Thank you, Mr. Chair. I thank the Minister for his answer. I guess my next question leads to diagnostic services. Where are these services based out of? Yellowknife? Or is it based out of all the regions? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. Mr. Chair, it is across a number of the different regional offices as part of the NWT Health and Social Services Authority, as well as Hay River and the TCSA, whenever we happen to have a diagnostic services lab, imaging, those types of things. Thank you, Mr. Chair.
Thank you, Minister. Mr. Thompson.
Thank you, Mr. Chair. I thank the Minister for that answer. Specifically to Nahendeh and the Deh Cho, are there these services available, or do they actually have to go out to either Hay River or Yellowknife? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. Most of the samples and whatnot are actually going from the Deh Cho to Yellowknife. Some of them may have to be referred south depending on the nature of the sample taken and time that the sample is viable, if you will. For the most part, many samples can be taken in the Fort Simpson Health Centre or other health centres and shipped to Yellowknife. Thank you, Mr. Chair.
Thank you, Minister. Seeing nothing further from Mr. Thompson, I have Mr. O'Reilly.
Thanks, Mr. Chair. Same page. One line down there is a reduction from 2016-17 to 2017-18 for pharmacy. Can the Minister or his officials explain the decrease there? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. We have decided people don't need drugs anymore.
---Laughter
I am just kidding. Bottom line is it is a procurement consolidation as a result of moving to a single authority. We were able to purchase together as opposed to purchasing in part. We recognize some cost savings by doing so. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. I could bank some quips there, but I won't. The only reason is because we are having some greater efficiencies in purchasing drugs, no other reductions or efficiencies being found there? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. Yes, it is not a reduction that is anything other than a reduction due to shared procurement, an opportunity to buy bulk instead of individually at one authority level like we used to. There has been some decreased demand on some of the different types of chemo drugs that are out there. This is purely a reduction based on consolidated purchasing and some demand. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. What additional kinds of efficiencies could we see here if we had a national pharmacare program, and what are we doing about that? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. Mr. Chair, at this point I don't believe the federal government has any interest in a national pharmacare strategy. I feel that that is a mistake, but that is just my personal opinion, not a government position by any stretch of the imagination. I have had an opportunity to talk to a number of the different provinces and territories who would like to see a national pharmacare plan put in place.
Having said that, given that, prior to this current government, we didn't really have a relationship with the federal government at a provincial or territorial level, having conversations about purchasing pharmaceuticals and those types of things, this federal government has actually joined part of the Pharmaceutical Purchasing Alliance that exists between the provinces and territories. That is a group that has been established by the provinces and territories, now joined by the federal government, who is looking at making some legislative changes that should help us control costs around bulk purchasing pharmaceuticals across this country. It is not pharmacare, but it is certainly an improvement of what has existed up to this date. So we continue to be part of the Pharmaceutical Purchasing Alliance. We are seeing some benefits of that. Our purchasing compared to some of the other jurisdictions is way down compared to others. As far as national pharmacare, we are the only nation with Medicare that does not have pharmacare, and at some point the federal government may want to look at pursuing that.
In the meantime, we are going to continue to provide supplemental health benefits to seniors, and we are going to continue to provide it to Metis. We are looking for a way to, obviously, address lowincome families, but we have a long way to go on those types of things. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. So I think I heard the Minister say that he is personally interested in trying to push a national pharmacare program. Is that the position of the Government of the Northwest Territories? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. Mr. Chair, pretty much every province and territory that I have had discussions with is looking and interested in a national pharmacare. We have had some discussions in the previous government, and I was given the authority to participate in those discussions in the previous government. I have not asked this government if I can continue; I just have. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. Yes, I would certainly encourage the Minister, whether he has the permission of his Cabinet colleagues or not, to continue to push for a national pharmacare program and work with provincial and territorial Ministers towards that. I know we had the federal Health Minister just here, and I hope he took that opportunity to talk with her about a national pharmacare program. Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Seeing no further comments or questions, I will call this activity. Minister.
Just for the record, Mr. Chair, the Minister of Health, federal Minister of Health, clearly knows my position, as does the Minister responsible for Social Services, as does the federal Minister responsible for Addressing Poverty, as does they all do. I have no problem continually mentioning the value of a national pharmacare strategy. I did raise it in our last social services FPT, where we were talking about poverty. It is certainly an opportunity to help this country address poverty, having a national pharmacare strategy. Thank you, Mr. Chair.
Thank you, Minister. Seeing no more comments or questions, I will call this activity. Health and Social Services, diagnostic and therapeutic services, operations expenditure summary, activity total, $24,275,000. Does committee agree?
Agreed.
Thank you, committee. Moving on to nursing inpatient services, starting on page 178, continuing on to page 180. Comments or question on this activity? Mr. Thompson.
Thank you, Mr. Chair. On page 179, they have an increase of $162 for longterm nursing care and then a reduction of $162 for medical and surgical nursing. Could the Minister explain the rationale for the reduction and increase in these two areas? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. Just for the record, the two aren't related. They are for different reasons. There are some forced growth costs in longterm care to help us deal with the fact that we are running two extended longterm care units in Hay River until we get the new Woodland built.
The drop in the medical and surgical nursing, you don't always know why something ends up in a particular line, but the reason this one is going down is, now that we have moved to a single authority I know this is going to sound weird, being the medical and surgical nursing section, but we have been able to avoid having to pay GST in some of our authorities. Some authorities pay GST. Some didn't pay GST. Now that we have rolled into a single authority, we have been able to make the case that we shouldn't be paying GST.
This recognizes the saving we are anticipating and getting from not paying GST in some of those authorities. When I looked at it, I was, like, that is an interesting line for it to be in, but for some reason that is where it shows up. I am not an accountant, so I cannot explain why it is in that line, but that is where it is. So, thanks, Mr. Chair.
Thank you, Minister. Mr. Thompson.
Thank you, Mr. Chair. I thank the Minister for that clarification. Yes, it is a bizarre place to have GST, in medical and surgical nursing, but I have heard about the GST being an issue for other authorities previously, so I thank the Minister for that answer. Thank you, Mr. Chair.
Thank you, Mr. Thompson. Do I have any further comments or questions? Mr. O'Reilly.
Thanks, Mr. Chair. When I tried to raise this earlier, in the main estimates, I was told to come back here. I want to ask the Minister and his staff about midwifery services. I think the last time I asked about this he said that they had hired some consultants. I am not sure exactly what they were doing, but can the Minister give us an update of where we are with the territorial midwifery service and particularly with regard to service here, in Yellowknife? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. Mr. Chair, the positions have been filled, the ones within the department that are doing the consultation and analysis. We have had a discussion paper put together with different options for a territorial program. That public consultation is going to be starting right away. I think we have got one date confirmed, and we are about to go out and announce some of the other dates, both in Yellowknife and in communities that would be receiving benefits from a territorial program. We have started receiving some input from all of the stakeholders, like physicians and others, so we are going to get all that information on proposed models and figure out where to go from there. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. Well, that is great to see that we are finally going to go out. Does he have a timeline, though, for this work? Like, this has been dragging on for years, so is there a timeline for these consultations? When is there going to be a report that comes out of the consultation, and then probably you have to develop an action plan, then it has to go to FMB for funding, like, this is just going to go on forever. Does the Minister actually have any particular timelines? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair, and I will certainly be sending a letter to the Members once the last date of the last consultation is booked and confirmed. The consultations, we are expecting, will be completed by the 14th of March. We expect that we will be able to have some sort of analysis of what we heard and some direction on where we need to go early in the next fiscal year. I can also get the deputy to go into some specific detail on steps and actions being taken moving forward. If we can go to the deputy, that would be great.
Thank you, Minister. Ms. DeLancey.
Yes, thank you, Mr. Chair. So we, as the Member noted, had committed to doing consultation by the end of the fiscal year. We are planning to hold focus groups in I believe it is eight communities. The delay we have had has been simply working community governments to nail down appropriate dates because this is a busy time of year and there is a lot going on in communities.
We will advertise through community radio, through radio, through newspapers, through social media, and we will be sending notices to MLAs. In each of those communities, we will hold as many focus groups as there is public demand for, so no one will be turned away who is interested in participating. There will also be an online survey.
As the Minister noted, our timeline is tight because we want this wrapped up by midMarch so that we can have a report very early in the new fiscal year out of that on a design of a territorial midwifery program. Then we will look at our ability to implement that within existing resources or go forward to the business planning process. Thank you, Mr. Chair.
Thank you, Ms. DeLancey. Mr. O'Reilly.
Thanks, Mr. Chair. I appreciate that detail from the deputy minister. I think I heard her say that the department is prepared to look within, internally, for the money to actually implement the program. Is another option to actually bring forward a supplementary appropriation? Is that something the Minister is considering? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
Thank you, Mr. Chair. We don't believe we will be ready for a supplementary appropriation during the next fiscal year. Once we get a model approved, then we have to do the design, do the implementation, job description writing, that will help us quantify what the costs will be so that we can come forward, identify what can be covered with existing funds, what we may need additional funds, so that we can have an informed discussion during business planning, looking at all of our services from a holistic point of view. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
