Thank you. I'll go to the deputy minister.
Thank you, Mr. Chair. I will also take us back in a little bit of time that when NTHSSA was established, one of the areas was our public health entity was not actually devolved to the NTHSSA from the function that happens at the Department of Health and Social Services. So some of the work that happens in pop health, or otherwise known as public health in our department, does straddle ministry and operations, and then as the Minister had noted, during COVID it became very apparent that we do need to do some work around roles and responsibilities and functions. So to transform our public health, our population health system, it really is about working with our health authorities to ensure that the functions are aligned with the appropriate entity, and so that is what that work is about.
Thank you. I'm going to go back to the Member from Yellowknife North.
Okay, And just to clarify, the idea is that population and public health will continue to straddle HSS and the health authorities or that it will be transferred entirely to the health authority? I understand that roles and responsibilities need to get sorted out, but is the intention that those roles and responsibilities will continue to straddle the two? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Yes, thank you. There will still be roles within the ministry and the department as well as, you know, actually -- and so there will be -- within the authorities, there will be more clarified roles and who's doing -- and the operations and so, yes, there will be still authority -- or a department straddling of how they work together. Thank you.
Thank you. I'll go to the Member from Yellowknife North.
Thank you, Mr. Chair. Is there a way we can monitor whether or not we've done a good job at this? I know there's a lot of things around reforming health care and systems that it's hard to point to a specific tangible outcome but at some point, we have to know whether we've done it well or not, right, whether we've achieved our goal of transforming the system in a positive way. Are there indicators that you can point to, or is the plan to sort of survey stakeholders and staff, or how will we know whether we've done the job that we set out to do in this case? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
If I may get a clarification, are you just speaking specifically in this -- in the public health section? Okay. If I may, I'll pass it on to the deputy minister.
Thank you. I'll go to the deputy minister.
Thank you, Mr. Chair. Yes, as we -- as the Minister has noted, while we wouldn't transfer all of the functions completely to the three health authorities for pop health or public health, because there are functions that do need to continue in the ministry from a strategic perspective as an example, and so as that function is transitioning, we will continue to monitor the success of that. At the end of the day, one of the challenges, from a client outcome perspective, when it comes to population health that shouldn't necessarily be -- that shouldn't change in the sense that it's really about how programs and services are delivered. And at the end of the day, the outcomes for clients should not be impacted by the health authority and the department determining roles and responsibilities, because ultimately the services that are being delivered to clients will continue to exist. So I'm not sure if that helps provide a bit of explanation.
Thank you. I'm going to go to the Member from Yellowknife North.
Yeah, thanks for that. I mean, I guess what I was getting at was are we expecting to save money at the end of the day by sorting out some of the roles and responsibilities? Are we expecting to have more effective responses, for example, to outbreaks of certain contagious infections or diseases and can we set some indicators that can show that we will have improvements in, like, how quickly we can contain, you know, contagious outbreaks of something or other, or get test kits to communities, or are we going to be saving money? Are any of those things included in the indicators of monitoring what we're trying to do? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, within public health and population health, the main goal is to have people working in the frontline for the health promotion piece. You know, we go out -- when you look at, you know, the things that fall under there, is immunization. We need to make sure that, you know, people -- our immunization rates are up so that means that we're seeing less of those diseases. When we think about population health in that same area is TB. You know, we had a -- like we talked about, we had a recent TB break. We should be able to manage those and better -- you know, on our surveillance and so doing more surveillance. So how it will be measured is we will see decrease in, you know, communicable diseases and that goes from all of those things that our vaccinations provide. And so if there is ways to, you know -- if it is -- it's not necessarily a cost saving thing. It's more an efficient of how people are working within the system so that they're better being able to reduce those instances. So better client outcomes. Thank you, Mr. Chair.
Thank you. I'll go to the Member from Yellowknife North.
Okay, thank you for that. That is good to hear confirmation that those kinds of tangible outcomes to people's health and how outbreaks are contained, that that will be monitored and included.
I just want to turn my last little bit here to community mental wellness and addictions recovery. So does this line item include detox; you know, either detox beds in facilities or detox services offered in some other way? Thank you, Mr. Chair.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I will pass that to the ADM for the detail in that section.
Okay, thank you. I'm going to go back to the ADM.
Thank you, Mr. Chair. I believe the funding associated with detox beds would be captured under the hospital services line, because that's where they're existing. But it is in this activity for sure. Thank you, Mr. Chair.
Thank you. Next on my list to speak is the Member from Great Slave
Thank you, Mr. Chair. I'd also like to ask some questions about population and public health services.
As the Minister knows, there has been difficulty keeping the level of staff needed to provide COVID and flu vaccinations outside of the flu clinic that I think happened here in Yellowknife in November. I've also had constituents reach out and say, you know, I want to get vaccinations for travel, and that's not a possibility right now. I think that that was work to be resolved recently, which is great. So I guess my question is how are we planning to build capacity in vaccinations? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, you know, I think with what happened with the reduced services and what happened within Yellowknife, we've had a couple of times where we've had reduced services in the public health unit and where they've had to focus their staff were to make -- ensuring that, you know, children immunizations, routine immunizations were being completed, as well as working on the TB situation that we currently had. As well as they've had vacancies. However, I do know that there are some -- they are in the process of bringing on some new staff in that area. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. And thank you to the Minister for that. When it comes to outbreaks, which of course we don't want to see but, you know, have seen as recently as last year with the TB outbreaks as the Minister mentioned, how are we addressing surge capacity for public health to go out and address outbreaks as they arise? That's an area of concern I'm hearing about. Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, the way that they are dealing with surge capacity in a situation like that is that they would reduce services and so that they can target to a situation like this, that this is a communicable disease, this is something that is, you know, potentially, if not dealt with right away, you know, and as -- I know that the Minister of Finance had details on what those costs were and how many people were involved with a case that just happened recently in Yellowknife, and so the amount of service and contact tracing and then directly observed therapy and all of those things they take -- they have to be done by the staff. And so the way that we have to deal with it is through decreasing services in some times in some areas that are nonurgent, so that is traditionally how it's done. And that's how it's done in our smallest of communities. When we have surge capacity of people that are coming in, a lot of our health centres end up -- and many people who live in small communities know this -- that we end up having to decrease services to just emergency services only in those communities, so there is no other services provided, and that's traditionally how we have had to deal with it. Thank you.
Thank you. I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. When small communities do have outbreaks of disease, how do we reallocate our staffing to adequately address those needs, and what are the impacts in the system for staffing? I realize that's really kind of a big question, but I guess I -- maybe the Minister could follow up with any standard operating procedures. I'm just curious. Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, I know that -- and I can speak to the region that I previously am from -- shortage of staffing and movement of nurses, movement of staff to different regions, you know, when we have -- whether we have an outbreak or, you know, I mean, or when there's -- there is, you know, different things going on in the community, we know some of our communities that have higher numbers of staff and when they're at a capacity when we can't get in nurses, we will move nurses around from one health centre to another and, you know. And more recently, you know, we find we have to look at casual nurses, contract nurses, which are not necessarily agency nurses that go out to the health centres but term nurses, locum CHNs that we have in our rosters that will go out and do short-term contracts in the health centres to help and to support when there's low numbers of nurses in those communities. So that's how we do it. Thank you.
Thank you. I'm going to go to the Member from Great Slave.
Thank you, Mr. Chair. So with the revitalization of public health that the Member for Yellowknife North was asking about earlier, will there be a contemplation of adequate staffing levels throughout the system so that surge maybe doesn't have such a strong impact on various regional centres when required? Thank you, Mr. Chair.
Thank you. I'm going to go to the Minister.
Thank you, Mr. Chair. Mr. Chair, when we have surge capacity, these are unpredictable time -- like, when they happen. So normally we would just use the staff on hand, overtime, and other contract nurses if we can from the department. Like, we would just move people around. And so that's within this public health reform that -- you know, the nurses that are working in public health, the one thing that we only have is we only have nurses that work in public health here in Yellowknife and I believe in Fort Smith, in Hay River, and in Inuvik, and the duties of public health are -- we rely on CHNs, community health nurses, in those other communities that are health centres to do those duties on top of all of their other duties. Thank you, Mr. Chair.
Thank you. I'm going to go back to the Member from Great Slave.
Thank you, Mr. Chair. Just more of a comment, really, and then I'll cede my time. But I'm hoping, and I look forward to primary care reform possibly increasing this line item so that prevention is more of the equation. I hope the Minister shares this sentiment. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Frame Lake.
Thank you, Mr. Chair. I do apologize if I'm repeating any questions here. I was trying to follow along with all the other Members.
But the community clinics and health centres, I notice there's a pretty significant increase there. Can the Minister just give a quick summary of what's happening there.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. I'll turn it over to the ADM for that detail.
Thank you. I'll go to the ADM.
Thank you, Mr. Chair. The majority of that increase is due to three specific areas, two of which relate to negotiated agreements for compensation and benefits so that collective bargaining with the UNW, that's a big factor in that, totalling $6.9 million. And then there's the ratification of the agreement with the physicians for a total of $3 million. And then there's about $14 million that got added to reflect funding to address physicians, supplies, relocation costs, things that the NTHSSA had been incurring that had been contributing to their deficit in recent years, and we've now allocated funding to those areas. Thank you, Mr. Chair.
I really appreciate that. And similarly, the community, culture and innovation is cut almost perfectly in half. Can they just give a quick description of what's behind that.
Thank you. I'll go to the Minister.
Thank you, Mr. Chair. Mr. Chair, that's due to the renegotiation of the Northern Wellness Agreement. So once we have that agreement finalized, that the money will go back there. So it's just because we're in -- by the time the budget is done, the agreement ended and so we're in negotiations for the future agreement, multi-year agreement. Thank you, Mr. Chair.
Thank you. I'm going to go to the Member from Frame Lake.
