by Glen Korstrom
Northern News Services

NNSL (Apr 24/98) - If Yellowknife wants to take over control of health care, it should understand the fiscal responsibilities that will come with it.

The advice comes with the first phase of a consultant's report on the possible transfer of health services to the city.

Terriplan consultant Andy Swiderski, whose been hired by the city, presented the report this week to a committee charged with recommending to council how and if to proceed with decentralizing health services.

"The purpose of Phase 1 is to summarize the information gathered to date," Swiderski said. "I wanted to share the direction where we're heading."

The report only identifies which services are now delivered and how they are provided. It does not make any judgments on whether any jurisdiction changes are preferable.

"It's so convoluted, honest to God," said committee chair Ruth Spence. "Because there are so many services which are being provided from different departments and the city has to be aware of what programs are being delivered and who's delivering them."

The process could eventually lead to Yellowknife taking on more services from the GNWT.

"This is why we're looking at it, in depth, to make sure that the citizens of Yellowknife don't get stuck and perhaps get lower standards of service," Spence said.

Swiderski said that, if services are downloaded, health boards would be able to retain surpluses but they would also be responsible for deficits.

That would mean if the city spent health-care money from block funding before all expenses were paid, money would have to come from somewhere else.

Still, he said, both the GNWT and federal government's health acts will bind the city to provide specific health standards. Therefore, there would be no danger of a diminished health-care system.

Committee member Lanny Cooke stressed the final report should note the city's total current health-care spending and not simply what the GNWT spends on health care in Yellowknife.

"A lot of money is spent on health and social services which does not come from the Department of Health and Social Services," she said.

"We're so far away from deciding, or recommending to council," Spence said. "This is just the first phase."

If the city does eventually receive more control over health services, it could tailor programs to more closely meet local needs.

Spence said home-care or mental health services are prime examples. "These are areas which really directly affect the citizens of Yellowknife and are not regional."