EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
For example, I can look at one of the member’s community, Chesterfield Inlet, give the break down on population, and look at the total number of visits to the health centre.
Would that be helpful for example, to the member.
For Chesterfield Inlet, I could say for example, there were 2,827 visits in 2000/2001.
Last year, there were 4,000, which is an increase of 41 percent.
So the member might say, what was happening in constituency last year when you had a 41 percent increase in visits to the health centre.
How is that driving the costs of the community for example.
Do you need more staff and so on.
I could tell the member that there were 1,393 medical travel trips out of the community.
I can say that there were 321 chartered.
I can give him the budget for the last two years in the community.
So, that level of detail is available but in most cases, if the Finance Minister could say, that level of detail is using is never present in these types of books and binders.
That’s the level of detail the member talks about that the health committee for example would see when they ask questions during their committee review and hearings.
Maybe that’s something as a house, that we have an opportunity to discuss what’s available.
I don’t know if it would be possible for every department in government to be able to put that level of detail in the budget proposed, given those amounts.
The reductions that the member talked about were adjusted to reflect the travel requirements.
Mr. Arvaluk: The last one on that page Mr. Chairman, referring to Mr. Iqaqrialu’s question on the supply of blood in the communities.
We understand it has a very short shelf life, do you have at least, an inventory of blood types in all the communities where if someone in Clyde River gets hurt and is bleeding like crazy or giving birth and cannot stop the bleeding, there’s a blood type B in at house 429 and our telephone number is 979 etc.
Do you at least have that inventory?
Mr. Chairman, one of the luxuries that we do have in Nunavut is that we have a homogenous blood type because of the population breakdown.
So, that is available to the staff.
Actually having blood products or blood supply on hand, we don’t have that.
We actually import our blood as the member knows usually from Ontario and Quebec at the present time for the Government of Nunavut.
We do have a supply at the hospital here but we don’t have it available in individual supplies in communities because of the issues around the storing of blood, the short shelf life, the number of products that you would have and so on.
We do have the homogenous group that the member talks about.
Mr. Arvaluk: So what you’re saying is that, if my sister is giving birth, and I have the same blood type, they would not be able to use it, even if we live in the same community because something has to be done with the blood first.
Is there anything that the department is taking as a measure because they cannot store blood but they know that they could get the information to the community, very small community of 1,000 people, say you can come in and give your blood type, if it is acceptable for blood donation if it needs be in case someone gets hurt, or having problems birthing, etc.
Do you have that kind of inventory, or are there some measure, or you have to wait until the planes in from you say Quebec to Grise Fiord for emergency purposes.
What is your preparedness now?
Mr. Chairman, the Member raises some good points.
It is my understanding, Mr. Chairman, that because of the storage issues, because of the supply issue, because of the short shelf life of blood products in general, we do not have a stock of blood in every community.
That has not changed for twenty years.
There is because of our homogenous population, we know what the blood type of the majority of the population is.
There have been instances, for example, Mr. Chairman, as I am aware of, since becoming the Minister of Health, where an emergency supply of blood that was needed, and we had people from a Health Centre from a community, that we able to give blood, because of the homogenous type.
However, every time that you give blood, it has to be checked for HIV, it has to be checked for Hepatitis C, and so on.
We do not have the Laboratory to do those tests in Clyde River, or Pond Inlet, and so on.
So you need to be very careful of any type of blood that you put into someone.
So those types of tests need to be done.
The blood needs to be screened.
We are all aware of the bad situation that occurred over the last decade when blood products that were not tested went into people and caused HIV, and Hepatitis C infections.
That is one of the things that you really have to be cognizant of, Mr. Chairman, when you are talking about blood products.
Just a quick question under the Grants and Contributions.
Mr. Chairman, it has Shelter Programs.
I am just wondering if the department provides any funding to the Homeless Shelter under any of the Programs?
In the Department of Health and Social Services we have been funding the Homeless Shelter in Iqaluit. Thank you, Mr. Chairman.
Does that fall under Shelter Programs?
Or if it does not mentioned here, it mentions the other kind of shelters, but it does not mention the Homeless Shelter.
I am just wondering if that falls under, or if it is somewhere else?
Yes, that is where it falls under.
It falls under people with special needs.
I know that the Minister know quite well that the shelter is always struggling to stay open and maintain the service that it provides to it’s clients.
Have the funding level has been increasing over the years to the Homeless Shelter?
Yes, Mr. Chairman, they have had an increase since this program had begun.
We have not been able to give the type of service that we would have like to in the program itself.
I believe right now, Mr. Chairman, that the Homeless Shelter in Iqaluit, the core funds that it receives is from the Government of Nunavut, they also other funding partners that help deal with the Oqota Shelter.
It is under the Illitiit Society.
Mr. Chairman, does the Minister, the department want to ensure that the Shelter has the adequate resources to provide the services that it does provide to the community, in Iqaluit?
Mr. Chairman, the Minister pointed out there are the residents, the clients that use the Shelter are not just from Iqaluit.
They are from all of the different Baffin communities and beyond that use that facility.
Is the Minister of Health is ensuring that they have the adequate resources to make sure that they can operate and keep the doors open for these clients.
Mr. Chairman, that is one of the programs that the Ilitiit Society has been running in the community as their quota on the homeless shelter.
With the advent of the Aqaqtuqsaarvik over the past two months since Christmas, we have actually taken quite a bit of pressure off the Oqota Shelter because they have people now staying in that facility.
So, that is actually helping them out too.
I am just wondering if the Minister responded, you know, he committed to ensuring that the shelter has the resources it needs to be able to maintain the level of service that it needs to provide not only to the community, but to the region.
Yes, we are, Mr. Chairman, within the budget framework of the Department, that it is something that we are trying to continue to work on.
First of all, is this page, on the next page a continuation from the page 10-8, page 10-9?
At the top of the page, I have a question on the shelter program, Funding Organizations to accommodate various individuals with special needs such as Women’s Shelter and Iqaluit Psychiatric Facility.
Is this all geared towards shelter program just for Iqaluit?
Hon. Ed. Picco: No, it is not, Mr. Chairman.
For example, we also support, under this budget line item, the Kugluktuk Women’s Group Home, the Cambridge Bay Stay Shelter, the Qataijaq Society, Aijitiimuuvik, Inuit Women’s Group Home, which is in Cambridge.
So, actually, there is a lot of different programs in different communities across Nunavut within this budget item.
Yes, when the communities, when they apply for shelter , to run Elders facilities or women’s shelters, is that the only time they are provided some funding to get these kinds of shelters only after they have requested or do they not need to request?
Mr. Chairman, usually in the case of the Nunavut, societies set up for like, for example, the Women’s Shelter and then they would apply to the Government for the money.
The Member is correct, it is after they are set up that they apply to the Government for money to operate their program.
How about in the smaller communities, have you seen smaller communities requesting to have Elder’s facilities or to have women’s shelters?
Mr. Chairman, we have seen a demand in communities asking about opportunities for program funding to bring forward women’s shelters in different communities.
One of the concerns being raised, Mr. Chairman, is that in communities, we have for example, some people in many cases stay home, but we actually do not have transitional homes and so on for women.
So, that is an issue that is being raised.
I’m just going to make a comment.
In the larger communities, of course, there is a need for these kinds of shelters. I’m not against larger communities receiving shelters.
What about the smaller communities.
They need more support and assistance too.
They need the same level of services as the larger centres.
I just wanted to make that point and also to get a commitment to consider these kinds of services in the smaller communities.
Under the shelter programs, women’s shelter, 2 million 996 thousand dollars, last year it was 2 million 36 thousand dollars.
There is an increase in this program.
My question is, on shelters, during times when there is family breakdown and violence, the shelters are used as part of the social services programs.
People also come in from other communities.
After the family breaks down, and one of the family members who had gone to the women’s shelter and after the women has been in the shelter, do you have any reports or statistics on how many women have been happily reunited with their families.
No, I don’t have those statistics with me.
Since there is not that kind of information available, we need to know to ensure that people don’t abuse this program.
Perhaps you can do a bit more research on the people who use the shelter and once they’ve gone through all that process, maybe you should do a review on whether these people who have split up have reunited, without mentioning the names, that way we can look at and be sure that this funding is not abused in this line item.
Mr. Chairman, I just want to go back to the first point, I said I don’t have the information with me right here, but I can make some of that information available to the member because we do have some statistics available.
If I can get the information in the next couple of days, that would be okay.
I won’t mind because this has to be done properly as Nunavummiut.
We are planning to use Inuit knowledge on resolving some of the social issues, so therefore I will just be waiting for that information, even though if it is not right away, I would appreciate getting it.
Chairperson (interpretation): Health and Social Services, branch summary, Healthy Children, Families and Communities, total operations and maintenance, who.
Under alcohol and drug programs, the funds there have not changed.
I’m sure the funding to provide alcohol and drug treatment programs comes under Nunavut municipalities.
Perhaps that is where they get their funding from.
In response to an earlier question, in areas such as this tax agreement with the Federal Government.
The contract with the Federal Government expires on 2004 and then we would hope to be able to renegotiate that amount up.
Since this is a negotiated figure I’m sure this is allotted to all the communities of Nunavut.
Mr. Chairman, that money is there for funding to Nunavut municipalities to provide for the alcohol and drug treatment programs under a stacked agreement.
Is that amount allotted evenly to all the communities?
Just a clarification, that’s money that is available in the budget.
So, for example, Mr. Chairman, the Ilisaqsivik Society in Clyde River, I think has $50 thousand dollars of that amount of money that they are doing for some of the group work that they’re doing in Clyde River that the member is aware.
So that’s how the project monies work.
On page 10-8, Healthy Children, Families and Communities.
Total Operations and Maintenance. $33 million, 683 thousand dollars.
Chairperson (interpretation): Would you like to take a ten minute break.
Please come back when it’s 25 past 5.
>>Committee recessed at 17:12 p.m. and resumed at 17:25 p.m.
Chairperson (interpretation): We can resume the meeting.
The Department of Health and Social Services.
Health Insurance Programs.
Total Operations and Maintenance, $28 million, 226 thousand.
We are on page 10-10.
Page 10-10, the Department of Health and Social Services.
Total Operations and Maintenance. $28 million, 226 thousand.
I just want further information on the Contract Services, which you see as the only line item here, and I am sure that there is a whole bunch of Contract Services in this same line.
What is in there?
Mr. Chairman, I will just give a brief overview.
The Health Insurance Programs includes the Extended Health Benefits, out of Territory Hospital Reciprocal Billing, as well as the Non-insured Health Benefits for a total of $28 million, 226 thousand dollars.
It also includes the Health Insurance Programs, such as Hospital Services within Nunavut and other jurisdictions.
That does not include Medical Travel, or Medivacs.
This is strictly the Hospital on similar care costs.
Hon. Ed Picco: That is right, Mr. Chairman, it does not include the travel, it includes the healthcare benefits that we receive.
Mr. Iqaqrialu (interpretation): Just for further information.
It says that the travel and medical services are not here, and it does not including the Contract Services. $28 million, 226 thousand is quite a lot.
Could you elaborate further on what it covers?
Mr. Chairman, the Medical Travel costs, we will find those when we get to 10-12 when we get to that point. For this one here, Mr. Chairman, for example, Hospital Services within Nunavut and other jurisdictions, is a major component here, reciprocal dealing with out of Territory Hospitals.
So every time we send a patient from Nunavut to Winnipeg, Churchill, Yellowknife, Ottawa, Montreal, Edmonton, and so on, we get charged for that.
We said the other night in the debate here on the budget, that it is over $1 thousand 6 hundred dollars for a paediatric bed.
On average if we took Mr. Iqaqrialu and he had to stay three nights in Ottawa in Hospital, it would costs us around $15 hundred dollars a night.
That is what they are charging us.
It is not free.
Every time you send a patient down south, they charge you back.
So those costs are increasing also.
When you see our budget increase, for example, we cannot control the costs of sending Mr. Okalik down to Edmonton for five days.
If Edmonton wants to charge us $15 hundred and 80 dollars, and last year they charged us $13 thousand, that is the way the reciprocal billing works.
Your costs are going to increase.
When we end up sending more patients down south, it costs us more money.
That is what is reflected here, Mr. Chairman, in the Line item.
I hope that helps explain the question.
Is it not possible to build a facility, or provide the services here in Nunavut so that the $28 million dollars does not go out of the Territory?
Is it possible to set up a system up here so that the dollars stay in Nunavut?
Instead of using the facilities down south, is it not possible to build those facilities up here to keep the dollars?
Yes, Mr. Chairman, that is what we are doing.
That is why we really appreciate the Member’s support for putting a new facility in Rankin Inlet, or Cambridge Bay, Mr. Chairman, as well extending the facility here so we can actually put more money back into Nunavut and provide more services here so that people do not have to fly out.
So, the answer is, yes, Mr. Chairman.
Non-insured health benefits is for aboriginal or anyone else that are not working, but with other Inuit who are Green Shield, I think it’s called Green Shield Insurance or something like that, is that for dental health only, or is it for general health for those who are working and are insured.
What is the definition of non-insured health benefits?
Mr. Chairman, non-insured health benefits, is a program run by the Federal Government specifically for Inuit or aboriginal Canadians. It’s not just unique as the Member knows, for Nunavut, it is also in place, for example, in the Northwest Territories and so on.
Those costs that we are able to bill right now are at 10 million 926 thousand dollars that we are able to bill back to the Federal Government for insured benefits for Inuit, let’s say for those hospital costs, although we know and the member knows, it probably costs us 40, 50, 60 million dollars or more.
85 percent of our population is Inuit and we are spending more than what they actually give us.
That is part of the negotiations that we are having with the Federal Government right now.
For example, Mr. Chairman, very quickly, in 1999/2000, we had a ceiling of 10 million 287 thousand dollars that we could only bill to.
We found out in that year that our actual expenditures were actually 10 million 791 thousand dollars.
We have an agreed ceiling last year of 2001/2002, of 10, 287 again.
We actually spent 14 million dollars that we actually tracked to that line item, plus more at the time.
So, basically, Mr. Chairman, what is what is included.
What is also put into that is vision care, eye glasses, drugs, medical supplies and equipment, as well as medical transportation costs, some of those are also covered in there.
The actual costs of prescription drugs, medical devices that are paid directly by Health Canada.
So, what is the legal responsibility of the Federal Government, then, if they are not going to pay for all the costs of non-insured benefits?
Do they give you some kind of explanation of why they would not pay 100 percent when they are paying 100 percent in southern Canada?
Mr. Chairman, I just want to make sure that we get this right.
The Federal Government, Mr. Chairman, has a program in place, called NIHB for aboriginal Canadians. We maintain as a government, that the Federal Government have a fiduciary responsibility to aboriginal people.
The Federal Government have basically said, since 1974 that is not the case, that they are just managing this program for aboriginal Canadians.
We maintain that they do have a responsibility, a fiduciary responsibility.
Basically, Mr. Chairman, the jury is still out on what they do or do not owe.
Because it is a Federal Government program, there may be a level in Nunavut and there is less than what is in another jurisdiction.
I’ll give you an example, Mr. Chairman, when there was a problem in Davis Inlet, and they had to send 47 kids out for treatment, it was not the Newfoundland government that paid for that. That was the Federal Government.
If I had to send 47 children from Iqaluit out for treatment, I would suggest to you very strongly that it would be the Government of Nunavut that would have to pick up 95 percent of that cost.
That is what is different.
So, it is a program delivered by Canada.
And because it is their program, there are some arbitrary ways that they develop that program and spend their money. Thank you, Mr. Chairman.
Mr. Arvaluk: I do not know if this is the budget, is the right time to discuss that, but it has to be discussed some more in detail, especially with the lawyers that have knowledge of history of how the Federal Government responsibility is for health programs for aboriginal people across Canada because there is a proclamation or Indian Act specifically stating that, for the purpose of health programs, any shall be included, it says that.
Okay, specifically stated that, I read it.
The aboriginal people in the south are covered 100% by the Federal Government.
Correct me if I am wrong, I don’t think that the Federal Government, I do not think that the Provincial Government pays that part.
I think it was called the Sprinkle Building, I do not know how to say that in English, but when you try to steal a thousand bucks if you live in Alberta, my Cree friend will, the Alberta Government will bill the Federal Government for that exact amount, down to the last penny.
Tell me, in the legal terms, what is the difference between Alberta and Nunavut when it comes to uninsured payments from the Federal Government.
Have you dealt with a lawyer in that one?
Mr. Chairman, first of all, I do not think I would be able to give a statement on the situation in Alberta with regards to the First Nations Programs that are on there because I do not think that would be acceptable.
What I can say is two things, first of all, the Federal Government has programs, I know we want to be quick here.
When the Federal Government has programs, they have made it very difficult since 1999 for Nunavut to have an uptake on those programs, to get access to it.
I will give you a quick example, Mr. Chairman, FAS/FAE, last year, the Federal Government announced that $4 million strategy for FAS/FAE.
When I, as the Minister of Health and Social Services, tried to access money for Nunavut, I was not able to do it because the FAS/FAE Program announced by the Federal Government was for on and off reserve.
We do not have reserves in Nunavut, Mr. Chairman, and that is just an example of how the differentiation between first status, no status reserve and off reserves are and how it affects Inuit.
After bringing this to the attention of Jane Stewart who is the Minister for HRDC and a former DIAND Minister, she agreed right away that this is a problem here.
And then we were able to change the program funding so that there was actually an access for it.
But then, we have another problem, which was the per capita amount.
So, Mr. Chairman, that is basically what we are talking about on the NHB in 1988, Mr. Chairman, if I can use the word hot, the Government of the Northwest Territories of the hot to take over Health and Social Services to the Feds.
And when he signed that lousy agreement in 1988, part of it was for a co-payment of $250 another example for paying tickets and it never increased, that is right, Minister Ng. It did not look like it either at the time and now, Mr. Chairman, 13 years later, the $250 co-payment is still in place and our ticket prices increased by 700%.
So, we have met, me and the Premier has met with Anne McClellan and talked about the co-payment and NHB.
We have lawyers looked at it through Government, we have had negotiations with Allen Rock and Anne McClellan and we are continuing to do that, Mr. Chairman.
I can say to you that Mr. Best has met recently with Health Canada Officials and I hope to meet with Anne McClellan in the next few weeks, possibly in Yellowknife with the other two Territorial Ministers to discuss the issue around NHB, which is a huge implication for offices of Government and especially for our deficits.
And a good example, Mr. Chairman, instead of spending $30 million a day on travel, what if the Feds paid an extra 20?
And that would take care of the deficit and be $20 million that I could put into hiring new nurses, more psychiatric facilities and so on.
And as well, I appreciate the question from the Member, the Member is correct.
Chairperson (interpretation): Arvaluk.
Maybe this is the wrong place to discuss that.
It is off the topic here.
Can we, though, along with the government and you as the Minister of Health and Social Services, discuss this, maybe in Baker Lake, or in a roundtable discussion or some kind of retreat and try to come up, at least have the regular members start having a little bit of a draft of complexities of the reneging by the Federal Government.
I don’t know how you phrase it, but there’s something wrong, from the Indian Act.