Debates of June 13, 2016 (day 19)

Thanks, Mr. Chair. I have a couple of rounds of questions for the Minister. The first one is on page 184, under contributions, there’s an early childhood development action plan. I see that there’s actually a reduction of $100,000 there, and I’m just wondering if the Minister can explain that because I understand it early childhood development is one of the best investments we can make as a government, so I’m just wondering what the reduction is all about. Thanks, Mr. Chair.

Thank you, Mr. O’Reilly. Mr. Minister.

Thank you, Mr. Chair. Mr. Chair, there was some money transferred to the authorities for $81,000. There was the sunset on the regional early intervention coordinator’s position, $18,000 that was for some O and M costs, but there was also an increase as the result of some northern allowance for its growth.. Basically an internal transfer and some sunset.

Thank you, Mr. Minister. Mr. O’Reilly.

Okay, thanks, Mr. Chair. While I encourage the department to find more money for early childhood development and for working with the Minister on the 2017-18 budget. I want to go back to one of his favourite topics which is midwifery. Earlier the Minister talked about how there was a consulting position that was sun setting around for midwifery. Then I understand that there’s two people doing work that had been hired as consultants on midwifery.. Can the Minister explain what position was sunsetted and why we hired two other consultants? I think I know the answer to the second part, but can you just tell us what’s going on. Thanks, Mr. Chair.

Thank you, Mr. O’Reilly. Mr. Minister.

Thank you, Mr. Chair. I’m happy to answer the question now or we can wait till page 195 where that actually falls. It’s up to you.

Thank you, Mr. Minister. Mr. O’Reilly. Do you want to just wait or you want to have another question addressed on page 184?

Thanks, Mr. Chair. I thought midwifery was in this section under community health programs because that’s where it’s found in the business plans, but if the Minister’s telling me that I should wait until 195, that’s fine I can wait until then.

I will allow that question on midwifery. Mr. Minister.

Thank you, Mr. Chair. Mr. Chair, this section is not the section that would be in, but I could see why people would think it would be in this section. There have been some changes of where things lay out as we come in line with how CIHI report, so I totally appreciate that. In previous budgets, there was some money allocated to the Beaufort Delta for the roll-out of a midwifery program in the Beaufort Delta. There was supposed to be some positions established. They were never ultimately established but the money was still there. We are basically eliminating those dollars that were to be spent in the Beaufort Delta. We had been in a previous year one time allowed to spend some of those dollars to do the organ and tissue donation which we did but the funding still technically existed. Given that we’re not rolling out a midwifery program similar to other midwifery programs in the Beaufort Delta, those funds were no longer required for that purpose. However, those positions are gone even though technically they were never established. I know it gets a little confusing. There was no people tied to those positions. They didn’t exist. What remains in the Beaufort Delta is the nurse practitioner responsible for the midwifery program as part of more OB which is a physician-led birthing program in the Beaufort Delta,. That’s one NP that’s doing some the pre and postnatal stuff that a midwife would do and working with community health nurses to ensure that we’re expanding the pre and postnatal work that a midwife does so that’s what’s happening up there.. All the additional money is gone. We had used some of those dollars to establish some unfunded midwifery consultant positions in the department. Now we’re officially establishing those in the department so they actually show up within our budget. It gets a little confusing. We had an old one through different funding that sunsetted, so now we’ve brought some of the leftover Beaufort Delta money to actually establish it so that we can maintain it to continue our planning.. We’ve set it up so we have one-and-a-half positions that are dedicated to doing the design on the territorial midwifery program. I can get the department to draw a chart that will hopefully explain how this is a little confusing. When you see it, it makes a little bit more sense, probably a lot better than I’m doing explaining it right now. Here’s how it ends. At the end of the day, we’ve got the midwifery support-type position through an NP in Beaufort Delta. We’ve got two positions in Fort Smith providing midwifery, we’ve got two positions in Hay River providing midwifery, we’ve got one-and-a-half positions in headquarters doing our design on the territorial midwifery program. That’s what it looks like. How it got there is a little convoluted.

Thank you, Mr. Minister. Mr. O’Reilly… Directed to 184, 195, as mentioned earlier, would discuss the financial supports to midwifery services.

Thanks, Mr. Chair. The reason why I’m asking these questions about midwifery here is because it’s community health programs, that’s where midwifery was found in the business plan.. I don’t know why the Minister is talking about nursing when I want to talk about midwifery, but anything he can do to help clarify would be great because if I wasn’t confused before by his explanation, I certainly am now.. If he’s got a diagram that’ll help that would be great. I guess at the end of this we still don’t have midwifery services in Yellowknife, and that’s why we had a person in the gallery earlier today who had to go to Hay River to have her birthing with a midwife there which is kind of ridiculous. Why does somebody have to go to Hay River from Yellowknife to get midwifery services? I look forward to getting this stuff resolved so that we can actually offer the services in Yellowknife which would also help surrounding communities as well. if he can give me information or give the House information about what the heck is going on that would be really helpful. My last question though is: there are midwives that would like to practice in Yellowknife. Are they able to practice in Yellowknife now or do we have to wait for the department to sort this out? Thanks, Mr. Chair.

Thanks. Mr. O’Reilly. I’ll allow that second question to go, but on the basis of the information as the Minister said it was going to be provided on the organizational chart and the finances, or the funding, to support midwifery will be deferred to 195. Go ahead, Mr. Minister.

Thank you, Mr. Chair. Mr. Chair, as I indicated, the way that the mains are presented are to line up with how we are required and needed to report for CIHI for tracking data, so we’re to create a logical system. I hear the Member that there’s some confusion about how it is between the business plan and the mains. We will work to make sure that everything’s lined up. Midwifery services under CIHI falls under nursing services recognizing that midwifery services aren’t exactly nursing services but that’s where CIHI has put them, so that’s why they’re identified in that particular section. We will work to make sure it’s clearer in the future and that it’s consistent with our business plans as much as possible. At the end of the day, I hear the Member. We have to take the report that had a number of different recommended models for the Northwest Territories. We are exploring the possibility of a Territorial model. We are working on design. I’ve answered a number of these questions in the House before. I’m committed to midwifery services but I recognize that there are challenges. I mean we have to make sure that the physicians are supportive and buy in. We have to make sure that we’re not making it difficult for physicians to maintain their competency especially those that are in obstetric services who are responsible for births here in the Northwest Territories. We’re doing this planning, but we’re also making sure that, you know, moving forward that we’re prepared to offer these services. By way of example, we’re building a new health centre at Norman Wells. We don’t have midwifery services there, but we hope someday we will. That new health centre in Norman Wells actually has a room dedicated to midwifery services all plumbed appropriately to put in birthing tubs.. We are moving forward with birthing tubs and other facilities in the new Stanton building that can be utilized possibly by midwives.. We’re doing work recognizing that that’s a direction we want to go, that we want to be supportive of midwifery services. We still have to build a business case and bring it through this House and get a budget supported. Given our fiscal situation, we’re going to have to find that money from somewhere which means we have to be prepared to look at reductions as a way to make these dollars available.

Recognizing the time and having said the issue of the midwifery would be deferred for further questions or debate underneath pages 195, inpatient nursing programs, go ahead, Mr. Testart.

Kieron Testart

Range Lake

Thank you, Mr. Chair. I move that committee report progress.

Recognize that a motion is on the floor to report progress. The motion is in order and is non-debatable. All those in favour? All those opposed? The motion is carried. I will now stand and report progress. Thank you, Minister.

---Carried

Report of Committee of the Whole