EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
The second piece that we’re looking at is the development of our own strategy in the north, for instance, the hiring of our graduates in this week’s graduation from nursing, and so on. So that’s all part of the process.
In terms of trying to deal with the agency file, we’re looking at putting forward a request for proposal to deal with one or two agency companies to deal with the cost pressures that we’re under in keeping those positions filled.
So there are a number of initiatives that are happening. I think in trying to deal with the recruitment of nurses, we have to approach it in such a way that it’s multi-dimensional, and it’s not just short-term but also very long-term.
We’re trying to capture some of those processes through our own strategy.
There is certainly a number of responses that are helpful to me, as well as the members of the committee.
In terms of actually going through the recruitment through agencies, obviously, there were some conditions that you probably considered. Do you have any specific kinds of conditions that they require that they have, at least personnel from this part of Nunavut, or is it strictly an experienced company that exists outside of Nunavut?
If that is the case, what type of experience does that agency nurse need, with respect to the minister’s department, to be awarded the contract?
In terms of going out for a request for proposal from a company that may provide agency nurses; that’s not yet finalized. Once that’s finalized, I’ll be able to share it with the Members of this House that will address the member’s question in more detail.
As it is right now, I can only speculate what could be in there and I don’t want to speculate.
So once we have finalized it and have legal division... it’s in Justice right now from what I understand, so we’ll be able to do the RFP.
Once that’s done I will be prepared to share it with my colleagues in the House.
Mr. Curley: I thank the minister for her response, but I certainly was not trying to jump, quick start, or anything to that effect, because the item that we considered yesterday, the $1.5 million, assumes that the agency nurses will be required, while the strategy is being implemented.
So the strategy was not fully implemented yet, and yet you indicated that the agency nurses might have to continue to carry on. So I was assuming that that practice was already in place.
If that is not the case, will the minister be putting something in that requires the agency to do recruitment with the Department of Health? Will you be putting in a condition where they have at least a senior representative or experienced Nunavut person that knows about staffing, or will you be completely leaving it up to the southern company; it most likely will be, to do all the screening and hiring for the Department of Health?
The member’s observations are on a lot of speculation.
The agency nurses that we hire currently to fill the 52 nursing positions that are vacant in Nunavut today are contracted with the agency nurse, that person. We don’t have a broad contract with one company or another company, but we rely on agency nurses that work for agencies who are available to work who have arrangements with us.
So what we’re looking at in the RFP process is to select one or two companies in Canada that provide agency nurses.
Those terms and conditions will be worked out through the RFP process when we select the firm that we will work with that will provide us with agency nurses when the vacancies occur.
In an ideal environment, we have our division in HR within Health trying to deal with the recruitment on the longer term, such as our students and so on.
There are two pressures here in that we have to provide essential services.
Essential services have to keep going while we’re recruiting.
So it’s a parallel process; multi-dimensional; and we can’t focus on just one to deal with the shortage issues of nurses in the north.
So I want to share that with the members when I have that information, and I would be prepared to share with the members and update members where we are at presently today. We have 52 vacant positions of the 182.
That is a lot better than 2004 statistics; a vacancy of almost 50 percent.
So there is some progress. We’re not there yet, but once we have that, I will be prepared to share it.
I would like to thank the minister at least for trying to clarify and respond to the question that I and my colleagues are posing. I see the deputy minister is here and I’m sure he will be able to help us out.
One thing, the reason for not really having a clear cut question is we really have nothing to work with.
The minister should appreciate our hands are completely empty.
We don’t have any reports about the agency nurses in print. We don’t have any information about how the contracts have been structured and so on, and where the nursing agencies that are being hired are located.
I know in the community of Rankin Inlet, the agency nurses that were hired are strictly doing home care, and occasionally they will appear once a week or so to deal with a particular patient.
So therefore, that’s all we have.
We have nothing in print; no reports of progress, or nothing for that amount of money.
We’re asking the minister not only to table a strategy, but at least provide a written report to the committee so that would help us.
So I think the minister certainly should appreciate we are trying to do our best to ask the questions.
If and when the recruitment agency, or hiring agency, or what ever you call it, is required, then I would hope that the experienced individuals from this company will be required to be on the staff of that company because it’s helpful.
I’m not sure that just by hiring an agency company to hire the recruiting requirement will have all that time to consult with HR people and so on.
So if the minister is prepared to table at least that plan to the committee, if not today, I would appreciate it if she would forward that to us.
Before I get the minister to answer the questions, would she like to sit at the witness table with her staff; she doesn’t mind if she’s alone at her seat?
Once the strategy is finalized this summer, I am prepared to share that information with the House and my colleagues.
In terms of where we’re at in vacancies, I’ve said this many times in the House, where we are at in terms of our vacancies, we have 52 vacant positions, just nurses, in Nunavut, of 182. So that’s an issue for us.
We had it broken down by region. We have 17 vacant positions in Kivalliq, 15 in Baffin, 14 in Iqaluit, six in the Kitikmeot; a total of 52.
So that’s where that is in terms of vacancies and we try and fill those to casual and indeterminate recruitment process or to keep the services rolling to agencies.
So I will be prepared to share that type of information with my colleagues once we finalize the strategy.
And thank you, Mr. Curley.
Mr. Arvaluk (interpretation): [Thank you, Mr. Chairman.
I had a question yesterday; however, I was ahead of myself. I think she remembers what my question was about, regarding what has not been approved, $7,305,000, for increases in travel costs.
We all know that when patients have to go down south.
We remember that in Kitikmeot they used to have to go through Repulse Bay through either Kenn Borek, or First Air, or Kivalliq Air.
The people from Kitikmeot prefer to go through the Yellowknife route. They had to stop this route because they didn’t have enough passengers.
I think the government needs to be more careful in spending their budget. For example, the government has to say if somebody is going down south for medical reasons, if you are going to fly, you have to go through this particular route.
We’ve seen this in Sanikiluaq; they have to charter a plane to go for medical to Manitoba.
We also know that people from Sanikiluaq will have to go through the Great Whale River and then to Montreal on regular scheduled flights.
Why do they have to charter a plane to Winnipeg for medical reasons?
It causes more delay for these patients because they have to wait for these chartered planes to have enough patients to fly them.
Normally, charters are used for emergencies, but there is also a schedule that they could use through the Montreal route, through Great Whale River.
Does this explain the increased cost that we see in the $7 million fund?
Thank you, Mr. Chairman.]
[With respect to the member’s question, we’re going to need to look into that issue of not relying more on regular scheduled flights.
This has been raised a number of times in the House, whether people in the Kitikmeot should come here to Iqaluit instead.
This is a complex issue and it is being reviewed with Kivalliq Air. It’s going to take time to look into these things.
As for the question regarding the Winnipeg route in favour of the Montreal route, perhaps the Minister of Health and Social Services is in a better position make an answer.]
The member is correct; medical transportation budget is probably one of the highest expenses we have. We spend a lot of money in transporting people before we treat them.
The Minister responsible for Transportation can speak to the broader issues of what they’re trying to do, including airline services for Nunavut. In the perspective of health, we do tender costs to try and get the best rate possible for our medical travels and our medivac contracts. Again, we’ll be doing that shortly as those contracts are coming up.
The situation with Sanikiluaq, the arrangement at the time was made that it was most feasible to go to Churchill and Winnipeg to provide medical services to patients in Sanikiluaq.
I’m speculating here, I’m not sure exactly when that change took place but the boarding home was closed in Montreal and transferred to Ottawa.
All of that’s part of the change in the division of Nunavut and how they became part of Kivalliq, and when, I’m not sure.
But I had posed that as an option to review further in the House to my colleague, Mr. Peter Kattuk, from Sanikiluaq, and a week later, a petition was held and I didn’t have to look further.
I can only say that we need to continue to monitor what kind of services we get from the airlines, and through the public tender process try and get the best rate that we possibly can, promote the development of airlines through my colleague, the Minister of Transportation’s role.
Just as an example, in the Kitikmeot, Canadian North just started flying again in the Kitikmeot, which allows a bit of a competition and so on.
So it is a huge issue for us.
Whether there’s one answer to it, I don’t know, but it is one that we have to try and manage.
But at the same time we’re dealing with the pressures of high cost of fuel, population growth, and increase in the number of patients with chronic illnesses that we have to send away.
So it keeps going up.
There’s not one answer to deal with this to try and decrease it again.
It’s multi-dimensional and there are a lot of factors in that.
If the Transient Centre in Montreal has closed, then where are the people from northern Quebec, Whale Cove, and other places going now?
Hon. Leona Aglukkaq: Mr. Chairman, that’s a question for that jurisdiction to answer.
I’m not responsible for the people from northern Quebec.
I can speak to what services we have available for people in the Baffin that have to go a hospital in Ottawa.
When that took place, I’m not sure. It was perhaps during the Government of the Northwest Territories days and so on.
I can’t answer that.
I’m a bit shocked because if I would be the Minister of Health I think I would try to explore any way possible from other jurisdictions as to how they handle their patients’ transportation and accommodation lists.
I recognize in that $230 million, almost $240 million, is a very, very big budget for a very small territory due to high transportation costs.
It’s not the fault of the government but we should try to explore what other jurisdictions are doing because we share the same transportation route in Sanikiluaq as Kuujjuaraapik.
I think it would be in our interest at least to talk to our counterparts in other jurisdictions about their operations to see if we can cooperate to cut our mutual costs.
Would the minister then tell me if she will be exploring differing avenues to determine how these costs can be cut down in the future?
Hon. David Simailak: Thank you, Mr. Chairman. (interpretation) The Minister of Health and Social Services has already responded to that question because she said that they followed the request by the Sanikiluaq residents because it was the cheapest way.
They look for the cheapest way to operate it and that’s how it was set up.
They’re always looking for alternate ways to cut costs to enhance this.
I believe that the minister had already responded to that.
Mr. Arvaluk: Thank you, Mr. Chairman. Thank you for that answer.
I’m still not quite convinced if that’s the cheapest way yet, but you know, we all should work together and try and determine the cheapest way possible.
If the hospital is completed in Iqaluit, will the Sanikiluaq people now be shipped to Iqaluit rather than Churchill?
It’s an option that we can explore through our request for proposals and tender calls for scheduled travel.
No decision has been made in regard to that.
I posed that option in the House to the Member from Sanikiluaq, and very quickly, a petition was filed in the House opposing any changes to the current services Sanikiluarmiut are receiving from Manitoba.
In terms of what kind of service we provide, I think it’s important that we continue to evaluate how we do.
The public tender process for scheduled travel, as well as medevacs, and/or charters is coming up again for all three regions.
At that time we’ll explore the costs based on the submissions that we do receive for those tender calls.
Mr. Arvaluk: Mr. Chairman, if I’m going to a hospital for a check-up, it should be up to the health professionals and the Department of Health where they send me.
It shouldn’t be up to me where I want to go. That takes taxpayer’s money.
I think that this system is quite old that is arranged in Sanikiluaq. I think there might be some other more economical way that should be looked at with the airlines.
Not just northern airlines, southern airlines, too.
For example, Baffinland is using Summit Airlines, I don’t from where, but apparently they’re cheaper.
We have to find a way. I know we should support our airlines here, but sometimes we support them until we can’t afford them anymore.
I would like to ask the minister: would there be some reviews done in trying to determine how we can cut down at least part of that transportation cost that is so exorbitant right now?
We continually meet with the various airlines.
We continually look for the cheapest way to use the airlines for medical travel and the airlines use cheaper fares for the patients.
We continually deal with this issue and we continually look for ways to cut costs for medical travel.
And also, thank you, Mr. Arvaluk.
Yesterday I was asking the minister under treatment programs there’s $1,542,000 there for the newly developed Nunavut Nursing Recruitment and Retention Strategy and additional funding for casual and agency nurses.
Can the minister indicate how much of that $1,542,000 is going towards casual and agency nurses?
The majority of the fund that’s identified in this line item, $1,542,000, is going towards filling vacant positions in casual and agency nurses.
Here we go again. I said yesterday that I wanted to exact number, dollar figure amount and not the majority of that was going towards that. So that’s what I am still waiting for.
The Nursing and Recruitment Strategy that I mentioned is in the works that we hope to have completed by this summer, within our internal HR division, will be implemented and will involve a number of multi-dimensional approaches that we are trying to take.
That strategy has not been finalized and approved by FMB and/or Cabinet.
Once it’s done, we will outline what financial commitments will be necessary in implementing that strategy.
In implementing the strategy that’s in place, once approved after this summer, we will go towards trying to recruit individuals on an indeterminate basis. But as we work towards that, we continue to need agency nurses in the communities, where we do not have indeterminate nurses, and that’s what this item is for.
When I say the majority of the funding that will be used will be to fill the vacant positions to casuals and agency nurses, any savings that we have in implementing the Nunavut Strategy for Nurses, of course, there will be a savings to us where we hire indeterminate nurses and will not be reflected off here.
But the strategy, again, is multi-dimensional in that first, we need the strategy approved by the Cabinet to find out exactly how much savings we can get or how much money it will take to implement it once it is finalized.
As it is right now, our work is to finalize the recruitment strategy and start the implementation of it, but in the interim we need to fill the 54 vacant positions in Nunavut with casual and agency nurses and that’s what this funding will go towards.
I still did not hear a number.
I do not know why the minister does not have it, but surely, when they come up with their submission for what they need, it’s broken down there: this is what we need for casual and agency nurses and this is what we need for the strategy.
You have to come up with that number somehow. You don’t just pull it out from the air.
Again, how hard is it for the minister to say out of those two categories in there, how much of that $1,542,000, exactly what amount of that is being spent on casual and agency Nurses?
The $1.5 million supplementary funding that we are requesting will go towards agency and casual nurses is an estimate in terms of how many we will get for casuals and how many we will get for agencies.
Exactly what and how that will be broken down remains to be seen because we have not filled those jobs to know how many will be agency and how many will be casual.
In terms of issues around agency nurses, we have used a lot of funding in the past to fill vacant positions in the north with agency nurses.
Last year, we had a supplementary bill around that. This bill amount is no different from last year.
What we are trying to promote internally is also to finalize our Nursing Recruitment Strategy for indeterminate nurses and any savings in hiring indeterminate nurses will be a cost savings to this line item.
Maybe they did just pluck a number from the air.
The minister cannot tell us for casual and agency nurses... there are two categories in this $1.5 million.
It says right here in black and white, “... additional funding of $1,542,000 for the newly developed Nunavut Nursing Recruitment and Retention Strategy and additional funding for casual and agency nurses.”
How much of that is additional funding for casual and agency nurses?
Surely, she must know to have put the number in there.
That is what I’m looking for.
Why won’t the minister tell us what that number is?
No, I don’t have that breakdown in my notes.
Mr. Tootoo: This is pathetic, Mr. Chairman.
The Minister of Health can’t tell us how they came up with that number that they needed.
There are two sections there.
So in order to come up with the $1,542,000, surely, they must have a number: this is how much we need for casual and agency nurses.
That’s what I’m looking for and that’s what I’d like to hear. I can’t understand why they can’t tell us what that number is.
I’ve answered that question three times.
The $1.5 million will go towards agency nurses and casuals.
Exactly the breakdown is difficult to tell at this point in time because we don’t know which positions will be filled by agency nurses or casuals.
There are different amounts there. Once we’ve have that, we’ll be able to respond to that, but I can’t predict how many will in the casual pool, which is a different rate under the collective agreement and the different rate for agency nurses.
As we implement the nursing strategy, that nursing strategy is not approved yet.
It’s not approved yet, but any savings in the implementation of that nursing strategy will be a savings in this line item.
For example, on Friday, we’re graduating five nurses here. We’re direct appointing nurses to indeterminate positions that graduated last year.
Those will be a savings to us to this cost item as we implement the nursing strategy.
But I can’t pinpoint exactly what amount will be required to implement the nursing strategy because it’s not finalized by Cabinet or FMB.
This line item is no different from what we used last year to fill vacant positions for agency nurses and casuals, and how we move forward in terms of breaking those from casuals, it’s not something I can answer until we fill those positions and have costed it out.
But I can tell you the trend in terms of last year.
The same amount is being requested for this year for agency nurses where we were over budget last year.
I think I finally understand what the minister is saying, but what I wasn’t asking for was the breakdown between the casual and the agency nurses.
I was looking for the breakdown between that additional funding for casual and agency nurses, one block, and what they indicate in here, what that money is going for as well is the newly developed Nursing Recruitment and Retention Strategy.
I think the minister just made it very clear that all of that $1,542,000 is going for casual and agency nurses.
So I guess the question I have is; it seems rather deceptive and misleading if they’re saying that to provide funding for initial resources of $1,542,000 for the newly developed Nunavut Nursing Recruitment and Retention Strategy, and additional funding for casual and agency nurses.
She just said that’s not what it’s for; it’s for casual and agency nurses, so why does it appear to be a misleading statement like that in here when that’s not exactly what it’s going for?
I apologize if the member is reading it that way. I think there is an interpretation in that, it’s not meant to be misleading.
The fact of the matter is that we need a Nursing Recruitment Strategy as being an item in this House. We’re developing that.
It’s not approved yet. It should be approved sometime this summer.
It’s a good news story for people in Nunavut.
That recruitment strategy, and we tried to implement it, any costs savings by hiring indeterminate nurses will be a cost savings to this line item.
It will mean less use of agency nurses as we implement the Nursing Recruitment Strategy.
But in the interim as we implement it, we are going to need to fill those vacant positions with casuals and agency nurses.
That’s what it’s meant to say.
It’s not meant to be misleading in that, it’s going to be all for that.
But recruitment is filling positions whether it be casuals, agencies or indeterminate.
It’s multi-dimensional and not meant to be one or the other, but rather to try and capture the fact that we are working towards the implementation and approval of the nursing strategy.
At the same time we recognize in doing that, we have to fill the essential services by using agency nurses as well as casuals.
I hope that clarifies to the Members in this House what that line item is.
I still think, in the Supplementary Appropriations, I have one here for 2006-07 and its number three, it has under treatment programs the same things: provided funding of $1,542,000 for the increased costs of costly contract service for agency nurses.
It makes it very clear that that’s what it’s for.
This statement in here is not clear.
It makes it seem like, if you’re looking at it and reading it, it’s for two different things, and it’s not.
I would like to ask the minister if, instead of providing misleading information and incorrect information, that they fix it and call it what it is. All it is is $1,542,000 for casual and agency nurses.
It has nothing to do with newly developed additional resources for the newly developed Nunavut Nursing Recruitment and Retention Strategy.
It isn’t even there.
Yet, you say that’s what some of that money is for.
Well it’s not.
It’s all for casual and agency nurses.
It’s very misleading.