EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
I’d like to see this department commit to having escorts for all elders who are going out for treatment, out of their communities or out of their region or out of Nunavut.
They should have escorts who can speak in both languages to make it a bit more comfortable for them and also for the cancer patients.
Mr. Chairman, I would like to ask this question, would this department commit to having escorts for the elders and also cancer patients who are going out for treatment whether they are young or old.
Yes, your comments are very well taken.
Yes, we would like to assist and support everyone.
I, too, since I come from a smaller community I ran for the Member of the Legislative Assembly.
At times, I find the policies a bit too stringent.
So therefore I believe that they need to be amended after we review it very carefully.
I expect it’s going to improve a lot in Nunavut, especially when the regional hospital opens in Cambridge Bay and Rankin Inlet, that way the patients will be closer to home, and I believe we are going to reduce the number of patients having to leave out of Nunavut for treatment.
As I sit here as a minister for this department, I want you to know that I have a heart and I feel all the issues that are being felt in the community, and I have experienced it myself, and we have all experienced that.
We have seen people going through difficult times, especially for the individuals with cancer.
We don’t know who is going to get cancer, and any kind of illnesses doesn’t exclude anyone.
We can’t say when we are going to be sick.
Even at times, I get angry at the hospital because some patients go through difficult times when the public health opens for a certain amount of time, and they can’t see any people who don’t have an appointment.
We can’t say we can’t make an appointment or you can be seen that day at 9:00 in the morning, that’s when your appointment is.
But it’s not the case.
So, I ran to be elected for the Member of the Legislative Assembly.
I will strongly deal with the issue that you raised, and I will work with the ministers in the Cabinet, along with all of the Members of the Legislative Assembly, and we will use our officials to work on this.
I am not scared to charge them with issues, especially for the unilingual speaking people; I will work harder to service them, and I have also mentioned this to my officials many times.
Our client travel policy will definitely have to be amended, and that’s how I feel as the minister for this department, I will work diligently to provide better service.
The reason why we get kind of upset sometimes because we are concerned about our constituents, especially the elders and the patients with cancer, and we as regular members are trying hard to help our people, you know that, too, and we know that you are trying to do the same.
I am sorry if I had mentioned that the Health Department is not a playground, but we should really try and help the patients because I strongly support the people who are going out, especially for cancer treatment because they are the ones that’s got more worries than you and I; they are a lot more worried about their lives of whether they are going to live tomorrow or not.
They should be treated well.
Also our elders, they should be treated well, and that’s why we raise these questions and comments to this House because they are not only coming from us, we are told what to say and do, and that’s why we are trying to work together, and lets hope that things will get better from now in the second year because the first year was a learning year for some of us.
Like my colleague mentioned, the second year, we’ll be looking at things very closely.
I would like to thank you for making some comments here and answering questions.
I don’t think I heard a question.
Mr. Curley (interpretation): Mr. Chairman, I would like to ask the Minister a question in regards to the KPMG Report.
Have the recommendations been approved and which recommendations have been implemented.
Yes, we’re working on the recommendations and some of the recommendations have been completed and some of them are still being reviewed.
I will have my Deputy Minister, Mr. Blais, to respond to the question.
I know that he KPMG report had about 8 major recommendations.
Quite a few of them have already been implemented.
For example, all of the RFP, as quoted by one of the members earlier, have been developed and most of the contracts with airlines for medivac’s and scheduled medical travel are completed with the exception of the one that is currently under way with the Kivalliq region.
The recommendations that were made that have been put into the RFP process, so that part has been done.
The integrated coordinated call centre dispatch, which was another major recommendation, that process is under way.
We expect that this will probably be completed by the end of this year with a possible implementation in the early part of 2006.
So, that is underway and an RFP process is being developed as well using not all of the recommendations but many of the recommendations that are included in that Report as well.
So, the standards part that was recommended by a consultant was put in place.
The RFP’s for the airlines are basically complete with one final set of negotiations being done over the next couple of months.
The part that really is not going to be done right away, of all the recommendations is the training of local residents, medical flight crew, I think was a recommendation.
When I look at all the recommendations of the Report, they were very ambitious that all of this should be done in one year.
We’re three years later and we’re still implementing these recommendations.
The reason why I think this will not be done right away is because we have other priorities like nursing and physicians that are, I think at this point in time, more serious and therefore our efforts are being concentrated in those areas where we think is the highest priority.
We will include the training of medical flight crew, who are basically paramedics or nurses. I am a paramedic, so I know.
I’ve worked in the ambulance service for many years, so I speak with experience in this area.
This will take at least two or three years to implement that kind of an initiative.
We will put that type of training in place as part of our Inuit Training Plan which was again proven recently by cabinet in regards to our Care Closer to Home Strategy.
So, the only one that’s outstanding that’s not in process or underway yet is the training of medical personnel for medivac’s.
I think we’ve made substantial progress in regards to the implementation of the report, which is an excellent report by the way.
I thank the Deputy Minister for at least making progress with the status of the report.
I do share some of the recommendations that are really quite good in that report.
I just wanted to allude to an earlier statement by Mr. Whitworth.
As you will recall last fall, I believe, I alluded to the practice that has become a tradition where medical people in our region have become favouring one airline, and I did indicate at that time, they used to have an insider who was one of the staff members of one airline and so on.
So I think my colleague from Nanulik was indicating is there some connection.
So it confirmed what I was alluding to at that time; whether that practice had been disallowed and it was confirmed last fall that it had been disallowed, but after quite a bit of a large amount of millions of dollars worth of expenditures.
I do have one question related to the government’s practice.
Without the airlines having a real, solid contract for medical evacuation travel, what is the government’s policy or procedure with respect to stand-by air carriers?
There had been a practice, as you know, in the past, you have one major preference of one airline, but you have another airline when you don’t have a contract that you ask them to be on stand-by for such eventuality.
So what is the status of this kind of practice?
I will get my deputy minister to respond to that question.
If my recollection serves me right, it’s up to the person that has the medical evacuation contract or the company that has the medical evacuation contract to ensure that they have backup services in the event that they are not able to provide that service, I think.
It’s included in the contract that they have a responsibility to ensure that they have a backup service available in the event that they are not able to provide the service for various reasons.
If they are basically currently on a medical evacuation, they would have to have a system in place to do that.
So it’s up to the person who has the contract to make those arrangements.
Mr. Curley: I would think that would be the case, but in Kivalliq, they have not had a contract for many years, and so, there was an arrangement with pretty much guided by the Health Department that when there was more than one airline, so they have been asked to provide medical evacuation travel in the event of an emergency that only both of them were practically on standby.
So, was there any obligation as a government to have any kind of responsibility for ensuring that there’s fairness into awarding which airline should be given work during the months or any part of the year?
Chairman (interpretation): Thank you, Mr. Curley. Minister Brown.  Hon. Levinia Brown (interpretation): Thank you, Mr. Chairman. This was part of the discussion before I became the minister. So I am not too clear on it, so I am going to ask my deputy to respond. Thank you, Mr. Chairman.
In this particular case, there’s a provision that was put in based on the request of one of the airlines to either responder of first refusal, I guess is what I would call it, that they would be called first and be given that opportunity, but the arrangements in the contract are between the contractor, which is the current organization that has the medical evacuation contract, and the backup, if you want for that, that has the right of first refusal.
So in essence we included that, based on that request.
So, there is really no commitment on part of the government, the commitment is on the part of the medivac contractor.
Mr. Curley: Thank you, I have another question, I appreciate the deputy’s response with respect to the medical flight crew, that was one of the questions that I had in mind.
I appreciate that they do have a goal to try and include local paramedic training be allowed.
So with support that provision, so I appreciate that answer, for his response to the recommendation.
I have one question with respect to the management team that KPMG had recommended, they recommended at one point that there be a medical travel executive director, has that provision been in place or has that been accepted by the government?
I’ll ask my deputy to respond to that.
That position has not been put in place, we do have a director of client travel that is basically responsible to ensure that the policy that’s been approved by cabinet be implemented.
But as far as the executive director position, the answer is no.
The objective of the medical travel center will be to have an executive director responsible for all medical travel and it’s because we’re moving forward with the implementation of the medical travel center, that we anticipate, that will be the time and place where that position will be in existence, so it has not been put in place in the interim.
Mr. Curley: (interpretation): I’d like to pose another question, you also recommended, obviously, and I think it’s now being practiced in some regions, that there be multiyear contracts for medivac travel and so on, what do you mean by multiyear contracts and what conditions are there for these multiyear contracts, as far as the review process as far as the contracts are concerned.
Hon. Levinia Brown: I believe it makes more then one year, so that it’s not every year that they’re negotiating, but if they have reached an agreement for a three year period that’s called multiyear.
Mr. Curley: Could you be a little more specific because I do believe the medical travel, medivac travel contracts have been issued in the Baffin region area, perhaps even in Kitikmeot and Kivalliq are probably outside it, so my question is to be more exact, exactly how many years contract does it go for air carriers?
Mr. Chairman (interpretation): Thank you Minister Brown.
I’ll ask my deputy to respond.
Mr. Chairman (interpretation): Mr. Blais.
The contract duration for the two regions that have been done, both the Kitikmeot region and also the Kivalliq region are for a period of five years, and the reason I think five years is because the investment that has to be made by the providers, it’s quite extensive and three years would probably not be sufficient to attract these kinds of people and the service that we’re looking for, so I know five years is what we have done.
The current region, the Baffin region, what I would call the Iqaluit to Ottawa route, and up island are serviced by two providers currently, and the RFP for that one will be going out, I would expect sometime in May with the same specifications as was originally put in the other two for also a five year period.
So, that one is up.
That one was in place at the time that the KPMG Report was tabled so we are just in the process now of putting in place the new RFP on the sidelines.
We hope to have a contract sometime this year with the medivacs for the Baffin region and also for Iqaluit’s Ottawa route.
The condition with respect to the review process.
Is there a review that goes up that the government is going to look too annually, yearly, or is it only based on after the five year ends that you do consider whether to extend the contract to the current provider at that time?
Or is there at any given time there is a service that is not satisfying?
Are you locked into the five years?
Is there a mechanism where the Cabinet or you could recommend that something happens?
If that were to happen you know the process to make sure that services continue with the other or any other kind of carrier?
I want the members to get good information so I will ask Mr. Whitworth to respond to that.
The member’s concerns have been addressed in the current contract.
We have reporting mechanisms in there where they report incidents to the department.
Besides that there is what is called force major clauses in the contract.
There is breach of remedy contract clauses in the contract.
So if there are any defaults or any issues that arise we sit down and negotiate and if we can’t come to a result then a contract can be terminated.
That is through our Justice Department.
We work closely with them to pull these contracts together.
Chairman (interpretation): Thank you, Mr. Whitworth.
Yes, I appreciate your response.
That was what I was looking for. I appreciate that.
I just want to give a bit of a demographics in the regions as far as the airlines are concerned.
When in five years, many of the travel or health medivac travel will likely shift hopefully to Iqaluit.
In some respects I don’t want... (inaudible), I don’t know whether that will be within a five year period or not but eventually that will happen.
I know too that Winnipeg will continue to be a major centre for our region.
We do have one major airline that does fly directly from Rankin Inlet to Winnipeg.
That airline is quite important, particularly to the elders.
Is there a provision where you could allow some passengers that they are in such a state, elders that really should not be put through a mail run system.
That they be allowed that provision, that right or privilege be allowed.
I have heard this concern that if it’s a direct flight, it usually takes a little over two hours.
I am going to ask Mr. Whitworth to respond to that.
Chairman (interpretation): Thank you, Minister. Before we go on, visitors are here, especially when we get elderly visitors in the House, I would like to recognize Mikidjuk Bruce and his wife.
They are the parents of Manitok Thompson.
Thank you, for coming to the Assembly.
Mr. Curley (interpretation): Yes, we’re happy that she is my aunt.
Ever since we were toddlers, we used to go out hunting with them and we will see them later on and maybe converse with them later.
I wanted to ask further the response that the Minister gave, that First Air is used and we would like our elders to be able to use the First Air.
It gets tiring after a while that for the people that are traveling down to Winnipeg and going back home.
(interpretation) There are patients that go through agony that they really cannot.
They get exhausted for many reasons that the Member of the Legislative Assembly for Nanulik indicated.
There is a lack of amenities on the small airline.
First Air flies direct three times a week from Kivalliq, going down and back directly from Rankin Inlet.
There is no reason why that airline can’t be used for patients, who are interested in flying directly to Winnipeg.
So, we do know, unless a patient indicates that choice, they are not encouraged to go through that route.
Could the Minister or her officials assure Kivallirmiut that you will make that provision and try to accommodate more severe or elders be allowed to fly directly to Winnipeg.
You would do Inuit a real service and rather than just saying we support Inuit Qaujimajatuqangit.
This is your opportunity to say that you are in favor of Inuit Qaujimajatuqangit and you will respect the elders and the most severe patients to fly directly to the place where they’re heading.
I would very much like to support his comments and I have used that route.
For those patients who have respiratory problems or they’re in agony and that two and something hours, that’s more ideal and as the Minister, while I’m in this position, I would support that route and I would let Mr. Blais elaborate more.
We are currently in negotiations, so it would be very difficult for us to say yes, we will make a commitment to make sure that happens.
The commitment we can make because we are in negotiations is we will take that under consideration and work to try and achieve such an objective.
That’s the best I can do at this point in time without compromising the negotiation process.
Do you have any more questions at this time?
Mr. Tootoo: Thank you, Mr. Chairman. Under this section here, it deals with medical client travel and I understand that there is a policy in place that outlines what the patient travel policy is.
It outlines what the patients are allowed to do, if they chose to stay in private accommodations.
I would just like to ask the Minister or her officials if they could outline under the policy what patients are allowed to do under, if they choose to stay in private accommodations, as far as per diems go for private accommodations rather than staying either at a hotel or at a boarding home?
Just before there’s a response from the minister, Mr. Kattuk.
Mr. Kattuk (interpretation): I just had my hand up for the next questioning.
Some of the patients coming home, sometimes the boarding homes are filled, and they have to be billeted privately.
I think it’s up to them of where they want to be billeted.
I have heard in the Kivalliq Region that there will not be a boarding home in Rankin Inlet. Say for instance, some of them can stay in the hotel, some of them can stay at the bed and breakfast, and some of them can stay at their relatives’ place.
That’s as far as I know at the present time.
I know, here for example, I know our Minister of Education had numerous occasions in the past and indicated where he has had people stay at his house instead of at the boarding home here in Iqaluit.
If the client ends up in that private accommodations, it’s my understanding that the policy allows for a per diem to be paid to the people that are boarding the patient.
That the policy indicates that the rates are based on what’s set in the Collective Agreement for duty travel as far as private accommodations go.
I would just like to ask if that’s still the case or is the policy changed?
In order to try and attempt to answer Mr. Tootoo’s question; as of October 11th of last year, 2004, Health Canada’s Non-insured Health Benefits Program administered by the Department of Health and Social Services, reviewed and reduced the amount paid for billeting services in Nunavut to bring the rates more in-line with the rest of Canada.
However, this is what I have, but it seems like it’s going backwards.
Anyways, I have the rates here.
Current status as of October 11th, 2004, the billet rate changed from $75 per person to the following: from 0-3 years old $10, 4-9 years old $25, 10 years and over $50 per day.
It went down from what it was.
I guess this is in-line with the Non-insured Health Benefits Contribution Agreement that the billet rates were stipulated to the same as the private accommodation rate outlined under the territorial duty travel.
These rates have since 1998 from $13, $20, $50, and up to $75.
Now, as we speak today, they are $50.
The dramatic rise in the rates over the past few years, and Health Canada ordered us to review.
So that’s the information I have, and it seems very much like what my dad used to make in the 40s and 50s, $30 a month.
This is not like, we live in Nunavut so, Mr. Chairman, I would like to review this further because it doesn’t sit well with me.
I appreciate the Minister’s comments and I would agree with her that it is a step backwards and I question the authority of Health Canada to come in and change our policies.
The patient travel policy is a policy of the Government of Nunavut’s Department of Health.
As far as I know, that policy states the same per/diems as the duty travel rates.
If we were getting $75 from Health Canada before and now they’re only giving $50, then that other $25 for northern rate in Nunavut, should come from the Department of Health because for people that have someone staying at their place for all the extra food and driving people around to appointments and stuff like that, it’s very difficult to feed an extra person for $50 a day.
I know that you can go down to the store and $50 of groceries doesn’t buy you very much so I would ask the Minister to look into this.
There are cases where it has happened because I know it’s been brought to my attention which is why I’m raising it, that they need to go back and look, that if Health Canada change their policy, do they have the right to change our policy too.
I don’t know if someone would like to respond to that but I would like to ask the Minister or one of her officials if they could give us a better explanation on that.
We are elected officials and I said before that I would work as hard as I can to help and we don’t want to go backwards but I feel that this is a backwards decisions.
I have thought about talking to our MP Nancy Karetak-Lyndell and to talk to the federal Minister.
I have seen him numerous times and I would like to write him a letter in this regard.
Perhaps if the members can help me, I’m encouraging the ordinary members.
I don’t think we have a quorum.
Chairman (interpretation): You’re right, Ms. Brown.
Mr. Tootoo: Mr. Chairman, would the Minister commit to reinstating it back to a rate that this government feels that $75 is a fair rate for private accommodations.
Would they look at bringing that back in line right away and in the interim while they try to continue to try and work on Health Canada to try to get them to increase their amounts back up as well.
Hon. Levinia Brown: Thank you, Mr. Chairman. If you could introduce a motion to possibly ask the Federal Government to restore the rates back for Nunavut for the billeting purposes.
I would have no problem with bringing in a motion like that, but in the interim we all know how long it takes to try and deal with our federal counterparts in Ottawa.
In the interim, until something is done, would this government look at reinstating that fair rate back so that people aren’t losing money in looking after people that have to travel down here for medical reasons.
I will get Mr. Blais to respond to that further.
Chairman (interpretation): Go ahead, Mr. Blais.
Yes, we could introduce that on an interim basis while we work towards negotiations.