Sorry. Thanks, Mr. Chair. So it sounds like the earliest there's actually going to be any funding made available is 2018-19, is that what I'm hearing? Thanks, Mr. Chair.
Thank you, Mr. O'Reilly. Minister.
That would allow us the time we need to do proper implementation, design, and move forward with potential rollout, yes. Thank you, Mr. Chair.
Thank you, Minister. Mr. O'Reilly.
Thanks, Mr. Chair. Well, it's good to get this out now. I think there's going to be a number of unhappy people but, look, I do appreciate that this is moving along even if it's at a snail's pace, but good that it's still moving. I don't think this is going to keep some folks very happy, but I appreciate the responses from the Minister and his deputy minister. Thank you. That's all I've got for now.
Thank you, Mr. O'Reilly. Seeing nothing further I will call this activity. Health and Social Services, nursing and in-patient services, operations expenditures summary, activity total, $34,140,000. Does committee agree?
Agreed.
Thank you, committee. We will continue on to supplementary health programs, pages 181 to 183. Do we have comments or questions on supplementary health programs? Mr. Thompson.
Thank you, Mr. Chair. On page 182, extended health care, there's a reduction of $350,000. Could the Minister explain the rationale for the reduction in this area? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister.
Thank you, Mr. Chair. Mr. Chair, I'll go to the deputy for the detail on the changes to the Metis health benefits.
Thank you, Minister. Ms. DeLancey.
Thank you, Mr. Chair. The change in Metis health benefits is not an actual reduction. What's happened is that there is a greater demand on the program than the budgeted amount, so we did get supplementary funding in 2015-16, but that was not ongoing forced growth. Thank you, Mr. Chair.
Thank you, Ms. DeLancey. Mr. Thompson.
Thank you, Mr. Chair. I think it's my fault, I sent us on the wrong rabbit hole here. It was the extended health benefits, and that's the $350,000 reduction. Thank you, Mr. Chair.
Thank you, Mr. Thompson. Ms. DeLancey.
Thank you, Mr. Chair. Or perhaps I misheard. So the $350,000 reduction is associated with savings that we plan to find associated with pharmaceutical costs. We are going to negotiate a new agreement with the NWT Pharmacists Association and we are hoping to find some efficiencies through those negotiations. We know that we have the opportunity to save some costs by moving to 90-day dispensing, which will reduce some of the charges associated with dispensing drugs, and we are looking at changes to over-the-counter drugs in the NIHB formulary, and if we can't get those changes made through the formulary we are considering switching to the Alberta formulary so that we can reduce some of our drug costs through that means as well. Thank you, Mr. Chair.
Thank you. Ms. DeLancey. Mr. Thompson.
Thank you, Mr. Chair, and I thank the deputy minister for her answer. It wasn't your hearing; it was me on a different track there, so I apologize for that.
So my next question is medical travel. I notice it's an increase of $379,000. Is this a forced growth or is this what we're expecting, unexpected costs coming up that we're not aware of? Thank you, Mr. Chair.
Thank you, Mr. Thompson. Minister Abernethy.
Thank you, Mr. Chair. It's forced growth, but for any more detail I will go to the deputy.
Thank you, Mr. Abernethy. Deputy Minister DeLancey.
Thank you, Mr. Chair. It is forced growth. We have in the past received some one-time forced growth or supplementary funding for medical travel to address some of the increased costs associated with the air ambulance contract and just the increasing pressures, and so we now have got forced growth funding which is stabilizing our budget, we hope, and is now in as a base adjustment in our budget. Thank you, Mr. Chair.
Thank you, Ms. DeLancey. Mr. Thompson.
Thank you, Mr. Chair, and I thank Ms. DeLancey for her answer. I have no further questions on this page. Thank you, Mr. Chair.
Thank you, Mr. Thompson. Next we have Mr. Simpson.
Thank you, Mr. Chair. Looking at page 182, extended health benefits, these are benefits for people over the age of 60. The NWT basically provides them with healthcare. There are people who don't have government healthcare plans, you know, people who worked in private industry who had private healthcare plans, who paid their $75-$100 a month and had healthcare. When you turn 60 in the territory, though, there's not much of an incentive to keep paying that $100 a month. It seems like if we could somehow encourage those people to hold on to that through a tax break or something the GNWT might save quite a bit of money on health insurance. Has this been a topic of discussion for the department at all? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. It's a good point and it's certainly something we should be exploring. We don't require that they keep it, but we require them to utilize it first if they have it. So if they have insurance, they utilize it first before they access extended health benefits.
I remember a number of years ago there was some work around this that didn't make it too far, but I take the Member's point that we need to do something to encourage people to keep their insurances for as long as possible, if not forever, to help us offset some of these incredibly high costs of this benefit that is provided in the territories and virtually nowhere else in this country. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, Mr. Chair. It's good to hear that the Minister thinks that they should be doing that. Will the department do that? Will the department look into that? Has there been any analysis of any potential cost savings? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, we're committed to doing a supp health review. I think we're required under legislation to do it every couple of years. Was it legislation?
No, it's in the mandate.
Oh right. Sorry, mandate review, Mr. Chair. We're committed to doing a complete supp health review, figuring out those types of things that the Member has described in 2018-19, and we will certainly do that at that time. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, Minister. My next question is on medical travel. How does the department determine what airline they're going to be transferring patients with? Say if someone is in Hay River and needs to be sent up to Yellowknife. Well, obviously there's only one airline now, but how is that determination made? Is there a standing offer? Is there some deal with a particular airline or is it open to the lowest bidder? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. Mr. Chair, I know we have standing offer agreements with airlines like Canadian North and First Air, whichever is the cheapest and the most appropriate for the time. So in Hay River the individuals would fly up on First Air and then if they need to go to Edmonton they would fly out on either First Air or Canadian North, whichever is cheaper. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, Mr. Chair. So theoretically if another airline wanted to come and start flying the route from Hay River to Yellowknife or Hay River to Edmonton, First Air or whoever you have the agreement with could just undercut them until that airline was no longer viable and the government would have to go with First Air because of the agreement and so it essentially keeps other airlines out of the market. Am I understanding this correctly? Is that how things would work? Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. I believe it was in the last government that this particular standing offer agreement was established. It is reviewed every couple of years. I do believe the discussion around whether or not we go for standing offer agreements in the future is coming up. It might be six months. It might be a year. I can't remember the exact date, but I know that it does have a finite time limit.
I will confirm what the duration of this particular standing offer agreement is. I hear the Member's concern, but I could also argue that it might go the exact opposite. They have got a captive market as a result of the standing offer agreement. They might charge more.
Bottom line is, we look at this every couple of years. We try to figure out what is best for the North, best for the residents, and most affordable. I've had some individuals in places like Fort Smith suggest that it would be great to fly Northwestern Air Lease rather than having to come up to Yellowknife, or in Hay River. Coming up to Yellowknife, it might be better just to fly direct. These are things that we're looking at as we move forward in the future with the new standing offer agreement, should we choose to go that direction. It might be better if we just went lowest bid, whichever is most convenient to get us south, which might open us up to West Jet, or Air Canada, or Northwest Air Lease. I'm prepared to look at all options to help us control costs of medical travel. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, Mr. Chair. How do you get these conversations that happen where you say it would save the government money by not having a standing offer agreement? It just feels as though the market is really held captive by the standing offer agreements and no new airlines are going to start flying out of Hay River, is what I'm concerned about. That's why it is $1,000 return for a 25-minute flight, and it seems like something has to change, and this might be the first piece now. This is something that I will be pursuing a little bit further, and I'll follow up with the Minister to find out when the standing offer agreement is going to be looked at again. Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
Thank you, Mr. Chair. I'll get the information update on when this particular round of standing offer agreements ends. As I said, I think we must be open to look at alternatives to ensure that medical travel remains as supportable as possible, but that we're not adversely affecting other airlines or the existing airlines in any negative ways. I think we have to look at the market, for sure. Thank you, Mr. Chair.
Thank you, Minister Abernethy. Mr. Simpson.
Thank you, Mr. Chair, and you might have to adversely affect some of the airlines, otherwise it's protectionism, really, so you have to look at what's best for the governments, and the bottom line, as well as, obviously, the services that you are providing. I guess that is the end of that line of questioning. Thank you, Mr. Chair.
Thank you, Mr. Simpson. Minister Abernethy.
