EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
So it’s a bit of a long answer, but I just wanted to give you my perspective. It was great being there when the program was underway, being involved, and talking to individuals and talking to elders involved, and the guides, instructors, and the people who were cooking on the program.
I personally thought it was a good program, but then again, it comes down to what the evaluation says, what the costs are, and how practical it is. My defence is that it was a good pilot project and we look forward to evaluating the results.
Chairman: Thank you, Minister Peterson. (interpretation) Mr. Oshutapik, I believe you’re done.
If I am mistaken in believing we are on page H-6 and go off on a wrong tangent, please correct me.
I want to speak to the issue of specialists’ services, such as dentists and optometrists as well as other specialists who only visit our communities sporadically. When they finally arrive in our communities, it seems they leave almost immediately.
When specialists visit the communities, only those with an appointment are allowed to be seen, whether they have an eye or tooth concern.
When a patient wants to make an appointment, they aren’t allowed to submit their names, even though the specialists are paid by our government. The specialists are ostensibly there to treat people in the communities that require their services to ensure that complications don’t arise.
What about the review of the amount of time these specialists stay in the communities and to have a set schedule for their arrival? I wonder if the Department of Health and Social Services arranges the schedules or length of time in between visits.
Questions arise, such as how long they can stay in the community and who specifies the duration of their visitations.
We’re well aware of the issues that Mr. Ningark describes.
Unfortunately all of our health centres in Nunavut just don’t have the level of specialist care that people seek and require.
That’s why we would rather bring the specialist into the communities three or four times a year. Let’s say, in the case of physiotherapy, we would send people out to see specialists.
In Cambridge Bay, for example, we would send some people to Yellowknife because we have a contract with Stanton.
I’m going to ask my deputy minister to respond in more detail to Mr. Ningark’s question.
As the minister has indicated, we’re very well aware of the need for more specialist visits within the territory. Maybe one of the first comments that I want to make is that it’s across Canada as well. So we’re competing with other people.
Obviously, we don’t have the specialists here other than a few specialists at the hospital that provide anaesthesia and some limited surgical work. We have to have contracts with different people across Canada to provide these services.
I think other members have indicated audiologists and different things like that. We have dental and other things like that. Typically, specialists stay in the communities anywhere from five to ten days, depending on the specialist and depending upon the number of patients that they’re seeing.
I can give you some indication of the number of days of service that we get in each region. For example, in the Qikiqtaaluk region, we had about 660 days; in the Kivalliq, it was about 480 days; and in the Kitikmeot, about 200 days.
I think we’re very much focused on trying to provide more visits. In some of our answers to members today, I think we have indicated that. For example, I think we had spoken a bit about oral health earlier.
Somebody may have raised it in their comments, but they didn’t directly ask a question on vision care services. We’re aware that this is an area that we need to work on.
I’ll leave it at that, Mr. Chairman. Thank you.
I also thank the deputy minister for the response.
I represent two small communities, Repulse Bay and Kugaaruk.
When the specialist visits the smaller communities, I haven’t seen any specialists staying in these two communities for ten days.
I think we have to keep in mind the smaller communities, which are more isolated.  When a specialist is coming in, the specialist should stay in the community a little bit longer.
Too many people are going to Yellowknife for specialized treatment for oral and vision health.
I think we have to keep the smaller communities in mind and ensure that all the people who are on the list are seen.
I have heard from different people who are going to see a specialist.
When they say that they have gone to the nursing station, as one of our colleagues said, there is no way for the person to be seen because they don’t have an appointment. Once the specialist team is gone, they have to wait a long time for another specialist to come in.
So I think special attention has to be paid to the smaller communities and that the specialists should stay in the community a little longer.
This is not a question. It is mostly a comment.
I’m just going to make an addition to my colleague’s question with regard to people getting cancer. There is no scan machine in the region and there is only a mammography machine.
Some of us note that when they go to the hospital, all they’re given is Tylenol and they’re told that they have to expect this sickness because they’re so old.
Much later on, they find out that this person has cancer. Is the medical team here in the north taught how to detect or diagnose cancer?
There have been too many people that we have lost that had been going back and forth to the hospital or nursing station because they were sick.
That’s why I wanted to bring this up again, Mr. Chairman.
We hope that the medical practitioners are trained and have spent many years at medical schools receiving training to detect a number of illnesses.  The human body is the most sophisticated piece of machinery around, if anyone has studied anatomy or read about anatomy and all the possible diseases that a person could pick up or develop cancers.
There are airborne viruses. There are all kinds of things. It is very difficult for nurses and doctors to accurately diagnose certain illnesses and symptoms.
Sometimes the symptoms of one disease are almost identical to the symptoms of another disease. It can get quite tricky at times.
I urged my constituents in Cambridge Bay when they talked to me about this issue that people know their own body best. If they are not feeling well and their initial diagnosis is not helping them out, they go home and they are still sick for a couple of days, then they have to absolutely insist and go back to the health centre and tell the doctor or nurse what is happening with their health.
With the lack of sophisticated technology in Nunavut right now, we don’t even have a CAT scan. We don’t have any MRI machines in Nunavut. These are the kinds of sophisticated equipment that could help diagnose early stage cancers.
Of course, if people aren’t feeling well, then they should be sent to hospitals where those kinds of diagnostic tests can be run to determine if they have the certain types of cancer and what stages they are at.
There has been some mistreatment in both of the communities I represent. There have been too many cases where they have been diagnosed too late.
It is especially elders and the older Inuit. Once they go to the nursing station, they are told that they are too old and they’re just given Tylenol.
Here he knows his body and he already knows what answer he is going to get and sometimes that deters him from going to the nursing station. This has to be corrected. This is just a comment.
The question that I have is in regard to the Mobile Addictions Treatment Program in Cambridge Bay.
Do I understand that this program can go to other communities and not just in the community of Cambridge Bay? Is it called mobile because it’s only going to the communities surrounding Cambridge Bay? Everything seems to be going to Cambridge Bay.
As Mr. Tapardjuk will recall, it was a pilot project that was announced and approved last year’s budget and Cambridge Bay was selected. It was selected before I became Minister of Health, fortunately.
Otherwise, I would probably be criticized by people for picking my community, but nevertheless, it was picked by the Department of Health because there is a facility there.
There are also mental health people there.
It was called the Mobile Addictions Treatment Program. There is no facility. It’s just a building there that they were able to use.
If there are facilities in other communities or buildings where they can accommodate people, because people may come from other communities, if there is a facility with classrooms and accommodations, then in terms, it would be mobile. You would move the team around.
You would train the folks in the community to support the people who take the program. After the team itself leaves, the people who were on the program will require support. That’s why you would need individuals in the community who are trained to provide that support so that folks have a good chance and not relapsing.
Again, it’s a pilot project. It has only run once thus far. We just got the evaluation report in the last couple of days and our department will be sitting down to review it.
It will be interesting to find out if this program was successful once we get the report because I would like to see more of this type of program.
We’re always saying that Nunavummiut are abusive and they have too many addictions, so we have to make laws. That’s what we have been doing all the time.
Here are some of the main problems that we have to work on. The causes of the problems are addictions.
Those are the people we have to help. That’s what I wanted to bring up. I think the minister agrees with me that this one of the root problems of other problems.
So it would be very interesting to hear how this program went.
We know that we have to fix the root cause of the problem, even though there are other problems on top of that.
The Nunavut Addictions and Mental Health Framework will be going into effect in 2013-14.
What are you trying to do in this program? What is the set-up going to be?
I thank Mr. Tapardjuk for his comments.
We’re going back to the mobile addictions treatment. As I was mentioning in my comments to Mr. Oshutapik, just based on my involvement in Cambridge Bay… .
I wasn’t planning to be involved; they just invited me to be involved. I got a lot of good comments from some of the participants. They wished to encourage all MLAs, ministers, and leaders in Nunavut to get involved at the community level and see the challenges that they are facing and to deal with their problems.
They were also taking the opportunity to lobby me quite heavily to provide more programs.
I do believe in helping the people closer to home in our communities where possible. That’s where people should be assisted and supported.
Mr. Chairman, the Mental Health and Addictions Framework for Action is ongoing.
Some of the areas we’re looking at would be illness prevention, health enhancement, and community development. We have been looking at self-help based programs and services, some of them I just kind of mentioned there for the MAT program, community-based programs and services, crisis response, and facility-based programs and services.
I’ll ask another question.
On page 98 of your business plan, one of the priorities for 2012-13 is to “Complete the development of the delivery model for rehabilitation services.”
Can you give us an idea of what you are looking at? Is it rehabilitation?
I hope you understand me, Mr. Chairman. Thank you.
I apologize to Mr. Tapardjuk for the delay. Looking at these briefing notes and then picking information out is quite a challenge here sometimes.
If I understand Mr. Tapardjuk correctly, we are developing a new territorial rehabilitation service delivery model so that we provide consistent delivery methods across the territory. We are currently in the review stages of that.
In regard to H-6, my first question is around the CT scanner.
I know the minister had given the answer to the House during an oral question, but I just wanted to follow up on some of his responses with regard to the CT scanner.
I know he had mentioned that it would be coming up by air and that training was ongoing.
I guess the one question I was concerned about is: when will the CT scanner be functional?
If he’s asking for a specific date when it’s going to be functional, I can’t give him a date, but I can tell him that the plan is to have it operational by the fall of 2013.
So the plan is to bring it in here in late spring and then we will be doing acceptance testing during the summer of 2013.
Mr. Elliott: Thank you, Mr. Chairman. Thank you for the response.
It’s good to know that by the fall time, it will be up and running.
On page 99 of the business plan, one of the priorities for 2013-14 states that “Based on the internal review, determine whether legislative amendments would be necessary for the Mental Health Act.”
Could the minister update the committee on what’s happening with the Mental Health Act?
I know Mr. Elliott has asked this question in question period and it was in the fall.
Just to give you an idea here of where we’re at, phase 1was a Health and Social Services internal review and that was in December of 2012; phase 2, there was an external review, which includes the Government of Nunavut contract psychiatrists, RCMP, NTI, and that’s occurring during January to March 2013; and phase 3 would be the public consultations and that would be later this year, spring or summer.
In terms of the Act, the internal review has been done.
It sounds like there has been discussion with some of the service providers, the RCMP, frontline workers, and now over the next couple of months, it will be taken out to the communities for consultation.
I’m just thinking in my mind in terms of legislation coming before us. What was determined with the internal review? Is it a rewrite of the whole Act and it needs to be started from scratch or is it just amendments?
Mr. Chairman, I don’t have all the details here, but the deputy just told me that that’s why we’re going through this process by doing the external review with the RCMP, NTI, and the contract psychiatrist, and then we will do a level of public consultations.
We started to talk to the cabinet about some funding to undertake that, but it is quite an old piece of legislation that goes back to 1988. Like a lot of legislation that we inherited from the Northwest Territories in 1999, it likely does not reflect the current conditions in Nunavut.
In terms of the timeline that we have left for the mandate of this Assembly, those consultations and then it would have to go into the committee on legislation, we’re looking at this being dealt with in the next Assembly. Is that correct?
Mr. Chairman, we’re looking at probably the next Assembly, the Fourth Assembly.
It would be nice if we could all amend the legislation or new legislation, but once you get down into some major pieces of legislation… .
We all know that there are many pieces of legislation in the Government of Nunavut that need to be reviewed and amended or introduced.
If you’re involving other people, external partners, and public consultations, then you have to go through the legislative proposal or legislative framework processes. It could take anywhere from six months to three or four years in some cases.
There is a piece of legislation from the Second Assembly, the Family Support Orders Enforcement Act, that finally came into the Third Assembly where it went for approval once the work was completed to the satisfaction of the standing committee and the government.
This work won’t end just because the Third Assembly ends. The work will continue because it’s that important.
In regard to mental health workers across the territory, I may be incorrect with the numbers, but I believe, last year, we had approved 12 positions for mental health workers to be hired across the territory.
If I’m incorrect, maybe the minister can correct me. Of those 12 positions that were supposed to be filled to help in dealing with some of the mental health issues we have across the territory, how many of those positions are currently filled and how many are vacant?
I’ll let my deputy minister take that question.
Unfortunately, this didn’t roll out as well as we would have liked. There were 12 positions identified. Most of the graduates from the Nunavut Arctic College program had found other employment and were in other careers.
What we did do, however, to turn this into a positive was use those positions to fill other mental health needs across the department.
There are a couple of individuals who may get appointed later and we’re just currently working on that. I think there are two or three off the top of my head. I don’t remember the communities off the top of my head as well.
Chairman: Thank you. Mr. Ma. Mr. Elliott.
Where are those current positions held?
Chairman: Thank you, Mr. Elliott. Mr. Ma.
Mr. Ma: The way the funding was rolled out, they weren’t specifically allocated by communities per se. However, I can tell you what the plan was last year. At the time, we had talked about the communities of Iqaluit, Arctic Bay, Pangnirtung, Arviat, Rankin Inlet, Whale Cove, Cambridge Bay, and I think Gjoa Haven.
Again, I think the issue of mental health is huge.
We just have to look at some of the reports that we’re getting back on violence. It has been announced in the House. Judge Kilpatrick just ended up writing some statements about the dire need for dealing with these types of issues.
I was wondering if the minister could clearly explain what it is his department is trying to accomplish. Does he see mental health workers in every community?
How will mental health services be provided across the territory to address some of the major needs that we actually have?
Of course, I have stated in this House that mental health is a high priority for this government. We put well over $13 million into mental health and through our budgetary processes, we get funding from the Territorial Health Access Fund, which is part of THSSI.
Now, with the support of the House, we’re renovating the Akausisarvik facility to meet the needs of Iqaluit, the Baffin, and possibly other regions if people come over here.
We are looking for funding for seven PYs up there. In the Kivalliq region, we’re looking at a facility there that could be turned into a mental health support facility and also in the Kitikmeot.
As the deputy minister indicated, we had good intentions with the mental health workers, but unfortunately, when we had the positions, when we went to ask a number of them if they were interested, they had already committed to other jobs or careers.
We continue to see mental health workers as valuable positions in the communities and, subject to approval of appropriations in the House in future years coming in before you, we will continue to seek funding for mental health workers.
I see that as something that will happen over a period of years to adequately get the mental health services in Nunavut up to the level and standard that we require.
As all members are aware, the Department of Health has got a huge number of priorities and funding is always a factor. Housing is a factor. Qualified individuals are a consideration.
So it’s not easy to just say that we’re going to put a position in there. You have to consider all the support mechanisms there.
Of course, at the end of the day, you have to have people who are willing to be mental health workers.
It’s a very challenging position. We know we need those positions, but recruiting them and keeping them is going to be one of our challenges.
I think part of the idea is to have people on the ground to be able to do the work, but then there are also facilities.
Over the last year, I believe there has been a lot of rotating of departments, whether it’s Public Health or I believe that you were mentioning Akausisarvik. Could you give an update to the committee as to what’s happening here in Iqaluit with that?
I know that at one time, there were some concerns or miscommunication once in a while about where appointments were and whatnot.
So in terms of mental health with that facility, I know at one time, there was expansion to allow more individuals to be housed.
How is that? If the minister could give an update.
I’m not aware of any concerns with the current plans for the facility in Iqaluit.
I know the Department of Health has met with the DEA here in Iqaluit to talk about the facility being nearby.
It’s currently being renovated and I believe the plan is to… . I don’t want to put a firm date on it, but it’s some time in April.
It’s all subject to construction schedules, other issues, and of course, approval of the Health and Social Services budget. We are seeking seven PYs to increase the level of staffing to support the larger facility and the clientele they will serve in the community.
Is the facility that we’re speaking about the old Tammaativvik before the move?
I believe it’s the blue-coloured building up by the high school. Is that correct?
I think this speaks to what Mr. Tapardjuk was talking about as well in terms of the idea of mental health, how it actually sometimes goes hand in hand with addictions, and how hard it is to tackle the problem.
I know that one of the priorities on page 99 is to “Implement the Mental Health and Addictions Framework.”
One of the ideas that we had come up with, I believe, under the Tamapta Mandate was to have an addictions type of facility here in the territory.
Is this facility that we were just talking about going to provide those types of services or is it specifically for individuals dealing with mental health issues?
This facility would be specifically for mental health issues.
So it is safe to say that by the end of the mandate of this Assembly, we will not have any type of addictions treatment facility within the territory.
Mr. Chairman, I think it would be safe to say that we will not have an addictions facility in this territory by the end of the mandate of this government.
On page 99 as well, one of the priorities for 2013-14 is to “Proceed through the legislative process to update the Vital Statistics Act.”
I was wondering if the minister could provide an update on what exactly is going to be involved in that process.
We have done a jurisdictional scan, a jurisdictional scan being all the other provinces and territories, and we are waiting to see what the Northwest Territories is doing with respect to their vital statistics.
While we’re talking about vital statistics, I believe, under the vital statistics portion of the department, is that where birth certificates are obtained?
Yes, Mr. Elliott is correct.
This goes hand in hand with questions that I was asking recently in the House and the questions were asked to the Premier in regard to social insurance numbers. As I’m sure everyone is aware, before you can actually get a social insurance number, you need be able to get a birth certificate.
All regular members were sent a copy of a letter from our MP regarding the issue of social insurance numbers. I believe the minister’s office did provide a reply to that, but not everyone that was originally cc’d on the letter received a copy of it.
For the public record, if the minister wanted to explain in terms of some of the issues that we hear in our constituencies about birth certificates being acquired for people before 1999 or in other jurisdictions, perhaps the minister could actually elaborate on his response.
It’s interesting that in the Second Assembly, the Minister of Health of the day received a similar question from Members of the Legislative Assembly.
I don’t believe much has changed since then. If you were born in another jurisdiction, if you were born in Alberta, that’s where you have to apply for your birth certificate. If you are born in Nunavut after April 1, 1999, Nunavut should have that information and issue birth certificates.
Our health department has people available to provide information to assist people to apply for their birth certificates, whether it is in Nunavut or outside of Nunavut. There is a website where you can access the necessary forms.