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Michael Miltenberger, the minister of health and social services, says the system is now at a "tipping point."

Michael Miltenberger: minister of health and social services says current system is not sustainable. - NNSL file photo

Miltenberger expressed that opinion in 'Building on Our Foundation 2011-2016', a strategic plan for the NWT's health and social services system released in August.

"We are now at a tipping point and need to make changes in the way our system is managed, operated and funded," he stated. "Individuals must also make changes and take responsibility for ensuring their own health and well-being."

Miltenberger also provided News/North with a brief written comment referring to the system's balance between resources and demand.

"We aren't sustainable due to a number of factors, including chronic disease in our population, human resources difficult to obtain and recruit, residents not taking personal responsibility for their health," he stated.

Damien Healy, manager of planning and communications with the Department of Health and Social Services, said its budget is growing at a faster pace than government can sustain.

"The programs and services that we're supplying to residents of the NWT continue to grow and outpace the budget that we're supplied," Healy said. "So we're almost at a tipping point where we need to make some reform and some real changes or we won't be able to provide the same programs and services that residents are accustomed to."

The GNWT is spending $344 million on health and social services in the 2011-2012 fiscal year, which is about 25 per cent of the territorial budget.

Debbie DeLancey, acting deputy minister of health and social services, said reforms could help contain cost increases.

"But it's still going to be a challenge," she said. "There are no easy answers."

DeLancey said there is now a patchwork of eight health and social services authorities in the NWT, but there needs to be some structure to run them as an integrated system.

"That's probably the biggest, most important thing that we can do because with this fragmentation comes a lot of duplication of effort, a lot of duplication of spending of resources and a lot of barriers to providing effective patient care," she said.

DeLancey noted the amount of money to administer authorities is not a huge proportion of the department's budget, so integration wouldn't mean great cost savings, but improved services would result.

"So we could really improve service to people in terms of budgeting," she said. "We could definitely achieve some savings and some efficiencies if the eight authorities were sharing some of those functions that don't touch patients."

For example, she mentioned financial processing, procurement and bulk purchasing.

DeLancey said there are no current plans to spend more money promoting personal responsibility for health, although she noted the new 17th legislative assembly will set its own priorities.

Existing social marketing, like the Healthy Choices campaign, concentrates on smoking, healthy eating, physical activity and injury prevention.

"We continue to put money into that sort of education and promotion," DeLancey said.

Along with stressing the need for personal responsibility, the strategic plan outlines, among other things, initiatives to further improve services in remote communities by employing new technologies such as tele-health, digital X-rays and online patient records.

It also discusses continuing to train northerners and encouraging youth to pursue careers in health and social services.

A proposal in the conceptual stage is to create a territorial support network for care providers in small communities.

"They need to have a way to have access to some advice," said DeLancey, noting that links into whether a patient should or shouldn't be medevaced.

One element of the network would be a 24/7 on-call centre at Stanton Territorial Hospital to put community healthcare workers in touch with the right expertise.

"Right now, it's done, but it's done on a more ad hoc basis," DeLancey said.

It is hoped the network could be established in a year or two, following a pilot project in a couple of communities or regions.

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