Agreed.
Thank you, committee. We will take a short recess.
SHORT RECESS
I will now call Committee of the Whole back to order. Committee, we've agreed to consider Tabled Document 81319(2), Main Estimates 20232024. We will now consider the Department of Health and Social Services. Does the Minister of Health and Social Services have any opening remarks?
Madam Chair, I am here to present the Department of Health and Social Services' main estimates for the fiscal year 20232024. Overall, the department's estimates propose a net increase of $15.5 million or 2.6 percent over the 20222023 Main Estimates. These estimates support the mandate objectives for the Department of Health and Social Services while continuing to meet the GNWT's fiscal objectives to prioritize responsible and strategic spending.
Highlights of these proposed main estimates include:
$21 million for initiatives, including:
Resources to fund operations at the Stanton Legacy Facility to provide for more extended care beds and support the new longterm care beds; and
Funding to support changes to the health care system to manage COVID as an endemic disease, including increased vaccination capacity and to ensure that sufficient resources are in place to continue to protect and treat NWT residents from more serious health outcomes due to the virus;
$9.983 million to address forced growth; and,
$9.4 million for other adjustments, the most significant being an increase in physician funding and the implementation of a labour market supplement.
There is a $11.6 million decrease in the budget reflecting the wind up of the COVID Secretariat. The remaining decrease represents sunsetting agreements with funding partners and 20222023 onetime budget allocations.
These estimates continue to support the priorities of the 19th Legislative Assembly and vision of Budget 2023 by:
Improving early childhood development indicators through the continued expansion of the Healthy Family Program to support expecting parents and those with young children;
Continued support for the ongoing health human resources workforce to meet increased demands through the delivery of the Practical Nurse and Personal Support Worker programs through 20242025; and,
Increasing the stability and representation of the workforce through recruitment and retention initiatives.
That concludes my opening remarks. Thank you.
Thank you, Minister. Do you wish to bring witnesses into the House?
Yes, please, Madam Chair.
All right. Sergeantatarms, please escort the witnesses into the Chamber. Minister, please introduce your witnesses.
Thank you, Madam Chair. On my left is Elizabeth Johnson, director of finance. And on my right is JoAnne Cecchetto, deputy minister of health and social services.
Thank you. Welcome. Does committee agree to proceed to the detail contained in the tabled document?
Agreed.
Thank you. Committee, we will defer the departmental summary and review the estimates by activity summary beginning with administrative and support services starting on page 190, with information items on page 191 to 192. Questions? Member for Yellowknife North.
Thank you, Madam Chair. I'm going to ask some questions about the deficit, which I think could be asked here considering this is where all the finance people go or probably on the overall summary. But can someone just tell me what we project the health authority deficit to be for the current fiscal year we're sitting in and what we then expect that to bring the total cumulative deficit to? Thank you.
Thank you. Minister of Health and Social Services.
Yes, thank you. For the last fiscal year, the deficit was $33.7 million for a total of $189.7 million. So we don't have a firm figure for this year. But given the pattern of the last few years, I'm anticipating it'll be in the same ballpark.
Thank you. Member for Yellowknife North.
Yeah, thank you, Madam Chair. So I think it's safe to say we're going to surpass the $200 million mark on our health system deficit.
You know, I get part of that is, you know, being dealt with through or looking for efficiencies and part of that is that we just need some more funding for health in general. Can the Minister speak to the extent the budget we're dealing with for the next fiscal, whether we anticipate that's going to curb the deficit at all? You know, clearly, we're still going to run one but perhaps at least it could plateau instead of increasing every year. Thank you, Madam Chair.
Thank you. Minister of Health and Social Services.
Yes, thank you, Madam Chair. We have a sustainability health system sustainability office that is working with a health sustainability plan. There are three major work streams to the plan, internal controls and cost containment, operational review and quality improvement, and funding and service levels. So this work has been ongoing for a couple of years. I think the end goal is to ensure that the deficit doesn't grow or grows more slowly so that we can contain those costs. There have been a lot of different initiatives within this area. And for more detail, I'll ask the chair if the deputy minister could provide that detail.
Thank you. Deputy minister.
Thank you, Madam Chair. I think ultimately the Minister has answered the question. I don't think I have anything more to add to that.
Member for Yellowknife North.
Thank you, Madam Chair. I'm not sure where exactly, or if, in this budget that the new federal money that we've got under the territorial health transfer shows up. But can someone just I remember the Minister saying, you know, it's not as well, the Minister and every single premier across the country is saying there's not as much as we'd hoped. Can the Minister just confirm whether that money is in this current budget and perhaps one more explanation of exactly how much money we got from the federal government. There was some confusion they were trying to, you know, say there was some existing funding we knew we already had wrapped into the announcement. Thank you, Madam Chair.
Thank you. Minister of Health and Social Services.
Thank you, Madam Chair. Madam Chair, the new health funding is not in this budget. What the government has proposed is $11.9 million in new funding and that comprises $2 million one-time only increase to the CHT, which is to pay for surgeries and backlogs; $7 million in tailored bilateral agreements in four priority areas; and $2.9 million in incremental funding for the territorial health investment fund. There's been no amount yet identified for personal support workers’ wages. But that is also one of the commitments that Canada made. So the detail on the spending and how it's going to be allocated will be developed through action plans that match the indicators that we're able to provide and Canada has requested. So there's still some work to be done before we can say definitively how the tailored bilaterals are going to be sorted out. Thank you.
Thank you. Member for Yellowknife North.
Thank you, Madam Chair. Yeah, you know, I think it's safe to say that, you know, $11.9 million of additional money is good but when you have an over $200 million deficit, you know, it's real long way to go.
I was hoping I could just get a brief summary of what the main drivers of the deficit are. I know a number of years ago there was a report; I think it was overtime was a big one. I believe reliance on locums was another one. Outofterritory services. But perhaps if someone can educate me as to what the main drivers are and if you have, you know, kind of how much of a percentage those drivers contribute to the additional unbudgeted spending each year. Thank you, Madam Chair.
Thank you. Minister of Health and Social Services.
Thank you, Madam Chair. Madam Chair, the deficit for the last fiscal year is $33.7 million. It was driven by the following factors:
Compensation and benefits, including overtime. Staff relocation and removal and call backs;
Secondly, physician services;
Thirdly, chemotherapy drugs;
Fourthly, foster care and voluntary service supports; and.
Fifth, health services that were transferred to the correctional facilities during that year.
We don't have that broken down by percentage. Thank you.
Thank you. Member for Yellowknife North.
Yeah, thank you. Just could we get a commitment to have that broken down by percentage, or if someone could even just point me to where I could find that. I've seen that list before, but I haven't quite I know there's a lot of work going on in the renewal and the efficiency side. But I think kind of getting a sense if I had to wager a guess, overtime is by far the biggest and everything else is kind of trailing behind that. But I'd like to know that for a fact, Madam Chair. So if someone could point me to where we could find that or provide it at a later date to committee. Thank you, Madam Chair.
Thank you. Minister of Health and Social Services.
Yes, thank you. I think that the best idea is to have the Member look in the annual report which, for NTHSSA, was tabled last fall, and there would be a breakdown in there. And if he requires additional information, please go ahead and ask me again. Thank you.
Thank you. Health and social services, administrative and support services. Questions? Member for Kam Lake.
Thank you very much, Madam Chair. Madam Chair, I'm wondering if this is the area where Stanton Legacy would be found.
Can you clarify that is that Minister.
Yes, thank you. There's a segment of our budget called longterm and continuing care services that will be discussed later on that will include Stanton Legacy information.
Did you still have questions for this section, Member for Kam Lake?
I'll wait then. Thank you very much, Madam Chair. I just wasn't sure if it was transferred other there or not. Thank you.
Are there any questions under administrative and support services? Seeing oh, Member for Frame Lake.
Yeah, thanks, Madam Chair. I've asked for this before. I had understood that there you know, with health system transformation from the regional, you know, boards to NTHSSA, that we'd have better data collection, better data capability. Do we have anywhere publicly available wait times for various services, and if so, where would I find that? Thanks, Madam Chair.
Thank you. Minister of Health and Social Services.
Thank you, Madam Chair. I'm going to start by saying that we report a number of indicators, health indicators, health outcomes, spending, wait times to the Canadian Institute for Health Information. And it maintains an excellent website which allows you to go into different levels of detail around the data that is NWTspecific. In terms of global wait times, I'll ask the deputy minister if she has that.
Thank you. Deputy minister Cecchetto.
Thank you, Madam Chair. We do also report some of our wait times, I believe, in our annual report as well as in the health authority annual report. I can give you some a variety of wait times. I'm just not sure whether he has the Member has specific questions about a specific area. But if he wishes, I can go through and provide a variety of summaries. There's a whole suite of wait times that we report on including longterm care, community counselling, home and community care, our rehab services. Those are the large tranches of the areas in which we report on.
Thank you. Member for Frame Lake.
Yeah, thanks, Madam Chair. I don't want to dig us into a bunch of different holes here. But is there what about a dashboard? We had the COVID dashboard, you know, during the pandemic where people could easily find data on their communities and so on vaccination levels, incidents, all that kind of stuff. Do we have anything like that for wait times? And if not, is that something we're looking at or going to do? Thanks, Madam Chair.
Thank you, Member. Minister of Health and Social Services.
Thank you, Madam Chair. There is no dashboard available that is equivalent to the kind that was maintained during COVID. But there is interest in launching one. Thank you.
Thank you. Member for Frame Lake.
Thanks, Madam Chair. And thanks for that. Yeah, I think the public would definitely be interested in that. Is that something that will happen in this upcoming year then, 20232024? Thanks, Madam Chair.
