Okay, so just to confirm that all costs that are retroactive have been included in these estimates that are coming forward for sups and that any forwardlooking benefits wouldn't could be captured in the main budget going forward? There wouldn't be any benefits that need to be covered between now and between now and our approving the budget for the next fiscal year?
Thank you. I'm going to go to Minister of Finance.
Thank you, Mr. Chair. So I think I do understand the question. So the sup here is only because the collective agreement was overdue in terms of being reached. So there was an amount owing under the collective agreement. Once it was finalized, that falls under this fiscal year. Only it wasn't built into the budgeting for the fiscal year because it was still being concluded. Now that that agreement's been concluded, we can bring it forward to the Assembly to reflect what the 20232024 total amounts would be. That collective agreement as it applies going forward will form part of the budget of Health and Social Services going forward which will be part of the main estimates that we'll see in May and June for 20242025. Thank you.
Thank you. I'm going to go to the Member from YK North.
Thank you very much, Mr. Chair. So moving on to the agreements with the federal government, various agreements around health funding. Can the Minister clarify whether any of these agreements have resulted in carryover from previous years' funding being unspent?
Thank you. Minister of Finance.
Thank you, Mr. Chair. Mr. Chair, I'm I suspect some. I mean, there's obviously quite a list of agreements here included and so some would and some wouldn't and the breakdown of that, again, I don't necessarily have that in front of me here but I could endeavour to get that. Thank you.
Thank you. YK North Member.
Is there an explanation for why even okay. So the first line item that is the largest amount, CanadaNorthwest Territories Agreement to Work Together to Improve Health Care for Canadians, so why is this coming forward as a supplementary amount that wasn't planned for that is is it being something that's being done ahead of schedule, or can the Minister provide an explanation for why this is coming forward as a sup?
Thank you. Minister of Finance.
Thank you, Mr. Chair. For this one, and I believe for several of the others, the agreements were either signed for the first time or renewed after the time when the business planning process had been completed. And so in such cases where there's an expected or a change coming to an agreement, if it's being renewed or if it's obviously again a new agreement that comes after the business plan cycle while materials that are before the House for approval as part of the formal budgeting process, then it would come forward as a sup. That is, yes, dealing with a supplementary appropriation, that is one of the definitions of when the management board secretariat would then receive that request and recommend that it be approved because it precisely meets that definition of when a department should bring forward supplementary appropriation. Thank you.
Thank you. I'm going to go back to the Member from YK North.
Thank you, Mr. Chair. Final line of questioning here. Are these agreements public, or could they be made public so that we can all better understand, you know, what has been the amount of federal funding for each of these pockets over the years, what's being carried forward, what you know, what aspects are ending, what are the new agreements? Are any of the details around these agreements public or can they be public? Thank you, Mr. Chair.
Thank you. Minister of Finance.
Thank you, Mr. Chair. So the agreements themselves are agreements with the federal government so the degree to which the agreement itself can be made public would be subject to what is in the specific clauses of the agreement, and they're federal government agreements that we are signing on to. So I anticipate that the agreement document itself probably has a clause in it that does not make it a public document. All that said, in terms of, as I said, you know, what numbers are subject to which ones are new agreements, which ones had carryovers, there certainly is some that can some details that can be provided in that regard. Details, for example, of what was agreed to between Canada and the Northwest Territories can be detailed. You know, what were the purposes of them, that can be detailed. And I can perhaps suggest that we sit down with the Member just to make sure that that is more clear. And I suspect my colleague from Health and Social Services would be in a position to support that. We certainly want to make clear to the public when we are benefitting from these additional dollars and what those dollars are meant to represent. It's just not necessarily the agreement itself. Thank you.
Thank you. Was there another question? Okay, no further questions. Any further questions from committee? Okay, I don't see any. Oh sorry, I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. And thank you for the indulgence. It's a very quick question. I heard when another Member was asking about the collective agreement that one of the witnesses said it's retroactive for five years. However, I just want to clarify the collective agreement is for five years but it should be retroactive for three fiscal years, is that correct, from 20212022 on? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister of Finance.
Thank you, Mr. Chair. Yes, it's not entirely going back five years. I don't recall just off the top of my head if it's going back two years or going back three. But okay, here we are. So it's covering 20212022 through to 20252026. Thank you.
Thank you. I'm going to go to the Member from Great Slave, is there a further question?
Thank you, Mr. Chair. So the collective agreement covers five years but the sup covers retroactive pay for three, am I right? Thank you.
Thank you. I'm going to go to the Minister of Finance.
Thank you, Mr. Chair. Yes, that's correct.
Is there any further questions? Okay. Any more questions? If not, I'll continue on. Thank you.
I'm going to read out again Supplementary Estimates (Operations Expenditures), No. 4, 20232024, Department of Health and Social Services, administrative and support services, not previously authorized $1,499,000. Does the committee agree?
Agreed.
Thank you. Moving on, Supplementary Estimates (Operations Expenditures), No. 4, 20232024, Department of Health and Social Services, health and social service programs, not previously authorized $25,525,000. Is there any questions? I'll now go to the Member from Range Lake.
Thank you, Mr. Chair. Mr. Chair, the funding for diagnostic laboratory services, chemotherapy drugs, radiology services, what do these increases represent? Is that more client usage, or is that replacement of equipment? Can the Minister provide more substantiation. Thank you.
Thank you. Go to the Minister of Finance.
Thank you, Mr. Chair. So these are demand this is demand driven as I understand it. So I can start one at a time.
We've got the referred diagnostic laboratory services. That is a funding shortfall to the laboratory services that we are under contract. So we send materials for testing to Dynalife Medical Labs, and it's a multiyear contract. They're set fees. If our usage goes up, then we have to pay more.
Under chemotherapy drugs, similarly, Mr. Chair, if we wind up having a greater uptake or greater usage of those or a need, then the costing will, again, go up.
And similarly, radiology services, we have an external contract with an entity that provides those services and, again, it's on an ifandwhen basis. If usage goes up then, again, we are in a situation where we are required under that contract to pay more. Thank you.
Thank you. I'm going to go to the Member from Great Slave oh sorry, Range Lake.
Thank you, Mr. Chair. So I thank you for that explanation; that's satisfactory.
Okay, let's talk about agency nurses. So this is 2 million 2. just over $2.3 million. So what's the total amount that's going to be expended on agency nurse contracts? Thank you.
Thank you. Minister of Finance.
So the total amount requested in this supplementary appropriation is $2.34 million for shortfalls here in terms of the staffing. It's yes, the projected that's the amount that we're requiring at this time. But the total anticipated cost for agency nurses this fiscal is $5.5 million. Thank you.
Thank you. Member from Range Lake.
Thank you. The media stands corrected because I think there's a news well, there was a news article recently of $5.2 million. That's what the public is and my constituents have seen and have brought it forward. So a $5.2 million expenditure is barely equivalent to 42 nursing positions at staff wages. So how many agency nurses are we getting from $5.5 million? Thank you.
Thank you. Minister of Finance.
Thank you, Mr. Chair. Mr. Chair, if there I mean, difficult to make a guesstimate of that. Different nurses have different fall within the pay scale at different rates. There is different overtime amounts, different enhancements, you know, again, so. I can give you there's a, you know, total number of scheduled hours that an agency nurse might work. I can try to break that down. But, again, breaking it down by what that does by hour, you know, again, different nurses come in at different hourly rates. So, you know, I'm not this is a discussion broadly about the fact that agency nurses are being utilized in the Northwest Territories and elsewhere in Canada. It is all over the news right now. It is an agreement that we have with the UNW to use agency nurses only when available. And the difficult challenge we put ourselves in, and I don't mean to steal the Minister of health's thunder on this one, but if you don't have the nurses there and then there's staffing is short and services close, that is difficult on morale. It's difficult for the public. But, of course, to keep things open, we're either relying on our own nurses to cut short on their time off, on their leave time, or we're bringing in agency nurses. It is a quagmire, and I acknowledge that, but at this point we really just looking for supplementary appropriation to cover the costs for the current fiscal year for being in that exact quagmire. The forward-looking challenge is a much bigger one. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Thank you, Mr. Chair. And I'd hazard a guess that the health Minister's probably only too happy to let the finance Minister sub in for questions here. But she's welcome to entertain this discussion as well; I'm sure we'd appreciate it.
So the issue, I think and I'm hearing this from nurses in my riding that, like so this is a morale issue in addition just because they're the prevalence of agency nurses. So can we get the Minister to commit to a very clear cost analysis of that $5.5 million that tells us exactly like, the equivalent position staff positions that it is. I appreciate they don't work the same way as fulltime health personnel in the system; they do work differently. So can the Minister just commit to giving us an accurate staffing numbers, how many bodies are coming through this contract that's equivalent to the staffing the staffing numbers that we currently employ in the health system and getting real costs to those numbers. Thank you.
Thank you. I'm going to go to the Minister of Finance.
Thank you, Mr. Chair. Mr. Chair, this is a longer one. And I certainly don't want to hold up any of the other commitments that we're making that I think can benefit Members, particularly at this stage of the Assembly as we're learning about departments and supplementary appropriations. I don't want to hold those commitments up. The commitment to better understand the drive on agency nurses, the usage of agency nurses, for example what departments are using more, what regions might be using more, what times of year they might be getting used, those are questions that I do want to be seeking answers to and myself and the Minister of health are actively working with the two departments to have a health sustainability discussion, and agency nurses, as well as dental travel, are both pretty hot topics.
So I will commit that I want to get more of a detailed analysis to the Member. I just as far as coming up with, you know, dollar for persons, I'm not sure that that will be the question to be asked in terms of understanding what's driving agency nurse use and how we can avoid it and get away from it. I think we all share the desire to have less agency nurses and more resident nurses. So long answer, and I know I've already told that I'm not going to make a commitment, but the commitment I'm making is that we want to actually find a way to not have as many agency nurses. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
One is too many. Thank you, Mr. Chair. I think that that's the sentiment I'm hearing from health professionals in my riding. And what they're looking for is accurate numbers and cost analysis. So in their words, we have been successful and we're seeing how we can compare if we've been successful in recruiting and training nurses. And these questions are not kind of to yeah, I guess we could put a spin on it and say, like, we're excoriating the department for relying on agency nurses and privatizing our health care system, which is probably more exciting for question period than it is for Committee of the Whole. So I won't do that. But what I will say is we need some transparency around this so the public knows where their money's going, and they're getting good value for money. And our hardworking health care professionals can see that as well. That's what they're asking for. So I think the Minister's made a commitment, and I'll I appreciate that.
Can the Minister tell me how much of this sup or the $2.3 billion, or the global total of 5.5, how much has that been to pay union dues to the UNW for the use of agency nurses? Because I understand that's a component of these contracts. Thank you.
Thank you. I'm going to go to the Minister of Finance.
Thank you, Mr. Chair. The total amount for everyone's pointing at my computer, Mr. Chair. Just $69,766, Mr. Chair.
Okay. Thank you. I'm going to go to Member from Range Lake.
Thank you, Mr. Chair. That's arising from this supplementary appropriation or the $5.5 million total? Thank you.
I'll go to Minister of Finance.
That is on the total, Mr. Chair. Thank you.
Thank you. Member of Range Lake.
