EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Sometimes it seems like we need to replace equipment when they need repair. However, an exact amount is difficult to calculate.
Our health infrastructure is aging. In fact, in most of the communities, 60 percent of our health centres are 20 years old or older.
Mr. Chairman, in order to properly maintain and provide minor repairs to our current facilities, we are requesting $700,000 for small capital.
We need to replace the boiler ventilation system.
The Department of CGS is responsible for repairs.
After they do their study, they make recommendations for improvements or replacements.
In the meantime, we are celebrating the successes from recent years’ capital plans, including the new Pangnirtung Health Centre, which opened its doors earlier this summer.
Mr. Chairman, I look forward to your support and I welcome questions from the members.
Hon. Tagak Curley (interpretation): I would like to have the deputy minister and the finance comptroller to appear with me.
Do my colleagues agree to have the minister accompanied by his officials at the witness table?
Sergeant-at-Arms, can you please escort the minister’s officials in.
Thank you, Sergeant-at-Arms, for escorting the witnesses in.
Minister, although we know the individuals, you need to formally introduce your witnesses.
To my right is Deputy Minister Alex Campbell and also to my left is our Finance Comptroller, Debora Voth. (interpretation ends) Thank you.
Before we proceed, I would like to ask the Chair of the Standing Committee on Social Wellness if he has any opening comments.
Mr. Aupaluktuq, I believe you have comments to make.
I would like to welcome Minister Curley as well as his officials.
I am pleased to provide opening comments on behalf of the Standing Committee on Social Wellness as the Committee of the Whole begins its consideration of the proposed 2011-12 Capital Estimates of the Department of Health and Social Services.
Members note that the department’s proposed capital budget for 2011-12 is just under $35 million.
This is the biggest capital budget brought forward by Nunavut’s Department of Health and Social Services since 2003-04, although members recognize that the department’s actual expenditures for the past six fiscal years have all differed considerably from the approved budgets for those years.
The standing committee has noted that supporting documents provided with the department’s proposed capital budget often lacked detailed and up-to-date information.
The committee recommends that substantiation sheets and other such supporting documentation be updated prior to standing committee review.
Mr. Chairman, over the past decade, the Government of Nunavut invested considerable sums of money in major infrastructure projects, including three new regional health facilities and two new 24-hour continuing care facilities in Gjoa Haven and Igloolik.
While the standing committee approves of the intent to provide and deliver more medical services at home, here in Nunavut, there is a concern that the new facilities are still not being used to their full capacity.
Committee members urge the minister to refocus his efforts on ensuring that as many Nunavummiut as possible can receive the appropriate care and services in the new Nunavut health facilities.
Ultimately this will reduce the need for travel, accommodation, and health services outside of the territory and the associated costs.
And, perhaps as importantly, providing Nunavummiut with the ability to receive as much health care as possible close to their homes and families will have a beneficial effect on the overall state of health and well-being across the territory.
The department’s proposed capital budget for 2011-12 includes funding for three infrastructure projects and two blocks of funding for minor and small capital projects.
Two projects relate to continuing work on the Qikiqtani General Hospital complex, including ongoing renovations to the former Baffin Regional Hospital as well as the purchase of furniture and equipment.
It appears that funding allocated for these purposes in previous years was transferred or re-profiled and is being replaced in the upcoming year.
The department’s third infrastructure project for 2011-12 is the ongoing health centre replacement project for Repulse Bay.
Three other health centre replacement projects have been identified for future years funding.
The standing committee continues to encourage the government to provide regular updates directly to the communities and members on the planning, progress, and timelines for these projects.
The standing committee has previously noted the department’s cost-saving initiative of using the same health centre design for three of these projects.
The committee cautions the government to pay close attention to costs that may arise from community-specific modifications or alterations to the design features of this multi-use plan.
Members encourage the minister in his efforts to work with his federal counterparts to identify any possible additional infrastructure funding that could support and accelerate his department’s capital plans.
Committee members have noted that the federal government has previously provided additional health centre infrastructure funding for First Nations communities and strongly urge the government to pursue any options that may exist to access similar health centre infrastructure funding for Nunavut’s predominantly Inuit communities.
Mr. Chair, the Department of Health and Social Services includes two blocks of non-specific funding in its 2011-12 capital estimates.
One of these blocks of funding is for small capital projects, such as repairs to buildings and emergency situations. The other is for minor projects including the purchase of new equipment and vehicles.
With respect to small capital projects, standing committee members have identified serious and outstanding repairs required at some community health centres and ask the government to commit to addressing these issues in a timely manner in the upcoming fiscal year.
The standing committee appreciated the minister’s willingness to look into the issue of providing support to community-based family violence shelters which are in need of repair.
While it is recognized that most of these facilities are not government assets, the department’s Saillivik policy does commit to supporting family violence shelters in meeting minimum structural and environmental standards.
With respect to minor capital projects, the standing committee continues to look forward to updates regarding new medical equipment purchases, such as dialysis machines, MRI units, CAT scanners, and cancer treatment equipment.
The committee recognizes that trained staff will be needed in order to offer services in these areas and encourages the minister to work with his cabinet colleagues to promote and support the education and training of Nunavummiut in the related health professions.
Adequate road transportation for medical clients remains an issue in many communities and the standing committee appreciates the minister’s efforts to evaluate his department’s mobile equipment status across the territory. The committee encourages the minister in his efforts to contract local private businesses to provide the necessary services.
The standing committee continues to look forward to receiving details of small or minor projects that have been identified and prioritized for the upcoming fiscal year as well as a listing projects on which such funds were spent in the previous fiscal year.
Mr. Chair, that concludes my opening comments on the proposed 2011-12 Capital Estimates of the Department of Health and Social Services.
I wish to thank the minister again, as well as to welcome his officials.
Whenever the members have to travel to Iqaluit for a session, we occasionally have to go for medical appointments. I went there recently and the level of care provided by the nurses and the doctor was very professional. I thank all of the health care staff at the hospital.
In the minister’s opening comments, he stated that many of the health facilities in Nunavut are aging.
That seems quite self-explanatory since I have referred to this matter in statements in the House.
I have also referred to the fact that Baker Lake is experiencing an economic boom due to the development of the mine near our community.
The population in the Kivalliq and in Nunavut is increasing. We are experiencing an influx of Inuit who are moving to Baker Lake to take advantage of this economic opportunity.
One of the issues to keep in mind is that Baker Lake has the highest number of elders resident in our community in Nunavut.
What exacerbates the problem is that the health centre is now too small to accommodate the number of patients and furthermore, it is set too high.
Many patients complain about the chairs in the waiting room, saying that they are too hard since they are wooden chairs. Also, the stairs are too steep and people with canes complain that they have difficulty accessing the centre due to the stairs.
I am just commenting on this and I am very pleased that the minister is stating that the majority of the health facilities in Nunavut are aging.
I just wished to remind you not to forget the health centre in Baker Lake.
That was just a comment, but Minister Curley, you have the option of responding to the comment.
They are very clear and understandable. We took note of what the Member for Baker Lake just stated.
Once the mining development started occurring in the community, it was evident that their work had increased.
We will inform them and keep them abreast.
During the standing committee review just recently, we spoke to the issue that the facility is not safe for people with canes or in wheelchairs.
We discussed that matter.
Once I hear more about it, I will let you know.
The Nunavut-wide director was supposed to be replaced following his passing. However, the individual who was going to be the replacement resigned before starting the position.
So, at this time, we are short-staffed.
I just wanted you to know. We won’t be short staffed for long.
Mr. Schell has his hand up.
It’s in regard to Repulse Bay getting a replacement health centre and then you’ve got comments in your opening statement there that Taloyoak, Arctic Bay, and Cape Dorset are on the list.
As we all know, Cape Dorset has the oldest health centre in the system there that hasn’t had major renovation and there is nothing going to be happening with it until at least 2014-15 and that’s not even construction.
I’m just wondering if you’ve had a chance to look at it and see if that could be speeded up to an earlier date or if there is no way that it can be done any earlier.
We are aware of the fact that the health centre in Cape Dorset is aging. The Department of Community and Government Services made a report last year on the aging facilities and their maintenance, and the department is in support of these.
It was not included in the five-year plan previously because we still have not constructed those facilities in the three communities which are in the five-year capital plan.
Once the one in Repulse Bay is completed, they will move on to Arctic Bay and Taloyoak.
Once those three facilities are completed, we will have to look more closely at the health facility in Cape Dorset.
We have not set aside any funding for the design of the new health facility for Cape Dorset and we will keep you informed of when they will be coming out.
The main reason I’m bringing that up is that three or four years ago, it was in the planning stages to be replaced and then it went off the radar, similar to Johnny’s school in Coral Harbour.
So that’s the reason I’m brining it up. Originally it was planned to be done and then all of a sudden, it’s back on down the list there. So I’m a little worried about it, but I guess I’ll wait and see what happens.
When the minister made an appearance before our committee, I suggested that he just start the projects and working from his other housing department, they just start and just bill other departments for the work. So that’s what I suggested, that we carry out all of the work anyway.
Anyways that was just a comment from Mr. Schell.
Mr. Elliott had his hand up. Mr. Elliott.
On page 2, again with Arctic Bay being one of the communities on the list for a health centre as well, I know there are competing priorities.
I was just wondering if the minister could explain a little bit more in terms of the capital planning process for his department. How do you decide who goes to the top of the list?
Repulse Bay obviously went to the top of the list for some reason and then at one time, Arctic Bay was on the list, it was removed from the list, it was second in line, and now it’s third in line. So I don’t know what happens in terms of… the building is still there and the nurses are still working and they are still overcrowded.
If anything, like you said, it’s aging, but what determines how you choose?
Chairman (interpretation): Thank you, Mr. Elliott. (interpretation ends) Interesting question.
Hon. Tagak Curley (interpretation): Thank you. I understand your question clearly.
I don’t remember when we changed the plan.
With respect to the five-year plan, the Kivalliq portion was behind schedule.
So when a plan has been delayed for a year, the priority is the first item in the capital plan.
However, if the funding was inadequate… .
There was no funding for health centres last year because there were more serious priorities, such as education and schools.
For example, this past summer and current fiscal year, Repulse Bay is the first priority after having been constantly delayed. Perhaps the member can help me find out when they have been slated for Repulse Bay after the member, John Ningark, was elected.
The plan is to start working on the Arctic Bay project next year.
Mr. Elliott: Thank you, Mr. Chairman. Thank you for that reply.
I was hoping, maybe, to get some more in terms of when CGS was talking about capital planning and stuff like that, they look at the age of the building and possible… I guess what Mr. Aupaluktuq was talking about with stairs.
I know that in Arctic Bay, there are problems underneath the facility where the actual CGS workers cannot get in to work on the sewage tanks and the water tanks. There are also the leaks in the roof and different things like that.
I was hoping to get some more substantial answers in terms of how you pick and choose in terms of what the priority is or how do they determine that. Obviously Repulse Bay was in the most need, but how did you determine that was of most need?
I think that the member fully understands that there is a capital planning process which involves various intergovernmental committees.
It also involves CGS and so on, but also within our own health department, we always had a capital planning director.
That position has been vacant, but it does not impact on the plans that the department has with respect to the five-year planning process, which has been established and pretty well guides the cabinet for proceeding with funding that is being allocated each year.
But one thing for sure that the member knows is that at least the plans and the architectural designs are fully completed with Arctic Bay. We’re not at all juggling anything whether or not they should come first or whatnot.
We’re sticking with the five-year plan. As far as the other administration, how they were juggling those capital projects, I cannot respond to that, but my deputy may help me a bit on that if you choose to do so, Mr. Chairman.
We do work with CGS intimately in this process.
CGS is our technical advisor to all departments when it comes to capital projects.
Part of the system process includes the age of a facility itself, the number of repairs that need to be made, the state of the building itself, and the ability of that facility to provide the program support that the community is looking for. So we do a whole list of criteria and we do have work with CGS. They do the technical assessment, they do the report back to the department, and then that’s when we make the determination as to which of those priorities should be in place.
We do work with the process is what I’m trying to say and we do go through a series of criteria working with CGS.
I was originally given my information from one of the budget speeches in 2008 where it had said that this would be happening and then also I know the Premier at the time went to Arctic Bay with the MLA at the time and was announcing that it would be built.
So, again, the community is still a little shocked that it went from 2008 to 2014 now.
I was hoping to find out what actually made those changes.
On page 3, you were talking about the health infrastructure aging, and whatnot, and we had CGS before us yesterday.
In terms of the money and the dollars they are spending on their RECAPP program, do you input your information for all of the assets that are owned by Health and Social Services? Is that put into that program as well?
The simple answer is yes, we do work with CGS, as I said, quite closely in determining the technical requirements of our facilities. We work with CGS and request them do inspections of these facilities.
As a matter of fact, we have been working with CGS quite closely on the other member’s question regarding Cape Dorset about the state of that facility.
We will be working with CGS on bringing an estimate on repairs to that facility itself in the next year.
So we do work closely with the system in trying to facilitate the process.
One of the things when we were, I guess it was a week and a half ago, in Arctic Bay when we had the Nunavut community integrated infrastructure meeting, it came up.
The number one priority was a health centre for Arctic Bay. The hamlet has, again, the power lines, has a road in there, and everything is ready for it to go once it’s approved in the budget on the year that it is supposed to happen.
But the other concern was with the community thinking ahead in terms of 5, 10, and 20 years, there was a concern or a question about the facility. Once the old health centre is finished, will that be turned over to the hamlet or what are the certain plans for buildings once that happens?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes, we do maintain the building as a government.
The CGS is the ultimate owner of all our facilities.
Usually the first right of refusal is the departments of the government and if the departments of the government don’t want the building, then it goes to the hamlet itself.
It is shared that way so that the public organizations would be given first priority over acquiring those buildings.
One of the things that the hamlet could do is actually write to your department and ask for the process to start now if it is four years in the making and could actually have it happen in tandem. Is that correct?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes, that is correct, with a proviso, of course.
Again I should reinforce that the first refusal would be government departments if they require such a facility there, and then it will go to the hamlet in this case.
With our MP, Leona Aglukkaq, being the Minister of Health for all of Canada, we have a tremendous ally on our side to push for infrastructure.
If we have aging infrastructure, what has your department done in the past year in terms of talking with Ms. Aglukkaq, or sending letters, or having meetings with her in Ottawa? Is your department constantly pushing?
Again, we are approving about $115 million worth of infrastructure and if we are building three of these health centres, that is roughly $90 million. It is a huge investment.
Have you been pushing, down in Ottawa, for this?
That is a very important question.
I think it’s a question that should be raised at every opportunity, not only by the cabinet ministers but also by the MLAs whenever they can find time to speak with our federal counterparts and also including our senators, if at all possible.
I can say to the members that the cabinet has done whatever we could, including our Premier, raising the issue of infrastructure requirement even to the Prime Minister.
Recently, not only Nunavut has now begun to see tremendous increased costs at all levels, whether it be infrastructure, but health costs throughout Canada.
I will ask my deputy to explain a bit about what the provinces are asking the federal government to do because in view of the recent federal health ministers’ meeting, the escalating health costs were really out of control throughout Canada.
There is a tremendous push now by our counterparts to lobby the federal government to put some extra funds for health-related costs as well as infrastructure.
Recently, again I joined federal officials at meetings in Halifax who tried to scope out some ideas for seeking extra funding.
We are not alone in this area and we are doing everything we could.
But I think the member fully understands as well that federal ministers seem to be saying that they don’t have any room to put any more extra funding in view of the economic situation.
Very recently, last week, the Minister of Health was here and on this very topic, she indicated that the faucet has stopped flowing and that kind of thing.
I don’t know what that means, but I’ll leave it to the member to interpret that.
We appreciate all of the help that you’re giving us in lobbying the federal government.
I have seen copies of your correspondence and I compliment you for that, and I urge all of the other MLAs to do the same. I think we should get a bit of a provincial scene of this. I missed that one due to the cabinet strategy the other day.
I was not able to go, but my deputy was attending that and he has the most up-to-date picture of where the provinces are standing with respect to all of these issues.
I believe Mr. Campbell was going to give a supplementary.
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes, just very briefly, Mr. Chairman, the minister just outlined that there was a meeting last week in Halifax that I attended.
It was a meeting of CEOs of health organizations, including deputy ministers of health, to talk about the challenges of health expenditures across Canada.
This is in preparation for the Health Accord which is expiring in 2014 and what to strategize around that with the federal government on developing our game plan and business case to access more funding.
The federal government, to this point, hasn’t been very receptive to providing funding to health facilities in particular.
We did provide our own list of requirements when the call letter came out to ask for provinces and organizations to submit into the federal fund that they were doing at the time.
Chairman (interpretation): Thank you, Mr. Campbell. (interpretation ends) Further questions?
I don’t see Mr. Elliott anymore.
Ms. Ugyuk
In referring back to the contents of the 2011-12 capital estimates, it seems that some of the capital items for Taloyoak have been deferred.
Specifically, with relation to this issue, ever since the Nunavut government was created, our community has been requesting a new health centre. Why is this capital project being deferred once again? Based on this continual deferral, it seems that the Nunavut government is not cognizant of the growing needs of the residents of Taloyoak.
We have been requesting this facility for a very long time. It even went as far as a design plan for a new facility as well as its capital construction costs. They expended funds to get the design plans for the centre.
The local council of the Hamlet of Taloyoak continually prioritizes the health centre as a much needed facility, but it seems like our request for a new health facility is turned down every year. It has reached a point where we have lost hope for a new health facility.
Taloyoak residents only see that our capital projects are continually deferred and delayed, and the health centre is always taken out. My question is: will the department actually undertake this project as it is outlined in the timing plans for the year 2013-14?
I understand exactly where you’re coming from. If we had money, we would build all of these health centres all at the same time.