EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Speaker (interpretation): Thank you, Mr. Tootoo. (interpretation ends) The debate is now closed.
Mr. Curley (interpretation): Thank you, Mr. Speaker. I would like the vote to be a recorded vote please.
All those in favour, please stand, and sit down once I have called your name.
All those opposed, please stand and then sit down when I call your name.
All those abstaining, please stand and then sit down when I call your name.
The results of the vote are as follows: those for the motion: 11.
Those against the motion: 6.
Those abstaining: 1.
Sorry, Ms. Aglukkaq.
Hon. Leona Aglukkaq: Mr. Speaker, I would just like to raise a Point of Order, during my statement I had said I would be introducing a motion in our spring session to have a modified plan. I plan to do that in the spring.
Speaker: Ms. Aglukkaq, I remind you that I do not take that as a point; there is no Point of Order in that.
We will return to Item 17.
Bill 09 – An Act to Amend the Nunavut Elections Act – First Reading
I move, seconded by the Honourable Member for Cambridge Bay that Bill 9, An Act to Amend the Nunavut Elections Act, be read for the first time.
The motion is in order and Bill 9 has had first reading.
(interpretation) Item 17. First Reading of Bills.
Bill 1, 2, and 3 with Mr. Evyagotailak in the Chair. In accordance to the authority provided to me by Motion 4 – 2(4), the Committee of the Whole will stay in session until it reports itself out.
Before we proceed to Committee of the Whole we will take a short 10-minute break.
>>House recessed at 16:45 and Committee resumed at 17:03
In Committee of the Whole we have the following items to deal with Bill 1, Bill 2, and Bill 3.
We wish to continue with Bill 1 and the review of the main estimates for Health and Social Services followed by the Department of Environment and Human Resources.
Are we in agreement to continue with the main estimates of the Department of Health and Social Services?
Minister Aglukkaq, do you have witnesses that you’d like to bring to the table?
Sergeant-at-Arms, could you please escort the witnesses?
Minister Aglukkaq, for the record please introduce your witness.
To my right is the Assistant Deputy Minister of Operations, Dave Richardson and to my left is Shirley Alder, Executive Director of Finance.
Chairman: Welcome to the chambers.
Members of the committee, we are falling behind our schedule as we proceed with departmental main estimates.
I will again mention that once a member has spoken that I have discretion as Chair under Rule 77(1), to allow you to continue.
Once again, members, I am going to impose Rule 77(2), which allows me discretion to recognize a member more than the one time or not.
Yesterday we were on H-11, Health Insurance Program. We have Mr. Curley, Mr. Barnabas, and Mr. Tootoo that have spoken to this page.
Health and Social Services Branch Summary, Health Insurance Program.
Total Operations and Maintenance. $4,662,000.
I have a question regarding the medevac policy.
I am not sure exactly what the medevac policy is so I would like the minister or one of her officials to give us a briefing on what the policy is.
The medical evacuations were contracted out and especially in the Keewatin area I seem to recall that one of the airlines that was in one of the tenders for the medical evacuations was required to have washroom facilities and so on but it seems to be confusing.
It seems to be a joke right at this time and last year as I said that the elders will be medivaced requires a medevac plane that has washroom facilities and the argument at that time was that the flight was only an hour and a half.
But your body needs to do its function whenever it has to, whether you are the Queen or a big official.
Since that is the case I would like to urge you and your department to make changes.
(interpretation ends) Charter flights more than enough to buy a decent medevac plane that would be satisfactory for patients.
So could the minister commit to change the requirement of the loosely worded policy that says whether or not they should have?
It should be a requirement that we no longer should be using these frontier planes to medevac people. Could the minister respond to the state of confusion in the Kivalliq?
The Department of Health has contracts with different airline companies to provide medevac emergency evacuation services. One is in the Kivalliq, one here and one in the Kitikmeot.
If the member could clarify for me what the confusion is I’ll try and address his concern.
Mr. Curley: Just respond to my question because I’m using up my time. I was really quite clear in my language.
Do these planes require washroom facilities or not?
The kind of aircraft that we fly, as far as I know from the guidelines around Transport Canada, the kind of aircraft that we use do not require toilets in most cases.
What we have asked for in the request for proposals is to try and get airlines that have washrooms.
But the types of aircrafts that are used to fly are under Transport Canada regulations do not need to have washroom facilities.
I hope that clarifies that question.
Mr. Curley: No, it does not clarify.
It confuses a lot more because the tender that was issued specifically stated that washroom facilities are required. I would like to ask the deputy minister to respond to that question.
Respond to that question. I don’t want to repeat the question because I am taking up my time. I only have ten minutes or less - six minutes right now.
I’ll ask the deputy minister to come here who is also a pilot and has firsthand experience with Transport Canada and knows more about the field to come here to respond to the question.
Minister can you please, for the record, introduce your staff.
Welcome to the Chambers, Mr. Browne.
Would you please answer the member’s question, Mr. Browne.
As the minister has mentioned there are three contracts for medevac services for the territory.
None of the current contracts require the availability of a built-in toilet on the aircraft.
What has been arranged in the case of a chartered scheduled medical service from Sanikiluaq is that there is a portable toilet in that aircraft for scheduled chartered medical flights.
We understand the benefits of being able to have a toilet available.
There is a new medevac contract that has been put out for request for proposals, and a successful responder has been chosen for that.
The wording in that new contract is that it would be desirable to have an aircraft with a toilet.
As the minister has mentioned, the most important thing is to have the appropriate aircraft for the patient that flies with the amount of equipment that is needed to medevac the patient, and those size of aircraft under Transport Canada regulations don’t require a toilet.
Mr. Chairman, I would like the deputy minister to give the breakdown on each of the regions’ three contracts. What amount they are roughly for the last year. I’ll settle for last year or the previous year if the figures aren’t there.
I would like to say to the minister and deputy minister that desirable is hardly a commitment by the government to have that service because it’s not a binding requirement.
I fully understand there are transport regulations, but the health regulations for specific needs are really not directed by transport rules. You, as for instance, the airline that is selected have to have certain medical equipment and so on; those are not part of transport regulations for these types of aircrafts.
These are medevacs, a type of air ambulance flight.
Why are you settling for less than real air ambulances for the amount of dollars that you are spending?
First you give me the figures; exactly what annually are you paying for the medevac service.
Yesterday in the House, a letter with the breakdown was tabled with the medical travel for the previous fiscal year.
This fiscal year is not over yet for us to provide that information.
Right now, we process in total over 33,000 travels in Nunavut. The breakdown, by region, over $16 million in the Baffin, Kivalliq is over $20 million, and for the Kitikmeot it is $10 million.
In total, that results in about over 33,000 people being shipped for medical travel as well as medevacs.
Mr. Curley: Part of my question was not dealt with. The word desirable, to have a washroom is hardly a binding requirement, isn’t it deputy minister?
I believe Mr. Curley wants the deputy to respond, so I’ll transfer that to Ron.
As I mentioned, the wording in the request for proposal for the contract that is currently being renewed uses the phrase; “...make the best efforts to provide washroom availability on the aircraft.”
There are a lot of factors that have to be taken into account in deciding the best overall arrangements for medevac aircraft.
And, at this point, the requirement for a built-in washroom has not been felt to be justified, so we are specifying it as something desirable rather than mandatory.
Mr. Curley: Thank you, Minister and Deputy.
But I tell you when you have constituencies like we do, then you would say then when you a 70 year old, almost an 80 year old man that has been medevaced and coming home and saying, “I wish these strangers have a washroom.” He barely made it to that location. That was my father-in-law just before he died of cancer.
You would likely do that if you were a politician. But you’re paying top dollars; you’re a real gold mine with those contracts. Why are you failing the constituents, the Nunavummiut, the patients of Nunavut and settling for I use the word ‘frontier’ type of airplane.
Not jets, not real air ambulances, when you’re paying top dollar.
They can finance any new airline air ambulance services with that amount of dollars.
It would be, I think, less than fair to the patients. You have tremendous opportunity to put the binding needs of Nunavummiut, instead of ... otherwise why pay that amount of dollars when you’re settling for less than what is really needed for the patients of Nunavut?
Sorry, Mr. Browne. Minister Aglukkaq.
First of all, the aircraft that are used for medevacs are similar aircraft any other jurisdiction uses.
I’m not sure what ancient aircraft the member is talking about. The aircrafts that are being used to do medical evacuations of people are modern aircraft.
There are some jets that we use in transporting patients in the north.
So I guess the top priority for us is to get the person into a hospital.
That’s our first concern. Adequate medical attention is given to patients on the aircraft. So that is our major concern and our top priority.
We pay huge amounts of money to transport people to hospitals.
That’s the only means we have at this point in time.
We don’t own our own aircraft and increasing the size of the aircraft right now would require additional financial resources for us. Bigger aircraft cost more money.
So we try and provide an adequate service to communities.
But the other thing is not every community, not every aircraft can land in the communities; they can’t land jets to Pangnirtung as an example, or Grise Fiord. So we have to use twin otters or the smaller aircraft to land, the top priority being, again, to get the patient to a hospital. So we try and address those concerns through the RFP process, and of course, it would be desirable to have washroom facilities but at this point in time we don’t have that.
In the case of Sanikiluaq, that issue has been addressed with the company with the scheduled medical charters, it’s not a medevac; it’s a scheduled medical charter.
It’s very different from the medevac contracts that we’re talking about.
I can tell, you know, with the amount when you calculate that amount of dollars in one week at $20 million a year, not all of it is for purchasing fuel and everything. So a lot of that percentage is profit.
We don’t need to worry about what type of aircraft that we are buying; you are just not putting out your tender exactly what you want in your tender and your services. You already made up your mind that we are not able enough and we are not that far ahead, so we’ll settle for something.
I was on the medevac plane going down to Winnipeg. I could tell you that was not the kind of a medevac plane that anyone really should be on. And yet that is what you guys are settling for.
It’s not something that you get the best deals of any kind of medevac plane.
I wish the minister would table some of the medevac planes that are available within the provinces and compare them with our services, will you do that? The type of aircraft that are available, as you have already said, you are now using similar planes and everything else.
Please table those types of aircraft of the provincial governments and our own, exactly what type we are using, which ones are being used by other provinces and that will help us a lot.
I will provide the photographs to the member.
I’m not just asking for photographs, I think we need the detailed information, what type of tenders they normally put out as well and look for their requirements for medevac planes.
I think, minister, you need to demonstrate to the Nunavummiut that while you are not willing really to give the patients, as well as elderly, comfort when they have been medevaced.
I wish that you would be, I believe, prepared to speak to the companies because you are giving them top dollars for the medical travel and medical charters.
I truly believe that they can bring in a special plane that is specially geared for a medevac instead of being part of the charter services of the general territorial region. So I believe if you do that the people will know that you are working your hardest to make them comfortable. (interpretation) Will you be able to do that?
We expect standards of different types of aircraft in our request for proposals process, I will be glad to share that request for proposals document with the members which clearly outlines what standards of care are to be provided. What kind of aircraft we use and the types of abilities of each aircraft, whether they can put in a stretcher, or whether we can put in an incubator and so on.
There are different standards, we also have standards of medical teams that we require on those flights, and that I can share the RFP information with the member, and those standards are similar to other jurisdictions. The aircraft that we use in the north are used, for instance, Sky Services is used internationally.
We use that company based in Ottawa to do our medevac for Ottawa bound.
The company that we use in the Kivalliq is Manitoba-based as well. The company that we use in the Kitikmeot is Cambridge Bay as well as Yellowknife-based. So other jurisdiction do use the same aircraft
But I want to state for the record that we try very hard to provide good service to the citizens in getting them to the hospitals.
The information I gave in terms of the figures before are not just medevac. Those are scheduled travel of patients on scheduled aircraft to and from the communities. It is not just medevacs in those figures that I provided.
For the record, I just wanted to clarify that.
I will be happy to provide that information to the member and what other standards are used by other jurisdictions and the standards and requirements we ask for in our territory and I also want to assure that the aircraft that are used are transport-approved aircraft and are safe.
I would like to ask the minister and her officials, there are many patients that tend to check in to the hotel instead of the Inuit centre for a number of reasons. Many of them are understandable. Once you check into the hotel, aside from the travel warrant or accommodation warrant issued to the hotel, you are responsible for all other expenses, meals, transportation, etcetera, although you can claim them back.
To claim those receipts is really extreme. Sometimes it takes, as in one case, two years. The person has forgotten about it but the cheque came in for a claim, $200, for a claim that was put in two years ago.
One of the things we learned was why it was so late?
The airfare had been paid for by the government, for tickets and everything else, but she had not got home with the boarding pass part of the ticket.
In order to submit the boarding pass, she had to get an affidavit. Why is that such a big deal when you already had a travel agency pay for it? The boarding pass is just a seat number required.
It is a part of the major delay of the Department of Finance.
Could you explain why that is such a big deal to the department?
I think the difference here, from what I gather from this particular case of an individual posting a claim, if an employee working for the government travels, they get reimbursed for their hotels and their meals.
That is outside the Department of Health.
If it is a non-employee of the territorial government; we cover all the travel, transportation, the boarding home situation and/or the others.
But if an employee is claiming back meals and so on, as part of the Financial Administration Act, employees are required to provide receipts.
That would be the particular department processing their claims that would handle that.
When it comes to treating individuals under the non-insured health program, we don’t have claims.
We cover that, we do the travel, we ship them to the boarding home, we pick them up at the airport, we provide them the meals at the boarding home and so on.
I think that those are the two differences in administering medical in that particular instance.
Under H-13, my question is in regard to I believe 2006-07, $46,322,000, (interpretation ends) but this year it is $2,189,000 less than last year.
What is the explanation for this?
Just give me a second. Thank you, Mr. Chairman. I thank the member for his question.
I believe there are about six or seven positions that were funded under a different line item for wait time reduction funding. We removed that from this item as part of the revised main estimates.
Are you saying that it would be the same for the travel and transportation costs for those staff is less than last year? It probably applies to the same staff that are withdrawn from this line item?
Is the member asking me a question around the Travel and Transportation line item, or are you still under the first item?
Mr. Aglukkaq, I’m sorry Mr. Alagalak.
I’m on H-13.
The $2 million something, where was it put?
As you stated earlier, because of six or seven positions, where do we see the increase in others, and is it the same with travel and transportation?
I think you would make a very good Mr. Aglukkaq.
I’m going to ask Ron to respond to that line item. Thank you, Mr. Chairman.
The main reason that the compensation and benefits is $2 million less is that because of the difficulty in recruiting nurses, and other staff, we realize that although money had been provided in the budget in 2006-07 to add additional staff in Cambridge Bay and Rankin Inlet that the likelihood of being able to staff up to that in the fiscal year of 2007 is very unlikely.
So we have temporarily frozen 24.9 person-years in Cambridge Bay and Rankin Inlet and that amounts to a reduction in the budget of $1,896,000.
It’s too bad that they had to put a hold on them because in Rankin Inlet and in the Kitikmeot, there is a big shortage of nurses.
I wonder if the minister, with all her power, because those positions have to be filled, has the minister tried to fill those positions to the best of her ability.
The staff that were missing, next week, on Thursday, we will be recruiting.
We’re always looking because we’re short in Nunavut.
I now have a title of minister, so I want washroom facilities in all the aircrafts.
I have a question. On more than one occasion, as members we have raised the matter of operation of medical transportation within the Baffin region.
As a minister, what improvements have you made of the problem that we have in the Baffin region.
At the first assembly this was raised during the first assembly too.
First of all, I’d like to start my response to that by saying that prior to any change we were dealing with approximately 200 complaints under the old system a year.
The volume that you see in the tabled documents and the number of volume we deal with in processing.
We needed to address that concern, particularly, here in the Baffin where there is only one hospital.
So the improvements that we tried to make to address the concerns were to have the hospital personnel travel south to deal with the patients at the hospital for any arrangements.
That was one. The second change was the creation of positions in Pangnirtung to provide a service to the health centres for any southbound, up island to Iqaluit travel.
Then we broke up the volume of this as it was. The Baffin hospital was providing services to people whether they were going to the hospital or not.
We tried to manage their workload a bit by splitting that function and to have them focus on their patients in the hospital.
You’ll see in the Baffin alone there are about 13,000 tickets that we’ve processed in twelve months. It’s a huge volume.
Of that about two percent we heard complaints from people.
One of the things that we’ve done to try and address that is deal with the airlines.
We’ve met with the airline companies and established better communication and better processes. I think that we had a very good meeting with First Air and they continue to be a partner in providing the service to us. There’s direct contact to our staff whether they’re here, Ottawa, or in Pangnirtung.
Another area we established was to have staff in the Pangnirtung office work after hours. There’s a person that receives the call who is on call if there is a need. Their hours of work have also been extended to work around the airline schedule a bit more effectively.
Regular communication has also been established from our personnel to the boarding homes to try to better case manage patient travel. Another area that we are working on and we’re hoping to try and address in the next year is to develop a computerized system of managing our patient records and patient referral systems.
Those are a number of areas that we have put out for improvement. I’d like to report back after one year of implementing this change to see if there has been a reduction in the complaints of our clients traveling in and out of the communities.
I represent three communities with one airline.
Whenever there is a load some of them are left behind that are supposed to go to the hospital. There’s always somebody left behind when the aircraft leaves.
The Larga Manager in Ottawa, when I spoke to them they said that whenever there is somebody that comes down to the hospital and has to stay in the Larga Home they have no more space, especially when they have relocated that position to Pangnirtung.
There’s a lot of information that we can provide through the telephone, fax, and through the computer. Even though it’s like that, even if you give a telephone number to an elder, they can’t keep on phoning the travel agent coordinator or the travel agent person because elders are not like that.
I wonder if the minister can consider that Pangnirtung position to ... (interpretation ends) ... Will the minister consider relocating the Baffin medical travel back to Iqaluit?
I think yesterday we spoke extensively about the challenge of trying to meet all the needs of the patients at the Ottawa boarding home, and we’ve been working very closely with Nunasi to address the boarding home situation in Ottawa.
There are capacity issues there; we recognize that and we will continue to work with the service provider in addressing their concerns.
The issue around relocating is a concern to me.
Relocating would not improve and address the two percent of the people that have complained before we made the change. The travel office at the hospital is still there. We have not removed that.
It’s still at the hospital. So the hospital is focusing on providing better service to the patients that are in the hospital.
The two positions that we created in Pangnirtung is to provide service to the health centres in the communities.