Debates of May 9, 2007 (day 3)

Thank you, Mr. Roland. Supplementary, Mr. Hawkins.

Supplementary To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Well, clearly, this is a problem having a club foot in the Northwest Territories. There may not be an epidemic, but it is an issue, Mr. Speaker, and, further, it’s an issue that we could solve; it’s something within our reach. So, Mr. Speaker, what is the apprehension of adding club foot to our extended health benefits? Thank you.

Thank you, Mr. Hawkins. Mr. Roland.

Further Return To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Mr. Speaker, it’s not just a matter of one subject or one disability over another being added to the list. There are many that don’t make the list, whether it’s in the drug side, particular procedures and, as well, we’d have to look at, as we do with a lot of our programs, income of individuals and whether they qualify for some of our programs or not. Thank you.

Thank you, Mr. Roland. Supplementary, Mr. Hawkins.

Supplementary To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Well, Mr. Speaker, we’re not allowed to ask the opinion of a Minister, although that would seem relevant in this particular case. However, Mr. Speaker, we pay for the surgery of this problem and it seems completely absurd why we would ignore the treatment side. I mean, what’s the point? So, Mr. Speaker, what would it take to get club foot on the extended health benefits list? Thank you, Mr. Speaker.

Thank you, Mr. Hawkins. Mr. Roland.

Further Return To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Mr. Speaker, the fact that in many procedures, not just in the Northwest Territories but all of Canada, we, as providers of health care service, would cover for surgical procedures, hospital bed time. In many cases when patients are released back to their communities or homes, they have to pick up their own tab on drugs and so on as a result of some of the procedures, so this is not a unique case. It would take for adding this one case to the list, we'd have to do a review to see if it's one thing or another; or, if we're going to add to this list, what's the priority. We have a growing cost already that we're having a hard time keeping in check and we add another procedure to it. That's some of the stuff we have to weigh as we look at this. Thank you.

Thank you, Mr. Roland. Final supplementary, Mr. Hawkins.

Supplementary To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Well, again I think the Minister underscores the oddity here; whereas we pay for the surgery but we don't pay for the treatment. I mean it becomes completely irrelevant at that point. Why do the surgery? It's confusing, Mr. Speaker. So my last question to the Minister is, what will it take this Minister to recognize and identify that this is a real issue to go on our extended health benefits? Does he require letters from mothers? Does he require a motion in this House? Does he require camping out at his doorstep? Does he require a petition? What would this Minister like to see to add this issue to our extended health benefits list? Thank you, Mr. Speaker.

Thank you, Mr. Hawkins. Mr. Roland.

Further Return To Question 40-15(6): Health Benefits For Congenital Club Foot

Thank you, Mr. Speaker. Mr. Speaker, the Member is continuing on his view of this. The situation is, as a government, if we had more money to put into our extended health benefits policy, would this be one of the priorities, and that has to come under the equation. We'd have to look at a whole number of procedures that are not included now that people would have to pay on their own or go to other jurisdictions that we can't provide. As I stated before, there are procedures, surgeries done on patients. Once they've gone home, they have to pay and pick up the tab on a number of other things. So this is not a rare or unique situation. Unfortunately, there are situations where issues aren't dealt with through our existing system. In all of our programs, as we're reviewing, we have to look at the ability of patients to be able to pay some part of their own care. Thank you.

Thank you, Mr. Speaker. Mr. Speaker, my questions today are for the Premier, the Minister responsible for the Deh Cho Bridge Act and corporation, and the proposed construction of the Mackenzie River bridge. Mr. Speaker, as I mentioned in my Member's statement earlier, most residents here in the North Slave region in the city of Yellowknife would welcome a bridge. But from where I stand, I don't believe the project has received any level of scrutiny by Members of this House, by the public; and by the sounds of the Premier's sessional statement, we're marching headlong into agreements without any federal assistance. Mr. Speaker, I'm a tad bit confused, I must say, because over the past three years the government has insisted that the project wouldn't go ahead unless there was federal assistance, and now in the sessional statement today the Premier is saying that the project is going to go ahead. So I'd like to ask the Premier, if he could, to let us know if indeed the project, the Mackenzie River bridge, will be built without any federal assistance. Mahsi.

Thank you, Mr. Ramsay. Honourable Premier, Mr. Handley.

Return To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Let me, first of all, clarify that responsibility for the bridge project now rests with the Minister of Transportation. But, Mr. Speaker, I'll answer the question since it was directed to me. Yes, we are going to move ahead. We'll move ahead carefully, but we'll move ahead with solidarity. We're not going to slow down on this one. Mr. Speaker, I wrote to the Prime Minister this week, asking him, reminding him of his commitment and that this is part of the national highway system and we fully expect to have that. Mr. Speaker, keep in mind that these negotiations are between the Bridge Corporation and the contractor. It is the Bridge Corporation who is owning this bridge during the concession period, so it's not 100 percent ours. But I will take a look at how we can arrange briefings for the Members. Thank you, Mr. Speaker.

Thank you, Mr. Handley. Supplementary, Mr. Ramsay.

Supplementary To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Mr. Speaker, the fact of the matter is the decision to proceed and whether in fact the Deh Cho Bridge Corporation enters into agreements with contractors, that is going to tie the hands of what's left of this government and the governments for the next 35 years into paying for it, not to mention the tolls that are going to have to be paid on goods that are trucked across that bridge. I think we really have to take a look at this and make a business case for it. Again, we've had one briefing in the past three years that would suggest if you're anywhere close to making a decision, without any federal money, Mr. Speaker, this project, to me, should be put on the back burner. I don't believe we should be taking all the risk. I'd like to ask a question to the Premier. How much equity or risk is the Deh Cho Bridge Corporation putting into this project? Mahsi.

Thank you, Mr. Ramsay. Honourable Premier, Mr. Handley.

Further Return To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Let me just remind Members that in 1978 I believe it was, the Legislative Assembly of the day looked at the price of the bridge and decided then that $6.2 million was too much, so they put it on the back burner. Today we're looking at, as the Member had said, something in the neighbourhood of 130, somewhere in that range. If we had done it in 1978 instead of putting it on the back burner, we would have had a bridge a long time ago and we'd have a cost of living that's a lot lower than it is today.

Mr. Speaker, I'm concerned of putting it on the back burner because the costs are going to continue to go up. So we've got to get on with this project and that's been our message to the federal government: Get on with it. Do it. It's going to be less money this year than it's going to be five years from now or whenever we think we may have the money.

Mr. Speaker, in regard to the equity from the Bridge Corporation; yes, they are putting money into it. They are investing in it; they are taking some risk on it, and I don't have the exact numbers on that information, Mr. Speaker. Thank you.

Thank you, Mr. Handley. Supplementary, Mr. Ramsay.

Supplementary To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Mr. Speaker, I know some of my colleagues are saying build a bridge. Well, build a bridge; we haven't seen a business case, we haven't seen the numbers, and I'd like to know how we can build a $130 million bridge with our eyes closed, Mr. Speaker, and to me that's what we're doing, we're building it with our eyes closed. We haven't seen a business plan; we haven't seen the numbers; the feds aren't coming up with any money, but yet we're going to move ahead and enter into agreements. Mr. Speaker, something about that just doesn't sit right with me. Sure, I want a bridge, like anybody else wants a bridge, but I want to know how the heck we're going to pay for it over the next 35 years and that has to be clearly spelled out. The stakeholders in the North Slave region have to be consulted. I'd like to ask the Premier if the stakeholders, and I'm talking about the business community here in the North Slave, when are they going to be consulted about the possible increase to the tolls that trucks are going to have to pay crossing that bridge? Mahsi.

Thank you, Mr. Ramsay. Mr. Handley.

Further Return To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. What is of concern to the stakeholders north of the Mackenzie River is the amount of the toll and what that is going to cost them. That's the bottom line for them. In terms of the detail of all the financial information and how it's being financed and so on, that's something that I will see if we can share it with the committee, but keep in mind it is the Bridge Corporation's contract not ours. We're paying a toll and we're paying, in addition to the toll, an amount to make this work including the ice crossing and winter road. But, Mr. Speaker, it's the bottom line of how much it costs that is going to be important to people.

Mr. Speaker, just a correction. The Member said earlier in his statement that the commitment was that the toll would not exceed $6. That's not quite accurate. The toll was set at $6, but there's also a factor that was worked in for inflation. So it would go up gradually over the years because some day, 20 years from now, 30 years from now, $6 may have the value of $2. So we need to have that inflationary built into it. Thank you, Mr. Speaker.

Thank you, Mr. Handley. Final supplementary, Mr. Ramsay.

Supplementary To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Mr. Speaker, I want the Premier and the government to know I'm ready and willing to work with them to see that this bridge gets constructed. I just want to know what's happening and, Mr. Speaker, we haven't been given the level of detail that would let me lend my support to us entering into a $130 million deal with the Deh Cho Bridge Corporation. At the end of the day it is public money. It requires the scrutiny of this Legislature before the government can enter into getting this project off the ground. I would like to ask the Premier if he could commit to coming back before any agreements are signed to vet the agreements with Regular Members of this House at the very least. Thank you.

Thank you, Mr. Ramsay. Mr. Handley.

Further Return To Question 41-15(6): Deh Cho Bridge Project

Thank you, Mr. Speaker. Again, as I say, the Bridge Corporation will be signing the agreement. They have undertaken to complete the agreements within a month, or by early June. Mr. Speaker, if we have the information that can be shared with the Members, then certainly we will do that. There is nothing secret in here other than the confidentiality by the partners in the agreement. Mr. Speaker, I must say I appreciate the Member’s support for the project. We will make it a project that is good. Mr. Speaker, if I might say, as well, there is P3 money in the federal budget for this year and for future years. There is also extra capital money, $25 million a year in there. We don’t intend to use big chunks of that for this bridge but, Mr. Speaker, we intend to get our share of that P3 money to apply for this and make it a great P3 project. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. Mr. Speaker, in my Member’s statement, I raised a number of issues. I want to start with one of them today. The question is about the announcement that was made on the wait times by the federal government and his territorial counterparts about a month ago in the Great Hall. I would like to ask the Minister of Health a question about how that proposal, in terms of how it relates to the North, has come about. The federal statement stated that the wait times would gear towards five categories. Some of them being cancer treatment, diagnostic imaging and surgical programs and such, but for the northern communities, the money is small. I understand that it is only about $5 million. It would go toward primary care. There is nothing wrong with that, but I would like to know how that program idea came about, because my understanding is we were not consulted in Social Programs committee. I don’t know what the Minister did. The insider constituency meeting suggested that, in fact, the federal government did want what the GNWT wanted. I would like to know how the Minister came about that idea. Thank you.

Thank you, Ms. Lee. The honourable Minister responsible for Health and Social Services, Mr. Roland.

Return To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, the issue of the wait times discussions that went on between the federal government, provinces and territories was one where the three northern territories were very concerned with how that was moving and what impact that may have on us, because a lot of our critical care needs are done in southern jurisdictions. If they decided to change how they dealt with us, it could have an impact on the overall health care delivery. So we looked at the issues where we felt had our greatest pressures and worked with federal Health in that area. Yes, the Member is correct; federal Health looked at it and agreed with the three territories on the unique challenges we face and agreed that we could have a different look and viewpoint on how we are going to move forward on this. We chose the primary health care area. Thank you.

Thank you, Mr. Roland. Supplementary, Ms. Lee.

Supplementary To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, like all things we deal with, all these things work in a continuum. We can’t isolate one issue at the exclusion of all the others. While we need to put resources into primary care in communities, that is important, but we still have to address the wait time issues in areas that the federal government talks about; in particular, diagnostic imaging. We have a long line-up at the territorial hospital here to get X-rays, C-scans, unless you go to emergency. You may have to wait days or a couple of weeks just to get an X-ray on your back about what is wrong with you. I would like to ask the Minister what we are doing about dealing with the wait times in that regard. Thank you.

Thank you, Ms. Lee. Mr. Roland.

Further Return To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, in a couple of areas we are already meeting what times we have talked about and discussed. For example, hips and knees and cataracts are areas where we have already got fairly good coverage, so we are meeting on some of those targets the federal government has sort of aimed at as we feel we are adequate in those areas. Our challenges are, and we continue to be challenged, for example in primary care first contact. When a patient goes into a health centre or a hospital, what are our challenges? Our greatest challenges are in the smallest communities. Hence, the target of a community health nurse education initiative that we are looking at as well as the nurse practitioners side. We are also working on diagnostic imaging. We continue to work in that area, for example, with Capital Health Authority. We are working in that area to improve on the diagnostic imaging area. Thank you.

Thank you, Mr. Roland. Supplementary, Ms. Lee.

Supplementary To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, I understand we need to have front-line care in the communities and also the argument is that because a lot of our cancer care and even surgeries are done with Edmonton Capital Health Authority that we are addressing it that way. But you could switch that. The reason we are relying on them is because we have been without a second surgeon for a long time. We are having a hard time recruiting that. We have a waiting list on surgeries for hips and joints. We haven’t had a full staff diagnostic imaging in a long time. So I think it is important for the government to work on all fronts. I would like to give the Minister an opportunity to explain how we are addressing those areas, surgeries and diagnostic imaging here and shortage of staff here, and therefore creating wait times. Thank you.

Thank you, Ms. Lee. Mr. Roland.

Further Return To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, when you do a comparison with what is happening in the territorial health area, Health and Social Services with other jurisdictions, we have a pretty good system in place. How we are able to meet the demands. If you go to Alberta even, which is seen as one of the richest areas of the country, and look at the demands on their system and some of the wait times there, we are doing okay here in the Northwest Territories. Yes, we need to continue to improve. That is why we are continuing to work with Capital Health Authority on the diagnostic imaging area. That is something we will continue to do. In fact, I think we are pretty close to coming to an agreement on how we will work together.

The actual area of wait time guarantees is still under a lot of discussion with Canada, the provinces and territories. It is not a concluded area. We are going to have to see how the federal government will come to the table in what manner and with what resources if we are actually going to nail down what wait time will be on any health procedure across the country. If we were to try to take over a lot of the services that we get done right now by our partners in southern Canada, we would have to infuse a whole lot more resources than we can afford at this point. So what we have tried to do, for example, and we have done it, is we have started our own Nursing Program in the North to get the nurses on it. We have a full complement of doctors here in the capital and working on it and trying to solidify that within the region. So we are taking a number of those steps to continue to improve in those areas. Thank you.

Thank you, Mr. Roland. Final supplementary, Ms. Lee.

Supplementary To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, with all due respect to nurses, nurses don’t do surgeries. Surgeons do surgeries and they don’t do diagnostic imaging. Primary health facilities, while they are important, don’t do these either. These are important wait times. I beg to differ with the Minister in that we do have our own problems here and wait times to deal with. First of all, I would like to ask the Minister to commit to giving us information as to how he compares us with the rest of the country. I would like to ask the Minister to commit to providing that information and also his commitment that he will continue to work with the federal government and look at this as a problem area, because I am sensing from the Minister that he thinks this is all okay and not working on that. We need to address those wait times as well. Thank you.

Thank you, Ms. Lee. Mr. Roland.

Further Return To Question 42-15(6): Health Procedure Wait Times

Thank you, Mr. Speaker. Mr. Speaker, the issue of wait times is not, as I stated, an issue that is concluded. It is an area where we are challenged. We are going to continue to be challenged, especially when you look at the partners that we have in the Northwest Territories, in delivering health care. Yes, I will work and provide information. I will gladly sit down with the Social Programs committee or all Members of this Assembly to show how we work through this and how we have come up to highlight where we think we need to focus on this time and, in fact, some of the areas we are working on like diagnostic imaging. We continue to work with the federal government. By signing this agreement, we have opened the door to potentially more resources in the area of how we deal with diagnostic imaging. Thank you.

Thank you, Mr. Speaker. Mr. Speaker, my question today is to the Minister of Education, Culture and Employment. Mr. Speaker. I would like to, at this time, just take a few minutes just to offer my condolences to my honourable colleague in the Nunakput riding to some of the students I went to school with that the Member mentioned earlier in this statement here.

My question is to the Education Minister, Mr. Speaker, is that in the sessional statement by the Premier, he quoted saying the education of our youth remains one of our most pressing challenges facing our territory and is a continued priority of our government. Mr. Speaker, what measures does the Minister have to compare the achievement levels of Grade 12 graduates in small communities to those larger centres? How are we doing in terms of the quality of our education in our smaller communities versus our larger centres? Thank you.

Thank you, Mr. Yakeleya. The honourable Minister of Education, Culture and Employment, Mr. Dent.

Return To Question 43-15(6): Enhancing Post-Secondary Student Achievement

Thank you, Mr. Speaker. I think one of the best measures of success of our students coming out the secondary system is how many of them can move successfully into the post-secondary system; how many can go on to college or to studies after high school. We can assess that by looking at the student financial assistance record. We know that before we got into grade extensions, we were seeing in their best years about 34 percent of students who were going to post-secondary studies who were aboriginal. There were only about 842 students a year accessing student financial assistance at that time. Most recently, we are seeing over 1,500 students accessing student financial assistance. That is the current number. Our five-year average is about 1,440. Of those, 661, or 46 percent, are aboriginal. So we know we are seeing people in the smaller communities come to the school and being more and more successful getting into post-secondary studies. Thank you, Mr. Speaker.

Thank you, Mr. Dent. Supplementary, Mr. Yakeleya.

Supplementary To Question 43-15(6): Enhancing-Post Secondary Student Achievement

Thank you, Mr. Speaker. I would like to ask the Minister what steps he is taking so that in the future high school diplomas in the small communities will be the same quality as the diploma from a larger centre such as Yellowknife, Hay River or Inuvik. Thank you, Mr. Speaker.