Thank you. Yes, I have no problem clarifying. The 2011-2012 revised estimates of $11.874 million, main estimates proposed $9.295 million.
Thank you. That’s the roll-up of the item that the Minister just previously talked about. So that is related to the supp appropriation related to the Canadian Blood Services, blood products.
Thank you. I believe that this is involving a number of, or a few potential patients and if these patients continue to reside in the Northwest Territories and give indication that they’ll reside in the Northwest Territories, my question is why can’t the department continue with a main estimate calculation given the fact that the treatment is relatively the same year after year.
Thank you, Mr. Dolynny. Minister Beaulieu.
Thank you, Madam Chair. Last year a lot of this cost was driven by two babies that required blood services, expensive blood services. So it’s quite possible that this coming year that cost may not be there, but we don’t know that at this time.
Thank you. I guess it’s a simple ask to the department, I mean, if there’s an open dialogue with the parents of these patients, if they give indication that they’re going to reside or continue to reside in the Northwest Territories, wouldn’t it be prudent to save a lot of grief in creating a supplementary appropriation when we can actually put it in the main estimates at this juncture?
Thank you. I’ll have the assistant deputy minister respond to that detail item.
Thank you, Mr. Beaulieu. Mr. Elkin.
Thank you. In terms of being able to forecast the number of clients that are accessing blood products during the year, that’s something we find out from the authorities after the fact. Again, due to client confidentiality and transferring of that kind of data between the authorities, usually at the end of the year we find out what their expenses are. So, again, we don’t know whether or not we’re going to have this under expenses for the upcoming year.
Okay, I’m getting a bit confused here. We’re doing a budget here for the 2012-2013 area and we’re not going retroactively in time, we’re going forward in time, which means if we know forward in time we have patients that are going to be under our care and attention, could we not put this in the main estimates and not have deviations and having to have supplemental appropriations that happen immediately after this process? Thank you.
Thank you, Mr. Dolynny. Mr. Beaulieu.
Thank you. Much like the supplementary appropriations that go forward for firefighting, the Department of Finance would prefer to not put these types of costs in the base. So only when it’s verified that the money has been used, then we get it through a supplementary appropriation as a standard process.
I don’t understand the direct link between firefighters and firefighting which we do not know and something that we do know. I’ll leave it at that, but I’m going to ask the department moving forward to take a look at this because, again, comparing this to firefighting, these are two different types of entities.
With that, my next question involves the contract services and the details of other expenses. We see a drop from the $5.776 million down to $3.028 million. Can we get an explanation as to that drop? Thank you.
Thank you, Mr. Dolynny. Mr. Elkin.
Thank you. Again, that item is related to the $1.9 million in the supplementary appropriation related to Canadian Blood Services. That’s the line item that it starts on.
Okay, so we’re seeing two different charge items dealing with the same entity, again creating confusion for those that would have to look at these estimates year after year and, again, creating a lot of extra work. Even by me talking for 10 minutes on this, this is creating work. Will the department put some commitment moving forward that these types of items be looked at that would be encompassed within the main estimates?
Thank you, Mr. Dolynny. Minister Beaulieu.
Thank you, Madam Chair. The Department of Health and Social Services is prepared to go back to the Department of Finance to see if the number can be put into the base so that this doesn’t occur in the future.
No further questions, Madam Chair.
Questions? Mr. Bromley.
Thank you, Madam Chair. I’d like to follow up on my earlier questions on the telehealth infrastructure and use of the technology. I appreciated the Minister’s information that we actually do have telehealth infrastructure in all 33 communities. That was really good news. I’m wondering, first of all, what activities or programs are we currently using that equipment for.
Thank you, Mr. Bromley. Ms. DeLancey.
Thank you, Mr. Chairman. We don’t have the breakdown of proportion but we use that service for a number of clinical activities including speech and language pathology, psychiatry, family counselling. It’s also used for training sessions for authority staff. It’s occasionally used to arrange visits for families with patients in other centres and very occasionally for meetings.
That’s quite a list and I imagine the list could only grow as we get familiar and more proficient and the technology improves. Thank you for that information. I’m wondering, given that the equipment is in all 33 communities, are we fully using it. Are all 33 communities fully up to snuff and engaged in implementing this technology to its fullest capacity?
Thank you, Mr. Bromley. Mr. Beaulieu.
Thank you, Madam Chair. In the 33 communities we have 73 locations using it but we could expand the use of this technology. There is room to expand the use of this technology, for sure.
Just to probe that a little bit, that could be interpreted with different degrees here, so I’m interested in… Let’s start with the basic use for the most fundamental things on the list. Is every community capable of using it for speech pathology sorts of work and for counselling, say?
Yes, for both speech pathology and counselling.
That tells me that the basic skills are there and engaged and I’m sure as people get more familiar, they will work towards the upper level of achievement as was the basis of my question. That’s all I have on that.
Thank you, Mr. Bromley. Page 8-17, Health and Social Services, activity summary, program delivery support, operations expenditure summary, $34.772 million.
Agreed.
Page 8-18, Health and Social Services, activity summary, program delivery support, grants and contributions, contributions, total contributions, $18.197 million.
Agreed.
Page 8-19, Health and Social Services, activity summary, information item, program delivery support, active positions.
Agreed.
Page 8-21, Health and Social Services, activity summary, health services programs, operations expenditure summary, $192.989 million. Mr. Bromley.
Thank you, Madam Chair. First, I just noticed that the NWT hospitals funding is down $7 million. Maybe I could start with getting an explanation of what’s happening there. I know our expenses have not changed there.
Thank you, Mr. Bromley. Mr. Beaulieu.
Thank you, Madam Chair. That is the reallocation of funding between the authorities that saw the move from the 2011-2012 Main Estimates to the revised, so that it went up in the hospitals because that’s where the deficits were. The reallocation from the other health and social services authorities and then we’re back on budget from back to the main estimates compared to the other main estimates there’s a slight increase.
I understand that now. I just wanted to follow up a little bit on the physicians versus the nurse practitioners to make sure I have this right. My understanding is from the Minister’s discussion, I think it might have been with my colleague Mr. Yakeleya, that there is now or there’s an intent to provide some flexibility in how authorities allocate their physician dollars, to some degree, to incorporate the possibility of nurse practitioners allocating some of the current or past physician dollars towards the nurse practitioners, given that we often fail to hire the physicians for the positions we have.
The process that we would be following is first providing direction to JLC, the Joint Leadership Council, of all of the authorities and asking them to come up with a physician recruitment plan and look at the flexibility of putting the possibility of allowing, within that plan, a role for nurse practitioners. Then once we get the plan, which we’re expecting this fall, in September, actually, we would then take that funding model for physicians, or the physician recruitment model, back to the Financial Management Board because the money that’s in physician funding is approved by the Financial Management Board.
Is there a target in terms of the portion? Are we asking for sort of a 20 percent flexibility for nurse practitioners? That sort of thing. Do we have an idea yet of what we’re looking for there?
There’s no target at this time. We don’t know. We know that a couple of authorities have used nurse practitioners and are very interested in building that flexibility into their funding, but we don’t have a target percent at this time.
I appreciate that information. It helps gives me some perspective. I wonder if the Minister would know what the experience is locally, even at the Primary Care Clinic. I know from talking to constituents that they really appreciate the nurse practitioner availability, and often, I can’t give you a proportion, but often are very happy to go to nurse practitioners as opposed to a physician. Is that experience significant, do you think, within even the Yellowknife situation, and would the thinking extend to even an enhanced use of nurse practitioners in Yellowknife?
The experience for the patients seem to be very positive in Fort Smith, Hay River, Yellowknife as indicated, and anywhere, even in the smaller health centres, where we’re using nurse practitioners, it has gone very well.
That’s really it. I guess the last part of my question was, does the Minister also see this enhancement being made available in the regional centres such as Yellowknife and the communities that he mentioned?
The request to the JLC is based on doing something at the regional centres and Yellowknife.
Thank you. Next I have Mr. Moses.
Thank you, Madam Chair. My question is going to be in regard to the NWT hospitals. I see from the main estimates 2011-2012 there has been an increase to the main estimates in 2012-2013 in the amount of $1.832 million. Knowing for one that the Beaufort-Delta Health Authority runs on a deficit of about $3 million, and that’s been something that’s been consistent over the last few years, and that we have the Yellowknife authority here that also runs on a deficit, I believe, knowing that and accumulating the costs and something that’s been trending I guess over the last few years, can the Minister give me some details as to why these deficits are occurring?
Thank you, Mr. Moses. Mr. Elkin.
