EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Under priorities 2014-15, one thing that I skipped here is the fourth bullet, “explore and develop a framework for enhancing performance, management and accountability.”
Who is that targeted at?
If I could ask the member to give us an indication of what page he is on.
Mr. Mikkungwak: Page 99, business plan, priorities 2014-15, fourth bullet.
I will ask Ms. Keenainak to answer that question.
Ms. Keenainak, if you can realize we have translators. Go ahead.
Ms. Keenainak: This is related to the ongoing work we are starting to do.
The minister mentioned improving clinical standards and quality assurance, the terminology, and it is one that your raised making sure that health care professionals and health care centres are meeting a standard. That is the work that this is talking about. We want to develop guidelines and standards to evaluate health centres and clinical professionals in the communities.
Thank you, Ms. Keenainak, for the answer.
The answer that I received and understood very clearly is it’s for the frontline staff who provide services to Nunavutmiut who are feeling sick.
With that answer, who will be enforcing this performance management?
We have frontline staff in the communities, but we also have positions in the regions as well as headquarters that mainly deal with policy and program development.
This would be one of their tasks to take a look at the overall quality management framework. We have been looking at quality assurance committees, which also include, for example, the chief of staff as well as regional directors, and so forth.
There are kind of four things that we’re looking at. It’s the organizational culture and values, the structure and processes within the department, the technical resources and supports, and quality initiatives to make sure that the work we’re doing aligns with the strategic priorities of the department as well as the government.
Thank you once again for the answer.
I heard very clearly that it will be all management staff, deputy heads, and whatnot from the Department of Health.
I would also like to suggest that the Office of [Patient] Relations be involved in that particular performance management considering the fact that they have heard complaints or issues regarding medical matters from the actual client who is feeling sick.
I guess that’s just a comment and I have no further questions.
Next name on the list, Ms. Angnakak.
I’ve got a few questions…(inaudible)… .
Chairman: Ms. Minister Ell.
When they’re translated into Inuktitut or English, sometimes we have miscommunication.
He mentioned deputy heads. It’s not just the deputy heads that will be reviewed, but they would be included in the review.
Mr. Mikkungwak: I just wanted to make myself clear. The answer that I understood is that enhancing performance management is going to come from all management of the health department. I guess that’s what I was trying to say.
So if you guys could also include the Office of Patient Relations considering the fact that they hear various complaints and they hear it first hand.
I want to just go to the policy and planning section when we talk about business planning processes for the department and this is where I’m referencing my questions to.
I would like to ask: what is the current status of the scheduled medical travel contracts for each region in Nunavut?
Please wait a moment while I look for it.
I am happy to receive this question. The medical travel contracts that I referred to in the Kivalliq Air Ltd., Nunasi Corporation, Canadian North, and First Air; all these airlines started September 1, 2011 and the end of their contracts is August 2014.
These were extended by one year, so now they will be ending in 2015 while the senior staff are doing the reviews. That was the reason for the extension of those contracts.
Ms. Angnakak: Thank you, Mr. Chairman. I would like to further ask what the current status of emergency medical travel contracts for each region in Nunavut.
Hon. Monica Ell (interpretation): Thank you, Mr. Chairman. My deputy will wait while I look for it. Thank you, Mr. Chairman.
I thank the member for that question. (interpretation ends) The current contract information for the Baffin region; the provider is Kivalliq Air. The contract started December 2010. It end December 2015.
For the Kivalliq, it’s with Keewatin Air. The start date was December 2011, and ends November 2016.
The Kitikmeot medical contract started December 2011, with Aqsarniit Airways and Medic North, and is set to end November 2016.
Thank you for that answer. What is the current status of the boarding home contracts in Yellowknife, Winnipeg, Ottawa, Edmonton, and Iqaluit?
I have that too. In Edmonton, Iqaluit, Ottawa, Winnipeg, and Yellowknife are all led out by contract agreements.
The only one different is Churchill, which we, as a department, run in Edmonton, October 2011, to end in September 30, 2014.
We can extend the contract for three years and we have the ability to do that for Iqaluit, 2010, and it will finish in March of 2020. We can also extend that by two years or five years.
For Ottawa, April 1, 2008 to March 31, 2028 and no extension.
In Winnipeg, June 1, 2013 to May 31, 2016 and we can extend that by one year.
Yellowknife; the transition began in 2008 October 23 to 2028. There is no extension period.
Ultimately it’s up to the Government of Nunavut to ensure that boarding homes are up to standards when it comes to ensuring that patients are in an environment that is clean and safe for them.
How often does the GN inspect the boarding homes to ensure that the contractor is keeping up to standards in all areas including cleanliness and safety?
I don’t know that information. I can look into it and get back to the House after I find out. Take the question as notice.
I’m going to go somewhere else with my questioning now. I’m going to go to the office of patient relations.
I know that my colleagues were asking some questions.
I wonder how well do you think the office is doing in addressing complaints being called in?
I know it’s less than a year, but so far what kind of feedback have you got that can tell you how well it’s doing.
I can tell the member that between April 1, 2013 and April 23, 2014 there were a total of 93 concerns registered with the Office of Patient Relations.
These represent a tiny fraction of the number of visits of Nunavut health centres as an example.
In 2013, Nunavut health centers received over 217 thousand visits from patients with less than half of one percent of these visits resulting in concerns brought to the office of patient relations.
I got a little confused between the complaints office and the visiting health centres with the number 217 thousand.
I’m going to go on to something else and I can talk with you about that later on.
What is the turn-around time for responding to complaints of this office?
It depends on the type of complaint.
It can be immediately, it can be up to 10 days, it can be more, depending on the complexity of the complain and who and where they need get the information from.
If you had a complaint about the complaint office because they’re not getting back to you, where does one go?
Hon. Monica Ell: That would be to the Deputy Minister’s Office.
I want to go on to the Extended Health Benefits Program.
As we all know sometimes this is the only way that some people in Nunavut can receive medical care away from home when such medical service is not available to them here in Nunavut. Your department is currently reviewing the program.
When will the review be completed?
I mentioned the four criteria earlier.
The committee will examine the clinical and financial implications of any enhancements and the sustainability of the Extended Health Benefits Program. We’re expecting the senior management to review the options and recommendations, including any financial implications of any enhancements.
We’re hoping that will be the next step and we’ll have a better idea of the amount of time that this will take, hopefully, before the fall.
I’d like to ask then if you know if the applicants under this program are growing in number. Are there more applicants over the last few years?
The example for the Extended Health Benefits Policy that I have for residents with exhausted insurance, or no insurance benefits in 2009-2010 were zero.
For 2013-14 there were 20, as an example.
Non-Aboriginal seniors over 65 years of age, access this program.
From 2009-2010 there were 91, and for the fiscal year 2013-14 there were 91.
For those with chronic illnesses in the same timeframe, 2009-2010, 160 accessed that program. 2013-14 a total of 198.
So if you look at all the totals for 2009-2010, that would be 251, and the 2013-14 fiscal year, it jumped up to 303.
I noticed that the budget for this program was increased significantly in the 2011-12 fiscal year. I also noticed that over the last five years, there has been a significant lapse of funds.
With this in mind, I wonder why the rates of the benefits of this program are so low. For example, if you’re an applicant and you’re accessing this program, it would be very difficult indeed to live on what you’re provided away from home. The reason why someone would access this program is because they really don’t have any other means.
I know the program pays for one night hotel and one meal, and after that, everything that you’re receiving is basically $20 per day for hotel and $20 per day for meals.
Will you, as the minister, commit to reviewing the benefits levels to ensure that the benefits are actually meeting the needs?
Chairman: Keep in mind that we have an interpreter that is trying to keep up.
Hon. Monica Ell (interpretation): Thank you, Mr. Chairman. (interpretation ends) The Extended Health Benefits are used by people who don’t have any other health insurance.
The policy is going to be reviewed.
There will also be a financial review and what you’re asking about will be included to look at the financing.
We’re also looking at other jurisdictions in Canada to see how they use that. We’re looking to see if we are unique or we’re doing the same thing as the other jurisdictions.
That’s being looked at now.
My last question. Will you agree to table the revised and amended policy in the House once it’s completed?
Hon. Monica Ell (interpretation): Yes. Thank you, Mr. Chairman.
Last name on the list, Mr. Mapsalak.
I have been listening to the questions posed about the end of the medical travel contract.
I’m asking about the Churchill, Manitoba boarding home contract. Who runs the boarding home in Churchill?
It’s run by the Department of Health.
How many staff do they have in Churchill?
Right now, there are four staff members there.
I think there are very few patients going to Churchill now other than dental patients, but the people going to the hospital usually go to Rankin Inlet or Winnipeg more now.
When we were there, the minister was also there, so she probably knows that there was just one patient there.
I think that’s the norm.
What about the cost of running the facility? How much does it cost to run the facility annually, even though there aren’t very many patients using the boarding home in Churchill, Manitoba?
Hon. Monica Ell (interpretation): Thank you, Mr. Chairman. I also thank the member for asking that question.
We have requested $810,000 for 2014-15.
Last year in 2013-14, we requested $894,436.88. We’re always going over budget in the operation budget.
I was able to go and see the Illualuk Centre in Chesterfield Inlet, and you’re correct in saying that there aren’t very many patients there.
Due to that reason, I told my staff to start looking at closing it down, perhaps to slowly start closing it down.
There are good hotels in that community and if patients need to go there, then we can come up with a contract or an agreement with the hotels down there instead.
Mr. Enook (interpretation): Thank you, Mr. Chairman. Thank you for recognizing me again.
We’re still on page H-4 and before we move on, I just want to get more information and go back to some of the questions I had.
Mr. Chairman, I want my constituents, especially the unilingual Inuktitut speakers, to understand fully. I want them to be fully served, as we are, like people who can speak English.
We don’t want them treated any differently. We don’t want them to have worse or lesser service than we do.
That’s why I’m working very hard on the issue and I will keep working hard on the issue as long as I’m able to until it’s improved.
Mr. Chairman, the first question I have now and I want it to be perfectly clear that whenever a patient goes to the hospital, the escort has to have a purpose.
I would like to ask a question based on your policy, for example, an elder or anybody who has to go to the hospital and cannot speak English at all.
If that person is eligible for an escort, what will that escort be doing?
Will he be a helper or will that person be a translator?
What is the expectation of that escort?
Hon. Monica Ell (interpretation): Thank you, Mr. Chairman. He is expected to be an interpreter or whatever to assist the patient too.
I’m confused because when you answered, you said that they can be an interpreter, but sometimes you say that even though that patient does not have an escort, it’s okay because there’s an interpreter at the destination.
Hon. Minister, I asked questions last year like what happens if they have to land before they reach their destination.
I’m confused now. Do I understand now that an elder or anyone who is going to the hospital can have an escort that is going to be their interpreter or the escort will be just a helper? Is it okay for that individual not to speak English at all?
Hon. Monica Ell (interpretation): I could just say that there are four guidelines followed for medical travel patients. There are four policies.
It has nothing to do with the escort being an interpreter because it’s one of the policies whereby he or she, the escort, can be an interpreter or not.
It depends on whether that individual going for medical attention has a disability and thereby they’re entitled for an escort or whether they’re too young to sign for themselves. That’s a different escort.
The fourth policy is the escort has to help out with the… .
There’s not just one purpose of the escort, but there are four policies. The individual who is escorting doesn’t necessarily have to follow the four policies that are in there.
I kind of know about the policy and they’re all different, but I’m talking about one thing.
I’m not talking about if the patient is too young. I’m talking about the elders who cannot speak English. I know the other three.
If the minister can work with me for a few minutes, I just want to get some understanding.
Has there been any time when a patient who doesn’t speak went down for medical attention? Has there been a case like that?
Hon. Monica Ell (interpretation): I’m not sure.
If he’s asking that question, I’m not really sure how to answer the member.
According to your policy, would it be right if I said that an elder who cannot speak English is allowed an escort who doesn’t speak English as well? Would I be right if I said that?
The member does not want to talk about the rest of the four policies.
If we’re going to be discussing if the escort is going to be a signatory for their child, they would need to have an interpreter. Even though they both speak only Inuktitut, they could have an escort. The individual doesn’t have to speak English.
Do I understand, then, that even though the patient doesn’t speak English, the patient can have a non-English-speaking escort?
Hon. Monica Ell: Qujannamiik, Mr. Chairman.
You’re correct. You’re understanding that.
A unilingual can travel with another unilingual escort, depending on the situation.
As an example, if the patient is a unilingual travelling with a unilingual son, daughter, or another patient, may be a mental capacity or any of the other criteria, or the person has to be included in the treatment of the patient, and/or the person has to sign for an under aged patient.
That is possible for someone to travel and still need interpretation under different criteria. They’re examined separately for each patient. There is no one stream.
So if it was possible to do this, who has the say that it could be done that way, and they cannot have an escort?
Who has the say?
When the patient goes to the hospital you have to talk to the directors.
If the director does not agree, then you have to talk to the regional director. If that individual is refused an escort, then the deputy minister has the last say, or they can go to the deputy minister if they don’t like the decision.
If a patient is going down for medical attention to see a doctor, say for instance, to Iqaluit, who has the say whether that individual who is going to the doctor will have an escort or not?
The Nunavut practitioners have to make a recommendation.
Could you define Nunavut practitioner then?
Hon. Monica Ell (interpretation): We have interpreters.
Mr. Enook (interpretation): Thank you, Mr. Chairman. I also know that we have interpreters.
I am trying to speak in Inuktitut more for the benefit of the public.
The communities have absolutely no say in determining whether the person would have an escort or not?
Chairman: Hon. Minister, Ms. Ell.
Hon. Monica Ell (interpretation): The doctors and nurses can only make recommendations to their supervisors.
Are you talking about the head nurse?
Hon. Monica Ell (interpretation): It’s not from the community, but from the regional directors in the Baffin, Kivalliq, and Kitikmeot regions. They all have regional offices and their regional heads are in those offices.
If Josephie Enook is going to the hospital, who determines who talks to the regional head? If a person says that they need an escort, who determines whether or not they should have an escort?
Hon. Monica Ell (interpretation): The person that is seen would determine that.
Mr. Enook (interpretation): Thank you for that clear answer.
So the nurse or the person who would see me determines if I need to have an escort, an interpreter, or that person as a support person who would escort me.
Hon. Monica Ell (interpretation): Thank you. (interpretation ends) They would recommend based on the patient’s condition.
Now I understand that it depends on what the patient would need to be seen for.
I know the policy is a new one and these must be reviewed.
Therefore, while this is going to be reviewed, where are you in terms of reviewing this policy?
We have not identified a year yet.
We have said that a whole year’s cycle has not completed yet, but the end of it would be up to 2018. As long as I have been a minister, it’s to be reviewed a year after it has been working.
The review will begin in the month of July.
Chairman: Thank you. I have no more names. Mr. Enook.
I will now rise to progress.
Iqsuktii, can you escort the guests?
Your committee has been considering Bill 2 and the main estimates, and would like to report progress.
A reminder that there’s a meeting of the Standing Committee on Oversight of Government Operations and Public Accounts in the Tuktu Boardroom at ten o’clock.
Speaker (interpretation): Thank you. (interpretation ends) This House stands adjourned until Wednesday, May 28, at 1:30 p.m.
Pages 187 – 227
Opening Prayer 187
Ministers’ Statements 187
Oral Questions 196
Revert to Item 5: Recognition of Visitors in the Gallery 210
Consideration in Committee of the Whole of Bills and Other Matters 211
Wednesday, May 28, 2014 187
014 – 4(2): Department of Environment Wildlife Research 2013-2014 (Mike) 187
015 – 4(2): Meeting of the Nunavut Roundtable for Poverty Reduction (Ugyuk) 188
016 – 4(2): North American Indigenous Games (Sammurtok) 189
045 – 4(2): Jump-rope for Ellen Rumbolt (Mikkungwak) 190
046 – 4(2): Summer Literacy Camp (Shooyook) 191
047 – 4(2): Arviat Water Reservoir (Savikataaq) 191
048 – 4(2): Successful Search and Rescue in Gjoa Haven (Akoak) 192
049 – 4(2): Proposed Merger between Canadian North and First Air (Enook) 192
050 – 4(2): 2014 Graduates of Whale Cove (Kuksuk) 193
051 – 4(2): Appreciation to Inuit Hunters (Quassa) 194
052 – 4(2): Repulse Bay Search and Rescue Group (Mapsalak) 194
053 – 4(2): Appreciation to Pangnirtung Volunteers (Mike) 195
054 – 4(2): Cape Dorset Talent Show (Joanasie) 195
056 – 4(2): Funding for Repulse Bay Search and Rescue Group (Mapsalak) 196
057 – 4(2): Casual Employment in the Government of Nunavut (Sammurtok) 197
058 – 4(2): Review of Grants and Contributions (Angnakak) 199
059 – 4(2): Polar Bears as a Threatened Species (Shooyook) 200
060 – 4(2): Proposed Merger between Canadian North and First Air (Enook) 202
061 – 4(2): Senior Personnel Secretariat (Savikataaq) 203
062 – 4(2): Operations of the Qulliq Energy Corporation (Mikkungwak) 204
063 – 4(2): Kimmirut Public Housing Unit 1-A (Joanasie) 205
064 – 4(2): Support for Nunavut’s Nursing Graduates (Hickes) 207
065 – 4(2): Considering a Board of Management for the QGH (Angnakak) 208
066 – 4(2): Patient Complaints Review (Mapsalak) 210
013 – 4(2): Legal Services Board of Nunavut Annual Report 2012-2013 (Okalik) 211
Bill 02 – Appropriation (Operations & Maintenance) Act, 2014-2015 – Health – Consideration in Committee 211
Mr. Tony Akoak, Ms. Pat Angnakak, Hon. Monica Ell, Mr. Joe Enook, Mr. George Hickes, Mr. David Joanasie, Hon. George Kuksuk, Steve Mapsalak, Hon. Johnny Mike, Mr. Simeon Mikkungwak, Hon. Paul Okalik, Hon. Keith Peterson, Hon. Paul Quassa, Hon. George Qulaut, Mr. Allan Rumbolt, Mr. Alex Sammurtok, Hon. Tom Sammurtok, Mr. Joe Savikataaq, Mr. Isaac Shooyook, Hon. Peter Taptuna, Hon. Jeannie Ugyuk.
Speaker (Hon. George Qulaut) (interpretation): Can you say the opening prayer, please, Mr. Mikkungwak.
Welcome to the people of Nunavut. Welcome to the Ministers and MLAs. (interpretation ends) Item 2.
Hon. Minister of Environment, Mr. Mike.
Minister’s Statement 014 – 4(2): Department of Environment Wildlife Research 2013-2014 (Mike)
I say “good day” to the people of Pangnirtung, the elders, and everyone in Nunavut either watching or listening.
Mr. Speaker, I would like to take this opportunity to inform my colleagues of the numerous wildlife research initiatives my department implemented over the past year.
The Department of Environment initiated 27 different research projects on key initiatives that included the first ever island-wide aerial survey of caribou on Baffin Island, and reassessments of the Baffin Bay and Kane Basin polar bear populations using genetic mark-recapture.
The latter is a new non-invasive technique that does not require the handling of polar bears. Other initiatives included the Peary Caribou Management Plan for Nunavut, and a Baffin Island caribou traditional knowledge and Inuit Qaujimajatuqangit study engaging elders and expert hunters.
A total of $2.5 million was invested by my department in wildlife research and management planning projects in 2013-14, from which our Wildlife Research section was able to independently raise another $1.6 million from external sources.
The total investment in wildlife research and management projects by DOE in 2013-14 was $4.6 million.
Through the Baffin Island Caribou Co-Management Steering Committee, we will continue to work together with our co-management partners - the hunters and trappers organizations (HTOs), the Qikiqtaaluk Wildlife Board, the Nunavut Wildlife Management Board, and Nunavut Tunngavik Incorporated - in developing a Baffin Island Caribou Management Plan over the coming year.
Currently, this is a top priority for wildlife conservation and management in Nunavut.
A follow-up co-management workshop, building upon last year’s “Working Together for Caribou” Workshop in Iqaluit (July 2013), will be held this fall.
Other wildlife research highlights in 2013-14 included a population reassessment of the Peary caribou and muskox on the Bathurst Island Complex in the Qikiqtaaluk region, which will help inform the Peary Caribou Management Plan and the Recovery Strategy under the federal Species at Risk Act.
Results from my department’s scientific research show positive signs of the recovery for Peary caribou.
This is consistent with the knowledge shared by hunters in the communities of Grise Fiord and Resolute Bay.