EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
If the member has a specific request on a specific patient and that was provided to me then with the permission of the patient then we could look into the diagnosis.
Again, we have to be very careful Mr. Speaker, in a public forum on issues of confidentiality.
Question 569 - 1(3): Early Cancer Diagnoses
This question is directed to the Minister of Health and Social Services.
It is in regards to people that are diagnosed as having cancer.
There are many people in the communities who right now are getting cancer.
I just wondered, I know there have been two people that have died of cancer this year 2000.
When they find out they got cancer they died right away.
I do not want to disrespect the nurses and the doctors but I think there should be a better system to find out the sicknesses of the people.
Doctors are paid a salary and they should do their work properly. I have heard recently, and I am not saying which community and who I heard this from but there was an individual that was trying to get assistance so the individual went to another community to get some help.
So this individual was able to get some help in another community and I do not know if the individual is still in Iqaluit or not.
When people do not get good treatment in their community they go to another community to get better treatment or probably a second opinion.
I just wanted to find out if the department could look into the system that the people are starting to go to other communities to get second opinions and stuff.
The member has brought up a very serious issue and in regards to first of all cancer and then second of all as Mr. Iqaqrialu has brought up on the diagnoses and the early diagnoses and other diseases.
Mr. Speaker according to the information provided to me, in 1998 which is the most recent report that we have available to us, there were thirty-nine cases of cancer diagnosed in Nunavut.
The most common cancer diagnosed is cancer of the lungs.
Mr. Speaker, cancer of the lungs is attributed to smoking, which is highly preventable.
Eleven other types of cancer were also reported in Nunavut.
The bowel, liver and breast, Mr. Speaker those cancers were diagnosed in nineteen people.
Half the cancer in Nunavut has a single cause and that is smoking.
Mr. Speaker, our cancer rates are higher than in other jurisdictions.
I think it is important to point out the answer is yes and no.
Our lung cancer rate is higher than any other jurisdiction in Canada.
However Mr. Speaker, we have a lower rate of breast and prostrate cancers, which are very common in the south.
After saying that Mr. Speaker, the second part of the member's question was on the diagnoses.
Let me make it perfectly clear Mr. Speaker, that on any opportunity the health care representatives have in our community, they are trying to work on the preventative side of medicine.
We are trying to prevent these types of diseases and that is why we are bringing in the program in September on anti-smoking so that we can start eliminating some of these highly preventable diseases.
On the diagnoses themselves Mr. Speaker, they are medical professionals, I am not a doctor or a nurse and when I had to go to a health centre my wife had exploratory surgery last week.
I know the medical professionals do the best job they can.
But again if there is a concern with a particular instance then that has to be brought to me outside of this forum.
In this forum I can say that the diagnoses made by the doctors and nurses, if there is concern about a missed diagnoses or an improper diagnosis then that should be brought forward and that could be a legal matter if there has been a misdiagnosis or something like that.
We need to know exactly what the details surrounding it were.
However, after saying that Mr. Speaker, the general point I think the member's question is a good one on how these diagnoses are made.
Medical professionals are trained to look at signs that indicate a problem.
For example Mr. Speaker, if there were a continuous cough then they would look for TB. Thank you, Mr. Speaker.
I was just using cancer as an example when I asked my question.
My question was, there are more and more people who go untreated or are not diagnosed with the proper disease, my question is that you have to review the treatment of patients.
Mr. Speaker, as I tried to explain earlier what we are trying to do at the Department of Health and Social Services and what medical professionals try to do is not something that this government makes up, there are guidelines for the detection and early warning signs of diseases.
If those are brought forward or notified in a patient then that medical professional has to bring it forward under the position that they are in as health professional.
Mr. Speaker, for example as I gave the example earlier with Mr. Iqaqrialu, we have screenings and pap smears to look at cervical cancers, perhaps someone is a carrier of TB, screenings at the community level and so on.
So Mr. Speaker, those types of things are in place and it's not for me Mr. Speaker, to second guess a diagnosis in generality.
I do not understand anything any more what is happening here.
We cannot say a person's name because of confidential issues and the minister stated that his wife had exploratory surgery.
We know his wife, is that proper, if you can say your wife had exploratory surgery then I am assuming that we can say somebody's name who has cancer.
Mr. Speaker, as the member knows when we bring up people's names in this House, in a public forum, I don't go out and talk about a neighbour, a relative, my aunt.
In this case, Mr. Speaker, as the members know in this House about my wife's situation last week, that's what I was trying to indicate that it was done to see if there was another problem.
I was just trying to explain and give that example, I felt comfortable giving that example because it is my wife.
I would prefer Mr. Speaker, not to go into any detail about that but I was just trying to give an example.
I don't bring up other people's names, neighbours, friends, relatives and so on because that is not proper.
In this case in trying to answer the question, I thought because the members were aware of it so I would gave that example.
My question, I would like you to respond to my question, it is nothing to apologize about.
I can say that my in-law, my mother or father in law, because she could not get diagnosed in a community, she had to go to another community to get the proper diagnoses and then go down to Iqaluit for the proper treatment.
My question is, are the people out there getting the proper treatment and are they being diagnosed in the right time frame.
Speaker: Minister of Health & Social Services, Minister Picco.
Mr. Speaker, I am trying to answer the member's question.
I gave examples of some of the diagnoses that are occurring.
I understand what the member is asking.
The diagnoses are based on medical knowledge and professionalism brought forward by the medical professionals.
That's their job and I gave examples, cancer was one of them, I gave examples, TB was another.
When a person goes into a health centre and they have a pain in their side, the medical professionals try to find out what is causing that problem, and then they do a diagnoses.
If the problem continues they will be sent to Iqaluit or one of our other hospital facilities in Ottawa or Edmonton or even Yellowknife to be further seen.
If something is going unchecked and they have a problem and they don't go to the health centre, then it is very difficult for the health professionals to know there is a problem.
So those types of diagnoses are made based on the professional knowledge and based on criteria and so on, Mr. Speaker, that is already in place from the medical professional's point of view.
Also from their education and their background as a medical professional.
So I hope, Mr. Speaker, that helps to answer the member's question.
In regards to if a person has been sent to another health centre for a diagnoses, maybe there might be some other person at that centre who is better able to look at that problem.
But Mr. Speaker, if the person goes into the health centre, a diagnoses is made and then it can be re-checked for example when a doctor is supposed to come into their community or the person could be sent out.
It happens as we know, Mr. Speaker, on a regular basis.
Question 570 – 1(3): CHR Smoking Cessation Work
I would like to direct my question to the Minister of Health.
During recognition of visitors in the gallery Mr. Picco stated that the CHRs were there to help with the smoking cessation program.
He stated the names of the representatives.
What plans do you have to work with the CHRs.
I would like to thank the member for his question.
Mr. Speaker, the CHRs are our community health representative at the community level and their idea is to bring forward preventative sides of medicine, work with the Department of Health & Social Services and with the Health Centre and the nurses at the local level on the preventative side of medicine.
That's what we would be doing Mr. Speaker, the proposal would be to bring forward the anti-smoking campaign, which we have already stated will be targeted toward the youth of Nunavut. The CHRs will be a fundamental part of that because they would have the packages that would be available to the schools.
They would have it at the nursing station.
They would do community radio programs, Mr. Speaker, to talk about the anti-smoking campaign.
Similar to what they do right now, Mr. Speaker, on other health issues at the community level.
Question 571 – 1(3): Final Say on Disease Diagnosis
I made a statement on this, this morning.
So, my question will be directed to Mr. Picco, Minister of Health.
I would like to follow up on the questions that were asked by my colleague, Mr. Irqittuq.
Mr. Speaker, we are not qualified, I know that I am not qualified and other members are not qualified on the medical profession.
The minister is saying who would diagnose them.
I would like to know, I probably have an idea who has the final say on the diagnoses for patients, but Mr. Speaker, in the past I have noticed that in order to accommodate the needs of our communities and the shortage of staff with the nursing profession, I have noticed that the minister has brought nurses from the south to accommodate our needs.
So I would like to know, who has the final say on the diagnoses of the patients.
Does the nurse diagnose the patient, or does the nurse get advice from the doctor before the doctor seeing the patient, and after diagnosing him.
Mr. Speaker, it depends on the circumstances. For example in the member's community, if a person went to the health centre in Arctic
Bay, a preliminary diagnoses would be made by a nurse in conjunction, if the nurse felt that there was a need, the nurse could make a call to Iqaluit and then have a consultation with a doctor in Iqaluit. Then at that time it may be decided that the patient should be sent out for the treatment.
Again, it depends on what the specific problem is.
For example, if it was a broken arm then they could do an X-ray and then the nurse would of course diagnose that at the community level, they have the X-ray and they know what has to be done.
If a person came in with a problem that the nurse could not diagnose or was unsure of what the concern was, then they would be in contact with the medical professionals in this case in Iqaluit. Then that person may be sent out to be seen by that medical professional.
If it wasn't considered to be of a serious nature, that person may be referred to the doctor for when the doctor is on their regularly scheduled trip into the community in question.
Mr. Speaker, the Inuit and especially the people who are not educated, even do not have life insurance.
Mr. Speaker, the minister stated that an Inuk if they wished could take legal action and sue if there is malpractice or anything.
So what happens now, the money is not available to go through the court system.
If there is an accidental death or a misdiagnosis, what other avenues do the Inuit have should there be those types of incidents.
Speaker: You should try to keep your questions on the same issue.
That is somewhat off the track of your last question, but if Mr. Picco as the Minister for Health wishes to respond then he may do so.
Mr. Speaker, the member has talked about malpractice and what options are available, Mr. Speaker, and I think it would be up to the Justice Department, it could explain better as the Minister of Justice, what is available. But Mr. Speaker, after saying that, I would like to explain in the context of health what would occur.
Mr. Speaker, if there was a concern brought forward and if there was a proven misdiagnoses and then a case of malpractice was brought forward it would be dealt with by the court system, by the justice system. If the person needed legal aid or legal help at that time there are remedies available for that person as there is for any person here in Nunavut who cannot afford legal help or legal counsel.
If it is a civil suit, Mr. Speaker, as for example, in malpractice, if that was the case, after discoveries were made, Mr. Speaker, then there would be an opportunity then for that type of case to be brought forward.
Again, Mr. Speaker, that would be a justice issue.
To change the subject, I would like to thank you for addressing that.
Mr. Speaker, I would like to know how much turnover there is on the staff.
I probably have an idea, and I understand that Telehealth will help out the nurses for their diagnoses, but in my constituency in Resolute there has been a high turnover in nurses.
The residents in Resolute question now sometimes whether if the same nurses are in the communities.
So that is why I was asking who has the final say on diagnosis.
What is the rate of turnover of nurses in smaller communities.
Mr. Speaker, I appreciate that third new question by the member.
Mr. Speaker, the turnover of nurses varies as the member said, depending on a number of different things.
It depends on the community, in some cases Mr. Speaker, it depends on the type of year.
On average Mr. Speaker, the average turnover could be anywhere between 30 – 45% per annum.
Mr. Barnabas: Thank you, Mr. Speaker, and thank you to the Minister of Health.
Where does this turnover come from.
Does it come from the south, these new employees or other communities.
Final supplementary, Mr. Picco.
Mr. Speaker, it depends on the situation.
If the person is leaving a nursing station and they are going to go to another community then we would be recruiting internally.
This means, Mr. Speaker, if the person is leaving the nursing station in Arctic Bay, maybe they want to go to Hall Beach or maybe go to Gjoa Haven.
So that type of recruitment would be done internally.
In the case, Mr. Speaker, like teaching or any of the other professions we have here in the north, we have a need to bring in those types of professionals, because we do not have them locally.
So we recruit from the south in that case.
Just a reminder to members that we have approximately 17 minutes left and just so members don't feel they are being left off the list, next we have Mr. Akesuk, Mr. McLean, Mr. Alakannuark, Mr. Iqaqrialu.
Question 572 – 1(3): Tender for Arena
My question is directed to the Minister of Human Resources.
I am sorry, Public Works.
The arena in Kimmirut, I was just wondering if there was going to be a tender resuming for this arena.
I will let the member know in a little bit.
When we get a request from a department for a tender then we put out that tender.
So I am not sure exactly what Community Government & Transportation is requesting.
So we have to have the request from the department first and I have not seen this in writing.
I will let the member know in a little while.
Supplementary. Oral Questions.
Question 573 – 1(3): Importance of Private Sector
Uqaqti, today I am going to pose my question to the Premier.
Uqaqti, I have been standing up in this House for the last year saying how important the private sector is to building capacity and creating jobs in Nunavut.
The private sector still today is probably the second largest employer of people in Nunavut and a lot of people get their start in the private sector in entry level positions.
Over the past in the old government whether it was with Public Works and Services, with leasebacks, with Housing lease backs, government office space, with Health & Social Services providing contracts for group homes, boarding homes, etc.
Could the Premier commit to me that the private sector is important in Nunavut. That the responsibilities that the government has given them in the past to provide services that weren't provided by the government before, because we know there is not a lot of capacity in this government at this time, will continue and be a priority in the Nunavut Government.
I believe that we have done quite well.
We have contracted a lot of our services out due to under capacity in the past year.
We are continually working on stimulating our economy and we introduced Nunavummi Nangminiqaqtunik Ikajuuti for example to try to provide more contracts to Nunavummiut and to Nunavut businesses.
So we will look for ways of trying to stimulate our economy further.
We realize that one day we will be full as a government for employees and we need the private sector to take on the task of creating employment for us.
That's the answer that I wanted to hear.
Would the Premier through his cabinet colleagues maybe mention that to the Deputy Ministers and the Assistant Deputy Ministers that the government's priority is to help stimulate the private sector and continue to work with them. Not to give them the message that the government wants to take everything back and do it on their own.
I haven't been advised of the situation but I will look into the matter and take appropriate action.
Question 574 – 1(3): Treatment of Seasonal Diseases
This question is directed to my good friend the Minister of Health & Social Services.
Some times there are sicknesses that are caught by a community in certain parts of the seasons, especially in the spring time.
We all know that spring time is when many people get sicknesses.
How are these dealt with. Thank you, Mr. Speaker.
I would like to thank the member for his question and he is my good friend too and I enjoyed his statement earlier running on my statement about the spring time.
Mr. Speaker, the member brings up an important and interesting comment on the spring time and some of the concerns that we have with the patients and some of the diseases that are prevalent at that time.
Now if I understand the member's question correctly or properly, the member is asking about the prevalence of those types of concerns in the spring time and how we deal with them.
What we try to do Mr. Speaker, is have extra staff on where possible. Usually Mr. Speaker, it is in the summer time when we don't have the number of staff that we have throughout the year because a lot of people are on summer vacation and filling in for relief.
So what we try to do Mr. Speaker, in the spring time is to have more staff there.
Also to look at some of the concerns that come forward because there are some diseases and problems, especially when there is an accident out on the land in the spring time it brings more work for the staff.
If the member would just like to clarify the question a little bit more, I would be able to give it my best shot at answering.
My question was to the Minister of Health.
We all know that in the spring time there are lots more sicknesses that the community catches.
Because I am older I know what happens in the spring time, so this being the case, I wonder why the communities get more diseases in the spring time than any other time.
Mr. Speaker, that's an excellent question and as I was trying to say earlier, in the spring time here in the north many people go out travelling on the land more.
Children and smaller kids get out and they play in the snow, the snow is wet, they get cold, they come in, it causes more colds, we see more respiratory problems, colds and so on.
Flu, Mr. Speaker, in the spring time sometimes we see outbreaks of influenza and flu which occur throughout Canada, Mr. Speaker.
Those are more prevalent it would seem in the spring time.
I guess Mr. Speaker, because people are more active in the spring time there is more intermingling, sometimes people stay in tents, so that may be one of the causes.
I don't know Mr. Speaker, why there is more prevalence of certain types of diseases in the spring time, as opposed to other times in the year, but I would surmise, Mr. Speaker, it is based probably on more activity outside and so on.
Perhaps there could be a study done in a community in the future to find out the main reasons why people get sicker in the spring time.
Perhaps it could have something to do with the food that they are eating or what the minister stated.
Mr. Speaker, the member brings up an interesting area, and that is why certain diseases and certain problems are specific to a certain time of the year.
I take his question and his comment very seriously.
One of the things we are trying to do Mr. Speaker, as the member knows, when we think for example, there is going to be an influenza outbreak or a flu outbreak, we try to inoculate the elderly people, the older citizens in that community, those that are infirm and also some of the younger people.
Those people who might be susceptible to certain types of diseases in our communities.
So those types of things are put in place.
I would take the question Mr. Speaker, from the member seriously and I will check with our medical professionals in the Department of Health & Social Services to see why in the spring time there seems to be a prevalence of more sickness, or if that is indeed the case.
Question 575 – 1(3): Improved Budget Consultations
Because we are going to be doing the budget planning in the coming months, and he stated that we would consult the public better than previously I just wanted to ask the minister if that is going to be the case.
The Nunavut Association of Municipalities will be meeting shortly, next week.
After they have their meeting, Community Government & Transportation will be able to meet the same organization as to how they can be more involved in the planning of the budget that we set up as Nunavut Government departments.
We will be asking those questions during the Annual General Meeting of the Nunavut Association of Municipalities.
We will involve them in the department's work of the Government of Nunavut.
Question 576 – 1(3): Implementation of Budget Consultation Results
I am going to ask a question about the consultation that we had with the communities.
I would like to ask the Premier if they are going to be using this consultation report when they are going to be doing the capital estimates.
Speaker: Mr. Ng, Minister responsible for Finance.
If those consultation reports will be utilized, there were not very many people that participated from the public when they had a public meeting in the communities.
My two communities in my riding attended quite well when we met there.
Some other communities did not have very many people that came out to the meeting.
I just wanted to find out if they are going to be using the majority of people who attended when they are planning the budget for the Government of Nunavut.
Speaker: Just to remind members that any items that are in committee of the whole, should be dealt with there, not in the main chamber.
However, I will allow this question.
Mr. Ng, you may answer it.
Hon. Kelvin Ng: There may have been the odd exception because of weather circumstances or other events that may have precluded having a big turnout.
Generally speaking, there was a good turnout percentage wise from the public at large.
And, yes as I indicated earlier, that is one of the bases of development of business plans, for main estimates for capital budgets.
I think once again we have to recognize that we can't address every single issue over the course of one particular year.
We are going to try to balance it out particularly on the capital side in the development of a draft five year capital plan.