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The FMB has also approved 4 million dollars to carry out new initiatives and enhanced program delivery for 2002/2003.
The department will move forward in a number of identified priority areas in support of Mental Health and Addiction Services such as prevention, self-help, and crisis response.
Within months, the department will be able to provide a range of critical, currently unavailable support to individual clients, families and communities.
Mr. Chairman, included in the Mental Health Initiative is the planned hiring of new mental health workers for the communities and the operation of the first, Mr. Chairman, the first psychiatric facility in Nunavut.
The department will be providing an increase to shelter organizations, including family violence homes.
It will also be including in those increases groups providing alcohol and drug treatment programs.
While the increases are modest, they represent the first increase in three years and with the members continued support the department will continue to try and improve the funding levels to these organizations.
Mr. Chairman, also approved in the new initiative funding was support to enable a community-based corporation to continue operation of a long-term care facility in Chesterfield Inlet that houses 12 to 15 developmentally delayed and severely handicapped clients.
With the support of the Department of Finance and the Department of Public Works we are currently finalizing a value-for-money analysis to consider options for leasing a new building or constructing a new GN owned facility.
The department will submit its recommendation to the FMB shortly and in questioning this morning by Mr. Arvaluk we hope to be able to do that in the next couple of days.
The Department of Health and Social Services remains responsive to the needs of individuals and communities.
Mr. Chairman, we provide ongoing support to the Committees of Council, we continue to seek the wisdom and advice of the elders and to ensure that our services and programs are culturally relevant.
The department continues to face challenges, severe challenges, Mr. Chairman, recruiting and retaining nurses to work in Nunavut.
We continue to examine incentive options for nurses to come to Nunavut and to stay for extended periods of time.
Meanwhile, we continue to provide funding support to the Nunavut Arctic College for the Nunavut Nursing Program, and we continue to deliver a program that trains individuals from the communities to work in the health and the social services field.
Health Canada’s First Nations and Inuit Home and Community Care Program is now being rolled out across Nunavut.
Nunavut will receive Federal Funding in excess Mr. Chairman, of 4 million dollars per year to provide basic home care and community care services that are comprehensive, culturally sensitive, accessible and effective for all Nunavummiut.
To date, Mr. Chairman, I think it’s important to note, to date, 80 Nunavummiut have received certified home care training; 44 have been hired already as community home care workers.
Another 20 additional hires will result pending the training.
Staffing is also underway for 11 dedicated home care nursing positions under that program.
Our Capital Plan is to be funded at a level of 5.9 million dollars for 2002-2003.
Capital Projects have been outlined in the 5-year Capital Plan and include such things as renovations to a number of community health centres and other facilities.
We are also proceeding with the development of the three major health facilities in Iqaluit, Rankin Inlet, and Cambridge Bay.
The functional plans for all three facilities have been approved and, with the birthright corporations, architectural designs are being developed.
With the assistance and counsel of the Department of Justice, we are forming the contracts and agreements under which construction can begin.
We also saw earlier this week the beginning of piles in Rankin Inlet.
The GN has conducted several meetings and discussions with officials of the Federal Government with respect to alternate financing options for the facilities.
At the same time we have maintained close contact and collaboration with the Department of Finance with respect to value for money analyses of these options.
Mr. Chairman, the next steps will be signing of agreements and completing design development for the hospital and the two health facilities.
In addition to these major capital projects Mr. Chairman, through the use of matching federal funds, we are entering year two of the expansion of the IIU Telehealth Network.
This is bringing Telehealth technology and expanded programs to a number of our communites and lessening the dependence on health services from the south.
Mr. Chairman, the rollout of these services will continue throughout the fiscal year and will upgrade the existing five telehealth sites or five communities to 15 by March 2003.
That’s correct Mr. Chairman, 15 by 2003.
Thank you Mr. Ng, thank you members.
Thank you, Mr. Chairman for the opportunity to address the committee today and I do look forward to your questions and comments as we begin the review of the departmental estimates of the Department of Health and Social Services for 2002-2003 here in Iqaluit this week.
I would like to ask the minister if he has any witnesses to bring to the Witness Table.
Hon. Ed Picco: That is correct, I would now ask the witnesses that are with me to join me at the table and they will include Deputy Minister Andrew Johnston and our Financial Controller, Mr. Don Maychruk.
In the Gallery standing by, will be Dr. Keith Best and Mr. Abraham Tagalik.
Chairperson (interpretation): Do you agree to bring in the witnesses.
Please introduce your witnesses Mr. Picco.
Mr. Chairman, on my immediate right is Mr. Andrew Johnston, the Deputy Minister of the Department of Health and Social Services, and on my immediate left is the Financial Controller, the Director of Finance, the man with a lot of power within the Department of Health and Social Services, the Director of Finance Mr. Donald Maychruk.
In the gallery Mr. Chairman, also standing by is Dr. Keith Best the Assistant Deputy Minister of Operations and Mr. Abraham Tagalik the Assistant Deputy Minister of Corporate Services.
Is the chair of the committee ready to proceed with his opening remarks?
Mr. Nutarak (interpretation): The Standing Committee on Health and Education has reviewed the budget estimates and business plans for the Department of Health and Social Services for the 2002-2003 fiscal year and I am pleased to provide you with the Committee’s comments.
The Standing Committee notes that the overall budget for Health and Social Services has finally received a substantial increase for the 2002-2003 fiscal year.
Members are optimistic that this budget will more realistically meet the costs of the department’s operations and avoid the necessity for repeated supplementary appropriations throughout the year.
Committee members are pleased to hear of the department’s successes in the continued staffing of health worker positions, recognizing that this is still an area of concern across Canada.
Specifically, the Committee would like to commend the minister for his efforts in reducing the reliance on agency nurses and the resulting costs.
Given that one of the keys to retaining health workers in the north is by training Nunavummiut for these positions, the committee fully supports the department’s continued funding of the Nunavut Nursing Program and the related access program.
The committee encourages the minister to continue exploring sponsorship opportunities to provide additional support for the students in this program and to enhance the profile of this very worthwhile program.
The standing committee continues to have grave concerns about contracted services such as medical travel, local transportation for patients and boarding homes.
Members understand that a study of such services has been commissioned and despite the minister’s commitment to provide them, are still waiting for the opportunity to review the terms of reference for the study.
It is worth noting that Nunavut’s distinctive geography poses a monumental challenge to providing health services across the territory.
The resulting costs for medical travel alone are almost equal to the sum of the total budget of our three smallest departments.
Metal health issues and problems relating to alcohol and drug abuse are a continuing concern.
Members are pleased to note that the minister has responded to committee recommendations by allocating funding for community based programs in this area as part of the overall mental health strategy.
Despite several recommendations, members do not note any signs of co-operative measure involving other departments such as Culture, Language, Elders and Youth or Education.
The committee recognises the need for shelter services across Nunavut and notes that the 2002-2003 budget proposes the first increase in funding in this area in several years.
However, members feel that greater efforts should be made to address the issue of family violence using the principles of Inuit Qaujimajatuqangit within the home community.
Members were pleased to hear about the hiring of a new Inuit Qaujimajatuqangit Co-ordinator for the department and look forward to seeing related changes throughout the department’s programs.
As indicated in the House, the amount allocated for the local committees of council has been increased for certain communities, based on the size of the population.
Members would remind the minister that on the national stage, Nunavut argues that needs based funding is more appropriate than per capita based funding.
I would like to quote our Minister of Health and Social Services in his presentation to Commissioner Romanow who was in Iqaluit as part of his investigations on the future of health care in Canada.
As his final recommendation to the commission, our minister recommended, and I quote, “Most importantly…that funding for Health and other related federal programs be based on need and not on population or per capita funding which severely penalizes and handicaps smaller jurisdiction.”
Mr. Chairman, the situation is no different for communities across Nunavut.
Per capita funding for community committees of council is not appropriate.
Members recommend that the department review this latest allocation formula at the earliest opportunity.
Lastly, Mr. Chairman, even though details of the three new health facilities are still under negotiation, members understand that functional studies are underway.
Members are concerned that although progress is being made towards construction, the determination of which services will be offered and delivered in each of these facilities has yet to be addressed.
In addition, the ongoing costs for the operation and maintenance of these facilities will have to be carefully considered.
Members have requested regular updates from the minister on the planning for the operation and staffing of these facilities and look forward to being kept up to date on these plans.
Before we proceed, I would like to recognize my two daughters who are in the House, Rena and Carmen Irqittuq and one of our colleague’s wife, Iga Iqaqrialu and my sister Geela and our friend Uttukuttuk.
At this time, following our rules and procedures we can now start with the committee of the whole.
The members who wish to comment may do so, but you will have ten minutes to do your opening comments.
You may pose questions after that section as is our practice.
After that section, I will allow some time for further questions.
Mr. Arvaluk (interpretation): Like my colleague, the chair, I really do not want to pick sides, but I want to express my pride for the minister when during his opening comments alluded so eloquently to one of my communities, Chesterfield Inlet and I am so grateful that this project will proceed.
I would also like to mention that the facility in Chesterfield Inlet is for patients with physical disabilities, these patients are not just from Chesterfield Inlet, they’re from all over Nunavut.
I know that it has been in operation for a good number of years, and I think there are over 60 patients. I’m very glad and proud of the minister for considering all the Nunavummiut in this facility who come from all of the Nunavut communities.
One of the hardest tasks is to be a Minister responsible for Health and Social Services.
In all of the Canadian provinces, there are no exceptions, their health departments are always short of funding.
Even hospitals were closing down previously, such as in Alberta.
Also the nurses, we always have a shortage of nurses, even throughout North America.
Even though there was limited funding, the minister kept requesting additional funding and I commend him for that and I know that he’s committed.
I would like to see the continuation for the training of the nursing program either by way of providing more assistance to the students and by way of giving them support financially or otherwise.
I would also like this considered, as Mr. Tootoo stated, most Inuit do not ask for food until they are hard up, so those of us who go out hunting should be looking for ways to provide traditional food to the students of the nursing program or other students.
I would also like you to consider that part.
Chairperson (interpretation): I apologise, we cannot hear Inuktitut on our receivers.
Mr. Arvaluk go ahead.
Mr. Arvaluk (interpretation): I apologise Mr. Chairman, I’ve had my cold for two weeks and I’ve had my hoarse voice for two weeks.
As I was saying Mr. Chairman, in respect to the students of Arctic College, I know that hunters try to provide traditional foods for the students providing that they know of the situation.
But some people here in the community and especially for the students from Kivalliq and Kitikmeot, where the population of hunters in Iqaluit don’t know these individuals, they are not provided with traditional foods because they don’t know that student.
I was wondering if the minister is willing to consider this idea of providing more support such as the provision of traditional food for the nursing students of Arctic College, and other students that are taking training programs at Arctic College from outside the region.
They don’t know where to go, to either receive or purchase traditional food in Iqaluit and they don’t know anyone.
One thing I would like to mention, in the minister’s opening comments, on page 2, the second last paragraph, the minister said that the FMB approved a 21 million dollar supplementary appropriation for 2001-2002.
In 2002-2003, when they applied for further funding in total, I don’t know what he said, but I believe that he stated 115 million dollars which he mentioned in total.
Total funding for the nurses, again it flew over my head but it was about 151 million dollars.
For fiscal year 2002-2003, it was increased by 36 million dollars for fiscal year 2002-2003.
I would like to ask the minister, for fiscal year 2002-2003 during the year, I was wondering if you will fall into a deficit situation like last year?
I will allow you to ask your questions later on, once all the members have had their general comments.
You have another ten minutes after the members have had an opportunity with their general comments.
General comments. Mr. Iqaqrialu, you have ten minutes.
I would like to thank the Minister responsible for Health and Social Services and his department officials.
I would like to say since we became a Nunavut Government, we’ve been continually facing the department.
I know that their departmental responsibilities are very challenging to deal with.
I know at times we run into some barriers because we have different traditions and cultures and languages.
We have had a barrier between us because these social workers and health professionals perhaps we have different or ways of thinking.
When the department starts hiring Inuktitut speaking employees we will have less language barriers so that we can have a closer working relationship.
I know that the health issue is very difficult to deal with for us regular members and actually for all members and I know that they expended quite a large amount of money ever since we became the Nunavut Government.
Because according to my colleague from Nanulik he mentioned some problems that arise since the department is very difficult to operate.
Although we know that, but in regards to social services, the social issues are close to my heart as this has touched my life the most.
I think that we have run into problems due to lack of understanding and due to communication problems in the past.
We’re not just opposing the work of the department, we are not trying to belittle their mandate but if we work close together and if we can communicate with each other on the same level, then we can look for more improvements within the department and for Nunavut residents.
For that reason, there are many clients that the department deals with who are Inuktitut speaking unilingual people.
They go to other provinces for medical purposes and when they go back to their community, the continuing concern we have is that the nurses have to work with patients who are unilingual.
After working hours, the patients have to go see the nurses who can’t find interpreters after hours and that’s one of the problems that we have encountered, having no interpreter after working hours in some of the communities of Nunavut.
They then spend valuable time canvassing people for an interpreter.
For patients who would like to go see a nurse after working hours this is a problem when they can’t find an interpreter to go see a nurse, they can’t go to the nursing stations.
And we have also seen in Nunavut that the patients that are supposed to go to the health centres, but they do not feel comfortable with communication and when they finally go see a medical professional they are diagnosed too late and this has become an overriding issue, the fact that the diagnosis is usually far too late to do any good for the patient.
So, since we don’t have the proper diagnostic equipment to diagnose patients earlier in their sickness, we need the proper equipment.
I know that it will be very costly to get modern medical equipment which will be beneficial for all Nunavummiut.
But for those patients, who have been ill for quite some time, when they are finally diagnosed, they have no place to left to turn to and we can’t help those people.
And the doctors can’t help them at that late stage; even the medical professionals can’t help those patients.
In the past when we were living traditionally, and when we lived off traditional food, we didn’t seem to have those kinds of medical problems.
We were raised using our traditional food and the majority seemed to just age gracefully.
Perhaps this has an effect on medical problems, this new diet.
Maybe it is due to the difference of our diet now, that we are starting to see poor health in Inuit people.
I am sure that it has an impact because there are a lot of contaminants falling down on our territory.
These contaminants are contaminating plants, animals and the things that the animals eat.
We have to make Nunavut residents understand the contamination level and its effects.
According to our traditional knowledge in the north, since we live up in the north, in some of the department’s work, within the system, they don’t know the things that we know, much like my comments last year regarding Inuit traditional beliefs and traditional knowledge.
Last year I said when there was someone who had their legs amputated, who had frozen limbs, if the Inuit method of treating frostbite was used, if they had been treated using traditional methods, they would not have to be amputated.
And there are some people that drown as well, who die from drowning.
According to the traditional knowledge of the Inuit, they can be revived if they follow the proper process.
The Inuit method of resuscitation and the western method of resuscitation are different.
We have our own method where we as Inuit, a person that has drowned, their mouth and nose cannot be touched when foam is coming out of the mouth.
Those are the things we know.
They can breathe on their own afterwards, and once they put them on their belly flop them with their head down.
These were methods that we used to use.
This has to be recognised and learned.
But in the modern method of resuscitation you go mouth to mouth.
We have to make traditional methods and European methods complement each other so that we can benefit from it.
In regards to midwifery, some women deliver babies that are stillborn.
According to the traditional knowledge we know, there is a method.
I cannot remember the year, we saw it here at the hospital, a mother had delivered a dead baby according to traditional beliefs an elder used traditional method by putting the baby on the belly and put the afterbirth on top of the dead baby.
After a while the baby breathed again, we used traditional methods because the mother is connected to the foetus.
We have to look into these things and find out what kind of Inuit methods there are.
If there is a good level of understanding between the modern techniques and traditional techniques we can perhaps combine those to complement each other.
We come from the north and we come from a cold climate, so therefore our methods are geared for our northern climate.
Like warm and cold techniques, they differ, they have to be taught in Nunavut and be learned.
That way we can complement those two techniques together at the same time.
We don’t have all sorts of diagnostic equipment at the hospital.
Since we don’t have the technological medical equipment, we sometimes are too late in diagnosing the patients.
Even though there are more ideas coming out, I am running out of time now so I will conclude before my time runs out.
The next person to speak, first of all I would like to welcome back Donald Havioyak to the House.
Welcome Mr. Havioyak.
At this time, the next person to speak is Ms. Williams.
Just a short comment Mr. Chairman.
There are a lot of things I would like to say but I would like to have a lot more questions than comments today, but I will ask them when I have the opportunity.
(interpretation ends) When I look at the Main Estimates that are before us like Health and Social Services, I question why is Social Services in there because it’s not mentioned and it’s all health related programs, which is wonderful.
As we all know, quite a few years ago the infant mortality rate was quite high and it is not so anymore.
So we are so grateful to have the health services that are provided to us.
I think some of us also have the understanding that we probably have some of the best health services in Nunavut; even compared to some of the provinces.
If I go to the hospital here in Iqaluit, I may complain if I wait for two hours to see a doctor.
But, if I was in Toronto, I may have to wait a good two days or for a very long time even for surgery.
So, I praise the health for having a good health care system in Nunavut and it is free to Inuit in Nunavut.
So don’t misunderstand me, I’m very grateful for that.
I think most Inuit are very grateful to have this wonderful health service and interpreters that we have in the health field in Nunavut.
But, sadly, social services are missed and I don’t anything in the main estimates that is going to enhance social service programs in Nunavut.
There are things that we need to look at like foster homes, foster parent’s associations.
They’re very much part of the system but they are never mentioned.
And if it weren’t for foster homes that we have in Nunavut, we would need to have at least three to four social workers in each community.
So I wanted to also mention in respect to prevention and at one time Mr. Minister mentioned something about prevention but I don’t see any kind of programs that are laid out as far as prevention goes.
I’m talking about prevention, like, so the children are not neglected or they’re not abused.
There needs to be prevention on that.
There also needs to be some prevention in other areas like youth.