Debates of March 12, 2018 (day 24)

Date
March
12
2018
Session
18th Assembly, 3rd Session
Day
24
Members Present
Hon. Glen Abernethy, Mr. Beaulieu, Mr. Blake, Hon. Caroline Cochrane, Ms. Green, Hon. Jackson Lafferty, Hon. Bob McLeod, Hon. Robert McLeod, Hon. Alfred Moses, Mr. Nadli, Mr. Nakimayak, Mr. O'Reilly, Hon. Wally Schumann, Hon. Louis Sebert, Mr. Simpson, Mr. Testart, Mr. Thompson, Mr. Vanthuyne
Topics
Statements

Question 242-18(3): Dialysis Services

Thank you, Mr. Speaker. On Friday I made a Member's statement about dialysis in the NWT. I would like to ask Minister of Health and Social Services some questions on that. I would like to know if the Minister could possibly commit to looking at providing accommodation in locations where individuals go for dialysis. At this point, I am thinking that the majority of the patients come to either Yellowknife, Hay River, or into Alberta to get their dialysis. Dialysis is something that happens three times a week for approximately four to five hours per session. The travel on top of that is a bit much. I would like to ask the Minister: would the Department themselves look at accommodation in those communities? Thank you.

Speaker: MR. SPEAKER

Masi. Minister of Health and Social Services.

Thank you, Mr. Speaker. Mr. Speaker, right now we deal with them on an individual basis depending on where the individual is coming from, how long they have to be in the community, whichever community it happens to be, whether it's Hay River or Yellowknife, for their treatment. If they have to stay overnight, obviously we will be accommodating them. If they are in during the day, we will certainly transport them to the facility and transport them back to the airport.

Mr. Speaker, when it comes to dialysis, we have expanded our dialysis services here for the Northwest Territories. We have peritoneal dialysis available through a partnership with the province of Alberta, so that people can do dialysis in their homes where possible and where appropriate. We know this is a fairly invasive procedure. We want to work with our residents to create the simplest and most humane process for dealing with dialysis. Thank you, Mr. Speaker.

I agree that home dialysis is an option. Staying with that type of dialysis, I would like to ask the Minister if there could be more family members, for each individual who would be receiving home dialysis, more family members trained? I had an elder who was on dialysis in the community of Lutselk'e. At one point, he felt like he was really burdening his daughter-in-law. Apparently, she was the only one who was trained to give dialysis. I would like to ask the Minister if there is an option to train several family members on home dialysis for patients.

With the peritoneal dialysis, which is the one that is done at home, the patient and their support person have to go to Alberta for a couple of weeks to actually be fully trained on how to provide that service, and then they are actually supported by the Alberta Health Services in their delivery. They have a constant contact with that individual.

I hear the Member. I mean, yes, people go on holidays. People may be out of the community. It is a burden. I hear the Member. I will have the department look at it to see what it would take to provide that training to more than one person so that there is that flexibility. I don't know what those costs would be, so I am not prepared to commit 100 per cent to actually doing it, but we will explore it to see what the costs would be and how we can work with our residents to make this process as safe and seamless as possible.

As you can imagine, there are various ways that dialysis can be provided to patients. I would like to ask the Minister if they would look at the option of providing dialysis in health centres. I recognize that there may be a community with no patients on dialysis, so then we would not necessitate that, but something that is easy to move into a health centre. It may be a little bit better system than what they have in the home, but to having something in the health centres where dialysis patients exist, I would like to ask the Minister if he could look at that option.

Hemodialysis is a very complex process. It actually involves removing the blood from the human, putting it through a machine, and inserting it back into the human. It is very complex. You need highly trained individuals to do it, and the machines need thorough cleaning after every use to make sure that there is no contamination or harm caused to our patients.

It is a very complex process. We are putting it in our hospitals. We have put it in Stanton. There is an expanded area in the new Stanton for dialysis. We have put it in Hay River. There is an expanded area in Hay River where it is. We have to work with our individual patients on a one-on-one basis. Sometimes their level of treatment is different than, say, somebody else's.

Having said all that, Mr. Speaker, there are mobile hemodialysis units that have been utilized in other jurisdictions, and we have explored that to see if it is a possibility. However, in the Northwest Territories, road access, road maintenance, and the quality of some of the roads, given the fragile nature of the machines, as well as some of the water supply we would need -- we need sterilized water; we need water that has no other chemicals and no other things in it -- really limits our ability to do the mobile hemodialysis.

When it comes to individuals with complex needs, we do transport them from their communities to where the service is available. In some cases, we have had to do some medical relocation, working with the families to bring them to those communities where the service is on a permanent basis.

We are open to being flexible, but at the end of the day, whatever we have to do or whatever we are going to do has to be safe, and we are not comfortable that the mobile hemodialysis is appropriate for the Northwest Territories at this time.

Speaker: MR. SPEAKER

Masi. Oral questions. Member for Tu Nedhe-Wiilideh.

Thank you, Mr. Speaker. Mr. Speaker, the mobile dialysis that the Minister spoke of also exists in Alberta. They have it set up on a bus. I know the Minister knows all this, but I would like to ask the Minister if he could at least look at that system that Alberta has, where they have retrofitted a bus in order to handle a dialysis machine or a couple of dialysis machines. I recognize that the cost is probably over $2 million, but I would like to ask the Minister if they would look at that and see what success Alberta has had with that system. Thank you, Mr. Speaker.

We have already had a cursory look at that, and one of the benefits they have is high-end highways that are paved, smooth, and they are usually transporting or going between communities that are a little larger, that have access to the sterilized water and the other things that they need to make sure that the equipment is properly cleaned and those types of things.

In light of the fact that many of our roads aren't paved in the Northwest Territories, and we don't always have direct access to the level of sterilization in the water that would be necessary for hemodialysis, recognizing how complex it is, we didn't feel that it was safe at this time to pursue that option, which is why we have entered into a partnership and arrangements with Health Services in Alberta to do the peritoneal dialysis.

As I have said, from time to time, we have had to enter into one-on-one relationships that have resulted in medical relocation. We don't have a policy on that, but it is something we are exploring because it may become more necessary.

Having said all that, Mr. Speaker, we all need to work together to encourage healthy living, healthy eating, exercise, and living as healthy as possible, so that we don't have to go down this road of dialysis. It is an invasive procedure. It is life-saving, yes, but for the most part, people who live healthy lifestyles will be able to avoid this particular treatment. I think we need to, as Members, focus more on prevention to avoid having to need this service in the future. Thank you, Mr. Speaker.

Speaker: MR. SPEAKER

Masi. Oral questions. Member for Deh Cho.