Debates of October 27, 2010 (day 24)

Date
October
27
2010
Session
16th Assembly, 5th Session
Day
24
Speaker
Members Present
Mr. Abernethy, Mr. Beaulieu, Ms. Bisaro, Mr. Bromley, Hon. Paul Delorey, Mrs. Groenewegen, Mr. Hawkins, Mr. Jacobson, Mr. Krutko, Hon. Jackson Lafferty, Hon. Sandy Lee, Hon. Bob McLeod, Hon. Michael McLeod, Hon. Robert McLeod, Mr. Menicoche, Hon. Michael Miltenberger, Mr. Ramsay, Hon. Floyd Roland
Topics
Statements

QUESTION 278-16(5): RISING HEALTH CARE COSTS AND HEALTH AUTHORITY DEFICITS

Thank you, Mr. Speaker. I’d like to continue with some questions for the Minister of Health and Social Services related to the other questions that I had for her. The Minister spoke earlier of all the good things that under her watch the department has been doing. If the Minister has been addressing the root causes of these deficits over her three-year reign as Health Minister, like the underfunding, the unfunded positions, the growing costs for medical supplies and equipment, billing issues, unwieldy accounts receivables, and governance structure, then why do the deficits continue to spiral out of control at our health authorities? Thank you.

Speaker: MR. SPEAKER

Thank you, Mr. Ramsay. The honourable Minister responsible for Health and Social Services, Ms. Lee.

Thank you, Mr. Speaker. As the Member is aware, the health care system as a whole as the amount of deficit that amounts to about 10 percent of our entire health and social services budgets. That’s quite typical. Jurisdictions across the country are experiencing similar kinds of deficits. Had we not been able to get federal funding in the amount of $15 million over the next two years, that would add another $15 million. We were able to obtain that funding.

Mr. Speaker, as the Member stated, we need to find a way to right-size our budget. That’s the work we are doing. The deputy minister and all of the senior management, including all of the CEOs and medical directors, are fully engaged in coming up with right-sized budgets for all of the authorities. We know from past experience that infusing cash into the system deals with the bottom line for the moment but it does not deal with the structural changes that we need to undertake. The work is underway and we are fully engaged and seized with this issue. Thank you.

I thank the Minister for that. I think that’s the right approach and we should be pursuing that, but how are we going to get there? I’ve been here seven years and the Minister’s been here longer than that -- 12 years or 11 -- and these are problems that have been ongoing. They’ve been a problem since the day I got here. I want to believe what the Minister is saying, but how is she sure that come next year when Members go into the business plans, is she saying that the health budget is going to be increased by 10 percent, and where is that money supposed to come from, Mr. Speaker? Thank you.

Obviously, that money will come from our territorial budget. Our health care system right now takes about 30 percent of the total budget. Across the country, health care expenditures take up somewhere up to 40 to 50 percent of the budget. What we are working on right now is we are reviewing all of the important aspects of our health care system. Physician resources, how we are spending those resources, because that is one big ticket item. We spent about $26 million on medical travel. We want to make sure that we are doing the right thing in that regard. We are reviewing the business planning model so that we are putting the money in the right place. And we are looking to see how we could find efficiencies so that come next business cycle, we are not going to be asking for 10 percent extra for the health care system but that we can demonstrate that for less money but doing more effective delivery, that we could have sustainability in our health care system.

I know we’ve been here for many, many years, but the senior management at the Department of Health has been there for a little over a year and they are making huge progress. All the management is very, very engaged and I am very positive and optimistic that we are going to come up with a great plan for us to consider. Thank you.

Mr. Speaker, again, I do thank the Minister for that response. The one thing I didn’t hear in her response was whether or not the government’s going to ask itself and us the hard question, and that is whether or not we can afford to maintain having several authorities across the Northwest Territories delivering health and social services for our people and whether that current governance structure is sustainable going forward. That’s a hard question and I’d like to ask the Minister is that going to be part of the discussions with senior management and the government. Thank you.

Mr. Speaker, that may or may not be something that this Legislature or future Legislatures have to consider. What we are doing right now is reviewing the government’s model and all of the chairs are fully engaged in working together as closely as possible, so that we are not working as eight separate authorities but we are working as a group. We meet every three months. We are looking at how to use doctors and resources better, how to find efficiencies in medical travel. How do we make sure that we collect all the money that is owed to us from anybody? How do we bill for services that we are providing to Nunavut residents or visitors or tourists who are having accidents? We are making sure that we collect every dime from them, any third-party cost. We are looking to change standby and call systems. We are working to make sure that all of our health care professionals are practicing at the fullest level possible so that if we could use nurse practitioners rather than using a doctor’s service, then we are doing that. The only way to do that is to have the doctors engaged, nurses engaged. If we could use midwifery, we are doing that.

Mr. Speaker, this is a multi-faceted, fully engaged, complex system change that we are engaged in. We are well on the way to making those changes. Thank you.

Speaker: MR. SPEAKER

Thank you, Ms. Lee. Final supplementary, Mr. Ramsay.

Thank you, Mr. Speaker. It is very easy to criticize. I like to be critical of the government from time to time, but I also want to give my suggestions to government and a suggestion, Mr. Speaker, if I could give that to the Minister, would be to look at the authorities and change the way they operate. Take away the management aspect. Make them advisory boards, if anything, and, to me, if you are looking for efficiencies, that is where you are going to find it. It doesn’t make any sense to have eight different authorities in the Territories with 42,000 people in it. If you are looking for efficiency, start there. Instead of 70 to seven, go from eight to one. That will be my suggestion to the government. Thank you.

Mr. Speaker, that is a valid suggestion. It is an important suggestion. It is something that I think we need to consider. But, at the moment, Mr. Speaker, I think we could go far and we could do fine efficiencies by combining, for example, purchasing, where really the dollars count. We organize in the back offices so that we lessen the duplication and redundancy. We are making sure that each health facility only provides a service that it should. So the Stanton Hospital should become the territorial hospital that it was meant to be and it is meant to be, that any services that could be done, any practices and procedures that could be done in Hay River or Fort Smith or Inuvik, we want to make sure we do that.

Mr. Speaker, the Member has a valid point. It is something that we need to consider more. We are looking at the governance structure of our health care system. We need to talk about that more. I thank the Member for his suggestion. Thank you.

Speaker: MR. SPEAKER

Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.