Final supplementary, Mr. Abernethy.
In the policy that Cabinet put out they indicate that the territorial Supplemental Health Benefits Program should be designed in a manner that does not cause employers to reduce supplementary health benefits programs to their employees; i.e., insurance. Everything the Minister just said pretty much encourages everybody to dump their insurance. It doesn’t make any sense at all. Even people who are making a lot of money who have insurance, if they have a catastrophic condition, it’s in their best interest not to have insurance from their provider. So right there on that fact they’re going against the policy that they put in place. I’m curious if the Minister can explain to me how they can put a program in place that clearly contradicts the policy that they put in place in the first place. Thank you.
To a certain extent that’s happening under the existing program. That is not new. We have learned that a lot of government employees who could extend their extended health benefits after their retirement for $25 a month have opted out of that because the GNWT covers 100 percent with no questions asked after they turn 60.
Mr. Speaker, the fact of the matter is there are a lot of people who make less than $50,000 who don’t have insurance coverage that covers basic dental and vision in the first place. So we are looking to cover them. Yes, Mr. Speaker, everybody says extend the coverage, but don’t take it away from anybody even if they could afford it and just expand, expand and do universal. The point is this is not an insured service. We are hard pressed to pay for the insured services, nurses and doctors in our communities. Mr. Speaker, the opt out happens anyway to a certain extent where we are looking at covering those on a low income. Thank you.
Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.
Thank you, Mr. Speaker. I’ll have questions for the NWT Health Minister regarding supplementary health benefits, and of course, it’s not to the Ontario Health Minister when we talk about Ontario benefits, and certainly not to the Alberta Minister of Health when we hear about how Alberta does stuff.
Mr. Speaker, speaking to the Minister for Health and Social Services in the Northwest Territories, my first question on the supplementary health benefits issue is this: under Section 5, and I won’t go into the details of how far down in the policy, under the Cabinet policy regarding supp health benefits, one of the issues that allows the Minister to deal with a particular policy is it says the Minister may make recommendations to the policy and bring them back to the Executive Council. Mr. Speaker, has this Minister done any effort whatsoever to take back some of the suggestions we have provided on this side of the House back to the Executive Council, and one namely being no co-payment? Thank you, Mr. Speaker.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. Every suggestion, proposal made by the Members and the general public in our two and a half, three years of review has been reviewed, noted, considered, analyzed. Every major public announcement I have made on this policy had gone to the Cabinet, Cabinet has reviewed and approved it, and this is a Cabinet initiative as well as the Minister of Health. Thank you.
I have to say I really just don’t believe the Minister, Mr. Speaker, and I know that it comes as a shock, but, quite honestly, I just don’t believe it. I mean, I’m not allowed to say I’ve felt misled on this particular issue, but I’ll tell you, I really believed, and so did a lot of people believe, that the issue of co-payments would be considered, not where your threshold would start or stop, but I’ll tell you a lot of people in this Territory believe that the co-payment was going to be discussed under the threshold issue, not just where it’s going to start or whether we should have one or not.
Mr. Speaker, was any issue like that ever taken back to the Cabinet table and said, well, wait a minute, this policy, I don’t totally agree with? Has any discussion ever been brought back to Cabinet to revisit this whole policy? Thank you.
Thank you. Absolutely, Mr. Speaker. We’re talking about health care benefits to make all of the programs and the service benefits available under supplementary health and to provide it without co-payment provided to everybody who lives in the Northwest Territories would make it an insured service. That would make it like any other program under the Canada Health Act and I understand that’s what people want us to do and we have reviewed that and it’s not something we are able to do, because the government has to focus on insured service. Insured services are doctors’ services, nurse services, community health services, our specialist services at the hospital, and no government in Canada could provide full, no questions asked, indiscretionary 100 percent coverage for all supplementary health benefits. No one can do that because we are hard pressed to pay for our physician and nurse services in our communities.
In the North, medical travel is part of the insured services. No government could do that. It’s easy for Members here to say, oh, just include everybody, do it as a universal, and no questions asked. Mr. Speaker, yes, we have considered that. This is not an option that we can afford. So we have to make alternatively a program that’s most accessible to most people in addressing the needs of those who need the government most. This is not a tax on the sick and the elderly because we will protect the sick and the elderly. We will have our seniors, we will still cover people who are not seniors as well. Thank you.
I’d just like to recognize the clock. The time for oral questions has expired, so I will allow the Member to conclude his supplementary questions. Mr. Hawkins.
Thank you, Mr. Speaker. Prior to 2004, the health policy was designated under the disease state coverage. It worked. It may not have been perfect, but it worked, Mr. Speaker. So if you had diabetes you could get care specific to diabetes. That didn’t mean that if you had the sniffles you could get a prescription automatically for antibiotics or who knows what just because you had the sniffles, Mr. Speaker, but that’s the way it’s set up now. It was like a slippery slope, those changes back in 2004. Disease state worked and I’m going to tell you right now that the network and process still exists. We could go back to the old system and it worked, Mr. Speaker.
I’m ashamed that this is the best, when the Minister talks about this three to four years to do, I’m embarrassed that this is the best we could come up with; truly I am. The question to the Minister is why do we waive some of the fees for some of the people, but why can’t we just waive the fees for the rest of the people? We’ve provided enough solutions how to do that. Why not? Thank you.
The fact of the matter is the old disease and conditions list did not work, and it doesn’t work now. Every day I get a request from the Member, every other Member, I get calls from all over the Territories wanting to know why we’re not covering this, we’re not covering that, this medication, there’s a new disease that comes on that gets diagnosed, there are new drugs in the market that we’re not able to pay, we have new wheelchairs, I don’t know, the list goes on. I’m sure if I did the Hansard research I could find a statement made by the honourable Member from Yellowknife Centre who said our program doesn’t work. This is the reason why we’ve had to review this. The better thing about our new program is that it has a mechanism for appeal. Right now there is no mechanism for appeal and under the new program we would allow for an independent appeal process where somebody could appeal their income status, as well as what’s included and not included in the program. Thank you.
Final supplementary, Mr. Hawkins.
Thank you, Mr. Speaker. I started this question period off from my set of questions asking did she take it back to Cabinet with the issues that I raised and somewhat similar as what other Members have raised here. She has implied or made it clear yes. I’d like to ask her, will she table every stitch of information that she’s brought to the Cabinet table to show that she’s provided an alternative approach than the one being presented, the one that this government has buckled into, the one that we have to thank the 15th Assembly for, that this Cabinet keeps defending and saying it’s the way to go? Will she provide this House and table in this House and if we can’t table it due to Cabinet secrecy or whatnot, will she make sure that it’s provided to every Member up there in the House under a confidential basis so we can see what the Minister has proposed other than just continuing to shovel the 15th Assembly policy on this House? Thank you.
I am aware, Mr. Speaker, that the Member considers himself a student of rules and procedures of the House. I know he knows the rules and procedures of the House. He studies books on the rules and procedures of the House. Mr. Speaker, he knows that I’m not privy to table Cabinet documents, but the Member is also aware that every major information and analysis about this program would go to Cabinet and then it was made available to committees. That’s our regular practice.
Mr. Speaker, if the Member has any other alternatives that he wants us to consider, we would look at that. This has been a very open process, Mr. Speaker, and we will continue to do that. Thank you.
Item 8, written questions. Mrs. Groenewegen.
Mr. Speaker, I‘d like to seek unanimous consent to return to item 7 on the Order Paper, oral questions.
---Unanimous consent granted
Thank you. I’d just like to follow up on my questions that I asked previously to the Minister of Health and Social Services with regard to the process in place for examining complaints about the conduct of physicians in the Northwest Territories. Again, I want to be clear, I’m not talking about a whole lot of people. I’m talking about one person. But I need to understand this process, as do my constituents who have concerns about the conduct of this individual.
Mr. Speaker, in response to a previous question, the Minister stated that these things can take a while. That is frightening to me, because when there is a complaint made and this person continues to practice, it necessarily puts other people at risk. I’d like to ask the Minister: what could contribute to this process taking a while? We are, as a government, and she, as a Minister, responsible to protect the public interest. People who are sick are vulnerable. People who are mentally ill are even more vulnerable. It is incumbent on us to make sure that the people who are providing services to them are reliable and of good standing and of good conduct and character. Why would this take a while? Thank you.
The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I do want to let the Member know that I do agree that people who have concerns of this nature should be able to go through the process and have the matter resolved as soon as possible.
Mr. Speaker, I would have to commit to look into how long certain cases do take, what is the normal course of process in going through this. I have to tell the Member that this does not come across my desk very often. I think I might have been thinking about a court case that seemed to take a little longer, but that’s different than the board of inquiry. So, Mr. Speaker, I just do not have information in front of me to give her the information about how long this takes. I am aware the Medical Profession Act has very specified steps laid out as to how this process takes place and I will undertake to get back to the Member. Thank you.
Mr. Speaker, if the conduct of a certain practitioner has been brought into question, if that has been out there unresolved for a period of time and that person continues to practice, does the Minister not see the problem or the danger in that occurring? I’ll ask the Minister again: is she aware of any practicing member of the medical profession in the Northwest Territories who is under investigation at this time and continues to deliver services to the people of the Northwest Territories? Thank you.
Mr. Speaker, as I stated earlier, the Medical Profession Act does state the process by which a complaint against a practicing physician is conducted. It does try to balance the rights of the client as well as the physician, Mr. Speaker. I’d be happy to give the Member a private briefing on how this works. Once in a while we do get concerns from people about what they are not happy with about what the doctor has done or not, or any other health care professional. There are different phases that this goes through. Sometimes just talking to the local authority resolves the matter. Other times it goes further down the steps. I do not have the information on how many are under investigation and I would undertake to get back to the Member. Thank you.
[Microphone turned off.] …again. Might I suggest that it is the Minister’s job to make herself aware of any outstanding complaints about the conduct of somebody who’s delivering services, medical professional services to the people of the Northwest Territories? This is not unheard of in other professions. Sometimes RCMP members are under investigation. Often you hear that until the matter is resolved, their rights and their work is suspended until the matter is cleared up. That takes care of protecting their rights. Sometimes you hear of it in cases of teachers. Not so much around here but in southern Canada you hear of teachers who are suspended with pay.
Mr. Speaker, I suggest to this Minister that there is someone practicing medicine in this Territory today who has been under investigation for years and this matter has not been… And this is adding double agony and strife to this person who has laid a complaint, for this not to be dealt with in an expeditious manner. That is owed to them by whatever practice or process she’s talking about that’s outlined in the Medical Profession Act. That is owed to this person. I am very alarmed, and I hope the public out there is alarmed to hear that somebody could be practicing who has been under investigation for years and just chooses not to cooperate with the process or the system or their peers. I mean, how can that be allowed to happen? This is squarely this Minister’s responsibility.
As I said at the beginning of my Member’s statement today, I have made the Minister aware of this and so now for her to stand up in the House and say she’s not aware of it, she’s had days to prepare herself to respond to these questions, because I forewarned her. I’d like to ask the Minister again: is there an ongoing investigation into somebody who is currently practicing medicine in the Northwest Territories today that brings their conduct into question? Thank you.
I just want to remind Members if there is anything before the court or a judicial process, that we try to avoid interfering in that process in this forum. But I will allow the Minister to answer the question, Ms. Lee, but remember that there are certain processes that are before judicial inquiries or reviews that is not privy to ourselves in this House to ask those types of questions. So, Ms. Lee, you can respond to the question.
Thank you, Mr. Speaker. Mr. Speaker, the Medical Profession Act, as any other professional body, it lays out a very clear process on how these things get conducted. It does not allow for Minister to intervene. I understand the overall responsibility I have as a Minister to make sure that there is a process in place. I do appreciate that the Member did let me know about that. I am not able to say anything in the House that would attribute anything to individuals out there. Having said that, I did let the Member know that I am concerned about what the Member has told me. I have told her that I will undertake to look into the process and give her a private briefing. I just feel that this is really inappropriate, other than talking about medical process and the process outlined, that we will be talking about an individual that we can be talking about. Thank you.
Final question, Mrs. Groenewegen.
Thank you, Mr. Speaker. It is ironic that probably Members of this Legislature are amongst the very few who can actually stand up and talk about this. We haven’t determined that there is anything before a judicial body or a court or anything. We have not determined that, but it is very interesting that if I go outside these doors and speak to the media about this concern about my constituent or this case, I then could become liable in the courts for something. This is the only place where I can stand up. I am probably the only person who can stand up on behalf of this constituent and raise this with some immunity, not to be reckless or careless about that immunity but to bring this to light. I am talking mostly about the process here today. I am trying to understand the process on behalf of my constituent who has been sitting there being dragged through this fight and I am concerned not only about her but the other people who have been affected. It is the tactic of predators who get into these positions where they can prey on people to isolate people. I would like to put it out there today in the Northwest Territories. If you have received treatment from somebody here in Yellowknife for a certain condition, and I think I have made enough clues about it, and you have felt isolated and alone and thought you could not come forward, I would certainly like to hear from them. Mr. Speaker, again, I would like to ask the Minister what she can do to become involved to ensure the safety of the people who are receiving services and care in our medical service. If she can’t get involved, then we have a big problem here.
Mr. Speaker, I think it is important for the Member to know that I do understand the Member’s concern. We do want to make sure that we have a process in place where our residents who provide service have a concern about their practitioner, that there is a process in place. I am just not able to say anything that would give comfort to her that would in any way talk about an individual who is not before this Assembly.
Mr. Speaker, I do commit to her that I will talk to her privately and give her the information that she needs, at least over a short period of time and then we could go from there. I understand her concern, Mr. Speaker. As far as I am aware, the Medical Profession Act has a process in place where a complaints officer could take a number of measures about a complaint against a physician, including putting a condition on their practice. Thank you.
Thank you, Ms. Lee. The honourable Member for Sahtu, Mr. Yakeleya.
Thank you, Mr. Speaker. My questions are to the Minister of Health and Social Services. It has to do with the supplementary health benefits. I want to ask in terms of this policy going forward. I want to ask the Minister about her decision along with her Cabinet in terms of her sense of this policy. Is this a good, effective policy? My concern is for the 2,200-some-odd people who are not receiving health coverage. Certainly there has to be a give and take in terms of how we make sure that this covers for these 2,200 families or people who are not receiving. Is this policy the most effective or the best that we could do in light of our fiscal restraints in the Northwest Territories?
The Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. On the basis of review of analysis we have done, we believe this is a very good program and provides fair and equitable coverage to most people and those 2,000 people that the Member mentioned. Thank you.
Mr. Speaker, just a primary focus of my question is on the coverage of these 2,200 people who are not receiving it today as we talk right now in terms of the coverage that other members of the Northwest Territories do enjoy. Now I want to focus on the concerns I am hearing around the table in the House here and in Yellowknife here, that there is a huge number of local people that are saying that a number of issues that they are telling us to not go ahead with it or scrap it or delay it or consider it again. I want to ask the Minister in terms of this policy here in terms of the people that we are hearing who are both vocal in terms of saying that it is discriminatory or it is not fair or we are going to be chasing them out. I want to ask the Minister, are those numbers high numbers in terms of what we are hearing in terms of the arrangement now or the policy that is being placed in terms of this supplementary health?
Mr. Speaker, I thank the Member for the question. I think what we agree on, and even the Members in this House and what we are hearing from outside, is that everybody says that we should find a way to include those people who are not included right now. I think the issue is about how we do that. The suggestions that have come forward in our public meetings are that we should do it by universality. Just make that part of the Canada, our NWT health care or bring them in by increasing taxes or progressive taxation or do it by reducing other government programs, but I think there is an agreement that we need to bring these people in. We have done the analysis of that and our position is that this is not an insured health service. This is supplementary health services. In most other parts of the country -- and there was an article done by Slave River Journal that did a cross country comparison -- by any comparison except for Nunavut, this program that we are proposing is more generous and it has wider coverage than any other available. Thank you.
Mr. Speaker, can the Minister answer me in terms of answering the question here in terms of this supplementary health benefit? It is not like the one that they have given to the aboriginal people or the Metis. That is the question that we are faced with. Can she then explain to me and residents in my riding, some of us in the Sahtu receive medical services under the federal government and some of the Metis constituents receive services under the GNWT and now we are talking about this issue here where we are talking about a co-payment plan for non-aboriginal people. I want to ask the Minister in terms of being clear to me in explaining how this is done in Canada and the Northwest Territories so we don’t get too far into the fine lines of who is covering who and who is getting what in terms of health care in the Northwest Territories.
Mr. Speaker, I think those are the similar questions that I got when I did the Minister’s tour with Minister Lafferty through Monfwi. In Wekweeti and Whati we had some questions and we were able to clarify having a discussion.
Mr. Speaker, I think it is important for everybody out there to know that when we are talking about supplementary health benefits, we are not talking about what people know to be a health care coverage. Everybody in the Territories and Canada, you go and see a doctor or nurse, get a surgery, have a baby, have a hip replacement, all those are health care services that everybody is entitled to and none of that is changing, whether you are aboriginal, non-aboriginal, you live in Yellowknife or anywhere in Canada. What we are talking about is extended health services which is not part of Canada Health Act which is covered in provinces and territories in its own way by the policies and direction of each government. For the aboriginal people in Canada, there is a federal program, NIHB. We have Metis Health Benefits Program in the Territories. There are lots of people in the Territories who get this coverage through their employer’s insurance. What we are trying to do is to cover those who are not entitled to any of those programs to access this. This is for drugs, for glasses, and dental. Those are the extra health care benefits that people need to find a way to access. This is our suggestion for doing that for those who can’t have access elsewhere. Thank you.
Final supplementary, Mr. Yakeleya.
Thank you, Mr. Speaker. Would the Minister explain to me what it would mean if this Legislative Assembly delayed the implementation of the new policy that she’s bringing forward? What would it mean to us, what would it mean to the people in the Northwest Territories?
As has been said many times, this program has been reviewed since 2003 because people feel there are people who are excluded from this program and there are no means for them to appeal or to have us look at the list. Unless you are under Income Support, you do not get support for dental or vision care. So I believe that it is incumbent on the government to come up with a program that gives access to 100 percent of the people, but ask those who could afford to make a co-payment to contribute a little, contribute part of that, Mr. Speaker. This will be like any other, it’s like giving everybody an employer health insurance program and I believe this is essential for the sustainability and viability of our health care system going forward. Thank you.
Thank you, Mr. Speaker. Mr. Speaker, I’d like to table a sample postcard I made up on the occasion to help the citizens fight for supplementary health benefits because they matter. This is a postcard addressed to our Premier, Floyd Roland, and Sandy Lee and it simply states Make Health Care Benefits Universal, No to Co-Payments and Find Another Way. Thank you, Mr. Speaker.
Mr. Abernethy.
Thank you, Mr. Speaker. I have a number of documents to table. The first one is a letter to the Honourable Premier Floyd Roland, dated April 16th, from me, outlining a significant number of concerns related to changes to the Supplemental Health Program, as well as some potential recommendations on how to move forward with fixing the policy without disadvantaging a significant population of the Northwest Territories.
The second tabled document I’d like to table is a response from Premier Floyd Roland dated May 6th, which doesn’t actually address any of the questions asked or talked to any degree about any of the recommendations that I made, but it does indicate that not only does Cabinet clearly approve the Supplemental Health Policy, it has also provided frequent direction on program development and implementation to the Minister of Health and Social Services and will review the program proposals again before anything is implemented. Collectively we remain convinced that asking those who can afford it to contribute something to their own costs, as most NWT residents already do.
The third document I’d like to table is the Policy on Supplementary Health Benefits.
