Thank you, Mr. Speaker. As I just stated, I have questions for the Minister of Health and Social Services about the lack of coverage for any mental health conditions when it comes to prescription drugs. I would like to ask the Minister, first off: what is the justification for offering prescription drug coverage under the Extended Health Benefits program for specified disease conditions? Thank you, Mr. Speaker.
Masi. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, drug coverage under the Extended Health Benefits program for specified disease conditions has evolved over time. With regard to mental health, which is the issue the Member is raising, the only reference within the GNWT Extended Health Benefits Policy to cover conditions is chronic psychosis. Within this broad category of chronic psychosis, there are a number of specified conditions that are open to interpretation and application to a number of specific conditions.
I would add, however, that this approach to extended health benefits is clearly dated, as eligibility for programs is based on a list of specified conditions rather than based on the clinical and/or financial need of the individual or family. Members may recall that there have been two previous attempts to review the approach to supplementary health benefits. Both were not successful. The last attempt was in 2010-2011, during the 16th Assembly.
I recognize, and the department recognizes, that there is a need to review and update the approach to supplemental health benefits, and it is in its initial stages of updating some inter-jurisdictional research to inform a review, with the intention of moving this project forward in 2018.
I bring up this program because there are no mental health conditions covered under that, and, while the territory is doing a lot to address mental health issues, it gives the impression that they do not take it seriously because there has always been a stigma attached with it, and it seems like they are just second class to physical conditions.
The Minister brought up some of the work that has been done. What work has been done when it comes to including mental health conditions in that specified disease and condition program? I am speaking in terms of: do they know how much it would cost? Because, if we know how much it would cost, there is no reason we cannot just, with the stroke of a pen, add those conditions to the list.
I would just like to provide a little bit of clarification. There might be a slight misunderstanding. The broad category of chronic psychosis does provide for coverage of a variety of mental health conditions. Those are based on advice from referring clinicians. Individuals need to consult with their referring clinician to determine whether their condition is in fact covered by the extended benefit under the chronic psychosis category.
I believe that most patients in the Northwest Territories are getting the care they need. However, it is clear that we need to update the policy and associated guidelines to ensure that they are focused on patients' needs and support the clinicians in the work that they do. I would also suggest to the Member and all Members that, if you are aware of someone in real need who is not being served by the system, I would encourage them to reach out to their local healthcare providers or even our system navigator to explore the opportunities for exceptions that the system can put in place where there is hardship.
As an MLA, I am the person who a lot of these people reach out to. I have never heard about these exceptions, and the people who come to me have never heard from their physicians about these exceptions, so what is being done to inform physicians, let alone the general public, that this coverage could be extended to them?
The department does work with the medical association and others to try to get that information out there. I will have a conversation with the department to make sure that they are working with our practitioners across the Northwest Territories. It does not cover every condition, but it does cover a lot of conditions. Where it is not covered, as I said, I would encourage the Member and all Members to have these people get in touch with system navigators or come to them, and the Members can come to us and we can explore opportunities.
Masi. Oral questions. Member for Hay River North.
Thank you, Mr. Speaker. I bring this up because people get swept under the rug because, like I said, most people have coverage, and so this approach of looking at a case-by-case basis does not seem like the best way to do things. When can we expect this review to be done and hopefully some specific conditions added to this list to help those who are in need of prescription medication for their mental health conditions but cannot afford it?
I would just like to confirm once again that the broad category of chronic psychosis provides for coverage of a variety of mental health conditions, so a number of them are covered. People need to make sure that they are working with their practitioners to get that information out. A full review of the supplemental health programs will take over a year as it will involve significant cross-jurisdictional review, analysis, and consultation. Once again, we are doing that work now. We will certainly keep the Member and committee updated as we move forward.
However, if the Member is aware where people are experiencing hardship, I would encourage them to deal with their practitioners or go through their MLAs to explore opportunities for exceptions. Thank you, Mr. Speaker.
Masi. Oral questions. Member for Nahendeh.
