EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Just talking to my officials here, they think it would probably be fine if we could agree to go back to October 2007, the start of this last Client Travel Policy. We would have some data from then and we could come forward.
Mr. Enook (interpretation): Thank you, Mr. Chairman. That leads me to expect this information to be tabled in the future for our review.
I appreciate that, Mr. Minister.
Finally, I am thankful for the answers provided as Nunavummiut can now understand what these policies state. I’m not stating that I agree wholeheartedly with all of them nor do I disagree with all of them.
At least it really helps to get this clarified and I thank the minister for that.
So the last question that I want to raise, which is a result of discussing medical issues with my colleagues and Inuit from all over Nunavut, is why we are hearing the same things over and over in the communities. My colleague, Mr. Tapardjuk, touched on this issue. Whenever anyone feels sick, their first thought is to book an appointment at the health centre.
In most cases, people are being told, “You’re fine” or “All you need is two Tylenol and you will feel better.” Doesn’t the department consider these?
I know this is not the first time you have heard about it because it has been an ongoing issue.
However, we’re starting to hear it all over. It’s not just in Pond Inlet or Igloolik. We’re hearing it from across the territory.
When a person feels sick, they go to the health centre. People know their own body and what is bothering them. The only thing people are not hearing is, “You are lying.”
What’s wrong with the scenario here?
Where is the bottleneck in this system?
Thank you, Mr. Chairman. I am finished.
I’m not sure how I can answer that.
I know, right across Nunavut, in every community, we have a lot of hard-working and dedicated health professionals, nurses, and physicians, when they visit, who work very hard to provide care and treatment to all the people who come to health centres and hospitals.
It’s a real challenge. We do live in a territory that’s two million square kilometres and three time zones. We’re really challenged.
I understand that people are concerned about their health and I just don’t know how to respond to questions about… .
I couldn’t imagine nurses or doctors telling the patients that they’re lying about their health because people who get into health professions, they get into it for a reason.
They want to help people stay healthy and get healthy.
They’re not going into those kinds of professions because they don’t want to help.
Chairman: Thank you, Minister Peterson. (interpretation) I believe that was your last question, Mr. Enook.
I wasn’t going to speak to this issue, but there are continual complaints about these issues, which I believe all members are informed about, especially regarding elders.
Elders are still fearful of going to the health centre. Many of them fear their upcoming appointments at the health centre.
If elders are not made to feel welcome, it is unacceptable as an Inuk.
I believe that we need to study this very carefully and resolve it.
The number of people going out for medical travel keeps increasing for appointments as many medical ailments cannot be treated at the local level, especially in cases where people have major health problems.
This has to be completely understood and this is why the concern is brought up time and again.
I just heard recently today on the radio about issues discussed at the Baffin mayors’ meeting regarding this matter.
My thinking on this is perhaps the minister could task his officials to remind all health care workers to have a welcoming attitude in our communities.
How can the minister provide more assistance to the local community where people feel they’re not receiving proper health care? If people feel they’re not getting proper service, can an official visit the community to discuss the health issues faced by the community?
Is the situation at a point where, when people know that nothing will be done, they don’t bother going to the health centre since they know that they will just be told that they are fine?
Now it’s becoming a bigger problem because it’s leading to people developing sicknesses that could have been caught, at least from my perspective.
When you have been in the field for a while, eight years in my case, this concern is brought up and I hear about this concern.
If I were to go on the radio in my hometown, that is what my constituents would pass along.
Can the minister at least task his department and his health professionals to be more accommodating to Inuit when they believe they’re sick? The only time Inuit go to health centres is if they feel there’s a problem with their health.
I would like to have that clarified.
Mr. Chairman, over the last three days, we have talked about public health and health in the communities. Our health centres are called community health centres. I appeared before the Baffin mayors yesterday and heard similar concerns.
Just in response to Mr. Enook, I did indicate that health professionals are in the business of helping people stay healthy, get healthy, and care for them.
I don’t believe that health professionals would deliberately turn away people or work towards trying not to help them.
I mentioned to Mr. Ningark yesterday and also to the Baffin mayors that if we have health committees in the communities, if they become more active and more vocal in their communities, work with the hamlet councils, and work with interagency groups, I think things could improve where they’re not working good now.
I heard yesterday at the Baffin mayors’ [meeting,] one of the mayors said that it’s important for the community health centres and other organizations to work together in the communities.
As department officials here, we will certainly continue to communicate that to our health officials and other officials in the Department of Health that we’re here to help people and to work with them in the communities.
We hear that standard response, but I believe we need to make a better effort to resolve the issues.
Whenever other departments experience issues with their programs, their answer usually is that the matter is under review, that the review will be completed in such-and-such a time, and that the report will be tabled at this particular session.
Whenever we debate health issues, even though our residents have major concerns with the health system, the system has never undergone a thorough review, especially at the community level.
With respect to this issue, can the minister expound on whether his department will conduct a review of the system or will the current system continue as is, without any changes?
Many people who are experiencing health issues are starting to feel unwelcome at the health centres, especially elders or unilingual Inuit who cannot communicate their symptoms as most physicians and nurses are, for the most part, unilingual English speakers.
Due to that reason, I ask how we can improve this situation in the communities so that people can go to the health centre without feeling fearful and to ensure that the government is providing proper health care.
Can the minister think about making improvements to our current system?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Curley for those questions.
Again, just to go back to my last answer, if we had better relations in the communities working with health committees of council, working with the hamlet council, work on developing interagency relationships so that everybody… .
We’re all working together in the communities to help each other. Through the interagency and health committees work to facilitate the understanding of each other’s roles and responsibilities, and how to help each other, I think that would be one way to help that.
Yes, that may be so and that ought to be the case as I know that some members really do try in these committees.
What I’m trying to ask of the minister is that other departments, for example, the Department of Education, conduct a review whenever problems crop up in the system and present recommendations to resolve it. Last week, there was a motion on the floor momentarily to that effect. We almost tabled the motion for a comprehensive review, which may still surface at a future time.
Can the minister task an experienced bilingual investigator to look into the health concerns of the patients, to review the complaints about the lack of proper health care or service?
I would like to know whether or not the minister will approve a review on this matter.
Mr. Chairman, as everybody can see from our business plan, it’s quite ambitious. We have a lot of work ahead of us in the next year to year and a half, reviewing numbers and strategies, initiating other programs, and trying to upgrade our facilities across Nunavut.
We just committed to Mr. Enook to review the client travel issues going back to October 2007.
We’re constantly receiving complaints from people on a daily basis and we look into them.
Through a review and analysis of the issues that people raise, we do strive to improve the delivery of our programs and services.
It’s not like we’re ignoring the people’s concerns; we do review them.
I know some aspects of the departmental operations are occasionally reviewed.
However, many of us know the situation in our communities as many people feel reluctant to go to the health centre.
This is particularly true of men.
Many men feel it is futile to go to the health centre, even though they may not be well or need medical treatment.
I don’t think it’s appropriate.
I believe the system has to be more open, especially since the majority of the budget stems from the federal government, all of it as a matter of fact, but certain funds are specifically for Inuit, such as NIHB.
We have to find a more open review and this is what we’re trying to put across. Many studies and reviews are done in other areas.
With respect to patient care in the communities, a lot of people who are sick or feel that their health is degenerating are loath to go.
These particular parts of the complaints have never been subjected to a review and I wonder why that is so.
I would like the minister to task this review, even if it takes a long period, such as a year or six months or even three months.
It would be fine as long as a review is undertaken since this review would look at this issue. They can discuss the concerns with all of the communities.
If the committees are the only avenue for this review, then a lot of the important medical and local health concerns and complaints will not be understood, at least from my view.
That is the reason why I would like to know the reason the minister is not in favour of a formal review and explain that to the committee.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Curley for the question again.
Mr. Chairman, as I have said before, the department is constantly reviewing their policies. We have a policy under review.
We are working on a document, the guiding principles for health committees.
We believe that health committees, once they’re functioning more effectively and understand their role, can bring a lot of concerns that Mr. Curly is raising, bring them up with hamlet councils, bring them up with our health officials in the communities, and bring them up with my senior officials and also with myself. So I think we’re on the right path.
I can’t make that commitment.
I understand that matter. The hamlets have to encourage their health committees to pursue this avenue, which is easy enough to do, to state that we will make more efforts. However, as I stated earlier, there are people who have a myriad of medical illnesses requiring complex medical terminology that the committee would most likely not be able to undertake.
Other departments hire consultants or professionals who conduct the review with appropriate terms of reference that focuses their study. I believe that this has to occur in the communities so that we will know not just the community perspective. I would like the minister to elaborate to the members of this committee and to Nunavutmiut as to the reason why he cannot commit to an independent review.
Hon. Keith Peterson: Thank you, Mr. Chairman. I have only been a minister for… .
I think this is my 100-day anniversary, so I have some ideas and thoughts about how to improve health. I have to talk to my health officials. I have gone around and talked to a lot of health officials.
I have lived in the communities. I do believe in communities.
I met with a committee yesterday where they are very proactive. They have initiatives and ideas that they believe will improve health in our communities.
It’s all about delivery at the community level.
I believe that the health committees, if we can strengthen them and help provide them with good guidance, can improve the communication, the relationships with our health centres and our health professionals at the community level.
Mr. Curley (interpretation): Thank you. That is believable.
However, since people are truthful in their recounting of their experiences, they feel intimidated and unwelcomed at the health centre due to expressions of that attitude. Some patients don’t want to see certain people at the health centre. This complaint has been lodged with quite a few members.
I would like the minister to speak to this issue.
How can people who are suffering from health problems or our elders in our communities approach the health centre comfortably without feeling intimidated or unwelcomed? In particular, even though men may be seriously hurt, they don’t want to go to the health centre.
This is especially true of full-time hunters.
They know that the prognosis will be that they’re fine.
How can the minister ensure that people who require medical treatment can go to the health centre without feeling intimidated? The treatment is only available at the health centre.
That is the way it ought to be. If the minister makes that commitment to the members here, we will put more faith in your statement as we believe that people should feel comfortable in their home communities’ health care system. We don’t think there should be health care workers with condescension towards patients.
I thank Mr. Curley for his comments. I’m not quite sure what he’s driving at, but when I go to health centres and I wasn’t always the kind of guy who would go to health centres and I thought I was a pretty healthy guy, but then I educated myself. I heard promotions of the Department of Health over the years, the last 10 to 12 years, that it’s important to visit health centres for regular checkups.
Don’t be afraid to go.
Even nowadays, when I go to the health centre, my blood pressure goes up. You go in there to get your blood pressure checked, but you end up getting what they call the white coat syndrome, where your blood pressure actually rises because you’re afraid to get your blood pressure checked.
Men, in particular, are more prone than females. Men are more prone to not go to health centres because we, as men, feel that we are healthy. We’re going to live forever.
We can’t be felled by an illness. That’s not true.
We all can. We’re all aware of cancer. We’re aware of many other diseases that we have to get checked up, especially when we are older.
Through the programs that the health department has, there’s a big promotion on public health and education. We will continue to encourage all Nunavummiut to get their checkups, go to the health centre, and not to be afraid of the health practitioners.
Even if you’re afraid or intimidated, then talk to someone who is not and they will probably support you and encourage you to come to the health centre.
Again, I do not believe that our health professionals are people who would try to intimidate you or scare you. They’re health professionals and that’s their job.
They’re there to help you and check you out and help you overcome your illnesses and keep you healthy. That’s why they get into this kind of profession.
We are trying to encourage a lot of our young Nunavummiut and some of our older Nunavummiut residents to get into the health profession so they can help Nunavummiut. That’s the kind of business we are in.
I understand you exactly, but one thing I don’t quite appreciate is your statement about what I’m trying to push with these statements.
I thought our statements were quite clear.
Since some elders feel apprehensive to this day, they’re not simply trying to denigrate an individual; they’re fearful of receiving perfunctory health care without proper treatment.
They fear the generic response about their health being fine and that there is nothing wrong with them. That has happened. As we stated earlier, this leads to people feeling unwelcome, especially when the sick person’s complaints are not believed, and this leads to a feeling of contempt for their health complaints.
Inuit are a minority in Canada. Inuit tend to be more timid than non-Inuit and we know that for a fact.
It’s just a traditional cultural value.
Inuit tend to be more fearful and that’s why I was trying to bring up the idea of a more welcoming attitude. I’m making this comment simply to make it clear because the minister asked what I was pushing and I didn’t really like what he said.
Nunavutmiut should not be fearful nor feel apprehensive when they go to the health centre. So if the department can keep making statements to the public that if anyone feels sick, they have to go get a checkup. Maybe we can make this a recurring theme, not just the public health side but the medical professional side as well.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Curley for his comments.
Yes, Mr. Chairman, any patient in Nunavut, whether you’re young or old, should feel welcome at a community health centre or hospital.
We understand that and we will continue to strive to make people feel welcome in the communities or the city of Iqaluit when they come to our health facilities.
Mr. Curley, you ran out of time, so we will move on to another member.
I, too, have some comments to pass along to the Minister of Health while we’re discussing this matter.
The issue of people’s experiences, as we hear from other parts of Nunavut, seems to be primarily related to one of attitude.
Although the higher echelons of management continually make the statement that the health care profession is largely made up of dedicated and welcoming people, that principle is very easy to state.
However, your department doesn’t see this at the local level daily since you don’t see the workers conducting their activities.
The fact that the headquarters level of your department is espousing a welcoming attitude is commendable. It is gratifying to hear that from headquarters, but it doesn’t seem to be filtering down to your frontline workers at the local level.
If you were encouraging all of your health officials and if you filtered down that attitude of a welcoming spirit starting now, then perhaps a lot of these nurses and employees in the health centres who are the cause of these complaints would hear this message louder and it would help to improve their attitude.
I think, occasionally, you should be reviewing local health centres. In some cases, I don’t think it has been properly reviewed in a while because I also heard the mayors speaking to the same issue. Wherever there is a gathering of leaders, we tend to hear a lot of these complaints.
There should be an attempt to resolve it immediately as we want to ensure that the people we represent are serviced properly. A one-size-fits-all approach cannot meet the unique circumstances of every community.
Hopefully, down the road, the operations could be looked into soon and improvements made.
As MLAs, we cannot make that change.
Even as individuals, if we go to the health centre and are not made to feel welcomed, then we will not return.
Directives originating from headquarters or a review about whether the situation is true based on the large number of complaints or recommendations coming from headquarters are more dramatic to your employees.
We really want to push for enhancement and improvement in the way health services are provided. I think we’re all trying to represent our constituents.
We keep hearing about the Tamapta Mandate.
Within the meaning of the word, we cannot deal with it piecemeal but as a whole. If the health system is not fixed, then other parts of operations that we’re trying to resolve will be impacted.
In order to ensure that we fulfill the Tamapta Mandate and we can put faith in becoming more self-sufficient and self-reliant, it has to apply to everybody.
We will continue to have problems if you allow it to fester and not resolve these problems, and we will never attain the principles listed in the Tamapta Mandate.
This was just a comment and thank you for allowing me time to speak, Mr. Chairman.
Chairman (interpretation): Thank you, Mr. Oshutapik. (interpretation ends) Minister Peterson, there were no questions asked, but if you want to comment. Minister Peterson.
I would just like to thank Mr. Oshutapik for his comments.
We hear what he says.
Chairman (interpretation): Thank you, Minister Peterson. I would also like to thank you for pronouncing Mr. Oshutapik’s name properly.
Total Operations and Maintenance. $176,298,000.
Just prior to voting on approval of this, I would like to put forward a motion.
Mr. Chairman, maybe you can provide direction as to whether I can put forward a motion now or maybe we could have a short break.
Mr. Chairman, can you provide direction on this, please.
You stated you had a motion available. Could you provide a copy?
I have not had this translated into Inuktitut, so perhaps we could have a five- or ten-minute break.
I have prepared the motion, but it has not been translated into Inuktitut.
The policy states that when we are in the Committee of the Whole, we have to follow the procedures laid out.
I would like to have a short break while Mr. Tapardjuk’s motion is being translated. So we will try to ensure that it is very quickly translated. Once it’s completed, we will be able to read the motion.
Once it has been prepared and in front of all of the members, I will ensure that I ring the bell to call you back. For the time being, we will take a short break in order to accommodate the translation requirement.
>>Committee recessed at 17:17 and resumed at 17:33
Chairman (interpretation): Thank you for coming back. Welcome back. This wasn’t intentional.
First of all, I want to state that Mr. Tapardjuk had the motion in English only. In my discussion with him, he stated that he preferred to read the motion in Inuktitut. Since the motion was not translated into Inuktitut, I ordered a break to translate it.
Apparently, the usual practice was to read the motion in English immediately and then to take a break while the motion was being translated.
We could have done that as well, but as the Chair, I felt that the Inuktitut language, which is now an official language of Nunavut, and with the preference of the member to speak to the motion in Inuktitut, I wanted to accommodate that.
He is an Inuk and he has the right to speak in the Inuktitut language.
I had to take that into consideration in my role as the Chair.
Although this is quite a complex matter to consider, I doubt I will have any regrets as I too am an Inuk.
It is due to this reason only and I don’t mean it to oppose any other procedure.
At this time, since Mr. Tapardjuk wanted to move a motion, you have the floor.
Mr. Tapardjuk, if you want to read your motion, your motion is ready for reading. Mr. Tapardjuk.
Committee Motion 008 – 3(3): Review of the Patient/Client Complaints Procedure of the Department of Health and Social Services (Tapardjuk)
Mr. Tapardjuk (interpretation): Thank you, Mr. Chairman, for giving me the opportunity.
We have been listening to the proceedings or statements this afternoon during Committee of the Whole and via complaints aired on the radio.
As MLAs, we receive complaints about the health system from our constituents with no avenue to make any changes to these complaints.