Thank you, Mr. Speaker. As the Member is aware, the health care system as a whole as the amount of deficit that amounts to about 10 percent of our entire health and social services budgets. That’s quite typical. Jurisdictions across the country are experiencing similar kinds of deficits. Had we not been able to get federal funding in the amount of $15 million over the next two years, that would add another $15 million. We were able to obtain that funding.
Mr. Speaker, as the Member stated, we need to find a way to right-size our budget. That’s the work we are doing. The deputy minister and all of the senior management, including all of the CEOs and medical directors, are fully engaged in coming up with right-sized budgets for all of the authorities. We know from past experience that infusing cash into the system deals with the bottom line for the moment but it does not deal with the structural changes that we need to undertake. The work is underway and we are fully engaged and seized with this issue. Thank you.
I thank the Minister for that. I think that’s the right approach and we should be pursuing that, but how are we going to get there? I’ve been here seven years and the Minister’s been here longer than that -- 12 years or 11 -- and these are problems that have been ongoing. They’ve been a problem since the day I got here. I want to believe what the Minister is saying, but how is she sure that come next year when Members go into the business plans, is she saying that the health budget is going to be increased by 10 percent, and where is that money supposed to come from, Mr. Speaker? Thank you.
Obviously, that money will come from our territorial budget. Our health care system right now takes about 30 percent of the total budget. Across the country, health care expenditures take up somewhere up to 40 to 50 percent of the budget. What we are working on right now is we are reviewing all of the important aspects of our health care system. Physician resources, how we are spending those resources, because that is one big ticket item. We spent about $26 million on medical travel. We want to make sure that we are doing the right thing in that regard. We are reviewing the business planning model so that we are putting the money in the right place. And we are looking to see how we could find efficiencies so that come next business cycle, we are not going to be asking for 10 percent extra for the health care system but that we can demonstrate that for less money but doing more effective delivery, that we could have sustainability in our health care system.
I know we’ve been here for many, many years, but the senior management at the Department of Health has been there for a little over a year and they are making huge progress. All the management is very, very engaged and I am very positive and optimistic that we are going to come up with a great plan for us to consider. Thank you.
Mr. Speaker, again, I do thank the Minister for that response. The one thing I didn’t hear in her response was whether or not the government’s going to ask itself and us the hard question, and that is whether or not we can afford to maintain having several authorities across the Northwest Territories delivering health and social services for our people and whether that current governance structure is sustainable going forward. That’s a hard question and I’d like to ask the Minister is that going to be part of the discussions with senior management and the government. Thank you.
Mr. Speaker, that may or may not be something that this Legislature or future Legislatures have to consider. What we are doing right now is reviewing the government’s model and all of the chairs are fully engaged in working together as closely as possible, so that we are not working as eight separate authorities but we are working as a group. We meet every three months. We are looking at how to use doctors and resources better, how to find efficiencies in medical travel. How do we make sure that we collect all the money that is owed to us from anybody? How do we bill for services that we are providing to Nunavut residents or visitors or tourists who are having accidents? We are making sure that we collect every dime from them, any third-party cost. We are looking to change standby and call systems. We are working to make sure that all of our health care professionals are practicing at the fullest level possible so that if we could use nurse practitioners rather than using a doctor’s service, then we are doing that. The only way to do that is to have the doctors engaged, nurses engaged. If we could use midwifery, we are doing that.
Mr. Speaker, this is a multi-faceted, fully engaged, complex system change that we are engaged in. We are well on the way to making those changes. Thank you.
Thank you, Ms. Lee. Final supplementary, Mr. Ramsay.
Thank you, Mr. Speaker. It is very easy to criticize. I like to be critical of the government from time to time, but I also want to give my suggestions to government and a suggestion, Mr. Speaker, if I could give that to the Minister, would be to look at the authorities and change the way they operate. Take away the management aspect. Make them advisory boards, if anything, and, to me, if you are looking for efficiencies, that is where you are going to find it. It doesn’t make any sense to have eight different authorities in the Territories with 42,000 people in it. If you are looking for efficiency, start there. Instead of 70 to seven, go from eight to one. That will be my suggestion to the government. Thank you.
Mr. Speaker, that is a valid suggestion. It is an important suggestion. It is something that I think we need to consider. But, at the moment, Mr. Speaker, I think we could go far and we could do fine efficiencies by combining, for example, purchasing, where really the dollars count. We organize in the back offices so that we lessen the duplication and redundancy. We are making sure that each health facility only provides a service that it should. So the Stanton Hospital should become the territorial hospital that it was meant to be and it is meant to be, that any services that could be done, any practices and procedures that could be done in Hay River or Fort Smith or Inuvik, we want to make sure we do that.
Mr. Speaker, the Member has a valid point. It is something that we need to consider more. We are looking at the governance structure of our health care system. We need to talk about that more. I thank the Member for his suggestion. Thank you.
Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.
Thank you, Mr. Speaker. I was listening to the questions raised by our Member for Hay River South, Mrs. Jane Groenewegen. I like her approach on suggesting bulk purchasing and trying to leverage the expertise and skills that private industry have. My question would be to the Minister of Health and Social Services just to make sure -- of course, recognizing individual MLAs have every right to advocate for their businesses in their riding -- if the Department of Health and Social Services is going to continue this line of consideration which I would encourage them to do, it would make it an open and competitive process that any territorial business could bid on this if this was the approved or considered approach going forward on the bulk purchases of pharmaceutical products. Thank you.
Thank you, Mr. Hawkins. The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. Yes, we would look at every way where that would allow us to find efficiencies and cost savings by competitive process. We would look at all of that, Mr. Speaker. The cost of drugs, equipment and supplies is one of the big cost drivers. We are analyzing them very closely. Members on the other side have suggested that we need to look at this. Jurisdictions across the country are looking at those. Mr. Speaker, yes, I take his advice and will keep that in mind. Thank you.
Mr. Speaker, if I could add one more issue to this particular problem in going forward, I would ask the Minister reach out to the Pharmacy Association of the Northwest Territories to engage maybe all their association and they could maybe leverage some of the expertise the association would have with their members and perhaps a collective approach could be given to help draw out the direction of this type of health care potential savings. I would hate to think that they would be excluded on any type of expertise that they would probably willingly offer to ensure that the government’s bottom lines are being met in an efficient way. They are truly a critical component in this solution and overlooking them would be quite insulting. Thank you.
Mr. Speaker, yes, we would do that wherever possible and wherever appropriate. Thank you.
Mahsi, Mr. Speaker. I wish to table the following document entitled Northwest Territories Aboriginal Languages Plan - A Shared Responsibility, October 2010. Mahsi, Mr. Speaker.
Thank you, Mr. Lafferty. The honourable Minister of Industry, Tourism and Investment, Mr. Bob McLeod.
Mr. Speaker, I wish to table the following document entitled Northwest Territories Meeting and Conference Planner 2011. Thank you, Mr. Speaker.
Thank you, Mr. McLeod. The honourable Minister of Municipal and Community Affairs, Mr. Robert McLeod.
Thank you, Mr. Speaker. I wish to table the following document entitled A Clear Path Forward, Municipal and Community Affairs Strategic Plan 2010-2015. Thank you, Mr. Speaker.
Thank you, Mr. McLeod. The Minister of Environment and Natural Resources, Mr. Miltenberger.
Thank you, Mr. Speaker. I wish to table the following document entitled Natural Resources Conservation Trust Fund, Annual Report 2008-2009 and 2009-2010. Thank you.
Thank you, Mr. Miltenberger. The honourable Minister of Finance, Mr. Miltenberger.
Thank you, Mr. Speaker. I wish to table the following five documents entitled 2009-2010 56th Annual Report – Northwest Territories Liquor Commission and Liquor Licensing Board; Supplementary Estimates (Operations Expenditures), No. 4, 2009-2010; Supplementary Estimates (Infrastructure Expenditures), No. 5, 2009-2010; Supplementary Estimates (Operations Expenditures), No. 2, 2010-2011; and Supplementary Estimates (Infrastructure Expenditures), No. 4, 2010-2011. Thank you, Mr. Speaker.
Thank you, Mr. Speaker. I give notice that, on Friday, October 29, 2010, I will move the following motion: Now therefore I move, seconded by the honourable Member for Mackenzie Delta, that this Legislative Assembly recommends that the NWT Housing Corporation reduce the rent scale so the maximum rental rate is 25 percent of the assessed gross income. Thank you, Mr. Speaker.
Thank you, Mr. Bromley. The honourable Member for Weledeh, Mr. Bromley.
Thank you, Mr. Speaker. I give notice that, on Friday, October 29, 2010, I will move the following motion: Now therefore I move, seconded by the honourable Member for Thebacha, that this Legislative Assembly urges the Government of Canada to reverse its decision to eliminate the mandatory “long-form” census questionnaire. Thank you, Mr. Speaker.
Thank you, Mr. Bromley. Item 16, notices of motion for first reading of bills. Item 17, motions. Item 18, first reading of bills. Item 19, second reading of bills. Item 20, consideration in Committee of the Whole of bills and other matters: Tabled Document 4-16(5), Executive Summary of the Report of the Joint Review Panel for the Mackenzie Gas Project; Tabled Document 30-16(5), 2010 Review of Members’ Compensation and Benefits; Tabled Document 38-16(5), Supplementary Health Benefits – What We Heard; Tabled Document 62-16(5), Northwest Territories Water Stewardship Strategy; Tabled Document 66-16(5), NWT Capital Estimates 2011-2012; Tabled Document 75-16(5), Response to the Joint Review Panel for the Mackenzie Gas Project on the Federal and Territorial Governments’ Interim Response to “Foundation for a Sustainable Northern Future;” Tabled Document 98-16(5), Supplementary Estimates (Operations Expenditures), No. 4, 2009-2010; Tabled Document 99-16(5), Supplementary Estimates (Infrastructure Expenditures), No. 5, 2009-2010; Tabled Document 100-16(5), Supplementary Estimates (Operations Expenditures), No. 2, 2010-2011; Tabled Document 101-16(5), Supplementary Estimates (Infrastructure Expenditures), No. 4, 2010-2011; Bill 4, An Act to Amend the Social Assistance Act; and Committee Report 3-16(5), Standing Committee on Social Programs Report on the Review of the Child and Family Services Act, with Mr. Krutko in the chair.
I call the Committee of the Whole to order. We have tabled documents 4, 30, 38, 62, 66, 75, 98 to 101, Bill 4, Committee Report 3-16(5) and Minister’s Statement 65-16(5). What is the wish of the committee? Mrs. Groenewegen.
Thank you, Mr. Chairman. The committee today would like to deal with Committee Report 3-16(5), Standing Committee on Social Programs Report on the Review of the Child and Family Services Act. We would like to proceed with general comments today. Thank you, Mr. Chairman.
Does the committee agree?
Agreed.
With that, we will take a short break and begin with Committee Report 3-16(5).
---SHORT RECESS
I would like to call Committee of the Whole back to order. Prior to the break we agreed that we would begin with Committee Report 3-16(5), Standing Committee on Social Programs Report on the Review of the Child and Family Services Act. Are there general comments on the bill? Mr. Abernethy.
Thank you, Mr. Chairman. Just my opening comments with respect to this report. Early in the life of this Assembly, I had constituents start to come to me and talk about concerns that they had with the Child and Family Services Act. Quite frankly, in the beginning I couldn’t tell whether it was problems that we actually had with the act or whether it was problems that we had with the implementation. There were issues that certainly through the review become clear that there are a few gaps in the act. There are some things in the act that do need to be looked at and a few things that do need to be changed in the act.
Overall, it is my opinion that this is a pretty good act. It has a lot of positive aspects. The one thing that I feel is quite positive is the requirement for community committees. I think that is a mechanism whereby communities can be empowered to take on some responsibility with respect to the apprehension of children within the communities. Unfortunately, as we all know now, the act really wasn’t implemented in several ways. Going out to the communities and listening to what the people had to say was incredibly valuable for me. I feel like I learned an awful lot about some of the difficulties that individuals are having in these communities, particularly with respect to the apprehension of the children.
As a committee, we came up with a number of recommendations. I support those recommendations. I am not going to talk about the specific recommendations. We will do that later when we are out of general comments and we are more on the detailed aspect of things and we are talking about those recommendations. I do want to talk about some of the key areas that I heard and my colleagues heard.
One of the key areas that I think came up in every community we came to is prevention. Prevention is key. We need, as a government, to take more proactive steps to help families; to help families that are in poverty, to help families that are in crisis. There are a number of things that this government is doing that are good. The Healthy Families Program is a very good program. Everywhere we went where this program is delivered, we heard positive statements. People like this program. In those communities it is adding value. Unfortunately, we are only delivering this program in four communities. We need to expand this program. We need to take other steps in prevention.
Earlier last month I attended an anti-poverty workshop. This was a good workshop. We had an opportunity to talk about some of the things that are leading families down difficult paths. Poverty is one thing that is obviously leading people to situations where their children are being apprehended for things like neglect. We need to work on an Anti-Poverty Strategy as the Government of the Northwest Territories. We make reference to that in this report.
One of the other areas that we heard about is how this system is perceived as adversarial, how this system seems to be combative rather than collaborative. We have made a lot of recommendations about changing our mindset around child and family services, about becoming more collaborative, and becoming more cooperative, and working with our families, and working with the parents and working with the communities. This is something that I think we need to do in order to find reasonable solutions to the challenges that we are facing with respect to child apprehension. We must help families. We must work with them. Fighting them is not the solution.
I have mentioned already the child and family service committees in every community. So far we have had one or, rather, we attempted to have one in Fort McPherson and the first round did not work out very well. To my understanding, they are now establishing a second committee in the community, but there is a lot more involvement from the Department of Health and Social Services. From what I understand, it looks like it is going to be a success. I think we should be very proud of that. We should be proud of the work that the community has done but also of the work that Health and Social Services has done to work with that community to actually get this thing up and running. It’s a step. It’s just a step. We need to have community committees in every community that we have.
One of the things that we heard over and over again is that when a social worker is called in due to concerns about a child in a home, the child may be taken out on a temporary basis at which point the social worker and the parents have to develop a plan of care where they work together -- I wonder if anybody’s listening -- where they work together to come up with a solution on what the parents and the family need to do in order to get their child back into the home. Unfortunately, a lot of the time one of the things that comes up is mental health and addictions. And the social worker and the family agree that one of the steps that need to be taken is mental health and addictions counselling of which there is none in the community that these people live.
Right off the top we are setting these families up for failure. We are not helping them; we are hurting them. Children need to be with their families where appropriate, which is most of the time.
We need, if we want to be successful, to be more proactive on mental health and addictions counselling; which, for the record, is also something we should be doing with respect to an Anti-Poverty Strategy. Two things we could be doing at the same time. The Department of Health and Social Services needs to be a little bit more proactive on providing front-line, in-the-community alcohol and drug counselling for those individuals in crisis.
Another thing we heard is the frustration that people have in the fact that they don’t even understand the act and what is happening to them as people and families. The act, although for the most part it is a good act, is confusing. It is very, very confusing. It is very complex. We did not hear one person who has gone through the system indicate that they had any understanding of the system at all. We need to be a little bit proactive there as a department. We need to get in there and we need to do some plain language work on this act. We need to make sure that people understand it. We need to do more communications. We need to educate our people so that they understand the act. We’ve made recommendations to that effect as well.
We’ve also talked about placements. A lot of the time, maybe not as much now, but often a child will be taken out of a family and placed in a foster home with a loving foster home who cares and wants to work with these children and do well, but that foster home may not be of the same cultural background as the child that has been taken out. This is unfortunate. We need to do a better job of working with families, grandparents, uncles, aunts, individuals who can take these children with a little support from the government. Right now if a grandparent takes a child, they get no financial assistance, yet they still have to pay the bills, they still have to buy the food. We’re not helping, we’re hurting. We need to make sure that we take those steps and find ways to allow and support families who take these children on short-term and longer-term placements if necessary.
We heard from the social workers as well. Social workers have an incredibly important job. I don’t envy them. I wouldn’t want to be an individual that has to go into a home and remove a child. I can’t imagine how difficult that is for the social worker and I can’t imagine how difficult that is for the family. Sometimes it needs to be done. Thank goodness our social workers are professionals. I’d like to applaud the social workers for all the hard work that they do. We know it’s a difficult job. They expressed concerns. They have concerns about the policy manuals. They have concerns about the regulations. They have concerns about the act themselves. They have asked for plain language documents. They have asked for more training. The department needs to do this. The department needs to do this so that the social workers can be more collaborative and less confrontational. Not that they are, but the system is. They want to help. They don’t want to hurt. Right now, often we’re hurting.
We’ve thought about these recommendations long and we’ve considered them. I stand behind them as a member of this committee and I think if we move forward with these recommendations, we can make a difference to these young people and these families. Yes, it’s going to cost some money. But the long-term benefits of this, if you tie this in with an Anti-Poverty Strategy, are significant and will save us money in many, many areas down the road. These recommendations talk to the Housing Corporation. These recommendations talk to Education, Culture and Employment. These recommendations talk to Justice. We all need to work together as partners to solve these problems. This isn’t just a health problem. This is a GNWT problem. This is a people problem. We all need to work together to find these solutions.
I encourage all the Members to read this report, think about the recommendations, and let’s all work together to help the families of the Northwest Territories.
Thank you, Mr. Abernethy. Next on the list I have Mr. Bromley.
Thank you, Mr. Chairman. I’d like to start by really acknowledging the superior level of support we had in putting this report together. I’d like to start with our research staff. We had Regina Pfeifer, Robin Stewart and Lee Selleck, all of whom put their stamp into this work and went beyond the call. The Clerk’s office contributed hugely and I’d like to recognize the committee clerk, Gail Bennett, who is very professional and thorough in her support with a keen eye for the detail that’s required to do a good job here. My colleague, MLA for Great Slave, Glen Abernethy put the motion on the floor and was instrumental in getting this review underway. I want to recognize that huge contribution. I also appreciate our chair, Mr. Tom Beaulieu, and other fellow Members on the Standing Committee on Social Programs, Ms. Wendy Bisaro and Mr. David Krutko, chair. Also we had three consultants who had significant contributions: Cindy Blackstock, Bruce MacLaurin and Sharon Sutherland. Thanks to them. The Minister and her staff and many others contributed in many ways helping with arrangements and advice and so on. And to all those who contributed with the arrangements and mechanics of our consultation, travel, meetings, report generation and printing were all much appreciated.
I have to say that the highest regard goes out to those constituents and family members throughout the Northwest Territories who contributed the real material we needed to hear and learn about in putting this report together. Some of them we heard before the idea of this review and it was on their contributions from constituents that we recognized the need here. The residents of the Northwest Territories, family people throughout our jurisdictions certainly affirmed the decision of the standing committee to conduct this review. A huge thank you to those people who participated and sometimes having to speak through considerable emotion and pain but importantly sharing their vital experience.
The four key points come to me just in terms of needing to be highlighted in general comments here. I guess the most fundamental issue, one that is not a surprise, is that the health of our children, families and communities are the crux of everything we do. They’re what this review was about. They’re what so much of what we do is about. That’s the fundamental issue.
As my colleague has mentioned, the huge opportunities for prevention are out there waiting to be taken advantage of. Right now they’re hardly being recognized in terms of the dollars and programs that we have in place.
Other things that became apparent very quickly and repeatedly are that the issues involved are intertwined with many other of our basic and serious challenges, including poverty, addictions, loss of culture and issues of literacy. Again, those are very specific things that will require cross-departmental response, government-wide response.
Finally, and perhaps most importantly, the ultimate answers are to be found at home, in our families, in our homes, in our communities and in our cultures. Government, indeed, has a crucial role in engaging all of these entities and providing them with the appropriate types and amounts of support to implement the solutions they know are required.
The cost of children in care is high and rising. If we are to do an effective and good job at addressing that and reversing that trend, there are opportunities for savings. As has been noted, this report calls for additional resources towards Child and Family Services Act implementation and revision. I just want to say, frankly, for the record, that I will be standing in support of these initiatives as we go forward with budgets. I’ll leave it there. Thank you for this opportunity.
