EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
We can better predict and manage our expenses, and
Our budget now closely matches our historic spending patterns
These improvements leave the department well placed to help the Government of Nunavut achieve the goals set out in Pinasuaqtavut, in particular the goals of ‘healthy communities’ and ‘self-reliance.’
Through the Closer to Home Strategy, we have undertaken a number of training and staffing initiatives that will help us achieve and maintain a stable, qualified workforce for both social and health services.
We are now poised to move forward.
Our focus needs to shift so that we can devote more energy and resources in protecting, rather than restoring health. Our partnerships with the federal government and other agencies have enabled us to support community based health promotion efforts, but we must do more.
It’s important to have a common understanding of what this means for Nunavut. It does not mean a lot of new buildings nor brand new services that did not exist before. For Nunavut, moving forward means ensuring that we provide a good, reliable system that meets national standards.
A system that is safe and trusted by clients and staff alike.
Our priority is to provide a stable system of health and social services with a deliberate focus on prevention and protection. We have small, scattered populations. We need to recognize that it’s not reasonable to attempt to offer the full spectrum of services that people in major population centres take for granted.
Instead, we must continue to nurture our partnerships with out-of-territory agencies and institutions.
We must look to them to provide services for Nunavummiut that we cannot offer here, but those services that we can provide closer to home are the ones that will affect all of us: primary health care, continuing care for people with advanced needs, and healthy living and health promotion.
For 2006-07, the Department of Health and Social Services is seeking a total of $224,709,000 for operations and maintenance, an increase of $9,490,000 over the previous year.
The additional funds for the most part cover forced growth. This is consistent with our interest in providing a good, reliable system that meets national standards. A rigorous approach was used to determine what positions and programs needed to be funded to achieve this.
I would caution members about a few matters, however.
First, our reliance on out of territory partners means their cost drivers can become our cost drivers. We have anticipated these as much as possible with the information we have on hand.
Second, all governments in Canada are facing increased costs for health care. We are all challenged to meet the social, mental and health needs of our population.
Lastly, as much as we try to meet the needs of Nunavummiut, we must still make tough decisions on the basis of available resources.
We need to put our resources where they make the most sense. We need to strive for a balance between two very important goals; maintaining quality and stability through prudent investment in treatment and care programs, and increasing health promotion and health protection to enhance the quality of life of Nunavummiut.
In closing Mr. Chairman, let me observe that the Department of Health and Social Services has made tremendous progress over the past four years with respect to human resources, range and quality of services, and proactive planning.
Yes, the department faces challenges still on all these fronts; however our hard work and progress to date leaves us in good shape to tackle them.
Mr. Chairman, I thank you for the opportunity to make these opening remarks, and I welcome any questions that you may have with respect to the main estimates for operations and maintenance for 2006-07.
I would like to ask for clarification on the dollar amount for the operations and maintenance increase of $9.9, $9 million something.
Hon. Leona Aglukkaq: The information that I distributed shows $9,490,000.
Hon. Leona Aglukkaq: Yes.
Chairman: Minister, for the record, please introduce your witnesses.
To my left is Dave Ramsden, Deputy Minister for Health and Social Services and to my right is Eric Whitworth, Acting Assistant Deputy Minister for Health and Social Services.
Does the Chairman of the Standing Committee on Health and Education have opening comments?
(interpretation ends) Members of the Standing Committee on Health and Education have reviewed the Main Estimates and Business Plan of the Department of Health and Social Services for the 2006-07 fiscal year, and I am pleased to provide you with opening comments.
The standing committee notes that the operations and maintenance budget for Health and Social Services for the 2006-07 fiscal year is $224,709,000.
This amount includes an additional $2.3 million, which was announced on January 18, 2006, specifically to address the loss of accreditation at the Baffin Regional Hospital.
Mr. Chairman, we have been assured that the quality of service at the Baffin Regional Hospital has not been reduced as a result of the loss of accreditation.
Members are concerned that sudden increases to the department’s budget to address a specific situation in one region, where the quality of health care is apparently not at risk, may not take into account other needs and priorities for healthcare delivery across Nunavut.
Given the department’s past difficulty in controlling overspending, committee members will be monitoring this situation closely.
The committee believes that the Government of Nunavut must be accountable to our public for how the funds will be used to improve the health situation for all Nunavummiut.
Members have noted that the department is proposing an increase of at least 50 new positions for 2006-07. The government’s January 18 news release on the accreditation situation further indicates that additional 24 staff positions will also be created at the Baffin Regional Hospital.
At that time, employment statistics show that at September 30, 2005, the department was only able to fill 73 percent of its positions, down from 80 percent the year before.
The committee has been following, with close attention, the department’s progress in hiring full-time nursing staff and urges the minister to continue to work with her officials to ensure that there are fully certified nursing staff in all of Nunavut’s communities.
Members of the committee continue to support, in principle, the department’s vision of a Care Closer to Home Strategy.
With two new regional health facilities opening in the Kitikmeot and Kivalliq regions in late 2005, members look forward to regular updates on the staffing and delivery of services at these facilities.
The committee supports the department’s long-term objective to train and hire more Nunavummiut to work in the health care field.
Over the next few years, members expect to see more beneficiaries filling positions at our regional and community facilities.
Committee members were pleased to note the department’s recent initiative providing training for mental health workers and look forward to seeing similar training initiatives in the upcoming year.
The standing committee continues to have concerns regarding care and treatment for individuals with disabilities or in need of long-term care.
It appears that many Nunavummiut are still receiving care and treatment in southern jurisdictions, far away from their home and family.
Recent news reports have also brought to our attention situations where families of individuals with disabilities have been forced to seek resources and services outside of the territory only to find that they are no longer eligible for support from Nunavut.
While the committee looks forward to the realization of our Arviat Full Caucus Retreat commitment to open 24-hour elders’ care facilities in Nunavut, it is unclear when the Care Closer to Home Strategy will begin to ensure that all Nunavummiut are able to receive more care, services, and treatment in Nunavut.
Committee members are pleased that the department has responded to its recommendations to address health issues at the community level by seeking greater involvement from the community-based Health Committees of Council.
Members urge the department to ensure that adequate resources are made available at the community level and to provide opportunities for elders to be involved.
The committee has noted that the Status of Nunavut’s Women’s shelters continues to be unstable across the territory and encourages the minister in her efforts to provide more support for the individuals and organizations operating these facilities.
Members further urge the department to address family violence issues by focusing efforts at the family level, with dedicated support for the needs of men as well as the needs of women, and by exploring and supporting opportunities for healing in the home community of the family.
The committee recognizes that some of the department’s increases in expenditure are the result of rising contract fees in travel, accommodation, and treatment services provided outside of Nunavut.
Although the department has little control over these aspects of health care delivery, members urge the minister to give careful consideration to the long-term impact of upcoming contract negotiations in these areas.
To conclude, Mr. Chairman, members of the committee continue to express concerns regarding the department’s Client and Escort Travel Policy.
The committee has noted that a revision of the current policy is underway; however members are of the view that to make this policy effective, the department must ensure that clear information is made available to all clients, escorts, and health professionals.
Members look forward to the long-awaited establishment of a Client Services Representative position who will be able to assist with these issues and other matters.
That concludes my opening remarks. I anticipate that individual members will also have questions and comments as we proceed.
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.
I thank the minister and welcome her and her officials to our hearing today.
Mr. Chairman, I have been an MLA for the last two years, as all of us have. Many of us are new. I’m sure that I speak for a lot of us, or maybe all of us, when I say that the Department of Health and Social Services is a very difficult department to manage or direct daily or even long-term.
It touches on everyone’s lives every day since we all know someone somewhere in our community who is ill or dying or needs help with homecare and social programs.
I think, I would say conservatively, 50 percent of the people I see in my riding every day who come to my office, or call me, or email me are people wanting help with the programs and services through the Department of Health.
I would like to credit the minister. When she took over the department last summer, I think she was tired of me after about three months. I think she heard from me two or three times a day.
It was a good dialogue because I was getting answers very quickly.
A lot of my constituents appreciated that an MLA, a minister, and her staff were getting responses quickly to their concerns.
Most patients or clients, I think, who deal with the Department of Health want to know that they are being treated with some...you know, that they are important; that there’s care and compassion being shown for their problems.
I’m like everybody else. I’m also a client of the Department of Health, so I would like to know right away what my problem is.
I would like to see a nurse or a doctor as fast as I can. I don’t like to be waiting too long.
I’m in relatively good health so it’s not a big concern for me, but I have many constituents who are in very difficult straits health-wise and who depend greatly on the Department of Health and Social Services for their lifestyle they can enjoy.
I will be asking the minister and I will be interested to hear the response from the minister about the department’s plan to hire more social workers for all of our communities.
I know in my riding, I think we might require one or two more social workers.
I know social workers have very difficult jobs and most of those work tremendous hours.
They are under great stress at the best of times because they have to get into situations where most of us can’t even dream of getting into, particularly if they have to deal with children; take children away from their parents or guardians.
So it’s a very stressful job and I’m sure if there were one or two more social workers in the community, it would be helpful.
I think, in some communities, the social workers also act as community corrections officers or probation officers so that heaps on additional stress to the social workers.
I will be interested to hear from the minister what the plans are to increase the social workers in our communities.
I will also be interested in hearing the plans to hire more nurses and doctors.
Particularly with respect to the new Cambridge Bay or Kitikmeot health facility that opened last October which a lot of people in our community and even the people I have heard from around the region are taking great pride in. They really think that it’s a wonderful facility.
As the department adds programs and services, then I’m sure that we will start to see some of the immediate benefits in terms of peoples’ health improving and maybe even lifestyles improving.
I know that currently, the staff that work in there, the ones I have talked to, they said a couple times that they are very happy to be working there.
The old facility caused health problems for some of the nurses and the health workers last year when it had to be evacuated. So it was great for them to be in there.
When you have happy and healthy staff, then I’m sure you could have patients who are happier as well.
I’ll be interested to hear what the minister has to say about patient care; how the caring for patients in the health facility, or the patients that are sent out to Yellowknife and Edmonton, or wherever they have to be sent for surgery.
I questioned waiting times in the House last week because there’s a patient in my riding who has been waiting 13 months for surgery, for a one-hour operation. It’s really a long time, and you have to put your life on hold because the health problem that the person had just didn’t allow them to work.
So that was a tough time for her and her family.
And I’ve heard of other patients as well who have had a similarly long wait. The client travel policy is still a concern in my riding. It’s come up a few times that elders are concerned that they have to go to hospitals in Yellowknife or Edmonton and they don’t have someone to come along with them to translate, when they have to deal with doctors and nurses, and we would like that to be addressed.
Community health representatives, I think I would like to hear some more on that.
We have two hard working community health representatives in our town. I think, across Nunavut, that there is probably a great need for community health representatives. They take the load off of some of the health officials, and in particular, the nurses.
I’ve heard from one of the community health representatives that there are three fully trained community health representatives in the Kitikmeot who are unemployed, and I can get those names for the minister if she’d like them.
The minister is well aware, and some of her staff, that after hearing all the complaints and issues last year, I conducted a health survey in the community last July, August, and September. I had a very healthy response to that health survey.
I conducted the survey in such a way that I didn’t want to hear only about the complaints and all those issues. I asked people to offer some suggestions for how to improve health care in our community that I could take to the minister.
I have suggested some of those recommendations to the minister.
I think what came through from the health survey that we conducted was that people would like to see the health officials in our community treat them with more care, more compassion, and deal with them as quickly as possible and spend a little bit more time listening to their concerns.
If a patient can’t come to the health centre, then send the nurse or doctor out to the house, particularly for elders because it’s tough for elders to get up to the health centre at the best of times, particularly in the winter time, when some of them are in wheel chairs, and on crutches and canes.
They know that the health department is doing the best they can, but they recognize that there is always room for improvement and that’s pretty much the message that I was getting from all those health surveys and discussions I had with people who are coming into my office.
So with that Mr. Chairman, I’ll end my comments.
I would like to make a brief comment to the minister.
The minister knows very well about some of the concerns we have in regard to the people of Sanikiluaq and their having to go to major centers outside of Nunavut.
I have made that statement more than once in the House. We have a lot of concerns and problems when you have to out of your jurisdiction to get treatment.
We get a lot of illnesses and I think we should be able to get prompt treatment or a diagnosis. People go out of their community for various reasons but when their appointments get deferred again and again, it creates a problem and added stress to the patient.
I think that there could be improvement in this field, or possibly what your department can do is talk to the officials at the major centres and to make sure that their appointments are not deferred repeatedly. There are people who were able to be treated at one point and it might be too late by the time they see a medical professional.
There are quite a number of people out there who are under homecare in my community. Their family members who are taking care of them have that added stress of taking care of the individual. It’s usually the children of the individual, or an immediate relative because, of course, we don’t have people who are dedicated to doing homecare.
In my community of Sanikiluaq, if an elder has to go out of the community for treatment, we’d have to go to Arviat to get treated, or to Winnipeg. Because this individual is an elder, usually he or she is unilingual and you probably know that the Sanikiluaq dialect is unique in Nunavut.
If they went to Arviat and if they are going to be treated there, he or she will use their own dialect and very likely they won’t be understood by the people who are working in the nursing station.
I am especially concerned about the elders who can’t take care of themselves and who need added support.
In regard to the community wellness workers, there are hardly any workers there. They have to deal with very stressful situations. For example, they work with the youth and they need proper workplaces.
Possibly the Department of Health and Social Services can look at this to make sure that their employees have a proper working environment.
In the communities people with mental problems usually would approach an elder, or someone that they know for support. The elders in our communities are usually the ones that do the counselling if anybody needs help.
We have to recognize the elders who counsel anyone who needs help and they work extremely hard so that they can help the individual overcome their problem, and I think that they could be recognized or given further support by your department.
Mr. Chairman, that was my last comment.
I would also like to welcome the minister Leona Aglukkaq, and the Deputy Minister, Mr. Whitworth.
To make a brief comment, I have a number of issues that I would like to touch upon.
One issue that is brought up in my ridings, because of course I have the smallest communities and the smallest population, is that they don’t have many elders left.
The elders are sent out without an escort, and this is a major concern in my three communities. You do have an escort policy, but usually these elders are sent down south without an escort.
They are unilingual, they don’t speak English and that is still happening to date.
The elders go from their community to a southern destination and it’s specified in the Escort Policy that this individual needs an escort if they’re unilingual and if they’re elderly.
With that, the three communities that I represent have very small populations and I think it would be easy to identify people who need escorts when they’re going to be going out for treatment in a Southern institute.
This is one thing that was brought up continuously when I was visiting the three communities that I represent.
For the patients who are down at the Larga Boarding Home, they wait way too long to see a doctor, and some of them wait six or more hours at the hospital.
I think that there should be a shorter turn around time for those patients when they go to their appointments.
I know that the doctors are very busy and they have a lot of patients to see, but if there is a sick person, and they are elderly, it’s very hard on him or her to wait six or more hours.
In regard to prescriptions, they have to be flown into our community, and I think that we have to get out of the individual having to order their prescription pills.
Another problem I have is the Transportation Office being relocated to Pangnirtung, and some individuals having to look for accommodations and buy their own airline tickets to go back home.
So what are the elderly, unilingual patients going to do when they have to arrange their own accommodations and flight arrangements?
Is it going to be up to them to make accommodation arrangements?
It didn’t used to be the case.
The hospital was the one who made all the billet or accommodation arrangements. They have a proper patient boarding home here and if there is no room, then they’ll be placed in a hotel or billeting.
Has there been, I don’t know if there has been a change to this yet, but I will look into it.
The people who are billeted or in the hotels were given a per diem so that they would be okay, and I am concerned about the people who are billeted in overcrowded homes.
I know there’s a shortage of houses though and a shortage of houses has an adverse effect on the health of the people.
This is one issue that has been brought up repeatedly again. If there are too many people in a household and someone gets a flu or cold it would be passed on to the other members in the house.
I was told to mention that to your department because it affects the health of the families.
And we all know that that’s the case in some of the communities.
Another issue that my colleague Peter Kattuk brought up is in regard to the mental health worker.
This individual used to go up to the smaller communities and they would like to see that again.
They would like to see more frequent visits from the mental health worker so that there would be services provided to the people who need those types of services.
Mr. Chairman (interpretation): Thank you, Mr. Barnabas.
Mr. Kilabuk: Welcome to the minister and her staff.
Mr. Chairman, I for one like to call my colleagues duly recognize and acknowledge the fact that there are many challenges that the Department of Health and Social Services deals with on a daily basis.
And I for one like many others both in this House and outside the House have gone over and I can spend many hours doing exactly what’s been done already.
Just spend many hours and explaining and expressing or rather identifying the problems that we see in our communities, but I want to currently present and take a different approach to this because Mr. Chairman, I think it’s about time that we start promoting solutions to the many numerous challenges that are held in health and social services. They have to listen what’s expressed to them daily.
If we look at the subtle use of the history of this government, we probably spent a good three quarters of our time identifying and expressing, again, the same problems over and over and over and over.