EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
With regard to access for the family and within the community, during the inquest itself in Igloolik, like I had mentioned earlier, one of the successful methods that we took was having members of our mobile trauma response team in the community to provide counselling services during and after the inquest itself.
Those services are continuously available again at request of different levels.
The staff in the communities themselves are becoming more aware.
They are trained in trauma so that the services can be provided.
Again, we want to make it more stable and equitable across the territory so that the people on the frontline in the community can determine immediate and aftercare needs and have resources available for them to supplement their counselling on an as-needed basis.
Recommendation 10 states that more support and better training should be provided to individuals who have a family member with mental challenges.
How will more support and training be provided for those individuals?
My initial response is yes. That being said, there are challenges that are within the system, even on diagnosis and recognition of different mental illnesses; fetal alcohol syndrome and autism.
There are challenges in identifying some of the cases, the severity there, and on what level of interventions need to be made.
One thing that I do know and that I am aware of is I do receive correspondence sometimes from people requesting assistance and I know the department reacts immediately if somebody brings forward a concern that they need assistance dealing with a family member or child. I do know that the department responds very quickly to make sure that additional services are provided and identify any training that may be needed to help the family deal with their loved one.
Recommendation 11 states that this government open an institution in the High Arctic that mentally challenged individuals can go to.
Will plans be drawn up for that?
Hon. George Hickes: Could I ask the member to repeat that question, please.
Mr. Okalik (interpretation): This is recommendation 11.
The government is urged to make plans to open a health centre for mentally challenged individuals in the High Arctic to live in.
While I appreciate recommendations that come from inquests such as this, it’s like similar ones where more physicians need to be in every community.
Sometimes it’s a longer strategy to be able to deal with actioning specifically a recommendation like that of actually developing infrastructure in the High Arctic specific to mental health.
Unfortunately at this time, as we have talked numerous times around the table, there are continuing challenges.
We do have in our planning stage a mental health facility in the Kivalliq.
It’s something that we will continue to explore to roll out so that all regions within the territory, hopefully in my lifetime, can have more localized access to mental health.
I know it is a focus of Health Canada right now to deal with mental health, and I have had discussions with Minister Philpott on addressing some of the infrastructure shortfalls that we have specifically for that context.
It’s something I’ll continue to have discussions with my colleagues around the cabinet table as well as at the federal level to enhancing our capital plan in mental health facilities.
Also recommendation No. 16 is that they ask the government to identify frontline workers who deal with mental health issues and work with the RCMP on identifying individuals in need of more help.
How will this be implemented by the Department of Health?
Through our Quality of Life, we’re looking at enhancing our Mental Health First Aid courses. We have people that are taking training to be trainers. We want to make sure that frontline mental health workers or frontline workers in our community health centres have access to support so that they know what services are available to them to assisting residents.
I just want to highlight that when we get recommendations such as this, it is something that we are continuously analyzing to see how we could... . I’m just trying to think of the right word, Mr. Chairman.
With the intent of the recommendation to make sure that we’re doing appropriate measures so that we can help address the recommendations that we are able to, like the previous one, with actual infrastructure, it is more of a challenge.
When it comes to training staff, it is something that we are continuously addressing on how to make sure that the staff at all levels are given the resources available to do their jobs and then some where we can.
Mr. Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) At this day and age, having a mental illness should not be a life sentence.
I encourage the department to follow through with these recommendations as we will continue to encounter these issues. I want to ensure and hope that the department will take these recommendations seriously and follow through with these recommendations. It’s not just Health.
We will turn to Justice from here to follow up on these matters.
At this time I will conclude my questions on this one and thank the minister and Member for Aggu. (interpretation) Thank you.
I appreciate the member’s passion about this topic.
I just want to again highlight that a substantial part of the upcoming supplementary appropriation is to do with over-expenditures in mental health. I think, in a lot of ways, the department has been… . I don’t want to use the word “too good of a job,” but we’re definitely spending more money than we have anticipated and budgeted for, which means that we’re rolling out services as people are more and more recognizing the need to request assistance and family members are getting better at recognizing mental health issues.
Going forward, we can continue to enhance the services that we’re providing with regard to mental health. We have a number of different avenues available to us, to our residents to deal with mental health initiatives and issues. I want to really emphasize to all members and people that are paying attention, if you know someone that needs assistance or just someone to talk to, there are counselling services available.
There are professional people that they can talk to.
I just wanted to thank the people that we do have spread across the territory that are working every day in this field and we are seeing more and more people address the need, to seek out these types of services.
I applaud the member’s passion behind this topic because I share it.
Mr. Joanasie (interpretation): Thank you, Mr. Chairman. Good day, Minister Hickes and your officials.
In the business plan for the Department of Health on page 134, Inuit Employment Plan, it states here on September 30, 2016 total vacant positions is 545 in all of Nunavut.
Can he state if time is taken out if the positions are not filled for a certain length of time? What’s the time limit for unfilled positions?
There are certain positions that are deemed like a critical need. A lot of these positions are filled with casuals or potentially with contract workers, so the duties are being done.
I wouldn’t say that we have a deadline on any position, but our goal as a department is to make sure that the positions that are critically needed have somebody in them.
We do work with the Department of Finance through their HR division to make sure that as positions are ready for competition, they get into the stage of getting filled.
At the same time, again, we do have continuous challenges across the territory like all departments.
Staff housing is a big one.
As of right now, on February 8, we’ve got 422 positions that are considered vacant.
We have 62 of those positions that are submitted to Job Evaluation. We have 172 of those positions within the staffing process.
We have 12 under review by Health HR, which is just prior to submission to Job Evaluation. We have 84 positions that are currently being reviewed as a result of the recent health reorganization. We have relief employees and casual employees.
Our vacancy rate right now translates to about 38 percent.  I hope that answers the member’s question.
He responded to part of my question.
He stated that even though there are vacancies, they’re filled by casual or contract workers.
They should be able to fill those positions, for example, by offering salaries at the top administrative level.
If we look at September 30... . I know the numbers will keep changing, but I would think it makes sense to put more effort into filling these positions.
That way, for instance, more Nunavummiut can earn more when they start working that will elevate their lives.
They can start from the lower positions and then start filling the higher positions based on the wishes of the employees.
I would like to ask a different question. This is about improving the Non-Insured Health Benefits Program.
If I’m not mistaken, once a person goes to the hospital or health centre, some people with physical disabilities are required to use canes or wheelchairs by their nurse.
I think that’s included in there.
How can this type of service be improved?
I have heard from some people that maybe they’re lacking such equipment in health centres.
Can he elaborate on that?
NIHB does pick up the cost for medical necessity equipment like wheelchairs and canes and things like that.
There are continual discussions with NIHB from our department and as well as with Health Canada on our NIHB.
If the member has a particular instance in mind, I would totally be open to having a talk with him to remedy this situation.
Again, I defer a lot of issues that we see and that you guys see from your constituents to our patient relations office.
If there is ever a time where maybe it may not be acted upon or the equipment seems to be stalled out somewhere, please let us know.
One of the fastest ways to resolve an issue is to contact the patient relations office so that they can get involved with Health Canada staff to make sure that any issues are expedited.
I thank you for being more open.
He said that they are trying to renegotiate an agreement for the federal program.
Do you expect any increase in funding through those negotiations?
As negotiations are ongoing, I wouldn’t be able to answer.
I would anticipate that Health Canada officials are very aware through numerous discussions with them on the challenges that we face.
There are continual negotiations and we’re looking at having these negotiations completed quite soon, as the date is looming.
They’re at a minimum. Other than just as-needed correspondence, there are formal quarterly meetings that we meet with NIHB officials.
Moving on to another topic, this is just for clarification.
In your business plan on page 123 it indicates that Kamatsiaqtut will be provided $75,000.
In the main estimates on page H-7 it says $50,000.
Is it going to be $75,000 or $50,000?
Which one is it going to be or will it be both of them for the Kamatsiaqtut Help Line?
There is $25,000 being funded from our grants and contributions budget, so it’s increased funding available to them.
Now that is clear.
I also want to ask about suicide prevention.
Upigivagitsi was mentioned, but I’m very proud of the work because it’s part of learning. We’re trying to understand why there are suicides occurring.
I’m very respectful of the Department of Health for dealing with this issue and also providing funding.
I’m sure this will be directed at finding solutions, for example, when the Internet is used for information.
You may have heard that people who are experiencing a personal crisis are increasingly using the Internet or cellphones to ask for advice.
Is there an online helpdesk for these troubled individuals to go to?
Is there some alternative crisis avenue that you are working on?
That’s always a possibility. The Quality of Life Secretariat is just getting their staffing ramped up and finalizing the grants and contributions.
When you say that you’re thankful of the work that I’m doing and that we’re doing as legislators, I’m thankful for the work that the Quality of Life Secretariat is doing.
They’re building a division from scratch with some general parameters and some funding that this legislature has approved to assist in the creation of it.
It’s a fluid operation and there are going to be a number of different processes that are going to be examined.
Just an example with the helpline, we have been talking about adding a texting component.
Some people have shown interest in that as a medium of communication.
We’re always open to different practices and processes to keep communication lines open for people or for training opportunities or just to assist people in however that we can as a group, but we want to make sure that we’re supporting initiatives that are going to have an impact at the community level.
On numerous occasions we hear that troubled individuals, out of ignorance or having heard something, tend to believe suicide is their only option. For example, when someone tells them, “Go ahead and put yourself out of misery,” that is not acceptable and a bad mistake.
It needs to be taken more seriously.
We have heard from outside of Nunavut that they have no tolerance and that they’re trying to make legislation that if an individual tells another person to go commit suicide, they are liable to be charged since it would be deemed to be committing murder.
Is your department going to be looking into this to see if it could be done?
The member brings up this issue at a very relevant time.
Just yesterday we were celebrating Pink Shirt Day, which deals specifically with bullying and things of that nature.
Cyberbullying is a big component of it that the Department of Education works with their DEAs and with the schools across the territory to help address.
Again, it’s another medium used in a negative way.
We want to make sure that we’re working with groups and educating people on how harmful that type of behaviour is and find ways to hold those people accountable.
I’m sure the Department of Justice is continuously looking at different examples that happen in other jurisdictions on cyberbullying. Recently at one of the conferences we had here, we had Amanda Todd’s mother, Carol Todd, here, who I spoke with personally at great length and talked about the impact of bullying over the Internet and cyberbullying.
It does happen and we all know it happens.
That’s where communities, parents, and peers make sure that people that are carrying on those types of activities get reported so that it can be muted, for one, and lessons can be learned from some of those kids on the real impact and implications of their actions.
There are a number of different avenues that are being looked at from Education, through Justice, through Quality of Life, through Health.
There are a number of different avenues that we’re looking at making sure that accountability is there on actions like that.
I’ll conclude now by saying to the minister that I am proud of you and I’m also proud of those that support you.
We’re on Health. Directorate.
Total Operations and Maintenance, to be Voted. $41,534,000.
Page H-5. Public Health.
Since we’re moving on to a different topic, in looking at the business plan, it mentions smoking cessation plans and the status of that work.
It’s in the business plan on page 126, the middle bullet.
I first want to ask about that.
As the member knows, smoking rates in Nunavut are incredibly high, approximately four times higher than the national average.
Right now the Department of Health is piloting a cessation program which focuses on youth and young adults, especially pregnant women.
In 10 communities right now there’s a training program for health care providers, clinical system enhancements, and quit line modifications.
Basically what that means is that we’re looking at making sure that at different levels within the health care system people are aware of a smoking cessation program so that they can intervene.
We’re providing smoking cessation products through our health centres to people that request them.
A lot of these activities are selected by community representatives, sewing groups, or support smoking cessation groups; on-the-land programs. We’ve got computer coding clubs. We have also developed a Nunavut-specific tobacco cessation training program for nurses, physicians, midwives, public health staff, community prenatal nutrition, program facilitators, CHRs (community health reps), and also community development workers.
With this pilot program that we’re in right now in this fiscal year, we’re in Cambridge Bay, Gjoa Haven, Taloyoak, Baker Lake, Arviat, Chesterfield Inlet, Arctic Bay, Clyde River, Pangnirtung, and Iqaluit.
I hope that gives a touch of what we’re doing.
Mr. Okalik (interpretation): Thank you, Chairman. (interpretation ends) I’m encouraged by the smoke-free zone by the hospital. That’s an encouraging sign. We’ve got to make it as inconvenient as possible for those that want to have a puff.
I’m encouraged by that movement.
As we all know, smokers start young and early. They start from there and they have a hard time quitting. Can we move this movement towards schools and make them smoke-free zones?
That’s my follow-up question to that. (interpretation) Thank you, Mr. Chairman.
I appreciate the suggestion.
One of the things that I have even noticed myself is schools are supposed to be a 15-metre zone and I often see people smoking close to the doorways, especially at the high school here near the back doors.
It’s something I think we need to make sure that we’re enforcing.
As far as making it a smoke-free zone, that’s definitely something I’ll have consultations with my officials and with the Minister of Education to see how fast something like that could be achieved.
Mr. Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I took up smoking as an adult. I didn’t start early.
What made me think twice were those graphic ads. I then started looking at what’s in these things, all the toxins that are in them and said, “What am I doing?”
I think we have to learn from other jurisdictions. I have even looked at Australia and they have the lowest smoking rates in the world.
They used to have it bad before, but they did a very coordinated effort.
I have even stolen their ads and put them in my Facebook to share with whoever wants to look at them. They’re quite graphic and they make you think twice.
Can they steal from other jurisdictions?
We have to do something and prevent this in our own territory. (interpretation) Thank you, Mr. Chairman.
An. Hon. Member: That’s horrible.
Again I applaud the member for taking those personal initiatives through social media to highlight the dangers of smoking.
I recall just recently as the Minister of Health, I get these little catalogues of different educational or promotional items and there’s a whole section on stop smoking.
Some of the displays that they use in there, you’re talking graphics on a cigarette package. If that doesn’t make you want to quit, I don’t know what would.
One of the things that we are doing is specific to Nunavut youth and we’re running as an after school drop-in program during the fall and winter months and it ends with a two-day on-the-land component next month actually.
We’ve got 9 communities with 16 leaders that are facilitating and helping to develop youth on making healthier choices and encouraging substance-free activities. They bring in role model guest speakers, using peer pressure to combat some of these unhealthy choices.
Like I had mentioned, nine communities were organizing wellness, empowerment, and intervention and those include Cambridge Bay, Taloyoak, Gjoa Haven, Baker Lake, Chesterfield Inlet, Arctic Bay, Pangnirtung, Iqaluit, and Sanikiluaq.
I really suggest to members that when they go home from those communities to actively encourage youth to participate in programs such as that so that they can see from their own peers that you don’t have to take advantage of substances to be cool, I guess if you want to use that term.
Mr. Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As I mentioned earlier, smoking starts early and they start young.
Can the department work with Education to do classroom promotions on reducing the rates of smoking in our territory?
Health and Education are collaborating right now on a number of different initiatives at the request of Nunavut educators.
Health has updated the educational youth tobacco video and teachers’ resource guide as part of the Tobacco Has No Place Here campaign.
Also a lot of members have probably seen the recent commercial that has come out highlighting giving your kid healthy options and not helping contribute by providing tobacco and other substances to their children.
We are also collaborating with the Department of Education on a series of books and teacher guides containing tobacco prevention information.
We are working with the Department of [Education] and we will continue to explore any and all avenues that we feel that together we can have an impact on deterring people from smoking or other substances.
Before I go on to the next name on the list, we will give the minister a bit of a break and take a 10-minute break.
>>Committee recessed at 18:09 and resumed at 18:24
Chairman: Welcome back. I call the committee meeting to order.
We’re on Public Health.
One of your priorities for 2017-18 listed in your 2017-2020 draft business plan is to develop a colorectal cancer screening program.
Is this initiative part of a broader cancer screening program to screen and diagnose other forms of cancer?
In a nutshell, yes, it is part of a broader cancer screening program.
One of the concerns that I had when I got into this chair is that we seem to have a big backlog for colorectal screening. One of the things that we’re looking at doing, and we’re working with the executive director of Qikiqtani General Hospital, is opening up the second operating room.
We have a second surgeon here now so that we can take at doing colorectal examinations, both in the operating room and out of the operating room, depending upon the need.
It’s a specific initiative, but overall we’re looking at improving cancer screening at all different levels. One of the determining factors of colorectal cancer is that rates are substantially higher than the national average in Nunavut.
It is one of our easily identifiable focuses. It is one of the cancers that if you catch it early enough, it is totally treatable.
Chairman: Thank you. We’re on Public Health. Total Operations and Maintenance, to be Voted.
I have a question on that as well.
The new (interpretation ends) Public Health Act (interpretation) was implemented in 2016.
As it is being implemented, can you explain what new things are going to come out of that?
There are a number of initiatives not just specifically through the Department of Health but through the chief medical office as well.
With regard to specific initiatives, I just don’t have that level of detail with me here right now.
As the Act was just enacted, we’re taking a look at different opportunities and different strategies on how to address cancer screening.
Overarching all of that is that we have identified the importance of identifying cancer and getting people into treatment sooner in the disease’s progress than later.
Unfortunately, with the remoteness and challenging aspect of delivering health care from across such a diverse territory, we’re working with some of the regulations to start with. Initially what I would like to say publicly is that we recognize the need for increased cancer screening.
We’re developing different strategies to help address that, again, working from within the Department of Health itself but also with the chief medical officer to coordinate strategies so that we can help educate people and help make sure that staff are aware when people come in showing any type of symptoms or to help alleviate any concerns.
When I go back to the colorectal screening, the wait-list, in my opinion and in the opinion of other officials in my department is that it’s too long.
We’re taking some initial steps to deal with that. It is taking up a bit of resources to triage the waiting list to make sure that the people who are in the most urgent need to be seen get seen first.