Thank you, Mr. Bromley. Minister of Health, Minister Abernethy.
Thank you, Mr. Speaker. For the 2015-16 fiscal year, $1.97 million in core funding was allocated for midwifery services in the Northwest Territories. Of that $1.97 million, it funds two midwifery positions in Fort Smith – both of which are now full – and the program costs. It also funds two midwifery positions in Hay River and also the program costs. Those positions are also full.
It also funds an NP position which is providing midwifery-type services for pre-birth throughout the region through community health nurses who is part of the MORE OB program up in the Beaufort-Delta. It was a desire of the region and of the people to move in that particular direction, recognizing the award winning MORE OB program in the Beaufort-Delta. That left some money available to move forward with the territorial Midwifery Program of the $1.97 million. This fiscal year, we got permission from committee to use $453,000 of that to move forward with the development of a human tissue and organ donation registry with the Government of Alberta. We are continuing to move on that.
The rest of the money for this fiscal year, 2015-16, was intended to be used to hire some midwifery consultants in the department to actually begin a design. Unfortunately, Mr. Speaker, it took longer than had been hoped to find the midwifery staff who can actually do that work. But I am happy to say we have now filled both of those consultant positions. Now that we have those positions filled, meetings with the NWT Advisory Committee on Midwifery are going to be resuming this month and the design is going to continue to move forward with a territorial program that will be based here in Yellowknife. Thank you, Mr. Speaker.
Thanks to the Minister for providing that clarification. The original midwifery report, NWT report, identified Inuvik as one of the four locations of interest, but Health has now decided to support doctors with obstetric skills instead, plus the one position. I am hearing concern about lack of consultation leading up to this decision in the Beaufort-Delta. It seems prudent to ask the public for their opinion before opting for a very different model that does not include midwives.
I ask the Minister who was consulted in the Beau-Del and what public engagement was conducted before the decision to scrap the midwife program in that region. Mahsi.
When that number or that decision to put a midwifery program in the Beaufort-Delta was originally decided or originally included in the report, a number of realities were quite different. We actually didn’t have stable physicians in the Beaufort-Delta providing birthing services. They had not implemented the MORE OB program in that particular region and the birth numbers were quite high.
Since that time and prior to this decision, birthing rates in the Beaufort-Delta had stabilized. We had full-time, stable physicians in the community who had actually gone out and put in the MORE OB program in the Beaufort-Delta. It’s actually a recognized and award winning program in the Beaufort-Delta.
Based on discussions with the physicians, practitioners in the community and some other stakeholders who had a vested interest, it was determined, given the low number of births and the desire of the physicians to still be involved in birthing that it would be more appropriate to focus on the front end part of the Midwifery Program, which is the education and working with the community health nurses. As a result, the Beaufort-Delta decided to take a slightly different direction, where they brought in a nurse practitioner to work as part of the MORE OB team to provide some of the pre-birth work that a midwife would actually do. Thank you.
Thanks to the Minister. Yellowknife had a midwife before we embarked on a territory-wide program. Now we don’t, but we now have two coordinator positions apparently with a goal of developing a territorial Midwifery Program based in Yellowknife and expanding into areas such as the Deh Cho and Behchoko.
I’m wondering: how does this affect the future of having practicing midwives in Yellowknife for Yellowknife, Ndilo, Detah and this region given the need for program delivery staff who support the territorial model. Mahsi.
The Member has been around long enough to remember that the midwifery position that was at the Yellowknife Health and Social Services was a completely unfunded position. There were no dollars allocated to that midwifery position. The Member should also remember that the authority chose to put in a Midwifery Program with one NP, which is basically a recipe for failure. There’s no way that one incumbent can actually provide midwifery services given that it’s a 24/7 operation. As a result, the incumbent did choose to leave.
Moving forward, we have the money that will not be utilized in the Beaufort-Delta for their program. They are still requiring some funds, of course, but we anticipate creating a territorial Midwifery Program based out of Yellowknife and the expectation is although they’re providing consultation, advice and support to regions that don’t have midwives, they will also be able to facilitate some midwife-supported births here in Yellowknife. Thank you.
Thank you, Mr. Abernethy. Final, short supplementary, Mr. Bromley.
Thank you, Mr. Speaker. Thanks to the Minister. So, when will consultations start here? When will we see midwifery here and what the heck is the NWT Advisory Committee on Midwifery? Thank you.
Midwifery services, as I indicated in the business planning process and the budget planning process, there will be planning that will take place during the ’15-16 fiscal year and into the ’16-17 fiscal year. We’re hoping by the end of the ’16-17 fiscal year we should be in a position to have a real solid plan of how many midwives we need and begin the staffing process. Thank you.
Thank you, Mr. Abernethy. The Member for Frame Lake, Ms. Bisaro.
Thank you, Mr. Speaker. My questions today are addressed to the Minister of Education, Culture and Employment. I’d like to follow up on my statement. In my statement I referenced a review of the Junior Kindergarten Program that was to have been completed in July of this year. There’s been no indication that that report is anywhere near completion.
I would first of all like to ask the Minister if he could provide an update to me and to the House with an update on the review of the Junior Kindergarten Program and when we might expect to see it. Thank you.
Thank you, Ms. Bisaro. The Minister of Education, Mr. Lafferty.
Mahsi, Mr. Speaker. It was agreed upon in this House in October 2014 where GNWT Members agreed to put the JK rollout on hold until such a review was undertaken, which is before us now, and that it will be brought back to the 18th Assembly. So that’s what we’re doing. We’re at the final stages of the review and it will be brought forward to the 18th Assembly government. Mahsi.
In October of ’14, we were advised that the report would be completed in July of 2015, which gave the current 17th Assembly Members, particularly the Standing Committee on Social Programs, an opportunity to review that report.
I’d like to ask the Minister, when was it decided that this would be punted to the 18th Assembly? This is news to me. I had fully expected to see this report before the end of this Assembly. Thank you.
Mahsi. The decision that was made in October 2014 by this government and also Assembly Members that we were going to put on hold the JK programming rollout until such a comprehensive review was undertaken, which, again, is happening now. At that time the decision was made that the comprehensive review will be undertaken by the 18th Assembly government, which we are doing. We are at the final stages. Mahsi.
I’m laughing because it’s ridiculous that a report generated by the 17th Assembly has been delayed almost by three months now, such that anything that’s in that report is now being sent off to the next Assembly. In my mind it’s ludicrous. That’s why I’m laughing. I’m not quite sure where to go from here.
To the Minister: If this is being sent off to the 18th Assembly, what does he expect in terms of an impact on the Junior Kindergarten Program? Not the details, but when does he think there’s going to be any kind of an impact on the Junior Kindergarten Program? Obviously, not for the school year ’15-16, but is he expecting impacts in the school year ’16-17? Thank you.
Mahsi. The Member is asking for my opinion. That will be up to the 18th Assembly government. Mahsi.
Thank you, Mr. Lafferty. Final, short supplementary, Ms. Bisaro.
Thank you, Mr. Speaker. I guess I can’t go there. When this report comes out, I’d like to ask the Minister, if it’s going to go to the 18th Assembly, will it be made public? Will it be available to the teachers’ union, the NWTTA? Will it be available to Members of this House, or is it simply going to be a report that is going to sit in the department? Thank you.
The final report, we’re at the final stages of a comprehensive report that Members of this House, this government agreed to. We are preparing that for the 18th Assembly government.
I can’t speak for the 18th Assembly government. We are the 17th Assembly government. We’re doing our due diligence. We’re providing the document as a recommendation to the 18th Assembly government for them to decide. So if they decide it is going to be public information, by all means the 18th Assembly government will decide. Mahsi.
Thank you, Mr. Lafferty. The Member for Inuvik, Boot Lake, Mr. Moses.
Thank you, Mr. Speaker. I have questions following up to my Member’s statement earlier dealing with chronic disease management specifically around the diabetes. I had mentioned there is an expected 200 new diagnosis every year of diabetes in the Northwest Territories. So, under our watch for the 17th Legislative Assembly, we had about 800 residents, NWT residents who were diagnosed with diabetes that could have been prevented under our watch of this government. Moving forward, when the 18th Assembly gets up and running, you’ve got to give them the tools, the knowledge and everything in order that we don’t have 800 more residents or 200, even, in the first year being diagnosed with diabetes.
I’d like to ask the Minister, what’s his strategy in terms of diabetes prevention, management and screening going into the 18th Assembly? What are we currently doing right now? Thank you.
Thank you, Mr. Moses. The Minister of Health, Mr. Abernethy.
Thank you, Mr. Speaker. Before I get into some of the things that we’re doing, I just want to make sure that we understand that the expected 200 per year increase is still just a preliminary number. We’re actually working on a prevalence study right now that’s going to help us have better numbers and feel more confident in the numbers. It could be higher, it could be lower, but I just wanted to be clear that that’s still just a preliminary number.
We are doing a number of different things. With respect to prevention, we’re focusing on education in two streams. We’re trying to get information out there. We’ve actually, through the BETTER project, developed a number of videos that we have sent out throughout the Northwest Territories, talking about food, exercise and other issues to encourage people to understand and become aware of healthy eating and healthy living to help prevent diabetes. We have, also, with respect to effective screening, put in the new Diabetes Screening Tool Diagnosis Clinical Practice Guidelines and those have been spread out throughout the Northwest Territories to our practitioners, and our practitioners are using those now. We’re getting really positive feedback from the practitioners and the people who have been assessed. That’s one of the ways that we’re helping to do effective screening.
With respect to management, some of it is still one on one because every case is unique and every case is different, but we are working closely with patients to manage them through their process and ensure that they are getting the treatment that they deserve. Thank you.
As I recall, we used to have a really effective Diabetes Program here within the department. It did a lot of work, a lot of outreach work, mobile work in prevention, education, did the screening, actually. From what I understand, the program isn’t up and running to the full potential that it once was.
I’d like to ask the Minister, what are his plans for this Diabetes Education Program that we used to have at the Department of Health and Social Services that did a lot of good work throughout the Northwest Territories and whether the full support is going to go back into that program. Thank you, Mr. Speaker.
As I indicated, through BETTER project we’ve developed these motivational videos. We’ve been working with Education, Culture and Employment that has a project called Screen Smart, which is introduced in NWT schools to help children who may be obese to pursue healthy living so they don’t develop type 2 diabetes later in life. I’m not 100 percent sure; I can’t remember the exact program the Member is referring to with respect to diabetes education, but we are, through our public health unit, getting information out there on diabetes to make sure people are as informed as possible. If the Member wants to tell me what specific program he’s referencing, I’d be happy to look into that. Thank you, Mr. Speaker.
I think it was more of a special diabetes clinic that did a lot of work. I understand the Minister talking about the videos and Screen Smart. As I mentioned, the CDA, Canadian Diabetes Association, recognizes that for diabetes care, it’s patient-centred and delivered by a multi-disciplinary team.
What specific training do they have in diabetes? Not videos or the Screen Smart assessment. You need that one on one. You need that interaction between somebody who’s trained.
What is the Minister’s plan to create a multi-disciplinary team that’s going to go to the communities to get this information out to the residents? Thank you, Mr. Speaker.
The multi-disciplinary team is more focused on the effective screening and management. The promotion and education can be done through schools, can be done through many different providers out there. We are working with many different groups to get the information out there.
With respect to effective screening and management, we do have the Type 2 Diabetes Screening and Diagnostic Clinical Practice Guidelines. These were developed in conjunction with the CANRISK questionnaire. These were all introduced in the fall of 2014. It is expected that they would be applied at every NWT adult recommended age range, so individuals who may be at risk for diabetes who present to health centres throughout the Northwest Territories, whether it’s in a small community or whether it’s in one of our larger clinics in Yellowknife, our staff are trained. They can go through the questionnaires and they can work with other practitioners who can help manage diabetes, whether it’s dieticians or other services that may be available in different locations within the Northwest Territories. Thank you, Mr. Speaker.
Thank you, Mr. Abernethy. Final, short supplementary, Mr. Bouchard.
Thank you, Mr. Speaker. As I mentioned earlier, there are complications that arise from diabetes. I mentioned earlier proposing a tax on sugary drinks to offset the costs of more hospital visits, more dental appointments, more medication. To put that into perspective, I would like to ask the Minister if he knows what it costs for an individual in the Northwest Territories to deal with people who have diabetes in the Northwest Territories should they have to go through appointments for blindness, heart disease, kidney failure, lower limb amputations.
What are the overall costs to this government for people living with diabetes? Thank you, Mr. Speaker.
That question is kind of impossible to answer standing up here today. Every individual is different and every situation is different. Not all individuals end up having an amputation; not all individuals end up blind. We want to manage diabetes with the patients to avoid having to go down that particular road.
We also know that diabetes is often complicated with other conditions, so how do you determine whether it’s strictly diabetes or another condition that has actually resulted in the particular amputation or blindness? It would be very difficult for us to actually quantify what is actually diabetes related and what might be related to other causes or other conditions.
I do know there are 2,900 individuals in the Northwest Territories with diabetes and that number is growing. It takes physicians’ time; it takes dieticians’ time and community health rep time to deal with all these issues, so the costs can be quite high. Thank you, Mr. Speaker.
Thank you, Mr. Abernethy. Mrs. Groenewegen.
I’m going to join my colleagues on this side of the House today and also weigh in on this issue of the Deh Cho Bridge. I haven’t talked about the Deh Cho Bridge for a long time, and I’m going to direct my questions to the Premier, if I may, today.
We’re aware of the situation with the Deh Cho Bridge. It was fraught with challenges and setbacks and change in contractor and all kinds of things. Everybody was out there on the job doing their best to ensure the delivery of this bridge project as close to on schedule and on budget as possible. It is not a perfect science. Construction is not a perfect science, so when it became apparent that some of the scour rock had to be hauled from a further distance. There is such a thing as agreements between contractors and subcontractors. They aren’t always signed out there on the workplace, but the work gets done and it’s done in good faith. That’s what I want to say.
Now we have a situation here where we have a couple pots of money. We have money for deficiencies, we have money for holdbacks, and we have a northern contractor that was really owed about $1.3 million and that amount has now been written down to $373,000. You can see, the Cabinet can see, the Premier can see from the support on this side of the House that Rowe’s Construction is a territorial company, a long-standing territorial company that has come to the aid of the GNWT on many projects, because projects run into problems. It’s not a perfect science. Rowe’s has been, I think, a very good corporate citizen in the contracting that they have done for this government.
Now we have the situation before us today where we’re talking about $373,000. I’d like to ask the Premier: Is there money in any of the pots of money either from holdbacks or deficiencies that could allow us to pay this northern contractor? Everyone else has been paid. The Minister of Transportation has said we had to pay Ruskin, they built us a bridge. They didn’t build a bridge without the subcontractors there to help them and support them to get the job done.
Thank you, Mrs. Groenewegen. The honourable Premier, Mr. McLeod.
Thank you, Mr. Speaker. This is a bit of a drawn out story, but as everybody knows, Rowe’s was working as a subcontractor to ATCON, who was the contractor to the Deh Cho Bridge Corporation, and when ATCON went into bankruptcy, Rowe’s submitted five claims to the receiver and also to the Department of Transportation. The receiver who was looking after ATCON’s bankruptcy action did not evaluate Rowe’s Construction claims as there was no evidence of a formal contract between ATCON and Rowe’s. The legal review by DOT and our legal division concluded that the Government of the Northwest Territories was not liable for any of the claims that were submitted. However, Rowe’s Construction is pursuing a political solution, so our government reached an agreement with the principals of Rowe’s Construction to hire a referee to independently review the claims and make a recommendation, so I think all our stories are coinciding.
The first report prepared by the referee noted that the GNWT probably has no legal liability to pay the Rowe’s claim, but if there is surplus funding available after all deficiency work is paid for, there could be a possibility of paying. Also, they noted that there were deficiencies in work that was done by Rowe’s, and if there was any work that had to be done to fix deficiencies, those should be offset against those claims.
There was a second report filed by the referee, who concluded that two out of the five had merit, so that both claims came up to about $722,000. The deficiency fund, backed up by the Government of New Brunswick, was to fix deficiencies, and any, the referee concluded again in the second report, that there should be a set off for any deficient work, and a condition that if there is going to be any payment to Rowe’s that there be unspent funds in the ATCON deficiency fund. They also recognized that there is at least one other company that is in the same situation. There is approximately $700,000 to $800,000 left in the deficiency fund. I am not aware of any other holdbacks for the bridge.
The Premier and the Minister previously have spoken about legal liabilities. Again, this project is not without its challenges and difficulties, but the government and Rowe’s agreed to a referee arbitrator. In the arbitrator’s report it says I believe Rowe’s is entitled to a part of all of the money still owing to them up to the amount of the funds available under the credit agreement. I mean, these are nonbinding decisions of the arbitrator but the government and Rowe’s came together to go choose somebody to look at this whole situation and now here we are today and we’re just talking about the absolute legal liability.
I say this government has a moral liability, in the interest of good business and good business practices, to support a northern contractor who in good faith performed work for which they have not been paid. As I said, that amount has been written down substantially to take into account any of those questionable things that the Premier has made reference to. I think, like I said, you’re hearing pretty clearly from a number of Members on this side of the House that we are interested in seeing Rowe’s paid this $373,000. I’d like to ask the Premier, how can we get that done?
I should point out that a fair and reasonable resolution process is still underway involving the Department of Transportation and Rowe’s Construction. We still don’t have any evidence of any formal contracts. We also know that there are deficiencies in some of the work that was done that we have to reach agreement on, so there is still ongoing work to be done. I expect that it will continue into the 18th Assembly in order to look for a resolution.
I would like to ask the Premier if it is within his purview to instruct someone within the Department of Transportation to meet expeditiously with the Rowe’s to see this matter brought to a conclusion.
I am led to believe that there may be people in the Department of Transportation who are not as willing as perhaps their political masters or their political bosses would be to see this matter resolved, and I would like to see it resolved. If it takes political intervention, I’m asking for political intervention. Does the Premier have it within his ability to ask someone in the Department of Transportation, in the next short while, to meet with the Rowe’s, representatives of Rowe’s to find a solution to this situation?
Between myself and the Minister of Transportation, I’m sure that we can find a way to meet with the principals. The problem is going to be finding a legal way if there is going to have to be some financial restitution because of the fact that we’re in an election process. That’s why I’m saying it would have to be looked at as part of the 18th Assembly. But we are quite prepared to meet with Rowe’s Construction. We have said that, and as I said, there is still an ongoing process.
Thank you, Mr. McLeod. Final, short supplementary, Mrs. Groenewegen.
Thank you, Mr. Speaker. I’m glad to hear that the matter is not concluded and that the Premier has expressed a willingness today to meet with the principals of Rowe’s Construction to see this matter brought to a satisfactory conclusion, understanding the challenges of the election period and so on. But I understand that Ministers will stay in their capacity and in their roles until after new Ministers or a new Cabinet has been elected and appointed, so I would still ask the Premier if this could be done still yet prior to that during the 17th Assembly?
After all, we are a responsible, transparent government, so we would be very pleased to do that.
Mr. Speaker, I wish to table the following two documents, entitled “Charting Our Course: NWT Cancer Strategy 2015-2025,” and “Measuring Success and Focusing on Results: NWT Health and Social Services System 2014-2015 Annual Report.” Thank you, Mr. Speaker.
Thank you, Mr. Abernethy. Mr. Ramsay.
