The NWT’s premier says amalgamating Hay River’s health authority with the territory-wide equivalent appears to him as “unfinished business” that could help solve some problems.
Hay River has no on-site emergency physician this week, the latest in a series of staffing shortages within the town’s healthcare system.
While the rest of the territory often deals with a similar issue – Stanton Territorial Hospital doctors in Yellowknife say the emergency room is at risk of closure because so few physicians are available – Premier RJ Simpson believes Hay River retaining its own health authority may not be the best path forward.
Previously, various regions of the NWT had their own health authorities. That changed in 2016, when most of those authorities were amalgamated.
Hay River’s authority did not join that process. Simpson, appearing at a briefing with MLAs last week, said he understood there were “cost implications that I guess were not acceptable to the government of the day related to pensions and things like that.”
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“So it’s unfinished business, essentially,” he told MLAs. “The Hay River health authority and the NT health authority do work together but there’s still a bit of a disconnect there, and I think there are opportunities to better support patients and better support the region through an amalgamation.”
Simpson – who is one of two MLAs representing Hay River, both in cabinet – now has a team working to “get a handle on how things have unfolded and make sure we can course-correct where necessary.”
The GNWT first meaningfully floated the idea of bringing Hay River’s health authority into the territorial fold in 2023.
It’s a shift that is expected to take several years, if it goes ahead.
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Simpson has created a healthcare system sustainability unit to examine broader concerns about the state of healthcare in the territory. Assessing the prospects for amalgamation is part of that unit’s work.
The 2016 amalgamation of most authorities (except Hay River and the Tłı̨chǫ Community Services Agency) “was a bit of an experiment,” Simpson told MLAs.
“Whenever these amalgamations happen, you need to be able to follow the progress on that amalgamation and ensure that it’s happening appropriately. And that has not been the case to date,” the premier said.
“The reason this [sustainability] unit was put together was to really get a handle on the healthcare system, the expenditures, the services being provided, so those can then be turned into recommendations – or at least information for decision-makers – so we can understand what we’re working with.
“When we look at Hay River health authority, we talked about looking at how that could be brought into the NT health authority, and that’s because we do see the benefits of amalgamation. We do see those economies of scale and the value in cooperation.”
The premier gave the example of Fort Resolution’s healthcare as an area in which the disconnect between the NWT and Hay River health authorities appears obvious. Fort Resolution is about 150 km east of Hay River by road.
“Communities like Fort Resolution are served out of Yellowknife. Hay River is just down the road and it doesn’t quite make perfect sense to have that system, and so we want to examine this option,” said Simpson.
Terence Courtoreille, who leads the sustainability unit, said work to analyze whether Hay River can be brought into the NWT health authority began in February.
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“I think this was last looked at in 2015 and the timing of that amalgamation didn’t work out. So this analysis is really just resetting the work that was previously completed to reflect current-day markets and current-day costs,” Courtoreille said.
According to the premier, the GNWT will by this fall “have a good handle on what the costs of an amalgamation will be” and will be in a position to decide what happens next.
“If it’s something that is feasible, then we have to look at the current situation of the healthcare system of the world, really,” he said in answer to a question from Yellowknife North MLA Shauna Morgan.
“In my five years of being a member of government, no year has gone by without a major crisis or something completely unexpected. So while I’d like to say that we know when we’re going to get things done by, the fact is that we should have the information later this year, then that will inform next steps.”
Broader work
Hay River isn’t the only focus of the healthcare system sustainability unit.
Simpson said the unit is finalizing a preliminary analysis of many healthcare programs and services, then will carry out a “deeper dive” to identify where the territory can get more value for money.
Courtoreille said the next phase of work will pick out “core” programs and services, improve “accountability and our budgeting and operational processes,” and put in place plans for monitoring and improvement.
“Our target is to try to wrap things up as much as we can by the end of this government,” he said of the unit’s timeline for examining NWT healthcare.
“We feel the urgency to get some of this work out as quickly as possible, but we also want to try to balance that with making sure we have all the data and the evidence to inform that conversation and to support those decisions.”
