With MLAs asking questions about the Stanton Territorial Hospital project, they should also ask: Why are the most essential services for people separated from the rest of the GNWT?

This year, the Northwest Territories Health and Social Services Authority (NTHSSA) has an annual $524 million budget and 1,870 employees. It oversees services from Fort Smith to the Beaufort Delta.

There are also two other health authorities: the Hay River Health and Social Services Authority and the Tlicho Community Services Agency. Interestingly, the Hay River Authority is running a $17.5-million surplus, while the Tlicho agency has a yearly deficit. Meanwhile, NTHSSA has an accumulated deficit of $272 million.

For 20 years and counting, the NTHSSA has never come in under or even on budget. This isnSA¹ú¼ÊÓ°ÊÓ´«Ã½™t surprising. Who can predict medical costs year to year? Add to that the challenges of a Covid-19 pandemic, a new $1-billion hospital, and inflation. Whatever the reasoning behind creating a health authority, it no longer makes sense.

A recent annual report noted that higher costs for locums and overtime were partly offset by vacant positions. However, vacant positions compromise care and stress staff. Numbers show that spending on compensation and benefits dropped by five per cent last year, while locum costs increased by eight per cent.

Most of the authoritySA¹ú¼ÊÓ°ÊÓ´«Ã½™s funding SA¹ú¼ÊÓ°ÊÓ´«Ã½” $460 million SA¹ú¼ÊÓ°ÊÓ´«Ã½” comes from the similarly named Department of Health and Social Services. Unlike the health authority, the department itself has no accumulated deficit SA¹ú¼ÊÓ°ÊÓ´«Ã½” only SA¹ú¼ÊÓ°ÊÓ´«Ã½˜revised estimates,SA¹ú¼ÊÓ°ÊÓ´«Ã½™ which is accounting speak for SA¹ú¼ÊÓ°ÊÓ´«Ã½˜we spent more (or less) than budgeted.SA¹ú¼ÊÓ°ÊÓ´«Ã½™ They simply adjust the budget after the fact to eliminate any deficit and it either takes away from the GNWTSA¹ú¼ÊÓ°ÊÓ´«Ã½™s surplus or adds to the government's overall deficit.

This deficit budget model just sets the authority up to fail. With no control over rising costs for staff, services and materials, the authority is forced to make poor spending decisions to satisfy its financial overseers. While contracting out may be easier than recruiting, training and retaining staff, it ultimately costs more, hurts the local economy and it doesnSA¹ú¼ÊÓ°ÊÓ´«Ã½™t build capacity.

Our minister has a legal mandate to provide healthcare meeting Canadian standards, regardless of cost. Yet as the deficit grows each year, NTHSSA management is told they are failing. This unreasonable financial pressure trickles down to front-line workers like nurses and doctors, causing frustration and burnout. ItSA¹ú¼ÊÓ°ÊÓ´«Ã½™s directly due to the deficit that the community people on the health board were dismissed SA¹ú¼ÊÓ°ÊÓ´«Ã½” again.

Healthcare costs must be justified, counted and paid. But the healthcare and social services system serves all Northerners. ItSA¹ú¼ÊÓ°ÊÓ´«Ã½™s the most important function of the GNWT.

There is nearly a $200-million gap between the health departmentSA¹ú¼ÊÓ°ÊÓ´«Ã½™s budget of $644 million and what it gives to the authority. This suggests expensive duplication, with two administrations serving the same population. Front-line workers likely arenSA¹ú¼ÊÓ°ÊÓ´«Ã½™t part of this duplication, but managers are, since there are two separate administrations.

Financially, it would have been cheaper to eliminate the health authority and keep the health board. Cuts should target administrative waste, not healthcare services.

The truth is, this deficit is largely an accounting practice targeting the health authority. Removing the deficit model would help restore public confidence in our healthcare system and pave the way for meaningful reform.