Thank you, Member from Yellowknife Centre. Yellowknife Centre, to your question.
Thank you, Mr. Speaker. As I was proceeding to my point -- thank you -- I'm getting at is why doesn't the Member -- Minister engage Members as being part of the solution rather than this wall of we know everything and stay out of our way? Thank you.
Thank you very much, Mr. Speaker. Mr. Speaker, the information that I have that empowers me as Minister, and a role that I carry because of the trust of the majority of this House, was to do my job. Part of my job is travelling to Ottawa. Part of my job is also talking to stakeholders. Stakeholders in this case have been very open about what it is they're looking for. That formed the letter. That is what I am now taking to Ottawa.
It is also worth saying, Mr. Speaker, that the Constitution gives the federal government exclusive jurisdiction over immigration. They have allowed us as provincial and territorial governments to administer parts of that program for them, but I cannot change the Constitution because a Member wants me to. Thank you.
Thank you, Minister of Education, Culture and Employment. Oral questions. Member from Yellowknife North.
Thank you, Mr. Speaker. I would like to ask some questions of the Minister of Health and Social Services about nurse practitioners.
So I've heard from many nurse practitioners in the NWT who report not being able to practice to their full scope and, certainly, we had a lot of gaps in our system that we need filled, and there might be potential for nurse practitioners to fill some of those roles. So my first question is what is the NTHSSA or health and social services doing to ensure that nurse practitioners can practice to their full scope and ability? Thank you, Mr. Speaker.
Thank you, Member from Yellowknife North. Minister of Health and Social Services.
Thank you, Mr. Speaker. If Mr. Speaker would be kind enough to let me respond to this one, so I might need a little bit more time but if not, you can let me know. Because I think a lot of these answers, to fully understand how nurses are regulated are going to take a lot more time than I have left. So what I will say is that nurse practitioners are regulated through CAN. The nurse practitioner scope of practice is defined by legislation and applies to standards of practice through CAN. Operationally, nurse practice is aligned with the role for which they are hired. So, example, a nurse practitioner working in renal care would be expected to practice to their fullest scope within that area of practice; however, this might look quite different for a nurse practitioner working in primary care. I have a lot more information to answer that, so I would be glad to share that with the Member and any -- and all the Members. Thank you, Mr. Speaker.
Thank you, Mr. Speaker. I do look forward to further discussion on this. I understand it's somewhat of a complex topic.
Before the team-based approach, nurse practitioners working in primary care in the NWT had their own patients assigned to them. On the current teams, though, the nurse practitioners are not allowed to be the most responsible provider. In some cases, patient have been forced to break their connection with the NT who used to be their provider. So is the NTHSSA planning to allow nurse practitioners to take on the role of most responsible provider once again? Thank you, Mr. Speaker.
Thank you, Mr. Speaker. Mr. Speaker, as this has only been implemented in the capital through the primary care clinic, the team-based approach, we are currently, you know, rolling it out in different areas of the territory. But in Yellowknife region right now, the nurse practitioners on the team do provide a full care with their scope to patients that are assigned to them. From the moving to -- from the old clinic space to the Liwego'ati, as it relates to nurse practitioners practice has not reduced their scope and historically nurse practitioners have not had patients specifically paneled to them on their team, but they -- you know, they were part of that panel, and when they changed the paneling, there was a lot of the patients with -- that were working with certain nurse practitioners and physicians were paneled together so that way those changes could extend. But, however, with the model of care with primary care, it is basically through that team approach is to being seen the best health professional that is to their need. And then if it needs to be bumped up to a nurse practitioner or to the physician, that would happen through that plan of care. Again, we can have this more further information and conversation so I don't take out the clock. Thank you, Mr. Speaker.
Thank you, Minister of Health and Social Services. Final supplementary. Member from Yellowknife North.
Thank you, Mr. Speaker. So I'm also told that nurse practitioners are only allocated about $2,000 a year for continuing education, but it often costs significantly more than that to keep up the professional development training they need to fulfill their license requirements. So how will the NTHSSA ensure that nurse practitioners are allocated a sufficient professional development allowance that reflects their level of responsibility and expertise? Thank you, Mr. Speaker.
Thank you, Mr. Speaker. And, Mr. Speaker, first of all I'd like to say, like, you know this type of feedback is the valued feedback that we have received and that we are examining ways to increase professional development support. With right now what we have is the PDI, which is a fixed current funding envelope for all health care staff, however, allocating more to the nurse practitioners in this right now would actually decrease it to the health practitioners that are in this. The program is -- it's actually related to their jurisdiction. So whether you live in Yellowknife, you may get $2,000 where a core of our nurse practitioners are, so that's why the Member might be saying there's a cap. But, for instance, if you live in the Beaufort Delta, you get additional because it'll take in account the costs maybe to travel to access some training that they may be required to do. However, this has been taken in account, and we are trying to find ways to work it into our new people strategy to look at all of the professionals. We even have a nurse practitioner lead that is looking at job descriptions to ensure that, you know, the things that are needed and to be able to provide on -- in-house training as well. Thank you, Mr. Speaker.
Thank you, Minister of Health and Social Services. Oral questions. Member from Range Lake.
Thank you, Mr. Speaker. Mr. Speaker, I know -- I spy some healthcare workers in the gallery, so I thought I'd ask some health care questions to the Minister of Health and Social Services.
Will the Minister of Health and Social Services give her guarantee to this House that Stanton Hospital's emergency department will have an emergency physician physically present for all times this summer 24 hours a day, 7 days a week? Thank you.
Thank you, Member from Range Lake. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, within the -- with the Member's question, what I can say, as the schedule as developed, we have been scheduling physicians, emergency room physicians. Beyond what the development of the schedule is, I would have to get back to the Member as the schedule is developed. Thank you, Mr. Speaker.
Well, thank you, Mr. Speaker. That didn't sound like a guarantee and perhaps we could see the schedule at some point, but that might be breaching operational concerns. But I will ask this: If we can't get a guarantee, what is the Minister's answer to a patient who arrives at Stanton ER for emergency treatment, there's no emergency physician, what does the Minister want them to do to get emergency care? Thank you.
Thank you, Mr. Speaker. Mr. Speaker, when any Northwest Territories resident arrives to any health facility, they are triaged. And especially in the emergency, there is the triage, the CTAST that every patient is triaged. And so based on their -- what their complaints are and what they're coming in for, then that is what designates their priority. If like their symptoms or something changed while they're waiting to -- they're encouraged to go back to the registrar and have a nurse reassess them. There are -- you know, and I think the thing what I would like to say is that the staff that are working in emergency, you know -- and I hear what the Members are saying and I'm not -- you know, I'm not trying to sugarcoat it. They're working hard. And, yes, there's a lot of things going on. There's medevacs coming in. There's physicians on the phone with small communities while there's people sitting in the waiting rooms, you know, the struggles that we've heard of accessing appointments and things like that, those are all on the -- like, those are things that they're currently, you know, working with. You know, I've had conversations with the PA just as recent as today on an update on the primary care clinic. So there are ongoing things that they're continuously trying to improve in the capital to improve the lives of the residents here as well as outside of Yellowknife. Thank you, Mr. Speaker.
Thank you, Minister of Health and Social Services. Final supplementary. Member from Range Lake.
Well, thank you, Mr. Speaker. Mr. Speaker, I'm glad to hear that we're talking about the whole territory, not pitting regions against each other. To that end, we know that the Inuvik hospital often suffers similar shortages and staff. Can the Minister guarantee to this House that labour and delivery services at the Inuvik hospital will remain open over the summer, preventing moms and their families from travelling to Yellowknife, or farther, to have their babies? Thank you.
Thank you, Mr. Speaker. Mr. Speaker, this was one of the reasons why, you know, we have an anesthetist, we have physicians that have -- we have to have the backup for cesarean sections to be able to provide services for labour and delivery and, you know, our physicians also need to go on vacation. So with the locum, the new locum rates, we're hoping that we can encourage locum and aesthetics and, you know, and GPs to come up to help with our physicians so that they can take the time off that they need as well as the nurses. As long as I've been in Inuvik, the nurses that do provide the obstetrics are our local core -- the ones that live there, they have their families there, and they need their time off too. So we will work by using any means to be able to keep that services open; however, we need to ensure that we have the staff there to do it safely. So what I'm committing to is to making sure that we are providing safe obstetric services, you know, and if it becomes where we do not have a service, then, you know, we will have to transition to Yellowknife. Right now, I haven't had that so hopefully that doesn't change over the summer. Thank you, Mr. Speaker.
Thank you, Minister of Health and Social Services. Oral questions. Member from Yellowknife Centre.
Thank you, Mr. Speaker. I want to follow up with a further question with the Minister of ECE.
So we've been told by elected officials outside of this House that the Minister has been offered 150 nominees if the GNWT demonstrates their utilization rates for asylum seekers, Mr. Speaker, through the program. Basically, take 150 refugees and get 150 -- and just to be clear, take 50 refugees and get 150 nominees. Can the Minister confirm this? Thank you.
Thank you. Minister of Education, Culture and Employment.
Thank you very much, Mr. Speaker. Mr. Speaker, we have discussed this previously on the floor of the House. That was an offer from the previous Minister in the previous government. Thank you.
Mr. Speaker, old government/new government, good offer/bad offer - I don't know. So why did the Minister refuse the 50 refugees so we couldn't get the opportunity for the 150 nominees? Thank you.
Thank you very much, Mr. Speaker. Mr. Speaker, we just heard a number of rounds of questions about the strain on our healthcare system in this territory. One of the questions in my response to the federal government, and I think it's worth saying that I never refused it, but I did ask questions. I did say, can you give me information on those 50 asylum seekers and what type of services they would require in the Northwest Territories. Because we would be required to address them and provide them. Thank you.
Thank you, Minister of Education, Culture and Employment. Final supplementary. Member from Yellowknife Centre.
Mr. Speaker, is the Minister supportive of the program to get the nominees and what's wrong with getting 50 refugees? It will help solve our economic crisis here we're having in the Northwest Territories, in all our communities, Mr. Speaker. So, Mr. Speaker, would the Minister write the federal Minister responsible for this file and take the 50 refugees so we can get the 150 nominees?
Thank you so much, Mr. Speaker. Mr. Speaker, the offer was for 50 asylum seekers and, at times, asylum seekers can require additional services. And so what I needed to know for my colleagues who would be in departments that would be required to respond is what type of services would we be obliged to provide and what level of service would be expected. I never received a response to those questions. I never received a response asking what type of supports we would receive to be able to provide those services to asylum seekers. So I was definitely in the conversation but, as we all know, the federal government did go into an election period. Never received a response. And I intend to continue the conversation on immigration for the Northwest Territories next week in Ottawa. Thank you.
Thank you, Minister of Education, Culture and Employment. Final supplementary. Member from Yellowknife North.
Thank you, Mr. Speaker. My next set of questions are for the Minister responsible for the public service, also the Minister of Finance.
So the NWT Medical Association has been advocating for interest-based negotiations as a way to ensure that the collective bargaining process can be focused on areas of common ground and the outcomes that everyone wants, which is ultimately a better healthcare system. In the winter sitting, I had asked the Finance Minister about the government's position on interest-based negotiations, and the response was that the government was -- would look into it. So is there any update from the Minister on any decision that the government has made whether or not to enter into interest-based negotiations with the NWT Medical Association? Thank you, Mr. Speaker.
Thank you, Member from Yellowknife North. Minister of Finance.
Thank you, Mr. Speaker. Yes, Mr. Speaker, in fact, there is a bit of an update. We are later -- I guess not quite this month. Early in June, Department of Finance officials and staff from NWTMA will be together going and doing a workshop that helps investigate and helps learn about what interest-based negotiation might look like, so we can see where that process takes us. Thank you.
Thank you, Mr. Speaker. So that is encouraging to know that the government has agreed to participate in the workshop. Is there a time by which the government will have to confirm or decide, indicating to the NWT Medical Association that it is willing to go forward and enter into these style of negotiations? Thank you, Mr. Speaker.
Thank you, Mr. Speaker. We're not under a deadline, per se, Mr. Speaker. There will be a new round of bargaining that will commence when the collective agreement that we're under comes to its conclusion which is in 2026 so that, I suppose, is the deadline, but as far right now, the next step really is to go to this two-day workshop and to, you know, engage really collaboratively with both parties there to determine whether or not that's going to be the process we use. Lots of time between now and 2026 to put that into place if that's the path that we go down. Thank you.
Thank you, Minister of Finance. Final supplementary. Member from Yellowknife North.
Nothing further.
Oral questions. Member from Range Lake.
Thank you, Mr. Speaker. I was meeting with a constituent over the weekend and learned that their child is having trouble accessing gender affirming care. Can the Minister explain why the government continues to rely on Alberta Health Services to provide Northerners with gender affirming care when it's well known that many surgeons are unwilling to perform these procedures due to the current political climate in the province? Thank you, Mr. Speaker.
Thank you, Member from Range Lake. Minister of Health and Social Services.
Thank you, Mr. Speaker. Mr. Speaker, the support that we have from Alberta, we have physicians here in the Northwest Territories that do provide this care. It's kind of like MAID. We have some physicians that do provide MAID. We have some physicians that do provide transgender care; that's a safe care for them to access. And with their practitioner, they work with their practitioner on how they move through the system. Alberta currently -- there are no surgeries done in Alberta currently so bottom surgeries and things that are done, there's only one place in Canada that those are done, and those are done in Quebec. Thank you, Mr. Speaker.
Well, thank you. I mean, in this case it is a surgery for gender affirming care. It is top surgery. But given that Ontario has far more capacity to provide gender affirming surgeries, why can't our health system send NWT residents there, given the political climate in Alberta is compromising access to timely and appropriate care for those seeking gender affirming surgeries? Thank you, Mr. Speaker.
Thank you, Mr. Speaker. Mr. Speaker, you know, and everyone is aware that, you know -- and I'm not going to speak for Alberta and their rules. And I know that their legislation does speak to puberty blockers before the age of 16 and surgeries before they're age 18. So when the Member speaks to top surgeries, yes, that's accurate. And also the conversation that I had in person with the Minister, and I am going to be going down to Alberta to meet with the -- you know, to schedule a meeting with the health Minister there. They have switched portfolios, so there is a new health Minister that will be responsible -- is to ensure that Northwest Territories residents, whether they're going down there, transgender youth, people, that are going down, any 2SLGBTQ going to access care in Alberta, that they are going -- for anything, because that is where our master agreement -- you know, where we get services from -- that they are going to be safe when they access any types of -- they're going to be respected for who they are. And this is an ongoing conversation that I will continue with the Minister of health in Alberta. However, I did also say on this floor of the House if -- you know, if there are services that we need to do differently, those are where we take master agreements and we start to look and those routes have been actually -- I've directed the staff to start to look at different routes that is not in Alberta. Thank you, Mr. Speaker.
Thank you, Minister of Health and Social Services. Final supplementary. Member from Range Lake.
