EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Members will note that I have recognized every member wishing to ask questions on page H-4 of the Department of Health, some more than two times.
I will exercise my discretion as Chair.
I will now want to move on to the next branch after we have consensus on H-4. Health. Branch Summary.
Directorate. Total Operations and Maintenance, to be Voted. $23,373,000. (interpretation) Do you agree?
Chairman (interpretation): Thank you. (interpretation ends) Branch Summary.
Health. Public Health.
Total Operations and Maintenance. $19,369,000.
In this item related to the funding allocation request for operations and maintenance in the business plan for the Public Health Division, it states that you require three more PYs for 2013-14 related to public health initiatives and preventative measures in public health.
It seems obvious that the funding amounts will increase, but I am unsure as to what type of services we will see for Nunavummiut for 2013-14.
I have to ask Mr. Tapardjuk if he could please repeat his question and direct it to the appropriate area where he’s asking the question.
On page 94 of the business plan, it states in English, “Health Promotion.”
Under this category, it states that the department is requesting three more PYs within the Health Promotion program.
What other services will be introduced to Nunavummiut? What other programs lead to this large increase in service provision? What has increased in terms of funding for these services within health promotion services?
Chairman: Thank you, Mr. Tapardjuk. Minister Peterson.
Mr. Chairman, we’re still not certain. Mr. Tapardjuk makes a reference to three PYs and we are increasing the number of PYs in the department, but the three PYs that I’m familiar with are the community health nurses that we discussed yesterday.
Mr. Tapardjuk, maybe you can help us to clarify where you’re coming from.
I will say it in English. (interpretation ends) I’m not sure if this question was posed to you since I wasn’t in COW yesterday.
Your Public Health Division will have an additional three PYs in 2013-14 and the Health Promotion program will see a significant increase in funding.
My question, Mr. Chairman: what additional services or programs will be provided to Nunavummiut in 2013-14? I hope that clarifies my question, Mr. Chairman.
I have to ask Mr. Tapardjuk if he could direct us to the reference to the three PYs. It would really help us.
Chairman: Thank you, Minister Peterson. (interpretation) Mr. Tapardjuk, perhaps you can identify the page you are referring to so that it can be dealt with. I want you to note that the three nursing positions for the communities were discussed and Mr. Rumbolt raised this question yesterday.
However, I don’t quite recall the other community as I can recollect Coral Harbour and Sanikiluaq. Perhaps it was Repulse Bay.
We were provided those details yesterday.
I raised that issue due to the fact that I was absent yesterday and I wanted to ensure I understood the reasoning for it.
If I can direct another question to the minister and if the issue was debated yesterday, then my question is similar to what Mr. Rumbolt raised for this matter.
I would like further clarification on this issue, Mr. Chairman.
If I understand Mr. Tapardjuk correctly, he’s referring to the three community health nurses and we’re positioning them in three Kivalliq communities. Sanikiluaq is not in the Kivalliq, but they’re serviced out of the Kivalliq. So it’s Coral Harbour, Repulse Bay, and Sanikiluaq.
Chairman: Thank you, Minister Peterson. Mr. Tapardjuk.
Mr. Tapardjuk (interpretation): Thank you. I also thank the minister for that response, which helps me to understand the issue.
This other question which I believe is relevant to this section is on another matter I have asked questions about previously. Perhaps it is because of my absence yesterday that I may be raising these questions again.
Based on the pages we are reviewing, this includes a matter that I have wanted to understand on previous times.
For the funds allocated for grants and contributions, it states that $250,000 will be available to the hamlet committees, if I am correct, to assist the committees.
Let me get a clearer idea, Mr. Chairman. Is this for the entire Nunavut territory or is it for the municipal government or a subcommittee of the municipality with a completed contribution agreement to release funds? What exactly is this fund for if this fund is for the committees run by the hamlets?
Yes, there are health committees of council in each community in Nunavut. There are 25 and each receives $10,000 and we provide that money to the community through a letter from the deputy minister.
In reviewing this $10,000 allocation, how much benefit can accrue from this $10,000 for an entire fiscal year set aside for these committees? What exactly is the purpose for this funding allocation? Let me grasp that idea first before I ask any further questions, Mr. Chairman.
Mr. Chairman, I don’t recall the exact year, but that program came into existence, I think, around 2000-01. I recall when I was on the hamlet council in Cambridge Bay, this is when they eliminated the regional health boards and then they went to the health committees. It was felt at the time that $10,000 was sufficient.
I’m not aware that there are any concerns that the funding is insufficient.
My reason for requesting further information on this issue is, for example, this forces hamlet and Department of Health employees to work closer together. As well, the nurses are generally working on separate matters.
Now these committees called the health committees are getting the $10,000 funding. What exactly is the purpose for this fund? As per my earlier question, is it for their honoraria, for their operations, or for their staff?
What is this funding for? Let me understand this first, Mr. Chairman. Thank you.
Mr. Chairman, it’s at the discretion of the health committee of council how they wish to spend the funding if it’s for honoraria or for promotional materials, paying for meeting expenses, and so forth.
Maybe I should wait for the next question period to ask this question as an oral question. However, does the government make the decisions on what it can be spent on?
Does the government state, “We are providing you with $10,000 and here is the list of eligible items you can put it towards”?
Does this mean that under the grants and contributions, there is a list of pre-approved expense items? Let me see if I can understand it with this question.
Mr. Chairman, if Mr. Tapardjuk wishes, we can table a template of the letter that we send to all the communities to cover how they could spend the $10,000.
I will expect a copy of the template since it clarifies the situation. The local health committees have a very hard time since they are only peripheral to the operations of the local health centre.
I will expect a copy of the template.
On another matter, under grants and contributions and the main estimates, it identifies an amount. I believe we are on page H-7.
I believe it is on this page where it also indicates that $600,000 is for public health initiatives. $600,000 is a fairly large amount of funds, so can you provide a snapshot of how this funding was used for fiscal year 2012-13? What were the funds used for in the past year?
Can you provide us an outlook for fiscal year 2013-14 as to what this $600,000 fund will be allocated towards?
Mr. Chairman, the $600,000 is available for communities to initiate health programs under the Public Health Strategy. We have a list that we can table for all the members to see if they so wish.
That leads me to expect this further information, which is an obvious need.  Additionally, under page 95 of the business plan, it states that a surveillance system will be created.
I take it to mean it’s for public health. It’s the Public Health Surveillance System. I imagine it will be specific to public health illnesses.
There are another two initiatives which may be a result of additional digital resource availability, one of which is called the Electronic Health Records Program.
I am unsure whether this digital database would require a different computer system or exactly how it will be implemented.
Let me grasp that concept first so that I will know what to expect in 2013-14.
As we were talking yesterday, information in health care is very important to all of us.
Yesterday, we talked about collecting data through the small projects that our health officials are working on, plus the interoperable electronic health record system.
This particular project is through our chief medical officer of health of Nunavut that we call public health surveillance.
We would be collecting data across Nunavut that we could analyze to monitor trends in disease and detect early outbreaks of diseases, and then help inform the health protection programs in Nunavut so that we can provide better health care in the communities.
As the minister will recall, I recently raised the issue of the need for preventative dental care in our communities.
The department’s Public Health Branch focuses on health promotion and the support of effective clinical preventive interventions.
In past years, Nunavut’s Dental Services program was included under the Public Health Branch.
However, for 2013-14, I note that it has moved to the Treatment Branch.
Can the minister clarify whether this indicates a shift away from preventative activities and, if not, then could he explain why the Dental Services Division was moved from one branch to another branch within the department?
Mr. Chairman, just to allay Mr. Rumbolt’s concerns, it wasn’t moved away from one over to the other.
It covers both divisions and the priority is in the Department of Health.
Deputy Minister Ma can provide more details to Mr. Rumbolt if he so pleases.
Pardon me. I was talking to my colleague.
Mr. Ma. Thank you.
Although it’s not intuitively obvious in the business plan, oral health is actually a priority for the department. We’re really glad that Member Rumbolt actually has raised this issue.
As the minister has indicated, it’s actually in both the Treatment Branch and the Public Health Branch because components of it cover both areas.
For example, in the public health area, this would be what we call promotion.
For example, we rolled out a tooth brushing program this year. So that’s promotion.
The treatment part is some of the questions the member has asked in question period. For example, we have many children, unfortunately, who have decay in their teeth and they have to be brought somewhere to have that treated.
We actually are in some discussion right now with Health Canada, who has also recognized this particular issue in our territory. I can’t go too much into details because I don’t want to prejudice our very positive conversation at this point in time.
They recognize the issue here as well. I think the minister has actually indicated in previous sittings the magnitude of the situation here.
So there are three components to this in our view. There is what we call promotion, which is through the Public Health Branch. There is treatment, which obviously is through the Treatment Branch, and probably prevention as well.
So this is actually a high priority for our department going forward into 2013-14.
Chairman: Thank you, Mr. Ma. Mr. Rumbolt.
I thank Mr. Ma for his explanation.
On National Aboriginal Day, June 21, 2012, the federal Minister of Health announced $25 million toward a new long-term aboriginal health research initiative called Pathways to Health Equity for Aboriginal Peoples, focused on suicide, obesity, tuberculosis, and oral health.
Can the minister indicate whether any of this funding is being directed towards the oral health initiatives in Nunavut and, if so, what specifics will be addressed?
We are participating in that program through our ADMs committee. All those areas that the national program announced as priorities are also our priorities.
Can the minister indicate whether any of the federal Pathways funding is being specifically directed towards the public health issues of suicide, obesity, or tuberculosis across Nunavut?
We’re still in the early stages, so the answer would be no. We are in the early stages. There have been a couple of meetings.
At a certain point, we will be directing some of the funds towards those areas.
Nutrition plays an important role, especially for infants and children as they develop and as their teeth develop.
On page 94 of the business plan, it indicates that the Nutrition program of the Public Health Branch will see an increase of almost double its budget for 2012-13.
What will these additional funds be used for?
Hon. Keith Peterson: Mr. Chairman, I apologize.
We don’t have the details with us here right now.
I wonder if the minister can indicate whether the Nutrition program will address nutritional issues for infants and young children and focus on the importance of nutrition to the development of good teeth.
I’m going to ask my deputy minister to respond to the level of detail that Mr. Rumbolt is asking.
I’m going off the top of my head a little bit, but I know that our nutrition folks have done some work in terms of getting materials out about nutrition.
I just don’t remember off hand what, in particular, with children that we have developed. I may have to get back to the member on that, but I know we have started some. I just can’t recall the exact details right now and I don’t have a note in front of me.
I just have one final question.
I wonder if the minister can indicate whether his department collects nutritional data and information on the many infants and children who were sent at a very young age to hospitals for dental surgery.
It’s a great question by Mr. Rumbolt.
If we’re not collecting that information, I think we should be collecting it, but we will have to confirm and then get back to Mr. Rumbolt.
The subject of teeth and nutrition is making me rather hungry.
As the Chair, I’m going to call for a 20-minute health break.
>>Committee recessed at 15:23 and resumed at 15:49
Chairman: Thank you, members. Welcome back.
We’re on H-5.
Under H-5, since 2010 or so, the population of Repulse Bay is increasing, according to Statistics Canada.
There are three nurses who work at the health centre and one nurse looks after home care.
I want to thank the minister and his departmental officials. Maybe after April, there will be two additional PYs for nurses.
Last fall, in November, there was a healing program during the day in Repulse Bay and the youth held square dances.
Definitely, there is a need to increase the number of nurses.
There is also going to be an increase for the mental health nurse position. There is definitely a need for such positions because the population is growing.
I don’t have any more comments.
Thank you and I want to show my appreciation to the minister and his department. If we run into an obstacle, I want to express my concerns.
There are no questions at this time.
I was going to try and go back to Mr. Tapardjuk’s question about PYs. If we go to H-1, in the Accounting Structure Chart, on that page, according to the Accounting Structure Chart on H-1 of the main estimates, it shows that there has been an increase in the number of positions within the department overall. The Treatment Branch has seen an increase of 20 PYs all in the Community Health Division.
The number of directorate positions has increased by two.
From the information we were given, there has been an increase of three PYs in the Public Health Branch. According to our records from last year, there were 128 positions under Public Health and now we actually have 131 PYs under that position.
To start, could you clarify if that’s the case? Was there an increase of three positions on this chart?
I thank Mr. Elliott for his diligence in reviewing the numbers.
Mr. Chairman, there have been a number of reorganizations within the department in the last year. As Mr. Elliott is probably familiar with, we signed a five-year agreement with the federal government last year and that required us to do some internal reorganizing. We call them clusters.
We’re also moving positions over to the Department of Family Services and we’re adding positions through this main estimates process.
I’ll ask the deputy minister to provide some clarity to the process that Mr. Elliott is referring to so that he understands how we arrived at those three PYs.
Maybe what I will do is start off with an apology to Member Tapardjuk because I didn’t realize where his line of questioning was coming from.
During 2012-13, in the current fiscal year, we did a reorganization of what we call the population health part of our operations. Public Health, for main estimates purposes, is considered part of Population Health.
To explain what population health is it is basically the health promotion part of our operations.
In 2012-13, the current fiscal year, we had approval from cabinet to add three positions. It primarily resulted from what we call the Health Portfolio Agreement with Health Canada. I don’t know if members recall, but I think earlier this year, in 2012-13, we signed a five-year agreement that provided flexibility to our communities in terms of funding for health promotional things like Brighter Futures and other programs like that.
I won’t go into full details, but that’s what it’s from, Mr. Chairman.
I apologize to Member Tapardjuk again.
What Mr. Tapardjuk was referring to is in the business plan on page 100 and you can actually see the difference in PYs.
So then the second part of that question in regard to the information that the committee was trying to get by asking that specific question, if you look at the difference in amounts on page 94 of the business plan for Health Promotion, the department is using $12,865,000 this fiscal year that we’re currently in.
In the coming fiscal year that we will be deciding upon, the department is asking for $15,430,000, which is an increase of $2,365,000.
What we were trying to ask as a committee: with that increased funding that we will be allocating to your department, what type of increased services will be provided to the communities?
Obviously, if you’re asking us to increase your budget by $2 million, what value-added services are going to be coming out of that?
I thank Mr. Elliott for the question. The $2.5 million of that funding that he is referring to is the tobacco framework strategy and the rest is the NEU increases.
On page 95 for the priorities for 2013-14 in the business plan, one of the bullets does talk about continuing the implementation of the Tobacco Reduction Framework for Action, which I believe the dates for those are 2011 to 2016.
One of the priorities for action on that is to build research and monitor capacity, including development of tools for baseline data collection on smoking patterns and consumption rates.
During 2013, I guess leading up to it, there is supposed to be an increase in the Nunavut-specific tobacco research initiatives. I’m wondering: has there been an increase? That’s supposed to be one of the key measurable outcomes.
Has there been an increase in the research in Nunavut to come and meet this priority?
I thank Mr. Elliott for the question. Mr. Chairman, we don’t have that information with us here.
One of the key outcomes for this year would actually start evaluating the Tobacco Reduction Framework and the final evaluation would come in 2016. Are the mechanisms in place to start the evaluation process in this coming fiscal year?
I think it would be helpful for Mr. Elliott if he understands that we can’t stick to strict timelines.
We have pushed the evaluation back.
We have spent the better part of this year preparing for phase 2 of the program. We rolled it out earlier.
Approximately $2.5 million will be going into the five-year strategy and of course, we will be evaluating it as we proceed.
I’m going by this document that was tabled and presented by the department. If there is a two-phase process in it, I would maybe ask the minister if he could provide us with these two phases so we know.
Again, to me, our job is we’re allocating $2.5 million that we’re voting on to give to the department under the assumption that it is being spent on this timeline, not the timeline that he said that they are following.
Could he commit to tabling the timeline that we’re supposed to be asking questions on?
I would like to thank Mr. Elliott for his reminders.
Mr. Chairman, last year about this time, with the support of the House, we increased the tax on tobacco products and the plan was to generate $2.5 million to $3 million to use towards this program. It’s a five-year strategy.
It’s only year one and now we’re into year two.
We have to be realistic in terms of where we’re going to evaluate after year one and that’s why we’re pushing back the evaluation.
I apologize to Mr. Elliott if we didn’t stick strictly to the document that he is referring to, but rest assured, the tobacco reduction/cessation strategy is a high priority of this government, and we have people working in the department and across all the communities in Nunavut who are working very hard to encourage Nunavummiut to not smoke or cease smoking or reduce smoking.
At some point, we will evaluate the success of our efforts. We are well aware that 60 to 70 percent of Nunavummiut over the age of 12 smoke, and lung cancer is one of the hardest cancers to detect.
As I have said before, too many people are getting sick and dying from lung cancer.
You can rest assured that we’re not just spending $2.5 million and not going to be accountable for the expenditures.
Thank you for that answer. I appreciate what the minister is saying.
Just as his other department in one of the hats he wears as Minister of Finance, I know he takes pride in the fact that our public accounts were put in on time for the last two years.
As the chair of the oversight of government operations and public accounts committee, I take my job seriously too.
We are the other side that pushes to make sure that money is spent properly. We can agree to disagree, which is great, because that is what this is all about in terms of the process.
One of the priority actions within the strategy was to collaborate with the Department of Education to develop educational resources for use in schools.
Could the minister give us an update as to whether that action priority has been started or whether it will be started in the future?
Hon. Keith Peterson: Mr. Chairman, I wish I could bring all of my subject expert members of the team.
There are probably 40 people who could fill the Gallery here.
I could bring them in and out and give Mr. Elliott the level of detail he is seeking.
I can assure you that the tobacco reduction/cessation team is working very hard on that strategy. We’re almost going into year two.
We’re hoping that the House will approve the $2.5 million so that we can roll out this program and work more robustly in the coming year. The plan is to work with the Department of Education. We’re working with communities.
We’re working with all kinds of groups. There is a Facebook page. There are community events.
We’re not taking this lightly.
I encourage all Nunavummiut not to smoke.
Of course, under my other department, when I put my finance minister’s hat on, yes, we detected early on that cigarette purchases have decreased by 3 percent in the first nine months after we increased the tax.
It was too early to determine if that was because of the tax increase or because of the education and all the activities that the tobacco team was working on across Nunavut or a combination thereof.
I can assure you that the plan with this five-year strategy is we’re going to tackle tobacco head on here.
We’re encouraging our young people, who are most likely to be targeted by big tobacco companies to smoke.
It is no secret that tobacco companies engineer their cigarettes to addict young people before they’re aged 20 so that they become lifetime smokers and we know what that causes.
I assure Mr. Elliott; he’s got our document there, but I have a huge department and we have capacity issues throughout the department. People come and go. Funding is tight in all areas, but this is a high priority for our department and we’re ramping up.