Both sides happy as slate finally clean

On first blush, it looks like the Government of the Northwest Territories just gave the Government of Nunavut a $2.9 million gift.

That's the amount of debt the GN owes the GNWT that the GNWT says it's willing to write off.

The debt is for services rendered by Yellowknife's Stanton Territorial Hospital to Nunavummiut in the decade since Nunavut was born.

"It's a misnomer to call it a debt, though," Sandy Lee, the NWT's Minister of Health and Social Services,, said in an interview.

In reality, she explained, the figure just represents the difference between what Stanton staff thought they should be charging for the hospital's services to Nunavummiut, and what the GN thought it should be paying.

Over the 10 years since Nunavut split from the Northwest Territories, the two governments had never gotten around to finalizing an agreement on medical service fees, Lee said – "how we put a number on the services we provide to Nunavut."

The GNWT just kept putting down in its ledger books what it thought it was owed, and waited for an agreement to be reached before worrying about collecting.

Meanwhile, GN officials had an entirely different idea about what its costs should be.

For example, Lee explained, whenever Stanton did blood tests on Nunavummiut, it would write in a certain fee for every test. The GN, meanwhile, thought it owed one fee for every blood sample tested.

But there can be seven tests on one blood sample, she said.

And when Stanton's general practitioners went out to do their rounds in Nunavut Territory, the GN marked that down for payment on a daily fee basis.

But Stanton was recording the charge at the daily rate, plus an additional fee per trip, and so the two territories' numbers just kept growing further and further apart, said Lee.

Earlier in the decade there had been talk of setting up a block funding deal – where Stanton would charge Nunavut a set amount each year, no matter how many Nunavummiut visited the hospital.

But both governments were gun-shy of that arrangement, Lee said. "It was too risky. Nunavut could overpay, or we could be underpaid."

Stanton hospital has always had a special relationship with the people of the Kitikmeot region, Lee said. And that relationship continued after the splitting of the NWT and the formation of Nunavut.

It's a relationship she is eager to see continue. "The bigger the catchment area for a hospital, the better."

The two governments finally settled an agreement on pay structure last fall, spurred in part by Stanton's ongoing operational debt that the GNWT needed to tackle.

"It was a matter of getting everybody together, hunkering down, and sorting it out," Lee said. Most of the work was done in the last eight months.

They finally agreed to use the same rate schedule that all other governments do, rates established by the Interprovincial Health Insurance Agreements Coordinating Committee.

When the dust had settled, Lee said, the two territories agreed that Nunavut would pay approximately $2.7 million of the $5.6 million "accounts receivable" on Stanton's books, and the GNWT would "write off" the remaining $2.9 million.

"It's not at all a problem for the two governments," said Lee. "I have talked with Minister Curley, and before that with Leona Aglukkaq when she was still Nunavut's health minister."

"Nunavut has paid what we both agreed to, and so we wrote off the rest and are moving forward."

She emphasized that the health ministers of Nunavut, Yukon and the NWT have a good relationship. "We have to stay together to work on [federal] funding issues."