EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Although I can’t divulge all the contents of the issues raised, primarily medical travel, communications issues, and issues relating to health centre visits have been the focus of those concerns, but I can’t provide much more detail than that. (interpretation) Thank you, Mr. Chairman.
Now, when you are talking medical travel, it is often the contact that I have to put my constituents in touch with that office.
That leads to my next question. I’m sure one of my colleagues may have further detailed questions on this, but the overall policy on medical travel right now has been revamped fairly recently.
What has been the response to the Department of Health regarding the new policy? Is it working? Is it saving money, yet is it still meeting the needs of our residents?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Like everybody, I get phone calls on medical travel throughout my term. It’s something that we will need to continue to work on and I look forward to finding some solutions in the near future, but that will require some more work and hopefully we can get that done. (interpretation) Thank you, Mr. Chairman.
With a little bit of time on the clock, Mr. Hickes, one more to finish it off or are we okay?
Mr. Hickes: I’ll leave it for the others.
We are on page H-4.
Health. Branch Summary. Directorate.
Total Operations and Maintenance, to be Voted. $27,280,000.
Turn to page H-5.
I’ll read it out and if you have any questions, please raise your hand.
I’m just going to touch on the Food Security Strategy.
In our chair’s opening comments, he alluded to the fact that there seemed to be a little, I’m not going to say disagreement, but maybe lack of clarity to the members on who is actually leading that endeavour and what type of communication is occurring with the Department of Family Services and other stakeholders to move that strategy forward.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Our department has provided administrative and technical expertise to the health security file and we will continue to do so. (interpretation) Thank you, Mr. Chairman.
The minister answered a portion of my question.
How frequently are officials and stakeholders in the Department of Family Services getting together to further the strategy?
Hon. Paul Okalik: From what I understand, they met as recently as two weeks ago. (interpretation) Thank you, Mr. Chairman.
Again the minister answered part of my question.
We all realize that the food security issue has been brought up a number of times in this House by different Members of the Legislative Assembly and we just don’t want this to fall by the wayside.
I know that the minister has stated a few times now that there are a number of different initiatives that his staff is working on and my colleague, Ms. Angnakak, brought up the time that’s needed to be committed to further some of these services and strategies forward, and I don’t want this one to fall by the wayside.
How frequently or how often do his officials and official stakeholders meet?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As we are there for administrative and other technical support, we are there to support whatever the Department of Family Services may call on us to attend to meetings, so I can’t really determine how frequently at this time, but I’ll get back to my colleagues and make sure that they know how frequently we are involved as a department. (interpretation) Thank you, Mr. Chairman.
There are references here in the main estimates under Public Health that talk about communicable diseases and stuff like injury prevention.
Under the main estimates, if we look at page A-IV-2, at the very back in the main estimates, your main estimates… . Do they have this?
Chairman: Ms. Angnakak, can you remind us which page it is on?
Ms. Angnakak: Okay.
It is in the main estimates on the appendix at the very back, A-IV-2.
Chairman (interpretation): I think you’re the only one who has a copy of this.
Are you looking at A-IV-2?
I believe I have that.
I’m looking at it now. (interpretation ends) Hon. Minister, (interpretation) did you find it?
My apologies, Ms. Angnakak, go ahead.
I’m sorry I created a bit of fuss there. I wanted to bring attention to some of the programs there that aren’t… . There is no budget for them right now, but there used to be, such as the diabetes screening project.
In 2013-14, you had $62,000 towards that.
Since the 2013-14 fiscal year, no budget has been allocated towards that kind of a program.
Can you tell me why?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) These are funds that we use from other parties, so I can’t really answer that one because these aren’t our funds.
Wherever we receive them is where we spend them and use them for those purposes. (interpretation) Thank you, Mr. Chairman.
I realize that. I guess I didn’t make my question clear enough. What I’m asking is: what kind of efforts have you made so that those kinds of programs, such as the diabetes screening project, I’m just using that as an example that is written here, can continue?
Is this now by the wayside? We don’t do this anymore? Is this now funded internally or is this a program that doesn’t exist anymore?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I must say that diabetes is one area where we are not leading the country in terms of something negative.
We are actually doing quite well in terms of diabetes for our territory.
It is one area that we can focus our attention on areas that really need our attention in our department. (interpretation) Thank you, Mr. Chairman.
I agree that diabetes is low here in Nunavut, but we want to keep it low. One way of keeping it low is keeping an eye on it and doing different initiatives in that area just to be proactive so that 20 years from now, we don’t have the same conditions that the First Nations are facing in Canada. That’s my point there.
The question I would like to ask is: is the Territorial Health Investment Fund that has gone down in numbers, can you explain to us first of all what those funds are used for and why the drop?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As I said, these are federal funds that we use.
I can’t really respond as to what rationale they used to drop their funding for these programs at this time. (interpretation) Thank you, Mr. Chairman.
I find it a little hard to understand his answer because when you have a contract with the federal government, they tell you what the money is for.
If there’s a drop, they usually tell you why there’s a drop in the amount that they’re giving you. Perhaps his deputy minister might know.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Okay, then my deputy will answer the question. (interpretation) Thank you.
Chairman: Ms. Stockley.
With regard to federal monies, it depends on the funding envelope, what’s allowed to be done within the funding envelope.
When we have monies for a particular project, we would have to use those funds in regard to whatever the parameters of the project are. In some instances, we’re allowed to carry monies forward from year to year. You could see a slight variation in the budget from year to year if we’re carrying funds forward.
With regard to the example you used with regard to diabetes, once we do projects and identify any areas of issues, we would look to have, for example, chronic disease screening happening within regular visits with nurse practitioners and with nursing, and so on. It becomes part of our practice.
Chairman (interpretation): Thank you, Ms. Stockley.
Ms. Angnakak, did that answer your question?
Ms. Angnakak: I guess, to some degree, yes, but not really. Perhaps what we could do now here with this question is just give a brief overview of what the Territorial Health Investment Fund, first of all, is used for.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) The fund is used for a variety of areas and we submit proposals and then they fund those specific proposals.
For example, for the next three years, the fund will be used for mental wellness, chronic diseases, and children’s oral health. (interpretation) Thank you, Mr. Chairman.
Ms. Angnakak: Thank you, Mr. Chairman. I thank the minister for his answer. I understand, I think, a while back ago, there were some difficulties in negotiating this fund.
I think you mentioned something like this is a three-year program. Can you confirm that?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes.
When we talk about communicable diseases, I think about the rising TB rates we’re having in Nunavut.
How are you addressing this and what kind of a percentage are we talking about in regard to the number of people contracting TB?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Unfortunately, there has been a rise in a number of cases and in 2014, there were 83.
So far to date, there has been one new case confirmed. Places that we have identified them are where we’re investing more nursing to try and turn the tide on tuberculosis here in our territory. (interpretation) Thank you, Mr. Chairman.
Ms. Angnakak: Over the years where you have seen a rise, have we been able to stop the rise now or is it continuing to climb?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We are doing what we can to turn the tide.
We need to stop it and we are doing our best right now to identify and track where the cases are and we have workers that track where they have been.
We’re following this situation very closely and we are investing money to try and put a stop to this because it’s something that shouldn’t be in our territory.
We are doing our best to try and make sure it is eliminated in our territory. (interpretation) Thank you, Mr. Chairman.
This is my last question with regard to TB. Is this only happening in Nunavut or is TB on the rise elsewhere in Canada?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) It’s on the rise primarily in Nunavut. Our rates are 49 times higher than the rest of the country, so we have to put an end to this. (interpretation) Thank you, Mr. Chairman.
We are on page H-5.
Public Health. Operations and Maintenance, to be Voted. $18,575,000.
I believe I can add my comments to this issue of (interpretation ends) medical travel (interpretation) and if I am in the wrong category, I know you will correct me, Mr. Chairman, but I believe it is in this section.
Mr. Chairman, ever since Repulse Bay ended up being served by only one airline, it has become quite problematic and you can see the problems faced by people who are on medical travel, and the result has been delayed flights and space limitations, causing them to be bumped off.
That has been the situation in our community. Further, our community of Repulse Bay is no longer a small community, as the population now exceeds 1,000 residents.
That number of residents is served by only one airline, Calm Air.
Nonetheless, I want to raise this question as to the way the Government of Nunavut hands out medical travel contracts to each airline. Is this part of this section or is it part of the capital estimates?
That is my first request for clarification and whether you can provide that information to me.
Yes, these are excellent questions and I believe they are under this section and I believe we do have a contract with the airlines with respect to medical travel.
Chairman (Mr. Akoak): Thank you, Minister Okalik.
Yes, I am glad to be able to raise questions in this section.
Indeed, ever since our community started being served by only one airline, Calm Air, our residents have been faced with growing problems due to the limitations of the plane. Ever since a single airline started to provide this service to our community upon the cancellation of First Air’s routes, it resulted almost immediately in problems.
As soon as First Air stopped their services with the last flight on October 30 to Repulse Bay, ever since that time, the airline arrival time is continually delayed by three or four hours.
When that situation arises, some of the medical travel patients are also faced with the prospect of the pilot daily hours being reached and they can no longer catch the connecting flight, so they only reach their destination late.
Calm Air, with the current monopoly, is concentrating on freight delivery, with most of the plane converted to freight, and they only offer a limited amount of seats for their passengers. That results in overbooked flights and lack of space for medical travel patients.
With that being the case, I wonder what improvements could be made to lower the late arrivals of medical patients and to ensure that medical travel patients are not bumped off.
Does the government have any stipulations in their contracts about these problems?
Yes, we meet periodically with the airline companies to discuss their efforts to deal with the medical travel patients.
We will be able to raise this concern at the next meeting with the airline, as the member has identified the areas that require improvement.
From my perspective, they require resolution.
I will ask my officials to add this item as part of their discussions with the airline companies.
Earlier in the minister’s opening comments, he talked about health centres being 24/7. Just for clarification, is he talking all the centres throughout Nunavut will move towards being open 24/7?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) All our health centres are 24/7 operations pretty much and they’re there for emergencies at all hours.
They are now and will continue to be. (interpretation) Thank you.
At the present time, I’ll just use my community as an example. It’s basically a nine to five operation and after hours, it’s all callout, nurses are on call.
If you move to 24/7 where nurses are at the desk during the evenings, I’m just wondering: have you decided how many additional nurses you will need in the communities in order to fulfill this obligation?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As I said, they are available 24/7 for emergencies after hours.
They have regular hours. We are looking to work on adjusted hours to reduce the burden on the nurses so that they can work at adjusted hours and at the same time, provide more services for the communities.
Those discussions are ongoing and will take a little bit of time. (interpretation) Thank you, Mr. Chairman.
With these adjusted hours for our health care staff, do you anticipate that additional staff will be required?
For example, in Sanikiluaq, we have three staff members who are there on a regular basis.
If you move to staggering their hours, will it require additional staff?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) You probably are aware that we come forward with supplementary appropriations quite regularly because we have to provide a 24/7 service, so we never know when and at what time the nurses may be called upon to perform a service for clients.
What we have looked at are hours where they are busiest, for example, and probably from five to eight o’clock in the evening is when they’re very busy and providing care and attention to patients.
We could adjust the hours to accommodate that so that we reduce the overtime that may have to be paid out for the nurses during those hours and adjusting them so that they start a little later.
We’re looking at that and that will require more discussions with the union and that is something that we’re working on. (interpretation) Thank you, Mr. Chairman.
At present in our health centres, patients are mostly seen for regular, day-to-day needs by our health professionals in the mornings to afternoons.
If you stagger the staff to now move to work some evenings, it will require a lot of patience, staggering their appointments, to work in the evenings too. I’m just wondering… .
Working the evenings, yes, I guess.
I’m just trying to get around… . I just can’t see this being operational 24/7 without additional health care professionals in our communities.
Can the minister just confirm that we are going to work with what we have in our communities at the present time?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We are not looking at increasing more PYs, but we’re looking at adjusting their hours to accommodate the level of care that they’re providing now.
A lot of calls are between 5:00 and 8:00 for nursing throughout the communities.
We will look at adjusting the hours, but providing that service. 24/7 service will continue to be there.
It is there now. It is there so that whoever needs immediate medical attention after hours is going to continue to be served.
We’re not looking at providing a 24-hour service; we’re just looking at providing a better service when it’s needed, where it’s needed, at those hours. (interpretation) Thank you, Mr. Chairman.
If no additional staff is required and you’re just staggering the hours of the staff we do have, I wonder if you can explain why your department needs another $5.56 million in order to provide a service that you’re already providing.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Those discussions are ongoing. As I said, they will require an agreement with the union to adjust the hours. Those are more monies that may be needed to deliver the service. (interpretation) Thank you, Mr. Chairman.
My first question to you in this area is about the client relations office. Perhaps you can start off by telling us how many people use the office.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We just dealt with that on the last page.
I believe there were 147 concerns raised in the last few months to January.
We just dealt with that item. (interpretation) Thank you, Mr. Chairman. (interpretation ends) From April 1, 2014 to January 22, 2015, 147 concerns were raised with the office. (interpretation) Thank you, Mr. Chairman.
I think I must have missed that, but let me go on.
From those 147 calls or raised complaints, what kind of tracking do you do to see if those complaints were actually addressed and resolved?
Hon. Paul Okalik: As I said when it was raised last, a lot of them relate to medical travel, nursing, as well as communications issues. (interpretation) Thank you, Mr. Chairman.
I think I’m trying to get at: when the office receives a call, is it logged somewhere and from the log, after a year, would you look at it and say, “How many calls did we get? What were the common complaints? Were they resolved?”
I’m just trying to get what… . Is this person just answering the phone and saying, “Yay, baby,” or is the department…
…using that information?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We dealt with this at the Directorate.
We explained that yes, we log and track the calls. I cannot divulge a lot of the details that may be discussed because those relate to privacy matters.
They are tracked by community and the issues they may have. (interpretation) Thank you, Mr. Chairman.
I thought I should put a little bit of humour in this heavy discussion.
Let me go on to home care.
I have a number of constituents who are elderly and in Iqaluit lately, the service has been cut back, although budgets seem to have remained the same.
I’m wondering if you can tell me why home service has been cut back. Some of them were getting service three times a week and now it’s only once.
I just want to get your take on that.
I’m sorry. (interpretation ends) I’m lost. Where are we on this?
We are going back and forth from Directorate and now we are working on H-6 right now because we approved the other ones already.
Can I get some direction where we are?
Chairman: Home care is under H-6.
Hon. Paul Okalik (interpretation): I’m sorry. (interpretation ends) We need a bit of time to review.
(interpretation) Thank you, Mr. Chairman. (interpretation ends) The assurance I have is that home care has not been cut, that the service is still there. (interpretation) Thank you, Mr. Chairman.
I am glad to hear that because I’m going to go back now to the constituents who had their home care cut and I guess they will be able to… . I will look more into this and get back to you because it seems like it has been cut.
Maybe there is just a break in communication here between your office and those delivering home care.
Just to go on to my next question, and it is under H-6 by the way, what are the long- and short-term plans of the department when it comes to residential care to elders and other adults who may need this kind of service?
This whole issue has been raised time and time again and as the new minister, perhaps you would like to give us your take on it.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As I alluded to in my opening comments, we’re increasing more services for those in need and repatriating as much as we can for this year and we will continue to work on other plans to try and increase capacity for elderly care in our territory. (interpretation) Thank you, Mr. Chairman.
Ms. Angnakak: Can the minister give us a timeframe where he feels that, for example, Iqaluit, who I represent, and Niaqunnguut, will have a place for elders to go to when they no longer can live at home? Right now, what we have is not only used by Iqalummiut; it’s also used by other communities, even as far as Kugluktuk. Obviously, there is a real need to do something about this now.
Hon. Paul Okalik (interpretation): Thank you Mr. Chairman. (interpretation ends) What we are doing is looking at a needs assessment throughout the territory and looking at where we can be strategic in investing our dollars for the coming years. (interpretation) Thank you, Mr. Chairman.
Can the minister tell us when this needs plan is going to be carried out, when it is going to be completed, and when we will know the results?
Hon. Paul Okalik (interpretation): Thank, Mr. Chairman. (interpretation ends) We hope to have something by this fall. (interpretation) Thank you, Mr. Chairman.
That’s great to hear. I look forward to learning more about what you guys found out.
In keeping in line with that, I’m wondering with my next question: is the hospital in Nunavut here, the one we have in Iqaluit, required to provide hospice care?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) They do provide palliative care. I have not heard of hospice. (interpretation) Thank you, Mr. Chairman.
I’m going to another topic and it fits under this and it has been raised, but I’m going to take a little bit of a different angle on it and that has to do with the medical boarding home contracts.
How often does your department converse with the managers of the boarding homes?
Hon. Paul Okalik (interpretation): Thank you. I’m sorry, Mr. Chairman. (interpretation ends) We’re having a little caucus.
We’re trying to get an idea of how often we meet and I can’t answer that at this time, but I know that we do have regular updates from the main contractors on what service they’re providing. I went to the one in Ottawa when I was down recently and I was quite impressed with what they do.
We will get back to the House on how frequently we meet with our officials and those contractors. (interpretation) Thank you, Mr. Chairman.
I’m going to go on and ask some more questions in regard to that. You might not have the information. Perhaps you can get back to us on it.
I want to ask: what kind of measures does the department have in place to assess whether or not the boarding homes in the south for people on medical travel are meeting the needs of those people? How do you know that and what kind of oversight is provided?