Thank you, Mr. Speaker. I would like to take this opportunity to welcome our new chief public health officer, Dr. Lorne Clearsky. Dr. Clearsky is the community medicine specialist from the Waywayseecappo First Nation in Manitoba. He graduated from the University of Manitoba medical school in 1990, completed his family practice residency in 1992, and began working in northern Manitoba for five years as a fly-in physician for First Nations communities.
He comes to us from the Calgary Health Region where he was a deputy medical officer, the medical lead for the Aboriginal Health Program, and clinical assistant professor at the Department of Medicine at the University of Calgary.
I’d like to ask you all to join me in welcoming Dr. Clearsky to a long and productive work time here in the Northwest Territories and get to know the people of the Northwest Territories and provide his valuable skills to them. Thank you and welcome.
Thank you, Mr. Miltenberger. The honourable Member for Weledeh, Mr. Bromley.
Thank you, Mr. Speaker. I’d like to recognize Wendy Lahey, a constituent of Weledeh and a keystone in the democratic process towards responsible midwifery services.
Thank you, Mr. Speaker. My questions are directed to the Minister of Health and Social Services and are in regard to my Member’s statement. In this day and age we still have critical programs and services not being delivered to a lot of our more isolated communities. I think in order to have healthy and vibrant communities, the building block of any community is to develop a healthy side to those communities. I’d like to ask the Minister what his department is doing to ensure we have essential programs and services delivered in all communities so we have healthy and vibrant communities.
Thank you, Mr. Krutko. The honourable Minister responsible for Health and Social Services, Mr. Miltenberger.
Thank you, Mr. Speaker. As a government we are doing a number of things collectively. Health looks at all the health services with the nursing stations and with the medical side, the social services side, the child welfare piece. We have significant education presence in communities. We have Municipal and Community Affairs that is there with communities as they work on the services that lead to a better quality of life as well as on the recreation side. We have ITI there supporting business, local business and small business, to do work at the community level to help with the economy. We have Transportation there building infrastructure with Public Works and Services.
Collectively as a government we spend a significant portion of our $1.3 billion in the communities trying to deal with the issues that the Member has talked about so passionately over the last 16 years.
Again, I think it’s important that we do as government seem to have a lot of programs and services in the larger centres. A lot of the time we lose sight of those programs and services that do not exist in a lot of our communities. I think I’ve talked about respite care and midwifery, caregiving programs, wellness programs, and even mental health and addictions programs. Those are the building blocks for healthy communities. I’d like to ask the Minister what the department is doing to ensure that it streamlines the funding that is going into the area of Health and Social Services, and ensuring that there’s a base funding for programs and services in all communities so that at least they are meeting the minimum needs of all our communities.
If I may use the specific example that the Member referenced, the midwifery review is going to look at potential birthing services in other communities across the North, keeping in mind that the Mackenzie Delta, Nahendeh, Tu Nedhe, Nunakput, Sahtu, Monfwi, and the Deh Cho have no birthing services of any kind. As we look towards what is the best service and how do we provide those services, that’s one of the key factors we have to keep in mind.
Again, in order for programs and services to exist, you need bodies on the ground. It does take investment. We have health centres in the Northwest Territories that don’t have nurses in them. I think it’s a shame in this day and age that we are funding health centres without the core staff to run them. I’d like to ask the Minister what he is doing to ensure we have nursing services, and programs and services in communities where we have the basic infrastructure already on the ground, yet we’re not delivering programs and services.
As a government we have committed many millions of dollars coming up with our own program for nursing in the North to train Northerners up to the degree level. We have expanded into the nurse practitioner range. We are trying to work with nurse graduates to give them enough additional training so that they can actually go out into the communities where they may be by themselves or where they may in fact be playing a lead role like community health nurses or nurses in charge. While we still have some ways to go, we have minimized our reliance on local nurses and casual nurses and remain committed to training Northerners for those roles.
Thank you, Mr. Miltenberger. Final supplementary, Mr. Krutko.
Again, I think that people have to realize that a lot of times our services in the communities include one doctor’s visit a month. If you’re lucky you might see a social worker once a month. The same thing with regard to core service positions, whether it’s dental care once a year. That’s the type of stuff that people want to see improvement on.
What are we doing to improve the number of days that doctors and professionals spend in those communities and expand that service so they can see more doctors visiting, more nursing days in our communities, and the same thing with dental care?
Last week, speaking as the Minister of Finance, I gave a fiscal update that indicated the financial fiscal constraints that we are under as a government and that our ability to deal with a lot of new program demands is very limited. This applies specifically as we look at the very great demand from the communities to look at service improvements. We will do what we can through the business planning process, through the forced growth that we do have available, but we are limited by our fiscal constraints that we are currently under. Through the business planning process coming up for 2012-2013 we’ll be looking at trying to address more effectively some of the issues that the Member has mentioned.
Thank you, Mr. Miltenberger. The honourable Member for Hay River South, Mrs. Groenewegen.
Thank you, Mr. Speaker. As I referred to in my Member’s statement earlier today, I think we all have some concerns after seeing what’s transpiring in northern Alberta right now with regard to forest fires. The situation that occurred in Slave Lake where within such a short time span a forest fire broke out and destroyed almost the entire community, are there any observations, lessons to be learned for us here in the North on how that whole situation transpired? Is that something that the Minister is going to look at to avoid such a tragedy in our territory?
Thank you, Mrs. Groenewegen. The honourable Minister responsible for Environment and Natural Resources, Mr. Miltenberger.
Thank you, Mr. Speaker. What we’ve observed, of course, is every community’s worst nightmare, where there is a confluence of time and events, and circumstances and conditions of weather and dryness that resulted in significant wind that resulted in a catastrophic event.
For ourselves in the Northwest Territories we have our fire crews in place. While we recognize that it is much drier than normal, we have our contracts with bombers and the rotary wing craft. We have been working long and hard in the communities to do FireSmart programs. We have changed our command and control structures when it comes to dealing with fires and making decisions at the fire site up through the chain of command so that people on the ground can now be able to respond quickly and efficiently with knowledge that they have, and not have to wait for it to bump its way up from Fort Smith or Yellowknife or some other place.
As we prepare for the fire season, we look to the south. Nightly I’ll look to the sky and as I say my goodnight prayers, I’m always praying for rain these days.
Last year the province of British Columbia budgeted $50 million for fire suppression and spent $500 million. What does our government currently have budgeted for fire suppression in the Northwest Territories? What contingency do we have should we end up with a worse fire season than normal?
We recognize the way we have set up the funding with the fire program that we will require supplementary appropriations. It was specifically designed that way so that we could monitor more closely and have the funding spent on an as-required basis. We anticipate we will be coming forward as the fire season proceeds for supplementary appropriations. The question will be for how much.
If I may point out, in B.C. and in Slave Lake what you have is fires very close to communities and large communities. In B.C. most of the money was spent protecting communities that were affected by fire. They had little resources even with the tens of millions, hundreds of millions that were spent to actually fight fires that were not tied to protecting communities. We are going to be doing our best to protect our communities in the Northwest Territories, doing the preparatory work, and we will spend the resources that we need to, to protect those communities.
What reciprocal agreements do we have in place with other jurisdictions in Canada to provide them with support if our fire season is not making busy our crews and equipment that are on standby? What agreements do we have in place to lend support where it may be required in neighbouring jurisdictions and where they may come to our aid should we require their assistance?
We have a number of agreements. We have the MARS agreement, which is applicable across Canada for mutual aid and reciprocal response. We have the Northwest Compact Agreement covering the western provinces and the northwest States, Canada/U.S. Reciprocal Agreements. We have the NWT-Alberta Border Agreements and agreements with Parks Canada for fires in national parks.
Thank you, Mr. Miltenberger. Final supplementary, Mrs. Groenewegen.
Thank you, Mr. Speaker. A lot of fires in the Northwest Territories are triggered by lightning. Some others are started by human carelessness. Given the anticipated dry season that we’ll be facing this summer, is the Department of Environment and Natural Resources doing anything to create more public awareness about the dangers of discarding of cigarettes or leaving campfires not completely put out? What is the department doing on the awareness side of the issue?
We have our own ongoing public education program. Every year, as the season progresses and we find out how dry it is and what the risk is, then as the rating gets more extreme, we increase the public awareness.
We work with communities, as well. Many communities have no burning bans around campfires. If it gets bad enough, there may be no campfires. We are already engaged in the process of making people aware, and everybody that’s been outside knows already how dry it is and how low water levels are, and that we are potentially facing a very incendiary fire season. Thank you.
Thank you, Mr. Miltenberger. The honourable Member for Frame Lake, Ms. Bisaro.
Thank you, Mr. Speaker. My questions today are addressed to the Minister for Health and Social Services, and I want to follow up on my statement about the cancellation of the Midwifery Program.
I recognize that cancellation may not be the correct word. The program was suspended, and it was suspended at the request of the Yellowknife Health and Social Services Authority, but that authority has never, ever been funded adequately for the Midwifery Program, and it has actually put them into a deficit, from what I understand. To my way of thinking, the Minister’s acceptance of Yellowknife Health and Social Services Authority’s request shows no willingness on the part of the department to find the money to keep the program going. I’d like to ask the Minister to explain why the department considered it okay for a well used, successful program to be cancelled or suspended -- your choice of words -- outright, without careful consideration of the impact that it would have. Thank you.
Thank you, Ms. Bisaro. The honourable Minister responsible for Health and Social Services, Mr. Miltenberger.
Thank you, Mr. Speaker. There was careful consideration given to the request. Yellowknife has, in the Northwest Territories, the best services available on the medical front, of nurses, nurse practitioners, doctors, obstetricians, everybody that you could possibly need to have a successful pregnancy, to do the prenatal and postnatal work. Yes, midwifery is nice to have if we can afford it.
I pointed out earlier that every region here outside of the large centres, the Sahtu, Nunakput, Tu Nedhe, Nahendeh, Mackenzie Delta, Monfwi, and Deh Cho, don’t have birthing services at all. So we have committed to a plan and we’re going to get that plan done so that for the next business planning session, that there will be a consideration for the recommendations put forward as a result of that review. Thank you.
Thanks to the Minister, I think, for that answer. I appreciate that we have excellent facilities here for birthing, and it’s not so much that we have facilities we should cancel one program because we have another program that allows for a certain kind of birthing. There are also the advantages to be considered of a secondary birthing program, and one of them is financial. I think that certainly midwifery is a cheaper alternative to hospitals. I appreciate also that the Minister talks about areas that don’t have midwifery services or even birthing services. Absolutely, we should be expanding the program, not cancelling, as he’s doing.
I appreciate the fact that we’re doing a review. I’d like to ask the Minister who is going to be involved in this program review and expansion analysis. Thank you.
As the Member encourages us to expand the programs here in Yellowknife, I just want to point out that I recollect sitting at that witness table and listening to the Member’s deep concern that we were going to overspend our supplementary reserve, and cautioning us and urging us to be fiscally prudent and responsible, which we’re trying to do.
Mr. Speaker, there will be a process. I don’t believe the consultant has been picked yet to do this, but there will be work with the current midwives, the medical community and stakeholders. They’ll be taken across the Northwest Territories to see what’s possible, should the time come when resources are available for us to consider those types of program expansions. Thank you.
Thanks to the Minister. I would encourage the department and the Minister to get as broad representation from users and potential users of this kind of a program as possible.
I’d like to know from the Minister, if they’re going to a contractor to do this review and analysis, would the Minister and the department be open to a non-government organization putting in a proposal to do this review and analysis? Thank you.
There will be an RFP put out and folks can apply for that. That will be an open kind of process, and if they are the ones chosen and meet the requirements, then they’ll get the job. Thank you.
Thank you, Mr. Miltenberger. Your final supplementary, Ms. Bisaro.
Thank you, Mr. Speaker. Thanks to the Minister. I would hope that when the Minister and the department evaluate these proposals that they look at the time frame that is being proposed at the time that they do that evaluation.
Can the Minister advise me and the House when we can expect the results of this review and analysis? Thank you.
As I indicated in the previous answer, the intent is over the life of this current fiscal year to get the work done and have it ready so that when the new 17th Legislative Assembly comes into place and the government is up and running, that they’ll be able to consider the results, findings and recommendations as they look at the 2012-13 business planning process. Thank you.
Thank you, Mr. Miltenberger. The honourable Member for Weledeh, Mr. Bromley.
Thank you, Mr. Speaker. My questions are also for the Minister of Health and Social Services. I note that the Minister has said that full obstetrical hospital services are available, so the loss of the Midwifery Program is not serious here in Yellowknife. This, of course, misses the point. Midwifery delivers a service that, in fact, ensures the health of young mothers and their babies far beyond surviving the experience.
Our current underfunded service is probably delivering big savings and enjoys enormous client support, but the promise since 2009 hasn’t been carried out. At the very least, a thorough analysis of the program can best be carried out while we have the program and community linkages to include in the analysis. Why must this program be cancelled during that analysis? Thank you.
Thank you, Mr. Bromley. The honourable Minister responsible for Health and Social Services, Mr. Miltenberger.
Thank you, Mr. Speaker. As the Member is aware, we are, as a government, facing significant financial constraints and that constraint is translated and transferred down to all the agencies and boards that we fund, which are health boards, education boards, housing boards, and all the other very many programs we run. Yellowknife Health and Social Services made a determination that it was not effective to run it with one midwife, so they made a decision to put these services on hold pending the result of the broader review. That’s what they’ve done and I supported their decision. Thank you.
Following up on my colleague’s question, the first step of the analysis will undoubtedly be assembly of the terms of reference for the review. We want to get off on the right foot, so let’s ensure that any review incorporates the concerns, insights and experience of the clients and stakeholders, that’s past and present clients of the program, the NWT and Nunavut Public Health Association who are on record in support, and even the Dene Cultural Institute to flesh out revival of this traditional practice. Will the Minister commit to including stakeholder groups in the development of the terms of reference for this analysis, and when will that take place? Thank you.
The Member is aware of the response to his petition that the former Minister of Health and Social Services wrote to him, and we will honour the points and the content of that commitment, that written response to his petition. Thank you.
Thanks for that response. Of course, it’s good to hear it in the House, having the record of the past Minister making claims that haven’t come to fruition.
Mr. Speaker, we hear a lot of talk about the money here. The money involved is actually quite modest, even for a backup for this, and we all are aware of the areas in the government that could be tightened up for this sort of thing. When you look at $1.4 billion, this is a priority that’s been stated by our people, so will the Minister immediately reinstate the Midwifery Program, add the necessary backup at modest cost, and conduct the review while it is in operation just as we do in all other program reviews? Thank you.
Mr. Speaker, the decision to suspend services was made by the Yellowknife Health and Social Services Authority. Just listening to Member’s statements, many of the small community Members laying out all the things that they require for basic services in their communities, some of them fairly modest in terms of cost if you just looked at them individually. So we have, and I’ve also stood up in this House and laid out the constraints that we’re under as a government. So the answer to the Member’s question would be no.
Thank you, Mr. Miltenberger. Your final, short supplementary, Mr. Bromley.
Thank you, Mr. Speaker. The Minister seems adept at pointing out the small communities and the service problems that they have there, things that Members on this side of the House regularly talk about. I’m getting kind of tired of that response when we’re talking about specific issues here. I’m wondering what will the Minister do in terms of getting this back in service immediately, and does he see this as a temporary cancellation extending for years and years. What is the end point, the actual implementation of recommendations as a result of the analysis? Thank you.
