Thank you, Mr. Chair. Mr. Chair, so I know that there's sunsets to -- oh, and I'm not sure if they're here. Anyways, so just related to labour market supplements to recruitment to referrals to -- recruitment and retention, period. And it's close to $3 million. So how is the department making up for this? I know we're in the midst of a bargaining process so is there a plan to bring something -- is there a reserve being set aside in case there's a need for this resource to be brought back once those negotiations are concluded? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. It'll be details will come after bargaining is done. And, you know, I mean, I think there's not much more information that I can provide as I don't have that. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
So the -- like, the labour market supplement was brought in around -- like, many provinces and territories were bringing in those kind of bonuses during COVID when health care professionals were leaving their profession or going towards private agency jobs that are much more lucrative, and the supplement existed outside of the collective bargaining process through an agreement with the union. So can the Minister explain why that -- why we're waiting for collective bargaining to decide whether or not to bring that back? Because my understanding is it's not a -- it's not related to that. It's in addition to the collective agreement. Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. That agreement expired on March 31st, and that agreement was decided during an urgent need, during COVID, and so it's now part -- you know, I mean, now there's collective bargaining on, and so that's as much as I can say about that. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Range Lake.
Thank you, Mr. Chair. Well, I look forward to the conclusion of collective bargaining, then. Hopefully we have clarity on what we can provide to frontline health care professionals.
So I'll turn to the midwifery cuts and also to the need for agency nurses to staff obstetrics at Stanton Hospital. Why is the department having such a hard time providing birthing services in the Northwest Territories or investing in birthing services? Because it seems like we're not really interested. Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. You know, for myself, I was a labour and delivery nurse, so I don't understand why nobody wants to be a labour and delivery nurse, so. But, you know, for the most part I know even when I was a manager trying to convince some nurses to go and train to be a labour and delivery nurse -- it's a specialty. It's just like any other thing people want to do. And, you know, and I think for a long time here once we -- one of the issues that we know that within the current obstetrics where we -- I mean, it's not a secret that there was many vacancies over COVID, and then that's when, you know, it enacted the time that we needed to start using agency nurses to ensure that we could provide birthing services back in Yellowknife. And since then, we've done lots of training. We've trained nurses. We've provided training. We provided combination training of education so that they could get the mentoring and the specialized training to be able to become obstetric nurses. And so we're starting to get more in that area. As of right now, they still need mentors because they're not independent and so that's why we're still having to use agency nurses to bring in because we don't have any permanent staff that are available or able to recruit at this time. And our goal is to be able to train enough nurses. And then with the change in model in supporting those registered nurses to be able to work at their scope, we've changed the model so that we could bring LPNs on into the obstetric unit, which wasn't there before. And that is taken off the weight of the RNs so that they can do the job that they need to do and then the LPNs can support them in that department. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Range Lake.
Okay, thank you. Thank you, Mr. Chair. I was going to ask the Minister if she cares about obstetrics. Clearly, she does, so I appreciate that. So when's this going to kick in, right? Like, because it's -- it sounds like a plan. It sounds like we have the resources coming together. So when can we expect this new model to take over and the agency nurses to be relieved of their contracts? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. It's currently ongoing right now. So that's the process, and that's what we're hoping that we will be able to phase out, the use of agency nurses, you know, in that area. And so it's currently -- we had a forced growth submission, and that's in this budget. So we're hoping that, you know, that will support that -- those additional nurses in that unit. But we are actively doing that training and I think recruiting, and I think there are LPNs now being trained into that unit. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Range Lake.
Can the Minister be more specific in terms of a target? Like, ongoing doesn't give me much comfort. Ongoing could be 30 years from now. So I'm wondering if we can get a fiscal year that meets the department's timelines, because of course, it can't offer this training indefinitely - there are budgets attached to it, there's staffing attached to it. So can the Minister give us a fiscal year when this -- when the changeover will take place? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, this is -- like I said, I'm sorry I can't give you a specific date or time. There are nurses that are going through this and being supported are different levels of where they are. And, you know, it can take up to one to two years for that specialized to be independent in this area. You know, we want to make sure that they have all the training that they need to be independent. Thank you, Mr. Chair.
Thank you. I'm going to go to go back to the Member from Range Lake .
Thank you, Mr. Chair. So one to two years, that's, what, 2026? So could the Minister commit to having -- phasing out agency nurses by 2026? Thank you.
Thank you. I'm going to go to the Minister.
Thank you. Thank you, Mr. Chair. Mr. Chair, I can't commit to phasing them out, and the reason why is I -- you know, I mean, somebody might go on mat leave. You know, somebody might move away. I can't tell the future of what the future of that staffing model will be. You know, we phrased out the -- by utilizing a lot of our education programs, the agency nurses in the operating room but, you know, every time somebody leaves and we don't keep them, you know, there's an opportunity that that service could shut down. And as many -- like as I mentioned in the House this week, is that some of the smaller communities, it's not just Stanton, it's not just Inuvik. It's keeping the health centres open when we've exceeded every other way to try and recruit a nurse to ensure that that health centre doesn't close, and that will impact our small communities significantly if we didn't have an option for them. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Range Lake.
Thank you, Mr. Chair. If you look at trends in public health care systems that use agency nurses, private health care, it always starts small. It's always a department here, a hospital there, a clinic there, and they start and it keeps ballooning, ballooning, and ballooning, and soon it's $65 million to provide a service that used to cost $10 million. And this is the case in Ontario, in Quebec, in large centres. It's the case in smaller provinces as well. I am watching the time, so I will wrap up here so the Minister can respond. But if you put an agency nurse into a small community, you will never get any other type of nurse in there because you'll never be able to meet those wages and then we're paying a huge premium for every community health centre. Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, you know, I think many of our communities are, you know, we have different models that are going on in our communities. We have job shares. We have term nurses. We have full-time indeterminant ones that have been there for years. The last resort that we want to use is agency nurses. And, you know, as a nurse I know that sometimes, yes, you're frustrated with that model but when you're the only one in there and that's the nurse that's going to come in and relieve you so you're not working 24 hours a day, you're very appreciative to have some time. So I hear the Member. I hear the concerns. What I can do, and I will continue to do for the Northwest Territories, is continue to advocate at the national level that this is a national crisis. Like, this is something that our health care system cannot sustain in the Northwest Territories and it cannot -- our public health system in Canada cannot sustain this. And so I will continue to bring this to the national table when -- at the FPT tables. I am a small territory but I'm pretty loud and I can be pretty strong, and I'll play the room with what I have to do, you know, I mean this takes the country to change. It's not going to be me saying I'm not going to use these five nurses this week, because they will just go somewhere else. And as long as they have somewhere else to go, we will continue to lose nurses here. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Inuvik Boot Lake.
That's me. Thank you, Mr. Chair. Mr. Chair, first of all, I thank the Minister and her staff. Monumental task. Huge department. Appreciate the work you guys are doing.
You know I've been an advocate for -- obviously for addictions, mainly for aftercare, and I'll certainly be speaking with the Minister on that come capital budget time and be prepared for that. But I know for now -- I know as I spoke to in my Member's statement today, the Gwich'in have built a wellness centre, are working -- having the wellness centre that they're working on using for trauma and for different addictions. We know that the Inuvialuit Regional Corporation are in the process of building a family centre which, again, will be focused on wellness. So I guess my question is, you know, from the business plan, what was the department been doing or plan to do looking with regards to kind of interaction, cooperation, if any, with these two groups and any possible maybe redundancies there as well that we can probably see as they kind of continue, as the Indigenous governments are doing in my region, and ramping up in all areas and this is certainly one of them. Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, this is -- you know, I hear the Member. And, you know, we've started our bilateral agreements as a Cabinet meeting with -- you know, we'll be meeting with all of the different Indigenous governments. And this is one of the topics that I'm sure will be on the agenda when meeting with the Indigenous groups in the region and how do we work together. I know that the -- you know, that they have very good leverage on federal funds up to date to be able to do the things that they've done with their centre. How they run programming and how we move forward, you know, I think that's -- we will continue to work close with all Indigenous partners that are running programs. As I said many, many times, and you'll see in the business plan, that we want to be able to have as many wellness and culturally relevant programs to people in the regions. And so this is where I -- you know, I want to make sure my focus is, is how do we work together in collaboration, how do we work together to access as much funds federally together for the operations of not just the program but, you know, Inuvialuit has their program going. I know that the Tlicho has programs that they want to do. Every single government I've heard from, I've spoken to, we all heard from all of the Indigenous governments when we were elected, that they need money and they want to work together on programs for their people in their communities, and that's what I want to do with them. Thank you.
Thank you. I'm going to go to the Member from Inuvik Boot Lake.
Thank you, Mr. Chair. And I thank the Minister for that answer. And, yes, of course, I mean, the funding that they receive to -- for in the Gwich'in -- for the Gwich'in centre to renovate, they got the feds, and I know that the Inuvialuit as well got federal funding to build their new centre. You know, and, yeah, we need their money likely more than what they need ours. But certainly for programming, and I get that. And I know this will -- both these programs will dovetail very nicely into the new aftercare centre we're going to build there next year. So that's great to hear.
So the other thing I wanted to mention -- and I know the Minister's heard me mention this in the House before -- is in our -- it is in the document that AOC has presented, and that's the dialysis machine for Inuvik. And I know we've spoke about this before. I don't think it's a huge cost for the machine and why I bring it up here, likely the CT scan would likely be a little more that's in there. But the dialysis machine, I think it's very important. Hay River has one. Yellowknife has two. I have spoken with people in Inuvik that if they don't need it, they may need it in the near future, and it would just be an absolute shame if someone who's lived in that area their whole life, or for 30 or 40 years, now have to move because they can't get that medical service they need. And I know we discussed this, and I know there's an issue with finding, you know, the right people to be able to operate this machinery, but I can't help but think there's got to be a way to train someone to be able to do that. And I guess, you know, has the Minister and has her department considered a way that we can potentially put a dialysis service in Inuvik? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. I know that there was a review done I think 2020. We do do reviews on patients that, you know, with renal disease and where they are and what their needs are going to be. I'm not familiar when -- I mean, I can get back to the Member as to when the next planned review will be. I'm sure it's going to be soon, to just find that out. But another area that I -- you know, and this is part of our business plans is the chronic disease management. And this is a chronic disease. And so when we can better know and better control our -- what we -- you know, with our chronic disease management in the Northwest Territories, we'll have a better handle on what supports are needed in the Northwest Territories. And as well as, you know, doing more into the health promotion and, you know -- so we were preventing these things from happening. I know not all renal disease is preventible. Sometimes, you know, there's certain things happen in people's lives that this happened. But I will say that I will commit to making sure that we have another review done soon to making sure that we see what the numbers are in the Beaufort Delta, you know, to require a service like this. Thank you.
Thank you. I'm going to go to the Member from Inuvik Boot Lake.
Thank you, Mr. Chair. And, again, thank the Minister for her answer. And I must say I was quite impressed as well when she didn't even flinch when I mentioned that the two other programs will dovetail nicely into her new aftercare facility she's building in Inuvik next year. So it's a good sign.
No, that's all from me, Mr. Chair. I realize that, you know, we also have a CT scan in there. I know we're going to have a conversation around that, but. So I have no further questions, just to say thank you and keep it up. It's not easy.
Thank you. I'm going to go to the Member from Frame Lake.
Thank you, Mr. Chair. Mr. Chair, I made some comments in my opening comments about the various kind of -- the sort of crisis that is being faced at NTHSSA, and I think I don't need to repeat those comments but was hoping to get a response back from the Minister and the department on ideas they are bringing forward to address these kind of issues.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. As I mentioned, you know, I mean, I've had these discussions on the floor of the House so I'm not denying that, you know, there has been many concerns brought forward. I know that there will -- you know, that the department is doing work. I know that there was an employee satisfaction engagement done and the results of that will -- you know, will help us guide some of the work. And, you know, we've heard from the Members. We've met -- you know, we've met with some of the Members and some people that are advocating for some of these changes. And, you know, that is one area like I keep staying to my staff that I just want to be able to fix this, you know. And just like everybody else, I want to -- you know, I want people to go to work and be supported. I want people to go to work and feel like they -- you know, that they're -- they want to be there. And so how we get there, it's going to take -- you know, it's not going to happen overnight because this issue didn't happen overnight. It's many years, you know. And I mean, it didn't help us with, you know, the COVID crisis in our health care system across Canada. Not even across Canada, across the world. And so there's many areas that we're looking at to try and increase support to staff, to increase staffing. You know, one of the other Members have raised, you know, international educated nurses. You know, my colleague from ECE, we will be meeting with CAN to look at different ways on how we can support -- you know, what's needed to support that, you know, how can we work -- you know, so there are many things on top of all of the other things in health that we're trying to achieve for residents. And I understand like, we are -- we need good staff and we need happy staff to be able to provide those programs to our residents. So I'm not sitting here going to say that everything's perfect, and I know things need to be done. And we've got some plans and we've heard some recommendations. And how we get there, I think it's going to take a little bit of everything. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Frame Lake.
Thank you, Mr. Chair. And, you know, I think we've got a big budget to get through here. I'm not going to belabour this point. I do appreciate the Minister acknowledging the problem. I do want to see the department, you know, actively working on finding solutions, trying things. You know, we've talked a lot in the business plan about taking risks, breaking status quo. You know, don't be afraid to try things. And if it's not working, try something else. I can just commit to continuing to keep the pressure on as long as I'm hearing from constituents about these ongoing issues.
Mr. Chair, I'm not going to repeat items that I think have already been raised by my colleagues and spoken to by the Minister. But I just want to say I strongly support midwifery in my community and support many of the comments raised by my colleagues on health. But I'm going to leave it at that for this page. Thanks.
Thank you. I'm going to go to the Member from Sahtu.
Thank you, Mr. Chair. When I look at the programs and the funding and the grants coming in there, it sort of encourages me to say here's solutions. As I mentioned several times here, I'm quite -- I would say quite proud about the actions taken by leadership to address the drug issue that we're experiencing right across the territory. But in our area, the leaders are grasping the problems and taking a hold of it and doing some planning and having some consultations. And this coming after the weekend, they're going to listen from the youth. So the youth is going to raise their list of priorities, and it's going to be incorporated into this plan. So when I look at this funding, I see a lot of good supports there for resources to support the plan of transition to eliminate the plague problems. But these problems are costing this government, I would say, millions of dollars. And if we have to pay for a medevac, I don't know how much that cost is, but I can only imagine it's costing the government quite a bit just for the airplane, not to mention the staff and the treatment.
And to help be more efficient on medical travel, will the department look at setting up a PY? We used to have -- the Sahtu used to have a medical travel coordinator. Anyway, it was taken and directed back to Yellowknife. But have we got any room for setting up a medical travel coordinator in the Sahtu? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, at this time I won't commit to that because what I am committed to is -- in the business plan is taking a look at the medical travel and how we move people around is going to -- you know, I'm hoping we'll be able to -- I guess what I want to do is I want to implement, by the end of this government, a better way to move people, a way to make sure that when people have medical travel -- and this is -- you know, are not as stressed about getting the medical travel as they are about having to go to the appointment that they're going for. You know, and I think we've heard that many times and so I won't deny that, you know, that's sometimes the feeling, especially when you're not getting your travel on time or the day before. And we know that this is -- you know, there's many reasons why, you know, our staff are working hard. They have so many medical travel things in front of them. Like I said yesterday, I think our stats are just under 50,000 people we are moving a year. So, you know, with a small team and so, you know, how I hear the Member that if there is -- if a position in Norman Wells is going to better support medical travel and the outcome of this, then you know that -- I can see that being put forward as some of the change. But as of right now, I don't want to commit to any changes and I don't want to put this on any person until we can -- you know, we can really figure out -- and review the program and review how we're moving people in the Northwest Territories. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from the Sahtu.
Yes, thank you, Mr. Chair. And thanks for that encouraging reply by the Minister.
On my last trip, which was a one-way from Norman Wells to Yellowknife, it cost the government $1,800. And there's many cases where medical travel patients are coming here only to find out the appointment wasn't booked but it was booked for a month later, or other cases where people actually told me their experience. So that's why I say it's costing the government because of some mistake that was made and it seems to be quite common for medical travel patients to come to their appointment when, in fact, it was the day before or the day after or next week. So in the meantime, it's costing our government. So if we can look at, as the Minister said, the movement of patients back and forth to their home community -- on the spirit of efficiency, I still recommend having a PY to focus on movement of patients. But I'm encouraged by the Minister saying that she will look at it. So thank you very much there, Mr. Chair.
Thank you. Next on my list here I have the Member from the Deh Cho.
