Debates of February 18, 2011 (day 42)
QUESTION 491-16(5): MITIGATION PLAN FOR HEALTH AUTHORITY DEFICITS
Thank you, Mr. Speaker. Over the years I’ve been here I’ve witnessed this government, through one-time funding and supplementary appropriation, handing over $38 million to deal with the deficits at the health authorities around the Northwest Territories, Mr. Speaker. Again, I think that’s a very disturbing way to manage our health care system here in the Northwest Territories. I’d like to begin by asking the Minister of Health and Social Services what is the plan going forward to try to mitigate the deficits at our health authorities. Thank you.
Thank you, Mr. Ramsay. The honourable Minister responsible for Health and Social Services, Ms. Lee.
Thank you, Mr. Speaker. We should first of all be clear that when we make a one-time infusion of cash, it’s very program specific. For example, I think medical travel is one that receives the most one-time funding due to the fact that that program goes over budget by demand.
Mr. Speaker, we are, as a system, working now with the understanding that deficits in our health authorities are not deficits to those health authorities but it’s a system-wide deficit. Many authorities right now are experiencing a deficit and we want to address that by changing the system and changing the way we manage our health care system as a system.
I can tell you that there are a number of major factors that we have determined to contribute to the system deficit: physician programs, medical travel, unfunded benefits, pension buy-backs, overtime and relief for essential services, and Canadian Blood Services, which has gone through the roof over the last number of years.
Mr. Speaker, I would also like to note that we are leading a number of initiatives and reviews to address this as a system. We are looking at a business process redesign, we are undertaking a medical travel review, we are also doing a physician review, health services administration review and extended health benefits review. Mr. Speaker, we believe that this outcome of this work underway will inform us and give us a set of decisions that we would have to make. Thank you.
Mr. Speaker, the Minister, the factors that she talks about today are factors that have been around since the day I walked through these doors in 2003. I mentioned, in my Member’s statement, Minister Miltenberger back in 2003 saying the board would be re-established at Stanton. There’s no board there today. This is eight years later. Mr. Speaker, in the Minister’s response she also didn’t mention whether or not the government is going to look at a new governance model for how we manage health care here in the Northwest Territories and the system-wide governance. Can the Minister answer that question? Thank you.
Yes, governance model review is underway, and I’ve indicated that in Committee of the Whole. It may be that we would have to decide on whether we should have one authority or not, but that’s something that we have to have more discussions on and we have to work with the authorities and do consultation with the community-at-large.
We should be mindful of the fact that that is not necessarily a silver bullet. We are aware of other jurisdictions where they have collapsed the boards and done all kinds of things in that regard without necessarily saving, I think.
I know the Member keeps saying that this has been going on for 10 years, but I have to tell you that this is the first time where myself, as the Minister, and the department and the management is looking at this as a system-wide challenge that we have to address in a systematic way. We have consent and input from our chairs across the boards who are looking at it in the right direction. We have all the medical directors of all the authorities working as a group to come with the solutions, because when you’re talking about reforming and changing the way the physicians deliver their services in a system and in an effective and efficient way, we need to have the doctors on board. And I can tell you that that’s the first time that we have them on board.
There are lots of players at stake here in managing the health care. This is a very complex issue. Mr. Speaker, I disagree with the Member that we’re talking about the same old issue in the same way. We’re making lots of progress in many different ways. Thank you.
Mr. Speaker, the Minister is right; it might not be a silver bullet, but we have 42,000 people here in this Territory and we really have to ask ourselves whether we need eight authorities in the Northwest Territories to deliver health services to 42,000. Mr. Speaker, I want to ask the Minister, now she tends to downplay the issue with the deficits. Mr. Speaker, the information I have has an accumulated deficit, and she wants to call it system-wide. It’s system-wide of close to $19 million come March 31st of this year. Mr. Speaker, going to March 31st of 2012, that system-wide deficit is expected to grow to close to $36 million. That’s an alarming figure. It’s something the Minister has to address immediately. I’d like to ask her how she’s going to do that. Thank you.
Surely, I don’t believe at any time, as the Minister of Health, have I ever downplayed the deficit situation in our health care system. That’s what occupies my mind as the Minister and my fellow Members on Cabinet. This is something that’s in the forefront of all Health Ministers in all jurisdictions. The entire country and the world is under pressure to address our health care funding needs.
Mr. Speaker, I could tell you that in ’09 and ’10 our system deficit was $14.685 million. We project this year that the system deficit will be reduced by about $4 million to $5 million. That’s as a result of just relentless and just yeoman’s work that our managers at Stanton, and medical directors, and Beau-Del, and the chairs are working to see how we make system-wide change. The easiest thing for us, not easy but the short-sighted way would be to reduce services or just do an across-the-board 10 percent reduction or something. That’s not acceptable. We are changing the system and we are seeing results, and our forecast for this year is much less. I think people would agree that they have not seen any lessening of services, which is what they expect us to do. They expect us to change the system for the better, without affecting their services. Thank you.
Thank you, Ms. Lee. Your final supplementary, Mr. Ramsay.
Thank you, Mr. Speaker. I guess, being a Member of the Legislature, I’m entitled to an opinion, and in my opinion the Minister has done nothing to address the deficits at our health authorities across the Northwest Territories and if we go by the numbers that have been provided, we’re looking at a $36 million system-wide deficit come this time next year. The question I had to the Minister was what are we going to do about it. I’d like to ask the Minister, the final question that I have, Mr. Speaker, is in the transition into the next government -- we’ve got six and a half months here -- is governance of the health authorities and how we manage health care here in the Northwest Territories going to be front and centre on the transition plan to the next government? Thank you.
There’s one thing that hasn’t changed, which is that for the last 10 years, well, I guess, not 10 years, the last three years the Member asked me about problems with deficits and he always says the same thing, that nothing is changing, when a lot of things are changing. Mr. Speaker, I just want to say that, more specifically, the system deficit that we had last year was $14.685 million but we are expecting about $11 million system deficit for this year. That is a huge progress. I think credit should be given where credit is due, because our management is working very hard to make long-term changes and Foundation for Change action plan is one of them.
Mr. Speaker, as I indicated in Committee of the Whole when the Health budget was before the committee, we are moving the governance model, and one board for the entire system could very well be an option that we would have to discuss as a transition. Thank you.
Thank you, Ms. Lee. The honourable Member for Yellowknife Centre, Mr. Hawkins.