Thank you, Mr. Chair. My question is to the Minister on x-ray machines in small communities. Do all small communities have x-ray machines? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. All the health centres that have health centre nurses in them do. The health cabins, however, do not. Thank you.
Thank you. I'll go to the Member from the Deh Cho.
Thank you. That's good to know because these x-ray machines help with early detection of illnesses if there's people that have TB, pneumonia, or lung issues, and can save a lot of time from people getting medevaced to Yellowknife or having to come for services here. If their illness is something like pneumonia, it'd just probably have to get them -- I'm not a nurse but I've had pneumonia, so I've had to take antibiotics. But the only time I've got tested for that was here in Yellowknife, so. Yeah, so that's one's that I just needed to know, are all those machines in the communities working and in good working order.
The other one I have is on community services. We're looking at that. And it's good that the department is supporting communities and addictions and stuff like that. Is there a community -- the health doing anything with on-the-land healing? Is that something that this department is working on? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, just to the first part of the Member's question is x-ray machines maintained. All the x-ray machines are maintained by our biomed and they are -- like, they're all maintained in the communities.
And to the next question, the on-the-land program, health is not running those types of programs. What the Indigenous governments have told us is that to make the funds available and more flexible for them, and so that's where the community wellness and addiction recovery fund it. And so that's where Indigenous governments from the communities can apply to access those dollars. And there is a fund, as I said, is a first come first serve. And so I would encourage, there is a staff member to help in community government, like the Indigenous governments to do their proposals, to work with them, to support them, to access those dollars. So I would encourage the Member to -- you know, to provide that information to their Indigenous governments and their communities. And they can use those for on the land. They can use them for hiring, you know, mental health workers. They can use them to do youth programs, you know, things like that within the community that are targeted for mental health and addictions. Yes, thank you.
Thank you. I'll go to the Member from the Deh Cho.
Thank you for the Minister for that response. Is there a number for the budget and a length of time that they can run these programs? Is there -- like, what's the max for the budget? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. There was a set amount for regional governments to be able to apply. As a region up until January 31st for multi-year funding. After that -- after April 1st, then it opened up to Indigenous community governments. And so individual Indigenous communities can apply up to 208 per -- that's for the regional. $208,000 a year.
Thank you. I'm going to go to the Member from the Deh Cho.
Thank you. And so that $208,000 a year, that's multi-year funding so they'll get that for three years?
Thank you. I'm going to go to the Minister.
Yes, I would encourage -- like I said, there is -- it is a set dollar in the budget, and it is now open for first come first serve. So that's why I'm saying, like, I encourage people to reach out to -- if they want to run on-the-land programs and they want to do these types of things in their communities, speak with their Indigenous governments in their communities so that they can access -- work with our department to access those dollars and do their -- you know, I think they're proposal-based, but there's a set amount per community. Thank you.
Thank you. I'll go to the Member from the Deh Cho.
Thank you. That's all the questions I have for the Minister for that. Thank you.
Thank you. I have one more, then I will go to the Member from Range Lake.
Thank you, Mr. Chair. So the electronic medical records system is now deployed in all communities in the Northwest Territories, which is good, but unfortunately it needs to be replaced, which is not so good. And I understand that the replacement cost is somewhere between 20 to $30 million. I know this is an issue because I was seeing my doctor recently and the terminal in the examine room wasn't working, and the system was down. So we had to actually go to his office and figure things out there. So this -- and it's causing an inability for services to be shared with other -- with Alberta and a whole bunch of other hosts. So this is a thing that, like, needs to be replaced urgently. What is the Minister's plan to deal with this problem? Thank you.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, again, this is one of the things that's in our business plan. I know it -- you know, I've had asked questions because the timeline is long. We started rolling out the EMR before, way back when I was still practising. And we finally just got it into the last community in the Northwest Territories. So now that we have to replace the -- it is a multi -- I guess to explain it, there's multiple systems. And so I think what the Member's referring to is like right now, what we want to do is looking into -- when we designed the system, I think the goal is -- you know, we've heard many times that our system doesn't speak to other systems. There's things in our system that it doesn't do because it's old. And so it's taking an account of all of the things. You know, we'll be working with our -- like, the frontline staff, like, as the needs, the doctors, what their needs are, what we need to transfer -- you know, if there's a possibility that we can access, you know, blood work. You know, we've heard all of those kinds of things that when we're going into Alberta as one of our service providers. So it is a huge task. It will be a large -- you know, there will be a large cost to that. So the RFP will go out in September for phase one, and we're hoping that we'll be able to begin that process. Thank you.
Thank you. I'm going to go to the Member from Range Lake.
Okay, thank you. That's more imminent than I expected, so that's good. That's good that we're moving towards that.
So we spend an awful lot of money on the authorities, which is to be expected given the cost of health care. But often I think there's a disconnect between what is accountable -- what the Minister is accountable for and what the authority's accountable for. And certainly when it comes to some of these workplace issues we're hearing about, some of the performance of health care services, there seems to be that disconnect. And I think that the Minister needs to be empowered to be more -- to have more direct -- ability to direct the authorities and to change things if they're not working instead of working through the board and all that. I think we see a health care system that's not performing optimally and where -- and it's not performing efficiently or effectively as well with the resources it's being provided. We keep giving it more money, and the results aren't changing that significantly. And I don't think the answer is just more money.
So how does the Minister propose to create more accountability and transparency around NTHSSA management so the public can be assured that there's value for money in health care programs and services? Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I hear what the Member says, to keep putting more money in here but, you know, Members keep asking for more stuff we keep needing more money. But no, you know, and I think one of the things that I will say is that, you know, within the department, it is -- there are many things that haven't been budgeted, you know, and they -- I guess for health, knowing in the health authorities, this is all the frontline workers. So when we think about health centres, when we think about, you know, staffing the units, making sure that there's always -- like, it's not a place where you can just close -- the nurse just doesn't show up that day because they're sick or they have a sick kid. There's always areas where we have to make sure that that is filled and overtime over years and years and years has never been budgeted. So that's always been -- you know, and I mean, I had my own system when I was a manager to make sure that we kind of limited how much overtime was happening and making sure that, you know, people weren't working into third weekends and things like that because those things drive up the costs that are not budgeted and that's what's driving up the deficit. The thing when we talk about -- you know, there's more programs, there's new ways of doing things, there's -- everything costs more. Salaries are going up every year and yet trying to expand programming into 33 communities. And it is expensive. So when we talk about how do we -- you know, I work with the leadership council. The budgeting process, you know, things that we are budgeting, making sure that those things are being spent on those things that are budgeted for and that's why when we have things that aren't -- you know, for years and years, if we have O and Ms that aren't being spent, or if we have positions that are vacant that are not -- you know, we have to really, really look at all of those things and say, you know, where do we repurpose this money and so that it's not just being spent into the department and we don't know where it's going. So I think those are the things that we've been working on. I know Minister of Finance has been -- is making sure that I'm making sure that I'm following that. So there is a lot of work, though, that still needs to be done and I have -- I kind of -- my department and finance have been working more together to kind of take more control and see where -- not necessarily control but where the money is being spent and how is it being spent. And the big part is is that there's so many things that we are -- as an insured service that we are to provide and then there's the other things. So those are the things that have been built into our health care system that we provide that have been political, that have been -- over the years that have been, you know, there's no -- you know, we keep saying there's gaps here, there's gaps there. So where do they fit in? They usually end up fitting in in health. And then it's not something that it's in our core job to provide but we end up providing it because if we don't, then there's a gap in service. But those all cost dollars. So thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Range Lake.
Thank you, Mr. Chair. Is there -- I appreciate where the Minister's coming from, and there's always going to be a push and pull between the -- or the demand for services versus what the government can realistically provide. But when we have our auditors telling us that take a look at how we're spending health dollars because it's unsustainable and it's, you know, causing the government -- the government's public accounts to teeter on a knife's edge, that's a problem that we need to solve.
So is the Minister willing to look at different models of governance for the authorities that would allow more closer scrutiny -- or sorry, more control and accountability and transparency and more action directly from the Minister over the operation of the system? Thank you.
Thank you. I'm going to go to the Minister.
Thank you. Thank you, Mr. Chair. And I hear the Member. And, you know, I'll echo what I've said is, you know, what we are funded for and our core programs and services and what we provide to the Northwest Territories, the things that are not covered in other territories and provinces that we provide over the years that we have just -- you know, we have decided as a government, and many governments up until now, that this is something that we need to provide to our residents is why we are in the shape where we are. And every new thing that we ask for and we want to do that's not a core service of health and social services that's a funded insured service that we can be billing for or, you know, from Canada becomes out of our pocket and so then it comes out of whatever the government's -- like, whatever we have as a territory left. So, you know, we've been working on a lot of things. Like I said, the NHIB agreement, trying to get that fully federal funding so that way that frees up those dollars. But even though we -- you know, we freed up $24 million this year, it's still -- it goes to our operating costs that we normally would need to spend for our health care program. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Yellowknife Centre.
Thank you, Mr. Chairman. Maybe just the -- if it's been asked, maybe just a quick snap answer which is how much money do we spend in aftercare? Thank you.
I'll go to the Minister.
Thank you, Mr. Chair. I think as of right now for aftercare, what we have is the budgeted for THARP. Up until now, I don't believe we -- you know, we provided wellness, you know, for homeless and things like that but we haven't had fund up until this budget for aftercare, and that is where the THARP program falls into that. Thank you, Mr. Chair.
Thank you. I'll go to the Member from Yellowknife Centre.
Thank you, Mr. Chairman. And exactly how much would that specifically be? So in other words, what's the specific number dedicated to aftercare? Thank you.
Thank you. I'll go to the Minister.
Thank you. This budget has $1.417 million, and that would be for the two THARP programs. Thank you.
Thank you. I'll go to the Member from Yellowknife Centre.
Thank you, Mr. Chairperson. Under community wellness and addiction recovery support fund, they look very similar to mental health -- sorry, mental wellness and addictions recovery. So you have a 3. -- we'll call it -- 055 budget and a $125,000 budget. What is the true distinct difference between the two; why aren't they collapsed and put together? Thank you. Because they say similar things.
Thank you. I'll go to the Minister.
Sorry, Mr. Chair. Just trying to get that. Are you asking -- I'm going to have to get back to the Member unless he can clarify which line item are you?
Thank you. I'll go back to the Member from Yellowknife Centre to clarify.
Thank you, Mr. Chairman. The community wellness and addiction recovery fund, we have just over $3 million, and then under mental health and addictions recovery fund, which is just over a hundred thousand dollars, why isn't -- what's the distinct difference to have two specific different line items? They say similar things, and I'm trying to understand why we don't collapse and make one. Thank you.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Sorry, the $3.055 million is the community wellness and addiction recovery fund, the one that I keep kind of talking about that Indigenous governments can apply on. And that is separate from the mental wellness and addiction recovery capacity building fund -- or no, sorry, the mental wellness and addiction recovery fund. In the one here is, 125, is used for the youth addiction prevention and youth detox model.
Thank you. I'm going to go to the Member from Yellowknife Centre.
Of course I'd recommend a hundred percent reprint of the whole budget just so we add the word youth. No, I don't. But I would recommend if it's targeted at our youth, then we should put in brackets youth just to help clarity. More of an edit there than concerns.
So maybe we could jump to one of my favorite topics, doctors. Why don't we start with how many doctors do we have employed under this service, and where do we find them? Thank you. In which authority -- thank you -- when I say where do we find them.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. You'll find doctors under all three authorities and so that -- here, well, you'll see grants, contributions, and transfers, when we transfer those dollars from the department to the health authorities and later on you'll see in the activities where we -- the health authorities later in the budget, so. But we do have a list of all of the different, like, FPTs, and I think we have a subtotal of 56.5, yes, regular physicians.
Thank you. I’ll go to the Member from Yellowknife Centre.
