EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
How can the local DEAs work on this? I know it’s obvious they have policies that they have to follow under the Education Act.
The minister previously stated that Inuit Qaujimajatuqangit is being used properly.
However, if the youth are apprehended by social services, then they could be taken for months.
Using Inuit Qaujimajatuqangit, how can they be helped if an elder could talk to them or something?
As this issue is very important, I thank you for your question.
We had a day last week to recognize anti-bullying everywhere. Let’s also remember that bullying does not occur only in schools and we have to deal with bullying elsewhere it can occur, such as at home.
Parents should be involved when we deal with bullying cases.
The parents have to be involved because this is not just a school problem; this problem can occur outside of the school, which we hear often.
For that reason, they use Inuit Qaujimajatuqangit as their foundation.
Our schools provide assistance programs for the teachers to support the students and there are student support assistants and counselling services are provided.
Those are the frontline workers.
If the problem is more critical or serious, then there are people who work outside of the school like social workers that are used as a last resort if they cannot resolve the issue within the school using traditional knowledge. They use the policy to deal with the issue using traditional knowledge.
However, the only time they go outside of the school for services is when there is no other choice.
I would like to reiterate that as parents, we should talk to our children, reprimand and educate them to lessen bullying in Nunavut.
Tabling of Documents. (interpretation) Member for Uqqummiut, Mr. Keyootak.
Tabled Document 259 – 4(3): Clyde River Integrated Community Infrastructure Sustainability Plans (Keyootak)
I am very pleased to table this document today.
As I noted earlier this week, I recently had the opportunity to consult with the residents and community leaders in Clyde River. I am pleased to table today an update to Clyde River’s integrated community infrastructure sustainability plans.
I encourage all members to review this with care. Thank you, Mr. Speaker.
Tabling of Documents. (interpretation ends) Item 15.
Bill 32 – Supplementary Appropriation (Capital) Act, No. 5, 2015-2016 – First Reading
Hon. Keith Peterson: Mr. Speaker, I move, seconded by the Hon. Member for Arviat South, that Bill 32, Supplementary Appropriation (Capital) Act, No. 5, 2015-2016, be read for the first time.
Hon. Minister of Finance, Hon. Keith Peterson.
Bill 33 – Supplementary Appropriation (Operations & Maintenance) Act, No. 3, 2016-2017 – First Reading
Hon. Keith Peterson: Mr. Speaker, I move, seconded by the Hon. Member for Arviat South, that Bill 33, Supplementary Appropriation (Operations and Maintenance) Act, No. 3, 2016-2017, be read for the first time.
Bill 35 – Supplementary Appropriation (Capital) Act, No. 1, 2017-2018 – First Reading
Hon. Keith Peterson: Mr. Speaker, I move, seconded by the Hon. Member for Arviat South, that Bill 35, Supplementary Appropriation (Capital) Act, No. 1, 2017-2018, be read for the first time.
Bill 32 – Supplementary Appropriation (Capital) Act, No. 5, 2015-2016 – Second Reading
I move, seconded by the Hon. Member for Arviat South, that Bill 32, Supplementary Appropriation (Capital) Act, No. 5, 2015-2016, be read for the second time.
Mr. Speaker, this bill makes supplementary appropriations to defray the capital expenses of the Government of Nunavut for the fiscal year ending March 31, 2016.
The motion is carried and Bill 32 is referred to the Committee of the Whole.
Bill 33 – Supplementary Appropriation (Operations and Maintenance) Act, No. 3, 2016-2017 – Second Reading
I move, seconded by the Hon. Member for Arviat South, that Bill 33, Supplementary Appropriation (Operations and Maintenance) Act, No. 3, 2016-2017, be read for the second time.
The motion is carried and Bill 33 is referred to the Committee of the Whole.
Bill 35 – Supplementary Appropriation (Capital) Act, No. 1, 2017-2018 – Second Reading
I move, seconded by the Hon. Member for Arviat South, that Bill 35, Supplementary Appropriation (Capital) Act, No. 1, 2017-2018, be read for the second time.
Mr. Speaker, this bill makes supplementary appropriations to defray the capital expenditures of the Government of Nunavut for the fiscal year ending March 31, 2018.
The motion is carried and Bill 35 is referred to the Committee of the Whole.
[Consideration in] Committee of the Whole of Bills and Other Matters. Bills 32, 33, 34, and 35 with Mr. Akoak in the Chair.
>> House recessed at 10:54 and Committee resumed at 11:07
Chairman (Mr. Akoak): Welcome back.
Fellow Inuit, welcome to the proceedings.
Just a reminder to members and guests, being Friday, we have translators.
You can come up for air once in a while.
In Committee of the Whole we have the following items to deal with: Bills 32, 33, 34, and 35.
Hon. George Hickes: If the committee will allow, yes, Mr. Chairman.
To my right I have the Deputy Minister of the Department of Health, Colleen Stockley, and to my left, Executive Director of Corporate Services Greg Babstock.
Yesterday we were at page H-5. Public Health. Total Operations and Maintenance, to be Voted. $18,973,000.
Good morning, Minister Hickes and your officials.
Under Public Health I don’t have too many questions, but I guess for clarification first of all, can I get some understanding?
Under Health Protection you have environmental health officers and they do inspections on public places. I noted in your business plan on page 125, it says, “unsafe housing.”
That caught my eye.
How does the department work with the housing corporation if there’s a house that’s unfit for occupation, whether it’s for mould issues? How does the department go about inspecting public housing in relation to health protection?
It’s my understanding that when environmental health officers inspect private domiciles, it is usually at the request of either the homeowner, the landlord, or the Nunavut Housing Corporation to deal with a specific issue.
The way I understand it, there’s not a regular annual inspection per se as there would be in public facilities.
I guess an example might be, like the member mentioned, if there’s mould discovered in a unit, to determine what type of mould, whether it would provide a health hazard.
That would be an example of how we would work with the Nunavut Housing Corporation or a landlord to determine the safety of the dwelling.
Mr. Joanasie: Thank you, Mr. Chairman. I thank the minister for his response.
In addition to that, can he clarify? He mentioned about private homes.
Does this also not cover public housing units?
The way I understand it and I could stand to be corrected, the way I interpreted it was that any building in the territory could request an inspection from an environmental health officer if there are safety concerns with that dwelling or residence.
Let’s say a public housing tenant feels like their unit might be unfit for occupation. Do they go through your environmental health officers themselves or do they coordinate through their local housing association or authority? Can you explain how that would work?
Initially their first point of contact would be with the local housing organization or the Nunavut Housing Corporation. That being said, if they feel unsatisfied with the response, they could have an opportunity to contact the environmental health officer to request further follow-up.
Initially we work with local housing organization or the Nunavut Housing Corporation to address any concerns brought forward to them.
Mr. Joanasie: Thank you, Mr. Chairman. Thank you for his response.
Moving away from that topic, on population health, the minister talked a bit about some recent trends.
Let’s say, we have heard syphilis is on the rise and about five years ago there was an outbreak.
Can the minister give us some… ? Are there other trends in population health that are on the radar for the department?
With regard to chlamydia, gonorrhoea has also been a concern with regard to sexual health.
When we’re talking about different concerns from a public health standpoint, TB is still an ongoing concern in this day and age in the territory. We’ve had a well publicized recent outbreak of pertussis, which put a lot of strain on the health care system.
As always, this time of the year we deal with influenza outbreaks in different communities where we want to make sure that, through education opportunities, we talk about influenza vaccines that are available.
Again, as brought up in the last sitting of this legislature, RSV is an ongoing concern.
We had very recent dialogue with partners to continue examinations on mitigating practices that we could take as recently as just in the last month.
There’s an ongoing study with Health and Public Health to take a look again at opportunities for vaccinations and an analysis of cases, whether they’re increasing, decreasing, or what additional methods we can take as a public health agency to help mitigate some of those concerns, as just some primary examples, Mr. Chairman.
It was mentioned yesterday about the Maternal and Child Health Strategy. I’m not sure if this falls under that, but is fetal alcohol spectrum disorder part of that?
Does the department have a handle on our population in relation to FASD?
When we talk about FASD and maternal health, it’s a very important component of our education campaign to make sure that parents or people becoming parents are aware that what they’re putting in their bodies, they’re putting it into their baby’s bodies.
We want to make sure that all people are aware and they’re cognizant of it.
I know myself, as a parent, you want to make sure that your child has as many opportunities and positive outcomes in their life.
When you’re talking about FASD particularly, it can put some initial challenges in a child’s life that, in my opinion, are unnecessary to put on a child.
As an example, the Department of Health sits on a steering committee with Canada Northwest FASD Partnership and there’s work supported in four specific strategic priorities of preconception care, youth justice, addictions and mental health, and early childhood education.
We are very engaged on a national level and specifics to north. We want to make sure that we’re improving supports available to the children and their families. We also are in the process of facilitating FASD training and knowledge transfer in collaboration with Public Health Agency of Canada.
Again, it’s an obvious concern. If we can look at addressing FASD particularly as a topic, it would alleviate a lot of challenges in a child’s life going forward; education, employment opportunities, mental health and well-being, community health and well-being. It’s an important topic that we work very hard from an education standpoint.
I thank the minister for his response. I look forward to the department addressing FASD from a diagnosis and treatment point of view. I think it would have a great impact moving forward.
On another thing, Mr. Okalik talked a bit about tobacco reduction and your strategy. I want to ask the minister: what is the department’s position on smoking with a baby on your back?
This has been a topic amongst our smoking cessation campaigns of smoking anywhere in the vicinity of children.
A baby in an amauti is in the vicinity of somebody who is smoking.
I would strongly recommend that people, if they choose to smoke, would smoke away from their children.
Mr. Joanasie (interpretation): Thank you, Mr. Chairman. (interpretation ends) Thank you, Minister Hickes.
I agree with you. I think the department can put forward an extra public education campaign for the population to move away from having mothers and/or fathers who have a baby on their back to avoid smoking at all costs.
I don’t think it is at all healthy for the baby and the individual themselves actually.
(interpretation) Moving on to something else, (interpretation ends) the other topic I wanted to… .
On page 125 of your business plan, Population Health Information, you guys gather statistics on all kinds of health information, including the utilization of health centres, doctor visits, in and out of the territory hospitalizations.
Does your department differentiate between whether these visits and/or… ? Let’s say, keeping in mind we have a large medical travel budget for scheduled services, but also emergencies, does your department differentiate between what is preventable in these cases and/or that aren’t preventable?
It is more along the lines of preventative injury in the workplace or living opportunities.
We wouldn’t have the resources to be able to track every individual health centre or hospital visit or emergency care.
To be able to track that data specifically of what was preventable, there is even some question in what is preventable. Did somebody crash on their snowmobile?
It’s preventable if they wouldn’t have gotten on it, but you don’t always know what conditions arose to create that crash, as an example.
There are different things that we look at mainly like communicable diseases, cancer, and tracking of those types of illnesses or issues.
In moving forward, maybe the department start looking at that.
Maybe if we have some more emphasis on prevention, we could target a lot of health issues that are dealt with by the department.
We hear every year that medical travel, both scheduled and emergency, it seems to be growing.
I just wanted to make that comment and that’s all for now.
I appreciate the member’s comment and that is a priority and a focus of the Department of Health.
I had mentioned yesterday or it might have been the day before that we’re just in the final stages of our negotiations with our Northern Wellness Agreement.
A priority of that agreement is prevention and wellness, so it’s a recognized priority for the Department of Health.
I thank the member for his support on those initiatives.
I would like to start off by asking a question on page 126 of your business plan. You talk about the Northern Wellness Agreement, formally known as the Health Portfolio Contribution Agreement.
To begin, can you tell us what that means? What is this agreement?
It has been an ongoing agreement that we’ve had with the federal government.
A lot of it is under the First Nations and Inuit Health Branch.
It was a ten-year plan that’s just in the process of expiring and right now we’re looking at a new agreement on a five-year going forward.
Basically it helps develop community wellness programs. We work closely with Health Canada to make sure that we’re continuing stable support for community wellness plans.
My apologies, Mr. Chairman, I just got handed a note.
The previous agreement was five years. The new agreement is ten years. I had it backwards earlier.
When we’re looking at different discussions, like I said, it’s still in the process of being finalized on what the specific programming is.
In general, like I said, we want to make sure that our wellness programs are sustainable and we want to make sure that capacity that gets built behind this programming is something that can be stable and again, with a focus on prevention and wellness in general but community wellness.
The Department of Health has just completed an evaluation of Nunavut’s community-based wellness programs, which has guided improvements to further administration of those program dollars.
Can the minister tell us who did these negotiations on behalf of the Government of Nunavut?
On behalf of the Government of Nunavut there are a number of people as part of the team.
It’s not just with the Government of Nunavut.
NTI is at the table to make sure that we are addressing community initiatives and issues. We work very closely with Health Canada.
When the MOU is signed, it’s by all three parties: Health Canada, NTI, and the Government of Nunavut.
Does NTI get money out of this agreement as well?
Hon. George Hickes: Sorry, Mr. Chairman, I missed a part of that question.
Could the member rephrase it or repeat it?
Ms. Angnakak: Thank you, Mr. Chairman. Certainly.
Would NTI get money out of this agreement as well?
No, the intention of their engagement is to make sure that we are addressing community initiatives as well as just, again, like I talked yesterday, how important IQ factors are taken into consideration with this programming.
Not only as a department do we work with Culture and Heritage, but we work with NTI to make sure that we’re bringing forward a good governing structure using all three parties at the table to make sure that we’re providing the programs and the needs of the community are being address for community and personal wellness.
On A-IV-2, Detail of Projects Funded under Third-party Agreements, one of the things that I noted here is the Canadian Partnership Against Cancer.
We got a bit of money last year, $118,000, and this year there is nothing.
Since we’re all fighting cancer and it seems to be a growing disease in Nunavut, why is there no money there now?
When we put these documents together, we were using the information we had available at that time. The federal government still hasn’t put out their budget for this year, so we’re not aware of what programs are going to be available or how some of the factors can be taken into consideration.
Some have ongoing funding and others are one-offs or they have sunset or expiry dates where we renegotiate.
We anticipate that upon getting informed of what the federal budget is going to be and what programs are available, I can assure the member that we work very hard to make sure that we access third party funds on behalf of the Government of Nunavut and our clientele, the residents of Nunavut.
I guess it’s safe to say that dollars coming in under the Northern Wellness Agreement and perhaps other third party funding like the Canadian Partnership Against Cancer funds, because they’re not known, they’re going to be added then to the revenue than what you have stated here.
It’s on top of that. Am I correct?
It would depend on whether it’s Vote 1 or Vote 4. If you look in our pages and our budgets, there are monies that aren’t approved in the legislature that were funded directly through third parties.
If it comes through the Department of Finance through the revenue stream, then we would get it through them through Vote 1 funding.
It depends on what we’re getting and how we’re getting it. There are variables associated with that.
Yes, I was just making a reference to the overall picture. We don’t really know what the overall picture looks like right now, right?
There are other negotiations that are going to be happening.
In speaking about prevention of cancer, I think colon cancer seems to be really on the rise. I don’t know statistically if that would be supported, but it seems to be to me.
It says on 127 of your business plan, “Begin development on a colorectal cancer screening program.”
Is this not being done now?
I seem to hear of so many people who have that kind of cancer.
Is it because we’re not doing the screening and we’re only beginning to look at developing one?
It makes me wonder why we haven’t started.
I know there is so much need that we have in Nunavut and it’s not always easy, but I wonder why we’re starting so late with this one.
I know I talked about this a little bit yesterday.
Statistic-wise the member is correct.
We are much higher than the national average in cases.
We are limited, especially at the community level, of what type of screening can be done.
Like I had mentioned yesterday, we’re looking at increased access for one to colonoscopy as an example. There’s not so much screening as diagnoses being done right now. That’s one of the things that we’re hoping to identify programs going forward.
That being said, our priority and what my priority has been directed to the department has been to deal with our list right now of people that are waiting for diagnoses, colonoscopies and things of that nature. The waiting list is quite long right now.
I’ve had correspondence from people who don’t feel comfortable if they’re a high-risk individual through their family history or whatever the case may be, that they’re dissatisfied with the length of the wait time right now. That’s something that we have been working very closely with the department to make sure that we are addressing it and we are taking steps to get through that list.
We are also looking at different testing that can be done at home through different stool testing programs that we are exploring right now, especially with people in different communities.
The delivery process of the specimens and things like that are a little bit more complex than they would be in other jurisdictions.
It is something that we are aware of and we’re working towards making improvements in that.
I bring it to the House today because really, I actually know some people that have died from it because it was diagnosed so late and I see the numbers are growing.
When you talk about you want to address it, you’re taking steps to address it. What are you doing? What you are going to do?
Hon. George Hickes: Thank you, Mr. Chairman. My apologies on the quick, little delay.
We’re working very closely with Health Canada on this.
In addition, one of the things, as I mentioned, we’ve got two operating rooms located here at the hospital and traditionally only one has been in use.
It’s one of the things that I’m directing the department to look at opening that second operating room now that we have a second surgeon here with anaesthesiology to make sure that people have access to colonoscopy at a faster rate to get through the waiting list.
Like I had mentioned, we are looking at home kits that are available in other places with the screening process to get stool samples.
We’re still exploring some of the logistics behind making sure that those samples don’t get spoiled or how they can be transferred to the lab for testing.
We’re very active in working amongst the department with the resources we have, but also in discussions with Health Canada on how we can either accelerate or supplement some of our programming right now.
We’ve got a Vote 4 budget right now that we’re getting in fiscal 2016-17 to develop cancer screening policies and programs, as well as actual screening.
When I say we’re working on it, it’s not just lip service.
Is this a type of screening that you said you do at the hospital? You have a second operating room, so they can offer this type of screening.
Am I to understand there’s no way you can do it in the community, eh?
You need specialized equipment that only a hospital has?
I apologize; I was just getting confirmation of some details. At the community level there is, as I said, availability through stool sampling and things like that which would determine an elevated risk, so then they would go in for further examination such as a colonoscopy.
There are stages of screening that can be done and that’s where we’re looking at standardizing so that we can make a more effective campaign.
Ms. Angnakak: I’ve just got one last question on this topic.
How many people are on the wait list to get a colonoscopy?
I know when I first got into this chair, it was around 300 and I know it’s dramatically down from that.
I don’t have the exact number with me today, but we have been making progress on this topic.
It was one of the first directives that I talked to my deputy minister about when I took over and became aware of this waiting list.
Sometimes I wonder why it takes a minister to give that directive for something like that to happen. When you start to see the numbers like that, obviously something needs addressing.
Just to go on to page 127 of your business plan, it says, “Implement Phase 1 of the Community Health Development Coordinators and the Academic Enhancement Program.”
Can you just tell me a little bit what that means? What program is that?
Hon. George Hickes: My apologies, Mr. Chairman.
I think I missed the very beginning of what program she’s talking about.
I’m going from page 127, fourth bullet down from the top, “...the Community Health Development Coordinators and the Academic Enhancement Program.”
If you could tell us a little bit more about what that entails.