EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
We need to space some of those positions out. Some of the other things that have also happened in the hospital is not just the hiring of people to address the recommendations in the Accreditation Report, but part was also to do further training of the current staff that are there to address some of the recommendations in the Accreditation Report.
So some parallel initiatives were undertaken to address the Accreditation Report.
At the same time the time, Mr. Chairman, the challenge also came when the accreditation company changed their standards, which we had to go back and evaluate. Do we have the right positions, as per the original recommendations, and so on?
So we needed to go back on some of those changes that were applied by the accreditation company and to make sure that the positions that they originally identified at first were in fact the positions that we’re going to need in meeting their new standards.
Would the minister commit to, once they figure out what they have to do to get their accreditation back, to provide that information to the Members of this Assembly?
I would be glad to provide that information to the members, and perhaps, even with some representatives of the accreditation company because at the same time Nunavut is participating in developing new standards for Canada.
I am proud of our participation in that initiative with the accreditation company and working towards establishing standards and participating and being a pilot project with their assistance that will be useful to other jurisdictions in Canada.
Questions on Directorate, page H-5.
I welcome the minister and her officials back to the House today.
I just wanted to begin with yesterday I asked a couple of questions and the minister indicated that she would have her staff work on getting the answers to provide that information.
I’d like to ask the minister if her staff have prepared that information and I can get it today.
A couple of clarifications from the member: Is he asking for the information related to the qualifications of doctors is Nunavut?
Mr. Peterson, can you clear up the matter.
Mr. Peterson: Thank you, Mr. Chairman. On page 50 of the Hansard from yesterday I asked for a rough breakdown between the indeterminate nurses and the agency nurses that are in the various health centres and hospitals across Nunavut.
The minister didn’t have that information.
She said that, “I’ll get my staff to collect that data.”
Then I asked the minister, “Can the minister provide an idea of what it costs to support one indeterminate nurse versus what it costs to hire one agency nurse?” Again, she said that she’ll get the information for me.
That’s the information that I requested yesterday.
While I look for that here I am going to also have the assistant deputy minister respond to the other information that he requested in the House yesterday related to the qualifications of our doctors, so I’ll look for my notes in regard to other two.
For a physician to practice in Nunavut they need to get a license from our licensing office; through the Professional Practice Unit. The standards for the licensing in Nunavut are similar to other parts of the country.
The director of that unit has a committee that reviews the credentials of physicians to grant a license.
There are two types of physicians in practice; there are the specialist positions and the general practitioners.
General practitioners have a wide range of practices where they provide general services to patients as we have in our communities.
We do have specialists working in the hospital, and providing consultations both in the hospital and outside of the territory on our behalf, as we refer patients to them.
The qualifications then differ from the specialists to the general practitioner.
The specialist requires a credential which is achieved with education following their license as a general practitioner.
Mr. Peterson: Thank you, Mr. Chairman. I thank Mr. Richardson for that answer.
Maybe I’ll continue to ask Mr. Richardson questions on that area.
I had a highlight here. On page H-12 of the business plan, there is section or a division called Professional Practice which I think Mr. Richardson has already clarified.
They maintain professional standards, best practice, and clinical procedures.
He explained the credentials for doctors and general practitioners. Could Mr. Richardson expand on who checks the credentials for nurses and other professionals such as psychiatrists, sociologists, and the other types of folks who might be providing treatment and professional services to Nunavummiut?
The Professional Practice Unit does the licensing for many of the professional categories in the territory.
For nurses, the licensing is handled through the joint Northwest Territories, Nunavut Nursing Association.
I thank Mr. Richardson for that information.
Just to clarify, who checks the credentials for psychiatrists or people in Nunavut who may be calling themselves psychiatrists? I’m assuming if they are going to call themselves psychiatrists, they have to have a designation.
Who checks their credentials?
A psychiatrist is a physician, so credentials for a physician would be checked through our Professional Practice Unit and the committee that awards the license to practice in Nunavut.
Mr. Peterson: Thank you, Mr. Chairman. I thank Mr. Richardson.
I’ll move up on that page. I wanted to get an update on the Telehealth Program. A couple of years ago when we first embarked on the Telehealth Project, we received a commitment from the former minister that we would receive yearly updates on how telehealth was being implemented, and then the cost savings that would generated by having telehealth in Nunavut.
So my question for the minister: is the department monitoring the savings to Nunavut from the implementation of telehealth?
The Telehealth has been implemented throughout Nunavut and it provides very good services in assisting the health centres in clinical assessments and so on.
The Telehealth has also been used to provide professional development of our staff in each health centre, conferencing and so on.
In terms of tracking some savings, yes, there is some tracking of some of the savings or cost avoidance, if you want to use that word as a result of having those systems in our communities.
I note that there is an approximately $200,000 decrease in the budget for Telehealth this year.
Can you provide an explanation for why your costs are going down?
The costs have gone down because the systems are now in place in the communities, the purchase of the equipment and so on. So that would be the reduction in that category.
I guess we never complain about costs going down, we always complain about costs going up.
I would like to see costs go down on some of the other areas here as well. How many PYs do you have in the Information Technology and Telehealth division?
Chairman: Thank you, Mr. Peterson. Mr. Kattuk.
Mr. Kattuk: Mr. Chairman, there are only nine members.
Chairman: Thank you, Mr. Peterson, and thank you, Mr. Kattuk.
About six ITs and six in the area of Telehealth, that’s the best estimate.
Can you clarify a thought on my mind in that area, the Human Resources Division; this is an area that always confuses me. We have a Department of Human Resources that’s responsible for hiring most Government of Nunavut employees, and then we have a Department of Human Resources, quite a large department based on the budget located right within the Department of Health and Social Services.
Could you clarify, minister, what is the role of your Human Resources Division versus what the role of the Government of Nunavut’s larger Department of Human Resources?
The role of the internal human resources division for health in terms of the recruitment piece is directly linked to nursing positions.
Other areas that they provide assistance is in the area of developing the recruitment strategy for nurses as well as the physicians.
Another area that they oversee in health is to provide assistance to the field in each of the regions in HR advice and support.
The other piece around that is to assist in the filling of vacant nursing positions throughout the territory.
So the division not only provides administrative support in the whole functions of HR but really around the recruitment and retention of our nurses in the territory.
Can the minister clarify that the Government of Nunavut’s Department of Human Resources is responsible for recruiting and hiring and supporting all other health department employees in the Department of Health and the internal Human Resources Department is primarily concerned with just health specialists, such as nurses. Is that my understanding?
One last question for the minister on this section, on page H-13 of the business plan; on the priorities for 2007-08, there is a priority to develop ongoing training for staff; specifically nurses and social workers; based on core competencies.
This is one of the issues in my riding. In Cambridge Bay, we’re supposed to have four social workers and we always seem to be down to one or two.
I asked a written question to the minister about that.
I am wondering if the minister could explain what her department is doing to, not only train social workers, but to recruit social workers and retain social workers, not only in my riding but all ridings in Nunavut.
I’ll start off with part of the answer to that and transfer over to Mr. Richardson.
One of the things that in terms of training we provide that training, part of it anyway, through Nunavut Arctic College, and the program is offered in Cambridge Bay. That program is to train social workers for Nunavut.
The other training that we’ve started this past year, and we hope to have the graduates, I believe there are about 10 graduates related to the mental health workers, which work alongside with social workers in the communities.
So that’s a piece around the training that is offered in Nunavut for that field and I’ll get Mr. Richardson to elaborate a bit more on what we do.
We are doing a number of things.
Social work is one of the difficult to fill positions. We have done training to create staff within Nunavut.
Last year we standardized the job descriptions so that all of the staff would be classified in a common way so that it would help us with the selection and distribution of our staff, with respect also to identifying the competencies required for each level of social work; whether it’s an entry level position, a supervisor, or manager.
The competencies; we have a committee of social workers identifying those and we have funding for social work instructors in each of our regions; who will be available to support the ongoing education of our social workers.
We believe when that is operational it will contribute significantly to the retention of social workers in our communities.
Chairman: Thank you, Mr. Richardson, and I’d like to thank you, Mr. Peterson.
Mr. Arvaluk since you didn’t finish your minutes I will give you one question to the minister.
I’m not sure what your ruling is on this one. Maybe I could make a quick comment so that my question will be clear.
I was asking questions before but I don’t see it in the estimates.
In the directorate, the decisions are made to accept directives from the Cabinet to relocate positions.
For example, the hospital worker, transportation from the Iqaluit hospital, being transferred to Pangnirtung; this is a frontline worker. It’s the same with doctors, nurses, and bus drivers, etcetera. They are needed here in the hospital for the whole of Baffin.
I don’t think it would work very well if a doctor was transferred to Pangnirtung to practice in Iqaluit, or a nurse, cook, or bus driver that is practicing in Iqaluit.
Also, a letter was sent to Mr. Alagalak on medical travel and escorts from the minister about the client service coordinator.
Would she review that decision and then move the client service coordinator from Pangnirtung if need be, and then put the transportation person back into this hospital?
The positions that provide travel coordination are at the hospital. They were not moved. In Pangnirtung, we created the position in Pangnirtung to provide that service for people that require travel for other services and not going to the hospital.
The hospital travel staff provides travel coordination planning for patients in the hospital to Ottawa.
Mr. Arvaluk, I had mentioned earlier when I opened the meeting, and I will mention it again that once a member has spoken, that I have discretion as Chair under Rule 77(2) to allow you to continue.
I plan to use this discretion so that we can achieve significant progress in our budget deliberations.
That’s what I mentioned earlier, and I would like to get back to page H-5.
Sorry. Mr. Peterson.
Minister, yesterday Mr. Peterson asked a question on agency nurses versus regular nurses. That was one question. The second question was cost to support one nurse.
Can you please answer the member’s questions from yesterday?
Currently within the Department of Health there are 182 nurses in Nunavut and the vacancy rates for those positions vary on a given day.
So right now, we’re looking at about 50 to 60 vacant positions of nurses. In those cases what we try and do is fill those positions first with casual nurses, and if all else fails we resort to agency nurses to provide the service so we’re able to fill the vacancies.
The cost of agency nurses is nearly two times the cost of an employee.
That almost answers my question.
What are your costs for a regular nurse?
The levels of pay for nurses vary by positions as classified through job evaluations.
What it costs on a daily basis, I would have to get that information to the member but on an annual basis per staff approximately $110,000 annually.
Page H-8.
Healthy Children, Families, and Communities.
Mr. Curley (interpretation): Mr. Chairman, I apologize. Thank you. I apologize, we had a blizzard quite close to the lake close by here and we got stuck down there.
I think that’s the way it used to go a long time ago.
I do have some questions and I do apologize for not being here.
If you would permit me and I know that it doesn’t refer to this page. My question, first of all: are we going to keep in budget with the Keewatin hospital?
It’s going to be very brief.
Chairman: I would like to ask the committee if you want to go back to H-5 to Directorate. Does this committee agree?
Mr. Curley (interpretation): The hospital has been in operation for about two years and it has beds, a treatment centre, and so on.
Are we going to be in budget for this year, or are we going to be within our budget, or are we going to be over?
This health centre has been in operation for the past two years and the health professionals work extremely hard.
Some of them are gone and we do not have a full complement of staff but my question to the minister is, is this health centre going to stay open now or is it not going to be used and are we going to be occupying those beds that have been made available.
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. Welcome back to the member.
Generally speaking, yesterday we spoke of some of the challenges in opening the facilities, particularly around housing for our staff.
In terms of the budget line item for the Rankin Inlet health centre that’s on page H-13, so we didn’t pass that subject.
But having said that, Mr. Chairman, the challenge that we are facing in moving forward in all the positions for each of those centres is around housing, around the fact that we need to build the boarding homes in the regions to provide expanded level of services.  At the same time the challenge that we are facing in recruiting for physicians where there are national shortages.
Some of those items we spoke to yesterday was to identify that staffing is one area, but providing the service as a result of those positions being filled requires housing, boarding homes, and so on.
We are looking at trying to move forward in that. The challenge we have is, as I had indicated, at the same time the budgets required for all the centres, we are challenged with some of those but we will continue to move forward.
We have had some progress in acquiring housing in Rankin Inlet for some of the positions and we will be moving forward in filling those positions.
Just before I get back to you, Mr. Curley, earlier when we started this Committee of the Whole meeting, I had mentioned to the members of the committee, we are falling behind our schedule, as we proceed with departmental main estimates.
I will again mention that once a member has spoken, that I have discretion as Chair under the Rule 77(2) to allow you to continue. I plan to use this discretion so that we can achieve significant progress in our budget deliberation.
Once again members, I am going to impose Rule 77(2) which allows me discretion to recognize a member more than the one time or not.
Before my time starts ticking, can I ask you a question with respect to overall procedure in the House, if there is unanimous or by vote that we wish to continue with that that we can override you?
This was mentioned on our regular members’ caucus this morning.
Mr. Curley: I would support before we start ticking, that it is not withstanding the Rules because the Rules clearly provide for members to ask for unanimous, or by motion, to extend a member or deliberation of the committee.
I would like to ask you as Chairman to check that and report back to us at the appropriate time, because I believe we could be seen as gagging a member from a constitutional right.
I’m not necessarily going that far but I just want to be clear that my role as a member is not gagged nor ended so that we take advantage of the Rules provided for us to extend certain discussions, as you granted me earlier.
Chairman: Mr. Curley, it is my discretion as the Chair under Rule 77(2) to allow you to continue. I am giving you 10 minutes to ask your questions to the minister.
Mr. Curley (interpretation): Mr. Chairman, I would like to thank the minister for her response and I believe that I will have to read up on it.
In regard to the Keewatin Health Centre, it was closed for a while, and I understand exactly what she said.
You said that there is a shortage of staff due to a housing shortage.
I think there is enough staff housing in Rankin Inlet to get a full complement of staff.
Some of the occupants are leaving. I would ask you to look into to it and see if there is a shortage of staff housing.
The health centre was opened two years ago, and to date, even when someone is very ill and has to be medivaced, they can’t occupy those beds, even if they’ve had a heart attack, or they require an IV.
Those individuals should be able to occupy those beds. Why is it that we are not using those beds when that facility was extremely expensive to build in the first place?
The current challenge we have, and I mentioned some of the internal challenges, but overall as a government, I think the Minister of Finance has made it very clear that we are in a very difficult situation in trying to address all the needs of Nunavummiut financially.
What we have tried to do is move forward in phasing some of the services in those three centres around Cambridge Bay, here, as well as Rankin Inlet. That is one of the challenges.
The other one we face that is a big issue here is that we have difficulty filling positions as is, especially around nurses and doctors in Nunavut.
There is a national shortage in Canada in both those fields.
To move forward in providing enhanced services in all the centres, we need the people there.
We are trying to enhance the incentives for doctors as an example to do further recruiting, as well as trying to address the issue with nursing.
We are trying to move forward in expanding the services in the communities. The issue around housing, we just received a decision from Housing to allocate a number of units for Rankin Inlet. We were short houses for health care professionals in Rankin Inlet, not only in Rankin Inlet, but Cambridge Bay as well as here, but as we move forward, we also need to address enhancing services for providing boarding home services to patients.
So, those have to be worked on as we go forward in trying to enhance services not just in Rankin Inlet, but Cambridge Bay as well as here.
Mr. Curley: Thank you, Mr. Chairman. I understand the territorial and the federal restraints on spending but the federal government agreed to build the hospitals in most of the regions, including Baffin, Kivalliq, and Kitikmeot, and also provide a number of initiatives to build facilities for boarding homes and so on, which they have done throughout southern Canada.
In Kivalliq, you know; you took part in the opening.
It is still not clear whether or not the Kivalliq Health Centre will be available for patients that severely must be hospitalized, and if that were to happen, when will that happen?
When will these beds be available for seniors that are completely very sick who do not have a 24-hour care at home to be able to taken in to the hospital in the middle of night as an elder once did with a heart problem, but she was sent home, and the taxis had shut down so she started walking home, the nurses let her out, middle of the night, winter time this winter, then she had to come back, and she’s one of the very prominent ladies in town.
The thing is that somehow she was able to get to back in the hospital, if she couldn’t get inside and be cared for overnight at least before. She was eventually medivaced later when she called an ambulance, she couldn’t reach anybody with the number provided that’s supposed to be 24-hour care number, and that is not acceptable to the family, nor acceptable to me, I hope it is not acceptable to you.
When will that facility be turned and be able to receive patients that need care at Rankin Inlet?
Since the opening of the Kivalliq Health Centre there are enhancements to the level of services being provided from that particular health centre. There have been some changes around ultrasound, x-ray, the laboratory, the specialist medical clinics, the birthing room now in full operation as examples.
We are not at the 24/7 hospital type arrangement at this point in time.
We are working towards that.
I don’t have a specific date of when that might be available, but what I have tried to outline in the House and to the member is the challenges that we face in meeting that objective: the shortage of doctors, the shortage of nurses. So we are trying to move forward in that and enhancing those services and not just Rankin but as well as Cambridge Bay and here.
I read an article not long ago that said that, and I believe the minister alluded to the federal government constraint on spending and all that kind of stuff. I read an article that specifically said that the federal government has issued a directive saying that this particular hospital will no longer care for the palliative care requirements of the elderly in that particular town and the only thing that they would accept now is the community basis for treatment of regular population of the community. Why is that so minister?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. I don’t know what the article is, the federal government article and if the member can please clarify what community that is, palliative care is provided right now in the hospitals that we use services for.
In the worst case scenario that’s where we get the services, but if the member can be more clear what community he is referring to where that announcement was made and when that announcement was made.
I have had many discussions with my colleague, the federal Health Minister on the challenges that we face in providing health care services to Nunavut.
He is aware of the challenges that we face, particularly around recruitment. The challenges that we face in providing care in all our communities and the travelling fees.
There is some progress that we work towards trying to address; hopefully I will be able to make some announcements in the near future. The federal government is aware of some of the challenges that we face just in recruitment and the services in the north.