EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Mr. Kattuk (interpretation): Thank you, Mr. Chairman. The concern that I brought up in regard to...because of the size of the plane, a lot of times the patients have to wait in order to get home.
Chairman: Repeat please, Mr. Kattuk.
Mr. Kattuk: It was my concern last week that the capacities of the airplanes are too small and they have to have some patients left behind until the next charter.
So I just want you to confirm that you will look into this and get back to me as soon as possible.
It’s just a concern that we request it, but I really want a change on this because people are concerned about it.
I will commit to that; I have committed to that before and reviewed the actual contract and what’s actually been provided. There has been some contact made with the airlines and we are looking to what types of aircrafts have been used.
I will be following up, in writing, to the member.
It’s just a matter of getting that information collected and shared with the member, and to also try and address the issue that in our contract that those airlines, if there is some discrepancy there that they adhere to the contract. (interpretation) I agree.
Chairman (interpretation): Thank you, Minister. Any more questions Mr. Kattuk?
Mr. Kattuk: I have no more questions.
Mr. Barnabas (interpretation): Thank you, Chairman.
My question is who makes the ultimate decision on medical travel in case of emergencies or other basics.
Chairman: Minister Aglukkaq.
The physician or the nurses that are treating the patient have the ultimate and final say on those medevacs.
They are required to fill out forms, especially if they have escorts, and they will have to send those forms to Pangnirtung. How long does it take to get an approval for those people who are leaving because of medical travel or that need an escort?
For a medical evacuation, emergency evacuation of individuals requiring emergency treatment in hospitals, that procedure is a little bit different than making travel arrangements for a scheduled doctor’s appointment in Iqaluit or in Ottawa.
In the case of emergencies, the paperwork for travel arrangements is not done. The nurse, in consultation with the physician, will organize the charter request to evacuate the patient.
The physicians, how often do they visit the smaller communities?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. I will get Mr. Ramsden to answer the question.
Chairman: Thank you, Minister. Mr. Ramsden.
Mr. Ramsden: Thank you, Mr. Chairman. It depends on the type of physician that we are discussing.
The family physicians go monthly or more often than monthly to communities. Some of the specialists only go to some of the communities once per year and in other cases, twice per year. The schedule is something that is worked out between the nurses in charge, and our physician services group in the hospital here.
If we need additional services, they work through OHSNI who makes arrangements to get extra days of service for whatever physician is being demanded more service of.
When the physicians go to the communities, they stay for very short times and there are a lot of patients that they have to see. If they do not have enough time to see the patients that they were supposed to see in the community, what happens to those patients?
As it is right now, we have 11 physicians on staff and sometimes we’ll get specialists that come up from the south to provide services in the north.
As much as possible, those patients that are scheduled for an appointment, the physicians are organized when those individuals are coming up to the north. If it is an urgently required service, then medical travel is arranged for that patient and if the person can wait in the community for the next physician, then those appointments are also scheduled when the doctor comes in.
Sometimes, the physicians come to Iqaluit and my constituents, like the specialist when they come up, they have to see patients and sometimes, my constituents have to travel down to see any kind of specialist they have to see. And when the plane cannot come into the community, then those patients who were waiting to be seen cannot be seen.
So what happens to those patients when the specialists are up here and the plane could not go to a particular community? Sometimes they will not be seen for a year unless the doctor or specialist goes to Iqaluit or to the community.
In cases where, an example, if a plane did not make it to a community because of weather, then we would reschedule the appointment for the physician to come in to see the patients listed, and if there is an urgent need, then we would review those on a case-by-case basis.
I mentioned earlier that if that is the case, then we would make the travel arrangement to have the person flown out by the community.
At the same time if there are increased needs of patients in the community to be seen by specialists or physicians traveling, then we would increase the time the physician is in the community. So the number of physicians or doctors is considered in this question.
I have a very short question I usually bring up in regard to the Escort Policy. Who is capable of traveling alone?
I just want further information if, in April, this policy will come into effect.
Our goal is to have the policy revised for implementation for April 1 this year. And at the same time, once it has been approved by cabinet and so on, that Communications Strategy be established or implemented as part of the promotion of the policy throughout the communities and the health centres, but at this point in time, the plan is to have it finalized for the new fiscal year.
You have indicated that you would advise the House or the communities.
Will it be through CBC Radio, or will there be community consultation before this policy is implemented, or are we going to hear it through CBC Radio or through media? Will that be the case?
My hope is to develop a Communications Strategy on the policy that will be broader than just CBC.
I would like to see a Communications Strategy that will have community workers such as Community Health Representatives speak on the local radios about that particular policy as an example, at the same time, through pamphlets; flyers for patients traveling.
At the same time, I would like the nurses or the physicians to hand out that information for travelling patients. I would also like to have that information available at the boarding home; that we cover a number of needs. And perhaps, CBC is one of those mechanisms, but I would like the staff to have an opportunity to put that plan together and then once it’s all done, it will probably involve more than just one media outlet to promote that information.
This will be my last question. I think you made it clear that the policies and rules for regional areas are all different. Is it going to be a Nunavut-wide policy rather than just the three regions?
The policy before was one policy in Nunavut. The problem with it was that there were some inconsistencies in how it was being implemented and applied.
The idea of revising the policy right now is to ensure that it’s clear and there are guidelines that can be used by the people that have to make the decision in applying the policy at the community levels to minimize the inconsistency in application of that current policy. At the same time, to also communicate to our staff, as well as to the patients, what that policy is and so on.
The other thing that we’re trying to incorporate in that is an appeal mechanism so that patients can go to one person within the Department of Health around the whole policy to again reduce the inconsistency in application of the policy.
We’re on page H-13.
Under Treatment Programs again, looking at the back of your business plan, it has a financial summary that lists the total number of PYs. There is an increase of 60 PYs in this area. I’m just wondering if we can get an indication from the minister of what those positions are and where they’re going.
Can you please indicate which page you’re referring to?
On our version of the business plan, it’s H-28. I know theirs has always been a little bit out, but it has a financial summary by branch with a comparison of the 2005-06 and 2006-07 Main Estimates with dollar amounts and PY numbers, if that helps.
I’m going to list by section where the change is in that area.
First of all, there has been an increase in this section by 26 positions for the hospital. First of all, I should explain under the Treatment Program Branch of the department, this includes the health centres, physicians’ services, the hospital services, medical travel, and medevac budgets.
So there was a transfer of 12 positions, with the mental health facility transferred back to the Government of Nunavut. In the past, that was contracted out. There has been in increase by six positions at the Family Practice Clinic; approximately 26 positions for the Baffin Regional Hospital services; two boarding home positions that were originally located in Churchill were transferred back to the department in Nunavut; one administrative position was added to the Hospital Services.
I think that would be it.
The minister said the new positions for the hospital here; I would assume it has to deal with the accreditation issues that they have; that they face.
Is part of that increase just for Hospital and Physician Services here is $12 million. By the looks of it, it’s $26,743,000 last year and it’s $38,226,000 this year. Is that $2.1 million that they announced in their press release last month included in those numbers?
Can I ask the member to identify the page number where he made reference to the dollar figures?
It’s on H-23 in their business plan. Treatment starts on H-22 and carries over to H-23; there’s Medical Transportation; Hospital and Physician Services; Community Health Centres.
That’s where I got the number from and the total of that gives you the total that we are looking at on page H-13.
The difference in that position, the amounts that he referred to are a transfer of the positions with the Mental Health Facility transferring back to the Government of Nunavut.
The other area is the Baffin Regional Hospital increase by 26 positions; and the appropriate budget to that; as well as the transfer of Rankin Inlet’s budget under Hospital Services. We made some moves to a couple of positions and realigned the budget to our actual spending patterns.
In that includes the Mental Health Facility; the Baffin Hospital; and Rankin Inlet’s position.
Could the minister clarify: does that mean that the positions that are working at the health centre there were under Community Health Centres prior to the transfer into Hospital and Physician Services? Is that correct?
That clarifies the reduction in community health centres. She mentioned the hospital here and the health centre in Rankin Inlet, but there was no mention of the health centre in Cambridge Bay. Are they looking at transferring those positions around in there as well, or in which category are those ones in?
Are they still under Community Health Centres, or are they under Hospital and Physician services?
Currently, in this budget item, the Cambridge Bay Health Centre is still under that Health Centre line item identified in the business plans. Perhaps down the road, we’ll look at transferring that to the second item, Hospital Services, as we progress.
Just to get a clarification: what was the rationale behind moving them from Community Health Centres into Hospital and Physician Services?
In the case of using Rankin Inlet as an example, the transfer of that budget was the birthing centre to the hospital. And basically, an analysis was done on comparable services and transferred from the Health Centre to the Hospital Services.
Mr. Tootoo: Thank you, Mr. Chairman. Also following that part of the page, it shows the numbers that have priorities and one of them that they list there for 2005-06 was to fully implement the ‘Closer to Home’ Strategy.
It said that for last year it had been incomplete, but it remains an ongoing priority for the department for 2006-07.
I just wonder if the minister can update us as to what portions of that strategy have yet to be implemented and when do they expect to have them fully implemented?
That particular strategy is a very long-term strategy.
The department is working on different areas. For example, the long-term care facilities are one example of that. It’s still ongoing in the capital planning and with that construction still not in place, those services will continue to be provided out-of-territory.
At the same time, there are a number of initiatives internally where we are looking at trying to develop strategies around say, public health. Public health is an example of where we are going to do more long-term planning for prevention, to provide more services at the community level in the area of prevention.
The ‘Closer to Home’ Strategy could mean programs at the community level, or regional level, or within Nunavut. In some cases, as an example, with the hospitals opening up in Rankin Inlet, Cambridge Bay, and eventually down in Iqaluit.
Some treatments will be offered more in Nunavut than outside of Nunavut with those facilities coming on stream, but it’s a very long-term plan. Part of that whole process also includes our training of staff, training of nurses, training of mental health workers, and so on.
So it’s not specifically identified by the years and so on, but there are a number of initiatives overall that we are doing, but are kind of under the umbrella of that concept of ‘Closer to Home.’
So to speak to one particular item, it’s difficult to say at this point in time, but there are a number of strategies that we are looking at internally that will provide ‘Closer to Home’ care.
Close to home care could be: you are receiving service in your community versus Iqaluit, or receiving services in Iqaluit, Rankin Inlet, or Cambridge Bay instead of Yellowknife or what not.
At the same time, people outside of the territory maybe can come back to live in Nunavut for their care. There are different ways of looking at that, so that’s where that is at this point in time.
Just following along in the priorities for 2006-07, it indicates that the department wants to expand hospital and specialist services across Nunavut and mobile technologies to support exactly that ‘Closer to Home’ care. Can the minister elaborate on any plans of exactly what they are looking at of how they want to expand hospital and specialist services, and mobile technologies, and what they are looking at doing this year in that area?
I am going to ask Mr. Ramsden to respond to that.
One example that I can use is in Cambridge Bay, in the new facility, there are plans to have scoping clinics where people have diagnostic services done in Cambridge Bay where before they used to have to have that done by the internal medicine specialist in Yellowknife. With the Rankin Inlet facility coming on stream, the only clinic that will have to take place in Churchill in the next six months is the oral surgery for children.
All the other clinics that people used to have to go to Churchill for are now going to be offered in the Rankin Inlet centre. Those are two examples where there is a broader range of services now or planned in very short time in Nunavut that used to take place outside of Nunavut.
That is good to hear that some progress is being made and they are about to repatriate those services to Nunavut.
I just want to look back to something that the minister had indicated earlier and that was under the Hospital and Physician Services where she indicated that there was the transfer back to the Government of Nunavut for the mental health services we get here in town.
I just want to clarify: is it 12 PYs that she mentioned in that area and just how many PYs are included there?
There was a transfer of 12 positions back to the Government of Nunavut.
I know that transition was something that took a little longer than was anticipated.
Can the minister give us an idea of what some of the challenges were that they faced in finalizing that transfer?
From what I understand of this transfer, the decision to transfer was made in January of this year.
In terms of what the decisions or what the challenges were prior to the transfer taking place, I started in this portfolio in June so the challenges before that, I do not know what they are, but I imagine the previous minister would be more familiar with what those challenges may have been at the time or else I can find out what they were.
A chance maybe the officials have an idea of what some of the challenges that they faced because I know that the minister had indicated it was announced in January or prior to that and it was supposed to take place at a certain date and it ends up not happening for a while after that.
So I guess I am just trying to find out what led to delays and what their problems were with the transfer.
I can understand that the minister may not have firsthand knowledge of that as she was not in the portfolio at the time, but maybe her staff has an idea of what they faced.
From what I am aware of, the decision was made in January with the transfer effective date of April 1, 2005. So I imagine, between that time of the decision between January and April, the transition plans were in place.
I can find out more of the specifics of what some of the challenges may have been during that transfer from my staff.
From what I understand, the decision was made in January, with an effective date of April 1, 2005. And I understand that timeline to transfer April 1, 2005 was met.
I wouldn’t mind knowing exactly what led up to the transfer and why, if there were any challenges they faced.
Given that that has been transferred back to the government, is it costing the government more now to run that program than it did when that was contracted out?
Prior the function being transferred back to the Government of Nunavut, we were paying out $1.475 million to provide that service. There has not been a significant change to that amount from what I understand.
Would the minister commit to monitoring this, I understand this is the first year of that happening, so that we can do a bit of an analysis as far as the cost to the government running it and what it was when it was contracted? Can they commit to monitoring that and providing that information say next year this time, when we’re sitting around the Qamutik again?
I am in agreement with that. I had made a commitment and stated in this House also that I want my department to review all the facilities that we operate in Nunavut, whether it is mental health facilities, or group homes, or elder care services.
I would like an opportunity for my staff to review all those services and service arrangements whether we have them within the government or outside of the government.
The top priority being that quality of care and services provided to individuals that are in those services are maintained.
I would like to see also internally that this be examined to ensure that we are keeping up with the times of change in terms of dollars, or in terms of training, and so on. The review will include not just this facility, but the facilities for group homes, as well as elders’ homes and so on, on a broader scale.
If we are providing those services through contract means, then also to look at what those service industry needs are on a regular basis, whether it be training, or whatnot. I want an opportunity to examine all of that because since 1999 there has not been a review of those facilities, and I think it’s long overdue to start putting our priorities in providing those services and quality of care services, should be one that we should examine on a regular basis. I will commit to providing all that information including this one to the House and to the members of this House.
The minister indicated there were 12 PYs that were transferred over. Were those positions advertised out again as indeterminate government positions, or were they just people that were working there for the contractor that automatically got slotted into indeterminate government positions?
From what I understand, where there were existing staff, those people transferred over, and where there were vacancies, those positions were advertised.
How many staff were transferred over? Thank you, Mr. Chairman.
From what I understand, there were about three or four indeterminate positions that were transferred over.
Is the minister or her officials aware of what exactly those positions were; like was it housekeeping, was it a cook, was it a supervisor, what exactly were those positions for those individuals prior...for the contractor and then also, what are their positions that they moved to indeterminate positions with the government?
There was a supervisor and a couple of life skills workers that were transferred. In terms of what the positions are for the facility, I can get a complete list of those positions for the member.
Can the minister assure us that the individuals that were in positions, whatever they were with the contractor, were qualified to be in those positions as they are all moved into the government because we all know that in some cases, the government has different qualification requirements than would a private contractor would be looking at.
Can she assure us that the people that moved into the positions within the government met the adequate qualifications to fulfill those positions?
From what I understand, the Department of Human Resources was involved in the transition plan from the centre to Government of Nunavut and they were involved in assessing those individuals as well as the job descriptions developed for the GN.
So through that process, one would assume, but I can verify that information for the member through my colleague from the Department of HR of what procedures were followed prior to those offers being given to those individuals transferring to the GN. Thank you, Mr. Chairman.
I just want to make sure because anyone who would want to make sure if they are going to put their clients there that you didn’t have someone say for example, it was a cook there that moved into a management position; that wouldn’t make very much sense.
So I would appreciate if the minister could look into that and get back to us.
I will look into that and it is in our interest to have people in jobs that they are qualified for also.
So I will commit to providing that information to the member and to everyone here.
We are on page H-13.
I wanted to ask a question in regard to...perhaps a short preamble under Treatment Programs.
I want the minister to be aware that this is very beneficial not just for social health, but also for counselling services, whether it is for alcohol or drug programs, or whether it is for substance abuse, and to provide help to those individuals who ask for it.
The individuals that want to get counselling or services, they don’t usually get counsellors.
So some individuals were calling me, there was an individual who was supposed to go down to Manitoba, but he was very thankful because he wanted to get some help and he called me for support or help. These kinds of treatment programs are very useful in our communities.
These kinds of treatment programs are very useful in our communities to individuals. Are you preparing for those kinds of social programs so that they can be done at the community level? I am talking social intervention services.
So I was wondering if your department is now working on these services so that at least we can have those services at major centers. Perhaps the minister can respond to me.
As a follow-up to a previous response I had given the Member of Arviat that the department is looking at the whole issue around how we deliver A&D programs, I think we have to look at that and in the concern the Member from Arviat had made was related to what kind of training programs are available to assist the A&D workers in a community or the mental health workers that are in a counselling capacity.
As a department, I think this is one area that we need to look at and evaluate and how we are doing.