The team tasked with making NWT healthcare more sustainable just reported back for the first time.

Premier RJ Simpson set up the Healthcare System Sustainability Unit in 2024. The unit published a brief, two-page annual report on Thursday alongside a fact sheet about its work.

A first phase of work – figuring out exactly what all of the NWT’s healthcare programs and services have cost over the past four years – is now complete, the report states.

Phase two, which begins now, involves a “deep dive” into seven areas identified as the source of the biggest recent cost increases.

Those areas are:

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addictions recovery and treatment;

foster care;

long-term care;

medical travel;

out-of-territory hospitals and physicians;

physician services; and

adult supported living.

By June 2026, the unit expects to be coming back with its first recommendations for change to make healthcare more sustainable – in other words, control the growth of costs.

Terence Courtoreille is the NWT government’s associate deputy minister of healthcare system sustainability.

In a Thursday interview, he set out how those seven areas were identified and what the work ahead will look like.

This interview was recorded on September 4, 2025. The transcript has been lightly edited for clarity.

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Ollie Williams: We have the first annual report in front of us, covering the period from June 2024 to June 2025. From your perspective, what are the big items here?

Terence Courtoreille: We’re a small unit and have been working hard behind the scenes. The biggest deliverable we were able to accomplish this year is the completion of our preliminary analysis, trying to understand what we’re delivering in terms of healthcare programs and services across the entire Northwest Territories.

We were able, for the first time, to list out all those programs and services and cost them out annually for the last four years. So we have a really good idea now of the types of programs we’re delivering and how much they’re costing. This piece of work was important because it helped us understand where the cost drivers are in the health system.

Seven areas have been identified as priorities as a result. They are addictions recovery and treatment, foster care, long-term care, medical travel, out-of-territory hospitals and physicians, physician services, and adult supported living. How were they selected?

Those are the areas driving about 70 percent of the cost escalations we’ve seen in the past four years. It’s allowing us to focus on areas of the healthcare system where we need to take a deeper dive and have a look at some of those operational opportunities for efficiency.

Those seven areas are going to be staggered out over the next 12 months, and we’re going to be systematically looking at each of them.

My understanding from these documents is that by about June 2026, the unit expects to start coming back with information from that deep dive with recommendations.

Yeah, that’s right.

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The government typically goes through its budget cycle – deliberations and formulating its next year’s budget – right around now, around August of every fiscal year. We want to be ready for that next year, so we’re in the queue for the 27-28 budget year to potentially have some of our recommendations implemented.

The report lists “early insights.” For example, the NWT spends twice the national average per capita on health and social services. Health and social services account for about 26 percent of GNWT total expenditures. There has been significant growth in the seniors’ population. These are things I feel we already knew, but the unit may have confirmed. Were there any insights that were less expected?

Those early insights certainly help confirm a few things. We know the NWT is going to be more expensive when you’re comparing us relative to jurisdictions in the south. We’ve got geographical challenges that other provinces don’t necessarily have. We have medical travel challenges that other provinces might not have.

One of the things we did find interesting is we do a really good job at reporting our costs individually, at the health authority level, and we have three health authorities across the NWT. All of our health authorities track separately. They have different processes and different systems to track those costs separately.

We’d like to see that standardized across all the health authorities so, when we go into the system, we can tell right across the entire NWT what we’re spending on a particular program or service. We think that’s going to be more helpful from a cost tracking perspective. We’ve got a little bit more work to do on that front.

When you come to recommendations – and taking medical travel as an example – which team is the one tasked with ultimately figuring out how to make the changes that your unit believes the GNWT needs to make?

We’re going to be looking at it from an operational perspective to see if there are opportunities to do things a little bit more efficiently, or maybe there’s a way to do it cheaper. Maybe there’s a way to bring some of those services closer to the Northwest Territories so the travel expense isn’t as much. Perhaps there’s a way to use technology to access some of those services rather than flying our residents to southern centres to receive those services.

We know other agencies within the system are also looking at this, and we’re going to be dovetailing our work into some of their efforts to make sure we’re all aligned. But it’s important to first understand what the opportunity is to improve and then, from there, we’d like to be involved in implementation as well, and formulating how that would be implemented in the system.

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