Thank you, Mr. Speaker. My questions today are for the Minister of Health and Social Services and are related to the Member’s statement I made earlier today.
In the last couple of months I have talked to a number of recent mothers who have utilized the midwifery services in Yellowknife. I’ve got to say that every one of them was extremely pleased with both Yellowknife Health and Social Services for putting in the program and the sole midwife who is in Yellowknife providing the services. Her dedication and her expertise are excellent.
The problem I have and that some of them have brought to me is that she’s alone. She’s on call virtually every day. She’s got no time off. She’s willing to do that, but I’d worry that at some point she is going to become burned out. To be effective — as effective as that great program we have in Fort Smith — we really need two midwives in order to share the load.
I’m wondering if the Minister could tell me today: when will the Minister be establishing a second midwifery position in Yellowknife Health and Social Services?
Thank you, Mr. Abernethy. The honourable Minister of Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. I don’t believe there is any question about the merits of the program or the skill sets of the midwife who is delivering the services here.
The issue, as the Member is aware and everybody here is aware, is that we are under extreme pressure in fiscal realities. In the Department of Health and Social Services that has meant we have to work really hard to make sure we protect the core services that Health and Social Services has to deliver. The midwifery program is not one of those core services. In fact, it’s a service that in seven provinces in the country is not even publicly funded.
I agree with the Member. I was a strong supporter of the midwifery legislation, and I do believe there is a huge potential for this program to grow. But in the interim we do not have the money to expand this program. At the moment we’re trying to hold everything we have and protect what we have.
Thanks to the Minister for that response. If I remember correctly, once upon a time the department had a midwife implementation committee that was recommending, and the department was recommending, four midwife positions in Yellowknife as well as midwife positions in Fort Simpson, Inuvik. There might even have been some in Norman Wells, but I’m not one hundred per cent sure about that.
I believe, originally, they were intended to be funded out of the Territorial Health Access Fund. I know that fund still exists. I also believe that it comes to an end in 2010–2011. Is the funding no longer there for at least one more position in Yellowknife Health and Social Services, at least for the duration or to the end of the THAF? That would give us two years of a second midwife in Yellowknife, which would help us demonstrate how valuable this program is and, hopefully, build a case for moving into the smaller communities where I think the benefits would be far greater, communities such as Fort Simpson, Inuvik, Norman Wells and Hay River.
I know that there is money in THAF, and I know it’s just short term, but will the Minister check into THAF to see if there’s any more money that we could pull out of that? A hundred thousand is all we need to get a second position in Yellowknife.
I don’t think we need to demonstrate that this program is useful. I don’t think we need to have any more discussions on that.
We need way more than $100,000 to create the second position. A midwife position comes with a need for about three more positions, so it’s about a four PY idea.
About the THAF funding. We do not have any extra room in that funding. This midwife position at Yellowknife health is currently being funded under THAF. As the Member knows very well, THAF funding will expire in ’09–10. We do need to look at how we are funding these positions. This is a valuable position, but it’s one that is an extra to the core services that this department has to provide.
I would commit to the Member that we will look at everything to see how we can use our money better. If the midwifery program is one of them, I would do that. But under the current financial situation, it is a difficult task.
I disagree slightly. I believe $100,000 would be about enough to actually hire a second position. We don’t need extra on call dollars and whatnot, because those on call dollars already exist, and they would just split between the two incumbents.
I am glad to hear that the Minister is saying that they’re going to check out all options and explore all opportunities. I know that we have all these wonderful strategic investment committees that are talking about our future and reinvestment into the public service to meet some of our mandates. I believe this one would fall under Building Our Future. Has the Minister talked with the Minister responsible for Building Our Future about the possibility of obtaining about $100,000 from that pot to build this capacity in Yellowknife and, once again, use it as a shining light on how we should be delivering these services in the other communities?
I believe the Members are going to get a chance to review all of the new initiatives under that strategic initiative committee and Building Our Future budget in November. I could confirm that every cent of that money has been subscribed to.
The midwifery program is something that we want to be able to expand to smaller communities, where there is, I think, even greater need for midwifery because of the fact that there’s not a regular doctor service and other arrangements for women who are expecting to give birth.
I would like to commit to the Member, again…. I just want to be frank and direct about the fiscal situation that the government and the Department of Health is operating under. In looking at all new initiatives, we’d be looking to protect the core services before we could expand to extra services. Midwifery, as good as it is and as much as I support it wholeheartedly, is still an unfunded program, and it’s one that is an extra to the core service.
Thank you, Ms. Lee. Final supplementary, Mr. Abernethy.
Thanks to the Minister for that response. This program, midwifery services — hopefully someday we will get them into the communities like Simpson, Norman Wells, Inuvik, Hay River — will actually, I believe, save us a lot of money in the future. I think it’s time for us to actually think outside the box. Let’s find ways to get this $100,000 that we need to create this second position and then pursue additional positions in the community.
You indicated earlier that you’ll explore all options. Maybe I can get a commitment from the Minister at this time to look into the department itself. How many assistant deputy ministers do we need? How many directors do we need? We’re awfully top heavy, and at the end of the day, we’re about providing services to our people. Do we really need to be spending all these dollars on senior management in all of these departments and paying them huge bonuses when we should be delivering service to our people? This is a valuable service. Let’s get in there, dig in there and find some money. Will the Minister commit to looking at the structure within the departments to see if there is any money there?
I’m happy to advise the Member that in fact the Department of Health and Social Services is one of the few departments that actually reduced their top management. We reduced the positions at headquarters by 13 per cent in the last round. We went from two ADMs to one ADM, and we have reduced a director position by one. That went unnoticed, but we did all of that in the last six months.
The second thing. While I support — and I do…. There’s no question that a midwifery program is the way to go in the future, but there has not been any evidence to suggest that it is replacing some regular medical services that pregnant mothers in Canada still undergo. I do personally believe that birthing is way too medicalized, and the more midwives we could have, the better. But that’s not how the system is being implemented right now. Midwifery continues to be an extra service to the core service. There’s no evidence to suggest that it’s saving us money right now.
But I will continue to review that and work with the Member, and I will look in every nook and cranny for every penny I can find to support such a program.
Thank you, Ms. Lee. The honourable Member for Kam Lake, Mr. Ramsay.
