Mahsi, Mr. Speaker. I know that the Minister of Health is feeling a little bit under the weather today, so I've got some easy questions that I hope will make him feel a lot better. Mr. Speaker, my questions are about midwifery. The 2012 midwifery report recommended creation of midwifery positions in regional centres, including Yellowknife. Whether a regional or territorial model is pursued, positions should be staffed in Yellowknife. Will the Minister commit to bring forward funds in the 2017-18 business plan to staff positions for a midwifery program based in Yellowknife? Mahsi, Mr. Speaker.
Masi. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, our goal is to build this on the success of the existing midwifery programs, to enhance access to birthing services, both pre- and post-natal care, and begin work on the development of a territorial midwifery program. We are doing that work now. We have been able to hire two midwifery consultants, which proved incredibly difficult. We had some significant turnover in that area, which really delayed our ability to move forward with the midwifery review that I had indicated in the previous government. We have those consultants in place, they are going through and they're working on evaluation frameworks, one that's being done in Hay River. They're also working on a consultation schedule to go out and have some engagement with stakeholders, not to reinvestigate it, but to help us develop a territorial model. The report that the Member is referring to gave us a number of different models to explore; that was territorial, regional, and community-based. We have two community-based models. We have one regional model. Now we're looking at developing the territorial model. We're doing the work this Assembly, this fiscal year. I can't say for sure that we'll be in a position to come forward for financial submissions for the 2017-18 fiscal year. We will try, but I make no guarantees. There's a significant amount of work that needs to be done. We do have to compete against other priorities. In order for us to get money for this, we do have to look at where that money's going to come from, and look at other areas where we may have to make reductions in order to make this a possibility. Thank you, Mr. Speaker.
I appreciate the answer from the Minister and would like to try to help him try to find some money for that. Midwifery, because I've asked the Minister questions regarding cost savings, how they could be achieved by relying on community-based midwifery rather than pediatric care. His response was that boarding and travel costs have not been included in the analysis done to date. Boarding and travel costs seem to be some of the biggest costs for the current approach. Will the Minister consider these costs as part of the consultations to take place this year on expansion of midwifery services?
Thank you, Mr. Speaker. Mr. Speaker, all costs will be factored into our analysis. One thing that the Member does need to remember is that bringing in midwifery services does not actually help us or result in a reduced number of physicians that are available in the Northwest Territories. There are no cost savings with respect to midwifery services replacing physicians' services. Physicians are still a key component of birthing in the Northwest Territories even with our existing midwifery services that we are providing in different communities. It doesn't mean that births that are difficult, complicated, or that they think there's going to be challenges with still don't come into a regional centre. Many of the births that are being facilitated still happen in Yellowknife, even though a lot of the pre- and post-natal care is being provided. This does not mean that I don't support midwifery services. I've been involved in implementation of midwifery long before I was an MLA. I actually helped write the job descriptions, I helped on the implementation of the Hay River model. I believe in the service, but we've got to make sure it's costed properly, we need to have a territorial program design that's going to meet the needs, recognizing that people are still going to have to travel in and physicians are still a key part of the process. Midwives don't result in reduced numbers of physicians in the Northwest Territories.
In the area of midwifery services, Nunavut appears to be ahead of the Northwest Territories in meeting birthing service needs. Nunavut staffs midwives in the regional centres of Cambridge Bay, Rankin Inlet, and Iqaluit, which seems to be at least partly based on cost savings. Would the Minister agree that having an NWT midwifery program focused on regional centres, including Yellowknife, would likely result in some cost savings, or will he research the Nunavut model to investigate this?
Thank you, Mr. Speaker. Mr. Speaker, midwives provide both pre- and post-natal. Much of the birthing that's happening in Nunavut is still happening in other centres. For instance, many of the births that are coming out of Kitikmeot are actually happening here in Yellowknife. We need to look at the whole picture. We can't just look at little pieces and components of it. The pre- and post-natal portion of the services that the midwives are providing is amazing services and provides better results when we're actually looking at building stronger families and having healthier families and kids. I mean, we support the initiative; we're trying to find a way to make it happen. We have to build a territorial plan. We'll build it and we'll have to come forward to this House and seek some support and some financial support to make this a reality, but at the end of the day, midwifery services is going to have to compete against all the other priorities that are coming up in this House for additional money. This is housing. This is all these other types of things that are coming. We believe it has value and we'll bring forward the case at the appropriate time. Thank you, Mr. Speaker.
Masi. Oral questions. Member for Frame Lake.
Mahsi, Mr. Speaker, and I appreciate the response from the Minister. But we've been talking about this for almost 10 years now, and we only really have midwifery services available in two communities. Can the Minister commit that he will fast track these consultations that he's talking about this summer, to bring forward final recommendations and an implementation plan as soon as possible? Mahsi, Mr. Speaker.
Minister of Health and Social Services.
Mr. Speaker, I feel that although we did have some delays, now that we have our positions in place, finally we are able to get some qualified applicants to do the work. They are going at this as quickly as they can. This isn't their only job. They're also working on the evaluation frameworks that are being put in place in Hay River. If we're going to continue to roll out these programs, we must be evaluating the work that's being done; they're doing that important work. They're also working with physicians and the practitioners in Fort Smith, Hay River, and Inuvik, learning from what they're doing, and as I've already indicated, we're fully going to engage with stakeholders as we design this territorial model. The report gave us options for three different models, but it didn't actually describe what those models would look like or how they would be rolled out or how they would be funded. That work needs to be done. We need to build a business case; we need to do that in cooperation with the physicians and other stakeholders. It's going to take time. It is being done as quickly as it can. I can't guarantee we'll have something for the business plans next October, I believe it is, but we will do our best. Thank you, Mr. Speaker.
Masi. Oral questions. Member for Deh Cho.
