Agreed.
Agreed. I will ask the Sergeant-at-Arms to please escort the witnesses to the table.
I’d like to ask the Minister if he’d like to again introduce his witnesses, for the record. Mr. Abernethy.
Thank you, Madam Chair. With me today are Jeannie Mathison, director of finance with the Department of Health and Social Services; and Debbie DeLancey, the deputy minister.
Thank you, Minister Abernethy. Again, if I could turn your attention, please, to page 8-9, Department of Health and Social Services, information item, revenue summary. Are there any questions? Agreed?
Agreed.
Thank you. Page 8-10, information item, active position summary. Agreed? Mr. Dolynny.
Thank you, Madam Chair. If the Minister could just clarify, we have 173 full-time positions in this activity summary. Are these funded active positions? Thank you, Madam Chair.
Thank you. Mr. Abernethy.
Yes, Madam Chair.
I appreciate the Minister’s comment. Are there any of those 173 positions that are inactive positions? Thank you.
No, Madam Chair.
Thank you, Mr. Abernethy. Page 8-10, information item, active position summary.
Agreed.
Thank you. Page 8-11, information item, active positions, health and social services authorities. Mr. Nadli.
Thank you, Madam Chair. The Minister has publicly stated some signals in terms of the movement of the regional boards and how they fit within the organization of the Department of Health and Social Services. I just want to clarify whether indeed his comments were in the context of assessment mode where the department is undertaking or has there been a cost-analysis of cost-savings measures for downsizing regional boards. Thank you.
Thank you, Mr. Nadli. Mr. Abernethy.
Thank you, Madam Chair. When I was responding to opening comments from Members, I talked about some of the things that were happening. There is no intention to downsize staff in communities or regions with respect to any of the work that’s going on trying to provide a more streamlined approach for our residents. So there is no intention of downsizing any of the positions in any communities or regions in the Northwest Territories.
I’d like to thank the Minister for clarifying that. I know there has been some discussions or perhaps overtures in trying to at least come to the point where we recognize we are fiscally challenged in meeting the objectives of providing quality care and programs and services to the citizens of the NWT. Has there been an assessment or cost analysis in terms of savings having been done?
We don’t anticipate savings through the exercise we are going through. What we’re trying to do is streamline services so we can provide the best results to residents of the Northwest Territories in all communities and regions. That includes having some back office functions where shared activities can be done at a territorial level regardless of the region it happens to be located in. Authorities and boards can work together to get economies of scale. We don’t believe it is going to save us money, but it will give us greater control over future spending because we will be able to get some economies of scale.
In that process of streamlining, I think you’ve outlined the scope and parameters of the efforts and activities associated with that. Have there been perhaps some figures that have been determined on some fiscal strategies to ensure, indeed, there are enough revenues to address the expenditures of delivering programs and services? Mahsi.
Currently all of our authorities are running deficits and this is something that’s been ongoing for a couple of years. We believe by sharing and collaborating on things like procurement and physician services, IT/IS/IM, some financial aspects, we’ll be able to coordinate efforts across the territory and have a more responsive, streamlined approach. But at the end of the day, as I said two days ago now, our focus is on the care that the patients receive and we want to make sure that our patients have a seamless flow through the system. We’ve all heard people talking about how frustrated they are coming from one authority and trying to gain services in another authority, so like from the Dehcho to Stanton. We’ve created these silos, these independent authorities and our patients can sort of bump up against the structures that we’ve created and we want to have a seamless approach.
Having said that, we absolutely recognize and we want to continue to have regional functions as far as advisory capacity at a regional level, so like an advisory board or something, advisory council. We’re still working out the details on those types of things. We are going to work with the current structures that exist. We’re going to work with Aboriginal governments, community governments, Members and everybody to try to find a solution for improving the health system to benefit all people of the Northwest Territories.
I’d like to thank the Minister for what’s in that outcome in terms of furthering my understanding of the process.
There has been some discussion of streamlining. It’s fairly obvious that the department is internally assessing its resources. At what point would there be a formal decision in terms of amalgamating boards? As you’ve indicated, departments and divisions, or divisions mainly are, or district offices are mainly working in silos and there needs to be linkages.
At what point would there be a formal decision point that the department will be undertaking to look at moving towards amalgamating boards? Thank you.
Madam Chair, we’re not actually talking about amalgamating boards, we’re talking about creating a central approach, a unified approach to providing health and social services and having shared functions coordinated across all the entities, possibly with a central territorial body that would be more of a virtual organization. It doesn’t really need to be located in one particular area and it could have individuals from what are all the authorities now participating. We’re not talking about amalgamation. We know and we believe, and I believe, that there still needs to be regional entities providing advice and guidance on the provision of services, but we do need to find a way to have a territorial approach to some of the back office stuff and standards so that we can set standards of care for all residents of the Northwest Territories, and our patients can have a seamless flow through the system and not experience barriers that we’ve created by design.
Initially my intent of asking questions is to seek some clarity. Again, if this streamlining effort is in the spirit of amalgamating, which the Minister says it’s not, then are we in fact in an exercise of centralizing the health authorities?
Madam Chair, we need to do something different. We’re not providing services to the best results that we can. We do have to have a territorial approach to a number of functions that exist, things like IT/IS/IM, procurement, our physician services, some financial systems.
The Member asked about some financial reports. It’s incredibly difficult to get a real comprehensive financial analysis done at a territorial level because every authority runs on their own unique financial system, which complicates things. So it’s not about taking anything away from the communities or regions, but it’s creating a system whereby those regions maintain an ability to have advice and guidance on the delivery of programs in their area, but they’ll also have a territorial voice which they don’t have now.
I’d be happy to sit down with the Member and walk through some of this stuff. I’d be happy to sit down with committee and walk through some of the details, but no decisions have been made. We are trying to take care and work on some of the back office stuff while, at the same time, having discussions about how we can improve the system overall.
Thank you, Mr. Abernethy. Next I have Mr. Yakeleya.
Madam Chair, thank you. I’d like to ask the Minister the number of vacant positions in the Sahtu under the health and social services board and if there have been any type of changes to these vacant positions. Which ones haven’t been filled for a long time and are they still active in our system? Thank you.
Thank you, Mr. Yakeleya. Minister Abernethy.
Thank you, Madam Chair. According to the report distributed previously, as of October 31, 2013, there were nine vacant positions in the Sahtu. Currently, of those nine positions, six have been filled, two are in competition in progress and there’s still one that needs to be advertised. We haven’t gone out for staffing on that one, or, rather, the Sahtu Health and Social Services Authority is waiting to get that in the queue.
Thank you, Minister. It does look promising to fill these positions. I wanted to ask the Minister if any of those positions are difficult to fill. The community of Tulita has been waiting for a social worker for some time and we put the suggestion forward some time ago to the previous Minister if they would be flexible enough to use that position in support of the community as a community wellness worker, some type of worker that would help out with the community issues if we’re unable to fill that social worker. I’ve heard that some of the social workers are doing their jobs designated for one of the communities, but they have to go to another community to do more work there and they’re getting tired. So, I want to know if that flexibility is available to the health boards and to the department to support them in that effort. Thank you.
I do know that Norman Wells was providing some back fill to the community of Tulita with respect to the social workers, but I don’t actually know the current status of the social worker position in Tulita.
We’re constantly working with the authorities, trying to find solutions to their communities’ challenges. We do have positions established for particular purposes, but if the community needs are such, we are always open to have some discussions as long as it’s within the same area of mandate.
I appreciate the Minister’s willingness to look at this. The community has actually been asking and there were several challenges to not allowing the social worker to come into the community. There’s no blaming why that couldn’t happen, we’re just asking if that is happening for reasons we sometimes don’t understand. The community is asking – and the previous Minister had that discussion with the community – if they can use that position to have a wellness worker to work with alcohol and drugs specifically to have that position. Today, as we sit, Tulita does not yet have a social worker. It is backfilled by workers out of Norman Wells, but that puts an additional load on them and they have to travel and spend a few days in Tulita and then get back to Norman Wells. They’re getting somewhat tired and it can cause some burnout for our social workers. That’s all I’m asking.
I’ll get the Member an update on the current status. I will say that obviously we want to fill these positions with the professionals identified in the job description to provide the services that we are committed to providing, so we will always want to fill that with a social worker. But you’re right; some positions are proving hard to recruit and we need to be open to some creativity in order to find ways to continue to provide those services, regardless of our ability to staff or not staff positions.
Certainly when the social worker left Tulita, it has been a couple years or longer and it’s been almost over 700 days since we’ve had a social worker in our community. Even though we get back fills from the other communities to help out, it has been quite a challenge and that’s why we ask if they’ll be flexible enough. We certainly want to fill those positions for those workers coming into our community. Sometimes it doesn’t work according to the plan, so I’m just asking for some flexibility if the community can work with the health and social services board to say it’s going to be a challenge, we’re unable to fill that position, as we all want to do, but this position is being vacant and we’d like to do something that would fit the needs of the community. Some flexibility within the department with the health boards to say, yes, we can do this. That’s all I’m asking.
I’m agreeing.
Thank you. Next I have Mr. Menicoche.
Thank you very much, Madam Chair. Just for clarification, we’re on 8-11?
---Interjection
Thank you very much. Just with still a bit of position growth here and with the Stanton Territorial Health Authority and the Yellowknife Health and Social Services Authority, I’m presuming all these are Yellowknife jobs. There’s an increase of 24 positions. Can the Minister explain what those are.
Thank you, Mr. Menicoche. Minister Abernethy.
We’re just trying to dig the specific details out of the binder. We will provide the specific details to the Member so that they have a better accounting, but by way of example, at Stanton most of the positions are located in Yellowknife and a significant number of those or a couple of those are accounted for through the Med-Response unit that we’re putting in as well as some other health professionals. Within Yellowknife Health and Social Services, the increase is about 13 and those are EMR. I’ll go to Director Mathison because I don’t understand.
Thank you, Mr. Abernethy. Ms. Mathison.
Thank you, Madam Chair. For details on the increases specifically to the Yellowknife Health and Social Services Authority between ’13-14 and ’14-15, the increase is 11 positions, four of them are related to the Healthy Family program, two are increased positions for prevention and promotion, one is related to the new funding for the EMR implementation, and three positions are related to the Information Systems Service Centre collaborative Shared Services Initiative.
Thank you, Ms. Mathison. Mr. Menicoche.
Thank you very much. I didn’t think it added up to 24, but between Stanton and the Yellowknife Health and Social Services Authority, I guess, Madam Chair. I’m just trying to understand why there are increases, 20 more positions for Yellowknife. As we go along, I think I pointed it out in the previous department too, although it was there that things continue to grow and grow in Yellowknife. It looks like these authorities, of course, are specific to Yellowknife. So just two more questions, I guess. I think we were short a couple of positions. I didn’t that came to 24, what she was saying. The second one is, specifically, does that growth have to be in Yellowknife?
Thank you, Mr. Menicoche. Ms. DeLancey.
Thank you, Madam Chair. I believe the reason the number didn’t add up is because we have a net change of 49 new positions in the system in these main estimates, but there are more new positions and then some positions have been lost or sunset, so it’s not a straight exchange, and although there are a number of new positions in Yellowknife there are also 23 new positions in other communities as well. Every new position that’s added to the system, we make every effort to look at whether it needs to be in Yellowknife. For example, some of the back office functions like the coordinators for the electronic medical records and the coordinators for our new Information Systems Centre are located in Hay River. Unfortunately, when positions go to Stanton, as the Minister noted, that’s a territorial facility, they are located in Yellowknife.
Thank you very much. I think the deputy minister clarified that when there’s a net change. I can appreciate that answer.
Just referencing my Member’s statement about how difficult it is for somebody new trying to get into a system, I know that a lot of these are largely professional, but we’ve still got accounting clerks, front desk personnel, et cetera. I’m also presuming that there are just as many vacancies in this department on average as anybody else, so can the Minister designate a task team and look at those entry-level positions, because I’m concerned, once again, about over-qualifying entry positions and, of course, not giving enough credit for equivalencies, I guess, as the HR Minister had indicated earlier in the day. If the Minister can comment on that and review any of those vacancies. I don’t know if he gave the number to Mr. Dolynny, but I’d certainly like to know the number of vacancies.
Thank you, Mr. Menicoche. Minister Abernethy.
Thank you, Madam Chair. We do have a health and human resource strategic planning unit with the Department of Health and Social Services and the exact things that the Member was talking about are the types of things we’re trying to do. The Member is correct; we do have a large number of positions that are or do require statutory appointments, and we would have to staff for those accordingly. But at the same time, we have been very supportive of training local people for local jobs. The resident care aide program that is delivered by the college, we have worked with them to have those delivered so that people can get jobs in the communities. We recently worked with them to deliver one here in Yellowknife that is going to be where a lot of people from Behchoko are trained for the long-term care facility there, and as I mentioned to Mr. Yakeleya, there will be one up in the Sahtu, and we’ll be working with the people in the Sahtu to have that training delivered so local people there, so they can have access to those jobs.
But we will continue to work with our communities and our regions to identify training opportunities for health care professionals that can be done without statutory appointments. We will be coming forward with a strategic human resource plan. I will be sharing that with committee and we’ll have an opportunity to discuss things that we can do better to employ people from the North in the North.
The second part of the question, which I forgot to answer, is the vacancy rate in the department for funded positions is about 18 percent. Just for the record, in the Deh Cho, there are 95 positions in the ’13-14 mains, and in that October 31st report there was 11 positions identified to be staffed in the immediate future. Of those, five have been filled, three are in competition right now, and three are in the queue to go for competition once there is capacity within the department to move forward with HR to staff those positions.
I’m glad the Minister was able to answer the questions on vacancies and specifically to the Dehcho, as it were, partly in my regional breakup. Social Services calls it Dehcho, but half of it, of course, is the Nahendeh. But certainly it addresses my issue of having job opportunities available for all residents as we move along.
Just with the vacancies alone, I think I spoke last budget in this House about Fort Liard and their need for consistent social work and mental health services. I just want to know if things have been addressed in Fort Liard. There was a high turnover of social workers. It happened again this year and there’s another turnover of social workers, and the concern about having consistent mental health services. What it is about is that people feel more comfortable and more trustworthy when they’ve got someone that’s long term, somebody’s there that developed a working relationship with them certainly helps with the community wellness and community health and the ability for clients to access treatment services if they are working with someone they trust and can develop a good working relationship. I would just like to know about the efforts to have consistent social work and mental health services in Fort Liard. Thank you.
