Debates of October 14, 2005 (day 10)

Thank you, Mr. Speaker. Mr. Speaker, my questions today are for the Minister of Health and Social Services, the Honourable Michael Miltenberger.

Probably one of the concerns we have had raised most often at our constituency office, and just from meeting people in the street and talking to them -- townsfolk of Hay River -- is the wait time to get into the Hay River Medical Clinic. That seems to be the hot topic right now in Hay River. With all due respect to our CEO and our board, they have devised a new plan where they are trying to resolve issues like backlog and avoid no-shows. Certainly people have a responsibility for those kinds of things, and there is always several sides to any given story. I just want to give you and example of what seems to be coming down to almost a work-to-rule.

We should have six doctors in Hay River. We have three: Two are leaving, and we have one half-year locum. I know the Minister can't wave a magic wand and make doctors appear; however, this is compounding the problem. The people of Hay River received in their mailboxes recently something called walk-in process. It says, "The walk-in clinic is not for prescription renewals, reviewing test results, requesting referrals, no-show for medical scheduled appointments, and no WCB follow-up. You can't do a walk-in to quit smoking; you can't do a walk-in for wart removal, dandruff, lumps or bumps that you have had for years or any ailments that you have had for six weeks or more." This was sent to every household in Hay River. The walk-in clinic in Hay River is kind of like "come take your chances." If the doctor is busy at the end of the day at 5:00, you could have sat there all day, but they clear the office and say go home, come back another day and try. If you try to book an appointment, they tell you that you have to wait until next week for this time slot. It is just this new regime, which I understand is supposed to help, but I have been in Hay River a long time and I remember the good old days when we paid doctors on a fee-for-service basis and nobody got sent home without seeing the doctor.

I just want to know, realistically, as the Minister of Health and Social Services, is there anything that you can do to help us address this, or is this something that has to be managed at a local level? Thank you.

Thank you, Mrs. Groenewegen. The honourable Minister of Health and Social Services, Mr. Miltenberger.

Return To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you, Mr. Speaker. Mr. Speaker, the Member referenced the fee-for-service and at one point there were fee-for-service doctors who made a decision to switch to salary positions. There have been concerns ever since about productivity issues; we work with the doctors and have tried to address that; we have added more doctors; we are going to continue to work with the doctors and the authorities to recruit.

The Member points out a problem that is an issue, and that is the access to doctors. I can tell you that the constituency that I represent has the same circumstance. I still, on a regular basis, get notices from the small communities, especially up north where they are on emergency services because they don't have nurses.

The authorities have a significant amount of responsibility and authority to try to address these issues as best they can. The Member does have me somewhat at a disadvantage; I haven't seen the document that she is referring to. I take the Member's point that there are problems with waiting times in the community and now that the Member has raised it, I will commit to following up with the authority and with the department and look at the circumstances. Thank you.

Thank you, Mr. Miltenberger. Supplementary, Mrs. Groenewegen.

Supplementary To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you, Mr. Speaker. Mr. Speaker, when we switched from fee-for-service to salary, it was intended to be a recruitment tool to get physicians to come here so that they would be able to enjoy a quality lifestyle. We could offer a definitive package which was competitive with other jurisdictions in Canada. Is the department looking now at doing a combination of fee-for-service, where there is a salary and a fee-for-service combination, something that would encourage physicians to see more patients on a daily basis? Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Further Return To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you, Mr. Speaker. Mr. Speaker, as a system, we are doing a number of things. We have added nurse practitioners; we have added midwives; we are going to look at trying to improve and upgrade the licensed practical nurses that we do have to give them a greater scope of practice; and we are going to work with the doctors with whom we have a long-term agreement that goes to 2008. But the Member raises a very good point. We are always looking at ways to improve how we do business, and we are going to be looking seriously with the doctors at ways to maximize performance and deal with the issues of wait times. Thank you.

Thank you, Mr. Miltenberger. Supplementary, Mrs. Groenewegen.

Supplementary To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you. For all intents and purposes, the old system of privately owned clinics run by physicians on a fee-for-service was private health care to some extent. What is the rule, or what would the opinion be now, of the Department of Health and Social Services if a physician wanted to come to Hay River or Yellowknife or Inuvik, set up a private clinic and bill the government on a fee-for-service basis? Seriously, it could run some very serious competition on the system that we have got right now. What would be the response of the department to such a proposal? Thank you.

Thank you, Mrs. Groenewegen. Mr. Miltenberger.

Further Return To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you, Mr. Speaker. Mr. Speaker, we have contractual arrangements, in actual fact, with all the doctors. They’re on salary, but they all have contracts. In fact we do, I think, still have four fee-for-service doctors in Yellowknife. So the issue of fee-for-service is a reality that exists in the North and we can’t exclude them from anywhere else, in my opinion, if they exist in Yellowknife. We’ve already accepted that fact. So there’s nothing, in my opinion, to preclude a doctor from setting up a fee-for-service arrangement. We already have the basic process set up in Yellowknife as we speak. Thank you.

Thank you, Mr. Miltenberger. Final supplementary, Mrs. Groenewegen.

Supplementary To Question 118-15(4): Wait Times At Walk-In Clinic In Hay River

Thank you for that, Mr. Speaker. I thank the Minister for that. We’re trying to think outside the box here in terms of how to address this problem because we don’t want people to see our communities as having a lesser standard of living or quality of life because of lack of medical services. So those are the kinds of things in discussions we’ll probably have in our communities. I’m glad to hear that response, and I’ll certainly pass that on in Hay River, that maybe we’ll have to do some recruitment as a community on our own, quite apart from what the Minister does. You know, I can’t think of a question, but we’ll continue to work on it. Thank you.