Thank you, Mr. Chair. I’ll say it again, there’s no intention and we will not be privatizing the delivery of medical and health services in the Northwest Territories, just so we’re incredibly clear.
This is a multi-year project. The RFP went out earlier this fiscal year. We have narrowed it down to three proponents. Discussions are happening with those proponents and we hope to have a proponent and move forward with a contract with that proponent. That, I believe, is expected to be June, if everything moves forward according to plan. Then there will be more of a design phase. That will be the first part of the year. Then it will be basically a four- to five-year process before we are finished everything.
We have learned some lessons on trying to renovate existing facilities while at the same time providing services. We definitely had some challenges when we tried to renovate and provide services in Fort Smith and that has helped inform the process. So this, in process – and the budget that has been allocated – includes the whole plan and design around the provision of services during construction, which means we’ve taken into account our needs operationally as well as how we move forward and where we move things so that we minimize impact on the delivery of services as small or as minimal as possible. But for better detail on that, it would be better to go to Mr. Heath for the specific details.
Thank you, Minister Abernethy. Mr. Heath.
Thank you, Mr. Chair. As the Minister said, we’re in the RFP recruitment. We’re hoping to have submission in June 2015. The funding allocated in the budget is several-fold. It is, again, for the construction, but the element we talk about, operational readiness, and one side of the project is getting the building ready for the people. The other element is getting the people ready for the building. So the budget will cover all the costs associated with the construction and the planning and the operational readiness component. Thank you.
Thank you, Mr. Heath. Mr. Bromley.
Thank you, Mr. Chair. I guess I would be interested in a few more details generally on what the $40 million will be used for this year and do you know what area of the hospital we’d be starting with in terms of helping people get ready as Mr. Heath mentioned.
Thank you, Mr. Bromley. Mr. Heath.
Thank you, Mr. Chairman. There is an indicative design and indicative phasing plan for the Stanton renewal. As the Minister said, we are very concerned about infection control, and you cannot necessarily renovate an operational hospital. So, the indicative design speaks to building an expansion to the facility. Essentially what would happen is an in-patient area would be developed first and any patients that were in the actual existing facility removed from that facility and moved into the in-patient area. We also talked about quite a bit of pressure around the ER and the emergency services area, that it’s undersized. So, those two areas would be implemented first.
We’re not expected to get into the actual construction of those facilities next year. Likely if any construction is happening next year, it will be around site works, getting the area and foundations ready before the winter season comes in and then with the next summer, being the summer of 2016, be in full-scale construction. Thank you.
Thank you, Mr. Heath. Mr. Bromley.
That’s all I have, Mr. Chair. Thank you.
Thank you, Mr. Bromley. Committee, we are on page 34, health and social service programs, infrastructure investments, $77,389. I have Mr. Yakeleya.
Thank you, Mr. Chair. I want to say to the Minister, certainly the health centre’s flooring replacement in Fort Good Hope is much appreciated and needed. I know I did do some visits. This was actually a couple of years ago, so I’m glad it has been looked at. It has been dealt with and I appreciate it.
At the same time, when I visit the health centre facilities in Tulita, I am hoping that we would look at more urgent need because of the progress that I’ve tabled to the Minister, not to have our hardworking nurses cohabit with mice in the communities within the centres there. That’s very dangerous, very dangerous. I know the Minister is supportive of our northern nurses in our small communities. You do the best for them because they work long hours. I hope that somewhere within the small capital project this priority can be looked at in Tulita as soon as possible with the living conditions.
I understand what the Minister said about the new Tulita health centre that has been on the books. Certainly people have been asking for that and they appreciate what the Minister is saying right now. However, we need to wrap this up because the urgency now is that the health residence with the furniture, with the flooring, with just the old age of the building and hoping that we could take out some mouse traps in that facility. That’s not good for us. The same with the shed that they have storing their medical health supplies there. We have to do better. I wanted to put that in your mind so that these nurses that we get are not going to have to continue to live in those types of conditions day in and day out as we sit here. Tonight they are going to go back to the same facility.
I guess they are looking for their leadership, now that you know it’s out there, what you’re going to do about it. There are some options and I’m glad you’re open to the options. Certainly within the government there are no guarantees, but I wholeheartedly ask you to look at it seriously for the nurses. There are some units that could be looked at in Tulita and having you work with your colleagues to look at this capital infrastructure budget here. Is it somewhere we can do some work so that we can make it liveable in Tulita?
The other stuff is long term. I understand that, but priority right now is the residence and the shed. So I appreciate that, even with the work that you’ve already committed to Fort Good Hope. I wanted to raise that, Mr. Chair, at the Assembly here, and the Minister again is being reminded for the last couple of days when I talked with him. I just wanted to raise that with the department, and senior officials are here and Members are here. The conditions need to be really improved in Tulita. Thank you.
Thank you, Mr. Yakeleya. Mr. Abernethy.
Thank you, Mr. Chair. With respect to Fort Good Hope, I appreciate the Member’s support. What we’re doing there is removing all the carpet in the health centre and replacement with impervious non-contaminable infection control appropriate flooring. It’s about health and safety of the patients and the staff and meeting our infection control standards. That’s what is going on there.
As I have said several times, we recognize the challenges of the Tulita facility. We know that facility is quite degraded and ready for replacement. It’s at the top of our list. It’s the first one that we feel needs to be done moving forward. It is a B facility, so we have a standard design. In the standard design, depending on the community, those units can include anywhere from two to four living units that are available for staff at market rent rates. That will address the problem long term.
But the Member is right; there are some short-term challenges in the community. The Member has raised them with me on several occasions. I have been talking with the department and we’re working with the Sahtu Health and Social Services in an attempt to identify some short-term solutions on that facility.
Long term certainly will address a number of issues in Tulita for the health care facility, the residence accommodations and the proper storage facilities. I got that. I’m really pleased that the Minister is looking at the short-term solutions, working with the Sahtu Health Authority on the nurses residence. It is shoddy. It should be torn down. It should be off the site, really, and same with the storage shed. There’s no floor. It’s just gravel, and on the gravel we have a very expensive piece of health equipment. We had a palliative care bed lying on the ground. If we are to look at the goals and the values of health care and what we are seeing right here, we are so far off.
I understand what the Minister is saying. Short term I hope is within a month or within a week.
How can we sit here and allow the nurses to be in these residences and there are mice running around? Mold. They are setting mice traps. That’s how we are looking after our nurses. I really want to encourage, support, push, pound everything for the Minister to get the nurses into a suitable accommodation so they don’t have to worry about the mice running around, or the furniture. The furniture is in pretty rough shape.
I appreciate what the Minister is saying. I know he is going to do his best to see this. So, I’m looking at the definition of short term. How long are we going to allow our nurses to live with the mice? They actually have their own trapline. So, I really need to stress the importance of this to our Minister.
In Tulita, in the Sahtu, that’s the level of quality we look after our health care workers. God bless them for working this long. How long has this been a problem in the Sahtu? Maybe longer. That’s why I’m stressing it. I don’t think anybody else in this community here around this room would allow their nurses in that condition. I don’t think so. That’s not the standard of health care facility we want for our nurses. I got it. I support the Minister and I’m very happy that they are looking at the long-term solution. That…(inaudible)…to a lot of his continuous effort and push to leadership, but it’s something that has to be looked at, at the Tulita health residence and the shed, that they have to work under those conditions. This is my last plea to the Minister. I’m going to keep checking to see how we’re doing with our nurses in the Sahtu. Thank you.
Mr. Chair, understood, agreed. The CEO will be going into Tulita to meet with the staff and attempt to address the problem and give us a better idea of how long it will take to address. I will absolutely keep the Member informed as we move forward. Thank you, Mr. Chair.
Thank you, Mr. Abernethy. We will continue on with detail questions on page 34. I have Ms. Bisaro.
Thank you, Mr. Chair. I just have one question and I want to ask it around the Stanton Hospital renovation project. We had a number of questions and answers yesterday, and at one point, I believe it was Minister Miltenberger who stated that there was a good business case to make this renovation a P3 project. I thought to myself, okay, yes there might be a good business case, but I have been advised and I have done a little searching myself and have found that hospitals are not necessarily the best projects for P3. There are some pretty damming reports out there about other jurisdictions that have done P3 projects with hospitals.
So, I’d like to know from the Minister, if he can tell me, in the consideration for making the Stanton Renewal Project a P3 project, what consideration was given to positive or negative results from other P3 projects across the country. Did you rely simply on the business case and on the numbers, or did you look at, sort of, the soft information that was out there and the projects or negative reports of projects which are out there to be considered? Thank you.
Thank you, Ms. Bisaro. Minister Abernethy.
Thank you, Mr. Chair. The lead on this project on the construction is the Department of Finance. They were the ones who would have been doing the analysis on the P3, so I would like to go to the Minister of Finance.
Thank you, Mr. Abernethy. Minister Miltenberger.
Thank you, Mr. Chairman. We brought in some professionals on this and they did a survey of the landscape. While there are clearly incidents where things maybe didn’t work according to plan, there are also many instances when they did. They looked at all of those issues, they looked at what was being proposed here, the type of projects, and when they came back with their recommendation, it said that from the balance of all these factors that there is a business case to be made for this project to proceed as a P3.
Keeping in mind all the considerations that have been talked about here today, the fact that it is not privatization, we will continue to run the programs and own the programs, and this is a deal on the building of the infrastructure and some of the hard services. We are looking at that. It was last March. From what I have read and understand, the document was shared with committee, and on that basis we are proceeding forward. Thank you.
Thank you, Minister Miltenberger. Ms. Bisaro.
That’s fine. Thanks, Mr. Chair.
Thank you, Ms. Bisaro. Continuing with questions on page 34, I have Mr. Bromley.
Thank you, Mr. Chair. The Minister of Finance has indicated that if the bids come in high that we would not go forward, or possibly not go forward with a P3, and if our borrowing limit requests come in, we might have some capacity to do it ourselves and do that. Is the Minister aware of that and supportive of that situation? Thank you.
Thank you, Mr. Bromley. For that we are actually going to go directly to Minister Miltenberger. Minister Miltenberger.
Thank you, Mr. Chairman. As with all projects, Public Works will be managing the infrastructure project itself, per se, but clearly when the value for money, the issue comes as we proceed with the P3 and that is where we finally go and the prices come in way off the mark, then I will have to look very carefully at the cause of that.
This is not a project that is a cost-plus where money is not an object. It is $350 million. So if that includes looking at other ways of building the project, of course we will look at that. We want to get the best, highest quality project that we can on budget and on time.
Yes, Mr. Chairman, if any project comes in over budget, no matter what method we use, we look very carefully at that project. We would rather scale them back or we would retender or do different things to make sure we try to live within the dollars available. Thank you.
Thank you, Minister Miltenberger. Mr. Bromley.
Thank you, Mr. Chair. I think it’s understood and I think the Ministers would agree that public infrastructure is generally cheaper because there is not a profit motive. In this case, bringing in a private enterprise, there is a profit motive. Motivation for doing this is that we are short on capital and this is a mechanism to get around that. But it is more expensive than a public project, so I just want to confirm that that’s the reasoning for going for a P3 here. Thank you.
Okay. We are going to go to the Minister lead on this project. Minister Miltenberger.
Mr. Chairman, that is not in fact the case. We are looking at a P3 procurement approach, first because our policy obligates us to for projects over $50 million. We had a lot of discussion around this whole P3 approach around the bridge, which wasn’t actually a P3 project. It is a recognized, valuable method of building infrastructure that’s used out around the world and across Canada. Issues like public interest are paramount. The value for money has to be demonstrable. Appropriate public control and ownership, as the Minister of Health has said, will be preserved. We have to have a clear accountability framework, and whatever we do on this process, as per our policy, will be fair and transparent and, of course, sufficient and economical. This is an opportunity to put that to work and see.
I point out again, as well, we’re doing a similar type of process with the Mackenzie Valley fibre link, a much smaller project in terms of size and cost but of considerable value in its own right. So, we want to see if this is in fact the case.
There was a lot of heated debate last time and initially there were thoughts that the project of the bridge would be a P3 but that quickly proved not to be the case, so this time we’re taking another look at it. There was a P3 project done way back in the 1990s in the 13th Assembly. First try at it, it was not an overwhelming success. Very expensive. This whole concept has evolved considerably since then and we will be monitoring it closely. We will be working with committee as we do this step by step and make sure that we hit all these critical principles. Thank you.
The bridge was certainly a P3 project and it was a failed P3 project and it cost us a lot to get out of that and we did it then as a project of public government. I wasn’t aware that we are obligated for projects over $50 million to use a P3 policy. I thought it provided the opportunity to allow us to look at P3s. So, that’s quite a finesse by Cabinet, so maybe I would like to just get confirmation of that if I could. Thank you.
Thank you, Mr. Bromley. Again we’ll go to the lead Minister. Minister Miltenberger.
Thank you, Mr. Chairman. For projects over $50 million, the policy requires us to look at whether the P3 approach is a viable approach to be considered, and we have done that. The business case has been done and the assessment comes in that yes, it is a viable project and the business case is there under the P3 approach, hence the consideration. Thank you.
Thanks for that confirmation by the Minister. So, what are the long-term consequences of this P3 project? Can you describe what the ramifications are to Stanton public infrastructure, its operation and maintenance, potentially, over the course of time?
Thank you, Mr. Bromley. Minister Abernethy.
Mr. Chair, we’re looking to build a state-of-the-art facility to meet the health needs of the residents of the Northwest Territories that will be maintained and operated for a significant number of years moving forward.
I would certainly hope it would be maintained and operated for a significant number of years. What I’m looking for is who is going to maintain and operate the hospital and for how many years before this public infrastructure returns to the public.
We maintain ownership of the property, the infrastructure and the resources that are in that building. If it is negotiated in a particular way, we may contract out the maintenance of the facility, but that has yet to be determined, and as I’ve said previously, it is still a giant ‘if’.
When will the public learn how long we will be contracting out the operation of our Stanton Territorial Hospital?
It is a 30-year agreement, and as I indicated previously, we will know where we are as far as contracting is concerned in June 2015 is the targeted date at this time. Implementation, if maintenance services are included in this, will occur sometime after that if indeed it happens.
Thanks to the Minister for that response. My last question is: Will there be another opportunity for committee input once the bids or tenders are made to participate in the final decision on this project?
Thank you, Mr. Bromley. Again, we’ll go with the lead Minister on this project, Minister Miltenberger.
Thank you, Mr. Chairman. As we do with all major expenditures like this, we’ll have full engagement with committee on a go-forward basis, especially given the approach being contemplated and the dollar amount on the table.
Thank you, Minister Miltenberger. Committee, we’re on page 34, health services programs, infrastructure investments, $77.389 million. Does committee agree?
Agreed.
Thank you, committee. If I can get you to turn back to page 31 for total infrastructure investments, Health and Social Services, total infrastructure investments, $84.395 million. Does committee agree?
Agreed.
Thank you, committee. Does committee agree we have concluded consideration of the Department of Health and Social Services?
Agreed.
