EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
There's more than half a million dollars you know, to, I guess, what I'm saying is that in the past GNWT made a generic model for most of the schools in most of the communities is there a similar thing, do we have any kind of reference that can cut down costs on designs.
When you total up all the capital designs in Public Works & Services and elsewhere that amounts to a few dollars that could be used elsewhere, is there anything that the government can dream of to cut down on design costs.
If you look at the budget for the 650 for Igloolik and the 650 for Pond Inlet and following down the page to 700 for Repulse, you'll note that the money there for those three communities, the plan is to give us the design for facilities that we can use.
The concern my understanding is Mr. Chairman, the concern is that with health facilities you really can't just take one off the shelf and build them like schools, because each community seems to be quite different on the needs and so on.
But that's a good point and it's well taken.
Mr. Arvaluk: Mr. Chairman I asked the question if the government could dream up something to cut down on costs, that was my question.
Hon. Ed Picco: Yes, Mr. Chairman.
Mr. Arvaluk: When will the yes be activated or are we expecting for next year for other centres.
Mr. Chairman, the Capital plan as I indicated what programs what projects that we are bringing forward.
Is there a specific question on a specific project.
If the member re-asked his question.
I didn't quite understand the question.
That was the same question that I was going ask as the member for Nanulik.
Because Igloolik and Pond Inlet have similar hospitals or the nursing stations, it seems like the plan or design of the Igloolik health centre and the design of the Pond Inlet, one design should be used, because the money to be used for those designs are almost identical.
I would like to ask a question on the new women's shelter and new treatment centre renovations.
Is that the new Arviat women's shelter, and the youth treatment centre renovations.
Are they just in the Kivalliq region or could they be utilized by people in the Baffin and Kitikmeot regions.
For the women's shelter in Arviat, the Hamlet has come forward and has said they'd build a safe shelter in the community.
So there should be Federal funds to help us with this program, to help us renovate an existing building.
However, they needed some help in Arviat.
It is a community driven program to help them do a needs assessment and functional program review for what they need Mr. Chairman.
So that is what this money is meant to do.
It is to help the local group on this matter.
Maybe I'll say my question in English.
The Arviat women's shelter. Is that for the whole region of Kivalliq.
Is that for Nunavut.
Is that for just the community.
The youth treatment centre in Baker Lake.
Is that for Baker Lake only or for all of Nunavut.
Mr. Chairman, the building in Arviat for the women's shelter is for the Hamlet of Arviat specifically.
The project for Baker Lake Mr. Chairman, the children's group home is currently being renovated in order to provide programming for youth with higher levels of emotional and behavioural problems.
So the renovations are taking place in this capital plan as it is for security reasons and this facility takes clients from across Nunavut.
Health and Social Services, branch summary.
Total Qikiqtaaluk region, 1 million 315 thousand.
Total Kivalliq region, 750 thousand.
To the next page 10-8.
Health & Social Services, branch summary. Directorate.
Total Kitikmeot region, 850 thousand dollars.
Total building, and works 2 million 915 thousand dollars.
Health & Social Services.
Branch summary. Directorate.
Equipment acquisition, 1 million dollars.
Ms. Williams (interpretation): My question is under telehealth.
I'm just wondering where this will be located.
Mr. Chairman, as it indicates there, the plan would be to bring on line in several different communities the equipment and the infrastructure needed to support telehealth.
Sometime back, I named some of the communities.
This will be used with the matching funds that we've heard just recently from the federal government, 3.7 million dollars.
So it will be all across Nunavut, in selected communities.
Perhaps he didn't understand my question. (interpretation ends) Nunavut communities, could you tell me Mr. Chairman, which communities is this for.
I know it's not for 27 communities.
Mr. Chairman, we haven’t selected the communities yet for the sites.
It depends on the bandwidth the other infrastructure we use.
I have heard though, Mr. Chairman, quite clearly from the member the concern with the North Baffin communities that she represents and that's something we can look into to see what's in the program.
Right now we have the telehealth services in three Baffin communities and two in the Kitikmeot.
We're trying to use this money in conjunction to hook up some of the Keewatin too and some of the other communities.
I do have a list of the communities.
But I don't have it with me right here and our officials don't have it.
So that's something I can have for the committee tomorrow.
My second question is that various Qikiqtaaluk communities for equipment and vehicles.
What are the criteria to get vehicles in the communities.
As you know, my communities in the winter are very cold, very dark and I had a request from one of the nurses to see if they could get one.
What do you need to do to get a vehicle in one of the communities.
Before I move to the minister, 10-7, 10-5 and 10-9. Once we've completed 10-9 we'll be going out or taking a break and having supper.
Mr. Chairman the process that we have in place right now in the Department of Health and Social Services is that we have a regional director for each of the regions.
For example, if a nurse in the community makes a recommendation that she needs a vehicle based on the need being brought forward by that nurse then that is how the decision is made at the community level, if the community needs a vehicle or not.
But of course dependent on how much we have available in the budget.
When you see that amount equipment and vehicles, only a small portion of that would be vehicles, the majority would be extra equipment for the health centre.
For example if the social worker was in the job and could use computers there, it could be any X number of things.
Mr. Arvaluk: For the telehealth, are these geared towards the decentralized communities only where there is a satellite link for the e-mail services and everyone else is excluded.
No Mr. Chairman. It is not determined for where we would be placing the telehealth if it were decentralized or not.
The determination is made on the three or four different evaluation criteria from the telehealth group which would include, do we have the technological ability on the ground to be able to hook up to the telehealth network, do we have the infrastructure on the ground, are there some people there that can help us with the equipment.
Does it have internet service and other wired and unwired services at this point in time and also on the case load at the health centre or mental or social work the department is involved with.
So, if we have a community where we have a heavy case load where we may decide by evaluation that the person, the doctors themselves are in charge of telehealth right now, which would be the best place to put it and those are the types of criteria that are used.
I guess my concern is these, six million dollar man, do you have technology in place like, dishes, what ground equipment do you use to make it possible for non-centralized communities to be serviced by telehealth.
Not just computers but how you get to the satellite system and things like that.
Mr. Chairman that's a very interesting question.
I think I'm not a technical person when it comes to satellites and so on but what I can say to you Mr. Chairman is that every community in Nunavut has the ability to have access to a satellite.
So when we are talking about telehealth what we are talking about having the receptor, let's say when you’re calling them for an example where we have a system set up. In Pond Inlet we have a system, when the cardiologist in the Baffin hospital in Iqaluit needs to be able to do a diagnosis, the system is uplinked from Pond Inlet by satellite and then dialled to Pond Inlet.
The carrier itself may go through Yellowknife, for example, because they have the infrastructure abilities there right now and that's part of the cost.
The other cost Mr. Chairman, is renting time on the satellite to be able to provide the signal.
So a detriment or a deterrent is not on the side of the community, but that's a good point that the member was making from the high arctic.
Grise Fiord if it had the infrastructure in place could have this connection.
It would be on the size.
It is based on the ability of the determinants that we talked about.
So that is how it works.
To the uplink, to the ground station, which would be in Yellowknife and transfer, back over for example in this case to Iqaluit.
That is the laymen's explanation of the infrastructure in place.
In here you have CBC and everything else.
I am talking about places like Grise Fiord.
What can you use there.
Are you going to use NWT, CBC to do your uplink and connect to Yellowknife through satellite.
When you look at Grise Fiord.
The last time I was in Grise Fiord they had cable television and that was in November.
They had the dish and so on.
Once they have that in the community that is why it is every community in Nunavut basically now has a satellite dish for cable or radio or any other telecommunication that need.
The opportunity is there then by using that dish or any other associated dish.
It could be through NWT.
It may be an agreement with Ardicom or one of the service providers to be able to give us that capacity to deliver telehealth.
That is only one of the factors that are involved.
That is how we would be able to do it.
Again Mr. Chairman, I am not an expert in this.
I am just giving you some of the briefing that I've had with the department.
When it comes to telehealth and how we are able to do stuff with the stuff that we have.
I don't have anyone on my list.
We will go back to Health and Social Services.
Equipment acquisitions.
Headquarters region, 1 million.
Total Qikiqtaaluk, 200 thousand.
Total Kivalliq region, 45 thousand.
Total Kitikmeot region, 40 thousand.
Total equipment acquisition, 1 million 285 thousand.
Total capital expenditures, 4 million 200 thousand.
Carried. 10-10 is just distribution of budget.
Go back to 10-6.
Go back to 10-5.
Health and Social Services, program summary.
Money is not a question.
What I would like to see from the department is when you are proceeding with your plans as doing Public Relations work with the selected communities that you explain to them not to have the attention of the newspapers but to have the attention of the potential patients about user friendliness and cut down on travel costs etc.
But the way the laymen, you and myself can understand, appreciate, rather than just getting headlines in the newspapers.
That's what I'd like to see being explained totally to the communities.
The member has made a good point and maybe when we get to the operations and maintenance, we'll be able to maybe do a response on some of the member’s opening comments.
Some of the good comments that we've heard around the table and that's a good one too.
Total capital expenditures, 4 million 200 thousand dollars.
We will now take a 20-minute break.
Supper is now being served in the Tuktu room.
>>Committee recessed at 5.16 p.m. and resumed at 5.48 p.m.
Chairperson (interpretation): Thank you, we can start the meeting.
Is it the wish of the members to begin the review of the department of Health & Social Services main estimates and start with 10-6.
Under the contract services.
What do we contract.
Mr. Chairman, depending on the contract, it could be a contract for the administration, it could be a contract for personnel, for services being delivered by the department of Health & Social Services.
I have a question regarding the grants and contribution 896.
It is on page 10-7. I’d like to move there if possible Mr. Chairman.
We will be returning to that page 10-7 then.
On the 600 thousand dollars for the Nunavut nursing program.
Are there any plans to improve.
First of all I should ask have you learned of anything that should be improved in the nursing program.
The member deserves some of the kudos for helping with this program.
Indeed as the former Minister of Education, you supported it with the 600 thousand dollars from Arctic College.
What we have found we just did a review with Dalhousie which is the University which we are using their curriculum and other support Mr. Chairman.
We have just finished a review of the academic standards as well as the curriculum that they are using.
The review went quite well.
I guess the big problem that we are having in the nursing program itself is the retention issue.
This one that has come up.
I just recently talked to some of the nursing students and the Minister of Education on some of their concerns.
That was discussed in conjunction with the Education budget.
Mr. Arvaluk: Thank you, Mr. Chairman. Will you be working with the Department of Education in correcting some of the deficiencies in this delivery especially in the retention of students and why some have been quitting.
As Mr. McLean says that is the only answer we have for the shortage of nurses in Nunavut in the long run.
We don't expect the government in the short run to make a miracle changes from the GNWT to now.
So I think we are patient enough at least it took us only 30 years to get land claims. So I think we will be patient enough to have long-term goals. I would like to see better compensation and retention plans including living allowances, student financial assistance similar to that of the law school program.
I am not only talking about the nursing program.
There are other professions too that could be looked at instead of the traditional University starving to death kind of attitude from adults and grown up people.
I had hardship.
I passed through it and look at where I am now.
That is our attitude because we went through it.
I spent a good 10 years in the south and I don't wish anyone else to go through that.
Instead of boasting about it, I think we should be concentrating.
Ok where did we not like it ourselves.
Where we can improve it so that we can have successful completion rates.
The other member brought this up earlier too.
We need to be able to look at programs and support services that are available for students.
All of our students.
Most of the students that we have in Nunavut are adult students and they are not like students in the south where they are 17-18 years old going into University.
The majority of our students are married.
They have children and they have all the other administrative problems of becoming students and need to get more support and that’s something that we found.
Right now we have eight students in the access year, three in the first year, two in the second year of the program.
So actually we have 13 students right now in the nursing program.
We need to be able to make sure that we retain those students and the member has made a good point.
Just recently Mr. Chairman, the Deputy Minister of Health and Social Services has met with the head of the college campus here to specifically talk about some of the concerns that we have with the nursing program and funding and retention issues.
We're on page 10-7.
If there's no further questions we'll then move back to 10-6, Health and Social Services, directorate. Total operations and maintenance, 16 million 862 thousand.
Total expenditures, 21 million 62 thousand. Agreed.
Health and Social Services, branch summary, 10-8.
Healthy children, families and communities, 19 million 865 thousand.
Mr. Arvaluk: Does this 11 million 606 thousand contract services also include dental programs in the communities.
Probably most of it now that we had a big problem a while ago in Kivalliq whereby the Kiguti Dental company took over and removed our dental therapists from the communities.
That had a devastating effect on the children who were receiving care on a regular basis from the dental therapists with dental problem prevention programs and tooth brushing and that sort of thing.
Have we gone back to that dental therapy program in all the communities rather than getting twice a year visits from Rankin Inlet.
This is part of the questioning that Mr. McLean had asked in the House over the last couple of days under contract and the dental services.
It seems the member was correct when we look at the numbers we can see the numbers have actually fallen for visits from what was previously there, what's there now.
I'm going to have an opportunity to actually go into detail on the opening comments by the members.
But I wanted to point out that one of the things that we are trying to do under the Department of Health and Social Services, is over the last two years, is to set up that practice unit, that best practices unit in Kugluktuk.
That best practices unit is going to review all of the contract services; ophthalmology, dentistry, look at our social workers and so on. In that office we have a dental specialist who will announce for the first time a review of the programs and contracts and so on and see where we are and what types of dental programs we are delivering.
Under that contract services, the member is correct, dental services are included in that amount.
I would like to remind the members that in our rules we should not name company names or individual names during the proceedings of the House.
We'll leave it general, we will just use general comments and not name specific company names or individual names.
Mr. Arvaluk :Thank you, Mr. Chairman. In that case, the member from Baker Lake alluded to stating that these dentists who are visiting the community do not finish their work.
I think you remember, sorry, that I called your office from Coral Harbour because two seniors were missed out because they did not properly meet the appointment from the dentist for denturer. The one who was there refused to do the work on them because they did not have proper appointments with him when he was still in Ottawa just about to come up to Coral Harbour.
It's bad enough for us who are able to understand English a little bit who try to get through all the channels to get our appointments let alone a senior doing it.
I would like to ask, will you be instructing you contractor dental workers to follow your opening remarks, to deliver flexible, culturally sensitive programs and demonstrate effective use of public resources by not omitting them simply because they did not make a proper appointment before the dentist comes.
I think these are small things.
But it has a bad effect or relationship between the dental program of the government and the patient in the community who will not be visited again for several months.
Mr. Chairman, it's been two short years since April 1, 1999.
Under Health & Social Services, we've inherited an 8.9 million dollar, last year, debt with the health board.
We've integrated them into the department.
We're setting up our best practices to do exactly what the members have been talking about. The member, what James is talking about right now.
It is not acceptable that when we have a dentist in the community, just because someone didn't have the opportunity to make an appointment, especially a unilingual elder, that they're passed over.
That's something that we need to be able to follow up.
That's why we set up the best practices unit in Kugluktuk as part of our decentralization.
In the past, the three health boards had different policies for different programs and services.
We want to make sure that we have the same policies and programs across and access to those programs and services for all Nunavummiut.
Mr. Chairman, as the members said in their opening comments, quite a few of them, I haven't had a chance to deal with any of the comments at this time.
But maybe we will a little later on this evening.
We need to be able to have some ongoing improvement and to make sure that instances like James just talked about, that the member talked about, don't happen.
Health & Social Services, branch summary. Healthy children, families and communities.
Total operations and maintenance, 19 million 865 thousand dollars.
Total expenditures, 19 million 865 thousand dollars.
We'll move on.
Health & Social Services, branch summary. Health insurance programs.
Total operations and maintenance, 226 thousand dollars.
For the contract services of 26 million.
Does that include only the treatments outside of the jurisdiction or does it also include payments to doctors in Nunavut that are the direct staff of the government.
If they are not direct staff of the government then what portion of the doctors are on contract with private practices in Nunavut.
Mr. Chairman, under the contract services.
There are earnings that make up the 226 thousand dollars, one of the out of Territory hospital costs which is the reciprocal billing the member talks about.
That is 15 million dollars.
The extended health care cost would be about 300 thousand. I believe 300 thousand.
The non-insured services agreement would be 10 million 926 thousand.
For the total of 266 thousand, the services for the 4 million dollars that has been in here we’ve moved that to the treatment branch to more accurately reflect the cost of treatment services provided to Nunavummiut.
I've been looking through the estimates here.
In this case does this include the transportation like medivacs and things like that.
Hon. Ed Picco: No.
That is the treatment branch.
I have no further names.
Health insurance programs.
Total operations and maintenance, 26 million 226 thousand.
Mr. Chairman, can the minister explain why there is a 4 million dollar reduction in that program Thank you.
Mr. Chairman, the 4 million dollars as I earlier stated, the 4 million dollars was with the physicians contracts and that was moved to the treatment branch to better accurately account and explain to Nunavut patients.
So that 4 million dollars reduction is the physician services contract.
That has been moved to a different line.
That is now called the treatment branch.
This health insurance program for non-insured health benefits.
Is that 100% refunded from the Federal government.
I have another question after that.
Mr. Chairman, there is a cap there.
The cap is 10 million 926 thousand dollars.
That is the agreement that we have with the federal government up to that maximum of NIHB for Inuit.
That is part of the negotiations that we are involved in right now as a department with our federal partners.
We believe there are more items under the non-insured health benefits that they should be covering for Inuit.
So that is part of our negotiations.
So, the cap is 10 million 926 thousand.
I don't want to ask a whole bunch of questions in this forum but can the minister supply us some information down the road, maybe in Cambridge Bay, that there are some treaties, Indian treaties that included Inuit under the health section of the Indian Act.
The federal government, has judiciary responsibility to look after the health and education of that I think it's an 1867 act.
I don't know what year it is but I forgot.
Why do they have a cap with that Indian act.
Secondly, what happens when the Nunavut population continues to grow, will the cap stay at 10 million when your costs go up to maybe 100 million dollars down the road. We don't really have time right now because we are all homesick but can the minister sometime, give us a briefing in the briefing room so that we could have an unbiased, non-political discussion on where we are going with our health programs.
At least health insurance programs.
Mr. Chairman, the member is correct, the federal government can't abdicate its responsibility for Aboriginal people, in our case, Inuit people in Nunavut.
The problem goes back to 1988 when the health care transfer agreement was signed between the NWT government and the federal government.