Tuesday, March 30, 1999 - 1:30 p.m.
Speaker: I will now call the House to order. We will proceed at this time with prayers.
Speaker: We will proceed at this time with the Order Paper.
Are there any tributes?
Introduction of visitors.
INTRODUCTION OF VISITORS
Hon. Mr. Keenan: Mr. Speaker, it does give me great pleasure indeed to be able to announce the presence in the gallery of Mr. Johannes Finke and entourage. They are employees of Kanusa, one of the largest wholesalers in Germany, and are here to look at the Yukon and to experience the feelings of the Yukon throughout the territory this spring on a fam tour.
So, I'd like everybody to join me in welcoming them to the Yukon Territory.
Speaker: Are there any returns or documents for tabling?
TABLING RETURNS AND DOCUMENTS
Hon. Mr. Harding: I have for tabling the issues paper on the task force review of the Yukon Workers' Compensation Act, phase 1, for the spring of 1999, and an annual report.
Speaker: Are there any reports of committees?
Are there any bills to be introduced?
Are there any notices of motion?
Are there any statements by ministers?
This then brings us to Question Period.
Question re: DEWline site cleanup, Yukon hire
Mr. Ostashek: Mr. Speaker, my question is for the Government Leader.
During the last election, the NDP made much of the issue of Yukon hire, threatening even to go to the Supreme Court of Canada and challenge the Charter to ensure Yukon hire. Mr. Speaker, that was then and this is now. It has come to our attention that, last week, the Department of National Defence is considering sole-sourcing an $11 million contract to a Northwest Territories company - Inuvialuit Projects Incorporated - to clean up the DEWline site at Komakuk beach in northern Yukon.
Mr. Speaker, the reason the federal Liberals give to justify this $11-million gift to non-residents to work in the Yukon is that the Northwest Territories company is the only firm in the region that could meet the requirements of the contract. This is despite the fact that the Yukon has several world-class companies, which could easily do the work.
My question to the Government Leader: is he aware of this latest Liberal insult? What does he plan to do about it?
Hon. Mr. Harding: I want to say to the member opposite that, first of all, this government is extremely proud of the work that was done by so many Yukoners, led by the Member for Whitehorse Centre, in terms of improving local hire in the Yukon and raising the total value of business contracts, from 59 percent under his administration, some 30 percent as a result of the policies of this government.
Some Hon. Member: Point of order, Mr. Speaker.
Point of order
Speaker: The hon. Member for Riverdale North, on a point of order.
Mr. Phillips: Point of order, Mr. Speaker. It's been clear. The Minister of Government Services has already rose in the House and said that he questions those very figures that the minister has been giving in the House. Mr. Speaker, he can't keep repeating the figures that are inaccurate.
Speaker: Order please. There is no point of order. The member can continue.
Hon. Mr. Harding: You can always tell when you're getting to the members opposite. The truth hurts.
Mr. Speaker, I want to tell the member opposite that we are already acting on this particular issue. We are engaging in discussions with the Vuntut Gwitchin. We do have some concerns. We believe that there are a number of Yukoners that should have the opportunity to participate in this particular venture. We don't believe that the federal Liberal government should be acting in this way. We think there is potential for work for some people of the Northwest Territories, but this particular project does indeed affect the Yukon Territory, and we believe that there -
Speaker: The minister's time has expired.
Mr. Ostashek: Well, Mr. Speaker, I'm very concerned by the minister's answer. What's he doing talking about Vuntut Gwitchin? It's the Department of National Defence that's issuing this contract - $11 million for work in the Yukon when our own contractors are sitting idly by.
Mr. Speaker, we have researched the Inuvialuit final agreement, and we cannot find anything that justifies the sole-sourcing of such a huge contract and not even allowing Yukon companies to bid on this job.
This is totally unacceptable, and once again the Liberal members in this House should hang their heads in shame as to what their colleagues in Ottawa are doing to the Yukon.
I would ask the minister: why hasn't he contacted the Prime Minister or the minister responsible for National Defence on this very important issue to Yukon contractors?
Hon. Mr. Harding: Well, the member opposite, I don't know - he must be faking his disdain here, because he can't possibly, given my last answer, be so upset. I told him we are working with Yukoners; we are dealing with Vuntut Gwitchin. We're also, Mr. Speaker, engaged in discussions, and will be engaging at very high levels, with the federal government on this particular issue.
I met with officials on this matter yesterday. We do think it is a concern. We are very upset about what seems to be the plans of the federal Liberal government. We don't support it, and the member opposite shouldn't say that our contractors are sitting idly by. There's significant capital construction work this year. This opportunity presents one more, and we're going to pursue it on behalf of Yukoners.
Mr. Ostashek: Well, Mr. Speaker, it's no thanks to this NDP government if they're not sitting idly by. They certainly aren't doing anything to put them to work.
Mr. Speaker, the minister hasn't even had the courtesy to reply to the person who raised this issue with him last week - or he hadn't yet at 10:30 this morning. Our office was in touch with Ottawa and asked what was going on and we found out that the contract has not yet been awarded but they are seriously considering it. They have until April 14 to put in official protests from individuals and other groups who don't believe this is right.
I want to ask the minister now: will he write a strongly worded letter to the people in Ottawa who award contracts, protesting these actions and asking that our contractors be considered?
Hon. Mr. Harding: Well, Mr. Speaker, I've told the member opposite we're acting on it. Nobody has raised the issue with me directly. I was briefed on it yesterday by my officials. Immediately, we said we had to develop an action plan. We knew we had a couple of weeks - which was a short time - to deal with this particular issue but we know that we have to correspond to high levels of the federal government, but we want to get all of the facts and act responsibly and thoughtfully to get the message out that we want to stand up in response to what we believe is a serious issue for Yukoners. We want to ensure that Yukoners get an opportunity for work in this area. We also want to ensure that the people whose traditional area might be affected are informed of what the federal government is considering here. I think that's a thoughtful, responsible way to approach this particular issue.
We do have a narrow window here, but it does give us a little bit of time to make sure that we take appropriate action in dealing with the federal government on this serious matter.
Question re: Workers' Compensation Health and Safety Board operational review
Mr. Jenkins: Mr. Speaker, I have a question for the minister responsible for the Yukon Workers' Compensation Health and Safety Board.
Mr. Speaker, this minister has politically interfered in the Workers' Compensation Health and Safety Board from his first day in office. He dismissed the independent chair and put in his own man. He put the Gladish inquiry report on the shelf to gather dust and then attempted to do a selective review of the act while denying the Injured Workers Alliance any meaningful input into the review process.
Today the minister has announced yet another review process, this time a legislative one, but the limited scope of the review appears not to have changed.
Will the minister cease and desist with his political meddling in the review process and now allow a full and complete comprehensive review of the Workers' Compensation Act as required in that act?
Will the minister do that, Mr. Speaker?
Hon. Mr. Harding: That preamble was so full of hollow, empty vessels of accusation that I don't even know where to begin.
First of all, the member opposite can provide absolutely nothing to substantiate what he says. The role of politicians and the minister in the Workers' Compensation Health and Safety Board is not to participate in the adjudication of claims. It's to stay out of that, which I've done. That's why we created the position of the workers' advocate.
Secondly, Mr. Speaker, it is the role of the minister to lead a legislative review in consultation with the stakeholders of the Workers' Compensation Act. That is what I have done.
When selecting the chair of the Workers' Compensation Health and Safety Board, there were so many complaints about the Yukon Party's selection process that we engaged in a process that came up with a mutually agreed upon - between workers and employers - neutral chair.
Nothing of the sort of illusions that the member opposite has just espoused ever occurred by this minister.
Mr. Speaker, the scope of the review is actually quite extensive. There are three broad, major areas, with a number of sub-issues to them, and I think if we work together with the stakeholders we will do good things on behalf of the workers' compensation system in terms of improving it.
Mr. Jenkins: Can the minister confirm the fact that he's received an ultimatum from the advisory group warning him that the current review is too narrowly focused and is being fast-tracked by the minister, to the detriment of treating injured workers fairly and expeditiously? Will the minister confirm that fact?
Hon. Mr. Harding: Mr. Speaker, I don't know exactly what the member is talking about with regard to ultimatums. We have engaged in meetings with stakeholders on these issues. It was actually workers and employers who decided on the timeline for a fall 1999 review, and at the last meeting that I held with a number of the stakeholders, they felt that if we kept within some of the parameters of the review, we could accomplish it by the fall 1999 deadline. I didn't have anyone say that they wanted to wait until the fall of 2000 to complete this review.
Mr. Jenkins: Well, Mr. Speaker, this minister's constant political meddling is undermining the entire review process. The act calls for a full and comprehensive review. What the minister is doing is just narrowly focusing on a few issues, which the minister said he was advancing as a review of obvious problems with the act. He's not. He's just concentrating on a few areas.
My question to the minister: will the minister now stop his political meddling and allow a full review to be done and include the workers' advocate on the review committee? Will the minister do that?
Hon. Mr. Harding: Well, Mr. Speaker, first of all, the workers' advocate has been engaged in the review process. I was just speaking to him a couple of days ago. Second of all, there are some 18 issues that are going to be the subject of this review that I just tabled in this House - hardly, Mr. Speaker, a narrow review - dealing with substantive issues on behalf of workers and employers surrounding things that have been raised with me constantly - accountability of the board to the stakeholders, issues surrounding the appeal process.
And under that particular heading, there are over nine issues that are going to be the subject of a lot of debate among the stakeholders as we try to improve this Workers' Compensation Act.
Another substantive issue is the whole relationship of the board to the administration, how they deal with stakeholders.
These are all big-ticket items in terms of how we're going to approach workers' compensation in this territory and improve the system for workers and employers so that they feel that they are more part of it.
There is a tight timeline, but we are going to stick to it. The stakeholders have said that they'd like the act review in the fall of 1999. We're committed to trying to do that with them, and we intend to work very, very closely and very diligently to try to meet that and improve the system for workers and employers in this territory.
Question re: Wood pellet industry study
Mr. Cable: I have some questions for the same minister about his press release yesterday on the public/private partnerships. The minister did this press release yesterday on what he called a public/private partnership agreement with a British Columbia company to look at Yukon's wood pellet industry. The minister's press release talked about the shared-cost feasibility study, but the press release of the B.C. company, Autumn Industries, went a lot further. Their press release says, "If the Yukon concurs with the feasibility studies, Autumn has the opportunity to design, develop, construct and operate the projects."
The question I have for the minister is, what sort of commitments have been made to this B.C. company, Autumn Industries, for the supply and operation of this wood pellet machinery and combustion machinery?
Hon. Mr. Harding: Well, I don't think that the member should get ahead of himself. This is another initiative by this government to try and take advantage of a couple of things: first, the fact that we've had a substantial fire kill of our timber resources in the last year and, second, devolution, which affords us an opportunity that we've never had before to, in a very quick way, economically pursue creating jobs in this particular industry. There has also been a lot of technological advances about the creation of what's considered to be fairly cheap, green power. This particular company has a good strategic alliance with companies in Sweden and England that already provide this type of service, on a very economic basis, to communities in Europe. So, that's the reason for this feasibility study.
With regard to the opportunity that the company references, they will have an opportunity, we would hope, for joint ventures with existing people in this business in the Yukon to try and pursue this further, if it makes sense economically.
Mr. Cable: The minister talked, in his press release, about a public/private partnership. He wasn't talking about a partnership between Autumn Industries and some local suppliers.
Now, there has to be a number of wood machinery suppliers around North America, both for pelletizing, and for burning - combustion.
Why was this arrangement set up as a sole-source arrangement? Why wasn't the partnership put out to the market for proposal calls, or for tender calls?
Hon. Mr. Harding: Well, Mr. Speaker, because this particular company has significant, proven connections with companies that are already in the business of providing to communities the same size as Whitehorse, and experiencing the similar climate conditions that we have in the Yukon.
They have strategic alliances, technologically, that give them significant advantages, and experience, to try and ensure that they can provide a feasibility study, and a real hard look at this particular initiative.
We also have some time constraints, because we would like to ensure that we can get this particular project - if we can see it add up - moving so that we can create some jobs for Yukoners, and a power source to provide some cheaper, green power.
This particular company will have an opportunity, as will others. We would hope to foster some strategic alliances with other companies that are presently looking at this particular business in the Yukon in the future.
Mr. Cable: Let me break tradition here, and give the minister a compliment. The minister has to be a slick negotiator. He's got Autumn Industries to cost share the feasibility study - in essence to buy part of the accounts payable, without any solid prospects.
Is the minister saying that Autumn Industries is in this deal on speculation, and the government can still put out the district heating deal for proposal calls?
Hon. Mr. Harding: Mr. Speaker, there is that potential. Absolutely. The member opposite should know that this government has been very aggressive in terms of new and innovative ideas.
In the budget alone, there were over 50 new initiatives; many focused on creating jobs and new economic activities.
We recognize that we can't sit back; we've got to get out there and hustle and ensure that we take every opportunity to try and ensure that, if there is a feasible way to create economic activity, we do it. This particular company approached us with their ideas, with their knowledge, with their experience, with their connections with major international companies that have experience in this particular field. They also approached us because they are well-capitalized and they have their own money.
We would like, based on the feasibility study, to try and create, as the press release we put out said, some synergies with people in the Yukon in business who are already interested in utilizing fire-killed, residual wood or, Mr. Speaker, who are also in the pellet business.
Question re: Wood pellet industry study
Mr. Cable: I want to question the same minister on the same topic.
The minister's department has a couple of dozen reports on wood, some relating to pellets, and it has produced a 19-page pamphlet on wood energy. One just has to go to the Internet to find all this experience that's outlined in the minister's department - and there are a number of policy and energy people in that department. We have a wood-pellet plant in Teslin and we have some experience with district heating. Why couldn't the study have been done internally? Why could it have not been done by the Development Corporation, for example, or by the minister's own department, Economic Development?
Hon. Mr. Harding: Well, I've already answered this question, Mr. Speaker. There are some significant opportunities as a result of devolution and the fact that we had such a big fire kill last year. There is also the synergy with this particular company that they are well-capitalized, they have their own money and they have a significant level of availability to capital.
Secondly, they have a very important strategic alliance, which, unfortunately, our local companies don't have right now with companies like Hotab in Sweden that do provide this type of service to communities in Europe of similar size to this particular community with climates like the Yukon's.
This company, Mr. Speaker, I think will be able, given some good, solid economics around this and some of the opportunities devolution presents, to have an opportunity to bid to move this project forward on a specific basis. The study will look at specific opportunities that are very tangible and hopefully create some opportunities in alliance with Yukon companies. That's certainly what we'd like to see because the member is right: there are already some people engaged in this business in the Yukon.
Mr. Cable: There is also any number of people engaged in that business across North America and in the rest of Canada. Now, there must have been some sort of prospects held out to this company, or they wouldn't have said in their press release: "If the Yukon concurs with the feasibility studies, Autumn has the opportunity to design, develop, construct and operate the project." What sorts of commitments have been made to this company?
Hon. Mr. Harding: Mr. Speaker, the member opposite is correct. They will have the opportunity. So will others. They have an opportunity to bid. In terms of commitments, none.
This is a feasibility study. This particular company has a very broad international strategic alliance with companies with extensive know-how, and they're also well-capitalized. That's the level of the commitment.
Mr. Speaker, there is a familiar pattern here emerging in this Legislature, and that is that the Government of the Yukon, in their determination to try and create economic opportunity, moves forward, comes up with ideas, takes risks. The opposition says on a daily basis that we're not doing anything, and then when we do do something, they criticize it.
Mr. Cable: Well, what we're criticizing is the fact that the minister is not laying out what this deal really is. It's not a public/private partnership at all if, in fact, there is no prospect for them to earn profits.
Will the minister put the contract on the table, and will he tell us how much each of these so-called partners have committed to invest in the feasibility study?
Hon. Mr. Harding: Well, Mr. Speaker, the member opposite is wrong. This is a public/private sector partnership. I don't know what he's talking about. I guess his idea of private/public sector partnerships is one where the government pays the whole shot. What we're trying to do in this case is try and improve the utilization of residual wood. It's to get a better use of the fibre to create jobs and economic opportunities. We're utilizing the services of a company - for a study - which is well-capitalized, has international experience and connections that, unfortunately, we don't have here locally. If it's successful, we intend to ensure that there is a fair process, that people are invited to come into the process to form strategic alliances to try and deliver on this.
There are some exciting things happening in this field. On the Queen Charlotte Islands, just recently, there is a six-megawatt electrical-generating pellet plant initiated and started, and it is looking very economically feasible. This is an important development that we as a territory cannot ignore, and we want to make sure a good solid look is taken at it.
Question re: Shipyards residents, relocation to Hot Springs Road area
Mr. Jenkins: Mr. Speaker, I have a question today for the Minister of Community and Transportation Services. Yesterday, the minister admitted in this House that the Shipyards squatters were being given a preference for country residential and agricultural land. Today, I would like to explore with this minister how far he is prepared to bend the rules in relation to squatters receiving agricultural land, such as is the case with this relocation to the Hot Springs Road area.
The application process for agricultural land normally takes from 12 to 24 months and requires the applicant to submit an acceptable farm development plan within 30 to 60 days, describing the intended use of the land. Further preliminary reviews of the application must be done by the agriculture branch of Renewable Resources, as well as the lands branch of C&TS and other government review agencies.
My question for the minister: has this process been followed in relation to the agricultural application on kilometre 5 of the Hot Springs Road, or has the process been circumvented?
Hon. Mr. Keenan: Yes, Mr. Speaker, the land that is in question is certainly going to be conformed to. It has been zoned for agricultural leases, and the would-be occupants - the residents of the waterfront - are going to adhere to that process.
Mr. Jenkins: Well, agricultural land is released under an agreement for sale, which requires the applicant to develop the property. The minimum work to be completed is calculated as being twice the difference between the market value of the land and the Yukon government's estimated development costs. Only if the applicant meets all of these obligations of the agreement for sale - and at the end of a five-year period - can the title be issued. Is the kilometre 5 Hot Springs Road application subject to the same provisions and, if so, where is the applicant receiving the funding to develop this agricultural land?
Hon. Mr. Keenan: I've already answered the question once today. I will continue to answer it for the rest of the week, obviously, until the member stops and takes the time to listen.
The land - and I'm glad that he agrees now - is agricultural land. It has been zoned agricultural land through due process, with and on behalf of the community. The waterfront residents who are going to be occupying the land are going to conform to the agricultural zoning. That is exactly what they're going to do. It is a condition.
If the member opposite is asking me if they're going to have to submit a plan, I can say at this point in time, categorically, no, they are not going to have to submit a plan but, yes, they are going to have to live up to the zoning regulations.
Mr. Jenkins: Everyone else who applies for agricultural land has to submit a plan and go through due process. Currently, there are 131 agricultural applications in process, 61 under active consideration, 44 are on hold, and 26 are awaiting land transfers to the Yukon government.
Can the minister explain why the Shipyards squatters are being given preference over these 131 Yukoners who have followed due process? Why do the squatters get preference and don't have to follow the process set out?
Hon. Mr. Keenan: Mr. Speaker, they are going to live up to the zoning regulation. That is a part of the condition.
What the Member for Klondike would very much like to see and what he's neglecting to answer is that the member would like to see them evicted from the waterfront lands but, in total eviction, would like to create homeless people in the streets and add to that. That is exactly what the Member for Klondike is promoting.
What we are saying and are not doing is that we are working in conjunction with the people of the territory, specifically the waterfront residents, to find them suitable occupation as willing partners, and they are doing that very willingly and working with us, as a government, to continue the good economic development drive that this government has.
Question re: Family Violence Prevention Act regulations
Mrs. Edelman: Mr. Speaker, my question is for the Minister of Justice.
When the 1997 Family Violence Prevention Act was brought in, the minister was clear that the regulations to go with the act would be done within a year. Well, it's now 18 months down the line and there are still no regulations in sight.
Instead, what we do have is the minister talking about the act all across the country. She spoke about what great work had been done at the Alberta summit on justice in January of this year, for example.
Mr. Speaker, without the regulations in place, the act doesn't do a thing for Yukon women in danger. It is my understanding that January 2000 is now being talked about as a new deadline for regulations - well over two years after the act was introduced.
Can the minister confirm the new date?
Hon. Ms. Moorcroft: Well, Mr. Speaker, sometimes with the member opposite, we're not sure whether she supports an initiative or she doesn't. At one time she was standing in the House and supporting the Family Violence Prevention Act, then became very critical of it, and now is in support of it again.
The community is involved in bringing forward any new legislative initiatives, such as, in this case, the Family Violence Prevention Act.
We have an implementation committee that includes the transition home, that includes other people in the community, and we have been holding meetings around the territory, about the Family Violence Prevention Act, and working toward implementation.
I have said we will implement that act when we are ready to, and the work is being done to get ready for implementation.
Mrs. Edelman: Mr. Speaker, can the minister confirm the new date?
Hon. Ms. Moorcroft: Mr. Speaker, what I can confirm is that we've had discussions in the communities about what is required in order to implement the Family Violence Prevention Act.
It calls for a justice of the peace, who can issue emergency intervention orders. It allows a woman who may be in danger to apply for an intervention order to stay in her home.
The justices of the peace need to be designated and trained. We have sent letters seeking people who are interested in that work. We have agreed that we will not implement the act until we're fully ready to do that. The consultations have just concluded, and we're continuing to work to designate people who can serve as justices of the peace.
Mrs. Edelman: Mr. Speaker, this is painful. All I'm asking is if she can confirm the new date. On the workplan that she has just outlined, that is the only possible date that we could be talking about. That's two years down the line - one year late.
Now, Mr. Speaker, a victim of domestic violence can have an abusive person removed from their home by a police officer, using the emergency intervention order under the new act.
Now, of course, some Yukon communities do not have RCMP detachments. We could then end up with an abuser being removed, dropped at the property line, and then the RCMP going back to the town that they came from.
This won't help the safety of the victim. I've raised this issue as a problem on a number of occasions, just as recently as last year, and certainly when the bill was being passed. We are 18 months down the road, and I understand we're no closer to resolving the issue. Why is resolving these issues and getting these regulations done not a priority for the government?
Hon. Ms. Moorcroft: Mr. Speaker, resolving those issues is the priority for the government. That's why we're working to resolve those issues before we implement the act. We have had people in the communities talking to the RCMP, to community members; we've had involvement of First Nations and women's groups to set in place the training that we need and the systems that we need to implement that act before it comes into effect. We'll continue working to do that and when we're ready and the training has been done and the justices of the peace have been designated, the act can be implemented.
Speaker: The time for Question Period has now elapsed.
Notice of government private members' business
Hon. Mr. Harding: Pursuant to Standing Order 14.2(7), I would like to identify the items standing in the name of the government private members to be called on Wednesday, March 31, 1999. They are Motion No. 162, standing in the name of the Member for Watson Lake, Motion No. 163, standing in the name of the Member for Kluane, and Motion No. 164, standing in the name of the Member for Lake Laberge.
Speaker: We will now proceed to Orders of the Day.
ORDERS OF THE DAY
Hon. Mr. Harding: I move that the Speaker now leave the Chair and the House resolve into Committee of the Whole.
Speaker: It has been moved by the government House leader that the Speaker do now leave the Chair and the House resolve into Committee of the Whole.
Motion agreed to
Speaker leaves the Chair
COMMITTEE OF THE WHOLE
Deputy Chair: I will now call Committee of the Whole to order. Is it the wish of the members to take a recess?
Some Hon. Members: Agreed.
Deputy Chair: We will take a 15-minute recess.
Deputy Chair: I will now call Committee back to order.
Committee will be dealing with Bill No. 14, First Appropriation Act, 1999-2000. Is there any further general debate?
Bill No. 14 - First Appropriation Act, 1999-2000 - continued
Department of Health and Social Services - continued
Hon. Mr. Sloan: I have some information for members that perhaps I could just read into the record. I'll begin with some questions.
The Member for Klondike asked some questions on Quebec rural reimbursement programs. We've been able to get some information in that regard, and I'll just provide it for the member right now.
Quebec is currently in negotiations. The following information is based on the agreement that ended March 31, 1998. There are a number of complexities and variations in Quebec's reimbursement process, so most provinces don't use Quebec's fee schedule and practices for comparative purposes.
Historically, Quebec physicians have been among the lower-paid physicians. The national weighted index for all physician services shows Quebec as having the lowest fee-for-service rate in Canada. Though this index is not current, having last been completed for the 1993-94 fiscal year, since that time, Quebec physicians have only received one increase, of 2.8 percent.
Quebec currently has a hard cap on total physician expenditures, combined with a ceiling on individual earnings. Quebec has four community categories: the university, urban, remote and isolated. Isolated regions include James Bay and Īles-de-la-Madelaine. Each of these categories receives differing reimbursement grades for schedules for services provided. Since there is also different reimbursement in agreements with specialists and general practitioners, I'll focus only on reimbursement for general practitioners, and I will focus on the remote areas and isolated areas.
In remote areas, physicians in private practice are paid 70 percent of fees for the first three years and 100 percent thereafter, with a 75-percent reduction in prevailing fees in excess of a trimester ceiling of $48,575. Salaried and contracted physicians provide most of the hospital emergency coverage.
Salaried physicians receive $76,000 for 35 hours per week of clinical time. This rate is halved for on-call time. Translated to an hourly rate, the physician would be paid $42 an hour for clinical time and $21 per hour for on-call time.
The position also receives a fee for any services provided while on call, based on the prevailing fee schedule.
Contracted physicians are paid $60 per hour for each hour of clinical time with no fee for services rendered being provided. The rate is half for on-call time, and is discounted for an estimated "social" time to reduce the rate to the same that is paid to salaried positions, of $21 per hour. The physician also receives a fee for any services provided while on call, based on the prevailing fee schedule.
The following earnings provided to general practitioners in remote regions are not included in the trimester ceiling calculations. For fee-for-service GPs, a $10,000 settling-in premium in each of the first four years, with a $5,000 annual retention premium for each of the next or following four years.
Salaried GPs get a $5,000 settling-in premium in each of the first four years, with a $12,500 annual retention premium for each of the following four years.
Fees for medical services are provided in the front-line emergency department on Saturday, Sunday or statutory holidays. Our fees for any medical services are provided in the front-line emergency department on Saturday, Sunday or statutory holidays or between 10:00 p.m. and 8:00 a.m. any day.
Physicians in isolated areas are either salaried or contracted. Physicians in isolated regions receive a 15-percent premium. Salaries are $76,583 plus 15 percent for 35 hours per week of clinical time. The rate is halved for on-call time.
Translated to an hourly rate, the physician would be paid $48.30 per hour for clinical time and $24.15 per hour for on-call time.
The physician also receives a fee for services provided while on call, based on the prevailing fee schedule plus 15 percent.
Contracted physicians are paid $60 an hour plus 15 percent - $69 - for each hour of clinical time, with no fees for services rendered being provided. The rate is halved for on-call time, and is discounted for an estimated social time, to reduce the rate to the same as is paid to salaried physicians - $21 an hour, plus 15 percent, for $24.15.
The physician also receives a fee for any service provided while on call, based on the prevailing schedule plus 15 percent.
Salaried GPs - $25,000 settling-in premium; the first four years, $12,500 annual retention premium for each of the next four years.
With respect to some questions raised by the Member for Riverdale South on the dental profession and the Optometrists Act, as I indicated, this was in the purview of Justice so I had to get the information from Justice on that.
Amendments to the Dental Profession Act and the Optometrists Act were made in the fall of 1998 session. The Dental Profession Act changes were to establish a registrar under the act to do the duties now assigned to the minister, amend the qualifications for licensing, revoke the ability to issue special permits and allow the registrar to conduct inquiries into complaints, to allow the recovery of inquiry costs from dentists and to revoke the exemption for dentists employed by the federal government and increase fees and penalties under the act.
The Member for Riverdale South questioned whether there should be a recognition of denturists and whether there should be a requirement for continuing education and Ms. Moorcroft responded to these questions in Committee of the Whole.
Regulations under the Dental Profession Act have been prepared and are being translated. The staff at Justice advise that the proposed regulations establish a requirement for continuing education hours and set minimum practice hours to renew licences.
The Optometrists Act amendments made in the fall of 1998 were to expand the scope of practice to allow optometrists to prescribe and administer therapeutic and pharmaceutical agents, TPAs to treat common and abnormal conditions of the eye and remove foreign objects from the body of the eye, to strengthen educational qualifications and to require mandatory continuing education for licence renewal. Consequential amendments to the Pharmacists Act allowed pharmacists to accept and dispense medication for prescriptions written by optometrists.
Regulations have now been prepared that establish practice guidelines, specific qualifications needed to use TPAs, and drug categories that can be prescribed and administered by optometrists.
With respect to a question from the Member for Riverdale South - I was merely pausing for dramatic effect - on the Sarah Steele Building, in the year to date, April 1998 to February 1999, the total admissions to all programs was 3,021, broken out as follows: 149 pretreatment program, 84 intensive out-patient, 1,251 shelter, 1,537 detox. Total beds available are 38 - 10 are intensive outpatient, 10 detox and 18 shelter. The staff ratios in detox are one to five; in the shelter, one to eight; pretreatment, one to eight; and intensive outpatient, one to five.
With respect to some questions on tobacco reduction activities, activities completed - trained environmental health officers in enforcement of federal legislation currently negotiating with the health protection branch, Health Canada, on funding for territorial officers to enforce the federal legislation. I think I'd indicated that we were already engaged in this.
We funded a school tobacco educator as part of the program with Yukon College this year, and participated with other provinces in developing the national tobacco reduction strategy. We reviewed the educational curriculum and legislation from other jurisdictions - I made reference to the B.C. anti-smoking material that we have received from B.C. and are considering for use up here in our schools. We've also had some activity on the idea of litigation with British Columbia in its class action against the tobacco companies. However, it appears that the situation in that regard is likely not to materialize because of some legal impediments that B.C. has in us participating.
Currently, we are involved with the Northwest Territories and Nunavut on developing a comprehensive northern approach for tobacco control. We are currently developing legislation for internal discussion regarding sales to minors. This is being done in collaboration with the Canadian Cancer Society. They have an individual who is quite accomplished in developing such legislation, and we have been working with the Canadian Cancer Society in that regard.
The proposed draft legislation would make it illegal to sell tobacco products to people younger than 19 years of age. It would set out the criteria for establishing proof of age by the vendor; allowing for vendors to request proof of age when selling tobacco products; requiring tobacco vendors to have a tobacco-vending licence; prescribe reasonable penalties including temporary/permanent revocation of tobacco-vending licences against vendors in breach of legislation; requiring sign, at point of sale, with legislation message requiring sign at point of sale with a health message. We're looking at getting a draft of this that we can then take a look at internally to bring forward on a future legislative calendar.
We have been hiring a youth health promotion coordinator who will focus mainly on tobacco issues, including social marketing, education of public merchants on tobacco legislation. The interviews are scheduled for April 7 to 9.
We are providing consultative services to community groups, such as the substance misuse coalition, Yukon educational theatre, design evaluation and programming. We have also been working with the Department of Education to develop tobacco prevention programming for Yukon public school students. Of course, the health promotion unit will help public schools with their programming if requested, but we are looking at this as coming from the schools as well. We're very cognizant about the idea of not putting yet more responsibilities on schools. We don't want to add yet further.
I have the breakout - it's a very preliminary breakout - the member asked about on what we're looking at in terms of the configuration of beds in the proposed continuing care facility. What we're currently looking at right now are probably two units of special care, each holding 12 beds, for 24. We would look at another unit of 24 beds that would be approximately level 3 or level 4. Level 4 is special care and level 3 is 24. We are looking at 18 young adults and 6 children, at this point. That is very preliminary. It is the general figures that we're working with - 72 in the level 3 and 24 with young adults and children.
There is level 3 and 4. Special care would be level 4. There will be 48 when the entire facility is completed. I am advised that they could be a combination of levels 3 and 4.
What else do I have here that would add to your life? There's a big chart here. I don't think so. That is the current information that I have.
Mrs. Edelman: Mr. Deputy Chair, I wonder if the minister could review the Blues from today and also give further information on the otherwise very detailed information that the minister has already given. In particular, what is our backup in the translation - the Dental Profession Act is being translated, and that's what the delay is right now. Are we talking about a three- or four-month wait or are we talking about a couple of days?
Also, the minister gave us very detailed information on the staff-to-patient ratio at the alcohol and drug treatment program at Sarah Steele, but the information that I actually asked for was only for the months of July and August, 1998. I wonder if we could get that information, in particular, although I appreciate the greater information as well.
Now, it's my understanding, Mr. Chair, that the chronic disease self-management program, which is running very well here in the Yukon, may be facing some cuts in this year's budget. Is that the minister's information as well?
Hon. Mr. Sloan: No, Mr. Chair, we're not planning any cuts or any withdrawal in any manner from that. Of course, the idea behind the chronic disease program is that it is the payer of last resort, you know. If individuals have other sources of funding - for example, if they have private insurance through the government, and things like that. But no, there are no planned cuts or any planned pull-backs on that at all.
The projected cost for 1998-99 was $898,000, so there's no anticipated cut.
Mrs. Edelman: Mr. Chair, there was some discussion earlier in this year - and I wonder if the minister can update us now - about the health centre at Beaver Creek moving into the former Forestry building.
Now, Forestry has finally moved out of Beaver Creek. Are we moving the health centre into that building?
Hon. Mr. Sloan: This has been something that we have been scouting out, in more ways than one. Actually, we've been very interested in that building for a long time, and we're currently trying to negotiate an arrangement with the federal government on taking it over prior to devolution. Presumably, in devolution the building would come to us.
There had been a delay for a period of time because it was our understanding that the White River First Nation was making a bid on the building - as part of their claim, or something like that - but subsequently, that has not materialized.
But, premised on that, I had discussed with the previous Chief of the White River First Nation, Margaret Nieman, our interest. If the building had gone to the White River First Nation, we were prepared, at that point, to look at working out some kind of an arrangement because the building is ideal. However, we've subsequently learned that the White River First Nation did not make a bid for the building and have instead moved ourselves and we're currently discussing with our federal counterparts getting the building as soon as we can. We'd like to be able to do the renovations and make that into a nursing station as soon as possible.
It's an ideal building. It's large. It's right on the highway, which is something we desperately want. It has bays that could be used for the ambulance where you could actually bring someone into the nursing station, and we have coveted that for awhile and we're now moving to make it happen and, of course, we'd like to do it sooner than later. We're interested in doing it in advance of devolution.
Mrs. Edelman: Mr. Chair, the current location of the health centre is in a converted home that is owned by the local First Nation, and it's located right in the centre of a considerable amount of First Nation housing. Is that building going to revert to the White River First Nation?
Hon. Mr. Sloan: Well, we haven't really proceeded, I guess, too much more on that because we have been focusing on getting the building in Beaver Creek. That's been our primary interest.
There will be a need for some residential quarters for a nurse practitioner in Beaver Creek, but we will cross that bridge when we come to it and we'll see what housing is available but, for right now, we're focusing on getting the forestry building converted over to a nursing station. At that point, we would have to consider what we want to do in terms of housing for a nurse practitioner.
Right now, the residence is right above the clinic, which is fraught with a lot of problems.
I think one the things that probably would happen is that there would likely be such an association of that building with the nursing station that we would have to see if there were alternative arrangements or alternative housing available in Beaver Creek.
Mrs. Edelman: Mr. Chair, does the minister have any indication of when this issue is going to be resolved?
Hon. Mr. Sloan: I'm advised we have an agreement in principle. What we have to move to now is a formalized agreement with the federal government. We have done some preliminary work on examining the renovations so, presumably, within the next month or so, if we could get this agreement in place and start to do the renovations, I would anticipate we could have this up and running by the summer, which would be our desire.
That's why we've chosen to move now, rather than wait until devolution occurs. If we can get this in place ahead of time, that would be our preferred option because, particularly with Beaver Creek being a tourist town, particularly with there being a number of people at the Westmark there - and, quite frankly, a number of elderly tourists - the position of that building is very good. It has proximity to the main artery and the tourist facilities, and so on, so we think it would be best if we could do it sooner rather than later.
Mrs. Edelman: Mr. Chair, I'd like to change the topic completely now.
There is a program in the Department of Health and Social Services for moms who are coming into Whitehorse to have babies. If they are not low-risk pregnancies, they pretty well have to come into Whitehorse to deliver and, indeed, if they're really high risk, they have to be sent out to Vancouver to wait there. The current policy is $25 a day, and that's supposed to cover your hotel. I know the Member for Klondike has dealt with this issue on a number of occasions with people coming in from his community.
What are we doing? Twenty-five dollars a day doesn't cover - well, it probably would cover meals, perhaps, if you weren't pregnant. Are we looking at updating this amount or is that the way it's going to stay?
Hon. Mr. Sloan: Currently, we have several options available. We have the hospitality house, as the member has indicated, which is our arrangement with Rotary. We also have the hostel program at the Whitehorse General Hospital, and this is available to clients and caregivers who are directly involved with services at the Whitehorse General Hospital who presumably are waiting to deliver.
The Rotary house provides short-term accommodations. We have been continuing on with the hospitality house and cover the net costs of accommodation. The contract doesn't include the administration of personnel.
Services will be provided on the same basis. Users will be responsible for their portion of the costs, which is $25 a night. People aren't required to use the services and can choose, if they wish, to stay with friends or relatives.
The Whitehorse General Hospital has rooms available for patients who may need to stay in Whitehorse awaiting or following treatment or receiving outpatient services. They are located in an area separate from the hospital's general operations. There are two single rooms and two double rooms, with access to a small common area and laundry facility. The member might be familiar with that as being upstairs. When one goes up the main staircase, the administration is at one end and the lodge is on the other side.
Charges for the rooms - and this is from the hospital - are $45 for a single room and $50 for a double room.
The Canadian prenatal nutrition program, which is the Dawson City chapter of the Canadian prenatal nutrition program, has made arrangements with the Gold Rush Inn and the High Country Inn to offer a winter rate of $55 a night for a kitchenette suite. The Canadian prenatal nutrition program provides $25 a night toward accommodation and $10 a day toward meals for the mother and $10 a day toward meals for each child.
I neglected to mention that we provide $30 per day after the fourth day.
Mr. Jenkins: I'd just like to get in on the debate here, because this is an issue that raises its head on a regular basis in my area, in the riding that I represent, and it is quite disconcerting to a number of women who are sent down here to await the arrival of a new addition to the family.
The awareness out there is not as much as what the minister would lead us to understand. That's one issue.
The way that the money flows to an individual is not too well understood. The understanding that most expectant mothers are left with is that they come down, and they spend the money, and they submit a claim, and it's refunded. That they can get the money upfront is not well understood, or they are not made aware of it.
Other areas are that you can cut a deal with any of the hotels here in the wintertime but, starting about the first part of May through until virtually the end of September, it's very, very tough to find accommodations in Whitehorse. A number of years ago, there was an initiative made through the Association of Yukon Communities to have a home or a number of apartments through Yukon Housing Corporation that would be made available to expectant mothers and families from rural Yukon. What happened to this initiative, Mr. Chair, and what steps is the minister going to take to fully outline the facilities that are available in Whitehorse for expectant mothers and the remuneration that they are paid? Because the minister spelled it out quite succinctly, and I'm sure he had to go back to his officials to find out all the different intricacies of what was available here in Whitehorse, because it's very, very difficult for a parent, or an expectant parent from rural Yukon, to, number one, find out about these, and, number two, to put something in place, especially in the summer.
Hon. Mr. Sloan: I think the member has raised a point which is well worthwhile. At this point, we've depended on nursing stations and physicians to provide that information. It may be that it's not as well understood, or as well articulated as we might have hoped.
I think that this may be something that could be done up in a simple sort of pamphlet form, that could be given to women - particularly rural women - who are expecting, just to let them know what the procedure is.
For example, I think probably some people might be aware of the idea that there are some accommodations through Rotary. But I doubt very much if people are aware of the hospital facilities at all. I really doubt that. As a matter of fact, I've found that most people aren't even aware that that unit actually even exists. So I think that's something we can take note of, and can do something in that regard.
With respect to the idea of a home or something having to do with Yukon Housing, I would have to go back and investigate that. I do know that very early on, when the Victoria Faulkner Women's Centre moved into the new facilities, we had attempted with them - and we had hoped it would be a good working relationship - we had actually approached Victoria Faulkner -
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: We had approached Victoria Faulkner. One of the options was that we were seeking if they would have - for example, they had a basement area that they could have made into a couple of small, short-stay apartments. And we had hoped that, at the time, we could have been able to work out a deal in that regard.
So, we will try to see if there are other options. I'll go back and I'll take a look at whatever we have, in terms of AYC's proposals. To be quite frank, I hadn't heard of that. But we'll go back and take a look. And I think we can also investigate any other opportunities that we might have.
Mr. Jenkins: Mr. Deputy Chair, there is an issue surrounding the uniform and consistent delivery of health care here and the universality of health care, and there are two sets of standards - one for residents of Whitehorse and Watson Lake, and another standard for residents of the balance of the Yukon.
Why is the minister maintaining this double standard?
Hon. Mr. Sloan: I think I have to take exception to that. In our opinion, there is no double standard. We have worked with the YMA to develop guidelines for rural obstetrics, depending of course on what services are available. I believe that, in general, the physicians in rural Yukon have some guidelines that they work with regarding level of risk - whether it's a first child or second child, et cetera.
I know that in Watson Lake, for example, unless there is anything particularly untoward or if there are risk factors, women are allowed to deliver their babies in Watson Lake. My own son was born in the Watson Lake hospital, so I know that that exists. I didn't consider that to be a double standard. There are, of course, places where rural obstetrics are not recommended, just because of the lack of support mechanisms, but I don't believe that we have a double standard whatsoever.
Mr. Jenkins: For the minister's benefit, there is a double standard. There's one standard that exists in Whitehorse and Watson Lake, and there's another standard that exists in the rest of the Yukon.
Now, if your government chooses to maintain this double standard, and the minister can refer to it any way he wants, but it is a double standard, why aren't the same levels of service available to individuals for their stay in the principal city here at Whitehorse when they come down to deliver a child? Why doesn't the government pick up the tab for that stay?
Now, low-risk obstetrics you can deliver in Dawson City, but it has to be a very low risk and it can't be a first time delivery.
In Watson Lake they call the shots a little bit differently. Your chances of delivering a child safely in Watson Lake are probably the highest in any rural Yukon community, but not so for Dawson City, not so for any other area of the Yukon. Even by the minister's own calculations, the dollars that are allowed for a stay in Whitehorse, even for the facilities in the Whitehorse General Hospital and the dollars that the Whitehorse General Hospital charges for a stay there - there's a gap. The government only covers partial costs. Why should that be, Mr. Chair?
Yesterday, we had quite a debate on the universality of medicare and the delivery of a standard form of health care across the Yukon. Now today, the minister's reversing his position and saying that what exists is not a double standard when, on analysis, it won't hold the test. The cost for a parent in rural Yukon to come to Whitehorse, to spend the time here - and sometimes it's not just a week or two; I know of occasions that exceed a month - those costs grow, and grow alarmingly, Mr. Chair.
There are two different sets of costs if the delivery occurs during the summer months when all the hotels and all the establishments here are running at very high capacity. The price almost doubles.
So, there has to be a better way of approaching this issue than what currently is in place, and there has to be a better awareness made in rural Yukon as to what facilities are offered, and their costs, and what the government's position is with respect to paying for some of these costs.
Now, have I made the position of rural Yukon clear and does the minister not now agree that there are separate sets of standards, one for Whitehorse residents, one for residents of Watson Lake and one for the balance of the Yukon? Because there are, Mr. Chair.
Hon. Mr. Sloan: Well, I think we're going to get into a protracted dispute over this. I should remind the member that physicians in rural Yukon make the call, based on a set of guidelines that they have agreed to with their medical colleagues. Those guidelines are based on the physician's best judgment about the risk factors, and so on and so forth.
I should point out that, with regard to the Rotary arrangement, we cover the net costs of accommodation. So, the users basically are responsible for a portion of $25. So, if the bill came to $75, it would still remain $25. As well, after four days, we provide an additional $30 in terms of a subsidy, beginning on the fourth day for clients. So, I think we are assisting families to come down. The member may have a point - and I concur that he may have a point - in the idea of making people aware of what some of the services are.
We have, as I indicated earlier, attempted to find other solutions in this regard. We've attempted to find permanent accommodations. We've made some attempts in that regard, and we'll probably make some attempts again in the future. But we do try to support people when they come in from rural Yukon. But I have to emphasize again that decisions are made on such matters based on recommendations from the physician and based on rural obstetrics guides.
Now, if we want to extrapolate out from that, when residents of the Yukon travel outside for medical care, we have the same kind of basis. We provide assistance after a certain number of days, if they're down for certain procedures.
So, I think what we're doing is basically administering this in a consistent manner.
Now, I certainly hadn't heard any indication that this was planned on being changed by the previous government, but then again, we've discovered that many things only occurred in September of 1996. We discovered that, prior to September 1996, there were no people requiring extended care, so my presumption would be that since the previous government had four years to do something about this, there were no women that had babies in rural Yukon prior to September of 1996.
Mr. Jenkins: Once again, the minister can't answer the question, so he goes on the attack and blames it on the previous government, blames it on everyone else, because he can't address his responsibilities and he doesn't understand the issues surrounding the double standard that he is maintaining within his department.
I will give the minister and his officials credit when an individual is sent from Whitehorse to, usually, Vancouver. That is clearly spelled out. Their tickets are purchased in advance. Tickets are provided for the accompanying parent, if it's a child. The whole arrangement and the facilities that are available in Vancouver are clearly outlined, and what they can anticipate in the way of per diems is all spelled out. That is done very, very well - Whitehorse outbound. Where there is a problem within the minister's department is with rural Yukon people - and it doesn't matter what community you go into - coming into Whitehorse. And this is not an issue that just reared its ugly head in the last couple of years or didn't exist two or two and a half years ago. It has been in existence for a considerable period of time, Mr. Chair.
I believe it was the Member for Riverdale South who brought it up at the Association of Yukon Communities table, quite a number of years ago when she was a Whitehorse city councillor. So it does go back a number of years. Government at that time promised to address it - and I might remind the minister that at that time it was an NDP government - and it has not been addressed, and this double standard continues to exist.
Now, I would urge the minister to consider the other options that are out there with respect to probably providing a couple of housing units - a couple of single-bedroom apartments or bachelor suites - that could probably be readily attained through Yukon Housing Corporation. Heck, they're giving away money left, right and centre at the Housing Corporation, and in-house it must be an easy task to accommodate the needs. They're developing lots, and building lots where there's no demand existing.
But here there is a demand. There's quite a demand, and the minister can probably serve a number of Yukoners very, very well by addressing this demand, putting in place some housing units and offering them at the same rate as the per diem is, that the government provides.
You know, we look at the residents in the Whitehorse General Hospital. The cost of staying there is almost twice the per diem. Why is that the case? Why can't the per diem be raised?
Even when you look at what an individual who would stay at any one of the two hotels that the minister mentioned here in Whitehorse would pay, the per diem and the cost per night, just for the basic accommodations, is almost double.
Now, the minister has an opportunity here to do something positive. Is he going to rise to the task or is he going to blame his predecessor for this problem and not address it? What's the minister going to do?
Hon. Mr. Sloan: What the minister is going to do is puzzle a little bit, because, yesterday, the Member for Klondike went on at great length about the role of the private sector. Now, it appears that, in actually working through this arrangement, there is money flowing into the private sector - the hotel sector - which I imagine the member is familiar with to some degree. So, what happened here? Did they have some kind of revelation on the road to Damascus, or what? Yesterday, they were asking for us to privatize the medical system; now, they want us to move away from putting some money into the private sector for this and return it, instead, to Yukon Housing, which the member seems to bear such a deep grudge for.
As well, I should remind him that we don't set the rates at the hospital. The Hospital Corporation has established those rates. I guess we could go around on our merry way again, dancing around what kinds of benefits should flow to the hospital again, but I have to remind him that it was the hospital that established those rates.
I have indicated to the member that we have looked at some alternative arrangements. When Victoria Faulkner was developing their facility, we thought it was a good mix; we thought it was a good fit. I guess, unfortunately at the time, the Victoria Faulkner Women's Centre didn't feel it was something they wanted to do. They said they wanted to make their own arrangements.
It would be something that, if we could secure a relatively low cost option, we would entertain. But here we are. We're putting some money into the private sector and the member is asking us to stop that. I guess his friends in the hotel association will have to consider that for what it's worth.
Once again, we've had a bit of a change here on the member's part, and that particular kind of erratic behaviour is something that we've become accustomed to. I find sometimes that, when the member is brought to task on certain points, he often comes up with a different tack.
Yesterday, it was to privatize. Today, it's to de-privatize. So, we're at a little bit of a loss to explain where the member is going on this. We have an arrangement. We do support people. The member may have a point in terms of maybe needing to make this better understood, maybe making it articulated in some form, whether it be in a pamphlet or whatever that is available from physicians in rural areas or the nursing stations.
But we have provided a level of support, and that support has remained consistent. We will continue to try to support people when they come into town through a variety of ways. We have been using our local hotels and, barring some major change, I guess we will continue to do so.
Mr. Jenkins: It would appear that the minister must have spent last night staying awake completely to put the spin on it that he manages to do here today. It is quite amazing how he has that focused ability to turn black into white. I must give the minister due praise.
To refresh the minister's recollection of the issue, yesterday we were discussing the new 70-odd bed continuing care facility. We were looking at the reasons surrounding why it hasn't been looked upon being constructed on a turnkey arrangement or the whole thing farmed out and we get a true handle on some of the costs associated with delivering and constructing the facility and operating the facility.
The other issue we were questioning was why the minister in his wisdom would take the Thomson Centre and construct a kitchen in there at some hundred-odd thousand dollars in additional costs, when just down the corridor is a $1-million kitchen in the Whitehorse General Hospital, and why he would go out and just staff it.
Why wouldn't he contract the food service out like the cafeteria in this building is contracted out? Why wasn't that avenue explored? The minister's response was a very lame-duck excuse of, "Oh, contracting out was tried three years ago and we really didn't like it."
Now, here we have this NDP government standing up and stating, "We support the private sector." But then what are they doing about it? They aren't doing anything about it. They are doing everything in their power to expand the role of government in every, every area.
Now, my questions of the minister today were quite succinct. There is a double standard that exists with child delivery in the Yukon. There is one standard that exists in Whitehorse and Watson Lake. There is another standard that exists in the balance of the Yukon, and that standard usually is that the individual has to go to a major centre, be it at Whitehorse or Watson Lake, to deliver their child. The amount of money that the minister has budgeted for these individuals for per diems doesn't anywhere cover their costs.
Now, the minister said, "We offer an amount of money and we don't set the rates at the Whitehorse General Hospital." Well, the minister is absolutely right, but anywhere else where the minister's department has contact with the Whitehorse General Hospital, they pay the charges that the Whitehorse General Hospital assesses the department and the various agencies, and it's paid through the insurance. Just because this is a non-insured service, as the minister states - and in some cases it is an insured service - the per diem is very, very low.
Now, we can go a couple of ways. We can raise the per diem to what the government pays its own employees, so that they have a measure of comfort with addressing their needs - pay the actual cost of their accommodations and pay a per diem equal to what the government employees receive. Or, there is the option of either farming out to the private sector for a number of bachelor-type apartment units here in Whitehorse or having Yukon Housing Corporation provide them. I think it can be done through the private sector or it can be done through Yukon Housing Corporation. There are a number of ways.
Some Hon. Member: (Inaudible)
Mr. Jenkins: We are not weaseling. We are seeking a solution to a problem to eliminate the double standard in health care.
Now, will the minister explore these avenues or is he just going to rise on his haunches and put another spin on what we're discussing here today?
Hon. Mr. Sloan: Mr. Deputy Chair, I don't have to make any spin on it at all. The interest that was generated by the member's comments about the privatization of public health yesterday was noted. As a matter of fact, I've had some requests, which we've concurred with, to provide some of those sterling quotes from the Member for Klondike for interested folks, and I'm sure they will be received warmly in all areas, because of the member's previous devotion to the idea of privatizing health care.
We have an arrangement that provides a subsidy to people. In other words, if the Rotary were to put an individual in a hotel and the room was $65, we will bring that down to $25. After four days, there's an allowance of $30, which the person can use either to offset the cost of the hotel or they can apply it to meals - whatever.
So I believe we are trying to support people in this regard. This is not an insured service, in the sense that it's not insured in the same way that hospital stays are, or things of that nature.
I should remind the member that under the Canada Health Act those are the kinds of services that are covered - physician fees and hospital costs are covered.
But this is not. This is something that we choose to bear, along with many other health care costs. For example, our medical travel outside - we are the only jurisdiction in Canada that still has that without a co-payment.
The member shakes his head. The N.W.T. has a co-payment, which the member has clearly not kept abreast of. Because I can tell the member that I've discussed this with my colleague, Kelvin Ng from the Northwest Territories, and he freely admits that there is a co-payment in the Northwest Territories. And we've discussed this in some detail. We're the only jurisdiction that provides that.
If an individual is in Atlin and they need a referral to a physician in Vancouver - even though that referral may be through a physician in Whitehorse - that's not borne by the B.C. medical system.
So I think we have a system here that is generous. I think we do try to provide some services for people. We have looked at some alternatives.
Now the member wants us to go to Yukon Housing and get them to offer apartments. I don't know what the availability is of units in Yukon Housing. I'm not sure whether, if by doing this, we'd be taking from the social sector or not.
I'm not sure what the relative costs would be, compared to what we're currently bearing. What I am a bit surprised at is the idea that here we have an arrangement that would appear to be of benefit for our local hotels and the member is suggesting that we dispense with that. That's somewhat astounding.
I would go a bit further, to suggest that, if we were to go to the Whitehorse General Hospital and ask them to draw down their costs, they are not required to follow our direction in that regard and they've probably established their costs for a very good reason. They probably feel that this meets what their cost recovery would be. So, whether or not we can get anything further out of the hospital in that regard, I don't know, but we do have some options available here. We will follow up on the idea of trying to get a bit more information out. We have never abandoned other options, such as seeking apartment spaces or things like that, but we have put in place some supports and we will always continue to look for other improvements under the system.
Mr. Jenkins: The minister is missing the whole issue here. The issue is that we're not here to benefit local hotels. The issue is that we're to address the needs of people who have a medical situation, be it a delivery or tests, or some procedure at the Whitehorse General Hospital and they are sent to Whitehorse for that purpose. That's what we're here to deal with, Mr. Chair.
Now, is the minister abundantly clear on the issue? I would hope so.
The issue goes further in that we have a cost that these individuals incur in coming to Whitehorse, spending the necessary time in Whitehorse for them to receive that service or deliver the child.
And that cost, the amount of money that the government provides for that purpose, is not adequate. It's not adequate at all, and I want to know what the minister is going to do about it. And while he's there, when was the last time the per diem was adjusted? When was the last time it was raised to the level that the minister just stated here in the House? How many years ago or decades ago was that, Mr. Chair?
Hon. Mr. Sloan: We will certainly find that out. I guess one of the things that we'd have to do would be to suggest that the previous government had an ideal opportunity to raise it and chose not to.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: That's true. The focus of the Yukon Party was on raising taxes rather than raising rates.
So, we can find out what the date was on that, but I can tell the member that we are proceeding to try to find support for individuals who are advised to come into Whitehorse. I think that we have made arrangements through the Rotary Club, which is a fine service organization. We have an arrangement through the hospital, and the member's own Dawson City chapter of the Canadian prenatal nutrition program has worked with us. So, we are trying to find some support for individuals, and we will continue to do so.
Mr. Jenkins: Well, while the minister is trying to provide some support, this double standard for the delivery of health care still exists in the Yukon, and it is causing some concern. Of all the constituency issues that I get to deal with, this one probably raises its head at least every other week, if not more frequently. It's right up there with workers' compensation claims that are not dealt with in a timely manner.
It is one of the issues that crosses my desk on a continuing basis. It's a case of "Gee whiz, I'm down here. I've been sent down here for this purpose. I've got to go back and tell them how much I've spent before I can get a cheque." That information is not properly conveyed to any of these individuals.
Now, we start looking at when the last time the per diem was increased. It hasn't been increased in the last two and a half years that the minister's held this portfolio, obviously, because the minister would be aware of it. The minister would have made a great big presentation and a whole lot of ballyhoo in the House here, as well as a press release telling people, "Here's what we're doing." But that hasn't occurred, so chances are the per diem hasn't been raised for a considerable period of time.
We were discussing other areas of Canada where this situation arises and I'm aware of a number of individuals in the Northwest Territories who have been sent to one of the provinces for medical services, and in speaking with the individuals in question or someone on their behalf, all of their costs were paid and a lot of their costs were paid upfront. Arrangements were made for their hotels in Winnipeg, in this one case, and all of the costs that they incurred were just dealt with by the government.
Now, I'm not sure if part of it was paid by Indian Affairs, but all of the arrangements were made by the Government of the Northwest Territories on behalf of these individuals and all of their costs were looked after. These are individuals who were sent south from the Northwest Territories, and the one individual, whom I know personally, was sent to Winnipeg for medical attention.
Now, as to a co-payment existing in the Northwest Territories, I couldn't find anyone that would tell me about their policy. I couldn't find anyone who was even aware of it. The minister said he got his counterpart in the Northwest Territories to admit that there was a co-payment, but I couldn't find anyone that had paid it, unlike the Yukon, where I know of a lot of people who are looking for remuneration from the Government of the Yukon and don't know which door to go knocking on in order to receive it.
So, there is an issue out there. It's been around for a long time, and it's about time the minister took the issue and did something with it to eliminate the double standards in the delivery of health care.
Hon. Mr. Sloan: I suspect that, in some cases, the member might be referring to individuals who are paid for by Indian Affairs. Indian Affairs has their own travel system. As a matter of fact, much of that travel has been devolved to the First Nations themselves. So, they have the responsibility for non-insured benefits that aboriginal medical travel provides.
I'm looking here at the comparison of travel for medical treatment, non-emergency. When I look down at the Northwest Territories, there is a co-payment of $125 or $250 per round trip. We have no co-payment in the Yukon. There is assistance for some people in northern British Columbia, but it is primarily in terms of discounts - air discounts or B.C. Rail discounts - and there is prior approval needed.
There is no comparable program in Alberta and no comparable program in Saskatchewan. Manitoba does have a northern patient transportation program that subsidizes the costs of transportation for northern residents to receive services at the nearest location. It's restricted to north of the 53rd parallel. It's administered and varies, because it's done by municipality, and there is a co-payment in that program.
Ontario has a northern health travel grant, but it is to assist people to travel to a medical specialist and it's basically based on 30 cents based on distance. Newfoundland has no comparable program. Of course, P.E.I. wouldn't be applicable, and Nova Scotia and New Brunswick don't have similar programs.
So, ours is the only program that does provide air and ground transportation as required. We do have a subsidy to assist with some travel expenses, such as meals and accommodation, and, as near as I can determine, we appear to be the only one that has an escort coverage provided. So I think in that regard we do quite well.
I believe what the member might be referring to, however, is the DIAND kind of travel, which is somewhat more generous, but I should note that the travel for non-insured benefits is quite high in terms of what is paid here for the population. I'm sorry, it's actually Health Canada MSB on that, but I think that's what the member might be referring to.
Mrs. Edelman: Mr. Chair, I'd like to get to an issue that we've discussed in the past, and this would be an issue about First Nations adoptions. It's one of the provisions in the Children's Act.
There are a series of problems with traditional adoptions. Part of them is it's not clear who has access to the child. The birth mother seems to have full guardianship under this particular type of adoption. And there seems to be more recognition in this area and greater protection for the natural parents than there is for the ones who are either fostering or who are hoping to adopt the child under the custom adoptions.
It's a problem that comes up over and over and over again. I think at one point the minister said that this was an issue that they may have been discussing with CYFN, in a policy sense and in a general sense. I'm wondering if there's been any discussion on that.
I know that we went to the First Nations child welfare conference, and the minister went to that as well - we both attended. That was an issue that came up over and over again, and I'm wondering if there's been any work in that area.
Hon. Mr. Sloan: I'm not aware of any current work in that regard. What I can do is go back to the department and see if any progress has been made in that regard. We have a number of discussions going on in parallel with our First Nation partners on a whole variety of issues. I can check to see if there has been any further work in that regard.
Mrs. Edelman:Mr. Chair, the issue of custom adoption is just one that is outdated in the Children's Act. There are a number of other ones we dealt with in the last session - some minor issues around grandparents' rights, the minister will recall. And there's also the issue of mandatory reporting of abuse, and this is something that they have in other jurisdictions. Some places it works well; other places it doesn't.
Here are two issues that we could go and review the Children's Act on; they're outdated pieces of the legislation. Is there any chance that we will be opening the Children's Act for a full review? It's one of the biggest pieces of legislation that we have. Law in that area has changed dramatically in the last 10 years. We review other large pieces of legislation on a regular basis. Would we be considering a review of the Children's Act?
Hon. Mr. Sloan: I would venture to say not in the next year. There are a couple of other major reviews coming up - the Education Act, for example - as well as some other legislation. This one isn't slated for review at this time.
Mrs. Edelman: Then, Mr. Chair, every time I bring up the subject, I am once again disappointed. I think that this act certainly merits a regular review. It's dealing with the welfare of our children and, as the minister is aware, there have been a number of groundbreaking cases across Canada, and we need to keep up to date with that. I think our children deserve the best that we can give them.
Now, one of the issues that I hear about - and this is an issue that I heard about growing up in Whitehorse - was the issue around foster parenting. Foster parents have a very difficult time for a lot of different reasons. I know that the minister has put some money into training and in equipment for certain types of special needs for foster care programs, but they are still issues. And I'll tell a story here, and that will illustrate my point well, I believe.
Now, let's say a child is left with caregivers while mom goes out drinking and, by 10:00 a.m., mom still has not picked up her child, so the child is apprehended by Health and Social Services and put into foster care. This happens fairly frequently. Now, a couple of months later, the child - and we'll call him Johnny - is put back with the mother. Three or four months later, Johnny is left with another caretaker, and mom leaves and doesn't pick him up again. So, Johnny is once again apprehended by Health and Social Services and put back into foster care. A few months later, after mom has taken a drug and alcohol counselling course, Johnny is returned to mother. And the story is repeated a thousand times in the Yukon, and, inevitably, Johnny will go back into foster care again and again and again. And the reason that Johnny is continually put back with his mother is that it's supposed to be in his best interest. In fact, reunification of the family is not always in the best interests of a child, particularly if there are outstanding issues with the parent - issues that are not dealt with properly.
We need to look at this issue. We have to really look at what the best interests of a child are. I'm not saying that the state should take over parenting children. That is absolutely not my intention in this discussion, but I am saying that if we are going to be returning children to their natural parents, and we've had to take them out of a situation because it was so bad, then we have to be very, very careful that we don't put the children back with their natural parents until there has been a significant change. And I'm not talking about somebody going off and taking a one-week alcohol and drug program or only dealing with alcohol and drugs and not dealing with issues on parenting and not dealing with their own psychological issues.
All of those things need to be looked at and we have to be very, very careful that we don't constantly, continually put children back into environments that are dangerous for them.
Now, I know that there are policies in the department about putting children back once there's been some change in the home environment but I think that we need to come up with much better and stronger criteria about when we return children to their natural family. Like I say, I grew up here. This story I heard a hundred times growing up and I hear it today. Nothing's changed. Are we looking at reviewing some of the criteria around returning children to their natural homes?
Hon. Mr. Sloan: Well, I would suggest that a social worker who is faced with that kind of situation would be very careful about returning a child to a situation in which there was physical danger. I think that would be something that they would have to make a real tough judgment call on what the situation is in that home. I'm sure that if a social worker felt that there was an endangerment of a child, they would be very reluctant to place the child in that kind of a setting.
I'll take the member's comments as they are, and I'll certainly raise them as issues with family and children's services. I guess my feeling is that in all cases - and I truly believe this - people who work in social work, and particularly having to do with issues around child apprehension and issues of that nature, must have one of the toughest jobs in the government, and I'm sure that a person who undertakes the responsibility for a child's welfare must agonize in terms of whether they are doing the correct thing.
At the same time, I think they're guided by the principle that, as much as possible, they should keep the natural family unit intact. Now, that doesn't mean at all costs and it certainly doesn't mean it at a risk to a child, but I really do believe that social workers try to act in the best interests.
I understand what the member is saying. Sometimes in the role as principal, I experienced similar frustrations, but I have to say that I think it's not done by any sense of neglect or anything like that. I think the attempt by social workers is to always act in the best interests of the child, and that must be their paramount thought. It can't be an easy job, and I commend them for the work that they do.
I'll take the member's comments as being friendly advice and friendly suggestions and I'll certainly pass them on to our folks in family and children's services.
Mrs. Edelman: Mr. Chair, I just want to reassure the minister that I would never make a comment that the social workers are putting children back into homes where they are in danger, but they are putting them back into homes where the child will suffer neglect and, in the long run, that seems to cause as many problems. That is my concern.
My concern is that there is no clear-cut policy on when we return children to their homes. There are guidelines but we don't update those guidelines, perhaps, on a regular basis. We don't review cases as well as we could, because there are children being returned back into neglectful environments.
Hon. Mr. Sloan: I'll take those comments as the member has expressed them and, as I said, I'll pass them on to the folks in family and children's services and ask them to make the due considerations.
Mrs. Edelman: Mr. Chair, I wonder if the minister could outline some of the work that's been done on the review of the policy and procedures in residential care. In other words, where are we in the recommendations from the group home review?
Hon. Mr. Sloan: The final report of the reviewer, Sandra Scarth, Along the Wayward Path, released on August 6, 1998. The report made 49 recommendations, 36 of which have been substantially implemented as of January 1999.
The status report identifying work done or underway to implement the recommendations has been placed on the departmental Web site to allow full public monitoring of the activity. An implementation planning committee has been established to assess each recommendation to develop workplans as needed and to facilitate implementation through the service system. There are representatives of CYFN, as well as our director of family and children's services. They are co-chairs on this planning committee.
As well, an independent - and this was the request of the CYFN - person not associated with the service system provides periodic monitoring of the progress of implementation. This person was chosen jointly by CYFN and the department. I can go through the recommendations if the member would like - all 49 of them.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: Okay. The appropriateness of placements be discussed as a specific agenda item at one of the regular meetings of YTG and Gibbs Group Home - we agreed with this implementation. We agreed and will implement this recommendation by having, on the quarterly agenda of the Department of Health and Social Services, family and children's services, the placement committee and a review committee.
The task was to put it on the agenda of the placement review committee; the lead organization was family and children's services, and the status is complete.
To add it as a line item in case review meetings; lead organization, family and children's services; complete. Annual placement and review committee policies, family and children's services, it was established as a guideline for January 1999. This is underway.
(2) That a special effort be made to ensure ongoing clarity of the roles of the YTG director and staff, group home operators and staff, in regarding both cases, and systemic issues, such as access to records and school attendance. One of the suggestions was that this could be done in separate meetings with each operator or staff, or as possibly part of regular year-end evaluation of the residential care system.
We agreed with this recommendation by involving family and children's services: Department of Education operators to develop and review the policy in this area; also as part of the quality assurance process, to include annual consultations with the above parties.
The task was current annual residential resource review. The lead organization on this is family and children's services; the timeline is March 1999. Develop written guidelines, describing the respective roles of residential resource staff - family and children's services, social workers, youth probation and regional services. The lead organization was family and children's services, and this is also slated for March 1999.
Develop a written protocol regarding information sharing between family and children's services and residential programs. I'm sorry, I should have identified in the previous one, on written guidelines, that that has been accomplished with the residential youth treatment centre - the former NNS. That one has actually been completed, so there's still a couple of those still outstanding. Receiving home, Gibbs Group Home.
The idea of developing written protocol is underway, and this involves the operators of family and children's services regional staff.
(3) YTG strengthened the expectations in the residential care manual for a written complaint and appeal procedure to include parents, and to ensure a procedure for appeal beyond the facility to provide for fairness and redress if required. We agree, and we will implement this recommendation by revising the manual. We are in the process of revising the residential care manual on complaints and appeals, led by family and children's services, and it is underway; to discuss policy with operators and ensure that operators have consistent policies and procedures. That is currently being done.
(4) To ensure that the Gibbs Group Home's program on lifeskills is implemented and outlined in contracts. We agree and will implement this recommendation by reviewing this bimonthly with Gibbs Group Homes for the next six months to identify impediments to implementation methods to overcome these. The task was that the Gibbs Group Home review and revise programs. The lead organization was Gibbs Group Home, and this is underway. The second task was the family and children's services' review with Gibbs Group Home - case-specific in general programming issues. The lead organization was family and children's services. That is underway.
(5) The Gibbs Group Home to obtain expert help in developing a more active recreation program - we will consider it underway. We will seek the advice of Gibbs Group Home, family and children's services, YTG sport and recreation branch, and First Nations to examine innovative solutions and, in particular, First Nation cultural pursuits that fall under this area of recreation. There are three tasks. One was to facilitate the consultation between Gibbs Group Home and identified recreation experts, led by family and children's services. That status is that it is underway.
That the Gibbs Group Home develop a recreation plan - their target on that is March 1999.
To review plan and monitor implementation - family and children's services will lead that, and that will be done on a quarterly basis.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: I'm advised that the information is on the Web site. However, as the member had asked me to move through all 49 recommendations, I was quite prepared to do that. I'm still prepared to do that, unless the member would like to, on her own, go to www.government.yk.Canada/departments/hss/fcsframe.html, and there should be an update on this by the end of March.
Mrs. Edelman: Mr. Chair, I'd be more than pleased to look at them on that site, but what I was trying to get from the minister - and it is not on the site - is an indication of where we're going to go in the future, how long we're going to continue the process.
The minister, just in the last couple of recommendations, talked about lifeskill courses and cultural component that the Gibbs Group Home is going to be delivering, but he doesn't talk about the additional dollars that the group home is going to require to deliver those programs, and that's information that's very much lacking from the site.
Where do we stand with that and how are we going to let or help the Gibbs Group Home implement these recommendations?
Hon. Mr. Sloan: The issues of financing and additional resources are ones that are being discussed as the process goes through, and those discussions are underway with our director of family and children's services and the home's operator.
Mrs. Edelman: Mr. Chair, am I to understand then that we're in negotiations and the minister, reasonably so, doesn't feel that he wants to discuss that matter?
Hon. Mr. Sloan: I don't know whether I'd characterize them as discussions. Whenever we have a contract with a group, whether it's an NGO or another organization and they are tasked with undertaking additional responsibilities on our behalf, I think there are always discussions around what additional resources, if any, are needed, and those are the kinds of issues that we're currently discussing.
Presently, we're also, I suppose, asking questions like if the financial resources are already in place, if there are already allowances for these kinds of things, and so on and so forth.
So, as we move through this, as we resolve a number of these issues and as we come to fruition on a number of these points, there will naturally be points at which discussions around resources will arise and our director of family and children's services is working with the operator in this case.
Mrs. Edelman: So, Mr. Chair, can I surmise from the minister's comments that he is aware that there will be additional costs and, recognizing that, he will be reasonable in his discussions with the service provider in this case?
Hon. Mr. Sloan: I need to caution the Member for Riverdale South here that she is drawing dangerously close to entering into negotiations, as did her friend down the line there. I never commit to issues of that sort. I can just say that we are always aware, but we will continue our discussions.
Mrs. Edelman: Mr. Chair, you'd never know that the people in this Legislature are politicians.
Now, in Macaulay Lodge, there have been a number of rumours that I have heard in the last couple of months about some changes in the use of Macaulay Lodge, and the minister talked earlier about possibly lowering the level of care at Macaulay Lodge close to what it was originally intended for. It was actually the first seniors' apartment building in Whitehorse and at one point - it wasn't even level 2 care, and it's certainly level 1 and level 2 care now.
When are we going to be changing over with Macaulay Lodge? Are we going to be waiting for the new continuing care facility to built? Is that what the plan is?
Hon. Mr. Sloan: I think the member has sort of hit the nail on the head. Obviously, as we develop a larger extended care facility - we know that many of the people right now in Macaulay should, quite frankly, not be there. It's just not an appropriate placement for them. Their needs are too high. And as we free up space in a new extended care facility, we would provide opportunities for sort of a restructuring within our extended care. We likely wouldn't have the ability to do this until such a time as we did have something in place. I mean, we're not looking at anything immediate. We just can't sort of chuck them out. We have to have an appropriate placement.
But we are going to be discussing a number of options. We'll be discussing with Yukon Housing their interest in trying to run it as a seniors apartment kind of complex and so on. But, quite clearly, we couldn't do that until we had an extended care facility in place. We could then do a reconfiguration. So, for example, the population that is at Macaulay that would be ambulatory and would have the ability probably to use the existing Thomson Centre facilities - that would become, in a sense, where the Macaulay-type population would go. The more advanced folks would go into an extended care facility, and then we'd look at a variety of sort of lower level options.
It could very well be that we might not be the service provider in that regard. If, for example, it became more of a housing type of function, the appropriate server in that case might be Yukon Housing. There may be some other options around that. There may be, for example, a society that might want to undertake the administration of it, and so on.
So, we're open to a variety of options there, but I can assure the member that nothing will take place until we have our seniors facility in place, though that doesn't preclude us exploring some options in the interim.
Mrs. Edelman: Mr. Chair, in discussions in the House on the continuum of care, the group that we seem to be ignoring is the group of gentlemen, usually single gentlemen. Some are around the age of 50, and there was a report that was done at Yukon College talking about the forgotten ones - many of the gentlemen who had had very hard lives. They had worked in the north. They had stayed in bunkhouses when they came into Whitehorse, and they would go out into the bush to work. And I can't remember the name of the report. It was done with the Yukon Council on Aging, I believe, and it was done with Yukon College as well, but it clearly identified that this was a very great need, and I do recall that the Alexander Street Residence, at one point, was the facility in Whitehorse for gentlemen who would find themselves in this position. There was a caretaker on site. This has changed now. Yukon Housing Corporation has changed that. But there was a caretaker on site, and she basically helped people remember that they had medication to take and that it would be a good idea to start eating, and these are people who have had very hard, hard lives. Many of them have problems around alcohol.
I don't hear any discussions around dealing with that particular age group and those very, very special needs, and relatively large numbers of individuals are in that group. Where are these people in the continuum of care?
Hon. Mr. Sloan: Well, first of all, I take a bit of exception to the idea of being "an older gentleman". I am, after all, reaching the magic age of 50 this year, and I am quite perturbed at being characterized as being "an older gentleman".
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: Well, I like to think so.
But with respect to this, this is a group that, in many cases, frequent some of our hotels and have made arrangements there. It's difficult in some ways to deal with, because, as the member has indicated, there are often a number of social issues, including alcohol abuse, that these folks are involved with, which don't lend themselves to sort of standardized or, I suppose, bureaucratic solutions; in other words, residents and things of that nature. In many cases, they choose not to, because the idea of having certain rules around drinking and parties, and things like that, within government facilities tend not to be well-received by this group. We do have our street nurse, who works with this population on a very extensive basis and tries to deliver services to them in their homes and in these hotels. But, it is a very difficult group to work with and it is a very difficult group to sort of get involved with.
I know that the Yukon Housing Corporation has taken a look at the whole question of the seniors population and seniors housing. I'm not sure what solutions they have devised, because these are primarily housing-type solutions. We try to work on the health aspects of individuals like this. But, I can tell the member that sometimes these folks don't really participate too well in many of our programs. It is a very difficult group to be working with.
Mrs. Edelman: Mr. Chair, essentially what we're talking about is level 1 care. That would mean that it is actually more the responsibility of the Department of Health and Social Services, but I will follow up with the minister of housing when we get to that debate. Fortunately, I'm the critic for that area, as well.
The Canadian Medical Association has drafted a privacy code. Basically, what it says is that if a doctor has information about a patient he has to share it with other agencies - and let's use the Workers' Compensation Board, for example. Then he has to tell the patient that he has done that and what information he has shared.
The CMA's health privacy code is quite extensive and it looks like they will probably be passing that in their next annual general meeting. Now, has the minister looked at this? We got this information off the Web, of course. An awful lot of work has gone into it. It seems quite reasonable and quite easy to read and something that we might want to look at here in the Yukon. We don't have any policies in this area and, as the minister knows, with modern technology, issues around privacy come up over and over again.
What are we doing with this issue?
Hon. Mr. Sloan: Well, I have to admit, I haven't read the CMA's proposal, but we have taken a look at the whole question of privacy, and we have consulted with the privacy commissioner. Part of the reason behind this was in some of our discussions on the FAS aspect - the idea of medical diagnosis. We did discuss with the privacy commissioner what kinds of reasonable restrictions we could put on the dissemination of such information as who should have access or what kinds of procedures would we have to put in place, for example, for a doctor to release that information to relevant - whether it's education authorities - and what kinds of provisions would have to be in place for the patient, or the patient's guardian, to allow that information to be released.
So, we have taken a look at some issues around privacy and medical information, but it has been more specific around that one particular question that we've been looking at. We have had some discussions with Justice about this, and we have discussed it with the privacy commissioner.
So, that's going to be one of the focuses that we will have in developing this legislation. I should also point out that this was an issue that was, I think, first and foremost, with some of my caucus colleagues. When I raised this issue with them, they did have concerns about accessibility of information and so on. As I indicated yesterday, I have to come back and provide them with a bit more assurances about what we're doing in this regard.
Mrs. Edelman: Mr. Deputy Chair, it sounds like the conversation around this issue is fairly timely. It's definitely something that we need to do with Yukon Medical Association, but we also need to do it with people who aren't involved in the professions.
Perhaps this is an issue that we might want to discuss at the health summit in the fall. And I'll read to you - and this is a critique, basically, of the CMA's new health information privacy code, and it's written by Dr. John Hoey, who is a medical doctor. And the last paragraph best describes this rather difficult situation.
It says, "None of us want our privacy to be violated or the details of our medical history to be released willy-nilly to just anyone, but most of us also recognize that a particular experience with illness, when combined with those of others, provides for an understanding of a disease and its management and are essential for the teaching of the health care professionals of the future.
"Although politicians may win points by introducing legislation designed to allay our distrust of big-brother surveillance in all its forms, what we really want is a balance, slightly tipped toward ensuring the confidentiality of disclosure to physicians, between a respect for privacy and the sane use of valuable data."
Mr. Chair, that was probably the best description I could find of the reason why we need to have this discussion, and we need to have it in the Yukon. I hope the minister has heard what I've said today and that he will consider it when he's talking about these issues around FAS as well.
Hon. Mr. Sloan: Well, these issues are timely in more ways than one, because one of the things that Mr. Rock is very involved in, and has indicated that he wants to raise, is this whole question of medical infomatics - the exchange of information, the exchange of data. So I think there's probably going to be a number of issues around there.
As well, there was a recent case, I believe last week. It was a Supreme Court decision that involved the limits that a lawyer can go in terms of confidentiality, but I think the initial aspect of it was the revelation of some information by a psychiatrist to a lawyer. The court actually said that there are some reasonable limits on client-lawyer privilege if there are issues of public safety at risk.
So, I'm sure all of these things are being looked at by legal people, and I would suspect that, with the increase in medical infomatics, it's going to become even more crucial.
So, I can probably guarantee that the whole question of confidentiality and protection of confidential information is going to be front and centre among some of the national discussions.
Mrs. Edelman: Well, Mr. Chair, once again, I don't know if I'm making my point well. My concern is not that lawyers and doctors are going to be talking about this, because, number one, it's a somewhat frightening combination, but, number two, the people whom it most affects are going to be left out of the equation. That's just the general Yukoner who goes to the doctor every day and includes, of course, physicians and lawyers themselves and their families.
My concern is that we have an open discussion about this, and we don't get too involved in the legalities of the discussion. What we want to talk about is a basis for discussion, and what we expect and what our standards should be, and what people will know are the standards when they go into a doctor's office and give information about themselves. They will know where that information is going to, and they will have some feeling of security that the Government of the Yukon, at least, has set a standard and done it in conjunction with the Yukon Medical Association.
Hon. Mr. Sloan: I think that just at the start of this discussion, the member did address a key point, and that is that the CMA is trying to establish a code of privacy in this regard, and I would imagine that the YMA would accept that, and certainly whatever the doctors feel is reasonable in terms of protecting confidentiality would be something that we could buy into.
I don't believe, quite frankly, that information of a private nature needs to be available to anyone who is not directly involved with that, or needs to be available unless there are issues of public safety or public health at stake. So, I would imagine that the YMA will follow the CMA code, and that will probably guide some of our actions.
But, I'll take the member's comments. This may be an issue that we might want to consider for the health summit - the whole question of informatics and the whole question of how you protect medical information in an age where there is so much online. That may be a timely subject. When we get toward that idea of sort of setting some agendas, this may be something that we can put on.
Mrs. Edelman: I think the minister has heard me.
At the diabetic clinic at the hospital, where they are teaching people about food and lifestyle, et cetera, they are doing a lot of the training that we would have done when we sent people outside the Yukon. This year's budget for that is about $60,000. What are our savings? How much are we saving by not having to send people out for diabetes counselling?
Hon. Mr. Sloan: At this point, we haven't really sort of quantified that. Initially, the whole premise was not so much on a cost savings. What it really came out of, I guess, was some of the discussions I had with the diabetic association where they described the trials of having to go out to a place like the diabetes centre in Vancouver and then they'd come back and perhaps your situation would change and you would have to go back again. One of the things that I heard from them was the idea of getting ready access to information, such as having somebody you could call up and say, "What was that again that I could have and I couldn't have?" and so on.
In my discussions on diabetes education, I thought this would be a worthwhile venture to see if we could establish an education centre here. We explored it on a pilot basis, and I'm pleased that in this budget we actually have increased the money fairly substantially. I guess, in some ways, we may save eventually on people going out - on medical transportation and so on and so forth.
My interest is primarily in trying to provide a service on a more local basis so that people would have an opportunity to take advantage of this counselling closer to home on probably a more frequent basis. So, we've been actually very pleased with the success of the diabetes centre, and largely based on that success and also, quite frankly, based on the fact that diabetes is a major issue among our aboriginal population, and as well, as diabetes is an issue as our population grows older, we felt that this was a worthwhile investment.
We have - as the member will see when we get into budget lines - actually increased that fairly substantially.
Mrs. Edelman: Mr. Chair, it would seem to me that there would have to be some accounting that went on, so that we could justify the expenditures in this program.
The minister just talked about a person having to go back out again and getting their levels checked, and new programming, and apparently this diabetes education program being delivered here saves us that additional trip.
Now, was there any sort of accounting that went on, in order to justify this expenditure?
Hon. Mr. Sloan: Well, initially there was some sort of accounting. What we felt was that the initial budget - the pilot budget - probably was the amount that we could reasonably save on, in terms of travel expenditures.
But these things are kind of odd, in some ways, because, in some cases, as the availability of a service becomes greater, what we actually do is create a bit of a blip as people - now that the service is more readily available - will actually use it.
An interesting analogy was on the idea of cataracts, because we had initially expected that when we brought in the equipment, in order to be able to do cataract surgery - and now we could do cataract surgery - we felt that we'd save money from people going out to do cataract surgery. In reality what happened was, now that we had the cataract surgery available here, all those people who weren't too crazy about going out to Vancouver, and having to go through this, and were worried about the travel, and worried about all this - now, all of a sudden, "Well, I can go over to Whitehorse General Hospital, get the surgery done, and be home in the afternoon." And we actually experienced an increase in the cost of cataract surgery.
So, sometimes just having the service available really does encourage people to utilize it, I think, maybe until we clear that backlog.
I guess I'm more pleased that people would actually be taking advantage of some of this initially to maybe prevent some future health problems, and diabetes can create so many dramatic, terrible health problems for individuals that I would willingly pay that extra expense if people would become more aware of it and utilize the service off the bat.
Initially, we estimated there would be about $30,000 in savings, and that's what we used as a benchmark. However, the program has proved so successful that, in a sense, it's - I wouldn't say a victim of its own success, but it's certainly given us some direction that we should put extra resources into it, and we have.
Mrs. Edelman: Mr. Chair, thank you for the figure. What I've heard from people is that it's not just the person who has diabetes who is getting the education. It's now involving the families, which couldn't have happened when they went outside for counselling. That's good news and it's bad news because it obviously helps out in the long run but, on the other hand, it's costing the government more money. It's certainly an excellent program. I went over to their open houses a couple of times and it was great.
The Pharmacists Act - I wonder if the minister can update us on where we sit with that? The update on the Pharmacists Act is apparently being reviewed.
Hon. Mr. Sloan: Once again, I'd probably have to go back to Justice and get a status report on that. It's one of those anomalies of our system. Professional acts are regulated by Justice, and I would have to go back and check with my colleague and ask her to give me an update on the status of that.
Mrs. Edelman: Mr. Chair, indeed it is a strange situation. One of the things that came up during the Dental Profession Act is that there are significant changes in what denturists can do and what they can't do, and particularly in what they do and don't do in Whitehorse, which services the rest of the Yukon.
So, I wonder, if the minister is going to be checking back with Justice on the Pharmacists Act review, could he see if there is anything happening with the denturists act? I know the Minister of Justice talked about changing the title or something during the debate. I see that the minister seems to be willing to do that.
How are we doing with the recruitment of a psychiatrist for the Yukon? Our previous doctor, who was also a constituent of mine, I understand left the employ of the hospital, and we are short in that area.
Hon. Mr. Sloan: I'm sorry. I just missed the member's reference.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: The psychiatrist? I just missed the nature of the relationship there.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: A constituent. I see. Okay.
Some Hon. Member: (Inaudible)
Hon. Mr. Sloan: Mr. Deputy Chair, they try and try.
However, yes, I can just go through the note here. It's expected that Dr. Smith will be retiring from practice in the next few years. The rule of thumb is one psychiatrist per 10,000 in population. We have formed a task force to review and make recommendations to mental health services. Among these recommendations was the recruitment of another psychiatrist to fill the gaps in the service. The Physician Resource Planning Committee has approved the recruitment of a second psychiatrist and an ongoing complement of two psychiatrists.
Psychiatrists are in short supply in Canada. Most psychiatrists choose to practise in larger urban centres. Even in urban centres, there is extreme competition to recruit and retain graduating residents. We have been working with the hospital. We are anticipating that what we might look at is a remuneration based on perhaps an alternate blend of contractual arrangement for services within the hospital and mental health services, and a fee-for-service for GP referrals. This is something that I think might make the practice a bit more attractive.
So, in other words, we're looking at an alternative payment mechanism that would permit the payment for certain services on, say, a contract basis within a hospital or for the mental health services, and allowing that person also to have some fee-for-service for private practice.
Insurance services and mental health services will jointly negotiate a contractual portion of remuneration, if this is how we choose to go.
The recruitment committee will likely be composed of the director of mental health services, the director of patient services at WGH, the president of the medical staff, hopefully Dr. Smith himself, and one or two physicians on the mental health assurance quality team.
Mrs. Edelman: So, Mr. Chair, I'm still not clear. How are we doing with recruitment? Is one coming in next month, or are we expecting somebody in the next year, or are there any expectations for this year?
Maybe the minister can be clearer.
Hon. Mr. Sloan: I know we're actually pursuing this. I'm not sure if we've gone to a situation of advertising yet or not, but I can check to find out what the status is - if we are indeed advertising for someone, or if we haven't advertised, when we're expecting to advertise.
It is - as I said, there will be a committee functioning, made up of the individuals that I mentioned, to go through and try to look at potential candidates.
In just reviewing some of the Greater Vancouver mental health programs, I was surprised to find that there were not very many psychiatrists actually practising in the public health field. The vast majority of psychiatrists in Vancouver are practising privately, and actually there are not that many people involved in the psychiatric aspect in public mental health.
So I think that really points to where some of the issues are. It's probably a limited group of people that go through this specialty, and choose to follow it, so it is quite clearly something that's going to be difficult to recruit for. So we have begun that process.
Mrs. Edelman: Mr. Chair, I wonder if the minister could update us as things unfold, particularly when we do hire a new psychiatrist here in the Yukon?
Hon. Mr. Sloan: We'll set the appointment date and time for the Member for Riverdale South when we are successful in that regard.
Mrs. Edelman: Mr. Chair, then I think that there are a couple of other specialists that I could probably set an appointment with for with the Minister of Health.
Whitehorse General Hospital is soon going to be a chartless hospital, and it will be the first in Western Canada. The Whitehorse General Hospital has got about $700,000 more in computer equipment that it is putting in in the next year.
There are some problems around the new chartless system. One of those is the one we were just discussing and that's the issue of privacy. There don't seem to be any guidelines around who can access this information and who can't, particularly if doctors, in their clinics, are going to be starting to go online with the hospital, and there is a question of who has access at that point.
I know there are some protocols at Whitehorse General but they don't really have guidelines for outside of the hospital. I have a very grave concern about privacy in that case.
Some of the other issues around the new chartless hospital - for some reason, we have to be the first again - is that there is going to be a lack of personal comments added to the charts, and we're going to lose some of that personal touch that we so enjoy here in the Yukon at a very small hospital in a location where we know so many people. I'm concerned that we're going to lose that.
The last point that I have a concern about with this new move by Whitehorse General is that there is a lack of training for people to use the new system. The Government of Yukon is going to be providing $700,000 worth of funding for equipment that people may not be able to use and I am very, very concerned that that's the case.
I know that they're training one person in each department and then, theoretically, that person is supposed to go out and train everyone else in their department, but someone who takes the training may not be the best teacher for other people in their department and they certainly may not have time to train other people in the department. So, I have a concern in that area as well.
We do fund Whitehorse General almost exclusively. I know that they have their own policies that they develop, and they are a stand-alone corporation, but I wonder if the minister has had any discussions with Whitehorse General on any of those topics.
Hon. Mr. Sloan: Well, the member is right in the idea of the adoption of the Meditech system. That was a decision that was made by the Hospital Corporation itself.
The member has raised a number of issues concerning privacy and training and so on, and these are some things that I can bring forward to the hospital. If the member does have concerns in that regard, I'll certainly bring forward the concerns that she's mentioned.
We've had a bit of a blip, I guess, in the funds that we've made available last year to our physicians in terms of going on-line with their offices and things like that, and we actually made some funds available, but subsequent to that the physicians have, I guess, returned them. Apparently, the state of technological readiness of a number of physicians really wasn't there to take advantage of this. So, I'm not sure what that will do in terms of being able to access records at the hospital.
I'll certainly raise the points that the member has brought up - concerns with the Meditech system - with the chair of the hospital board, and with the CEO.
Mrs. Edelman: Mr. Chair, how long is this blip that doctors' offices can't access the hospital system?
Hon. Mr. Sloan: Well, I guess I didn't characterize it properly. Last year, we gave an amount to the YMA to sort of encourage physicians to get into putting offices online, to adding computers and so on to try to maybe, in a sense, modernize their offices.
We made that available to the YMA for distribution among their members. We didn't know if they were going to do, say, a couple of pilot offices or how they were going to organize it. Well, apparently there was some internal discussion as to how that could be best allocated. Since, apparently, the YMA couldn't come to an agreement on some of those issues, they chose to give us back the money, and I guess we'll have to try again at a future juncture in that regard.
Mr. Jenkins: One of the areas that we've been tracking with the minister's officials is the dollar side of the ledger with respect to the Department of Indian Affairs' claims in process and their success at collecting money. Their success at providing the service is quite evident. In fact, we're sending over or incurring expense at the rate of about $9.5 million a year. That's slightly more than three-quarters of a million dollars a month, so we're collecting it at the rate of about $4 million a year.
So, we're going backwards at the rate of almost $5 million a year, Mr. Chair. And currently, if I read the figures correctly, there's about $28.9 million outstanding and due to the Government of the Yukon for services provided to Yukon First Nations through the various agencies of the Government of the Yukon.
For the record, could the minister just confirm that that is a correct figure - what is outstanding and what is due for the last fiscal period, 1997-98?
Hon. Mr. Sloan: In terms of outstanding claims, as of January 1999, the claims outstanding were $17.2 million for child welfare, $2.7 million for the Thomson Centre, and all others were $1 million - so, a total of $20.9 million. This takes us up to 1996-97. 1997-98 claims outstanding as of January 1999 are $8 million in total.
We are continuing to meet with DIA. The deputy minister has met with the regional director general for DIA on this issue. We have expressed to the department our frustration on the part of Health and Social Services about the time it's taking to resolve this issue and the issue of being able to recover dollars actually spent on behalf of First Nation individuals.
We think that there may be some progress made. We basically have agreed to establish an agreement that an individual from DIA's B.C. office will be working on the file, and we expect that will take place by the end of March. We are hoping to see some significant progress and hopefully finalize the agreement by April or May at the latest.
The regional director general has also indicated that he would go to his finance staff to see about the possibility of making additional interim payments on account, based on invoices that have been submitted by Health and Social Services up to 1998-99. Our regional director general has indicated that he would see if anything could be paid on account in advance of the provision of detailed materials.
As well, there was review of the Thomson Centre and Thomson Centre claims. We gave assurances that the services offered in this facility fit what we believed to be a level 1 and 2 facility - definitions used by DIA, as such. We've contended that the costs attributed to First Nations receiving services in that facility should be eligible.
We are prepared to offer the assurance in writing that for all First Nation clients who have received current or past services, it's our understanding that this would give the regional director general the authority necessary to provide payments on the account. We believe that the services provided at the Thomson Centre are of a similar type and nature as provided at Macaulay. They're not services of an acute nature - so they're not, in other words, hospital-type services.
And we've given them some technical definitions, which we feel may help them. So we're working positively with the Department of Indian Affairs. We are working on this; we are trying to - my deputy minister has expressed that it is frustrating, and I think that I can echo that. We are working with a department that seems to have their own timeline and agenda.
Chair: Is it the members' wish to take a brief recess?
Some Hon. Members: Agreed.
Chair: Ten minutes.
Chair: I will now call Committee of the Whole to order.
Is there further debate on the Department of Health and Social Services?
Mr. Jenkins: We were dealing, Mr. Chair, with the Department of Indian Affairs invoicing from the Government of the Yukon for their various facilities. When we look at the outstanding claims up to 1997, we see a figure of $20.9 million. When we look at the 1997-98 claims outstanding - a further $8 million. So, we're at $28.9 million.
I'd like the minister to confirm that for the fiscal year 1998-99 that's going to end tomorrow there is probably another amount equal to the total amount that was invoiced in 1997-98 - another $9.5-plus million that's due.
You know, Mr. Chair, we're approaching $40 million here. Now, the Government of the Yukon's O&M budget is $400-odd million. This, from my rough calculation, is eight percent of the total O&M budget of the Yukon that's due to the Government of the Yukon from the Department of Indian Affairs.
I don't believe that we're doing enough to collect this amount. We're providing a darn good service, from what I'm given to understand. In fact, in most cases it's an exemplary service. The service is definitely being provided and the Department of Indian Affairs, which has the lead role to provide this service and pay for it, is not.
It is an area that shouldn't be just left on the back burner, to be resolved by some ongoing negotiations that obviously haven't produced results. We have collected $4 million, and we leave riding almost another $5 million. So, we're going backwards $5 million a year, and we've collected $2 million for 1997-98.
Can the minister confirm that there was an amount equalling approximately another $9.5 million for the current fiscal year, and how much has been paid?
Hon. Mr. Sloan: We don't have the exact amount, but I can confirm that it's probably an amount in the same range. It's certainly not for lack of trying on our part, but I have to suggest that our impact on the federal machine is probably minimal to them. I mean, we have made this case. We've argued very forcefully. We've made our case in terms of the costs themselves as being justified.
It's my understanding that the regional director general has made some commitments, as I outlined in the letter, in at least trying to look at the possibility of some interim payments, that we have explained what our charges are in the Thomson Centre - that was one point of contention. They had not been satisfied that, in fact, the services we were offering at the Thomson Centre were of an extended care nature, but rather they thought they were of a medical nature. We have demonstrated what we actually deliver at the Thomson Centre.
We have responded on every occasion to requests for information from them. We have tried to make our case. We are arguing and we will continue to argue and continue to press. This is something that I know the deputy minister has spent considerable amount of time on trying to resolve this issue.
But, quite frankly, I don't think that the federal government cares that much. I don't think that they see this as a big issue for them. It is certainly an issue for us, but I think we just continually have to press and make our case on this, and hopefully we can get some leverage with some of the aboriginal population.
I suppose the ultimate thing that we could do is withdraw services. I'm not suggesting that at all. I think that would really impact on many Yukoners here, because what could we effectively do? Could we stop taking children into care? Could we stop providing child welfare? That would be fraught with all kinds of dangers. We can't really restrict people from some of our services.
So, we are continuing to try to resolve the situation. We have put considerable energy in and we will put considerably more energy in. We seem to be getting a bit of momentum from the new regional director, and hopefully that can carry this thing to a positive resolution. This is a problem that has gone on for years and years and years. We have made some progress, but we need to make more.
Mr. Jenkins: Well, I believe we have to make more than progress. We have to start making decisions as to how we're going to collect this.
Fully eight percent of the O&M budget of the Yukon government is outstanding in one department of this government and is due from one agency of Canada for services that this government is providing to meet a fiduciary obligation of the federal Department of Indian Affairs.
Isn't it about time, Mr. Chair, that we looked at the option of turning over some of these facilities back to the Department of Indian Affairs to operate and we pay that Department of Indian Affairs for the involvement of non-status Yukoners in those facilities?
Because certainly, Mr. Chair, we have to look at some other options to explore. We have to look at some deadlines being given to Indian Affairs to start meeting their obligations. We are looking at a $40-million debt due to this government. Eight percent of the O&M budget for this last year is due.
I'd like the minister to go back and calculate what the interest would be over the past few years at the normal rate of interest that the Government of Canada pays - what we're losing in interest. We know that there's approximately $40 million due to the Government of the Yukon. Now, over the years, it would be a very simple exercise - and I'm sure that amount would amount to additional millions of dollars - and those millions of dollars could have been used for other purposes within the health care system, other than the carrying cost of this receivable.
So, I believe it's time for more than just negotiations. It's time for deadlines, and it's time to put other options in place. Give them this deadline: "On this date, this facility is turned back to you, Indian Affairs, and you can operate it." These are the kinds of the deadlines and situations that senior governments will respect, because the obligation for Indian Affairs to provide this type of health care system to our First Nations doesn't go away. That is their responsibility. We're delivering the health care system.
Now, I'm not suggesting that we withdraw the service. I'm just suggesting, Mr. Chair, that we explore the possibility of giving a deadline to Indian Affairs to turn over the operation of the facilities to them at a certain date if they can't come forward and meet their obligations.
And furthermore, Mr. Chair, in the past I was involved in one federal Crown corporation, who ran into the same problems with Indian Affairs, specifically in the Northwest Territories, and the only way they were made to pay their bills was by giving them an ultimatum, and that ultimatum had a timeline to it, and the money started to flow and, because of the burden that it put on this Crown corporation, they were made to put upfront a certain sum of money, because it took them anywhere from - 90 days was early payment. It was usually 365 days plus, and sometimes several years before they paid their bills, and we have the same situation here, and it involves the treatment of humans and human lives and human care. So, we've got to do more than just negotiate this.
I'm urging the minister to take that offer forward and deal with it, and I also want the minister to put together the interest charges that would have accrued on this liability that the Government of Canada has incurred through Indian Affairs to the Yukon. It just has to be a rough and ready interest calculation based on outstandings at every six-month interval. It could be easily calculated. I'm sure that the minister will come up with millions and millions of dollars, and wouldn't the minister like an additional several million dollars in his budget this year?
Hon. Mr. Sloan: Well, I'd love more money. The unfortunate thing is that, if this were to generate interest, I'm advised that, by our funding formula, we wouldn't realize the net benefit of it anyhow. It is a substantial amount of money, but I don't think there would be any net benefit for us because, basically, the interest would not revert to us.
I think there are a couple of things that need to be realized. The facilities that people are in - and in this case First Nation individuals who are at Thomson or First Nation children in care - are in our facilities, so it isn't a case of turning back facilities. These are not related to health care charges. These are related primarily to social service charges.
So, I don't think it would do any good in that regard. Probably the only alternative that we would have would be to simply pick a date and suggest that, after that date, we would no longer provide services to First Nations people. I think that would be extraordinarily difficult to do in this territory because it would really mean that, basically, we'd be saying that there's a group that we won't serve because of a dispute with the federal government.
I'm very concerned about the amount of money that has been accumulated in this regard. We have been pressing forward, as I read in the letter, to get an agreement just on the type of upfront payment mechanism that we would be seeking. It's our goal to have that completed by May.
We have delivered the message to the feds that we expect some resolution of this whole issue by May or we are going to have to take a look at alternatives. But, we don't have the capacity to turn over facilities to DIAND, simply because the facilities are ours. The only thing we would have is to restrict services. That, I think, would be highly problematic.
We are continuing to press and continuing to press actively on this.
Mr. Jenkins: Well, I'm asking the minister to assemble the interest figure, not because I anticipate the government ever collecting it from the federal government, but just to show the amount of interest that would have accrued on this outstanding amount for the period of time that it's been outstanding. It is a relevant figure because anybody who doesn't pay their bills on time is going to be charged an interest charge.
The federal Government of Canada is no exception. Only, with the feds they set the rules as to how much they're prepared to pay. Let's take their rule and do a rough and ready calculation of what would be due to the Government of Yukon.
I want to make it abundantly clear that I'm not suggesting that we withdraw services. I don't believe that that's an option we should be exploring. But, I do believe that we should be looking at saying to the feds that we're going to turn over some of these facilities to them to operate, because given the number of First Nations involved in it, or given the number of First Nations involved in this program - and a number of these programs are predominantly First Nations - why can't they deliver the service that they have the responsibility of delivering themselves?
There are a number of options that can be explored. The minister might explore further the option of taking the chiefs of the First Nations here in the Yukon with him to meet with the minister, because it sounds like they're one heck of a better group of negotiators than the minister and his department have with this Indian Affairs group. Perhaps they can realize some benefits for all of the Yukon.
This bill must be paid, and we're going backwards on it. It's increasing, and it has been increasing for quite a number of years. Probably by the end of the fiscal year that ends tomorrow we'll be looking at almost $40 million - not quite half of the minister's annual budget, but eight percent of the total O&M budget of the Government of Yukon. That's a considerable impact.
While the interest couldn't be collected from the federal government, on the investment side the Government of Yukon is losing income as a consequence of these funds not being here because it would be in our bank account and would be generating investment income somewhere - unless this NDP government decided to spend it, like they probably would very quickly. That could be another $40 million of cash on hand that we could realize further investment income from.
Now, I've stretched my mind, but I can't understand why the federal government is refusing to pay. Perhaps the minister could enlighten the House as to the reasons why the Department of Indian Affairs is refusing to pay. He's gone over the issues surrounding the Thomson Centre and the children in the care of the social system but, overall, why are they refusing to pay? What reasons are they giving over at Indian Affairs for not paying this outstanding amount?
Hon. Mr. Sloan: I guess some of the struggles that we've had with the feds in this regard have been around issues about what they consider to be direct and indirect charges. There was the dispute around the Macaulay and the Thomson Centre as to whether indeed these were acute-care facilities or long-term care facilities.
There's also been some issues in terms of the DIA's refusal to pay actual costs. They have, basically, a formula that they use in western Canada to calculate the cost, and they disputed the fact of what our actual costs were. Those are some of the reasons.
With regard to First Nation involvement, we have been working with CYFN on this issue, so it's not a case that the First Nations people aren't aware of this.
But with regard to the idea of turning over facilities, I have to emphasize that a lot of the facilities that we have - child welfare - that would involve us basically turning over group homes, which we have. It would involve us basically abandoning something like residential youth treatment, and saying, "Okay, you run it."
I honestly can't see us doing it with Macaulay or Thomson Centre. I can't see us walking away from that. I mean, that just wouldn't make sense.
I mean, which group homes? Which would we do? How would we hive them off? We have the residential youth treatment centre. McDonald Lodge itself has $261,000 in arrears. I mean, we certainly can't turn over McDonald Lodge. Kaushee's Place - $716,000. We can't simply walk away and say, "Thank you very much, it's your business."
We can't walk away from the Dawson women's shelter, which shows $17,000. We can't walk away from that. We simply can't walk away from the $3.8 million for the Thomson Centre. I think that idea, while it may have some attraction, is just not practical. I mean, certainly we have some major concerns in this area. The member doesn't have to remind me how much money it is, but I think we are working as best we can with the federal government in this regard, but I think the member also has to recognize the fact that, probably for DIA, this isn't a major issue for them. They probably don't see this as a major issue. Considering all the other challenges facing DIAND around the country in terms of issues such as aboriginal housing and things like that, this may be small potatoes to them. It's big to us, but I think the best thing that we can do is continue to work, continue to make progress with our regional office, try to get in place a solid agreement, which would give us some guarantees, and continue to try to resolve this at the table.
I'm just a little bit leery, quite frankly, of taking a very drastic action that might imperil the health and well-being of First Nations citizens in this territory. I'm really quite frightened of the prospect of simply saying, "We won't do child welfare any more. You do it." Because I think that's fraught with all kinds of dangers, and I simply would not feel that that would be a responsible attitude to take, nor do I feel, quite frankly, that the First Nations of this territory would feel that that was a responsible attitude to take.
So, we are continuing to work on this. We will continue to work. We'll press vociferously on this. We will continue to work with the regional office to try and have this thing resolved.
Mr. Jenkins: The minister speaks, Mr. Chair, of making progress with the Department of Indian Affairs. The minister speaks of having interim payments made by the Department of Indian Affairs.
I remind the minister that he hasn't made any progress. In fact, the debt that is owed to the Government of the Yukon - today or tomorrow, at the end of our latest fiscal period - will probably be at an all-time high - an all-time high, Mr. Chair - and we haven't received any interim payments.
On the issue of interim payments, all that's been paid for, Mr. Chair, is what's classified under "all other", and it's only a partial payment for the provision of general medical services. All of the other areas remain outstanding. There have been some lump sum payments made in previous years, but a lot of these amounts go back to 1993.
I'd like to ask the minister, Mr. Chair, at what stage, at what level of indebtedness, is he going to look at drastic action? Or is he going to look at saying, "We can't continue to operate these facilities. They'll have to go back to you, Mr. Federal Government." How much of a debt load, or how much of an accounts receivable, is the minister prepared to allow before he does take some drastic action?
What I'm suggesting for drastic action is to give the federal government timelines as to when programs and facilities will be turned back to them. They can operate them.
I'm sure it could be accomplished. There has to be a way. The minister can offer all sorts of excuses but the fact still remains that the Government of the Yukon is due $40 million from the feds for the provision of services.
The minister says, "Well, we're working on it"; "Well, we're negotiating" or "Well, we're talking and we want to continue to talk." At what level are we going to say, "Enough is enough" to the federal Government of Canada and the Department of Indian Affairs and get them to address their responsibilities. This fiduciary responsibility is between the federal Government of Canada and the First Nations of the Yukon. That is abundantly clear in any of the land claims agreements that I have read and in the UFA. It is stated quite categorically.
I don't think it was ever anticipated for the Government of Yukon to provide the service and not get paid. Now, we've got a few lame-brained excuses as to why they're not paying. If the minister wants to hide behind that for a $40 million indebtedness, I think he's very naive in the business world.
This minister is running the largest department in the Government of Yukon. It's charged with the provision of health care. The health care has been provided. Why isn't it being paid for? At what point is this minister going to say, "Enough is enough? We have to be paid." Is it going to be $40 million, $50 million or $60 million? What is it going to be?
Hon. Mr. Sloan: Well, Mr. Chair, there isn't a magic number. I've given the member the indication that we've been working with DIAND to try and get some resolution on this. We feel we're making some strides in that regard, particularly with the DIAND regional director general. We've targeted May for getting a resolution and an agreement that would prevent these kinds of situations from growing.
The member is taking a highly simplistic attitude. Is he suggesting that if, by some magic date - say July - the federal government doesn't pony up the money, that we turn over McDonald Lodge, that we turn over Thomson Centre, that we turn over Macaulay Lodge, that we simply say, okay, we're not going to deal with child welfare for aboriginal children or we're not going to deal with social issues for aboriginal people? These are people who - I mean, I agree that the fiduciary responsibility resides with the federal government and there is no argument with that. That's what I've argued at all meetings with our federal counterparts, but there is also a responsibility that we have to our aboriginal citizens in the territory to provide certain services.
I can't, despite any argument I may have or any dispute I may have with the federal government, step away from the responsibility to deliver certain services for aboriginal citizens. I simply can't do it. That would not be right.
I'm actually quite frightened that the member's suggestion is that we simply walk away from programs or walk away from facilities and say, "You guys take it." Because I don't have any guarantee whatsoever that the federal government will do it. The federal government's track record, quite frankly, in fiduciary responsibilities in western Canada, has not been good. They have walked away from fiduciary responsibilities in Saskatchewan. They have walked away from fiduciary responsibilities in Manitoba, where they've simply decreed that for First Nation people living off reserves they no longer have a responsibility to them. And ask Minister Mitchelson in Manitoba how that has impacted on the budget situation in Manitoba.
It's been disastrous. It's added millions. And they're making the same arguments with the federal government as Saskatchewan has - that the fiduciary responsibility is with the federal government.
We're not walking away from this; we're continuing to argue; we're continuing to put forward our position, and what we feel is a very justifiable position.
But the alternative that the member's suggesting, the alternative about relinquishing facilities - and why on earth would I relinquish the Thomson Centre to the federal government? What would that do to the residents there? What would that do to all the people who depend on that service? How can I walk away from Macaulay Lodge? How can I simply say, "Here it is", to the director general of DIAND in the territory? Say, "Here, it's yours." What would I do about the residents there?
I can't walk away from the children's receiving home. I can't simply say, "Well, tough; there are 16 children in there but hey, they're not my responsibility any more. It's yours." I can't do that. That's irresponsible.
Regardless of any disputes I may have with the federal government, I can't abrogate the responsibility for individuals in that way. As appealing as the rather simplistic solution proposed by the member might seem, fundamentally it is wrong.
I don't like being owed this money. We're endeavouring to reach a resolution with DIAND, but the alternative the member's suggesting, to simply give up, to simply stop serving aboriginal Yukoners, I find, is unacceptable. We can't do that.
I can't simply say that a child who needs protection, or a child who needs to go into a group home can't, because that child has aboriginal ancestry. I can't say that. I honestly can't.
And I can't suggest that I'm going to throw that child on the tender mercies of DIAND. I mean, what structure do they have in place to do this?
What structure do they have to intervene in matters like this? These are human beings. I can't simply walk away because I'm in a staring match with the federal government. I can't do it.
What I can do is work with DIAND here. We can resolve the situation. It's frustrating. It's extremely frustrating, but we can continue to work. We can look at other alternatives. Those alternatives may be a different billing-back system to, say, individual First Nations and let the individual First Nations chase DIAND.
There are some alternatives that we could do there, unless they resolve these situation, but I can't simply turn over facilities, and I simply can't walk away from responsibilities to aboriginal Yukoners. I can't do it.
Mr. Jenkins: Well, Mr. Chair, we can't continue to carry this outstanding amount that is growing every year. Now, there is nowhere in the UFA or in any of the land claims agreements that I have read where it says that the Government of the Yukon is to provide these services. I remind the minister that all he is is the agent delivering the service to our Yukon First Nations on behalf of the federal government. That's all he is, an agent delivering the services.
I would suggest to the minister that there is a lot more we can do, and we could do it a lot better if we all got together - all of the Yukon First Nations and the minister - and made a presentation to the Minister of Indian Affairs and Northern Development.
Obviously, all the steps taken to date are not working. We're incurring a larger and larger liability every year. We're up to almost $40 million in outstanding billings to Indian Affairs.
Why doesn't the minister explore that avenue? If the First Nations were aware of how much outstanding debt there exists in the Government of the Yukon health care system on behalf of the respective First Nations, perhaps it would be a first step - that each one of the Yukon First Nations be made aware of how many dollars were due to the government on behalf of each of the respective First Nations. Is it broken down on that basis? Are they aware of it?
When you start talking in tens of millions of dollars you lose focus on the amounts. You really do.
I don't believe this minister, Mr. Chair, is making enough initiative to recover these funds. We did make progress for awhile, but we seem to have gone backwards. Now, why did we start sliding backwards? Is there not enough initiative being taken by the minister himself, or not enough direction being provided to his department to go out and make this a priority? We're looking at almost $40 million - ballpark; it could be a little more, it could be a little less - that's due to the Government of the Yukon from Indian Affairs.
The various First Nations around the Yukon could be made aware of how much in the way of services have been provided to their members, and this is an issue that we should all resolve together.
I believe that, with an initiative like that, it can be resolved. Otherwise, in another year's time we're going to be sitting here and it's going to be approaching $50 million.
Now, there has to be a game plan put down and laid out as to how we're going to go about collecting this. The plan that we have in place to date is not working. Every year, we collect a small amount, and our accounts receivable goes up, up and up.
At what step do we decide to do something? Could the minister advise the House?
Hon. Mr. Sloan: Well, the member seems to be somewhat deficient in some information in this regard. We have been working with First Nations on this. As a matter of fact, the Government Leader and Grand Chief Adamson made a written submission, I believe, to the federal government on this.
We do have a process in place for First Nations chiefs through summit meetings that we have had. I have raised the issue of DIA recoveries at some of these meetings. I will be meeting later on this month with the First Nation health commission, and it's our intention to raise this particular issue again.
So, we have been working with our First Nations partners on this, and I'm sure they are aware. What is problematic is being able to break out for individual First Nations how much is actually owed on their behalf. That is considerably more problematic.
But we have set in place a process. The member says, well, why did we start and then stop, and start and stop? We have never stopped, but I have to say that DIA's interest in this has waxed and waned at different times. Now, we have been making efforts with the new regional director general to get this process going again. I have just gone through the substance of the letter, and I can give the member what we are working with here in trying to achieve an agreement on this.
The regional director has said that a person will be assigned from DIA to work on this file. We're hoping for some significant progress, and hope to finalize an agreement by April or May at the latest. He has indicated that he is willing to go back and talk to Finance to see about the idea of making interim payments. We have clarified some questions that they have on this. We are working with them, but the member seems to want, at this juncture, to declare war on the federal government yet again.
I would suggest that the people who would be collateral damage in this would be the First Nations citizens of this territory, and I'm not willing to sacrifice First Nations children, First Nations elders or First Nations people in general by any kind of intemperate withdrawal of services or intemperate curtailment of services. We are going to work on this issue. We are going to continue to work on it. We are going to continue to put forth tremendous efforts in that regard. This is something that we've made a commitment to.
I would say, just from the tenor of the meetings that we've had with our regional director general, there seems to be a willingness to at least move this file and process ahead. Because of that, we are hopeful.
Mr. Chair, I move that you report progress.
Motion agreed to
Hon. Ms. Moorcroft: I move that the Speaker do now resume the Chair.
Motion agreed to
Speaker resumes the Chair
Speaker: I will now call the House to order.
May the House have the report from the Chair of Committee of the Whole?
Mr. McRobb: Committee of the Whole has considered Bill No. 14, First Appropriation Act, 1999-2000, and has directed me to report progress on it.
Speaker: You have heard the report from the Chair of Committee of the Whole. Are you agreed?
Some Hon. Members: Agreed.
Speaker: I declare the report carried.
Hon. Ms. Moorcroft: I move that the House do now adjourn.
Speaker: It has been moved by the Minister of Justice that the House do now adjourn.
Motion agreed to
Speaker: This House now stands adjourned until 1:30 p.m. tomorrow.
The House adjourned at 5:26 p.m.
The following Sessional Papers were tabled March 30, 1999:
Workers' Compensation Act (Yukon) task force review: phase 1 - Issues Paper (dated Spring 1999) (Harding)
Yukon Workers' Compensation Health and Safety Board 1997 Annual Report (Harding)