EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
It could be a year later.
It could be five or ten years later.
To be able to track that on an ongoing basis would be difficult at best.
That being said, I know that with the aftercare there would be a little bit more data that could be accumulated.
It’s maybe something we could look at enhancing our tracking on that regard.
Again, when we’re talking about aftercare, it’s involving the family, it’s involving the person that’s there or sometimes peers. There are other components to make sure that people have the supports in place so that they don’t relapse.
It is often the case that somebody goes down for residential treatment and it doesn’t always work the first time.
I know many people that it is the second or third time they went down before it stuck, that they change their lifestyle to avoid the temptations and the lifestyle choices that put them in a state where they weren’t able to avoid their addictions.
It takes a lot of work from the person themselves.
There are people that self help. They recognize they have a problem and they seek out some initial counselling, and then they may stop and have stopped whatever they’re addicted to.
It would be difficult to track with any sense of accuracy.
It’s something that I appreciate your comment and it’s something that we will take a look at on how tracking like that could be achieved.
It might be a really good written question for the end of session to look at how much money is spent.
I guess I do have one more question about addictions.
In your opening comments you talk about “social-emotional learning programming for children and youth...” I’m wondering if or how much of a need has the department had to respond to addictions involving in youth and, if so, have you involved the child and youth advocacy office in your work.
I just had a quick little confer here.
To our knowledge we haven’t engaged the child and youth advocacy office. That being said, we have had communications with them over individual cases.
One of the things that we wanted to highlight, if somebody has engaged their expertise and their advocacy, is to make sure that it is communicated with us so that we can start mitigating the issues sooner rather than later, instead of waiting for a report or an annual report to come out saying that there is a child who has been going on for three months being exposed to something, where if we would have known about it, it would have stopped immediately.
I know there is ongoing stuff not just with the Department of Health and with Family Services, but there are engagements with that office and it’s a developing office.
There are things that we’re learning about each other as we move forward and I think there are good partnerships that are starting to materialize.
Some of the work that that office is doing, they’re doing some good work.
It’s just a matter of making sure that the communication lines are open all the time so that we can make sure that we’re looking after the best interests of the children involved.
One thing that comes to mind right away when I think about addictions, children, the Department of Health, and the child and youth advocacy office that I think should be worked on but we don’t really talk about it here, but we talk about it at home when we hear of things happening… . In fact it’s an issue that came up, wearing my other hat when I’m at the Sailivik board, when we were meeting with hunters and that’s gas sniffing.
We really don’t talk about that here, but I think just from comments I have heard over the years, it’s almost like a hidden problem that we all talk about, but it has never really been addressed.
Has the department worked on any issues around that?
I really thank the member for bringing that up.
It’s not a common issue and hopefully it never is, but we do see instances of gas and propane sniffing and other materials.
We’ve had successful initiatives of lockboxes where hunters can put their gas cans and propane tanks and that with.
Through the Embrace Life Council and through the Quality of Life there is representation from the RCMP on there through Sergeant Lawson and a number of different people from around the territory. One of the things that I think I really want to emphasize is that when we talk about the Quality of Life Secretariat, although when I answered my question from member from Sanikiluaq, is although the positions are located here in Iqaluit, it is a territorial focus.
We’re looking at initiatives all across the territory.
I think it was Kugluktuk. When I was there last year, I saw a local example of the lockboxes that were being used there.
I believe it is taking advantage of best practices that you see from successful programs in communities and rolling them out on a more as-needed basis, sometimes territorial-wide and other times to address certain concerns that a community may have.
That is where the community wellness coordinators really assist us in identifying what their wellness plan is involved in and how we can provide supports to their issues.
It’s not a one-size-fits-all from one community to the next.
We need to make sure that we’re addressing issues as they arise on a community-by-community basis. That’s where the focus of these initiatives and the grants and contributions through the Quality of Life is going to be focused on.
I think it’s perhaps more common than you say.
I think it comes not just from being able to lock up a jerry can and that; it comes from skidoos that are parked somewhere and people are taking off the thing and the kids are sniffing the gas.
It’s a very difficult and complex problem, no doubt.
I’m not saying it’s easy; I’m just saying that I really think it really affects the brain, obviously, when people become adults.
You can see the damage.
I would like to see a bit more emphasis on trying to really stop our future generations from doing that kind of behaviour.
I think it’s well worth the money.
Now I only have three and half minutes, so I better go on to something else.
I know what I wanted to talk about.
The cultural orientation program that you’re developing and you say in your business plan on 121 and my colleague, Mr. Okalik, also spoke of it; it says here in your business plan, “A cultural orientation program is being developed with Culture and Heritage and the Foundation for Healthcare Improvement.”
What areas are you targeting within your service delivery where they’re going to be more culturally sensitive?
I hesitate because it’s kind of a complex question and a complex answer.
When we talk about the history of Nunavut and some of the historical traumas that have occurred over generations, bringing us to today’s world where you’re competing against traditional values, beliefs, and way of living versus those traditional values and how they’re encompassed into today’s society, it’s a very complex issue.
That’s where we find working with the Department of Culture and Heritage to be paramount in making sure that we’re finding ways to bridge that.
As a health care professional, you’re dealing with youth who are struggling to find their identity and you’re dealing with elders who are living in a world that is unfamiliar to them.
The technologies and the lifestyles of some of their family members are different.
Our member from the High Arctic has brought it up a number of times where the traditional values still need to be respected, yet brought and melded into the modern world society.
That’s a very complex question.
Can I answer it here?
No, but that’s where we’re looking at making sure our orientation package links at least some of the knowledge of some of the challenges that residents of the territory can go through when you’re dealing with residential school and sometimes through the colonization of the lack of respect from professional people, teachers, the RCMP, doctors, nurses, and that type of thing.
We want to make sure that our health care providers go into that knowing that it’s not just Joe Blow walking into the health centre and complaining about some stomach pains.
They may not have had the access to health care that those health care professionals might be used to seeing in their previous jurisdictions. Again, we have all heard stories of somebody going in with an illness and an acute need and they’re given Tylenol and sent home without actually listening to the patient. That’s where we want to make sure that we’re educating our health care professionals when they come to the territory that they know that that’s an issue and a perception out there so that they don’t fall into that same trap, so that they can make sure that they’re taking a look and taking people’s… .
I have heard it often from elders that I have spoken to regarding health care.
They say, “I know my body.”
When there’s something wrong, they need to make sure that the communication line is open to the health care professional so that they take a look at the validity and the seriousness of what concerns are brought to their attention.
I hope all health care professionals, not just the ones coming to the territory but the ones that are here and have been here for a number of years, it’s very important to take people’s concerns seriously.
I can’t emphasize it enough on how important it is for the piece of mind for somebody to go in and know that they have been treated not just with respect but with the seriousness that whatever it is they’re in for deems.
The thing I thought about right away when you were talking, and I’ll use Mr. Shooyook if he doesn’t mind, he went to the hospital, I think it was in the fall, and he waited I think it was eight hours.
I have heard recently of the wait times because there is a lot of flu, even greater now. I heard of a mother and her child who waited 12 hours, and then they were told, “Well, you have the flu.”
Somehow if we want to culturally sensitive, we have to put our elders first and that includes the hospital.
I understand if you’re in an emergency and you’re going to have a heart attack, it’s common sense that you need to see that person first.
When you have a full room where you know everybody is suffering from earaches or chest or whatever cold, look around for the elders first and look around for the young kids first because, if you want to be culturally relevant, that’s how you treat them with respect in that way.
I remember when I was waiting at the hospital and it was at night. Actually one of your constituents, an old lady was there and she had been waiting there, she told me, since the morning.
She was sitting in those chairs because there are no couches, nothing where you can rest your back.
I remember it was the janitor who had just come on duty later on. He hadn’t been there all day. He saw her and he went into the OR section and he went to the wait section in the OR and got that big chair that can kind of go out so that she could lie down.
She was sick and had been waiting there a very long time.
I understand why you have wait periods.
Everybody is sick and there are only so many doctors, but I really believe you need to look a little bit more closely at who is waiting in the waiting room and how you can help people like the elders to be a little bit more comfortable during those long wait times.
If we’re really talking about making a difference culturally, then do it in action.
That doesn’t really take any money.
It doesn’t take very much time just to have a sweep and say, “Okay, who needs special attention here,” not because they’re going to have a heart attack but just to be sensitive to it.
I’m glad my time is up.
I know I have been in the waiting room for hours and hours with both my kids and things like that and even myself on a rare occasion.
I don’t go to the hospital usually, unless it’s broken or bleeding.
I do appreciate the comments.
We’re in the process right now of our model of care and it could be something that we will take a look at.
The main thing I really want to emphasize is that we do follow national standards.
I realize where you’re getting at, having a more cultural component to it, and I see some validity to that.
I guess the challenge, and I’m just thinking off the top of my head, is when you’ve got trained health care professionals that are triaging people according to their medical need, how do you bump someone because of a category that they fit in, elder or youth?
That would take a little bit more thought to be put into.
I do appreciate the comments that the member has brought forward.
I’m sure some people are putting their thinking caps on a little bit already.
Before I recognize the next member, we will take a 10-minute break.
>>Committee recessed at 17:55 and resumed at 18:10
Chairman: Good evening.
Calling the committee meeting back to order.
Mr. Mikkungwak (interpretation): Finally!
We were told to smile at our fellow Nunavummiut, so I smile at you.
Dealing with the Department of Health is very challenging.
The minister will understand my questions.
I have asked them in the House, but while we’re dealing with this, my first question is on your 2017-18 business plan and you mentioned Baker Lake in your opening comments.
The elders facility in Baker Lake, the Martha Taliruq Centre, was funded by Family Services, but it is being transferred to the Department of Health.
That being said, will the operations and the care that the elders receive at the elders facility change when it’s transferred to your department?
Initially there won’t be a direct change. There is a contract in place with the society that runs that facility.
There may be different levels of oversight because, when Family Services would have it, there might be a different level of professionals looking at it.
The clinical side of things may be a little bit more accessible because it’s a health facility.
I would imagine that there would be a little bit more of a clinical analysis of it to make sure that the elders that are in there are assessed appropriately for the level of care that the facility can provide.
Along the same lines, I think it was one or two years ago when I had asked about the operations and maintenance funding. The society had thought the elders who were being cared for in that facility should benefit more.
They requested funding for providing better care, but the funding is always limited.
With it being under the Department of Health, how would that change?
When you are talking about standards of care, it would be components of the contract with the society that has the agreement currently with Family Services transitioning over to the Department of Health.
At such time as the contract is up for negotiation again, those could be circumstances that could be examined.
As far as providing better care, we have to make sure that they’re being provided the best care possible under the agreements of the contract.
Could there be changes in the expectations from the Department of Health?
That’s possible, but I can’t speak to that until an actual negotiation and the contract is up for renewal.
Mr. Mikkungwak (interpretation): Thank you very much, Mr. Chairman. I’ll ask my next question based on his response.
Some of the agreements were signed by Family Services.
The responsibility will be transferred over to the Department of Health for the elders’ homes in Baker Lake, Iqaluit, and I don’t know where the third home is that you mentioned.
With that being the case, will you be reviewing the agreements right away on what improvements can be made to the operations and maintenance funding?
Again, it would depend on when those contracts come up for renewal. Just as an example, Family Services was allocated $200,000 for improvements. That is also being transferred over to the Department of Health on the transition date so that we can still continue the work.
That’s the whole objective. We’ve had a transition team developed working in coordination with Family Services to make sure that it is a seamless transition.
The whole ideal of reallocating these facilities and the services back to the Department of Health was that there was disconnect between different programs and services. This is bringing them all back in line so that there’s more of a seamless quality of care. As people age in place, you want to make sure that they’re in the facility that’s best suited to what their care needs are.
This just gives a little bit better solidity or more a solid ground to be able to move forward on making sure that the people are in the facilities that are suited to their level of care needs.
Moving on, my colleague from the Kivalliq had asked a question and I would like further clarification.
He had asked about the transition homes for medical patients and if they require further review.
The minister and his officials are well aware that I represent Baker Lake and I always support Baker Lake residents.
The residents of Baker Lake are now well aware of the patient relations office.
The transient centre is not only for residents of Baker Lake but all residents of the Kivalliq and it has some serious problems.
Kivalliq MLAs are always talking about it mainly because our elders are unilingual Inuktitut speakers and those of us in the middle generation speak Inuktitut and English.
However, in the agreement, it is obvious that the ones who won the contract said that they were going to do certain things. How will you be dealing with Department of Health policies that require care for the patients?
Will you be urging the contractors to rectify the problems? The minister is well aware of the problems and concerns along with his officials.
Whenever we’re dealing with boarding homes and medical travel, there can be challenges associated with it.
We work very closely with any contractor to alleviate concerns for one, but also to make sure that any issues that are identified are addressed and that’s on an ongoing basis.
Like when the member mentioned the patient relations office, it’s a key point of contact for people if they do come across a challenge or concern with the service that’s being provided.
For us to be able to communicate those concerns to the contractor, we need to know about it.
Too often I have seen lately of social media, people bringing forward concerns on social media and pictures and stories. While sometimes I would be made aware of it through other channels or people brining it to my attention, it’s not a formal way of making communication in an effective manner.
When I get an issue and most of the members here have brought forward issues to me at one point or another in the last year, I feel that we have responded very adequately to and very promptly to.
When a concern about a boarding home or a facility like that is brought to our attention on a general basis or through social media, as I’m sure you guys sometimes get made aware of issues through social media, it doesn’t do the system justice in a way that the staff that are involved.
I’ve had occurrences here in Iqaluit where it dramatically impacted the mental health and well-being of staff, where somebody is saying a scenario that a hospital or a health centre or an office space is unsafe or dirty or whatever the case may be, where it actually is totally contrary to what an effective communication to resolve an issue is.
Sometimes education is a factor.
Even just knowing the circumstances from the other side is more effective than shouting from the rooftops that there’s an issue with a general statement, where we can identify and deal with that specific circumstance in a professional manner.
That is the way of going forward with things.
Like the member said, you and some of your colleagues travelled down to that centre last year and you guys talked to me about it. We were going to sit down and go over some of the details and address specific concerns.
I believe that you guys are going down again in the next month and a half or so where possibly maybe I can join you, where we can take a look at some of the concerns specifically that you bring forward.
In the meantime any issues that your constituents bring forward to you or to patient relations, I can assure you they’re addressed promptly with the contractor. Those deficiencies or expectations are established very clearly from our standpoint.
We want to make sure that they are also upholding their end of the bargain as we’re upholding our end of the bargain in the payment side and providing the services to our residents across the territory in a manner they expect.
I know I talked a little bit longer and maybe got a little bit off track on it, but I did want to just get that emphasis out there that there is a proper protocol for bringing forward concerns and issues so that we know about it, so we can address it.
I know your response makes sense, but I would like to ask another question.
As a minister, you know when those agreements will expire. The patient relations office is also a place where people go and bring their concerns. They have records about the boarding home that I am referring to.
When the contract comes up for renewal, will you be explaining the problems that they’ve had with the previous contractor or present contractor to the prospective contractor? As the Minister of Health, will you and your staff make them more aware of these problems once the contract is up for renewal?
If I understood the member’s question correctly, if a new proponent comes on board or when we put an RFP and if they put in a proposal to take on a contract of this nature, it wouldn’t be something that we would go over and discuss deficiencies of a previous contractor.
We set our expectations of the level of service that we want to have provided to our patients and residents.
That’s the expectation that we go forward. We don’t dwell on what has happened in the past with the previous contractor or it could even be the same proponent putting in another bid.
We establish our expectations very strictly within our contract parameters of what our expectations of service are.
Our job is to make sure that we’re monitoring and making sure that they’re adhering to those conditions and it’s their job to make sure that they’re meeting the expectations that we’re establishing.
Moving on to a different topic, in the minister’s opening comments on page 2, there will be 18 new mental health that will deal with addictions or patients that need to go for treatment in 2017-18.
It states here that they would go for addiction treatment referrals.
What have you decided on that? Using Baker Lake as an example, the nursing station is too small. How would that be dealt with?
I could just clarify a little bit. The positions that we’re looking at hiring are mental health and addictions counsellors, local people that would be trained to be able to address issues from people coming in and identifying their level of need.
It’s not necessarily for people to be sent out for treatment all the time.
That’s in more of the aggressive addiction cases where people actually need to be sent out and the person needs to be ready for that as well. Most times those people are going to be working with people in the community on an ongoing basis to help them address their mental health issue or their addictions issue in a counselling manner where the person is not necessarily leaving the community. It’s an ongoing thing.
There would be appropriate times and appointments would be made.
It wouldn’t be a matter of 12 people showing up at the health centre expecting to get addictions counselling. There may be some potential for group conversations.
That all depends upon the level of need for the people that are involved and discussions with them on how best to treat their mental health or addictions issue.
As having been a former regional addictions mental health consultant based in Baker Lake, when you look at these 18 new mental health and addictions workers for 2017-18, are you going to re-advertise that position in Baker Lake?
Having been the former regional addictions mental health consultant, I was based in Baker Lake.
Are you going to have one of the positions based in Baker Lake?
Currently we have three PYs associated with the mental health staffing in Baker Lake right now.
Like I had mentioned in an earlier response, we’re still assessing the actual specific communities where we’re going to be allocating these positions to.