Debates of June 1, 2022 (day 116)

Mahsi, Mr. Speaker.

WHEREAS half the population of the Northwest Territories is Indigenous;

AND WHEREAS there are 33 communities in the Northwest Territories;

AND WHEREAS there is one capital, six regional centres, and 26 small communities;

AND WHEREAS Indigenous peoples make up the majority population in the small communities;

AND WHEREAS Indigenous peoples were subjected to colonization and genocide; and whereas the legacy of colonization is embedded in the health and social services system as systemic racism;

AND WHEREAS Indigenous peoples were forced to experience systemic racism in the health and social services system, which is a significant contributor to lower health outcomes;

AND WHEREAS Indigenous peoples suffer disproportionate health inequities as a result of a lack of access to quality health and social services care where cancer and other chronic diseases that are misdiagnosed;

AND WHEREAS those Indigenous peoples who have cancer and other chronic diseases that are misdiagnosed, suffer and die prematurely;

NOW THEREFORE I MOVE, seconded by the honourable Member for Tu NedheWiilideh, that this Legislative Assembly calls upon the Government of the Northwest Territories to provide increased access to physicians and medical specialists to offer quality care, diagnoses and second opinions;

AND FURTHER, the Government of the Northwest Territories prioritize cultural safety, traumainformed care, and antiIndigenous racism professional development training within the health and social services workforce, including locum doctors;

AND FURTHERMORE, the Government of the Northwest Territories provide additional training to nurses, health care workers, and locum doctors in the small communities on the detection of cancer and chronic illnesses;

AND FURTHERMORE, the Government of the Northwest Territories conduct a quality review on the health centres in the small communities, including an external audit of client treatment records and client satisfaction;

AND FURTHERMORE, that the Government of the Northwest Territories provide a comprehensive response to this motion within 120 days.

Mahsi, Mr. Speaker.

Thank you, Member for Deh Cho. The motion is in order. To the motion? Member for Deh Cho.

Mahsi, Mr. Speaker. Mr. Speaker, I rise to give points related to my motion, the reasons for it.

I came to the 19th Assembly with the intent on improving health care in the small communities and especially in my community where I went out campaigning and I was hearing all the stories regarding health care. There were many instances and complaints, lack of compassion, and the seriousness of illnesses. Many patients, they became patients after numerous visits to the health centre for the same ailment. That was about three, four, five times, and each time they were sent home with a Tylenol.

This led to medivacs after about the third, fourth, or fifth visit, in which case the patient was seriously ill and in great danger for their lives.

There are instances where patients did end up losing their life. Many were due to misdiagnosis of their ailment or a total disregard of their problem. And they're also being sent home without any followup whatsoever.

I realize that small community health centres are not equipped with the appropriate medical devices to properly diagnose an unknown ailment. This is an increasing dilemma, and residents have grave concerns of this situation.

I have made several statements of this situation over the course of this Assembly since I've been here. And I believe that it's not a new issue. I believe that it's been brought up many times in previous Assemblies.

And after the statements and all these complaints and everything, there's still no actions nor any intent to action to address these concerns. There was more of the “fill in a complaint form” is all, you know, people are receiving.

I just want to note that we as MLAs are the voice of the people. And when we come into this House, we bring forth all those concerns. We shouldn't have to look for consent forms. These are real lived experiences. I live in a small community. I experienced all this. I bring it to the floor or the House. Something should be done about it. That's what we expect from this side of the House. We need someone to listen to us, to help us.

And there are also several news stories. There was the stories of the ladies in Fort Res that brought up concerns. You know, there's lots of concerns. And there was also the recent one from the Deline elder, and we know what happened there. It was newsworthy. So it is a serious concern.

You know, we expect, you know, from all these concerns not to fight us and make us think that it's not real. We would expect to get respect from Ministers to say okay, hey, I will come into your community and I will meet with your leadership; I will listen. Because there are many complaints. You know, I've had to deal with many. I have made statements galore on these issues, and I've finally figured well, I better put a motion in and see what happens there.

I'm hoping for concrete action from the department by way of this motion. And that's all I have for now, Mr. Speaker. Mahsi.

Thank you, Member for Deh Cho. Motion is in order. To the motion? Call on seconder, Member for Tu NedheWiilideh.

Mr. Speaker, I support this motion. Just hang on.

There was feedback. Sorry about that, Mr. Speaker.

I just want to say in speaking to the motion that the issues that I've been raising the last little while has really hit home, and I've been dealing with everything from mental health issues to suicide to medical travel. And the things that really makes me think is that, you know, a lot of this stuff could be easily fixed if we went back and take a look at some of the policies that are in place that are prohibiting some of these problems we're having in the community. I think it's an easy fix if we went back and take a look at it.

But the issues in the community are alive and well up and down the valley, and I've been hearing from a lot of people, getting feedback on this issue. And I'd like to work with the Minister of social and health and see what we could do to look for solutions to these problems we're having in our community. And when I was asked to support this motion, I agreed to that. And I'm just asking if there's a way where we could all work together and to look for solutions so that we could provide better outcomes in health issues in the communities a lot better and so that we're not able to say no to, or get back to the families that are asking for help and let them know that I'm sorry, you know, this is what happened.

I'm just saying that, you know, this is a good time to come together. And in terms of spirit and content, you know, and I'm asking that maybe with this motion that we look for a solution to some of these problems. So I just want to just leave that there, Mr. Speaker. And mahsi.

Thank you, Member for Tu NedheWiilideh. The motion is in order. To the motion? Member for Hay River South.

Thank you, Mr. Speaker. Mr. Speaker, I didn't really have any comments. But I guess listening to my colleagues and reflecting on, you know, some of the people I know, some of the things that have happened in the past. You know, my own sister, for instance, she was diagnosed with cancer at the last minute after a few years of going to doctors and, you know, and passed away, you know, two months after that. So, you know, the issues here are, you know, small communities and even regional centres and whatever, but I think it comes down to, you know, Indigenous peoples.

You know, we have like, there's a lack of doctors, lack of nurses. We have restrictive policies. We see misdiagnoses. We have you know, there's a lack of culturally appropriate services, lack of understanding of Indigenous peoples. You know, there is some racism as well. And all this affects the way, you know, medicine and health is dispensed. And I think that, you know, it's time that we took a hard look at how we're you know, how we're treating and, you know, the people of the Northwest Territories when it comes to health because, you know, like I've always said we've got one life to live, and I think it's very important that we do everything we can, everything in our power, to make sure that every person is treated with respect and gets the help they need.

Again, you know, this government is in charge of health. This is where the dollars come. People have nowhere else to turn. And, you know, when they start coming to us, you know they're lost. You know that we're probably their last you know, their last hope for some type of help. So, you know, I support and therefore I support this motion. And, you know, I think we all see that there's, you know, pitfalls and downfalls within health care for Indigenous peoples. But there's pitfalls and downfalls in all areas. And this is one of them. And this is an important one because, again, it's a matter of life and death. Thank you, Mr. Speaker.

Thank you, Member for Hay River South. To the motion? Member for Great Slave.

Thank you, Mr. Speaker. Mr. Speaker, I may not be a small community MLA but what I am is an MLA that listens. And as a result, I do speak with a lot of people from across this territory who share with me their stories. And oftentimes I'm told that they've been told to come to me because their own Member doesn't listen to them. And as a result, I've now find myself in a situation where because I care so much about the people in this territory that I'm struggling to deal with the stories that I'm hearing and the trauma that I'm hearing our people are experiencing on a daily basis.

And when it comes to medical care and health care, there's nothing scarier in the world than facing a medical crisis and it being unknown.

Mr. Speaker, I've been in that situation time and again, and I'm currently waiting in that situation. However, I can't imagine now being someone from a small community and being turned away when I come to say something isn't right and I don't feel well.

So Mr. Speaker, I've stood up here before to stand in support of my small community colleagues. I will stand up here again today. As they spoke, I sat here and nodded along. Everything that they've said, I feel in my heart. I'm sure the rest that continue on to speak after me, I will feel the same way. I couldn't support this motion more, and I thank my colleague for bringing it forward. Thank you.

Thank you, Member for Great Slave. The motion is in order. To the motion? Member for Inuvik Twin Lakes.

Thank you, Mr. Speaker. Mr. Speaker, I too am in support of this motion. As everybody here knows, my past experience as a registered nurse. I am still a registered nurse. You know, I have many past colleagues who've worked in these health centres. I've sat on hiring committees that hired nurses, you know, in these small communities. And these nurses are trained to be most of the nurses that are trained in the communities are hired, they're trauma nurses. They're emergency nurses. Some have community health experience but because of the lack of nursing experience, they mostly are trauma, ICU, you know, nurses because they need to be able to deal with the emergencies in the health centres as they come as they are the only ones there to deal with them. You know, and I've raised this in the past that, you know, in our small communities, we don't have specific designated home care nurses, health promotion nurses, public health nurses, mental health nurses. We don't have them. That one nurse is everything. And when you're dealing with a community that is short staffed, you know, the nurses are I know that they're probably they're working. They wouldn't become a nurse if they didn't care. But there is a difference between being in a health centre and working overtime, constantly tired, patients coming in, you know you don't have the equipment that is needed. You know, I don't know if there's more that we can do but, you know, the thing is is I think there's a barrier when it comes to medical travel. Because when we talk about some of these appointments or some of these clients that are going to the health centres, you know, they can't just ask for a second opinion when there's only one nurse there and the other one can't come in because they're on downtime and they're on mandatory downtime, you know. They can't get a doctor's opinion right now. So we're not allowing them to fly in to see doctors. Especially, you know, when I think of the studies that have been done in Aklavik and in the Sahtu on all the cancer because of the high rates of cancer coming out of those communities and now we're seeing, you know, like my colleague said, you know, the gentleman that went to the news that said it was too late. You know, he arrived too late. The reason a lot of our people arrive too late is they don't have trust in the health care system. They don't go to the health care. I lost an aunt because she refused to go to the doctor. And when she finally went to the doctor, she had end stage cancer, you know. I have family members that are dealing with cancer. You know, I've got ongoing family members who have been able to access cancer treatment early because they live in a regional centre. But, you know, Mr. Speaker, in these small communities, they don't have that. They don't have an advocate sometimes too that they can go to. You know, we've stepped ahead and we've got these senior Indigenous patient advocates in our hospitals. We need to do more. We need to make sure there's advocates in our communities or that there's a reasonable place for them to access these advocates to support them. Because, you know, when I'm asking for an elder to this is the complaint, I'm bringing it forward, and I'm told well, they can do a complaint through this. Well, they don't use email. And the majority of our elders are Indigenous elders. When we say we got to do this, we got to do this, you know, I hear never mind, it's okay. You know, that's what they do, and then they get sicker.

You know, I mean, Mr. Speaker, your own community has a nurse once a week and during breakup and freezeup. You know, we know that this is a problem in our small communities that our patients, our clients, our residents, are not able to just access any care. And, you know, I fully support my colleague on putting this motion forward because, you know, I know we can't put a doctor in every community but what can we do to support these nurses and these community residents so that they are being able to access the care in a culturally safe way and try to make sure that they're being heard, and they're not being turned away, or is it they feel? Because I can't you know, because that's the thing. Is myself, even if I was working in a health centre, you know, and I did something, a lot of times people don't sit down and explain everything that they're doing. It's such a rush. We need to take that time with our clients. They don't understand. They're afraid of the system. And they won't ask questions. It's not polite. We don't ask questions. We just let you do what you got to do and we'll get out of your hair. You know, that is especially with elders.

So we need to understand that culture. We need to sit down and explain and ask them if they understand and give them their options. If they don't agree with what care that they're getting, what their options are. You know, these are the things that we need to make sure. And this motion will hopefully start to turn the department's way of looking at how we can support small communities better. Thank you, Mr. Speaker.

Thank you, Member for Inuvik Twin Lakes. The motion is in order. To the motion? Member for Monfwi.

Thank you, Mr. Speaker. Yes, I do feel the same, and I do support the motion as well. And I know that it is about time, Mr. Speaker, that we start paying attention to small communities, give them some recognition that they do lack lot of services, especially in health care. It needs attention. It needs to be improved.

We have some communities with no nurses or some do not have any health centre. So that needs to be so we need to recognize those communities as well. There are people living in those communities. And people that are living in the communities are mostly Indigenous. So that's what I do support and we do need we need to do something about it, Mr. Speaker.

And as a result of the lack of health care, a lot of services that we're lacking in the communities, a lot of community members are moving away.

For example, dialysis. We have some community members that are relocating from their community, wherever they are from, maybe from Tuk, from Gameti, whenever, they are relocating to Yellowknife to have access to that dialysis machine. And these people are moving away from their family, from their home, from their culture, their tradition, their language. I mean, that's another burden on these people who are not used to those lifestyle.

So for that reason, I really do support, and I'll tell you that, too, I do agree. Tylenol are overprescribed in many of the communities. And I also do have some community members, Tylenol could not fix the problem that they were going through. By the time they paid their own way to get to Yellowknife, it was too late. They already had stage 4 cancer.

So things like this are happening too often. So I think that it is about time that we have lot of services. We need to improve the services in the healthcare system, in healthcare system in the communities.

I cannot stress it enough that we need to do more with the small communities. If not, more of those community members are going to move to Yellowknife and they are going to become your responsibilities, the Yellowknife MLAs. So are you guys ready to receive them? If not, then we need to do something about the small community healthcare system. Thank you.

Thank you, Member for Monfwi. The motion is in order. To the motion? Member for Frame Lake.

Merci, Monsieur le President. I want to thank the mover, the Member for Deh Cho, and the seconder, the Member for Tu NedheWiilideh, for bringing the motion forward.

I want to acknowledge what I've heard from small community MLAs over my six years as an MLA here in the House and in committee about issues around healthcare in small communities. At the same time, though, I want to recognize the work and initiatives by the department and the staff. I think we are doing some things in these areas. You know, we worked together to get funding for Indigenous patient advocates. I know the department is working on that cultural safety. Change is slow, but I think this motion is another step in making the change that we all want, and I look forward to the response from the other side, from our Cabinet colleagues. Mahsi, Mr. Speaker.

Thank you, Member for Frame Lake. The motion is in order. To the motion? Member for Kam Lake.

Thank you very much, Mr. Speaker. Mr. Speaker, I too would like to thank the Member for the Deh Cho for the hard work that he put into this motion and for bringing it forward here today.

I want to reflect on something that the Member for Monfwi said. And the Member for Monfwi reflected on services not being available in communities and the result of that hollowing out small communities.

Hollowing out small communities is not true reconciliation. True reconciliation is ensuring that Indigenous communities have the services that they need and the resources that they need to continue to practice their culture and to continue to be in the North and to continue to be in their home communities. A lot of the work that this Assembly is doing is trying to create that space for communities to continue and communities to thrive. And so healthcare is a huge part of our communities and access to healthcare is so incredibly important to our communities.

One of the things that in social development we hear most often is about services and resources being culturally safe, and that goes beyond the way that policies are written. It is in how people and what they are saying is received and how they are listened to. And how that support is provided and heard.

And what I'm hearing here today is my colleague saying that it's not okay and that their communities are not being adequately serviced and resourced, especially when it comes to healthcare.

As our population ages, Mr. Speaker, we're going to see more and more chronic illness in our communities. And so this is an opportunity to listen and receive what MLAs from small communities are saying to us and to make changes to get it right.

This motion is an opportunity to listen, receive, and reflect, and be leaders in remote Indigenous healthcare in the Northwest Territories. And we owe it to the people of the Northwest Territories to do better if that's what they're asking for. Thank you.

Thank you, Member for Kam Lake. The motion is in order. To the motion? Member for Yellowknife North.

Thank you, Mr. Speaker. I would like to thank all of my colleagues for speaking to this motion and bringing it forward. I just also would like to rise in support. I think it is clear that many in our small communities don't have trust in our current healthcare system. And I think we always have to keep that top of mind.

I'm well aware that in many ways Health is by far our largest budget, and it is going through a deficit reduction exercise right now and I fear, when we look at models that we've seen in other jurisdictions, rural healthcare is always a potential target from that deficit reduction. Closing health centres has happened in many areas across other jurisdictions, and I think this motion is just a reminder to Health that we have to adequately resource to make sure that our health system is equitable, and that's going to take some hard conversations about other budget priorities. But our small community healthcare could not be at the expense. Thank you, Mr. Speaker.

Thank you, Member for Yellowknife North. The motion is in order. To the motion? Member for Thebacha.

Thank you, Mr. Speaker. I too will get up in support of the motion.

This motion is to address the healthcare deficiency in small communities; the access to doctors, specialists must be addressed.

Personally I've always addressed each concern brought to my attention from my own constituents to the Minister's office. I just want to mention that 99 percent of the answers, in the replies, have always been positive. And I want to thank the Office of Health and Social Services for that.

The Indigenous file for small communities is extremely important. And the leaders at all the former meetings, in my 14 years as chief of Salt River, have always brought this to the table, especially at the Dene Nation meetings and Metis Nation or any of those. And I want to thank MLA Bonnetrouge for this motion. And I know it's very dear to our heart. And for that reason, I will be supporting the motion. Thank you.

Thank you, Member for Thebacha. The motion is in order. To the motion? Minister responsible for Health and Social Services.

Yes, thank you, Mr. Speaker. Mr. Speaker, I appreciate the points that are being made today. It is a priority of the health system to ensure that people have equitable access to safe and effective healthcare. I know that isn't the case all the time. But "all the time" is certainly what we are striving for.

It's important to say that we are facing an unprecedented crisis of staffing in our healthcare system. We have vacancies across the board. We have, coming out on Friday, our health human resources plan, which will discuss some of the medium and longterm initiatives that we plan to take to increase staffing. But in the short term, we are still very short staffed and I anticipate that that will continue through the summer.

This is being portrayed as a racial issue, and I understand why that is. I've done the Living Well Together training and so have 92 percent of my colleagues in the department and 61 percent in the health authorities. And there is a segment of Living Well Together that deals with the trauma that was caused by what were then called "Indian hospitals" where people went, usually for tuberculosis treatment, and often stayed over the very long term until they felt they were strangers to their communities and cultures.

So we have a division within the Department of Health and Social Services called community culture and innovation. It is staffed primarily by Indigenous people. And I feel that they have done good work over the last nine years to assist us in understanding systemic racism and developing materials that help us to become culturally safe in the interactions that we have.

I want to say that the health and social services authorities were accredited in 2019, following an extensive process of both internal and external review, and that the next review is scheduled for next year.

We provide surveys; they are online. I heard that people don't always use online. But we have recently closed the patient experience questionnaire, and I hope that we'll have some good learnings from that.

We recently put out our community counselling questionnaire, and I was very pleased to learn that 73 percent of the people surveyed who completed the survey were satisfied or very satisfied with the care they received.

So Mr. Speaker, we hear the concerns that are raised here. We will provide a response to the motion. Today, the Cabinet will be abstaining in this vote. Thank you.

Thank you, Minister. The motion is in order. To the motion? I will allow the mover to do closing comments.

Mahsi. Mahsi cho, Mr. Speaker. I would like to say a big mahsi to my colleagues for your unwavering support for small community issues.

Excuse me.

This is about the concerns of the residents of the Northwest Territories, the many people that have been affected by the lack of quality healthcare. That is the big issue. Not a question there. It's an insult. And I really hope there's sincerity on that side of the House for our issues, because it won't go away. We understand there might be shortages. But there is always that trip you can take to Ottawa, because healthcare is supposed to be looked after by both the governments, the GNWT and the federal government. And we need the Ministers on that side to really hammer home that issue in Ottawa.

You know, this is about the concerns of the residents of the NWT. I'm just a voice for them. It's not about me; I don't look for glory or nothing. This is real. I'd like to say mahsi again to my colleagues for all their positive comments and support. Mahsi.

Thank you, Member for Deh Cho. The motion is in order. To the motion?

Question.