EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
This is just one example of how the Department of Health and Social Services is transforming an economic drain into an economic driver.
I am proud that this example of community capacity building will be supported by the addition of two health centers in Rankin Inlet and Cambridge Bay.
Contracts with First Air and Canadian North for scheduled medical travel on jet routes is projected to save $500,000 per year, but more importantly, these new agreements stabilize the per-ticket price for scheduled medical travel.
Our increased focus on public health reflects the connection that Inuit value between health and the environment.
Like our environment, our health is a complex system that we must take care of.
We know not to pollute the waters because the fish and seals and whales will be affected.
In turn, our food will be affected. We know this through Inuit Qaujimajatuqangit.
The highs and lows in any system need to be in balance; when one is out of alignment, the system crashes.
As a territory we face many challenges, and many of those challenges are directly related to the health and social status of Nunavummiut.
Every day, lives in this territory are affected by suicide, poor nutrition, and respiratory illness.
We have a high birth rate and low life expectancy.
Through public health initiatives, we will be better able to prevent disease, promote health, and prolong life.
Investment in this area can eradicate diseases, like those affecting dental health among Nunavummiut children and significantly lower cases of other diseases.
Through public health programming and health promotions the Department of Health and Social Services supports Nunavummiut in their growth to become healthy individuals.
We celebrate healthy individuals making healthy families and we recognize that healthy families build healthy communities.
I am pleased with the progress of my department, but recognize that we continue to face financial and human resource challenges.
Operating in deficit with serious staff shortages, my department deals with life and death.
Our job is to improve health delivery and health status, and I believe that starts at home with the improved health of each and every Nunavummiut.
Mr. Chairman, I would like to thank you and the members for the opportunity to speak to you today, and I welcome any questions regarding the Department of Health and Social Services’ main estimates and business plan.
(Interpretation ends.) If you would like to go to the table.
Do you have a witness that you would like to bring to the table?
Sergeant-at-arms, if you could please escort the witnesses.
Madam Minister, please introduce your witnesses.
Hon. Levinia Brown (interpretation): Thank you, Mr. Chairman.
I apologize, but I did not hear you.
Could you repeat that again please?
Chairperson (interpretation): Madam Minister, please introduce your witnesses.
I think I have to rise.
It is all very confusing, I apologize.
On my right is Deputy Minister Bernie Blais, and on my left is Victor Tootoo, the assistant deputy minister.
Chairperson (interpretation): Does the standing committee have comments?
Mr. Alagalak: Thank you, Mr. Chairman.
Members of the Standing Committee on Health and Education have reviewed the budget estimates and business plan of the Department of Health and Social Services for the 2004-05 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 2004-05 fiscal year represents 25 percent of total proposed government operations and maintenance spending.
Mr. Chair, the committee understands that despite an increase from previous years’ allocations, the adequacy of the base funding for the Department of Health and Social Services remains a concern.
Members of the committee recognize that this department faces ongoing challenges, especially when dealing with uncontrollable costs related to events such as sudden outbreaks of viral infections or other crisis situations.
However, the committee feels that there are a number of areas where costs are more predictable and more progress could be made to economize or better plan expenditures.
In the area of staffing and employment, members have noted an increase of over 200 positions within the department.
Members encourage the department in its efforts to recruit and retain full-time staff.
Members have noted that the department’s reliance on casual staffing is one area where projected expenditures are frequently overspent.
In the case of nursing staff, for example, members encourage the department to continue to develop initiatives to recruit and retain full-time nurses.
The committee is fully supportive of the training of Nunavut residents as nurses and other healthcare professionals, as well as involving community individuals, such as elders, in healthcare issues.
While the committee understands that it is often necessary to employ professionals from outside of Nunavut, members strongly recommend that the appropriate orientation be made available to these individuals so that they can better respond to the unique circumstances in which they are working.
Members have noted that expenditures relating to medical travel continue to represent a large proportion of the department’s projected budget.
The department’s new focus on bringing care closer to home is a promising direction for reducing costs related to accessing healthcare outside of Nunavut.
However, members continue to have concerns about a number of different aspects of medical travel.
While there have been recent announcements of certain new travel contracts with air carriers, the results of other negotiations have not been made public.
Members recommend that the department table reports and contracts relating to medical travel both within and outside of Nunavut.
Members have also raised some concerns regarding the department’s medical travel policy, specifically with respect to patient eligibility for escorts.
Members look forward to hearing further detail on the plans for the decentralized medical travel office and its operations.
Mr. Chair, committee members have been given to understand that some of the operations and maintenance costs for the three new health facilities in Cambridge Bay, Rankin Inlet, and Iqaluit have been included in the projected allocations for this department, especially with respect to staffing.
Members look forward to hearing details on realistic operations and maintenance costs for these facilities.
Members caution the department to ensure that the lack of accommodation for new staff does not delay the opening of the new facilities. Further, members would not wish to see brand-new multimillion dollar facilities being under-utilized due to a lack of physicians and nurses to actually staff the facilities.
Members are of the view that the involvement and empowerment of community members is the key to reaching the objectives of healthy communities and self-reliance.
On this note, committee members are pleased to support the department’s plan to focus on developing midwifery services at the community level.
Mr. Chair, members encourage the department to develop a more comprehensive approach to addressing the needs of Nunavut’s under-represented population groups such as women, children, and people with disabilities.
Members have noted a lack of coordinated policies and support for family violence workers and facilities.
Similarly, there is a lack of coordinated support services at the community level for individuals with disabilities and elders.
Members await with interest the minister’s formal response to the Qulliit Status of Women Council’s recently-published report on abuse and violence against women in Nunavut.
Finally, members of the Standing Committee on Health and Education look forward to working with the minister on future initiatives relating to public health.
Members recognize that a number of factors, such as overcrowding, lack of employment, and unhealthy lifestyle choices influence the spread of disease and affect community and individual wellness.
Chairperson: Thank you, Mr. Alagalak.
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 the matter under discussion but not until every member who wishes to speak has spoken.
I suggest to members that wherever possible you ask detailed questions during the page-by-page review of the department’s estimates.
Do members have any general comments?
And I also would like to thank the minister for her opening comments.
I would like to talk about how in my constituency, in the smaller communities when government is decentralizing programs and services, the health centres have been lacking funds to improve the buildings.
For well over five years we have been lacking funds.
It has deteriorated the health centres in the non-decentralized communities.
Also, once those health centres, especially in the smaller communities, were constructed, the population increased.
We have been experiencing some problems in the communities where the patients have no waiting room.
They lack space in a waiting room, they lack office space, and the sewage intakes are out of code. Also, the patient treatment rooms are way too small. Although the chairperson of the standing committee has touched on those issues, yes, we need more funding in the non-decentralized communities.
If they are left alone, and if there is no funding to make improvements to the health centres, the problems are going to increase. It’s going to get more expensive to rectify the problems and to maintain the health centres.
Also, the lack of doctors visiting my constituency… There is a large concern in regard to the doctors visiting the communities.
In that way, if there are more doctors visiting the communities there will be fewer patients having to be flown out of the community.
Currently, there has been an elder going back and forth to Iqaluit.
These patients need to be treated because they need treatment.
The patients with terminal illness end up having to be flown back and forth to the hospital here and if they can’t be treated here they are sent down south to Ottawa for treatment.
If I had a terminal illness it would be very tiring for me even though I am a young person. I don’t blame these elders who have to travel for long periods of time and who must get exhausted.
I know that this can’t be rectified overnight, but at least you have to be more sensitive to our elders when you have to transport them for long hours.
Yes, they’re being treated, they are sent out for treatment, and some of the patients have to be treated with chemo-therapy.
We have also been experiencing problems in my constituency where an individual who had accompanied me was complaining about a lack of interpreters at the health centres, for the doctors and the escorts.
It creates problems between the doctors and the escorts; when the doctor has to give the diagnosis they end up using the escort as an interpreter for the patient.
This creates hardship, and I experienced that myself.
I had to break the news to a patient, to my mother, about her illnesses when the doctor told her how long she is going to live.
This is a great concern to the escort because when you are an escort you hear all these words, the diagnosis. And even though you are not an interpreter you have to interpret for the patient whom you are escorting.
Mr. Chairman, we have heard that we need to come to a decision about health interpreter-translators; health interpreters will have to be given more terminology workshops in regard to naming of the illnesses.
We are still learning about new illnesses such as AIDS.
Although we had terminology made up for AIDS, we need more terminology for some new illnesses so that the patients can have a better understanding of what is being said.
Also, the continuing problem in the High Arctic we experience, especially if the patient is having to go to for operation, whether it be optomology or physical: I know that we lack resources, but they need these services, especially when the patients have to go for an operation, especially when they are elders.
Elders need escorts because they need help in caring for themselves.
They don’t know the southern way when they go down to Ottawa.
Sometimes the elders will just sit at the airport in Ottawa and they won’t know who is going to pick them up.
They’ve never been to a city before, especially our elders. We have to be quite sensitive to our elders.
Although there are a few problems with Larga-Baffin House, many people go stay at the boarding home, Tammaattaavik boarding home. They lack space and they end up being billeted out to the peoples’ homes.
This has to be rectified, especially when you have various illnesses; if you’re housed in one house, they all have different diseases. There are patients, too, who are on maternity, and they’re all housed in one house. They have various diseases, and that becomes a concern for us.
Therefore, I believe that we need to improve Tammaattaavik here so that we can have appropriate boarding homes for the patients.
I’ll conclude with that for now, Mr. Chairman.
Chairman (interpretation): Thank you, Mr. Barnabas.
Mr. Alagalak (interpretation): Thank you, Mr. Chair.
I would like to talk briefly about the confidentiality issue.
In the health centres, I have been told many times, and also many people have complained, that for many years some patients go to the health centre and they have an interpreter, and this confidential information is very rarely leaked to the public.
That’s what I have heard. Also, there have been individuals who have been requesting support and help on this issue.
I’m requesting the minister to commit.
I know the interpreters have a confidential agreement and that they should keep everything confidential.
There should be a policy, or the health centre should be made aware of the confidentiality policy because we lack interpreters, we need interpreters; it is urgent.
At times we have to get an interpreter just for a moment.
I think there should be a policy stating the process for the interpreter so that they will not leak confidential information.
We have no policy for the interim interpreters about keeping the information confidential.
I don’t know if this is an oversight, but I would like to encourage the minister to be sensitive to the confidentiality of the interpreters.
This is one of the very important parts of it because there are various diseases that people are sick; whether you are an elder or not, their illness should be kept confidential.
Even if it’s minor information, it’s leaked out to the public.
There should be some kind of process or some kind of something that you could do when the information is leaked out.
Chairman (interpretation): Thank you, Mr. Alagalak.
I would like to welcome the minister and your officials.
The general comments that we’re making, it’s not a personal statement, but I would like to make a statement in regard to health.
As Minister of Health and Social Services, we are very pleased that you are responsible for this department and there is a high expectation of the public out there, and the public is very pleased to hear what comes out of you.
That is the first thing that I would like to state.
In the past, we could not really understand the process, and I am sure the minister was working very hard in Keewatin, and the continuing concern is the use of the airlines.
I am going to be asking questions in regard to this issue a little bit later on when we go to the questions.
There were some concerns with the department of health. We have heard in the past that the previous medical officer in the Keewatin who was in the Baffin region previously, we have heard that he did not have the appropriate licences even when he went to Yellowknife.
I know that the medical officers have to deal with very critical issues. He did not have the appropriate licences and he was the chief medical officer in Baffin and then he went to the Keewatin region, and then when he went to Yellowknife. He was caught for having an inappropriate licence and we have not heard about that from the Nunavut government previously.
But I am sure that Nunavummiut will want to hear about why they did not find out about the medical officer’s credentials.
Do we investigate to make sure that the medical officer’s references are checked? His references were never checked by the minister’s officials.
When he was sent to Yellowknife last winter, they found out that he had inappropriate permits even though he was the chief medical officer here in the Baffin region. Here, I thought somebody was going to have to make a comment in regard to that issue.
Also, the concern in the Keewatin region in regard to the airlines that have been chartered for medical travel services: it seems to be done inappropriately and they use the same airline.
It has been like that for some time now; Skyward Aviation had to get out of the airlines because they were not being chartered. These small airlines were chartered to the smaller communities, and it really helped with the things that you had to bring. But the medical services were not in support of that and we have some idea of why it that was the case.
In the health department, the department of travel referral, the Kivalliq area’s pilot’s wife was working in transportation.
When there is a referral to charter a flight, the pilot’s wife was always ready to make the referral for the airline.
According to the policy, I do not think that should be conflict of interest.
For that reason, that is why it seems like they did not want to service Kivallirmiut for many years. I have heard that Skyward Aviation would do the investigation when Kivalliq Air would complain to Transport Canada.
When they were going to quote a charter they would make a complaint, and when they do a complaint, and then they do an investigation every time they try to charter Kivalliq Air, the other airline would complain.
The Skyward Aviation stopped after they talked to Transport Canada, they were investigating for nothing, for no reason at all.
Once they found out that Kivalliq Air and Skyward Aviation were investigated by Transport Canada, that is when this was stopped.
I’m sure that they believe that there was a problem, but they were complaining about their transportation and this has to stop.
The Kivalliq region is in support of that airline because it really helps to transport goods and services at a cheaper rate.
If they were used, the health department would have saved a lot of money and so that is going to be part of my question later on.
I would like to welcome the minister and her staff here to the Committee of the Whole and our Legislature.
It’s the minister’s first appearance at the witness table so I wish her luck.
I’m sure she’ll do fine.
Mr. Chairman, this department and I think one of the key things and one of the most important things that this department deals with is the health and well-being of our families and our children and our friends and constituents and the people that are care-giving, such as the doctors and the nurses in the community and the health facilities here in Iqaluit, at the regional hospital through agreements that we have with other more specialized areas in the south, where we don’t have those services available here in the North.
I noted in the minister’s opening comments on the whole group recruitment steering committee: I know that the department reacted quickly a few weeks ago after the announcement from the Registered Nurses Association of the Northwest Territories and Nunavut that they felt that they weren’t being made aware enough of what they were getting themselves into.
So, I know that the department has moved quickly in that area to try and address some of those issues and I congratulate them on that.
I think that we have to try and find ways; if we have someone that is willing to come up here, we don’t want to fool them, get them here, and then they’re going to leave right away again.
Then they’re going to pass the word around, “No, no, you don’t want to go there,” because it’s turned out that they had a bad experience.
We need to find ways so that once people show an interest in coming here, we get them here and they want to stay here.
I think we need to look more proactively at maintaining some of the levels of nurses within the regional hospital here and throughout the communities, because I know over the last few years it sometimes takes them months and months to recruit one nurse. If there’s a way that we can find to try to expedite that whole process to be able to find and recruit someone, a nurse to work anywhere in Nunavut, we should try and find ways to do that.
There always seem to be shortages.
I hear they’re shutting beds down because they’ll find out all of a sudden someone leaves and it takes a long time to hire someone.
That mean time you have the nurses that are left behind; they are short-staffed.
You have to shut beds down.
It’s a snowball effect on the rest of the staff that are left behind.
I don’t know if anything can be done to expedite the process or start earlier so that you don’t have to wait until someone says, “Okay, I’m gone,” before you look for some more people.
We’re always looking for more nurses.
There should be always some that are in works, looking for people to come up here.
I think that is something: if we could get a quicker turn around time it is going to be much more beneficial for the staff that we do have left here, make their lives a lot easier if they are not doing the jobs of people that aren’t there.
So, I think that is something that, hopefully, can be looked at to try and help them out because I know the long hours they work.
Someone works double shift or triple shift.
It can be pretty tough at times on them and on their families.
So, we should find ways. We need to try to find ways to expedite and speed up that process so that we can have a slower turn-around time when there are vacancies in the system, as with both nurses and doctors.
I know that there has been finally work started up there on the new hospital.
It’s good to see that coming and I’m sure that we’ll be able to reap some rewards of repatriated services as a result of the new facility going up there.
But again, staffing-wise, to make sure that we’re ready when that happens, it takes time and especially with the crisis of shortage that is projected for the next couple of years.
You know, if we wait until then to get people signed on it might be a lot tougher to do.
So you may want to find ways to beef it up now so that when the shortage comes we are not trying to find people at that time. Then we have the people that we need to work in the new facility when it is ready instead of having it sitting there empty with not being able to hire staff to fill it.
On the facility itself, I know that there have been some concerns; I’ve been up to the hospital here a number of times for different reasons and a couple of times I’ve seen the fire department people going in there and checking some detectors or smoke alarm, or some kind alarm that has gone off. There is just a really wear-and-tear system because of the age of it.
They are a good indication as to why the new facility is needed.
But in looking at some of the upgrades that were done to the reception area, it allows for a little more privacy and that. But I’m just wondering if there are any requirements that we may need to look at to make the whole emergency area more practical and usable and suitable for the growing demands; I mean how long ago was that built for?
How many people were here?
How many people are going through there now as opposed to when it was first built? And does it have the ability to accommodate that under the current demand?
There was an incident a few years ago that one of my colleagues talked about where an individual was wheeled through the lobby area on a gurney and that’s it.