‘Hopefully … in the new year we’ll have a better solution,’ says Health Minister

The NWT Legislative Assembly’s 10-day fall sitting has wrapped up, with the MLAs now in their ridings until February 4th. There are two weeks of committee meetings in each of December and January, but the elected reps can attend remotely if they choose.

One of the recurring themes during the fall sitting was health care. In particular, the apparent degeneration of booking lab appointments and accessing Primary Care services.

Here are a few of the exchanges between Regular MLAs and Cabinet.

Yellowknife Centre MLA Robert Hawkins raised the issue several times:

• “Can the Minister explain why there’s such lengthy line-up there in the walk-up portion of the clinic every single day wherein in the old days there wasn’t that type of backlog. What has significantly changed that things either get deferred, delayed, or denied completely?”
• “When people arrive at 7:30 in the morning, there’s long lines, you can’t make phone calls because no one answers the phone, there’s no chairs so people with mobility issues are standing there and struggling, and there’s way more people there than the slots available for doing that.”

Health Minister Lesa Semmler provided a wordy answer in which she said that there is the budgeted amount of staff, but “the amounts of referrals for blood work have been increasing.”

So, the Health Department is “working through the business process” to find the, “right amount of staff for the right amount of tests.”

She did admit the current system, “is not working.”

“Hopefully … in the new year we’ll be able to have a better solution.”

Then there’s the increasingly lengthy wait times to see a doctor or nurse practitioner.

Yellowknife North MLA Shauna Morgan said:

• “So it’s hard to believe, that in this day and age, we can’t seem to create either an online system or even a phone system that works to book a primary care appointment in Yellowknife.”
• “What is being done to ensure that people in Yellowknife can actually book a primary care appointment in a timely way for issues that cannot wait several weeks or several months to be addressed but may not qualify as an emergency that would necessitate an emergency room visit.?”

The Health Minister said there are ongoing discussions with the Northwest Territories Health and Social Services Authority (NTHSSA) about making bookings easier and reducing wait times overall.

MLA Morgan also noted that private walk-in clinics in the NWT, “not only have systems where you can check your lab results online, which sometimes means you can avoid the need to book a follow-up appointment, but they have online systems for booking appointments.

“So it’s unclear what’s preventing the public Primary Care system from using an online system. Is this being explored or developed, or what are the barriers here?”

The Minister said: “implementing a similar system in the public care system is significantly more complex. The public system is subject to stricter regulations, including procurement rules, enhanced privacy, security requirements that do not apply to private clinics.”

She added that the “new system that we’re looking to move towards will have all of those pieces incorporated; however, it is challenging in a smaller jurisdiction to try to incorporate that, you know, with everything and with all of our technology being, like, there’s multiple different systems that also need to be fed into that one system, and not all of them are compatible.”

And Great Slave MLA Kate Reid said:

• ”I’m concerned for residents who … often need to line up outside the downtown Primary Care Centre for same-day lab appointments. Right now, it seems that we will be asking our Elders, folks with disabilities, and those in chronic pain, to queue in the dark, cold winter weather outside the lab for an hour until staff arrive to let them in just before 8 am This is not a viable, compassionate solution.”
• “Will we see reasonable accommodations to make sure that folks aren’t standing outside in the cold for a same-day appointment this winter?”

Replied Minister Semmler (verbatim): “When the lab staff arrive, I think — I believe that — you know, that’s the issue, is that the place where they are downtown is the landlord is the responsible person and so the staff can go in, but the doors open at a certain time. And then the issue that was raised not just today but yesterday with the chairs, that that issue has been raised with the landlord; however, they do not recommend that chairs be in the lobby of the waiting area. They don’t recommend that even moveable chairs that could go there and be removed. So this is an ongoing discussion that I will have NTHSSA continue to follow up with.”

MLA Morgan also inquired as to he “no-show” rates at the downtown Primary Care Clinic and the clinic at the Łıwegǫ̀atì Building (old Stanton Hospital).

Semmler said she also wants to know how many patients are being seen in the clinics and what the trends are year over year.

Morgan continued: “So what is being done now? We’ve known for a number of years this is a problem. So what’s being done now to try to reduce the number of no-show appointments … such as automated reminders or phone call reminders by administrative staff?”

Semmler (edited for clarity): “What’s happening is, people are booking in all of the different areas and then they’re not cancelling when they get an appointment. We’re not allowed to bill people for missing appointments … under the Canada Health Act.”

Morgan: “I’ve heard directly from primary care physicians, practitioners, as of a few weeks ago that there is in fact no cancellation list, there’s no waiting list, and we don’t have any mechanism for trying to fill spots that are open on a same-day basis so I would very much appreciate if the Minister could clarify even what’s currently happening in Yellowknife Primary Care and then what’s being done to improve it?”

Semmler: “I can follow up with NTHSSA.”