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Bill 24 – Appropriation (Operations & Maintenance) Act, 2012-2013 – Health and Social Services – Consideration in Committee
At this time, I would like to ask the Minister of Health and Social Services if he has any opening comments.
I am pleased to present the Department of Health and Social Services’ business plan and main estimates for 2012-13.
The Department of Health and Social Services is seeking an increase of $6,987,000 from the revised 2011-12 main estimates amount of $309.69 million. This represents an increase of 2.3 percent.
The department is also expecting to bring forward a supplementary appropriation request for a further $14.5 million in the winter sitting.
For 2012-13, the department’s appropriation needs will be $316,677,000, which is $18,919,000 more than the 2011-12 main estimates amount of $297,758,000.
The majority of this increase is to bring the department’s operating budgets in a number of areas in line with anticipated demands and to recognize recent cost increases.
In addition, there are areas that require additional investments to ensure that Nunavummiut continue to receive quality health care.
Significant areas of proposed increases include:
Travel and transportation in the social services area, $4.34 million;
Residential care, $4.1 million;
Nunavut physician services, $2.99 million;
Interoperable electronic health records, $1.67 million;
Mental health workers, $1.65 million;
Materials and supplies, $1,305,000; and
Laboratory services, $1.2 million.
In 2012-13, the department will continue to move forward on existing initiatives, as well as introducing additional initiatives, that continue to improve the health and well-being of Nunavummiut, which include:
Strengthening the provision of mental health services in the territory;
Establishing a culturally relevant pilot program for addictions treatment;
Continuing the implementation of the Public Health Strategy;
Ensuring that Nunavummiut make wise lifestyle choices through health promotion in areas such as tobacco reduction, sexual health, and nutrition;
Reviewing and updating legislation as necessary, such as the Child and Family Services Act, Public Health Act, Vital Statistics Act, and Mental Health Act;
Reviewing and updating policies as necessary, such as the Client Travel Policy and the Nunavut Nursing Recruitment and Retention Strategy; and
Continuing to implement the interoperable electronic health records system so that relevant data and information can be collected to assist in better planning and the appropriate recoveries of third party billings.
Mr. Chairman, the department has set out an ambitious business plan in the upcoming year, one that will depend upon adequate fiscal and human resources.
I am sure that members have questions and I would be pleased to take questions. Thank you, Mr. Chairman. This concludes my opening comments.
I would like to ask the Co-chair of the Standing Committee on Social Wellness if he has opening comments.
Chairman: Thank you, Mr. Elliott. You may proceed.
Members of the Standing Committee on Social Wellness have reviewed the 2012-13 main estimates and business plan for the Department of Health and Social Services and I am pleased to provide you with opening comments.
The standing committee notes that the 2012-13 operations and maintenance budget for Health and Social Services is $316,677,000. While this proposed amount represents an increase over the 2011-12 main estimates that were approved in this House a year ago, it is a fact that the total yearly cost of providing health and social services consistently exceeds the approved budget for any given fiscal year.
Supplementary appropriations for the Department of Health and Social Services have been brought forward every fiscal year since 1999-2000.
Mr. Chairman, the standing committee notes that the department’s proposed increases in budget cover all service areas.
Committee members recognize that rising costs for services provided out of the territory are beyond the department’s control and appreciated the minister’s assurances that such costs are kept to a standard rate across the country, ensuring that no jurisdiction is charged more than another for the same services.
The standing committee supports the department’s proposed investments in initiatives such as the electronic health records system and increased laboratory services.
Members have noted that the transportation of lab samples from some of Nunavut’s smaller communities occasionally takes so long that the accuracy of test results is called into question.
The committee recommends that the department continues to review and improve service delivery processes such as this.
Mr. Chairman, the committee is of the view that the basic formulas used to determine base federal funding contributions for Nunavut and specifically for health and social funding transfers will benefit from revision and renegotiation.
The standing committee supports the minister in his efforts to ensure that the most-up-to-date data and statistics for the territory’s population and needs are taken into consideration. The electronic health records system will be useful in this regard as well as in identifying health trends, including patterns of outbreaks and the spread of communicable diseases, which lead to costly interventions.
Mr. Chairman, Nunavut’s unique position with respect to population, geography, as well as the linguistic and cultural aspects of health service delivery has been recognized to some extent by additional federal funding such as the Territorial Medical Travel Fund.
The standing committee supports the minister’s efforts to ensure adequate and sustained federal funding for the delivery of health and social services across Nunavut and would appreciate regular updates on progress in this area.
The standing committee recognizes that staffing issues have consistently been problematic for the Department of Health and Social Services.
The committee continues to support initiatives within the Nunavut Arctic College Nursing Program, including certification opportunities for community nurses and the new Licensed Practical Nurse Program, as well as other health career programs.
The department’s efforts to reduce its reliance on agency staff for filling nursing and social worker positions have been noted.
Committee members are aware that the lack of housing in some communities is impacting the successful employment of full-time social workers and encourage the minister and his officials to work closely with their counterparts at the Nunavut Housing Corporation to address this issue.
Mr. Chairman, the standing committee is aware that a number of initiatives are currently being considered by the Executive Council, including the possible reorganization of health and social services delivery in Nunavut.
The standing committee will be closely monitoring developments in this area and recommends that the government move forward cautiously as certain decisions will most certainly have far-reaching consequences.
Mr. Chairman, the standing committee notes that one of the department’s key initiatives for 2012-13 is the introduction of new child and family services legislation. Members continue to urge the government to ensure that the needs and concerns relating to elders are also given the necessary attention. It is critical that Inuit societal values are integrated into legislation and service delivery in order to be effective.
Mr. Chairman, following the dissolution of the divisional health boards, community health committees, called committees of council, were established under municipal authorities and funded by the GN. The standing committee encourages the minister in his efforts to revitalize the role of such committees through increased funding and support to coordinate local health and wellness initiatives.
Committee members note that in the past, community interagency committees often included representatives, such as the RCMP, hamlet SAO, community health representative, and others working together to address local issues and concerns.
The standing committee encourages the minister to fill the five regional community health and wellness coordinator positions as soon as possible.
The standing committee was pleased to note that a number of new mental health positions will be established in 2012-13. Members also look forward to reviewing actions and initiatives that will address the issue of suicide in our communities.
Issues relating to addiction and substance abuse are also of great concern. Committee members strongly support the concept of culturally relevant, community-based programs and encourage the minister to work with his officials to provide more support for adapting proven programs from community to community and from region to region.
Members have noted that plans for a Nunavut-based treatment facility have not yet been brought forward.
Mr. Chairman, medical travel is one of the most expensive expenditure areas for the Department of Health and Social Services. The standing committee recognizes that there is often no other recourse than to fly clients to regional centres or even to other jurisdictions to receive care and services.
Concerns continue to be raised regarding the policies and appeals process relating to medical travel and the provision of escorts. The standing committee notes that the department has recently undertaken a review of the Client Travel Policy and members encourage the minister to bring forward any findings or recommendations from this review at the earliest opportunity.
Mr. Chairman, access to nutritious food is a critical component of maintaining a healthy lifestyle. While members recognize that the Department of Health and Social Services is not in the business of providing food to residents, it is important that efforts continue to address food insecurity. Committee members were disappointed to note that contribution funding for breakfast programs will not continue in 2012-13 and recommend that the impact of no longer providing funding for this initiative be assessed as soon as possible.
Mr. Chairman, committee members note that constituents continue to bring forward concerns with respect to the diagnosis and prevalence of cancer across the territory, and would encourage the minister and his officials to focus efforts on initiatives which specifically address the detection and treatment of this disease.
Mr. Chairman, that concludes my opening remarks. I anticipate that individual members will also have questions and comments as we proceed. Thank you, Mr. Chairman.
Chairman: Thank you, Mr. Elliott. Mr. Enook.
Mr. Enook (interpretation): Thank you, Mr. Chairman. (interpretation ends) I would like to move a motion to report progress. (interpretation) Thank you.
Chairman: Thank you, Mr. Enook. We have a motion on the floor to report progress and the motion is not debatable.
Speaker: Thank you, Sergeant-at-Arms.
The committee has been considering Bill 24 the main estimates, and the committee would like to report progress.
Just a reminder to all members that there’s a meeting of the Full Caucus tomorrow at ten o’clock in the morning in the Nanuq Boardroom.
Speaker: You’re welcome.
This House stands adjourned until Tuesday, February 28, at 1:30 p.m.
Tuesday, February 28, 2012
Pages 1812 – 1873
Opening Prayer 1812
Ministers’ Statements 1812
Members’ Statements 1814
Returns to Oral Questions 1820
Recognition of Visitors in the Gallery 1820
Oral Questions 1821
Written Questions 1837
Tabling of Documents 1837
Consideration in Committee of the Whole of Bills and Other Matters 1838
Report of the Committee of the Whole 1872
Orders of the Day 1872
Tuesday, February 28, 2012 1812
124 – 3(3): Russia, Belarus, and Kazakhstan Ban Harp Seal Pelt Imports (Arreak) 1812
125 – 3(3): Air Greenland Link (Taptuna) 1813
126 – 3(3): Decentralized Functional Review (Aariak) 1813
172 – 3(3): Thanks to All Volunteers (Aupaluktuq) 1814
173 – 3(3): Narwhal Consultations (Elliott) 1815
174 – 3(3): Potential Impact of Global Warming on Water Situation in Kugaaruk (Ningark) 1815
175 – 3(3): Sila Rainbow in Arviat (Shewchuk) 1816
176 – 3(3): Igloolik Participants at the Arctic Winter Games (Tapardjuk) 1816
177 – 3(3): Best Wishes to Iqaluit Athletes at the Arctic Winter Games (Ell) 1817
178 – 3(3): Visit to Baffin Correctional Centre (Ningeongan) 1818
179 – 3(3): NIRB Approval of Access Road (Curley) 1819
Return to Oral Question 227 – 3(3): Security at Nunavut Airports (Taptuna) 1820
270 – 3(3): Baker Lake Airport (Aupaluktuq) 1821
271 – 3(3): Community Morgues (Tapardjuk) 1823
272 – 3(3): Narwhal Consultations (Elliott) 1824
273 – 3(3): Community Health Committees (Ningark) 1826
274 – 3(3): Dust Control in Communities (Oshutapik) 1827
275 – 3(3): Power Outages in Pond Inlet (Enook) 1829
276 – 3(3): Additional Office Space for Sanikiluaq (Rumbolt) 1831
277 – 3(3): Contracting Process for Air Ambulance and Medical Travel Services (Curley) 1832
278 – 3(3): 2010-11 Procurement Activity (Ell) 1833
279 – 3(3): Men’s Healing Facility in Rankin Inlet (Elliott) 1835
013 – 3(3): Government of Nunavut Responses to Resolutions Adopted at the 2011 Annual General Meeting of the Nunavut Association of Municipalities (Tapardjuk) 1837
154 – 3(3): Report on the Functional Review of Decentralization, August 31, 2011 (Aariak) 1837
155 – 3(3): Correspondence Regarding Nutrition North Canada Dated February 24, 2012 (Elliott) 1838
156 – 3(3): Report of the Auditor General of Canada to the Legislative Assembly of Nunavut – 2012 – Procurement of Goods and Services (Speaker) 1838
Bill 24 – Appropriation (Operations & Maintenance) Act, 2012-2013 – Health and Social Services – Consideration in Committee 1839
>>House commenced at 13:32
Before we get started, I would like to ask Minister Shewchuk if he could lead us off with a prayer, please.
Minister’s Statement 124 – 3(3): Russia, Belarus, and Kazakhstan Ban Harp Seal Pelt Imports (Arreak)
I would like to say “hi” to the people of Clyde River and my grandchildren, as well as Jimmy.
Mr. Speaker, I would like to express my deep concern and disappointment with the import ban on harp seal pelts recently implemented by the Russian Federation, Belarus, and Kazakhstan.
Our government strongly opposes the adoption of trade bans that are brought about by political pressure or the emotional response of the public to the seal hunt based on the misinformation campaigns of anti-sealing lobby groups.
It is our contention that trade bans must only be adopted for species that are scientifically demonstrated to be threatened or in decline, of which the harp seal is neither.
In fact, recent estimates of the northwest Atlantic harp seal population exceed 9 million animals.
Seal hunting in Nunavut is humane, sustainable, and is a vital part of Inuit culture.
Seals provide a source of both income and nutritious food in our communities where economic opportunities are limited, costs of living are high, and agriculture is impossible.
As you are all aware, Nunavut hunters harvest numerous seal species, foremost of which is the ringed seal.
History has shown, such as the EU import ban, that trade restrictions on harp seals also have negative impacts on trade in other seal species.
Mr. Speaker, I strongly urge the Russian Federation, Belarus, and Kazakhstan to reverse this import ban immediately before further harm is done to the livelihoods of seal hunters in Nunavut and in Canada’s Maritime Provinces.
Minister’s Statement 125 – 3(3): Air Greenland Link (Taptuna)
Good afternoon, colleagues, Nunavummiut, and Kuglukturmiut.
Mr. Speaker, there have been two recent announcements that will have a very favourable impact on the travelling public in Nunavut, Greenland, and other destinations in Canada.
Mr. Speaker, in mid-January, Air Greenland announced the opening of an air link between Nunavut and Greenland, with service between Iqaluit and Nuuk starting in June of this year.
Hon. Peter Taptuna: Mr. Speaker, shortly after this announcement, Provincial Airlines and Air Greenland jointly announced that they have signed a memorandum of understanding which will allow same day connections between Newfoundland and Labrador and Greenland through Iqaluit.
Mr. Speaker, these developments will provide passengers from Europe and Greenland a much more convenient route to many Canadian destinations and will allow for expanded opportunities in areas such as tourism, construction, mining, and exploration in Greenland, Nunavut, and of course, in other parts of Canada.
Mr. Speaker, these exciting announcements will also mean an increase in traffic at the Iqaluit International Airport.
Mr. Speaker, my department will continue work that is underway to ensure that the much needed improvements to the airport become a reality in the very near future.
Minister’s Statement 126 – 3(3): Decentralized Functional Review (Aariak)
Hon. Eva Aariak (interpretation): Good afternoon, Mr. Speaker. In March 2011, this government began a review of decentralization as part of our continuing efforts to strengthen the public service committed in Tamapta/ᑕᒪᑦᑕ: Building Our Future Together.
Let me begin by saying that this government supports the principle of decentralization in the organization of government services and will continue to situate at least 60 percent of all public service jobs outside of Iqaluit.
Mr. Speaker, the review by the consulting firm of Oliver Wyman looked at how decentralization was implemented, its current status, and how decentralization is working today.
The purpose of the functional review was to identify strengths and weaknesses of decentralized offices, as well as opportunities for realizing the initial intent of decentralization in Nunavut.
The consultants met with a total of 94 GN personnel in departments and agencies at all levels, from frontline workers to executives.
In order to get a good sample of communities with decentralized offices, they also visited the communities of Arviat, Baker Lake, Kugluktuk, and Pond Inlet.
While in those communities, they met with both staff and mayors. However, mayors in all decentralized communities were invited to respond to a survey.
The final report was submitted to the department on August 31, 2011 and offers 29 recommendations for our consideration in the following areas:
Making changes in decentralization policy and governance
Strengthening the decentralized model
Improving structures and supports for a decentralized public service
Enabling decision-making and influence
Promoting Inuit employment
Practicing Inuit societal values
Mr. Speaker, there is an action plan being developed to move ahead with the recommendations and improvements to decentralization that I look forward to sharing with my colleagues during the spring session.
Member’s Statement 172 – 3(3): Thanks to All Volunteers (Aupaluktuq)
I rise today to thank all the parents, volunteers, teachers, coaches, and our district education authority in Baker Lake for instilling confidence and challenging our youth in academics and sports. Everyone contributes, commits, and students are supporting each other.
Mr. Speaker, I rise today to thank all and state as community members, we recognize all of our important people who contribute to society.
I ask my colleagues in acknowledging the many volunteers who can and do make a difference in our communities because, with volunteers in our communities, they remind us as a society that reaching our goals can be reached together.
Community members are taking action voluntarily. They are instilling pride in our youth by continually supporting at a local level our school athletes, the Baker Lake Blizzards.
I would like to thank the parents and volunteers as it does start at home and it does start by community members volunteering because they believe in contributing and participating in our community programs as well as the enhancement of our youth. That is why the Blizzards program is successful, as a result of the many volunteers who contribute and make it a successful program.
Thank you, volunteers. Our community thanks you. As well, this also applies to the many volunteers who are providing contributions to our communities, such as the firefighters, as well as other breakfast program volunteers.
I think, at this time, I would like to recognize all the volunteers in Baker Lake as well as all those in Nunavut.
>>Applause  Speaker: Thank you, Mr. Aupaluktuq.
Item 3. Members’ Statements. Member for Quttiktuq, Mr. Elliott.
Member’s Statement 173 – 3(3): Narwhal Consultations (Elliott)
I rise today to applaud this month’s announcement that Nunavut Tunngavik Incorporated and the federal Department of Fisheries and Oceans will be holding community consultations on a draft integrated fisheries management plan for narwhal and to discuss the total allowable harvest levels for narwhal.
Mr. Speaker, this issue is of concern to my communities in the High Arctic. I am pleased to note that consultations will be held in Arctic Bay from March 28 to 29 and in Grise Fiord from March 23 to 24.
I also note that the consultation meeting that will be held in Kugaaruk from March 19 to 20 will include representatives from Resolute Bay.
Mr. Speaker, NTI’s announcement indicates that regional wildlife organizations, hunters and trappers organizations, the Nunavut Wildlife Management Board, and the Government of Nunavut will also participate in the community consultations.
Mr. Speaker, I look forward to playing my part in ensuring that my communities are aware of these important consultations.
At the appropriate time, I will be asking the responsible minister to provide more detail on our government’s role in this process.
Item 3. Members’ Statements. Member for Akulliq, Mr. Ningark.
Member’s Statement 174 – 3(3): Potential Impact of Global Warming on Water Situation in Kugaaruk (Ningark)
I rise today to speak about a situation that occurred in December late last year.
Mr. Speaker, a tidal heave washed salt water into the community’s fresh water reservoir in December.
As a result, the municipality worked with the Department of Community and Government Services to build a new ice road to the new fresh water supply.
I applaud this cooperation between different levels of government.
Mr. Speaker, my concern is that incidents such as these ones may be connected to global warming and rising sea levels. Our Department of Environment has indicated that one of its priorities is to undertake an arctic sea level rise assessment.
As a courtesy to the minister’s office, Mr. Speaker, I wish to advise the Hon. Minister of Environment that I will have questions for him at tomorrow’s sitting on this issue.
Item 3. Members’ Statements. Member for Arviat, Mr. Shewchuk.
Member’s Statement 175 – 3(3): Sila Rainbow in Arviat (Shewchuk)
I rise today to recognize three women from Arviat who have created what is called the Sila Rainbow Organization. Sila Rainbow helps to encourage people about healthy living in the community of Arviat.
They educate and discuss such issues as bullying, staying in school, suicide prevention, and much more.
This past December, Sila Rainbow hosted the second annual group competition.
Twenty groups of one to four persons entered in this competition. The focus of the whole competition was about encouraging people about working together, motivating their self-esteems, healthy living, and making friends.
Mr. Speaker, Sila Rainbow also involved raising funds to help the community.
To date, they have actively been involved in the recycling program initiated by our local co-op store.
They have so far collected two sea containers full of pop cans each worth $1,500 to fund the organization and now they’re on their third sea container.
Mr. Speaker, I would like to recognize the Sila Rainbow members Doreen Ikakhik, Melinda Kaviok, and Laura Tassiuk for their hard work in making Arviat a better place to live.
Member’s Statement 176 – 3(3): Igloolik Participants at the Arctic Winter Games (Tapardjuk)
Mr. Tapardjuk (interpretation): Good afternoon, my colleagues. Thank you, Mr. Speaker.
I rise today to celebrate with you about a recent announcement regarding the Arctic Winter Games in Whitehorse that will commence this weekend.