Thank you, Mr. Chair. Mr. Chair, the savings in this area are as a result of some reductions to the PDI Fund that we provide to our staff. We still have the fund but we have reduced it slightly.
Thank you. Go ahead, Mr. Minister.
Thank you. For clarity, that’s the Professional Development Initiative Fund. That fund is available to help professionals in the Northwest Territories to do non-required training, training that is beneficial but not required for their jobs to help them be more well-rounded and offer them some skills sets that aren’t part of the normal job.
Thank you, Mr. Minister. Mr. Thompson.
I’m good. Thank you, Mr. Chair.
Thank you, Mr. Thompson. Mr. Nadli.
Thank you, Mr. Chair. I’m just going to figure out at what point I could ask the appropriate question. My question is in regards to the transformation efforts in terms of centralizing or getting the health authorities together under one umbrella, that was via Bill 44. I just wanted to get a sense from the Minister in terms of providing reassurance especially for small communities that have at the ground level, at the community level an input in terms of decision-making of their healthcare needs and, you know, their aspirations to ensure that we bring good quality care to people that live in communities. Can the Minister distinguish between transformation in terms of centralization? Thank you.
Thank you, Mr. Nadli. Mr. Minister.
Thank you, Mr. Chair, and through the entire exercise, we heard clearly from people across the Northwest Territories that they wanted a health system that met their needs and focused on the client. We moved forward with health transformation. The residents across the Northwest Territories were also very, very clear that they didn’t want to see centralization. This isn’t about centralization. This is about bringing the system together to work together. It isn’t resulting in positions being taken away from communities across the Northwest Territories. The frontline positions are critical care providers and must be there. It is going to result in some change of relationships across the Northwest Territories as far as how the authorities will be required to work together. Previously, we occasionally worked together and it was more goodwill than design. We have gone out and done a call for members to be on our regional wellness councils across the Northwest Territories. We received a lot of interest. We have begun and have gone through the selection process. We’ll be announcing the members of the wellness council shortly. I just have to get it through Cabinet and Regular Members before we actually finalize that, and we continue to move forward with the process of creating a collaborative, integrated system working together for the best interests of the people of the Northwest Territories. It’s not centralization.
Thank you, Mr. Minister. Mr. Nadli.
Thank you, Mr. Chair. The other question that I have is the riding that I represent, of course, has four communities. Two could be categorized in a South Slave district for regional administration purposes. One of them, of course, is the Hay River Reserve and Enterprise, and then you have Kakisa and Fort Providence. How do communities ultimately decide which authority they’re going to work with and is it the prerogative of communities to make their own decisions, or is it the Minister and department that decide which communities should work with what authority? Thank you.
Thank you, Mr. Nadli. Mr. Minister.
Thank you, Mr. Chair. We do rely on some historical precedent. I mean, some of the authorities such as the Sahtu, by way of example, are… The wellness council is going to be made up of roughly the same geographical region that the Sahtu health and social services board members were actually on. For areas where there was a question, I did have conversations with some of the leaders in communities to find out what their interests were, where they thought might be most appropriate. In most cases, they deferred to having input into the region or health authority or, sorry, health council that was the one where most of their people were going to receive services from. by way of example, K’atlodeeche opted to have representations on the Hay River wellness council as did Kakisa. No, sorry, as did Enterprise. Kakisa opted to have a representation on the Dehcho Regional Wellness Council.
Thank you, Mr. Minister. Mr. Nadli.
Thank you, Mr. Chair. This will be my last question. Perhaps in the future, a community decides for the purposes of bringing better services to their communities, how would they remove themselves from the authority perhaps to join other authorities, say, from the Deh Cho to perhaps the Hay River Health Authority. Thank you.
Thank you, Mr. Nadli. Mr. Minister.
Thank you, Mr. Chair. I think it’s important to remind everybody that one of the reasons to go to a single authority is to make sure that individuals have an opportunity to influence care where they’re going to receive care and ensure that services are custom tailored to meet their communities’ realities.
On a bigpicture scheme, as long as they have representation, it’s filtered enough through regional chairs to the territorial level of the voices going to have impact. However, as I indicated, we did have conversations with leadership at K’atlodeeche and they indicated they’d like to be on Hay River because that’s where they’re receiving most of their care. We are open to having discussions, but there has to be some, you know, recognition that, you know, where are you receiving most of your care? What’s your proximity? Who are you close to? Where are you getting most of your services, you know, to help us figure out where people can and probably should have representation? We’re open to anything. We’re open to discussion. There’s going to be evolution in this process. We accept that.
Thank you, Mr. Minister. Recognizing Mr. Simpson.
Thank you, Mr. Chair. I just wanted to go back to the Hay River Health and Social Services Authority. You said since 2005 it’s been costing about a million a year, some years a million and a half to top up the pension fund? We’re looking at already about $11 million. I understand to bring them into the single authority 15 years ago would have cost maybe a couple million. Now, I have heard estimates, $20 million, $30 million. Does the department have a plan to actually bring the Hay River Health and Social Services Authority under the single umbrella and when do they foresee that happening and how much would that cost? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Mr. Minister.
Thank you, Mr. Chair. I can’t recall the exact number that it would have cost to bring Hay River into the public service in 2005. Anecdotally, I have heard numbers of $2 million, $3 million, $4 million, $5 million to bring them into the Superann as a pension. Now we believe that number to be significantly higher. We are working with Superann. We are working with our partners to try to quantify what the exact cost to bring them into the GNWT’s pension would be. We are still doing work that is going to be necessary once negotiations begin with the UNW and the Hay River Authority to bring their employees into the public service. We obviously want to see this happen. We believe that to have a truly unified health care system in the Northwest Territories, Hay River needs to be in. I have talked to people in Hay River including staff. They want to be in, but we are currently doing several negotiations, collective bargaining, both in the GNWT, in Hay River, NWTTA, a number of negotiations. The individuals who are going to help us with the negotiations and bring Hay River into the public services, it’s all the same people, so we need to finish some of this additional, this upfront work, two collective agreements, and then we’ll be in a better position to figure out what the timeline will be to bring them in. We have to figure out the money. If it’s $23 million, we’re going to have to figure out where those dollars are going to come from. It will be a onetime cost to bring them in, but you’re right. The Member is right. I mean, we’ve spent a million to a million and a half a year since 2005. It’s costing us money not to bring them in.
Thank you Mr. Minister. Mr. Simpson.
Thank you, Mr. Chair. When do you expect those negotiations to happen? When do you expect to actually get an exact cost? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Mr. Minister.
I can’t say when those negotiations will begin, but they certainly will not begin until we have concluded all the other collective bargaining negotiations that are underway, because as I said, it’s often the same people. As far as the pension costing, we are continuing to do that work. It isn’t simple. Superann has a lot of questions. They have a lot of concerns. We need to ensure that whatever happens is fair and reasonable. We don’t know what the cost on the individual basis might be. We certainly don’t want our employees, the employees of Hay River to be in a worse position. We want to make sure that they’re protected, so we continue to do the work to figure out what those costs will be, but we don’t have those costs today. We have general ranges, but nothing concrete.
Thank you, Mr. Minister. Mr. Simpson.
Thank you, Mr. Chair. it’s a little more complicated than just figuring outthan what that one number, that one big number. Are there other issues, seniority, any of these other kind of things that need to be worked out along with the final number? Thank you.
Thank you, Mr. Simpson. Mr. Minister.
That is certainly one of the issues. I mean, pension is where the significant cost is going to come from. There is no denying that, but the Hay River collective agreement is different than the UNW collective agreement. We have had some early discussions with union as we are talking about bringing Hay River in, and there are certain things that they wanted to flag and things like seniority are one of them. We have to figure those out. We can’t have two collective agreements if we roll into one authority, so we have toit’s going to take some negotiations. It’s not just a cost thing. It’s a negotiation.
Thank you, Mr. Minister. Mr. Simpson.
Thank you. I will leave that regional issue alone. I guess it’s kind of a territorial issue when you’re talking about tens of millions of dollars. I just wanted to discuss the Human Tissue Donation Act. I think this would be the section. It was passed in the last Assembly. It came into force last June, I believe, and the latest information I found on it says that we have to wait until the organ donation registry is set up before people can register. I was wondering how far along that process is, if that’s going to happen in this budget year. Thank you, Mr. Chair.
Thank you, Mr. Simpson. Mr. Minister.
Thank you, Mr. Chair. Unfortunately, we are not as far along as we would like it. We have basically done everything that we need to do on our end. We had agreements to move forward with the Alberta government. Since their election, it has put a bit of a hold. They have indicated that they’re still happy for us to come on board, but they weren’t ready or prepared to actually begin that process. They had other things they needed to take care of in Alberta. We will be part of the Alberta registry, and that’s what the onetime costs were to set up our portals and those types of things to allow NWT residents to access their registry. We still get indication from them that they want us to be part of the registry, that they are willing to move forward. I have had oneonone conversations with the new Minister of Health in Alberta. She indicated to me they still want us to come on, but they haven’t re-engaged, given us a timeline of when they’re ready to start actually developing and doing the work. They are going through significant challenges in that province and it’s a new government. We keep asking. I will continue to ask. Next time I see the Minister, I will bring it up again.
Thank you, Mr. Minister. Mr. Simpson.
Thank you, Mr. Chair. Thank you for the answers. Nothing further right now. Thank you.
Thank you, Mr. Simpson. Recognizing Ms. Green.
Thank you, Mr. Chair. I wanted to follow along with some more questions about the health system transformation. Could the Minister tell us what the cost of health system transformation is up until this point and for this fiscal year. I am not sure where to find that in the mains here. Thank you.
Thank you, Ms. Green. Mr. Minister.
Thank you, Mr. Chair. Mr. Chair, as they look for the exact numbers, the funding that we needed in order to do the work and the analysis and the system design and all the work required to move from a fragmented multisystem, multicompeting system to a single authority was actually federal funding that we got under the Territorial Health Innovation Fund. The fund, the total fund is $4.3 million, of which we use some of it for implementing and designing regional health strategies, some of it for medical travel, and $2.8 million annually for the duration of implementation and design for the system transformation costs, so that’s hiring the people, doing the work, doing the analysis, getting the consultants, helping with the design.
Thank you, Mr. Minister. Ms. Green.
Thank you, Mr. Chair, and thank you for that answer. For how many more years into the future will there be this $2.8 million available for implementation and design? Thank you.
Thank you, Ms. Green. Mr. Minister.
Thank you, Mr. Chair. Mr. Chair, it was threeyear funding from the federal government. This is the last year of that fund. If there is any money left over for any of the three initiatives that I have indicated, if we haven’t spent all the federal dollars, we can roll it forward into the next fiscal year. As far as the Territorial Health Authority moving forward, that will be our cost and we were designing a system that wasn’t going to cost us any more money. We weren’t asking for more money to move to this single system, but we needed these innovation dollars to help us design, implement.
Thank you, Mr. Minister. Ms. Green.
Thank you, Mr. Chair. if I understand correctly that once this design and implementation phase finished at the end of this fiscal year, there won’t be any additional costs to the department for health system transformation. Thank you.
Thank you, Ms. Green. Mr. Minister.
No, Mr. Chair. I mean, at the end of the day, we’re redescribing existing positions, some reprofiling some positions out of the department that are going to now be territorial health Authority positions. This isn’t about growth. This isn’t about creating a whole bunch of new positions. This is about utilizing what we have in a better way in a more collaborative way to meet the needs of the residents in the Northwest Territories. In the future, what you will see is a smaller department, more as a ministry function, and an authority that actually has some of the functions and roles that are in the department today, and then the authorities are going to maintain their CEOs, their positions, but the relationships, how they work together will be changed. We didn’t have Government of the Northwest Territories dollars to do the design work. We used the federal innovation dollars to do the design work and implementation. From that point forward, we’ll be using the health dollars.
Now having said that, who knows what tomorrow looks like? We may do some additional activities. We may come back to you, but anything we come back to you will come through this House for discussion. I can’t foresee that at this point, but forever is a long time.
Thank you, Mr. Minister. Ms. Green.
Thank you, Mr. Chair. What I take from that is that it’s not supposed to cost any more money, but it could.
Thank you, Ms. Green. Mr. Minister.
