Thank you, Mr. Speaker. As I said in my Member’s statement today, I have questions for the Minister of Health and Social Services. This has to do with the delivery of specialist care, specialist services to residents of the Northwest Territories.
Mr. Speaker, I fully understand and applaud the department for attempting to attract, recruit and retain specialists of various disciplines here in the Northwest Territories. It makes sense. However, Mr. Speaker, the truth of the matter is that specialists are sometimes available here in the North and sometimes not.
In the last several weeks in Hay River I’ve had two constituents who had been seen for a long period of time by a specialist in the south who was a neurologist, because most of these constituents have MS and this is a chronic condition, which properly managed and monitored can go into remission and can be substantively, even held at a certain level for a period of time. One of the negative contributing factors to a condition like MS is stress, and when a patient has had a longstanding relationship with a doctor, they know their case, they are trusted by the patient and this creates some stability for that patient.
So in both of these instances, kind of on the eve of medical travel to go to Edmonton to see their specialist, they were informed that their medical travel was denied because there was now a neurologist available to see them in Yellowknife. This does not seem like a good way to manage this and I’m asking the Minister of Health today is there a different way we can do this so that we avoid this kind of stress for these patients? Thank you.
Thank you, Mrs. Groenewegen. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I do appreciate the need to make this sort of process as smooth and seamless as possible for the patient. I am aware that one of the patients in Hay River we did approve the travel, but we did give notice that for next year she would have to travel to a neurologist in Yellowknife. Also, I will work with the department to make sure that we review the files and see that if there is going to be a change in specialists that they need to see, that we give them as much notice as possible. Thank you.
I do appreciate the Minister is right that there was an exception made in one instance. However, it doesn’t really address the problem going forward and ongoing. I think that a more in-depth analysis needs to be done of the situation. For example, even if there is a neurologist now resident in Yellowknife, what is the caseload of that neurologist? How long will additional patients being added to the caseload have to wait in order to see them? Is there an extraordinary heavy caseload? Is it a light patient load whereby if we don’t include these other folks then they won’t be able to continue to practice here? We need a more in-depth analysis.
The other complicating factor is that quite often, even if they come here to Yellowknife and are assessed by the neurologist, some of the procedures and testing they need are done in Edmonton anyway. So I don’t think we can take just a really simple approach to this. I think we need to take a very critical look at it on a discipline-by-discipline basis when it comes to the specialists. Could the Minister agree the department could undertake that?
I agree with the Member that this is not a simple matter and it does involve patient care and comfort and continuity of care that the patient expects.
Specialist service in the Territories and at Stanton Hospital is one of the most important and expensive services. We’ve spent about $13 million on specialists and they’re often over budget. We also spent a lot of money on out-of-territory services. So it is important that when we get a specialist service such as a neurologist, that we use those resources at maximum.
With respect to wait times, we did review that and I certainly could work with the specialist to make sure that those wait lists are managed as much as possible. I am aware that, especially with MS patients, we have quite a few of them in Yellowknife. It seems it is more common in Yellowknife and Hay River. It is important for us to have a neurologist service here. We’re lucky we have those and we just need to make sure that we manage as well as possible so that we communicate well with the patients.
For further clarity then, in the case where a patient with MS has had a longstanding relationship with a physician, with a specialist, a neurologist in the south, has been travelling out to see that specialist, is it only the medical travel portion that is affected? So, in fact, if the patient said it is so important to me that I need to see this particular doctor because they know my case, I know them, there’s a trust relationship built, is it possible for that patient to say, okay, I will pay for my own medical travel to get to Edmonton? Will the department then continue to support that patient to receive that service in the south? Is it the medical travel that’s the issue or is it the actual care that the service that the position is delivering?
I’ll have to get the details, but I would venture to guess that actual service of that specialist that we would have to pay in wherever place that they go would be as high, if not higher, than the medical travel and related expenses. There is a formula for the services like neurologists and inter-jurisdictional billing and such. So we would be paying for that specialist in Edmonton or wherever, while at the same time we are paying for our in-house specialist.
Specialists are, as you know, quite, I don’t want to say expensive, but we pay a lot of money to have somebody like a neurologist. We have to minimize occasions where we are double paying when we have an in-house specialist in the Territories.
Thank you, Ms. Lee. Final supplementary, Mrs. Groenewegen.
Thank you, Mr. Speaker. Would the Minister consider grandfathering people who already have a longstanding, established relationship with a specialist in the south?
Also, can the Minister confirm that the neurologist who is currently located in Yellowknife, does that specialist have a full patient load or do they have capacity to take on more patients?
I would be happy to get back to the Member on the load, the wait times and such. Also, we should be mindful of the fact that the Medical Travel Policy says that we pay for medical travel and treatment of patients where those services are not available in the NWT. It may be that somebody may have to see another neurologist because the service that they provide here is not exactly alike. So we make sure that we have the services there. I will get back to the Member on what the patient load is, wait times.
With respect to grandfathering, that is always not a good idea. I will just get back to the Member with that information.
Thank you, Ms. Lee. The honourable Member for Kam Lake, Mr. Ramsay.
