EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Members look forward to seeing improvements in trend analysis and communicating results as the department works towards addressing specific health issues across the territory.
Mr. Chairman, the committee has recently sent correspondence to the minister requesting further detail and clarification on a number of issues.
The committee looks forward to receiving the information that we requested in the near future.
I anticipate that individual members will also have questions and comments as we proceed. (interpretation) Thank you, Mr. Chairman.
Chairman: Thank you, Mr. Aglukkaq… (interpretation) Mr. Alagalak. I apologize.
Chairman: Before we proceed, I would like to remind members of the following: according to Rule 77(1), you have ten minutes to speak, and according to Rule 77(2), subject to the discretion of the Chair, a member may speak more than once to a matter under discussion but not until every member wishing to speak has spoken.
Welcome, minister and your officials.
I am happy, along with Mr. Mapsalak, that the funding for health centres were identified but there are some concerns that I have; the amount is not identified there.
At this time, it’s more verbal commitments.
They have not started the design or preparation up to date, which could have been started if it was left on there, and they will have to make preparations for the sealift by next month.
They will have to go up to Arctic Bay and they will have to be at the site before the shipping in April, so I am happy to hear that.
I just visited my constituents and one of the main concerns that we have is with the Medical Transportation Office in Pangnirtung.
There haven’t been any improvements.
For example, I’ll use myself, I was trying to get information and I tried to call the office in Pangnirtung for two hours but all I got were recordings, and I know the elders also go through that.
This is still a major concern, especially for my constituents, when we have to travel during the weekend and sometimes, we have to fly during the weekend. The patients going back home from hospitals have to wake up early Saturday morning.
I am still supporting my constituents because it was a lot simpler when the office was here in Iqaluit and we want it moved back to Iqaluit.
We didn’t encounter any problems when it was here in Iqaluit.
I think most of the problems are not just in the Baffin region.
I’m pretty sure there are some patients who are left behind.
What happens is... I was going to bring my sticker that they put on there where it states... and this also has an affect on people who are on medical travel.
If we leave Iqaluit to go to my community and if the plane cannot land, we have to look for our own accommodations, pay our own meals, and we have to pay for our transportation.
That’s what we do. The minister mentioned that she was going to talk with the airlines in regard to that.
Those patients who were coming from the hospital... I even know that Mr. Arvaluk was on the flight; he had to get off because one of his constituents didn’t have room on the flight.
We see people who are on medical travel, or for example, even an elder who was here for about four weeks and got stuck here because there was no room on the plane.
This creates a lot of problems and we still have problems.
Yes, we are aware that you don’t own the airlines but you deal with medical travel.
Due to the overcrowding of Tammaativvik, government employees sometimes have to stay in hotels.
There was a meeting here in town and all of the hotels were booked.
This government employee, who was on medical, had to check out by eleven o’clock because of the requirements and because he couldn’t leave, there wouldn’t be any room and it’s left up to those individuals to find their own accommodations.
So this problem has not been rectified yet.
In the community of Grise Fiord, there was a case where a grandmother was escorting her grandchild here to Iqaluit.
While waiting to be seen by doctors, the doctors had asked to have the grandchild go to the hospital alone. When the grandchild had to go home, she was escorted by a person who was on medical travel coming in from Ottawa.
For emergencies like that, there should be a plan. For example, if something happened to the escort, that child probably would have gotten lost and not be able to take care of herself.
That has been the case in St. John’s.
It’s not acceptable the way it is right now and this always comes up.
People who are on medical travel to Ottawa don’t have escorts.
Not too long ago there was an elder who went down without an escort and just very recently, this young person had to bring his or her child down because that person didn’t want to go down and was scared.
Mr. Chairman, I think my time is up but I want consent to extend my time.
Mr. Barnabas would like unanimous consent to extend his time. Are there any nays?
There are no nays. Mr. Barnabas.
I would also like to thank the members for giving me this opportunity.
There are a lot of problems, especially in my constituency. I am sure that the minister is tired of hearing about me complaining but nothing has been done to date.
I think that there are also problems in the department itself, such as lack of staffing or high turnover. We’re seeing more and more agency nurses based in the communities and I am sure that they’re not too familiar about the community that they’re in.
I’m sure that they refer to medical records to find out about their patients.
We have experienced problems way too many times, for example, people being given a prescription for a year, or two, or for the rest of their lives and the patients don’t even know what kind of pills they’re taking, or what they are for, or why they had to take that medication for years at a time.
I have seen people take prescriptions that are not good for them on more than one occasion and they get adverse reactions to the medication.
I have been told about this from my constituents and it comes down to a safety issue.
The Tamaatarvik Boarding Home is not a hospital or a medical centre. We do have people who are boarding for a long time and they have chronic conditions.
I have heard of patients who have boarded at Tammaativvik; they go there in good health but then they become ill after they have left because of contagious patients and the different viruses they contract from that facility.
The boarding home, we know for sure, is way too small to accommodate all the people who come down here for medical reasons.
It’s obviously way too small for the Baffin medical patients who come down here but I am sure that your department will do something about it.
Referring to the Chair’s opening comments; we have no social workers in my constituency. The two communities that I represent have only one social worker and this individual has to go back and forth from one community to another. Arctic Bay doesn’t have one at all.
Of course, we do need social workers because there are clients who want to see social workers. It is not acceptable and only when it’s required does one fly in.
Each individual community, no matter how small, should have a social worker because even small communities have every right to those types of services offered in the larger centres, so I will be asking further questions on this.
At this time, I will just thank the minister for dealing with these issues and the letters that I do get from my constituents.
Just recently, I got a letter from one of my constituents about getting a wig and they couldn’t get it because it wasn’t covered under the Non-Insured Health Benefits Program.
And also, I’m sure that we’ll be able to do something about wheelchairs because it’s a necessity for the people in Nunavut.
I’m very pleased and delighted that our health centre will finally become a reality.
Well, I did have to table photographs at this House… but when the health centre smells like sewage, you wouldn’t want to be staying or working there.
Very briefly, I am not happy; I had been hoping that in the 2008-09, in the minister’s opening comments, I thought she would mention move Pangnirtung office to Iqaluit.
During the Finance Minister’s Budget Address, he stated that there will be a rollback and he gave us a lot of comments that were very interesting.
The Health Minister could have also mentioned the Medical Travel Office in Pangnirtung. The transportation costs are creating problems because of the office being based in Pangnirtung and I was kind of anticipating that, in her opening comments, she would say something about recentralizing the Pangnirtung office to Iqaluit.
I would like her to make a comment before the end of the session about recentralizing that office back to Iqaluit.
There are some people who are paying their own airfares to go home.
As Mr. Barnabas had stated earlier, some people... well, he stated that he kept calling the office and they kept getting a recording and because they have that problem so often, they eventually buy their own ticket home.
It wasn’t meant to be that way.
We will want to see what improvements we will see in the Health Strategy. In your opening comments, you made a statement about the nurses, the education, and to decrease the costs. We would like to see some numbers to see exactly where the cost savings are; I would like to see those figures.
As Mr. Barnabas had stated, I was waiting at the airport to get on the plane, and this patient couldn’t get a seat.
I eventually let this individual take my seat and I ended up staying here for the weekend. If I hadn’t done that, the individual who was still here for medical reasons would have been stuck here and very likely would have kept trying to call the office in Pangnirtung.
Mr. Chairman, it’s very simple to fix this problem.
As I stated in an earlier comment, there was an interpretation of the time zone which created a huge problem for the whole of Nunavut and it was fixed; we went back to the three time zones.
It’s the same situation with the office in Pangnirtung; it’s very simple to fix like the time zone problem.
It’s not creating any benefits for Pangnirtung, except for the creation of one PY, but it’s creating a huge problem for the patients. Even the people of Pangnirtung get stuck here because there is no travel coordinator here.
I would like to see something before the end of the sitting and I would like to see the minister make a statement saying that at the next spring session, you will see this office recentralized to Iqaluit.
I welcome the minister and her officials today.
In the four years as MLA, I have come to realize; I already knew this but I’ve got more of a better perspective on the Department of Health than I did when I wasn’t an MLA and even when I was a mayor. I have come to realize that the Department of Health and Social Services is a very demanding and challenging department, and that it’s not only in Nunavut but right across Canada – every province and every territory.
Good health/bad health, it’s important to all of us and we’re concerned that it affects all of us one way or the other. It has a more of an affect on individuals than departments, such as, let’s say, the Department of Finance or the Department of Environment.
Individuals are intimately connected to the Department of Health, so we tend to hear more from our constituents as MLAs than we would if we had a problem in our community with a garbage dump or a road.
So in the Cambridge Bay riding, I would say most of my issues or concerns that come from constituents are related to the Department of Health.
There’s no doubt about that. Although, I noticed a trend over the years that it has been decreasing; in the first couple of years, I would get five or six issues a day, and now, it’s down to three or four in a week if I want to just toss out numbers, so I think people are starting to understand health a little better.
Having said that, many of my constituents are still very frustrated when they want to see a nurse or a doctor; they don’t understand, for example, that there may be people who are sicker than them that are ahead of them in the queue to see a doctor or a nurse.
When you have a shortage of doctors and nurses in the community, they’re working 24 hours a day.
I know this happened in Cambridge Bay over the Christmas holidays with the outbreak of flu in the community.
I had to explain to some of constituents, “This is how it is,” and I think they understood, but still, it didn’t make them feel any better that they might have to wait a week. Waiting a couple of days to see a nurse or doctor is acceptable to most people but when they’re told they might not get to see a nurse for a week and they’re sick right now, it’s difficult for them to understand.
In the House the other day I raised the issue of some of my constituents who suffer chronic pain from a variety of ailments. When constituents are in a MLA’s office or when they see you in the store, it’s very difficult to watch them as they describe their issue and they break into tears when they’re telling you how they have been told they have to wait four months, six months, or longer to see a specialist who will diagnose them.
In all honesty, I just don’t have an explanation for them.
I know down south I have heard of medical patients who had to wait as long as two years to get hip replacements. I know there is a long wait everywhere in Canada but that doesn’t help you explain it to people that there is that waiting list while they’re suffering and they’re suffering with great pain.
Medical travel continues to be an issue for my riding. I’ve had quite a few people over the last years that have had to travel to Yellowknife or Edmonton for medical travel.
The issue was not so much with the patient; it was with their requirement to have a medical escort with them.
They wanted to have an escort with them, someone there who could help the doctors to explain their medical condition or options they have when they’re meeting with doctors in Yellowknife or Edmonton, or have someone who could help them make those decisions or explain it with more clarity about what the doctor is trying to do to treat them.
I remain very concerned that Health and Social Services is unable to recruit permanent nurses and doctors in Cambridge Bay. I know there are a couple of reasons. It’s no secret that agency nurses appear to have a better deal than permanent nurses.
I know if I was a nurse, I would probably choose to be an agency nurse as well because you can come in for three weeks or a month and then you go out and have all of your expenses paid, whereas if you were an indeterminate nurse, then you would have to remain in the community and then you’ll pay higher rents and pay for the food that you eat.
So I know that’s an issue that I hope, through your Nursing Recruitment and Retention Strategy, you will overcome.
Having said that though, continuity is important in treating patients; I know personally that I would rather see a doctor or nurse who I have known for three or four years. It seems like every time I do go to the health centre and I’m seeing a new nurse or new doctor, they don’t know my family history or my personal history, so you would have to explain it to them even though they have the file.
So that’s a big concern.
Another issue or area that I think is going to be a problem for the Department of Health in recruiting nurses or doctors permanently is we have to compete with other jurisdictions. I know in provinces like Alberta, I believe they’re opening a new hospital in Edmonton, a specialist hospital for hearts.
I’m not 100 percent sure of that but I know they’re opening a new hospital and they’re going to require 600 nurses. I understand that they’re on a recruitment campaign overseas for foreign nurses and they’re targeting the Philippines.
So any nurse in Canada who is interested in going to Alberta, including nurses in Nunavut, there’s that opportunity there.
My constituents are also telling me that they’re concerned about the services they receive at the Lena Peterson Boarding Home in Yellowknife.
We brought those issues up many times over the years and we continue to urge the minister to have her department monitor the contract to ensure that improvements are being made.
It seems like every time I go to Yellowknife on the way here or way home, I have an opportunity to visit the Wal-Mart there and a lot of my constituents stay at the Super 8, which is nearby. So when we’re down in an aisle there at Wal-Mart with my shopping cart and their shopping cart, they’re telling me about the boarding home or the hospital issues there. So it continues to be an issue for my riding and I’m sure for all of the Kitikmeot.
Another area I think that the department should give some consideration to is improving the communications with patients and the community, not only in Cambridge Bay, or other communities in my riding, but right across Nunavut.
I have had representatives of elders who tell me that the elders will go to nursing stations or health centres and they don’t understand what the doctors or nurses are telling them of what their diagnosis is; it frightens them to some degree.
I think it would help if the medical department would meet more frequently with the community, not just with the hamlet council but maybe have regular town hall meetings to explain how the on-call nursing program works and how the medical transportation works.
It doesn’t have to be a big meeting; have 300 people at the meetings; 30 or 40 people might come out where you could explain it.
If you put out some local translated brochures, pamphlets, and posters on the notice board, that would help people understand how the local health facilities operate, how they could get services, and why there are delays.
Basically, an overall communication policy would help.
With that, Mr. Chairman, I’ll end my comments.
General comments. Mr. Curley.
First of all, I would like to welcome the minister, her deputy, and her officials.
I cannot see their names, so I cannot address them at this time.
Please be welcome during your stay here.
First of all, what we’re looking at is that you’re asking for over $250 million in the 2008-09 main estimates.
This is not a very small amount. It’s a very significant amount.
For this reason, while we’re here at the House, we are going to be monitoring it and looking at the expenditures that will be used as to how we’re moving forward, if they are being carefully managed, if it is an effective amount, and whether or not the programs are impacting our people where assistance is needed.
Whether or not we need to make adjustments, we are here to assist the department with suggestions that can improve the services provided. We’re not here just to talk about bad things about departments and so on.
Mr. Chairman, prior to starting my commentary, I would like to quickly make this statement.
I would like to thank the staff of the Department of Health and Social Services, especially our nurses and doctors.
We know that some of the communities are struggling with shortages of nurses in Nunavut.
Mr. Chairman, in your business plan, minister, it states that this will move forward in looking for retaining staff and preparing for hiring practices in the communities.
We have heard this time and again at least for the last three years, every session that it will be included in the business plans and also significant amounts of resources are involved.
Mr. Chairman, I want to hear from the minister that they will be putting in implementation plans that will implement hiring practices and retention of the staff in Nunavut.
This has never come about as of today. The business plans for the staff and retention for the staff has not been put forward.
It seems like it’s sort of hidden in the back because we don’t want to give out any more funding towards this hidden cost.
(interpretation ends) Mr. Chairman, I think it’s important I state that further that I think that the recruitment and retention plan is something that should be completed soon because I think to have what I call an “elusive plan” is really not justifying funds to be appropriated and asked for when we, in fact, have never even seen either stage one, two, or three, if it takes that long.
I don’t think the minister should be given any more open-ended strategies.
She should have a temporary recruitment plan before she finally finds one that will work.
I don’t think the minister should be given a continuing responsibility to continue the agency nursing; the authority that she has to extend the contract to these.
I think the minister should know very well that this particular policy is not working; it’s not good for teamwork and it’s not good for this government to put any additional figures or costs towards it. I believe we can do a bit more improvement.
We can certainly move the funds to the Arctic College and have an accelerated program and not give them a nickel-and-dime to say we need more nurses and only apply it for one year or on an experimental basis.
Secondly, the other important point that I want to see which I think should be addressed, and I want the minister to highlight it, administration of health services. I believe what we have in Nunavut with the Health Department is top-heavy.
The minister has tremendous influence and authority over health services, along with the deputy and ADM or directors in the region.
I believe we should separate the health services and have the administration of health services through a non-political appointment of officials, and I did indicate last fall that the minister should consider appointing health administrators in each region and leave the current ADMs, if any, or directors, out there so they can play ball with politicians and local health officials.
Right now, it’s dangerous to send a letter to or an email to a director in the region when you won’t get any replies now.
Because it’s politically sensitive, they normally forward, without any comment, to the minister and the minister’s office or deputy then provides a response to us.
So for those of us who have experience-d, experienced that, we don’t write any more correspondence to directors in the region because I was told that they have a protocol that says, “Once you send me a letter, it goes to the minister.”
That’s political interference.
What is the role of the MLA in the region? If it’s so sensitive, then restructure the health services so they are completely separate, so the nurses and doctors deal with the administrative issues.
And we, out there with our constituency, must have someone to contact on policy issues, policies that appear not to work, for instance, travel issues and complaints from our constituents; we have many.
Our elders sometimes suffer. We tend to intervene without hesitation when we find our elders in the boarding homes either in Winnipeg or any other location having some concerns.
So I think, for the minister to justify the spending of this amount, surely, there is a lot of room to improve the effectiveness of providing services as a whole.
I believe that having administrators that are separate from directors, that are sort of politically policy kind of individuals who are separated, would improve not only the relationship between the nursing professions and the doctors but also for the overall health of nursing stations, health centres, and regional groups.
Mr. Chairman, I also found on the business plan, page H-4, reference to the Maternal Training Program has moved on from… I think they didn’t use the move to that issue but they used that the training program that has expanded from Rankin Inlet to Iqaluit.
I’m a little sceptical about that because I believe it means that it has been transferred to Iqaluit.
So I will need a clarification with respect to that.
I wanted to comment briefly on the Mental Health Training Program that has been initiated. I think that’s a good first step. I applauded the government for that but I have some concerns.
It’s a two-year program but I’m not sure it’s an accredited program. I will need to ask the minister why that is the case because for someone to spend that long and not having it accredited really doesn’t count in the long run.
(interpretation) That’s it Mr. Chairman, before you stop me. (interpretation ends) Thank you.