EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
The Committee is pleased to note the Department’s significant investment in replacing or upgrading community Health Centres this coming fiscal year, accounting for nearly 75% of its capital budget.
Many of our community Health Centres are over 20 years old and the space and conditions severely limit the ability to deliver programs to a rapidly growing population.
Mr. Chairman, Members of the Committee have expressed the view that resources and facilities should be set up closer to home, so that children or adults in Group Homes, Shelters or similar facilities can receive services closer to their families and relatives in addition to providing employment and business opportunities for Nunavut residents.
The Committee urges the Minister to give due consideration to projects and proposals brought forward from Nunavut communities and regions for such community-based facilities.
On a related note, the Committee is looking forward to seeing the completed results of the Department’s review of boarding facilities that are located in other jurisdictions.
Committee members continue to have concerns about these facilities.
Just over 20% of the Department’s capital expenditures are allocated to a code upgrade at the Iqaluit Hospital.
Members of the Committee recognize that the current Iqaluit facility will still provide certain services once the new facility is built.
Members would appreciate receiving information on this issue as it progresses.
With respect to the three regional facilities, Members have been somewhat disappointed that they have not been receiving regular written updates from the Minister on the planning and development progress for these facilities.
Members are aware of reports in the media relating to funding arrangements for at least one of these facilities.
In addition, in a recent presentation by the Nunavut Association of Municipalities to the House of Commons Standing Committee on Finance, the figure of 70 million dollars was portrayed as being the overall cost for the three Nunavut facilities.
Members of the Standing Committee have requested on a number of occasions that information on the funding arrangements for the three facilities be provided.
They have been informed that funding figures are unavailable as “functional role studies” have yet to be completed.
It is therefore somewhat disconcerting for Members to learn about projected costs from other sources when we have yet to learn what services are to be delivered in each of these facilities.
Members are of the view that these kinds of issues should be determined at the outset and in an open manner in order that projected costs may be appropriately determined.
The Committee expects regular updates from the Minister on these developments.
Mr. Chairman, the Committee recognizes that the Department of Health and Social Services faces many challenges in delivering services across the broad expanse of the Nunavut territory.
When services cannot be delivered close to home, clients must be transported to a facility where they can receive the necessary care.
This results in tremendous costs for our health delivery system.
Strategic investments in our Health Care infrastructure will help to reduce the need for travel as more programs can be delivered close to home.
The Standing Committee urges the Government to support the Department of Health and Social Services in making this investment.
Mr. Chairman, that concludes my opening remarks.
I would anticipate that individual Members will also have questions and comments as we proceed.
Just before members make comments or questions I would like to tell them that you have ten minutes to make comments so other members will have a chance to make their comments and ask their questions.
Just a short comment, Mr. Chairman, just to welcome the minister and his officials.
The hospitals and the schools were not being replaced or renovated during the territorial government days before 1999 because they didn’t have the budget to do expansions and replacements.
I welcome the minister’s comment on the renovation and expansion of health centres.
But looking at the capital pages for Health and Social Services I will be asking later on, if I can put them together, the design for the other communities such as the health centre in Pangnirtung replacement is going to be 450 thousand for 2002-2003. For Iqaluit it’s one million dollars for the planning and the design of these health centres.
It’s a concern that I have.
I think there could be a better way of utilizing the money instead of using it for design and evaluation of codes of each health centre.
Because you can tell right away that in the three communities there’s two million dollars that is going to be utilized up to 2007. I think this could be better used for other government operations because it’s very expensive to do the design and replacement.
Sometimes it goes up to 33 percent of the total.
I will be asking the minister questions as we go page by page for Health and Social Services.
I have no names so Mr. Arvaluk you go ahead and ask the question.
The planning, I am not just talking about the health centres, but for any government projects, whether they are going to be schools or special health facilities or other government buildings.
I think there could be a better way of utilizing the money to do a good code evaluation and definition instead of using half a million dollars because there are 26 communities in Nunavut.
It takes up about 12 million dollars to do the evaluation and design of those projects.
Maybe I should ask Public Works or the Finance Minister if there isn't a cheaper way that we can utilize the money instead of using it for functional design.
Mr. Chairperson, there are two issues that the member brings up.
One of them is on the code and one of them is on the actual functional program.
The functional program dollars Mr. Chairperson, is for the design of what the building will be used for.
For example, will it have an operating room or will it have a birthing room, and so on.
The code for example under the Iqaluit Hospital is to look at the building code itself to make sure that we are up to proper specifications.
As the member knows, the current facility was built in 1962 and several areas have code violations.
So this money would be used by the Public Works department to go in there and examine what code violations there are and that is why we need to be able to do that with the larger amount of money.
On the design Mr. Chairman, that is usually between 400-600 thousand for standard costs and looking at the design of the health facility.
As you know Mr. Chairman health facilities are different than schools and other buildings and there are other special requirements for example, for oxygen and so on.
Yes, you do have staff on hand, I don't know what they are being paid for, can't they do their own study within your department to determine the functional programs, whether they need oxygen or other issues.
Can't your department officials find determine the functional program, for example in Pond Inlet and Pangnirtung nursing stations can't they do functional studies within your department.
You are going to be spending half a million dollars just for the functional program reviews. I know if we could look at this for example, Pond Inlet, 650 thousand dollars is geared towards that, for health centre replacement.
We could hire six people for 650 thousand dollars, and they usually work on this for one month on the design of functional programs. Where does this money go.
Six hundred and fifty thousand dollars, is it just for the design or the functional study.
Although he told me what this funding would be used for.
Perhaps in the future you could, I am just using the 650 thousand dollars, perhaps you could show us how you divide the funding or do you provide this funding for the architects so they can travel and so they can do the design.
Since we have limited resources for example, the government in total for one fiscal year including the capital estimates, if we are going to be using 650 thousand dollars just for the design alone can’t you consider or look for cheaper ways of spending money on the design part.
I think the member makes a good point.
One of the things we’re looking at is do you need to design a different type of health centre for each community.
And one point for example the Department of Education has a standard size school that they would use in each community with depending on seven, eight or nine grades and so on and then you can take it off the shelf and then be able to put it in different communities and that saves us money.
As the member knows it’s a little bit different in health in that we have, as the member points out in his opening preamble, governments haven’t been building health centres.
The last health centre that we built was actually in Gjoa Haven as the Government of the Northwest Territories and we did a P-3 in Arviat.
So we need to be able to go back to the drawing board in the first step of the planning process and have someone from Public Works and Services as well to help on that design team.
They look at all the different services and programs that would be delivered outside of the facility.
But I take the member’s point and one of the things that hopefully we’ll be able to work on is to get that cost down because I agree with him.
If we can lower the cost on the functional program design, the more money we can put into programs.
So I would agree with the member.
Looking at the new health facilities, that’s very encouraging so that our patients don’t have to go down south.
And now it’s right in the community or within the region that the patients will be able to go.
As well our young people will be able to utilize these facilities in the future because we can’t always go way down south to go to a hospital.
I want to say perhaps in the regions in Rankin and Cambridge Bay I’m just wondering where would the boarding homes be placed. Because it’s very stressful for the patients who go down to the hospitals when they have inadequate boarding homes and not knowing where they’re going to be placed.
In some cases the patients are boarded in other homes but it’s very encouraging to hear about the health facilities.
But we also have to look into the boarding homes within the regions so that the people in the communities will be able to go to these facilities without being worried.
Another comment in terms of the children who are going into the group homes from other communities, we don’t have any programs or placements for group homes because as we know the community populations are starting to expand.
As we said a few days ago and I will say it again, the children who were placed into the group homes have to be placed outside their communities because there are no group homes.
That causes a lot of stress in terms of their lifestyle and when they’re separated from their parents there’s a lot of stress being placed in another community.
Their mind, their way of thinking starts to deteriorate.
I am strongly encouraging the minister to work at the group home programs, and I want to stress to you that communities are expanding in terms of population. That is all I have for comments and I have questions to follow.
Yes, you can ask your questions now, the floor is open for questions.
In terms of the patients going down to the hospitals, the group homes or the boarding homes, perhaps in Iqaluit as we know there is a boarding home for the patients.
Do you have plans to put boarding homes into the capital plan along with the new health facilities.
Mr. Chairman, the last boarding home that we owned as a government was Baffin House in Montreal. The government would probably in all likelihood Mr. Chairman, move forward on an RFP to request the private sector for the development or the leasing of space for a group home likely down in Winnipeg, like we've done in Churchill, like we've done in Edmonton.
I would expect that is what we would do.
I'm pleased to hear that, when will this process take place.
Mr. Chairman the facility in Kitikmeot is scheduled to be complete in 2004, I would suspect Mr. Chairman six months before the completion date, we would do an RFP for a boarding home facility.
Based on the need and what the capacity would be at that time in Cambridge Bay, sometime in late 2003, we would probably do an RFP at that time.
Mr. Havioyak (interpretation): Thank you, again because the patients that have come back, they have no place to stay while they are down in the hospitals and that's an example from the Kitikmeot boarding home and I appreciate the answer I received.
(interpretation ends) In reviewing the capital estimates, the items here, which cover the design of hospital health centre replacements and a garage and deck for the group home.
It kind of makes me wonder about the priorities of this department, when you are addressing the needs of a group home that is identified by your community.
Sometimes I wonder how they priorize these things. I'll give you an example, in the capital items here we have the design of a garage and a deck.
For the last seven months I have been raising the need for a group home in my community.
It is not here and I was advised by the minister that there was a possibility of meeting sometime last week, but that didn't happen.
So I just wonder where that is now, that's why I am raising this again.
Where is it going.
I don't see anything on the capital and maybe the minister could just update me as to where he stands here on the issue of group homes in Nunavut.
Mr. Chairman, specifically on the question on the Cambridge Bay facility, as an example.
The idea for the deck is for the residents there so they can actually get outside for fresh air and so on.
Instead of having them standing outside on the porch, so that's the idea of the deck on to the building.
The idea of course for the garage is because of the wear and tear on the vehicle that we have had and experienced there.
The situation in Kugluktuk is a little bit different.
What we are looking at right now and that was what I was speaking to the member about, is we have facilities in Baker, we are operating a facility as an example, here in Iqaluit.
Is to look at the boarding needs and the needs of Nunavut itself when it comes to a boarding home.
It depends on the patients, what patients we are housing in those homes, Mr. Chairperson.
Is it mentally handicapped children, adults, and so on.
So that's where we are with that.
As I said, my question is, what is your priority.
It seems like the garage is more important than the needs of the children or the people that need to be in the group homes.
It seems like your priorities are the other way around.
You are saying that the garage, or the vehicle needs to be housed because it is always outside and it seems your priorities are backwards. My question is, when are group homes going to be a priority.
When will I get an answer for Kugluktuk.
Just using Kugluktuk for an example, when you will look at the need for a group home in Kugluktuk.
Mr. Chairman, there is a two part answer to the question and I will try to be brief.
The 30 thousand dollars in Cambridge Bay for the deck and the garage, that's only one tenth of one percent of the total capital budget that we are talking about here.
On the group homes specifically, what we are doing right now is a need analysis in Nunavut to look at what we need for group homes.
What type of group homes do we need, and that's why I tried to say that there are different group homes that we are running.
For example, Saint Theresa's could be considered a group home.
Baker Lake is a group home, there is a group home here in Iqaluit.
So right now, as a department, we are doing a needs analysis across Nunavut to see what needs we have for group homes and where we don't have a group home, where would be the best place to facilitate that.
For example, Kugluktuk has made it very strong, very well known to us that they would be interested in having a group home.
So that would be part of the needs analysis that we are doing.
I have concerns regarding the future of our young people and the patients that visit our health facilities.
I am not too concerned about things like garages for health centres.
I am more concerned about the patients that are there for treatment.
I have one question I'd like to raise with the minister.
You can raise your question. Mr. Alakannuark.
I know that it has been raised before.
I want to ask the minister about people that have to be seen at the health centre.
If they are going to build a hospital in Cambridge Bay, do they have plans for a boarding home for patients that will be traveling to Cambridge Bay.
Hon. Ed. Picco: Thank you, Mr. Chairman.
Mr. Chairman, that is something that we will be looking at as we get farther along in the process in the development of the Cambridge Bay facility.
And as I indicated to Mr. Havioyak, I would suspect that some time in 2003, 6 months before, at least 6 months before the opening of the facility in Cambridge Bay, we would be in a position to look at the boarding home that we need on the ground.
That would give enough time for a contractor to be able to facilitate the provision of that space.
Do you have another question.
I understand his response. When the hospital opens in Cambridge Bay, does the minister expect the hospital and the boarding home would be open at the same time.
That is what we planned.
To have that ability to be able to do that before the facility is open.
Again we would base that on what the needs are at that given time.
I don't have anybody else on my list.
We will go on to 10-6.
Mr. Iqaqrialu do you have general comments.
If you have me on your list. I have been waiting for a while.
While we are discussing capital estimates for Health and Social Services, under buildings and works, as a member, I am in support of new hospitals that will be built in the three regions.
And under Inuit Qaujimajatuqangit.
It is very important that we need to be able to diagnose these illnesses.
It's important, if we are going to build a hospital, that the equipment is more advanced. Because quite often individuals or people are sent down south for treatment and a lot of the patients find out they have cancer or other illnesses when it's too late.
While we are dealing with the capital estimates it's going to be important that there is more advanced equipment in the hospitals.
We'll have to make sure that patients are being seen in the region and not have to travel south.
I feel that it will be important to have the technical services available.
There are a lot of people in Nunavut that have mental illness and it'll be important that there are psychiatric services and it's important that there are services available for individuals that are not well mentally.
Those are my comments, I feel the minister and his staff are very capable of dealing with these issues and these services will made available for people of Nunavut.
These things will have to diagnosed before it is too late.
If you have any questions, you can raise them now.
Mr. Iqaqrialu (interpretation): I just want to ask him if they understood my comments earlier.
Not only do I understand these comments, I agree with his comments very strongly in the three health facilities. The major costs for Iqaluit and the Baffin region, Rankin Inlet in the Kivalliq region and Cambridge Bay for the Kitikmeot region will be for new equipment.
New equipment with which we can do the diagnostic work the member is talking about.
Roughly Mr. Chairman, we're looking at probably about 15 million dollars in new equipment for those three facilities.
Once we’re up and running over the next two years I think that will help with some of the things the member was talking about.
Chairperson (interpretation): Thank you Mr. Minister. Mr. Iqaqrialu.
Mr. Iqaqrialu (interpretation): One other question with respect to mental health issues.
Are we going to be provided with mental health testing devices.
Are you aware of these devices that might be made available in the new hospital.
Mr. Chairman, in response to a question earlier today, I was talking about a mental health strategy that we are putting together and we have a psychiatrist that has spent several years in the Baffin who is now back.
We have him working on a mental health strategy.
To my knowledge there is very little equipment available that actually looks at psychological or psychiatric problems.
This is usually done through one on one, through counselling, through psychiatric services and analysis.
One of the things that we would try to have in place, are the types of instruments and equipment that would be able to allow us to do more here in the region.
As the population gets larger and there are economies of scale for example, maybe we would be in a position where we would actually have a CAT scan.
I believe Mr. Chairman, that type of equipment is a long way off.
I will ask more questions when we are on the capital issues.
Chairperson (interpretation): I am sorry I didn't hear your question.
Can you repeat your question.
Was I speaking English to you.
I would like to ask another question, Mr. Chairman.
For example, they were going to make telehealth available from Iqaluit to places like Pond Inlet.
I wanted to find out if this has been done.
Is that in your plan in the near future, Mr. Picco.
Mr. Chairman, I am just getting the up to date information on telehealth.
Mr. Chairman, as the members in this House know, we have been moving forward aggressively on the telehealth implementation strategy.
Last year I spoke to Minister Allan Rock of the Federal Government who brought forward 3 million dollars for our telehealth program in Nunavut and we matched that, the Government of Nunavut matched that.
We spent over six million dollars.
So the existing sites today Mr. Chairman, are Iqaluit, Cape Dorset, Pond Inlet, Cambridge Bay and Gjoa Haven.
That's where we have existing telehealth sites.
We are in the process, with this extra money and so on, to hook up ten more sites.
Those are Rankin Inlet, Arviat, Baker Lake, Coral Harbour, Sanikiluaq, Pangnirtung, Igloolik, Arctic Bay, and Mr. Speaker, the member's own home community of Clyde River, as well as Kugluktuk.
The proposed sites are being considered right now and we are hoping to confirm them.
About a week and a half ago we did have some of our people for example, in Baker Lake and we are doing a needs assessment on each of those communities to see which communities can be best serviced and accessed through telehealth.
I am not sure if my question is making any sense.
But with his particular comments I just heard, I don't see anything in the capital plan here in front of me.
So I want to find out where it is in the capital plan.
Is it in the capital plan, Mr. Chairman.
Mr. Chairman, the 3 million dollars from the federal government portion is not in our capital plans.
That is the contribution of the federal government.
What we have in our capital plan is the capital carry over of a million from last year.
As well as the in kind contribution that we've used to match to make up the difference on the 2 million.
And the federal government contribution is 3 for a total of 6 million dollars.
With respect to the 5 year capital plan.
We approved the 5 year capital plan.
If I understand properly, for the health centre for Igloolik in 2002-2003. It is not showing in the capital plans in front of me.
But it has been moved to the next 5 year capital plans to 2003-2004.
This has been moved and then it would be completed in 2006.
I would like to see this plan proceed.
But I don't have too much comments to make.
But I would like to ask this question. I would like to get some clarification as to what is happening with the capital plans because I don't see anything under my present document that I have with me.
With respect to 2003-2004.
There is a plan for 400 thousand.
I want to find out what is happening with the health centre plan for Igloolik.
Chairperson (interpretation): Minister Picco, Mr. Irqittuq has asked you a question.
The member is correct, in the 5 year capital plans we had done the design work.
When the capital plan was put together Minister Ng and his wisdom had allowed for flexibility in the 5 year capital plan.