Thank you, Mr. Chair. I think we are agreeing. I think we need to look at it all, and think about the clients. With the health system moving to a single authority, one of the things that we've been very clear and consistent on is this is about client care. Our system needs to be client-focused and client-driven. Are we there? No, no. No, we are not. Can we get there? Yes, yes. Yes, we can. Do we have a lot of work to do? Yes. I think we have all heard frustrations people have had with medical travel, and clearly, we have got to be focused on trying to make sure that the experience is not negative and is positive, if possible, which means we have to explore all opportunities around airlines. Thank you.
Thank you, Minister Abernethy. Any further questions? Next, we have Mr. Nakimayak.
Thank you, Mr. Chair. The questions asked for the previous Member answered most of my questions on medical travel. Sticking with medical travel, I don't know if this is the line to ask, but with the high cost of medical travel being this high, do you think that in the future, longer -- in my region of Nunakput, the cost of travel is high, and sometimes it's days. I am just wondering if this is the right avenue to ask, if having longer doctor visits in the region would bring these costs down a bit to balance it out a little bit to ensure that clients get the care they need? Thank you, Mr. Chair.
Thank you, Mr. Nakimayak. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, as I have indicated, moving to a single system is our over-arching theme, or our goal is client-focused. Focus on the patient, client-based, a client-based system. Having said that, because not every service can be provided in every community, medical travel is going to continue to be a necessity. By working together as one authority, we've had the opportunity to look at different standards, different practices, having authorities cooperating, including Stanton, to a greater degree, with some of the remote communities and some of the work done.
We also put in a program called Med Response which is basically the first program of its type in Canada where we have professional staff available to community health nurses and others, including access directly to a doctor. If somebody calls from Nunakput, as an example, they could call Med Response, talk immediately to a doctor. Med Response has actually helped us reduce some issues, or some demand for Medevac, but also has been able to help us avoid medical travel when proper diagnosis can be done on-site.
We have a long way to go here, and I think we've already seen some benefits of the single authority in helping us curb some of the utilization of things like med travel and air ambulance. We are still early days, so we need to continue to encourage our residents to use the quality control mechanisms. When they are frustrated, we need to have the residents continue to work with us to share their frustrations, but also their good points, so that we can do continual quality improvement moving forward. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Nakimayak.
Thank you, Mr. Chair. I appreciate the response from the Minister. Getting back to medical travel, also in my region, sometimes language is a barrier, as well as across the territory. Sometimes medical travel requires the need for an escort and also medical travel to understand the specific needs of Indigenous peoples, and people who sometimes cannot speak or read English properly. I just want to hear what the Minister has to say on that portion of medical travel. Thank you, Mr. Chair.
Thank you, Mr. Nakimayak. Minister Abernethy.
Thank you, Mr. Chair. Language limitations, unilingual people, that is one of the criteria for an escort, a non-medical escort when needed. If an individual is unilingual or has some limited capacity, they're certainly eligible for one. From time to time, I have heard of individual situations where somebody who met that criteria was not approved an escort. We do have an appeal mechanism now that was not available to us before, so they can challenge the decisions of medical travel staff if they feel that they have not been properly assessed. We just continually need to hammer, and hammer, and hammer on everybody that there is an appeal mechanism. If you have a question or concern, utilize that so that we can make sure you get a medical escort. Language is one of our criteria. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Nakimayak.
Thank you, Mr. Chair, and I appreciate the response. More just a comment: I look forward to seeing what the information on the appeal mechanism, as sometimes this happens on weekends when sometimes the service is not available. Thank you, Mr. Chair.
Thank you, Mr. Nakimayak. Minister Abernethy.
Noted, Mr. Chair, and we are always looking for opportunities for quality improvement. If you have got individuals who are willing to flag that, please have them flag it so that we can include it and take it from anecdotal to reality so that we can move forward on that.
I guess when it comes to language, the only recommendation I would have for individuals who wish to have non-medical escort as a result of language barriers is do not also take a unilingual person with them. Try to find someone who is bilingual. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Next, we have, Mr. Beaulieu.
Thank you, Mr. Chairman. Mr. Chairman, I just have one question on medical travel: is that 100 per cent of the budget that we have here in front of us? Thank you.
Thank you, Mr. Beaulieu. Minister Abernethy.
Thank you, Mr. Chair. It doesn't include GNWT staff in that number. GNWT staff are covered by the Department of Health and Social Services as opposed to the Department of Health. They are covered by Human Resources instead of Health and Social Services. There are some revenues that come in that are not here as well, but total costs are a bit higher. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Any further questions, Mr. Beaulieu? Thank you. Next, we have Mr. Thompson.
Thank you, Mr. Chair. Just to go back to medical travel in regard to it being opened up, or it is going to be opening up, I guess, for competition again for it to be contracted out. Is the department looking at local businesses as well, local airlines, or are they just focused on the main ones like Canadian North, First Air, and Air Tindi? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Mr. Abernethy.
Thank you, Mr. Chair. Mr. Chair, I believe we have a contract with the travel agent who books the flights, but we do have a Standing Offer Agreement with Canadian North and First Air, so the travel agent's requirement is to book on those two. Occasionally if there's some unforeseen circumstance or other driving issues, we can go to Air Canada or WestJet, but our Standing Offer Agreement says first and foremost Canadian North and First Air.
Thank you, Minister.
Thank you, Mr. Chair. My deputy just pointed out that I completely answered a completely different question, so this time I'll try to answer the question that the Member asked. When this service agreement ends we're certainly open to exploring what is best for the people of the Northwest Territories including, as I said to the MLA from Hay River, other airlines, other opportunities to help control costs and provide the best services to the clients possible. Thank you, Mr. Chair.
Thank you, Minister. Mr. Thompson.
Thank you, Mr. Chair, and I thank the Minister for his answer. I was going to ask a different question when you answered that other one, but I greatly appreciate hearing that. Are you looking at regionalizing medical travel or does it have to be the global territory picture? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. Let me be clear that I'm talking about medical travel, not air ambulance or medevacs. Air ambulance and medevacs, we've already gone on with an RFP. We've got a 10-year contract which covers that. What we're talking about is right now we have a standing offer agreement with two airlines for medical travel, so when someone has to travel to Yellowknife or south. What I'm indicating is I don't know what it's going to look like, but I'm certainly open to all potentials, which could mean different airlines, local, regional. There's been a lot of talk about an airline like Northwestern Air Lease might be an appropriate one, maybe some in the Deh Cho. I don't know, but we have to be open to all of them recognizing affordability, safety, and quality for our clients.
Thank you, Minister. Mr. Thompson.
Thank you, Mr. Chair, and I thank the Minister for his answer. Yes, I was talking about medical travel because I'm looking at, in my riding, there are a couple of airplanes that are actually suitable for flying doctors, nurses, and MLAs, twin engines and that. So the question was asked, and so I'm glad to hear that. In regard to this medical travel and when you talked about the medevacs, is that part of this medical travel in this contract, this money in here? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. The air ambulance is in here, as well, the annual costs, and as Mr. Beaulieu was asking: is this the total amount? Like I said, no, this isn't the total amount. A bunch of it is offset by NIHB, who can be charged back travel. So the actual cost over a year not including GNWT employees is about $41 million, but this is the amount we require to cover our portion that isn’t offset by other things. Thank you, Mr. Chair.
Thank you, Minister. I see nothing further by Mr. Thompson. I have Mr. O'Reilly.
Thanks, Mr. Chair. I was glad to hear the Minister mention NIHB. Can he just give us a bit of an update of where the negotiations are at in terms of changing that or updating it or whatever? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair.
The Minister has indicated Ms. DeLancey.
Thank you, Mr. Chair. Our current contract to administer NIHB on behalf of Health Canada actually expires at the end of March of this fiscal year. We have had discussions with Health Canada and we have an agreement to extend that contract for an additional year while we go through contract negotiations. We've already had preliminary discussions with Health Canada. We have identified where we would like to see improvements in the contract in terms of administration. The reality is that we probably have very little ability as a government to influence the NIHB formulary or the levels of coverage. Those issues that are of concern right across Canada, and I know AFN has just a review as well, but where we do hope to have some influence is improving some of the speed with which approvals are given, and some of the coverage for the administrative costs that we incur in administering this program for the federal government. Thank you, Mr. Chair.
Thank you, Ms. DeLancey. The Minister would like to add something.
I would, Mr. Chair. Mr. Chair, over the years a number of MLAs have raised issues about what's covered in the formulary and what's not covered in the formulary, and we'd always hoped that we might have an opportunity to influence that. What's becoming particularly clear, as the deputy alluded to, is that we're not going to be able to have too much influence over what is in the formulary.
Having said that, they change the formulary all the time and they don’t tell us necessarily what they've done or what they're changing. So apparently in December as I was writing letters to MLAs and others saying, you know, progressive lenses aren't covered, the federal government was in the process of changing their formulary to cover progressive lenses, which we were only notified that that is now covered in the NIHB formulary in late January. So I've asked the department to draft up a letter to the MLAs letting them know that progressive lenses are now covered and will be covered, and I've asked the department to also draft me letters to all the constituents over the last number of months who wrote about progressive lenses, a letter indicating that it looks like progressive lenses are now covered.
So I haven't got that information to the MLAs. This seems like as good a place as any to let you know I have asked the department to draft up letters and those should be coming to you soon, but, hey, progressive lenses are covered. Whoo. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. I'm going to let the Minister personally deliver that good news to a couple of constituents who have already shelled out of their own pockets for progressive lenses. Look, okay, good thing. How do we change that crazy system, like where we don’t find out about these things? There are things that we've been trying to change for years. I personally know medical personnel who will shell out of their own pocket because of the ridiculous turnaround times or what's covered or not covered. How do we get a critical mass to change that ridiculous system? Sorry, there's a little bit of frustration there and I'm sure that the Minister probably shares that. Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. We just keep trying to encourage them to make reasonable choices and to apply common sense. Unfortunately, common sense is so rare, it might as well be a super power, but we keep trying to encourage them to look at some of the realities as medicines change, as products change. As far as notifications, like this case apparently made the change in December and the notifications came out in January. We didn't see it until January, so unfortunately I sent out more letters to constituents saying this is not something we can cover at this time and apparently they could, not us but NIHB, but we'll be able to help facilitate that now. So I hear the Member's frustration; I share it. We'll keep trying to encourage them to utilize the super power known as common sense. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. I wanted to ask, I believe I heard the deputy minister talk about switching to an Alberta formulary, so I just want to get a little bit more detail about what would we be switching from and whether it's going to leave any of our residents short in any way if they're not covered by personal plans or insurance and so on. Just a little bit of explanation would be helpful. Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. The Minister has indicated that Ms. DeLancey will answer this one. Ms. DeLancey.
Thank you, Mr. Chair. Right now our policy is that we apply the NIHB formulary to all of our extended health benefits programs, and the rationale behind that policy is that it provides equity so all residents of the NWT who are on a non-insured health benefits program are getting access to the same benefits. I am not the expert, so I'm not going to drill down into details, but generally when we had a review done by Alberta Blue Cross looking at where we might achieve some savings with respect to pharmaceuticals, there are some opportunities for buying lower cost drugs that are not included on the NIHB formulary, are included on the Alberta Blue Cross formulary.
So one of the things we're looking at is whether we want to actually make a policy change. This would then mean that eligible residents would remain on the NIHB formulary as we administer that program, but residents who are enrolled in one of our supplementary health benefits programs might have access to a slightly different suite of pharmaceuticals, medications, and supplies. We can certainly provide some examples in writing, but I don’t have the detailed knowledge to speak to the details today. Thank you, Mr. Chair.
Thank you, Ms. DeLancey. Mr. O'Reilly.
Thanks, Mr. Chair. I'd be interested in getting that information. Just maybe one last question on this is before making a switch: what formulary might be used? Is that something that the Minister and staff would bring to the Social Development Standing Committee before making the change? I would hope that the answer's going to be yes. Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
