EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
The government introduced or promoted Arctic College courses for nursing and we still are using a lot of agency nurses.
I’m just wondering what kind of supports were given to Nunavummiut to become graduates of the Nursing Program here in Nunavut.
I think I’m going to make an executive decision and go straight to the Minister of Health, Ms. Ell.
That question was raised earlier by the (interpretation ends) hon. Mr. Hickes (interpretation) just a short while ago. The Nunavut Arctic College students are people we take pride in, and we wish them success in their studies.
I stated in my response at the time, that we do need to consider better benefits to our students.
Currently, we have approximately 20 students enrolled in that program and nine of the students are Inuit beneficiaries.
There are different class years, for example five students are taking the first year of the program, and ten students enrolled in the second year, with six students who are Inuit taking the third year and two students taking the fourth year who may graduate and one of the students is also an Inuk.
Indeed, we are aware and I personally know this, and the Minister responsible for the Nunavut Arctic College is someone I want to work closely with to determine what other means of support we can provide to these students.
Chairman: Thank you, Minister Ell.
Ms. Angnakak (interpretation): Thank you, Mr. Chairman.
I wish to ask another question related to graduates of the Nursing Program. Does the government immediately offer employment positions to the graduates of this Nursing Program?
Again, I will go direct to Minister Ell.
When the nurses graduate, they have to do some (interpretation) what’s that word? They have to work in a hospital, while learning on the job, and they generally are required to complete this practicum, perhaps as long as three years and sometimes a two year period.
There are some two year practicum agreements made with other colleges offering nursing programs where they can practice their skills in a southern hospital, such as in Nova Scotia.
Sometimes, they work for another period which occasionally has them working here at our hospital. The requirement is to have a supervisor, and the term is called a (interpretation ends) practicum.
(Interpretation) That is the word in English, and they are required to undertake further training prior to becoming a nurse capable of working in our communities.
Chairman: Thank you, Minister Ell. (interpretation) I wish to remind all members that we are trying to review the items listed on page 7, dealing with Supplementary Appropriations.
Not Previously Authorized. Please keep your questions to the point, and sometimes it’s better if you ask your question during Oral Questions.
We are looking at the numbers here. That’s just a reminder.
Ms. Angnakak (interpretation): Thank you. (interpretation ends) Okay, I’ll keep to… .
Under Medical Travel there is a request of $6.2 million. Is this for escort travel, or for patients?
It is my understanding from the briefing note that the $6.2 million is for patients who must travel.
I think I have Mr. Savikataaq.
On Mental Health contracts, the $2.8 million, are you hiring more mental health nurses that weren’t anticipated?
How did you come up with the $2.8 million?
I thank Mr. Savikataaq for his question.
From the information we were provided from Health, it is to increase staff capacity, providing more mental health services in the territory, plus sending more folks to treatment in the south.
We know we all need more mental health nurses.
In your briefing notes, is there a breakdown of how many new mental health nurses were acquired with that extra money?
We don’t have that information at the table here with us.
Back to agency nurses now. This may be borderline O&M. You can use your judgement on that.
The agency nurses, we need them and we hire them. But I’ve known of instances where regular permanent nurses become agency nurses because the benefits are better for an agency nurse while they work, like no rent.
I thank Mr. Savikataaq for the question. That is correct.
The agency nurses are not charged rent, they’re contractors.
This is just a last comment.
I guess we are encouraging our permanent nurse to work for agency’s department.
Chairman (interpretation): Thank you, Mr. Savikataaq. (interpretation ends) I will take that as a comment, unless Minister Peterson, you wanted to reply to it.
The Department of Health is working to address that, as I think we have indicated in an answer earlier that hiring of agency nurses is a last option.
There is a requirement to have nurses in all the health centres. There are times throughout the year when indeterminate nurses are out of town or unavailable and you do need nurses. So there is a combination of indeterminate nurses, casual nurses, and agency nurses, but agency nurses would be the last option to hire staff at a health centre.
I just have a question on the pharmacy services. I would like to know what that is.
Is it for physicians or is that for all that Tylenol that you give away?
I thank Mr. Akoak for his question.
It is for additional pharmaceutical products.
Earlier, one of my colleagues had asked, but they didn’t quite catch on it.
On medical travel, it was identified that it is geared towards patients. My question here is on that medical travel aspect. Has the Department of Finance notice a difference in the figures with the inclusion of the Office of Public Relations which started, I believe, at the last Assembly?
Just to clarify my earlier answer, it would be medical travel for patients and escorts. The Patient Relations Office only opened for business last, I think, July 2013, so it is early.
I have heard anecdotally that there has been some success in terms of patients, clients and others getting faster responses to their concerns when they’re on medical travel or escort travel.
I guess it is something that we will have to watch for if it is a success or not.
On the very top there, Travel and Transportation, what does that cover?
Seeing that we already have medical travel there, what is Travel and Transportation?
Chairman (interpretation): Thank you. (interpretation ends) Hon. Minister
With your permission, I’ll ask Mr. Neish to respond.
The travel and transportation request covers several areas.
There’s a request for Directorate, which we spoke of earlier. There’s also a request under our Public Health and then under our Treatment Branch.
In the Treatment Branch, it’s mainly our casual nurse travel. So we have casual nurses that we don’t have funded for and their travel is not funded for under removal in or removal out, so we’re flying casual nurses in and out of the communities. Whenever possible, we use casual nurses over agency nurses.
Chairman: Thank you, Mr. Neish. (interpretation) Thank you.
Just one last comment on the overall thing, on the additional funds that are being asked for, it would help us if we knew how much had been spent so that we can compare it to what’s being asked.
For example, you’re requesting $8 million for out-of-territorial hospital services.
If we knew that you had already spent about $200 million on there, then we would say, “Okay.
Well, they’re not asking for much of an overrun,” but if it was only like $20 million, then we would say, “Holy smokes! Their budgeting is really screwed up!”
So for the next time, if we could just have, on each line item, how much was actually spent so that we can compare that to what is being asked for.
Chairman: Thank you, Mr. Savikataaq. (interpretation) Let me remind you to be aware of what you’re talking about and your language. (interpretation) Hon. Minister.
I thank Mr. Savikataaq for the suggestion and recommendation.
I’m not sure how that would change the presentation of these supplementary bills and the main estimates, but there is a way to compare or in the main estimates, you could see the overall budget for the entire year. So you can look at those areas there and then do some cross-referencing and research. You will find that the $8 million is an addition to the approved amount earlier in the main estimates process.
One of the things that we have been bantering about quite a bit in the House in the last couple of weeks is almost two sides of the coin for medical travel expenses.
As I’m sure all of us want to see the numbers reducing, some of us are still very concerned about the amount of escorts that are being denied or approved in whatever case it may be.
One of the concerns I have, and I realize the minister is fairly new to this portfolio, but I don’t recall a year ever occurring where there wasn’t a supplementary appropriation for medical travel, so I don’t see those costs reducing.
There are a number of factors, as I have questioned in the House this week and last week, on telehealth, as an example, and different programs being utilized to reduce medical travel. I’m not seeing the results.
Can the minister comment on that?
I thank Mr. Hickes for the question and comment.
A few years ago, before I was in the health department the second time, I had a conversation with Finance people and some Health people. I said, “If the health care costs continue at the pace they’re going, there will only be two departments by 2020 or 2022, the health department to incur the bills and Finance to pay the bills.”
I attended FPT finance ministers’ conferences and FPT health ministers’ meetings when I was health minister, and it is a reality across Canada that the health care costs in all jurisdictions are increasing.
We started an initiative or a process several years ago in Health when I was health minister. We call it bending the health care cost curve because the health care costs in Canada are increasing at an exponential rate in most jurisdictions and some provinces are at almost half of their annual budget.
In Nunavut, we live in one of the most challenging jurisdictions in Canada to deliver health care to all our residents.
We only have health centres in communities.
There’s a hospital in Iqaluit, but when people get sick, and we have no control over that, if they really need medical care, we have to send them south. There’s no two ways about it. There are a significant number of medevacs every year; I think 1,500 or 1,700 medevacs.
We have tens of thousands of patients who have to be sent south for check-ups and specialized tests. We have hospitals in the south charging us very expensive fees for the facilities.
Doctors are charging us very expensive fees.
Until we get to the point in our territory where we have facilities and trained physicians and nurses in all communities, we are going to continue to get increasing costs.
There was an initiative started in the Second Assembly, preventative health, where we started educating Nunavummiut about caring for themselves; eat a proper diet; lifestyle choices.
Obviously, if you smoke, if you’re a lifetime smoker or you’re smoking, that’s going to catch up to you at some point.
We’re educating people about taking care of their health and taking care of their families.
I understand Mr. Hickes’ question, but until such time that we’re able to provide more care in our communities, we are going to incur these costs. There have been some initiatives.
The Minister of Health announced last week the CT scanner that is in place at the hospital here in Iqaluit. That’s estimated to save approximately 600 trips to southern hospitals that they can do here and provide the CT scan work here in Iqaluit. That’s going to save on travel costs.
There are midwifery programs. Again, there is healthy living, campaigns to quit smoking, and campaigns to eat healthy.
There are initiatives, but the reality is that it’s going to take time for us to get to the point where we can significantly reduce the health care costs, as they are rising at the moment.
Chairman: Thank you, hon. minister. (interpretation) We are on page 7. Mr. Hickes.
Out of the seven program areas that are under this $26 million request, I see four of them that have relations to sending people out of the territory.
The minister just alluded to, until such time we get the infrastructure needed within the territory, I’m not sure how much longer we can afford not to before we are stuck with the two departments that the minister alluded to earlier.
I understand that there is not a magic chequebook that we can just pick up and develop these infrastructure projects on our own right now.
We have an opportunity with a former member of this legislature sitting at a national level, and I’m sure numerous discussions have been had with the federal Minister of Finance dealing with the Department of Health specifically.
Can the minister indicate what kind of discussions are ongoing right now to help us with our infrastructure demand so that we can start saving money by keeping people here instead of sending the money to other jurisdictions?
Well, as finance minister, I have talked to Minister Flaherty, former Minister Flaherty now, about investing in infrastructure in Nunavut, but that was primarily on items such as housing and infrastructure related to ports and roads.
When I was the health minister, of course, and when our MP for Nunavut was the health minister, we had conversations about initiatives that would result in savings to Nunavut, but it wasn’t specific to providing more infrastructure for hospitals and health centres.
The Government of Canada will always tell us that they would provide us with funding through the Territorial Formula Financing Agreement and through the processes that the Legislative Assembly has, through the main estimates and the capital estimates process that we’re working on this week and last week.
We do budgets for health centres. We do budgets for other facilities to provide health care services to Nunavummiut. As everybody is well aware, there are competing demands from all departments for capital monies.
Education requires schools. Economic Development and Transportation needs airports and roads. Working with the small capital budget that we have relative to our size, it’s going to be very challenging to provide the entire infrastructure we need in the health department as time goes along.
It is challenging, but it’s up to us to work with the resources we have.
Ministers continue to talk at their FPTs with their counterparts. The Premier talked with his colleagues at his level.
MLAs, by asking questions in the House and raising awareness, of course, the media picks up on our debates every day and also, I know there are officials in the Government of Canada who read the Hansards every day, so they are well aware of our pressing needs up here.
Just one final question.
When I’m looking at the overall budget of O&M, it is $1.3 billion and today, we’re asking for a total of a little over $34 million. I know that it’s only little under 3 percent of the overall O&M budget, but it’s still a lot of money.
I believe the member from Arviat South mentioned earlier that there maybe needs to be a little bit more work done during the budget analysis process.
I understand the need to come back for these dollars, but some of the themes are very recurring. I’m just wondering if some little bit more work can be done through your office with the other ministers’ departments and their staff to help “accurize” the budget process.
I don’t know if there was a question there, but Minister Peterson, if you want to reply/comment.
I thank Mr. Hickes for his comment.
Mr. Chairman, when departments come to the Financial Management Board for additional funds, we tend to, well, don’t tend to, we actually make a recommendation that departments have to go away at it and begin to analyze the figures that they provided to us. We make recommendations and usually in the fall, in this case, come back with an evaluation of the costs.
We have our own officials in the Department of Finance who work with the department to help analyze costs.
I know the health department has some people internally who are constantly working to evaluate their programs and services and analyze the cost figures to find ways to save money.
Hopefully, during the main estimates, all departments can provide you with information on how they manage their appropriated funds and why they sometimes require additional funds.
As we continue in this process, the Department of Finance is going to be working with all departments in terms of reviewing the programs, reviewing their services to find out what works, what doesn’t work, and what needs to be improved, what needs to be discontinued so that we can make better use of our limited resources.
Chairman: Thank you, hon. minister. (interpretation) I have no more names on my list.
Please keep in mind that we still have three bills to go through before we report progress today.
We’re on Health. Operations and Maintenance. Not Previously Authorized.
Directorate. Total Directorate. $400,000.
Chairman (interpretation): Public Health. Total Public Health. $100,000.
Chairman (interpretation): Treatment. Total Treatment. $25,500,000.
Chairman (interpretation): Total Department. Not Previously Authorized. $26 million.
Page 2. 2013-14 Supplementary Appropriation (Operations and Maintenance) No. 3.
Schedule 1: Operations and Maintenance. Appropriation Authority Required.
Operation and Maintenance Appropriation. $34,565,000.
Please refer to Bill 3 in your legislation binder, No. 3.
I believe you have a copy of the bill in your binders. I believe you now have a copy of the bill in front of you. Bill 3 is in your legislation binder.
I believe you now have the bill in front of you. Let me read out the title.
Bill 3, Supplementary Appropriation (Operations and Maintenance) Act, No. 3, 2013-2014.
Chairman (interpretation): While we’re on this clause, go to the Schedule on page 3.
Total Operations and Maintenance. $34,565,000.
Do you agree to Bill 3 as a whole?
I’m sorry. My documents were missing some pages.
We have to go back to page 1. I apologize for the missing pages in my documents.
Chairman (interpretation): Turn the page. Clause 5.
Pursuant to Rule 62(2), does the committee agree that Bill 3 is immediately ready to be placed on the orders of the day for third reading?
We have now concluded the review of Bill 3. If you have any closing remarks, Minister Peterson.
I would just like to thank you and your committee for your scrutiny on Bill 3.
I would like to thank Mr. Neish for appearing as a witness to assist with answering detailed questions.
I would like to thank my colleagues, Minister Okalik and Minister Ell, for their assistance in also answering detailed questions.
Committee Motion 001 – 4(1): Extended Sitting Hours (Rumbolt)
Pursuant to Rule 6(2), I move that the Committee of the Whole continue its sitting beyond the hour of daily adjournment for the purpose of concluding its consideration of Bills 4 and 5.
Chairman (interpretation): Thank you, Mr. Rumbolt. There is a motion on the floor and the motion is not debatable.
The Committee of the Whole will stay in session until we report progress on Bills 4 and 5.
We will now proceed with Bill 4.
If you have any opening comments on this bill, Minister Peterson, you may now proceed.
Bill 04 – Supplementary Appropriation (Capital) Act, No. 4, 2013-2014 – Consideration in Committee
I am pleased to present Bill 4, Supplementary Appropriation (Capital) Act, No. 4, 2013-2014, totalling $3,093,000.
This bill will provide three departments with additional capital funding for two special initiatives and one project over-expenditure.
Bill 4 consists of the following items:
$200,000 to the Office of the Legislative Assembly for the child and youth representative tenant improvements and furniture, fixtures, and equipment;
$2.6 million to the Department of Family Services for leasehold improvements to the old courthouse, which will allow the entire department to co-locate under a single roof; and
$293,000 to the Department of Community and Government Services to offset a budget shortfall for the Repulse Bay Pumphouse project.
Chairman: Thank you, Minister Peterson. (interpretation) Are there any general comments or questions on the opening comments?
If there are none, we will go to page 4 of the bill. Office of the Legislative Assembly. Capital.
Not Previously Authorized. Assembly Operations. Total Assembly Operations. $200,000.
Chairman (interpretation): Total Department. Not Previously Authorized. $200,000.
Chairman (interpretation): Page 5. Family Services. Capital.
Not Previously Authorized. Corporate Management. Total Corporate Management. $2,600,000.
Chairman (interpretation): Total Department. Not Previously Authorized. $2,600,000.
Page 6. Community and Government Services. Mr. Savikataaq.
Can we ask questions on the line items now?
There’s the $293,000. I just want to know what the total project cost was on the pumphouse.
Hon. Keith Peterson: Thank you, Mr. Chairman. Just before I answer that question, may I ask, with your permission, to bring in my new, old witness?
I thank Mr. Neish for his time at the witness table there.
Chairman: Thank you, hon. minister. (interpretation) Do you agree to bring in another witness?
Sergeant-at-Arms, please escort one witness out and the other witness in.
Mr. Savikataaq, if you can repeat your question, please proceed.
My question is: what was the total cost of the pumphouse project?
My calculations are approximately $4 million for the project total cost.
Chairman: Thank you, hon. minister. (interpretation) We’re on page 6.
Capital Planning. Total Capital Planning. Not Previously Authorized. $293,000.
Chairman (interpretation): Go back to page 2. Page 2.
Schedule 1. Capital. Capital Appropriation. $3,093,000.
Refer to the bill in your legislation binder, No. 4.
I believe you have Bill 4 in front of you now.
Bill 4, Supplementary Appropriation (Capital) Act, No. 4, 2013-2014.
Chairman (interpretation): While we’re on this clause, please refer to the Schedule on page 3.
In Inuktitut, it’s on page 4 and in English, it’s on page 3.
I believe you all have a copy in front of you now.
Schedule. Vote 2: Capital.
Total Capital. $3,093,000.
Go back to page 2 in Inuktitut.
Some Members: Agreed.  Chairman (interpretation): Clause 6.
Do you agree to Bill 4 as a whole?
Pursuant to Rule 62(2), does the committee agree that Bill 4 can immediately be placed on the orders of the day for third reading?
Bill 4 is now concluded. (interpretation ends) Hon. Minister, (interpretation) if you have any closing comments, I give you the opportunity.
I again thank yourself and your committee for your questions today in support of Bill 4.
I again thank my colleagues, the ministers, for being here to answer questions, if any, that were forthcoming.
I thank my witnesses at the table for their help in preparing this bill.
Chairman: Thank you, hon. minister. (interpretation) We can now proceed to Bill 5.
I believe all of you have a copy of the bill.
Minister Peterson, if you have any opening comments on Bill 5, I now give you the floor.
Bill 05 – Interim Appropriation (Operations & Maintenance) Act, April 1, 2014 to July 31, 2014 – Consideration in Committee
I am pleased to present Bill 5, Interim Appropriation (Operations and Maintenance) Act, 2014-2015, totalling $446,313,000.
Mr. Chairman, this bill is required in order to allow the Government of Nunavut to continue to spend money and keep paying its employees until the budget is approved in the House, which is expected to happen during the spring session starting in May of this year.
This interim appropriation is to cover departmental operations from April 1, 2014 to July 31, 2014.
The interim appropriation was calculated in consultation with all affected departments and territorial corporations.
It took into consideration both their previous maximum spending patterns over a four-year period and their cash flow requirements for the first four months of the fiscal year.
Bill 5 consists of the following items:
$7,300,000 to the Office of the Legislative Assembly;
$11,394,000 to the Department of Executive and Intergovernmental Affairs;
$21,885,000 to the Department of Finance;
$40,518,000 to the Department of Family Services;
$32,440,000 to the Department of Justice;
$8,571,000 to the Department of Culture and Heritage;
$72,923,000 to the Department of Education;
$85,028,000 to the Department of Health;