.
Early today in my Member’s statement I spoke about the lack of social worker issue as well. I don’t know if it is appropriate to this page, Mr. Chairman, but it is probably a few pages down, but a provision of a health and social services worker for our communities is much needed and the people have asked for... They are looking forward to it only because having a staff member in the community, in the larger communities, to develop a repertoire with the local clients and local people and are able to respond more quickly than if we were to fly somebody in a day or two after an incident or via phone call, Mr. Chair. So I’m supportive of doing what we can to fill the positions that are there. I think in my case the community of Fort Liard was asking for coverage while that one staff member is away on personal leave. So that’s something that’s got to be... We’ve got to listen to the community. That’s what they want and those are the needs that they see. So, Mr. Chair, I’ll just let the Minister comment on that again once more.
I committed earlier in the day to get back to the Member on that and I just want to say that, for the record, when our Member said earlier that a community was without a social worker for three years or something like that, I think it’s important to state for the record that where there is a vacancy, the system would have social workers going in and covering those. It’s not necessarily about coverage of the work. I just want to say that I appreciate that for many communities they would like to see the actual body of the social worker there working in the community, getting to know the community and not be flying in and out. So I just want to state I understand what the Member’s concerns are and to say, for the record, that no community will be without a social worker for three years, they would still have access and we’re talking about two different things. Thank you.
Thank you, Minister. Next on my list I have Ms. Bisaro.
Thank you, Mr. Chair. I have some questions on this page. The first one is related to the health and social services authorities’ agency administration. The description talks about that this funding is for activities associated with management under the administration of authorities. I’d like to know if the Minister could advise what actions have taken place or what actions will be funded in this budget to improve the administration and management of health and social services authorities. Thank you.
Thank you, Ms. Bisaro. Minister Lee.
Mr. Chairman, I’m assuming that the Member is referring to the bottom of page 8-17. That’s the block funding for the authorities. Thank you.
I’m referring to the text on page 8-16, the last paragraph.
Yes, that is the section where through this program we block fund the authorities and the Member asked what we were doing to improve the administration. I, as a Minister, work through Joint Leadership Council. We have regular meetings, we talk about all manner of things right from the budgetary issues, policy issues, working as a system, Foundation for Change action plan or whatever else is on the go. We seek advice from each other. So that’s how we work together at my level. The deputy minister is in constant touch every day with the administration, on delivery of services and so are the director of Finance and ADM for operations. So this is what we do every day in delivering our services. Thank you.
I understand that all those things happen. My question was more to what on the ground, or what sort of day-to-day changes have been made to the way the health and social services authorities are managed and administered. I believe the Minister advised us some time ago that the department was looking to try and streamline things between authorities and the department. So have any changes taken place and, if so, what are those? Thank you.
