This isn’t to pick on the Department of Health and Social Services, but I’m wondering under whose authority is the Minister and the other departments. They seem to be placing employees at random without this budget having gone through the full scrutiny of the Regular Members of this House. There’s something fundamentally wrong with a process that allows the government to do this to employees without it getting fully aired in this public forum by the Members duly elected to the 16th Legislative Assembly.
I’d like to ask the Minister: who’s giving you the instructions to be placing employees? Is it the Minister of Human Resources, or is it the Premier?
Mr. Chairman, I appreciate that this is an issue where the Member has concerns, not specifically with Health and Social Services alone but government-wide. I believe the answer has been given in that regard, in that a decision was made to notify the employees of their potential impacted status. Then the choices are given to the employees to see whether they want to pursue other options. I do understand there are affected employees who have chosen not to do that. That’s their option as well.
As the Member is aware, the principle behind it and the good intention behind it was so that instead of having the entire civil service of 4,500-plus employees wondering whether they would be impacted or not.... It was thought it would be a better idea to have 100 or so employees who were potentially impacted notified of that. Obviously, nobody is forcing these employees to be looking at other options, but there are constantly positions being opened for competition, and these employees are free to consider other options if they have chosen to. If they want to wait until the budget is processed, that’s up to them as well. I believe that’s how the processes were rolled out.
Mr. Chairman, I guess that is a fairly large assumption on behalf of the department and on behalf of government: that this budget is actually going to pass. We’re affecting the lives of over 100 people to what end? It’s not entirely necessary, in my mind, that we’ve had to do this. Notifying them is one thing, but moving them around and impacting other people while you’re doing it, to me, is not a very good process we’re following here. It’s totally pre-empted the budget we have before us.
Really, we’re working with a document that’s not set in stone. It’s evolving every day as people come and go and move around. I really don’t know what we’re doing here. I don’t want to pick on the Minister and the Department of Health and Social Services, but they do have 17 positions that were eliminated. By the looks of things they’ve moved around five people or placed five people without us even passing the budget. That’s more an observation than anything, and that’s an issue I’ll bring up with every department that comes before us.
Thank you, Mr. Ramsay. As there was no question there, we’ll move on. Page 6-8, Department of Health and Social Services, information item, Active Positions — By Region.
Department of Health and Social Services, Department Summary, Active Positions — By Region, information item, approved.
Active Positions – Community Allocation, information item.
Department of Health and Social Services, Department Summary, Active Positions – Community Allocation, information item, approved.
Moving on to page 6-10, also an information item, Active Positions – Health and Social Services Authorities. Ms. Bisaro.
Thank you, Mr. Chairman. There is an increase in staffing at community health authorities of seven positions. I wonder if I could get some explanation, some rationale for the need for these changes. I want to say I don’t begrudge the health and social services authorities from getting more staff, but I’d like to know why we’re cutting positions in headquarters and increasing at the authorities.
Thank you, Ms. Bisaro. Minister Lee.
Thank you, Mr. Chairman. There is a reduction component of this budget, but there are lots of other investments. The increases in the positions for the department are on the THAF program, which is federal funding that we have. It’s the Territorial Health Access Fund. There’s a coordinator for accreditation, which is located in the department. There’s patient wait times, e-health project management in the department. There’s a midwife position being funded in Fort Smith. There’s an STI nurse being funded in Yellowknife. There’s a registered nurse, a Northern Women’s Health position, being funded at Stanton. There is a dialysis registered nurse at Stanton, a home care nurse in Deh Cho, a home care coordinator in Hay River, and home support workers in Tlicho, Beau-Del and Hay River. That amounts to 12 additional positions, but with the reductions and reallocations that’s a net increase in the authorities.
Thanks for the information. I thought I heard the Minister say there is a position in Fort Smith, but if I look at the numbers on page 6-10, Fort Smith is going down by one. I’m getting confused again.
These are net numbers. I am going to ask Mr. Elkin to do the math for me.
Mr. Elkin.
Thank you. There were three positions related to the aboriginal health position at Stanton, and in last year’s budget they were reflected in Tlicho, Beau-Del and Hay River incorrectly. We are just correcting that to show them under Stanton as opposed to those communities.
Thank you, Mr. Elkin. Ms. Bisaro.
Okay. Thank you. That’s fine.
Mr. Hawkins.
Thank you, Mr. Chairman. I’m just trying to get a grip on some positions here. Are all the positions listed on this page funded?
Yes.
How many unfunded positions do we have?
Mr. Chairman, there are 2.5 unfunded positions in Health and Social Services, and they are in the department: one in population health and one senior policy adviser and intergovernmental officer.
Mr. Chairman, under Stanton Territorial Health Authority I see we have five in growth. Is that a net gain of five, or was there a growth of, say, 6 or 7 and the loss of a couple? Is that a net, or what type of change has happened at the Stanton Hospital?
At Stanton there is a net change. The three Aboriginal Wellness positions are reallocated — the two dialysis RNs, the RN for the Northern Women’s Health Program — and offset by the Telehealth reduction.
Thank you, Mr. Elkin, for that. I have to tell you it got muddled in there. I was trying to get a sense of the dialysis positions. Were they lost or gained?
It’s a gain.
Seeing as we’re on the dialysis positions, how many positions are dedicated to that type of treatment in the unit?
Mr. Chairman, we don’t have that detailed information. I’d be happy to get it for him.
Thank you. I’ll accept that. On the positions that were deleted, could you highlight exactly what positions they were? If I understand it, the Aboriginal Wellness came in and two new dialysis positions. Were there any losses in this calculation, just for the official record? I was having trouble hearing that.
Mr. Chairman, the increases to Stanton are the registered nurse for Northern Women’s Health and two positions for dialysis registered nurses. So that’s three. There is a typographical change, a correction of the error from last year, on three positions, so it’s not real positions per se. The only reduction at Stanton Territorial Health Authority is a Telehealth position.
On that Telehealth position, what analysis was done on that?
It’s exactly the same analysis as previously noted. If you look at the program we have there, currently the Telehealth program has a coordinator in headquarters. Then there were a regional position in the Inuvik health authority, one in the Yellowknife Health and Social Services Authority and one at the Stanton Territorial Health Authority.
We had to look at that program and see whether it was possible to deliver the program with fewer resources. The technology has improved a lot in that regard. The machines and equipment we have from the funding from Canada Infoway have enabled us to deliver those services much more cheaply.
The decision was made that the Stanton position and the Yellowknife position could be eliminated but we could still do the programming in a different way. I think it should also be noted that there are lots of communities in the Northwest Territories without a coordinator for Telehealth. But they do still turn on the machines, and they do still participate in the Telehealth program.
So to answer the question — sorry for being long-winded — looking at the job description, duties, the make-up of resources within that program and how we could still deliver the program were the criteria that were used.
Mr. Chairman, I’m just trying to get a sense of all of this. We have a Telehealth coordinator in headquarters, and that makes sense to me. As to whether we need a coordinator or not, I’m not in a position to say yes or no. But then we lose the Telehealth person at Stanton. I’m just trying to follow the format here. That’s not seen as a position that needs to be kept, but the duties could be spread out.
Again, I’m not necessarily speaking for or against the reduction. But then we lose one in Inuvik and it gets reinstated because the program can’t run without that person, but then in the communities it runs fine without a Telehealth coordinator. I’m just trying to understand the principles of how we can save one and not the other. I’m just trying to make sense of this. Is Telehealth training a practicality of training to all nurses? Or is it reasonable for administrative staff to do that? Or are the patients scanning themselves? I’m just trying to get a sense of why it works well in one area where you need a coordinator of some sort, or an operator in that area, but you don’t in other areas. Someone says you don’t need one at Stanton. That seems to be the evaluation. I’m trying to get a sense of how this was justified and, furthermore, if I held it up how it would make sense. If the Minister could explain that.
Mr. Cummings.
Thank you, Mr. Chair. In the analysis we did, we looked at all of the positions we have supporting the Telehealth program for the whole system of Health and Social Services. The position that exists in the Department of Health and Social Services has system-wide responsibility and participates in things like negotiations with Canada Health Infoway to receive additional funding into the system and so on. It also provides support to staff in the authorities and at the local level, if they have equipment and they need troubleshooting, et cetera. So the position at the department can be written to exclusively provide support from the department to the regions and the local areas or can take a greater role in a particular authority where there’s more need.
We looked at all the positions, but the positions don’t support only one service or one community. They all support additional communities. For example, the position in Inuvik supports all of the communities in Beaufort-Delta and also provides services to the Sahtu.
We did that kind of analysis to see how we could take the existing expertise and spread that out to provide as much support as is needed to all the communities. The other thing we took into consideration is that the kind of equipment we have has evolved, sort of in the same way as equipment related to satellite television. It used to be more difficult to operate and less reliable than it is today. Nowadays the equipment is fairly straightforward, so we’re able to increase the application into small communities and not provide specialized expertise just to book appointments and turn it on.
Thank you, Mr. Cummings. Any further questions on page 6-10? Mr. Hawkins.
Thank you, Mr. Chairman. Although I had asked this question, I would just like ultimate certainty.
I have a constituent who uses the services at the dialysis unit, and it's my understanding that that position has been left vacant or unfilled or other — and I’ll leave “other” pretty vague — and I just want to make sure it is fully staffed at this time. What is the exact staff of that whole unit again, just to make sure it’s on record?
Mr. Chairman, I could give him that assurance. Anybody who needs that dialysis service is being, and will be, provided with it at Stanton.
There is another area I forgot to mention, and I’d be remiss if I didn’t bring it up. I’ve heard from a number of nurses — and it’s been heard by a number of Members throughout this Assembly, and I’m sure even the Minister must have heard this from time to time.... The nursing staff have been described as over-prescribed in work and undersubscribed in relief. Does the Minister — speaking of Stanton specifically — have a grip on the actual numbers of staffing of nurses there, and how many? Is there a difference between how many we have staffed and how many we have in the sense of funded/unfunded positions? Furthermore, is it grouped around how many are required to operate the hospital properly and safely?
There’s lots of information that’s required there. The information I have is that the vacancy rate at Stanton for nurses has been decreasing over the years. I could give him specific information on that.
The overtime hours there.... I think I saw the stats where it’s a little bit less than the national figure, and I could provide the Members with that. Over the years the casual nurses float pool has increased NWT-wide, making it possible for us to use fewer agency nurses.
I could advise the Member that right now at Stanton we do have the stand-by, the float pool nurses, of nine. There has been a suggestion made that perhaps we should look at increasing that to 15. Stanton is actively looking at that option, to see what the optimal level of float pool nurses are, taking into consideration the qualifications required. Because, from my understanding, the float pool nurses need to have intense two-year training to make sure they’re at least trained to work in three or four areas: ICU, surgery, psychiatry, pediatrics, medicine, obstetrics and such. Obviously, these are not for all the nurses, so we need to get a pool of nurses to be trained for that. At the same time, we need to do a cost-benefit analysis to see what the optimal level of those numbers is. What I want to tell the Member is that I’d be happy to get him all the information on those stats I’ve mentioned already.
There’s no question that the human resource issues at the hospital have been under stress or under a little bit of pressure. I think I’m working toward getting some of the more clear information on that, an action plan on that. Part of the work the public administrator is doing there with the management of Stanton is part of that exercise. Finishing the human resource plan is part of that exercise, and it’s one on which I am confident I could have a full and more clear package of information to go forward to the Standing Committee on Social Programs and other interested Members to address that situation.
Although I’m not on the clock, I thank you for giving me the chance to say, Yes, I’ll take that information. I certainly would hope that every other Member on this side of the House would receive the offer of that package of information the Minister had offered.
Thank you, Mr. Hawkins. Ms. Bisaro.
Thank you, Mr. Chair. I wanted to, unfortunately, review the Telehealth positions. I got confused with the numbers, and where they are, how many they are, and how many we’re going to be left with. I thought I heard that there currently or were four Telehealth coordinator positions and that the budget is going to leave us with one in Inuvik. If I could get that confirmed, please.
Thank you, Ms. Bisaro. Ms. Lee.
Thank you, Mr. Chairman. The headquarters person in Yellowknife…. We have one in headquarters, one in Inuvik, one in Yellowknife Health Authority, one at Stanton. We are proposing to eliminate the positions at Stanton and the Yellowknife Health Authority.
So we would be left with two coordinators then: one in Inuvik, one at headquarters. I do understand from the information the department provided to the standing committee that some of the sort of technical support is going to be provided by TSC, and that’s a good thing. What is going to be the function of the two coordinators that are left? Will they have a regional scope, and just what regions will each of these two people cover?
Mr. Cummings.
Thank you, Mr. Chair. The remaining positions actually have a territorial scope, and the functions they provide are to assist with the scheduling of sessions on Telehealth and to do training around Telehealth and to provide support if there are technical glitches during the sessions. It is possible, with the technology we have, for that to be done remotely. So the people who do that work can be located anywhere in the system and can do that work on-line. The plan is to have the position remain at the Beaufort-Delta Health and Social Services Authority and in the Department of Health and Social Services, but either could have a territorial scope of responsibility.
Thank you. That’s great. That’s good.
We’re on page 6-10, Department of Health and Social Services, information item, Active Positions – Health and Social Services Authorities. Mr. Ramsay.
Thank you, Mr. Chairman. In Mr. Hawkins’ questions to the Minister I don’t know if she answered as to how many unfunded positions we have across the health authorities. I’d be interested to know that, especially at Stanton.
Thank you, Mr. Ramsay. Minister Lee.
