EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Are you going to be training the trainees using the traditional Inuit Qaujimajatuqangit methods?
Hon. Ed. Picco: Yes, Mr. Chairman, that is as part of the process and that is also part of the plan and we would hope to be able to expedite that over the coming months.
So, they are not using Inuit Qaujimajatuqangit, traditional birthing methods at the center in Rankin?
As I had indicated earlier, the birthing center right now is fully staffed.
There are three midwives and one maternity care worker at the center and a second maternity care worker will be hired out of this budget in the coming week.
So, Mr. Chairman, it is actually taking place and I want to be able to say to you that as of February the 25th, there were, I believe, 26 births in the past 6 months in Rankin Inlet from that birthing center, I think that is pretty good.
We are hoping to be able to expand that and we are planning right now, Mr. Chairman that about 100 births will be occurring in Rankin Inlet at the birthing center over the coming year.
So, I think, again as a Government, that the Department has done an excellent job in providing something that the Standing Committee and Members have been asking for.
Hopefully we can expand that process and that procedure across Nunavut in different areas.
Do the elders of Rankin Inlet teach the midwife trainees using Inuit Qaujimajatuqangit?
Mr. Chairman, the department right now is involved with the Manitoba health as well as Nunavut Arctic College in developing an education curriculum that will lead to the graduation of Inuit midwives, one of the things that the members have talked about, of certifying Inuit using Inuit Qaujimajatuqangit and we’re moving forward with that.
I also want to say that the member is correct, that we have been using elders and would like to include the development of a midwifery education curriculum involving elders who have knowledge or experience using traditional birthing practising in this case.
So the member is correct again.
I’m not trying to argue the point.
I just want to see the proper incorporation of Inuit Qaujimajatuqangit, if it’s going to be used right across Nunavut.
I was taught by and elder on birthing methods.
Inuit have a very practical practise of midwifery.
Do you know what those methods are Minister?
Mr. Chairman, I know some of the methods and the member knows himself that he may be from one community in one area of Nunavut and they may use and practise one type of natural child birth.
That’s not to say that it’s same one that they would use in the western arctic or in the Keewatin.
So I’m aware of two or three different cases.
I’m not a paediatrician.
I’m not a doctor or physician.
I’m not a gynaecologist.
But I would suggest to you Mr. Chairman, that we are aware in the department.
We have Inuit involved in the process.
We want to be able to expand it and we are taking the recommendations seriously.
That’s why we’re saying right now, Mr. Chairman, if the member said three years ago that you have 26 births in Rankin Inlet; it would be up to 101, fiscal 12 month period, that’s 100 women that don’t have to go south, that don’t have to leave Arviat or Baker Lake or Rankin Inlet and go Winnipeg or Churchill.
I think that’s pretty good news.
That’s something that wasn’t there before your government was in place, Mr. Chairman.
So we need to be able to put more Inuit Qaujimajatuqangit within the process itself.
But we are doing that with the midwifery program that we have in place.
We’re trying to expand.
So, I think that’s actually pretty good.
I think it’s a very good project because it’s well received by the people of Rankin Inlet but you stated that they’re using the midwifery practises of Manitoba so, I would take it that there are no Inuit Qaujimajatuqangit incorporated into the birthing practises in that centre.
Using these amounts of money are you going to find out the traditional midwifery practises and the taboos so that we can properly use this money.
Maybe I didn’t make myself clear.
Mr. Chairman, we are incorporated Inuit Qaujimajatuqangit within the work and I said Nunavut Silaktusarvik, Nunavut Arctic College is also involved in the curriculum development with the Manitoba Health.
The reason why we’re using the Manitoba Health is because there’s no other medical unit out of Winnipeg, is our partner in delivering health in the Keewatin Region, as the Baffin is with the Ottawa Health Services Network.
They have some good equipment, they have some good people.
There is a Midwifery Program that they have some expertise in.
And incorporating the best of both is giving us the opportunity to do that.
I just wanted to make that point clear.
The Member is correct again, it is a good program.
I want to thank them for being there to support this type program, not just today, but every time that we have an opportunity to discuss this issue in the House; he is one of the guys who really wants to see more Inuit Qaujimajatuqangit incorporated.
And I hope that we will be able to move forward.
We are not moving forward as fast as we would like to but we have, I think a real success here.
I want take this opportunity, Mr. Chairman, to thank the staff at the Birthing Centre in Rankin Inlet for the excellent work that they have done.
Like I said, over the last six months there have been over 26 births there.
Those are all mothers, wives, sisters, who have not had to leave their community to have a child.
I think that that is really terrific.
If we could look at the smaller communities outside of Rankin Inlet, have there been any traditional births in the smaller communities outside of Rankin Inlet?
Mr. Chairman, yes, there have been.
I would suggest to you that in almost every community in Nunavut, over the last five years we have had babies that have been born at the Health Centres.
For example, in some cases, they have been born at home, where a woman’s water has broke, for example, and we were not able to get them to the Health Centre.
In some cases, Mr. Chairman, as you know that in most cases, right now in Nunavut, one month, usually four or five weeks, just before the delivery date, a woman is sent from her community to Iqaluit, for example, or in the Kivalliq, in some cases, they are sent to Winnipeg, or Churchill, and in the west they are sent to Yellowknife, and if there are complications, they are sent to Edmonton.
Sometimes, Mr. Chairman, the baby will not wait, and they have to have those babies in the community.
In those cases, I know and I am sure that the Member knows, where the children have been born at homes, and then go to Health Centres.
But because of the risk to a child before a woman, would, for example, use midwifery services, they want make sure that it is low risk.
For example, we do not have the ability to do a blood transfusion in communities.
If the mother lost a lot of blood during labour, then you would be putting the mother in a very difficult position in communities because of the transference of blood products and so on.
We want to make sure that when mothers are delivering, that there is a low risk, not only to the mother, but also the child.
That is one of the complications that are in place with having a child outside of a medical situation.
Mr. Chairman, the Traditional Midwifery Program that we are running, right now in Rankin Inlet, is for low risk mothers so that we try to negate and mitigate those types of risks to both the mother and to the child.
I am keeping tabs on my time.
As the Minister has said earlier, there have been births at homes in the smaller communities outside of Rankin Inlet.
I know that in my community there have been healthy live births.
I have another question regarding is it possible to put emergency kits together to the Nursing Stations, for example, blood products etc.
Mr. Chairman, the situation with blood products, the Member makes a good point.
Blood products have a very low and short shelf life.
Which means you cannot store them for very long.
Just touching on it with Mr. Best the storage time is very, you know and because of that, you would always had to be turning the product over and not ensuring that you have enough on hand.
The health centers are prepared and had done an admirable job.
As you know, Mr. Chairman, they have most cases in incubators in place, for example, if they had to deliver a child and they had done that in the past.
However that is not the optimum circumstances.
The health centers are prepared to have a kit and everything to deliver children in the community, but at the same time, some of the staff may not be as that proficient in child birthing and so on.
So, that is the reasons why we want to get the mother out.
That has been the practise over the twenty odd years.
We use an large amount of money for the Department of Health and Social Services.
If we deliver babies in the community home for example, I am not sure how I am going to word it, maybe this way, How do they have blood products here and not for the other communities?
The Baffin Regional Hospital does have a small supply of blood products on hand.
In most of our communities outside of Iqaluit, there are no blood products available.
For example, in the Member’s community because of the high turn around time.
Mr. Iqaqrialu (interpretation): As you mentioned earlier, you said that you are going to be looking at other communities using Rankin Inlet, as an example, if we can have blood products for example, then the smaller communities will not have birth centers if it is not going to be feasible.
They stay away for a long time and leave their children behind.
Have you thought about what we can do to get out of this situation?
Hon. Ed. Picco: Mr. Chairman, the birthing center in Rankin Inlet was originally set up and I believe and I stand to be corrected with it, around 1993, Mr. Chairman, your Government, this Minister started the practise and in 2000, three years ago, we opened up the program so that, as the Member has just stated, we could actually do more births in Rankin Inlet, for communities surrounding Rankin Inlet, so, for example, a lady in Arviat or Baker Lake can go to Rankin Inlet and have their child.
Again, we think that that is great.
No, we are not going to be able to offer that type of service in every community across Nunavut.
However, if you can help a mother, I am sure the Member knows, if you could have the mother not have to leave Repulse Bay and having to go to Winnipeg to have a child that she can be in Rankin Inlet that is a lot better.
If you can help a mother, for example, not have to go from Pelly Bay to Yellowknife or Edmonton that would be a lot better.
And if we can help more women in this region, not having to go to Ottawa to have a baby, I think that is what we are trying to do.
And the Member is correct, that not only will it save money, but it is better for the family as well as the spouse and the children and so on.
So, we are cognisant of that and that is why this Government moved it three years ago to make sure that we expanded the birthing center to include communities surrounding the Rankin Inlet area.
Regarding the health of people, yes that’s true, that’s an improvement in services but it’s also ruins relationships when they have to go away for along time.
It’s raises animosity between relationships, especially when young mothers are away for so long.
It creates a lot of problems in relationships as well, when they have to go away for so long.
I have heard of cases Tammaatarvik and I frequent there.
I think that’s something we have to look into more and I’ll leave it at that.
But, under the same page, on another issue, I would like to ask under travel and transportation, $1 million 939 thousand dollars, the year before and now $936 thousand dollars.
What is the reason for the reduction?
Mr. Chairman, that was adjusted to reflect travel arrangements for social and the mental health workers for the community for escorts.
Grants and contributions, it says it’s for suicide prevention, $97 thousand dollars for the spring conference in May and on this page, in the estimations, for 2003/2004 I don’t see the estimates.
Mr. Chairman, the $97 thousand dollars was, the member is correct to help fund the Canadian Association for Suicide Prevention Conference that is occurring in May.
That’s why it is only a one year line item.
It’s almost $100 thousand dollars that we’re putting towards that conference.
On top of that, as the member knows, the Government of Nunavut is also doing their own suicide prevention workshop before that one.
Mr. Nutarak (interpretation): 2001, 2002, 2003, there were funds of $97 thousand dollars for suicide prevention on page 10-9, on the bottom part; there is none for this year for 2003/2004 fiscal year.
That’s the question. Did he allot those funds to another area?
Thank you, Mr. Chairman.  Chairperson (interpretation): Mr. Picco.
Mr. Chairman, the amount is there under 2002/2003 because it was paid out during this fiscal year before March 31, 2003.
This year coming up, 2004, which is what the Main Estimates are for, there is no conference, so there are no special funds within our budget of $97 thousand dollars to pay for.
It’s just recording what was expended for this year, and in the case that there are no conference next year that we’re going to be putting money into for the Canadian Association of Suicide Prevention Conference.
So I hope that helps clarify the question.
Where are you going to fund suicide prevention?
Especially, after that motion on the floor today, where are we going to get the funds for that task force?
Where can I find other funds being brought up for that issue?
Mr. Chairman, throughout the budget, under the mental health strategy that we talked about before, we had budgeted $2.2 million dollars toward that program which is also inclusive of the suicide prevention program.
The Taskforce that was in a Motion today, and I would suggest to you, a very important Taskforce.
It depends on how the scope of that Program goes, according to the Motion and I spoke to some of the Ministers about it earlier, if that means travelling around to communities, appointing the members that are talked about in the Motion itself, that Motion came after the budget was put together, so there is not the resources right now identified specifically for that Taskforce in this budget.
There is no line item for that Taskforce in the budget that the Motion talks about.
Mr. Nutarak (interpretation): In the budget, there are no funds set aside.
There is probably another explanation for the use of the Suicide Prevention Fund?
Mr. Chairman, there is several million dollars in the budget itself dealing with issues around suicide and suicide itself.
For example, the Mental Health Workers, the Training Programs, we are having Seminars, Counselling sessions, through the Mental Health Strategy.
So there is a whole group of dollars available within the budget framework for Suicide Prevention Programs, and Issues.
The line item that was there which was for one Conference.
The Motion of today, which was setting up a Suicide Taskforce, that was done after the budget was put together, so that is something that we need to be able to look at what the scope of that Motion entails, as opposed to this Taskforce, itself.
So the Member is correct, throughout the budget of the Department of Health and Social Services, several million dollars to look at issues surrounding and for suicide.
We are dealing with 10-8?
The Contract Services $15 million, 405 thousand, is this reflected in your Business Plan page 10-20, under the Out of Territory Hospital for $15 million dollars?
Can I get that clarification please?
Where is the Contract Services for $15 million, 405 thousand dollars, indicated in your Business Plan?
Those are for Residential Care Contracts, Foster Service Payments.
Like for example, for Foster parents, groups homes, like the Adult Group Home, that we have here in Iqaluit, the Elders Group Home that you have there in Baker Lake, Arviat, and here in Iqaluit.
The priority here in last year’s Main Estimates were insufficient to cover off all those obligations and that is why the revised estimates were adjusted.
Mr. Arvaluk: Maybe the Minister of Finance can answer that.
It is extremely difficult.
If you are not a member of the Standing Committee, if you are a member of the public for that matter, it is very difficult to find from your Main Estimates into your Business Plan, it does not really clarify anything either what reflects in the budget or the Business Plan.
The Business Plan figures differ from the actual estimates, because they are grouped differently.
Let me try the Compensations and Benefits, $12 million 4, under the same 10-8 Main Estimates, is this reflected in the Business Plan?
And is this for nurses and doctors and family doctors and the Healthy Children, Families and Communities, what are all these employees for $12 million 4 thousand dollars.
Mr. Chairman, Mr. Maychruk is getting some of the main details of the budget, so I’ll give you some examples of the positions that are included under healthy children, families and communities, you’re talking about social workers, you’re talking about health promotion, CHRs, residential care, you’re talking about dental care for example, Mr. Chairman, mental health, you’re talking about nutrition anything that involves healthy children, families and communities.
So when you’re looking at the budget of Health and Social Services, a social worker, you don’t have one category that says social worker; social worker maybe dealing with mental health issues or corrections, probation, maybe dealing with family issues and so on.
That’s one of the difficulties of this department because you’re doing a range of services.
It’s not like; let’s say education, where a teacher teaches.
So, that’s one of the issues.
For example, nurses, we have home care nurses, not just nurses in a hospital.
We have health care centre nurses not just nurses in an elders’ facility.
So there are a lot of different variants for the different cost categories and so on.
I hope that helps just explain a little bit better.
The clock is ticking away really fast.
Do you have some kind of success indicators for those services because I think the school has success indicators for their budget that the children are actually benefiting and learning from the instructions they get from the teachers.
With your program, social services, promotion of health etc., for $12 million dollars, do you have any idea if the programs are actually working?
Are things improving?
Do we have less suicides and less illness.
Is there some kind of indicator that you use in your department?
When you’re looking at the analyses of data, under Health and Social Services, you can’t do it in a snap shot of one year or two years.
For example, on the health promotion and prevention, the member may say I spend $8 million dollars in anti-tobacco programs, where’s the evidence.
You might not see that evidence for several years, until you see a drop in youth smoking and so on.
That’s one of the indicators.
Under social services, some of the work that’s being dealt with, when you see more children not being taken into custody through foster care or something.
Would that be an indicator of some of the work happening or would it be an indicator of something else.
So, it’s more of a non-descript way of looking at how it’s done.
If it’s a small amount, we don’t mind, it’s just that I think some days, some how, we’re going to have to have maybe one of these retreats to talk about where we want to go.
It’s a big department and we have inherited this from Government of the Northwest Territories.
There are some things that may need to be trimmed or done differently, more efficiently maybe, as in government terminology.
This is a whole lot of money and what I worry about is that you have approximately $700 million dollars, which is capped for the whole Government of Nunavut and every dollar in the budget.
It does not matter what kind of Department we have, we have to be accounted for, at least success measures or measurable success will have to be indicated sometime in the future.
We cannot just pay salaries and salaries, salaries without getting anything in return, at least something tangible or something we can see that is happening in terms of improvement, maybe five years from now.
You know, we want to be able to see success of that dollar that is spent from, I mean, we all pay taxes and Nunavummiut pay taxes.
It is not free money from the Federal Government, you know, we all pay taxes.
I think we only will want to see, we are going to attract some mining companies and things like that, that we will only want to start mineral accord and that sort of thing, that the money will be used for good reasons, for good use.
And compensation benefits, which are legitimate today, maybe we will have to review maybe to streamline or do things differently that may be more effective than now.
That is my concern, Mr. Chairman.
The only thing that is outlined in the other section of the page 10-9, that Mr. Nutarak talked about, grants and contributions for $3, million 945 thousand.
Nothing else is itemized, you know, itemized for shelter programs, alcohol and drug programs and suicide prevention conference, but nothing else is itemized.
Is there anything in the future, I mean we talked about the last three years, that you, Minister, are a good Finance Minister that, although this is a standard acceptable method of putting the Main Estimates, for young Nunavummiut, it really does not make sense.
Their plan and business plan, similarly has adopted itself to be as vague as possible rather than saying, okay, we have 26 communities, average of 4 nurses, this is what it costs us.
You know, okay, for how many doctors, 24 doctors or 25 doctors, here is what it costs us.
Something simple that we could help you with in convincing our people in Nunavut Territory, you know, try to live a healthier lifestyle.
Try to understand what is in the potato chip?
What is in the pop?
What is in the alcohol, tobacco or anything that is not healthy?
With this kind of budget process, it is very hard to talk about it.
I will have a hard time going home after we approve it, try to explain to people in Coral Harbour or Chester of what is happening, I do not have a breakdown, I do not have explanation of what this good money of $12 million is used for.
You know, and I need more clarity so that we too, as regular Members, can participate with your staff and promote healthy communities.
Some options of the things like you talk about Inuit Qaujimajatuqangit, birthing program, along these lines.
Right now, this is mind-boggling and not just mind-boggling, so many things are hidden.
Mr. Chairman, my last page, one minute left. Travel and transportation, you had $1 million,939 thousand last year, you have $936,000 this year.
What caused the reduction of travel?
Mr. Chairman, first of all, on the points that the member has made, there are good points.
I don’t know if the program review that was ongoing will be able to address some of the issues around programs and services.
The member is correct, a lot of what we’re doing right now in the organization came from the Government of the Northwest Territories and we’re trying to put our own spin on it, we trying to change it where we can and so on.
We’ve had some success through the decentralization and so on but it will be interesting to see how the program review shapes up to develop that.
On the level of detail in the budget, the level of detail that’s available is standard throughout different jurisdictions and indeed most members in this house have a better opportunity to see the budget than any other jurisdiction in the country.
As you know, the members don’t get an opportunity in other jurisdictions to sit down with budget briefings and so on.
You don’t even see the budget until it’s entered in your house.
In this situation here in Nunavut, the members actually have a chance to contribute to your budget, see the budget of the department by committee, line by line basically.
There are very few surprises in the budget when it comes to floor house.
After saying that, the level of detail that the member is talking about is available.