EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Northern carriers pretty much are guided by what type of arrangement they will have with the Department of Health so that they can align their transportation system.
So, what I’m saying to you as a Directorate is that you guys are in charge of transportation policy, the Department of Transportation is not.
They just merely follow your lead.
Cross references on transportation comments, yes.
Northern transportation strategy, but in a sense.
Now, having said that, I think it’s really quite important that whatever the contracts the department signs are not cast in stone forever.
Because there are people who use transportation for various reasons.
One is the private sector.
They need their supplies.
Their costs of cargo shipments must come in.
They are not always guided by medical transportation’s guidelines.
The Minister must know that whatever the Health Departments enter into has a long term impact on the consumer; consumers who want to have their shipments come in cheaper.
You are creating a monopoly with long term contracts.
If the contract does not have a triggering mechanism that within a year or a certain year that they will come to a review process, or a couple of years.
So, I’m just making my comments to these.
I want to ask the Minister whether or not in fact she shares my view that when you enter into medical contracts for medivacs as well as medical travel, you are aware that you are, in some places, creating a monopoly with airline services.
Chairman (interpretation): Is that a question.
I understand what my colleague is saying and I feel the same way because even though the Health Department uses air carriers and other consumers too.
I can understand what you are saying and I am in agreement with you.
Mr. Curley (interpretation): I would like to thank the Minister then for sharing my views.
Not only that if she shares my views and understands my views, she will then also agree that whatever the contracts that are awarded to the successful bidder will have a mechanism that will be reviewed within two or three years at a time, that it’s not be too long so that we can have private sector component to have the cargo, you look at our region for instance, in Kivalliq Region, cargo is stock piled in Churchill, because the medical policy to Churchill is mainly one except for the First Air part through other regions.
There are smaller ones.
The main floor of cargo is aligned with the Churchill health centre.
So, I’m asking the Minister if you will have a mechanism put in place that these contracts will have a review process for every two or three years.
That they not be too long a contract.
I am representing the whole of Nunavut and he was making reference to the Kivalliq Region.
I am aware, because I am from the Kivalliq Region.
He is asking for a review process after two or three years.
They might go through that route because when we have a long term contract; it is very hard to terminate the contract even if there are disagreements.
I like his idea.
Chairman: We are well aware that you are the Minister for Department of Health for all of Nunavut, not just for the Kivalliq. (interpretation) Do you have any comments, Mr. Alagalak?
Under the Directorate, I feel it’s insufficient, and the minister and her officials have big responsibility, even though there are a number of people who are working for the department, it seems like they are lacking direction, especially for the staff.
The patients who have to travel out of Nunavut or medically evacuated, it was clear that, last summer, they didn’t have anywhere else to go.
It seems like they are not working together with the Directorate.
So starting from 9:30 to 5:00, it seems like there are no phone numbers that are available.
The nurses in the communities seem to be like that.
Within the Department of Health and Social Services, they should be more accessible to the public, and especially to unilingual Inuit who can’t read English, and sometimes people are left alone in the house, and they are alone in their house.
For those patients who leave, sometimes it takes a long time for the family to find out what is happening.
I wonder, especially in the communities in the regions, there should be a centre of some sort where people can get more information.
We know there are Health Committees in the communities or the chairpersons even get phone calls, and the counselors are not accessible, but it’s not even the RCMP’s responsibility either.
I feel that there should be improvements because I hear this constantly ever since I became a Member of the Legislative Assembly.
I would want this to be checked into.
I want to ask if the minister has ever thought of setting up or getting an advisor of some sort within regions.
So I would like to ask her that question.
I feel your concerns and they have been experienced by many people.
It doesn’t matter in which community; this always comes up because a lot of times we don’t even know who to get a hold of when they go down south.
If possible, I am going to ask my Deputy to respond.
Chairman (interpretation): Just a minute.
First of all, I want to acknowledge the statements that have been made that it is obvious that we need to some changes in Nunavut in order for us to make sure that clients that go south and families who need information about their families in the south are provided that information.
Part of the organizational structure that we have proposed with Closer to Home involved the putting in place of a Client Service Coordinator who will be responsible to connect people and hopefully provide that information that they need.
The other piece that we are looking at, through the visitation of various Boarding Homes that we have done over the last year, with other Members of the Legislative Assembly as well, that we have heard a lot of concerns in regards to the same issue.
In cooperation with the Boarding Homes, as well as the Client Coordinator, we hope to have in place by the end of this year a comprehensive strategy of how we are going to provide better information to Nunavummiut, who travel south and their families who require information on their statues.
So we will commit to making sure that that is in place by the end of this calendar year.
You responded in some part, but I would like to mention again that it is very hard at the community level to have nurses who speak Inuktitut.
If I use Arviat as an example, I usually listen to the local radio station in the evening and there are quite a lot of callers after the nursing station has closed that are looking for people who could speak in English.
They are saying that they would like to talk to the nursing station, because there is an emergency or something has happened to a child, they go to the local radio station that they are looking for somebody who can speak English so that they could confer the nurse.
We definitely have to something about that and the minister should do something about that.
Usually they’re in an urgent matter when they are looking for somebody who can speak in English, and then nobody says anything.
It seems like nobody speaks in English at all in the whole community.
I have put in my bit more than once to help those unilingual people.
Usually it is the new nurses who have that problem and I think that at least if there is a recorded answering machine, it would help other people out there.
I just wanted to mention that again and I will be asking further questions once we get to the appropriate page.
Chairman: I didn’t hear a question, so I will go to Mr. Mapsalak.
I wanted to make a comment and I do have a question.
I know that this is an issue that has been brought up in most of the communities because we always mention the nurses.
We have the Nunavut Arctic College Nursing Program and other programs available, which is very nice to see.
I am very glad and look forward to getting Nunavut nurses trained and going into the workforce.
We keep hearing that there are shortages of nurses up here.
My question is if we look at the Nunavut Nursing Program, I know that these graduates will very likely prefer to stay in their home community once they complete their training.
If they should be transferred or are asked to transfer to another community and there is no job opening in their own community.
Chairman: Madame Minister.
Last year, we had two graduates from the Nunavut Nursing Program and they are now eligible to work anywhere in Canada.
The position won’t disappear and I can say that we’re looking forward to two more graduates in 2005 in the spring time.
For example, even if they wanted to work in their community and there were no positions open, there are always other positions available in other communities.
You see a lot of other graduates from other programs who complete their training but if there is no opening available in their preferred community, they just don’t look to fill the other positions that are available.
What if there was a situation in this case.
What if there was a graduate who didn’t want to go anywhere except their own community.
Would they have to ask the people who are currently working in those positions to move in order to put that person in that position.
Hon. Levinia Brown (interpretation): With the graduates, if there are no positions available in their preferred community, I’m sure that they would be under the collective agreement and they could be appointed by the government to fill that position.
Chairman (interpretation): We’re on page H-5, H-6, H-7. Mr. Evyagotailak.
In your speaking notes, you had mentioned that there are about 100 nurses that will be coming into Nunavut.
I would like to ask a question to the Minister on that.
You had also mentioned that mid-wives are also very important in Nunavut.
There is a nurse where her contract was not renewed and I’m sure you know who I’m talking about. But anyway, she’s been in Kugluktuk for probably three years and has a son who is married to someone from Kugluktuk.
They were wondering if anything was going to happen.
I think the nurses are very important in the communities that work in Nunavut.
Since her contract was not renewed, she was going to move out of town.
She asked if I could ask some questions on what was going to happen.
She wanted to know if her contract would be renewed or not.
I would like to know too because when you’re hiring the nurses from outside of Nunavut, there is money involved as well.
You’re paying a lot of money for their transportation.
The nurse is right in the community and you don’t have to pay for the transportation to pay for the contract and stuff like.
Is there anything that’s going to happen to the nurse that is in our community.
I will have my Deputy, Mr. Blais, respond to your question.
Mr. Blais: Thank you, very much, Mr. Chairman.
In regards to issues dealing with staff, if it’s inappropriate for us to have discussions pertaining to specific individuals, and our reasons why a contract should be renewed or not renewed.
Really at this point in time, we are simply not in a position to make statements, I think this is between the Government of Nunavut and the staff that are under contract or under collective agreement.
Chairman: Thank you, Mr. Blais. Mr. Evyagotailak.
I think it would a lot cheaper to hire the local nurses who are living up north rather than getting new nurses.
I would like to thank you for answering my question.
I didn’t hear a question. (interpretation ends) We are on H-5.
Health and Social Services Branch Summary.
Total Operations and Maintenance. $22,303,000.
Go to H-8.
I just want to follow up on my colleague’s question about hiring nurses.
How do you hire nurses these days?
There are still a lot of nurses on those, what do they call them, medical agencies, nursing agencies versus all of our own nurses or indeterminate nurses.
What’s the ratio?
How do you hire nurses?
Have there been any improvements since last year?
Chairman: Which one wants to answer?
The issue of agency nurses is pretty well the same as it was last year, but we expect hopefully in the next six to nine months that we will see a change in that direction given that we have already extended at least 28 full-time positions to international nurses, and probably another 20, or so in the next month, as well.
So how many of those will accept?
We are hoping that at least 40 new nurses will be recruited into the territory.
So at this point in time, I think we made some slight progress, but the big progress will come as we recruit these nurses on board.
And thank you Mr. Blais.
When you recruit these nurses from other countries, are you offering them any additional benefits over and above what we might offer a nurse in Canada?
No, the salaries and benefits are identical to what nurses are currently making in each community.
Thank you, Mr. Blais.
I have heard in the past that some nurses are offered an annual bonus of $6,000 per year if they remain in Nunavut for a length of time, but I am not sure how it works.
Is that in addition to their salary or is that part of their salary?
Like I said earlier, there’s no difference in salary between those who are currently here and the ones that will be coming in, our international nurses.
There is no annual salary or bonus or a retention fee that is paid.
They are paid identical and what’s in the collective agreement.
So just for the record, you don’t pay any nurses a bonus of $6,000 per year?
There are some nurses who are currently being paid under a previous agreement that were recruited and they were guaranteed a bonus per year for a three-year period, and that will run out in the near future.
So once that agreement runs through, then again, everything will revert to all nurses will be receiving what’s in the collective agreement.
That’s as long as they remain nurses under that contract.
I’ve heard of instances where nurses come up as nurses and then they transfer to other positions within the health department and they’re not nurses anymore, but they’re still receiving those bonuses.
How do you deal with situations like that.
I’m not aware of that.
So, if there is a case like that and you would like to bring it to my attention, I would be prepared to look into it.
At this point, I am not aware that a case like does exist.
So, Mr. Chairman, Thank you.
Could you just tell us, again for the record, where you’re currently recruiting nurses from in the world.
I believe you hired a recruiting firm, an international recruiting firm.
Could you update us on how they go about recruiting international nurses and then what kinds of incentives you are offering them to come to Canada and encouraging them to stay in Nunavut for any length of time.
Continuity in the nursing profession in Nunavut is very important.
The agency nurses, many of them are good, but they come into a community and only stay for 3-5 weeks and then they’re gone.
I’ve heard many complaints from my constituents that the nurses don’t know them or don’t understand them or aren’t familiar with their family history or the health of their children.
I would be interested in hearing from the minister or Mr. Blais on the efforts to recruit nurses who are going to remain in Nunavut and remain in our communities for two to four years, if possible.
There are no incentives in terms of bonuses and things like that.
What we do pay, and I do believe we pay our nurses a good salary that is competitive with all of the other jurisdictions.
The incentive for nurses to some there; Canada is an attractive place for many countries.
We’re recruiting currently in the Philippines and India.
The company that we have is a company out of Toronto.
So, basically, it’s a Canadian firm who does constant recruitment for a number of provinces and hospitals across Canada.
They are paid on a fixed fee.
I believe we are paying them about $13,000 per person recruited for Nunavut.
They also provide in that, a guarantee that if a nurse was to come and leave within that period of time that they will replace them at no charge to Nunavut which is somewhat unusual.
So, we insisted that we have this guarantee built into the contract and they willingly agreed with that because they feel very confident about the process that they have in place to screen out nurses that they recommend to come to work in Canada.
So, for all intents and purposes, the people who come here come here willingly I believe because it’s attractive to them.
The salaries that are paid are no different than the salaries that are paid under a collective agreement.
The fee that is paid to the recruitment firm is a flat rate with the guarantee.
When you consider the cost of agency nurses and the cost of moving nurses to Nunavut if they don’t stay for a long period of time, most of them under 18 months, then there is a huge cost for all this movement in and out and also an additional cost to fly nurses, agency nurses or casual nurses in from other jurisdictions.
So, the rate that we pay, I believe, Trillium, is really pretty reasonable when you consider what we’re currently paying at this point in time with no guarantee.
Hopefully that answers the question, Mr. Chairman.
How much are we paying Trillium for their recruiting services.
Mr. Blais: I think I mentioned, again, it was $13,000 per nurse recruited.
So, if we recruit 40 it will be 40 times 13.
If we are able to recruit up to 100 then we will be applying that amount.
I thought maybe you had $13,000 plus some kind of lump sum on top of that.
So for those services they are going to guarantee that nurses will stay a minimum of two years, and if they don’t, they will recruit them again at no cost to the Government of Nunavut.
The move in/move out cost; who covers all of those?
Will that be Trillium?
Sorry for that delay.
Basically, we will cover the cost to move them to Canada, and the Department of Human Resources will cover the cost to move them from wherever they land in Canada, possibly Winnipeg to Nunavut.
Maybe you could expand on the relationship between Trillium and the Department of Human Resources.
How does that relationship work in terms of how they go and recruit the nurses and land them in Canada, then Department of Human Resources somehow gets involved to bring them to Nunavut.
I know there’s a requirement to post positions in Canada, or in Nunavut, and then if you can’t recruit someone who’s in Nunavut, then you expand to the north, then if you can’t get anyone in the north, then I think you recruit from the south.
So there are all of those sorts of obstacles that get in the way of government policies.
So maybe you could take us through that so I can understand how the process works.
The recruitment of nurses is the delegated responsibility of the department, it’s the only one that we have the responsibility to recruit in.
Everything else is basically done by Human Resources.
So, for example, if we are recruiting a physiotherapist or a manager that would be done through Human Resources.
The delegate of responsibility then give us an opportunity to recruit, advertise, and offer and plan it without having to go to Human Resources.
The movement of staff from one jurisdiction to the other.
Again, that is still covered under the Government of Nunavut policy for recruitment.
It’s a very simple process.
We can recruit on our own.
We can offer employment on our own only for nurses in Nunavut.
Mr. Peterson: Thank you, Mr. Chairman. So there would still be a cost to Nunavut in the end if a nurse gets here and decides after six months, or four months, or less, that she or he doesn’t like it.
The Department of Human Resources or your department will have to cover the relocation cost to the point of entry in Canada, whether it’s Toronto, Winnipeg, Vancouver or Edmonton, is that correct?
I am not sure what the money costs are, it ranges, I think, for Human Resources between $10-15,000 to move people in and out.
So there’s still a cost to the Government of Nunavut.
Chairman: Is that a question or a comment?
Mr. Blais: That’s correct, Mr. Chairman.
There were still a cost to the Department of Human Resources and Health and Social Services.
We had consider as well, though there with the 23 percent vacancy rate of nurses, and the opening of three new Health Centres, that the cost to do nothing is much more when you consider the impacts and the risks that this department faces.
So I guess it’s one of those situations where you have to decide what’s in the best interest of Nunavummiut and also to ensure that we can provide services here.
We have done extensive recruitment across Canada and have had some minor success.
The other piece is that given the report that have been published by national nursing organizations in other jurisdictions, there’s a projection that they are expecting about 100,000 to retire over the next five years, which will add to the challenge that we are facing in Nunavut.
So I think the guarantee that Trillium gives us at least is the reassurance that they are convinced that these nurses will stay in Nunavut, and the screening process that they put them through hopefully, otherwise they are not successful, they will not going to be very successful as a company.
So this is the best guarantee we could obtain, and none of the other people who submitted proposals were prepared to offer that guarantee.
Was your department involved with Trillium at all when they recruited from these other countries?
Did you have someone from Nunavut go with the recruiting group?
They must have gone to the Philippines and India to do interviews.
Yes, our team, from November 15 to December 15, we sent a team of two people, very experienced people to participate with the Trillium team to do the interviews, as well to be part of the screening process.
Out of the 100s of people interviewed, they short listed 55 initially, and then in the second phase of the interview they short listed another 58.
So we think that we have been able to screen out what we considered, the best candidates, excellent candidates with good English languages skills as well.
So, Mr. Chairman, hopefully that addresses your response.
What type of employment contract did the nurses sign with the department?
Is it your typical letter of offer, like a normal government employee would sign or was that a special contract?
Chairman: Is that it, Mr. Peterson?
Please let me know if my question doesn’t correlate with the page.
I would like to talk more about Social Services and social workers.
What is the process for selecting social workers?
I wanted to ask questions in regards to social workers.
The social workers, do they have to come from a different community to obtain a social worker position in a community?
I know the social workers, their job is very challenging, but we do get a social worker who is totally alien to our culture.
When they come to our community, it seems like they do whatever they want to do.
I am sure they comply with the rules and regulations but when some clients in the community are refused by the social worker, they have no place to turn to.
I have been told by my constituents that they are concerned that our constituents have no place to turn to, especially when they can’t talk with the social worker.
It seems like the RCMP officers really listen to the social workers’ comments, or whatever they say.
What is the process of selecting a social worker?
How can I ask this question?
What is your policy in hiring social workers in the communities?
Would you like to respond, Madame Minister?
Hon. Levinia Brown (interpretation): I will have Mr. Blais respond to some of the questions because there are different levels of social workers.
I am glad that my colleague asked that question in regards to social workers.
The report and the recommendations for Care Closer to Home, once that is being implemented, I know that there are going to be improvements and it was just accepted not too long ago.
Once five or seven years are over, I’m sure that the contents will be visible but we’re now working on the implementation on some of the recommendations.
In some communities, we do want them to get into the field of social worker training program.
There was one program in Cambridge Bay and I would like to see that program open again through Nunavut Arctic College because there are a lot of avenues that we could use to help us develop more.
I’m glad that the member asked me that question.