EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
So as I said to the House earlier is that I would like to report to the House on some of those changes and to evaluate whether in fact we have reduced that two percent of the complaints we received before we created the office in Pangnirtung, but we did not dissolve the operations in the hospital; it’s still there.
Perhaps some time when we’re not sitting I can walk you through the hospital and explain the procedures that are in place to provide services to the patients, and go and walk through the process of how we deal with patients that are being discharged from the hospital, how they get their airline tickets, and so on.
Individuals at the other end in the Pangnirtung office are Inuktitut-speaking individuals.
The tickets are processed through the Pangnirtung office and so on.
So in responding on the service, I would like an opportunity to perhaps set up a time to go through the process. I would also like to be able to report back after a year to see if these changes in fact address the two percent.
My staff were at the mayors’ and QIA meetings just on this very issue and they said two percent is not acceptable.
And we’re trying to address that two percent with these improvements to the system.
So I would like to be able to evaluate it before I consider the member’s recommendations and report to the House on these complaints, or whether we’ve been able to reduce that.
Mr. Barnabas (interpretation): Thank you, Mr. Chairman. Yesterday I asked a question on the tabled document that was provided by the minister: Kitikmeot, Kivalliq, and Baffin region uses for medical travel.
A little over $15 million for the Baffin, $20 million for the Kivalliq, and $10 million for Kitikmeot, something along that line for medical travel and for their escorts.
What has the department done to try and not spend a huge amount of money for medical travel and their escorts in 2007-08?
Some of the initiatives that we are undertaking internally are initiatives to prevent illness; initiatives in keeping people healthy. I think that is one short answer to what we are doing.
The other is to develop more services in the communities through the diagnostic imaging as an example, developing systems of fetal fibronectin system which diagnoses false labour, I think last year we prevented 40 medevacs from happening because of that investment and we are hoping to expand that service to the regions, providing more specialists to travel to the communities.
So, quickly, that is the kind of initiatives we are undertaking, it is very, very difficult to predict illness. It is very, very difficult to forecast illness costs, so we try and provide as much service as possible in the communities.
But at the end of the day if a person requires treatment in a hospital we only have one hospital in Nunavut so we have to transport, so there are initiatives of trying to reduce this.
At the same time the investments in Telehealth, we have tried to do the diagnoses in that way.
So I hope that, in short, answers some of the member’s questions.
Mr. Barnabas (interpretation): Thank you, Mr. Chairman. (interpretation ends) In response to concerns raised by members regarding services and treatment, including medical travel, the department has indicated that these would be addressed by creating a position of client service coordinator. What is the status of the client service coordinator?
We are proceeding with the advertisement of that job. I have committed to advertising that. The position will be located in Cambridge Bay.
I thought I had sent a copy of the response to the chair of the standing committee on some of those issues. We are moving forward in that, I apologize, and the member may not have a copy of that, but we plan to fill that position.
When did that position come about because we have been trying to get that position for three years?
I said we are planning to advertise that position. It will be located in Cambridge Bay. I stated that in my letter on March 6, 2007, to the standing committee members, the plan to do just that.
Have negotiations with the federal government, with respect to funding for accommodations for medical clients in the three regional centres been finalized?
And, when will the standing committee be advised of the results of these negotiations?
The answer to that question is twofold; some of these contracts with the service providers have not expired, so we haven’t started that process of the request for proposal.
Normally we do the public request for proposal process of getting submissions to operate the facility.
Where we have been negotiating is trying to increase the rate that we get paid from Health Canada to operate them. And, that one was related to the one in Ottawa. As part of that discussion and negotiations for that, we’ve dealt with that through Nunasi.
And, that one is concluded.
The other contracts are still existing, so when they do expire, and shortly before, a public process will be advertised where we request the proposals from providers on that. We don’t sole source those services.
I have visited quite a few communities and a few days ago I visited Baffin Larga in Ottawa. I have visited the Winnipeg Larga too, and I have also visited the Yellowknife Larga.
The Yellowknife Larga and the Winnipeg Larga are brand new. The Winnipeg Larga is brand new. It has even got an elevator, and there are washrooms in all the bedrooms.
The restaurant is spacious and there is room for Inuit to eat. They accommodate Inuit needs.
Likewise in Yellowknife, the design is very good.
I went to see how Larga Baffin is doing. The kitchen is running out of space, and people eat in the living room. Patients eat in the living room when the dining room is full.
There are two buildings used as Larga Baffin; one is a boarding home, and the other is used for patients who have had surgery, and they have to go to the next house for their meals.
(interpretation ends) What is the status of the boarding home accommodations in the three regional centres?
The status with the boarding home is we have a boarding home in Edmonton and a service provider, and that contract is still in place. In Yellowknife, we have a lease on that building and the contract to operate it is still in place.
In Cambridge Bay, we don’t have the building yet. In Rankin Inlet, we don’t have the building yet.
As for Winnipeg, the contract with the service provider is still in place.
So, there are different facilities in every region; different sizes, different issues, and so on. I recognize the situation in Ottawa is a challenge and an issue. We’ve been working very closely with Nunasi, as they are a partner.
We have been working closely with them trying to move forward on constructing a new facility in Ottawa.
To build a new facility, we needed to negotiate a new daily rate with Health Canada. So, that we’ve concluded, and they can move forward now in constructing a new building. So, that’s where that is.
The others, we have not gone down that path yet, as it is.
Mr. Barnabas (interpretation): Thank you. Just to go back a bit to the Client Travel Policy.
When do you expect to complete the Client Travel Policy?
I reported in the House this last week that I have received, what you call, interim support to the draft that I presented to Cabinet.
I have to go back to the Financial Management Board. Any changes to the policy will require incremental funding.
One example I will use is that we provide escorts, and the recommendations from the members were every elder should have an escort whether they are medically required or not.
That will have a financial impact, and I have to go to the Financial Management Board to seek that funding.
It’s a challenge.
I’m hoping I will have that direction completed by this summer.
At the same time I have been directed to develop the guidelines in administering the programs for every health centre along with the policy. So, that is going to take a bit of time.
I’m hoping this summer. It’s taken a lot longer than I expected.
But in the interim, we still use the current policy that was approved in 2002.
Mr. Barnabas, keep your questions to Treatment Programs, page H-13, please.
I’m asking questions on page H-13, and some on H-20 in the business plan.
(interpretation ends) When will the department conduct a public information campaign to explain the Client Travel Policy to the public, and to ensure that staff responsible for implementing the policy are up to date?
Quickly, as soon as I get support from Cabinet, and it’s approved, we’ll be doing that.
I have a few questions on this branch summary regarding medevacs.
First of all, I wanted to know how much it is to charter from Sanikiluaq to Winnipeg.
It is approximately $15,000 per trip.
I think that’s enough to charter a modern airplane now. $15,000 is a lot of money.
My next question; the minister said they are using modern airplanes now.
What kind of plane are they using for travel between Sanikiluaq and Winnipeg? Thank you, Mr. Chairman.
When I said modern I meant that these aircrafts are Transport Canada approved. The one in Sanikiluaq, I believe it’s a King Air of some sort; I don’t have the exact knowledge of the model types, makes. I know in some cases we have Lears, Citations, and King Air 100s and 200s, but I can get back to the member on that.
I think I can update the minister as to what kind airplanes they are using. What I’ve been told since Kivalliq Air was bought, I don’t know when, but right now, they’ve been using the Mitchell, which is long, noisy, and they need earplugs for when the plane is taking off. I’m hoping that the minister will correct that.
I heard a rumour that they might use a King Air 200. Is that true that the airplane that’s used for the Sanikiluaq to Winnipeg medical travel must be a King Air 200?
It’s probably best I contact the company and ask that question. I don’t know the answer to that rumour and it is better I ask the company to provide this information of what their plan is in regard to that aircraft.
I can place a call tomorrow.
I have one more concern or question. It’s difficult sometimes when we’re in a small community; we’re kind of an isolated community.
I think the government or the department is using a lot of money transporting from Sanikiluaq; maybe it’s about $15,000.
Sometimes there are patients that are going to Churchill for checkups but they’ve been transported to Winnipeg, from Sanikiluaq to Winnipeg, and they overnight in Winnipeg and then go to Churchill.
But the way I see it globally from Sanikiluaq to Churchill is shorter, how come they get transported from Sanikiluaq to Winnipeg and then from Winnipeg to Churchill. Which way is cheaper to transport?
I think one area to consider is what the patient’s needs are. Maybe there was no room in the Winnipeg boarding home, or the hospital, or the treatment wasn’t available in Churchill.
I don’t know the answer to that but I imagine it has to do with providing the service to the patients. Again, I would have to get that information specifically from the Rankin Inlet office in those instances and why we went to Churchill.
The other thing that I’d like to ask and I’ve had some discussions with my staff, is around why doesn’t Sanikiluaq go to Ottawa?
So that’s an area that I’ve asked my staff to explore; perhaps that’s a better arrangement. I don’t know the history behind why Sanikiluaq is being serviced by the Kivalliq, and Winnipeg.
I think, in light of these kinds of concerns, I want to review the possibility of having this service to Ottawa as an option at this point in time.
I will check to see what instances people in Sanikiluaq went to Winnipeg and then to Churchill and report back because I don’t know why.
It could be related to the patient, is my assumption.
Mr. Kattuk: If she wants to find out, go down to Sanikiluaq and talk to the people. We’ve talked about that in the past.
I don’t think you understood my comment about transporting patients yesterday, or the day before.
There was a patient who had to go to Churchill for a check-up but they transported her from Sanikiluaq to Winnipeg, and then next day from Winnipeg to Churchill.
She had a one hour check-up in Churchill. Yesterday she went back down to Winnipeg and she is coming home tomorrow.
That’s using a lot of money, unfortunately.
I don’t know why the charter couldn’t go to Churchill direct from Sanikiluaq.
It would be better for everybody, for the department, for the patients.
I think the department has to look at which is better for both sides, for patients and the department.
That is all that I have, Mr. Chairman.
I will look into that situation with the staff in Rankin Inlet.
I don’t know why they went from Sanikiluaq to Winnipeg to Churchill. I don’t know the answer to that specific question.
My guess is the patient had an appointment and the earliest appointment was available in Churchill.
I am assuming these things. I don’t know the answer. I will take that information and talk to the staff and figure out and get them to explain to me why that was the case.
It could be bad weather; it could be...I don’t know. I really don’t know and I apologize to the member for that. I don’t know the response but I will contact the office to explain to me that particular situation.
I don’t know if I explained enough, or not.
I am saying that it happened more than once, to my knowledge.
They had to see a doctor in Churchill and they transported them to Winnipeg first, and then the next day to Churchill, instead of taking them direct to Churchill.
That’s a shorter flight and cheaper.
And going back they have to go down to Winnipeg again, and then from Winnipeg to Sanikiluaq; that’s a long haul, eh?
So I think the department has to take a look into this seriously.
That’s just an explanation.
I welcome the minister and officials to the House again today.
On Page H-18 on the Business Plan under Treatment the division there, Hospital and Physician Services.
The budget seems to have increased by approximately $5.6 million over this current fiscal year.
Could the minister explain what the increase entails?
This relates to the increases of the out of territory services of our patients.
Does that include bed nights in hospitals in southern provinces?
Hon. Leona Aglukkaq: That would be correct. Thank you.
I am wondering, if the minister could give us an idea of what the, I suppose they call it bed nights or patient.
What’s the cost of being in the hospital in Yellowknife, Edmonton, Winnipeg, Ottawa, Montreal, and Iqaluit, would you have those kinds of figures available?
I don’t have that level of detailed information before me but I can give the information to the members.
One of the reasons I asked this question is I asked it several years ago to the former minister of health.
Provincial hospitals are being squeezed quite a bit for funding so they will bump their patients and they will take patients from the north, Nunavut, and the patient rates could range anywhere from $900 a night to close to $5,000 a night depending on how seriously sick the patient is. I know in Yellowknife, I think it was $1,200.
I wanted to get that information just to see if the patient bed night rates have increased or decreased or if we’re still into that situation where we have to pay fairly exorbitant rates to support our patients in the south. If the minister could provide that information, I don’t need it today, but if we can get that information for the standing committee and Members in the House.
I know we are always trying to stay positive when a patient has to go to a hospital down south and the only beds available are a $4,500 bed then that is what you have to pay.
On the same page there is a description of audiology services.
I had a constituent last year who required a hearing aid. She said it was almost a two year process for her from the time she saw the ear, nose, and mouth specialist.
I am wondering: is there a way to speed up the process of trying to see the specialists if you need a hearing aid or if you need some other aid or whatever your health condition is.
Is there a way to speed up the process so that specialist comes to the community, diagnoses the patient, they don’t have to wait for three more months before they see that patient again and then three more months before they... you know, eventually it adds up to a year, a year and a half.
I wonder if you could look into that scenario and how you could speed it up.
I can review the process and get back to the member on how that service is provided in Nunavut by region and report back to the individual.
That would be fine. I know if we live in the south we’d probably be able to see a specialist in a lot more timely fashion, maybe within a month or so. In the north, it’s a
little bit more difficult. They’re only coming in every three months, and then you get diagnosed, and it’s another three months before they come back.
I’d like to help our residents up north from the time they’re diagnosed to when eventually their health issue is resolved. On the same page, under Community Health Centres, the budget there has decreased by $5.5 million.
I wonder if the minister can explain there is a decrease in community health centres.
The facilities in Cambridge Bay and Rankin Inlet that was originally under the health centres were transferred down to, part of it under the Hospital and Physician Services.
Mr. Peterson: Thank you, Mr. Chairman. I thank the minister for responding.
It’s kind of more a rebalancing of those two items. Okay.
On page H-19 of the business plan, I want to follow up on one of your priorities for 2006. There is a statement there: it says; “Status of expenditures in the new regional health facilities in Rankin Inlet and Cambridge Bay.” The statement there says; “Emergency outpatients, specialist clinics and diagnostic services have been enhanced in Rankin Inlet, and Cambridge Bay.”
Can the minister expand a little bit on what you mean when you say the services have been enhanced?
I’m going to ask the Assistant Deputy Minister of Operations to join me back at the witness table to respond to that question.
Thank you, Mr. Richardson. Welcome back.
Please answer Mr. Peterson’s question. Mr. Richardson.
The enhanced services in Cambridge Bay, with the new facility includes a new adult day program, laboratory services are just about to be opened with new staff and new equipment under way, the availability of lab technology and new pharmacy services have been provided in the community.
Those are the new services.
There have also been, in Kitikmeot in Cambridge Bay, rehab physiotherapy services in the new health centre. There are plans to introduce and offer an endoscopy program with the assistance of a specialist from Yellowknife.
Perhaps the minister or assistant deputy minister could tell me what level of operation do you consider the Cambridge Bay Health Centre to be at in the new regional health facility? You heard me talk about the fact that we should have four doctors and we only have one, and we need 20 nurses.
Seems like they are doing a lot here, what Mr. Richardson describes as enhanced services in that health facility.
Obviously if we only have one doctor and you don’t have the full complement of nurses then this facility isn’t 100 percent operational and delivering all the services intended to deliver, what level of operational capabilities do you consider the health centre to be at as of today?
Sorry Minister, Mr. Richardson.
The only services that were planned for the facility that we are not currently able to operate due to the shortage of staff are the obstetric services and the acute in-patient services and those will require additional new staff that will be difficult to recruit.
I thank the Mr. Richardson for that answer.
I have been telling everybody prepared to listen to me that it’s probably only 50 percent operational. People like to have numbers. What do you consider it to be 50 percent or 60 percent or 70 percent?
Can you give me a number?
It is not as easy for me as the member to make this calculation. We are using the entire building.
The majority of services apart from the in patient and the obstetrics are being provided.
I would say that we are more than 50 percent operational in the facility and I would put it at about 70 percent of the capacity of the facility.
Mr. Peterson: Thank you, Mr. Chairman. I thank the Mr. Richardson for that answer.
Now, I can start telling people that it’s more than 70 percent operational and when they ask me what that means I will refer them to the assistant deputy minister.
Just further down on the page under your priorities for 2007-08, one of your priorities is improve tracking of specialist referrals. Can you clarify what you intend to do there for that priority?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. I have spoken on the need for our organization to develop case management of our patients.
Right now everything is manual. We are looking at trying to put in systems that can track patients as well as their appointments in the referral system. One of those is also the specialist services that come up or they have to go down to, as part of the development of this system and services that they provide are physicians.
I certainly hope that the tracking does improve.
I’ve had complaints from some of my constituents who are waiting for specialist service they are told that it will be a month or two. Then suddenly they’ll get a phone call after a week that’ll say just before lunch “you got to go on the flight today” because the specialist is available in Yellowknife.
I know it applies in the case I said earlier about hearing aids. It puts a lot of stress on constituents when they had other plans for that day, or that week and they are told by the people looking after the referrals that you have to go on the plane today to go to Yellowknife, or Edmonton to see that specialist, otherwise you will have to wait three months.
It would certainly be something that my constituents would appreciate it if the tracking and appointment process was organized and orderly, and not sudden and surprising for them. I am not saying that it happens in every instance but in a couple of instances it’s happened. It puts a lot of stress on my constituents and they come into my office and you know what it’s like - the stress and strain and you don’t want to miss your appointment.
Mr. Chairman, that’s more of a comment.
I wanted to bring that to the attention of the minister and her officials, that referrals, if they’re not done properly, can place a lot of hardship on constituents who are in poor health already.
I don’t believe that there was a question, but I appreciate the member raising that. Yes, I agree we need to work on that and it is identified as a priority that we want to work on this year.
Chairman: Thank you, Minister. I’d like thank Mr. Peterson.
Mr. Curley, you had your hand up earlier, and I will give you just one question. Mr. Curley.
I truly regret that work to rule is on all sides because I want to say that this Assembly and the government appears to completely ignore the plight of those with special needs; those people with mental illness. There’s very little reference in the government work plans in the health department on H-14 of the business plan for mental illnesses in Nunavut.
I believe there are a tremendous number of our constituents that are diagnosed with mental illnesses and they don’t have any representatives, and it’s really shameful that you are also a part of that, Mr. Chairman, that we’re now working to rule because we need to know exactly...
I have a constituent who came to me this summer in a very difficult situation.
The children are somewhat treated, the mental health facility in Rankin Inlet, is a good example. I am not questioning that one, but there are adults that don’t fit into that category and cannot get into that facility.
Yet we don’t have any allocations of funds, or strategy, or how are the mental health strategy, or treatment programs being delivered by this government, because in view of time and the gag order that I would like the minister to fully explain in detail exactly what are we going to do with those with special needs, and mental health treatment requirements in Nunavut?