EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
The minister indicated that there are existing initiatives in introducing additional initiatives, followed by the first bullet on the bottom of the page. It states, “Strengthening the provision of mental health services in” Nunavut.
Can the minister educate me on this, as well as be able to elaborate or expand on what this means?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Aupaluktuq for the question.
Mr. Chairman, in my previous answer with the hiring of 12 mental health workers, we’re also looking at an initiative here in Iqaluit to acquire the old boarding home near the Inuksuk High School and refurbishing that into a mental health facility.
I have two issues that I don’t quite get, so I would like to ask questions on them.
Mr. Chairman, they’re related to the minister’s opening comments.
It talks about these issues at around the middle of the first page. It talks about the cost of living increases and these are forecasted.
Further, they delineated the previous increases that were to be implemented.
Mr. Chairman, perhaps if I state it in English, it will be a lot easier to say exactly what is stated here.
It goes like this: (interpretation ends) “recognize recent cost increases.” (interpretation) I would like to ask what that’s talking about.
Mr. Chairman, with your indulgence, on the fourth bullet, it states in English, (interpretation ends) “Interoperable electronic health records.” (interpretation) I don’t know how to say that in Inuktitut and I apologize, Mr. Chairman. What is that exactly?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Enook for his questions.
To answer the first part of his question about the anticipated demands or recognizing recent cost increases, those would be costs that have increased in out-of-territory hospital costs and out-of-territory physician costs, primarily for costs down south.
As everyone knows, health care costs are rising in Canada. It’s no different for us.
The second one is interoperable electronic health records. That’s a national initiative that both provinces and territories are participating in. It’s to put all of our medical records on electronic databases so it’s easy to access health data, regardless of where you are in the territory or in Canada.
If you look at the bottom of the first page in the minister’s opening comments where it states, (interpretation ends) “In 2012-13, the department will continue to move forward,” (interpretation) underneath that, (interpretation ends) in the second bullet, (interpretation) it states, (interpretation ends) “Establishing a culturally relevant pilot program for addictions treatment.”
Can you give me one or two examples of culturally relevant programs that you will be including in this, Mr. Minister?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Oshutapik.
An Hon. Member: You got it, buddy.
Hon. Keith Peterson: Thank you. It’s a tough name to… . I apologize.
When I responded to Ms. Ell the other day in question period, we were talking about a mobile addictions treatment centre. It’s a pilot project that would be based in Cambridge Bay because we have a facility there where that pilot project could be set up in. What we’re now going to do is involve the elders and local people.
I think part of the plan would be to use their knowledge to help people, elders’ knowledge to help people, and also to take them out on the land.
I also thank the minister for responding to my question.
That’s the very first time he has ever pronounced my last name properly.
The first bullet speaks to recruitment. Without reading the entire wording, the second bullet talks about Nunavut nursing recruitment. I would like to know if the goal here is to recruit more nurses to work in Nunavut.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Oshutapik for the question.
The Nunavut Nursing Recruitment and Retention Strategy, if I understand it correctly, that’s a five-year strategy that was signed, I believe, in 2007. The department is required to review that and they will be reviewing it to see how successful it has been in recruiting and retaining nurses.
I believe there is some information that indicates that there has been a decrease in our dependency on agency nurses and an increase in indeterminate nurses.
It’s something that we’re going to be review and I believe it is necessary.
I would just like to remind members that 99.9 percent of the time when the minister has the opening comments, it relates to page by page in our O&M estimates.
Now I have Mr. Ningark.
Mr. Ningark: Thank you for the reminder, Mr. Chairman.
As a member of the new Liquor Act task force appointed by the minister at the witness table, we attended many public meetings.
We had radio talk shows. There were comments about not having treatment centres in Nunavut on the radio talk shows and public meetings.
My question subsequently to what I have stated is: how many addiction treatment centres do we have in Nunavut?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Ningark for the question.
Currently, we do not have any treatment centres in Nunavut. Hopefully we will have a mobile addiction treatment program after this initiative starts.
Now that connects me to the issue of significant areas of proposed increases which include travel and transportation in the social services area, which is in the amount of $4.34 million.
Is that related to not having treatment centres in the jurisdiction? For that, we have to travel outside of the jurisdiction. Does that include people going to treatment down south?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Ningark for his question.
Mr. Ningark: Thank you, Mr. Chairman. Now I go to the bottom of the page of the hon. minister’s opening comments, the very last bullet, and I quote, “Continuing the implementation of the Public Health Strategy.” Now my question is: does this include a suicide strategy in Nunavut?
I don’t think I have to emphasize that because in every community and every level of government, we talk about the high rate of suicide in Nunavut.
Mr. Chairman, I don’t believe that we will tailor the suicide prevention strategy into the Public Health Strategy.
That concludes my questions and comments at this point until we get into the page-by-page [review].
Chairman: Thank you, Mr. Ningark. I have Mr. Tapardjuk.
Mr. Tapardjuk (interpretation): Thank you, Mr. Chairman. I would like to welcome the Minister of Health and Social Services, along with his officials.
I’m just going to make a comment with respect to the opening comments, but I will save my questions for the page-by-page review.
Based on the minister’s opening comments, it has become a lot clearer and my colleague also raised a question on this matter that I really want clarified. I would like to understand why the department requires an extra $4.3 million for transportation costs in our fiscal year.
Additionally, it includes a reference that a review will be conducted. Based on the comments here, it also states that there will be a review of current legislation, particularly the Child and Family Services Act, Public Health Act, Vital Statistics Act, and Mental Health Act.
We will have to be very careful in deliberating the language. If we’re conducting a review, I do understand that aspect of what you’re planning to do, but I want to totally get clarified so that I can understand.
Mr. Chairman, when we look at the costs of air travel and transportation for the department, the $4.34 million of additional funding that they’re requesting immediately popped in my mind. Perhaps they’re anticipating that there will be an additional cost and that’s why they’re requesting additional costs.
Is this geared towards patients who have to leave family? It really causes a lot of concern when there’s nothing clarified and what the budget is for. In order to satisfy myself, I will have to get a good idea.
For the time being, I’ll forewarn the minister. I’m just speaking to the issue, but I will be raising questions when we go to the page-by-page review.
If the minister is willing to provide a response at this time, I’m willing to hear it.
I’ll wait until we get to the appropriate page and then respond.
Chairman: Thank you, Minister Peterson. (interpretation) I have no more names on my list. Would you like to proceed to the page-by-page review?
We’re on (interpretation ends) Health and Social Services. Branch Summary. Directorate.
Total Operations and Maintenance, to be Voted. $21,310,000. (interpretation) Do you agree?
We’re on page H-4. I apologize if I didn’t say that we’re on page H-4.
I asked if you agreed. Are there any questions?
In regard to the electronic health records, I was just wondering… .
I know I had asked this question before, but there was a Minister’s Statement that was out in June. It talked about the implementation of the electronic health record system.
It will decrease the turnaround time for reports and eliminate the need for film handling for X-rays and patient records will be available to all appropriate practitioners across Nunavut anywhere, anytime.
That was what the Minister’s Statement from June said. I was just wondering: how much time savings does the minister anticipate with the new electronic health records?
Mr. Chairman, it’s hard to put a figure on it right now. There are probably more efficiencies that we’re going to experience from the system.
If I’m a person from Cambridge Bay and I get sick in Iqaluit, they can access my medical records here in Iqaluit very quickly and diagnose me and help me out. So that will be a major improvement.
If I’m down south, it’s the same thing. That’s what we’re looking for. Once this is implemented, we will be able to assess the turnaround times on reports and diagnostic testing, and then put some savings figures on those.
In terms of X-rays not requiring film, is that already going on in the communities? I’m assuming they’re scanning them and then sending them as JPEG or something. Is that already happening?
That will be part of our capital supp when we see it later this week.
In terms of access to the information, I know, in terms of when the Privacy Commissioner was before us, she seems to feel that the department is working really well in terms of ensuring privacy of information. Will this be inter-jurisdictional or is it just kept in Nunavut? Will our health records be accessible if we’re getting treatment, let’s say, in Edmonton or Winnipeg or Ottawa?
Mr. Chairman, when we send people south to our referral partners, they will be able to access that information.
I know we spent a lot of money over the years in terms of increasing the bandwidth and the speed of Internet access and fibre optics in the communities for Intranet.
I’m just wondering: with the information that is collected on individuals across the territory, is that housed on a server in Nunavut or is it on multi-servers in different jurisdictions?
The information will be on, I believe, two servers here in Iqaluit and hopefully be backed up in Ottawa.
I know, within the government, a lot of times, we don’t have the capacity, so we do contracts and sometimes sole source too much.
Is this done by GN employees and the servers are maintained by GN employees or are we contracting a different party to handle this information?
It’s done through CGS.
So again just for clarity, should I ask the minister if it’s a GN employee within his department who handles this or is it contracted out?
I’m just wondering if it’s a GN employee who actually handles the documents.
I thank Mr. Elliott for the question again. It is done by CGS staff.
On page 132 of the business plan, one of the priorities for this year is to “Establish a Licensed Practical Nurse (LPN) program.” I’m just wondering: in terms of that program being offered with Nunavut Arctic College, are there students within that program now or is the program going to start in September of 2012?
Mr. Chairman, the program was postponed and I believe it will be offered again in September 2012.
On the same page, on 132, the final bullet for the priorities for this year is to continue to collaborate with EIA and the Department of Finance to “ensure that a renewed Territorial Formula Financing arrangement addresses the fiscal needs of the department.”
I guess maybe the first question would be: in terms of the allocation of funding that we give to your department every year, you’re consistently coming back and asking for supplementary appropriations.
Is the budget or the territorial transfers that we receive from the federal government not adequate?
I can assure the member that there will be close collaboration between the Department of Finance and the Department of Health.
I was at the FPT in Victoria when Minister Flaherty gave us the news. FPT stands for federal, provincial, and territorial.
At the time, there was a little bit of fear, panic, and terror when a letter was handed out.
There were a lot of upset people.
To answer your question, it’s hard to say that the costs will be contained. Right across Canada, in all provinces and territories, the health care costs are increasing. We have an expression in the Department of Health and Canada-wide of bending the cost curve.
I believe the premiers met, I believe, in Victoria in January and they have asked the health ministers to have a couple of meetings and talk about how we can be more innovative and bring our costs down.
I did meet with the federal Minister of Health in Iqaluit last month or earlier this month, pretty close to month-end, to talk about how Nunavut could work with Health Canada to bring some of our costs down.
So I can’t say with any certainty that we will keep our costs down, but right now, the cost drivers are out-of-territory hospitals, out-of-territory physicians, and medical travel, so it will be difficult and it will be a challenge.
I never heard it expressed that way for FPT. I think I’m going to remember the fear, panic, and terror.
In terms of the minister’s department, have you completed a business case outlining the resources it needs to provide health and social services to Nunavut residents, to come up with a dollar figure, not a wish list, but a more realistic dollar value of what is needed to provide health services to the territory?
Again, Mr. Chairman, with news from Mr. Flaherty in Victoria in December and the premiers’ meetings, and the meetings that health ministers will be having, I think this is an important initiative that we will have to undertake this year.
My deputy has indicated that it is something he planning to do.
Mr. Elliott: Thank you, Mr. Chairman. Again, with the idea of there being fear, panic, and terror and the way this is worded for a priority, is this renewal of the territorial formula financing or is this renegotiation?
Is there any ability to negotiate a better deal to get the needed resources to provide better health care and social services to our residents or is it just a renewal and whatever they will be passing on, they will be passing on?
The current TFF agreement expires on March 31, 2014 and they extended it at 6 percent of a year for five years. They will make the necessary legislative changes.
We did talk to Minister Flaherty as the three territorial finance ministers that we need some help here.
I specifically mentioned to him and my officials have been talking to his officials about reviewing the gross expenditure base so that it more accurately reflects the current needs of providing basic services to Nunavummiut.
So we’re hoping that, through technical adjustments and other changes, we will get an increase in our TFF, but there is no guarantee. It’s very difficult nowadays in terms of getting funds.
In the department’s business plan on page 131, one of the priority bullets there was referring to “phase-in implementation of the Office of the Auditor General cost-recovery recommendations.”
I’m wondering: to date, has your department been tracking how much it has recovered and how many more dollars they have been able to recover, following the Auditor General’s recommendations?
Currently, we have not done that, but it will be part of our medical travel audit when we proceed with that.
Again on page 131 with the implementation of the communications strategy, what is the role of his department in implementing that?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Elliott again for the question.
We’re working on a newsletter that will be sent out controlling the message on health initiatives, putting out positive news about health initiatives and generally educating people about the importance of health across the territory.
There will probably be TV spots, radio spots, and those kinds of initiatives.
Again on page 131, one of the goals from last year was to “Continue to develop a health services strategic plan based on the health care gap analysis.”
I’m just wondering: in terms of the health care gap, what specific things were they targeting?
One of the areas that we would focus on the gap would be Inuit social workers.
Was the need seen as hiring more Inuit social workers or training more Inuit social workers?
What exactly was found?
We’re developing the program or will be developing the program with Nunavut Arctic College. I believe that in Cambridge Bay, there’s a human services class, year one and year two classes.
I’m not sure of the exact numbers of the folks over there, but there are Inuit who are training to be social workers.
The director of the department is actually tasked in its… . In the O&M main estimates, it says it’s for the development of policy and legislation.
In your opening comments, you mentioned the Child and Family Services Act, the Public Health Act, the Vital Statistics Act, and the Mental Health Act.
That’s four pieces of fairly big legislation.
Could the minister go through and maybe give us an update on what’s happening with those pieces of legislation?
I know we received some information about the Child and Family Services Act with consultation all across the territory, but maybe now would be a good time to find out, with not very many more months left in our mandate, when he anticipates bringing these forward into the House.
I believe the legislative proposal for the Child and Family Services Act will be developed and introduction then brought into the House in 2013.
We’re currently revising and updating the Public Health Act and the work on a legislative proposal will be brought later this year. A review of the Mental Health Act has been initiated for 2012-13. The department is updating the Vital Statistics Act, and then at some point, the legislative proposal will be developed and brought into the House.
In terms of the Mental Health Act, it’s nice that the department is putting more resources into more mental health workers in the communities to help continue with healing in our communities. I was hoping to maybe get a little bit more detail specifically on the Mental Health Act.
When will your department start going to the communities or speaking directly with the frontline workers in terms of what needs to be done to improve the Act and what needs to be built into the Act to make it better?
Mr. Chairman, we’re at very early stages on this. When we get further advanced on the planning, we will have to get back to him with that information.
Mr. Elliott, you have 34 seconds.
In terms of the Mental Health Act, could the minister provide us with a list of potential contacts of who they will consult with?
Will this go to the Inuit organizations, social workers, and community groups?
Mr. Elliott’s playing games with the clock. I see he’s got 11 seconds left and talking faster.
Yes, Mr. Chairman, we have already begun some early discussions with other government departments, agencies, and non-government organizations, such as NTI, regional Inuit associations, the RCMP, and the public, so I believe we can provide that information.
I assure the minister that I was just trying to get as many questions as I can to help understand what’s going on within his department.
When his predecessor was minister, one of the things he committed to was to try and stay from sole source contracting and rely on full-time, indeterminate, and casual employees.
I’m wondering: is that still the mandate of the department? Maybe report back on how well that policy is being followed through on.
You’re working overtime.
I believe we have heard loud and clear from MLAs that the government departments should try to rely less on sole source contracts and our department is no different.
However, it is a medical department, so we do have to provide… . For example, out in the communities, there is a need for nurses. If we don’t have a nurse, we will have to rely on an agency nurse or a casual nurse.
More questions on Directorate on page H-4.
I have one question similar in nature to what Mr. Elliott has been asking.
This has to do with recruitment and retention of the beneficiaries in Nunavut.
We all know that over 85 percent [of the population] are Inuit who live in Nunavut.
We know that there are graduates from the Nursing Program thanks to the Government of Nunavut, but there are other opportunities in Health and Social Services that our beneficiaries can work.
My question, Mr. Chairman, is: what factors are affecting the recruitment, especially the retention, of Inuit employees in your department?
Are people moving to other opportunities across the board or are they moving south looking for better jobs, higher pay, and so on?
That’s a very difficult question to answer.
I think what we have to do as a government, as a department, is we have to offer the training opportunities and make the training programs available for people who, when they do graduate from high school, can make a career or profession in the health department if they want to be a nurse, a social worker, or another type of health professional.
So it’s important that we make those opportunities available for training, and then when openings are available in the Department of Health, we encourage people to plan for those positions and then we support them.
I do believe, at some point, that it will be important for Nunavut to have a largely homegrown group of health professionals to work in all of our communities and our hospitals.
I don’t have any more names here.
Mr. Chairman, right from the outset, I will limit my questions to the department in view of my previous involvement with the department.
That being said, Mr. Speaker, I do have some questions with respect to the national context of the issue as well, particularly with respect to the federal government’s unilateral announcement earlier this fall about the health transfer agreement to remain at a particular set of financing, which the minister already indicated in response to one of the members.
Subsequently, there have been some disagreements with the federal announcement. I wonder exactly what the Nunavut government’s stance is with respect to whether or not they agree with the federal unilateral decision as to how the funding should remain without negotiating the whole health transfer complexities that the provinces articulated together.
So could the minister give us some insight as to exactly where he stands, whether he agrees with the federal approach, or does he agree with some of the provinces that do feel that there should be some series of negotiations prior to the final date being, I think, which the minister indicated was extended to 2017?
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Curley for the question.
Mr. Chairman, coming from a territory where we’re always experiencing shortage of funds for all of our operations, obviously I was concerned that the Canada health transfer funds were going to be at 6 percent for the next few years and then they were going to be lowered to 3 percent.
In our circumstances, we do sort of have a unique situation where our Canada health transfer funds only comprise, I think, $31 million this coming fiscal year of the total $316 million that we’re seeking.
So the bulk of our funding comes through the Territorial Formula Financing Agreement. On the finance side, we’re working with the federal government.