Thank you, Mr. Speaker. Earlier this month Hay River was in the midst of a serious physician shortage. We had one physician in the community; one physician to service not just Hay River but all of the South Slave communities served by the regional health centre; one doctor to manage the workload usually allotted to five full-time positions. The number of scheduled appointments was limited, and walk-in appointments, which are hard to get on a good day, were either limited or sometimes cancelled entirely, so, as you can imagine, the emergency room turned into the walk-in clinic.
Mr. Speaker, this shortage has further eroded public confidence in our healthcare system. It is unacceptable, and we have to take steps to ensure it does not happen again.
This situation also makes it harder to attract staff to Hay River. What doctor wants to work somewhere when they think they might be put in a position to be on call for days on end to do the job of five people? I understand that it’s tough to find full-time doctors and even locums, and I acknowledge that there is a doctor shortage all across rural Canada. However, Mr. Speaker, there are things we can do to attract more full-time physicians to Hay River, and we need to start doing them.
First, we need to break down the barriers that isolate Hay River from the rest of the territorial health system, including those barriers that prevent authorities from sharing resources like staff and physicians.
We need to make more land available for development so there are actually homes for potential physicians. Mr. Speaker, while the availability of land does not sound like it’s related to the healthcare system, it’s a practical consideration that has become a real issue.
We have to shore up our electronic records management system so that, when a locum works in Hay River, he or she does not return south and tell everyone that it’s difficult and time-consuming to simply find information about patients.
We have to fix administrative issues so doctors are not frustrated when they tell a client to book an appointment to see them in two weeks and then they never see them again because it’s impossible to book appointments.
We need to support our residents who are attending nursing school or taking pre-med courses at university by offering them summer jobs. That has not happened in Hay River in years.
Mr. Speaker, these are just a few of the examples of things that need to change. They are not insurmountable challenges, but, when you add them all up, they stack the deck against us. I will have some questions for the Minister of Health at the appropriate time. Thank you, Mr. Speaker.
Question 721-18(3): Recruitment of Physicians in Hay River
MR. SIMPSON: Thank you, Mr. Speaker. Just a moment ago I spoke about the need for more permanent physicians at the Hay River Health Authority, and I talked about some of the issues, some of the barriers that we are facing, in terms of being able to recruit physicians. There are just a few. I often get complaints about the work environment as well, but I didn’t want to delve into that too much.
I have a series of questions for the Minister of Health. My first is: what steps is the Hay River Health Authority, along with the Department of Health, doing to recruit more physicians in Hay River? Is there a strategy? Is there a plan, or are they going to continue to use the same recruitment practices that have had failed results? Can the Minister please elaborate? Thank you, Mr. Speaker.
HON. GLEN ABERNETHY: Thank you, Mr. Speaker, and I understand the frustration that the residents of Hay River have had. Obviously, we need to do better in Hay River than we have done.
The authority is actually currently developing a new formal recruitment strategy in order to help them find more physicians, hopefully on a permanent basis. A lot of work needs to be done. I think the Member did a great job of articulating some of the things that need to be done. Some of those things are the types of things that they are doing, but I will reach out to the authority and figure out where we are on some of those exact items.
In addition to that, Mr. Speaker, the NWT Health and Social Services Authority is currently recruiting an area medical director who would actually be based in Hay River. This individual would be working in Hay River to serve patients while also being part of the territorial medical staff for the entire territorial health authority. This will help build a relationship, an important relationship, within the system to help address challenges that we know are arising.
They are also working with the territorial authority to understand how we can better coordinate our physicians on staff, potentially looking at options to make Hay River physician staff formally part of the territorial physician staff. This would allow us to benefit from shared resources in a more coordinated, system-wide approach to recruitment and retention, and we are working closely with the territorial authority to help make those steps a reality.
There are a number of things happening. The Member did raise a lot of things that need to be addressed in the Hay River authority, and I will be following up on those as well. Thank you, Mr. Speaker.
MR. SIMPSON: As I mentioned, we have a budget for five physicians in Hay River. Maybe we need six. Maybe we need seven, but we are probably never going to get there. Our healthcare system seems to rely on that model, the one that is heavily dependent on physicians. Are there any systematic changes that are being implemented to improve patient care, in light of the fact that it is so difficult to get full-time physicians?
HON. GLEN ABERNETHY: Yes, absolutely. As part of our Cultural Safety Action Plan, the territorial health authority and health system have recently embarked on work to undertake a reform of our primary healthcare services across the Northwest Territories. This work is being led by the territorial authority and the department, with pilot projects happening in the Yellowknife, Fort Smith, Deh Cho, and Tlicho regions.
Just as an example, Mr. Speaker, two of these projects in this reform effort focus on the implementation of integrated care teams. The goal of this team approach is to provide safe, high-quality care that makes the best use of existing resources by creating integrated multidisciplinary care teams, where each member works to their full scope of practice to provide what we hope and we expect will be flexible, responsive primary healthcare and health promotion.
These teams, and this is the exciting part, will have a wide range of providers, including mental health supports built in, different scopes and practices, nurse practitioners, community health nurses, admin staff, all to work as part of a team to provide high-quality primary care to our residents.
MR. SIMPSON: I think that the Minister was speaking about what is called the Nuka model, or something based on that. He mentioned that there is a pilot project going on in a few different regions. When can Hay River expect to become part of this pilot project or expect to have the end result of the pilot project fully implemented?
HON. GLEN ABERNETHY: Nuka is a model that is very similar to what we are moving toward here, and we are certainly learning a lot from them, but it will be a made-in-the-North design. The primary healthcare reform is a system-wide initiative. Although our first six demonstration projects don’t include Hay River, I want to be clear that Hay River Health and Social Services is participating in the planning and design process to ensure that they are a part of the effort from the very beginning. Although the pilot isn’t happening in the community, they are definitely a part.
As we begin to implement integrated care teams in other parts of the Northwest Territories, we will be able to test these new approaches that might work well in Hay River and will likely work well in Hay River. We will certainly be helping with local staff, leadership, and residents to be more active once we start rolling those types of things out in the community.
Primary healthcare reform has been identified as a strategic priority for the Hay River Health and Social Services authority, and we look forward to them being part of our solutions moving forward.
MR. SIMPSON: Thank you, Mr. Speaker. I appreciate the thorough response. If this type of model is implemented, will there need to be staffing changes, like a reduction of staff? A change in staff? New positions? Can the Minister elaborate on that?
HON. GLEN ABERNETHY: We are talking about a new model, and in many of these primary healthcare teams where we’ve seen, it does involve different types of staff working in different relationships. It doesn’t necessarily mean we need to get rid of staff. It doesn’t necessarily mean we need to add staff, but it does mean we need to change how they operate and work together and the structure that they provide services in. It could result in some job description changes. Those always have a potential of having some impact on employees, but we have proven that we are quite good at working with our employees to recruit and retain, and especially when they have skillsets that are very, very valuable in the Northwest Territories. Our front line providers clearly fit that, and obviously, we don’t want to lose any of our professionals, but we need a system that really meets the need of our residents, and it needs to be designed with outcomes as a priority, and focus on our clients, not on the systems themselves. Thank you, Mr. Speaker.