EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
My question today is to the Minister responsible for Health and Social Services.
Is it the policy of this government and I want to follow up my colleague, Mr. Arvaluk's question on contracts, that if ownership of a company changes, does the contract automatically go to the change of ownership.
Minister of Health and Social Services. Mr. Picco.
Mr. Speaker, I'm not an expert on government contracts, I believe that's held by a different minister and portfolio.
But I can say in this case the contract portion of the ownership was bought out, and therefore there was nothing wrong with the contract being held by that same party.
The contract is to run the facility, the contract wasn’t awarded on the basis of the owners.
I think that has to be key here, Mr. Speaker, I think that is the point that the member was trying to make.
Like I say I want to follow up on my colleague Mr. Arvaluk’s concerns.
The minister is absolutely right on that facility.
I brought it up in the Legislature I think in the last sitting, about the vermin problem we had in that building, the state of it.
I myself visited that facility and really was not happy with the overall physical and operational, the physical side of the building.
Is the minister going to replace that building within the next year.
Hon. Ed Picco: Thank you, Mr. Speaker. Mr. Speaker, that facility is not owned by the Government of Nunavut.
That facility is leased by the contract holders.
As I said earlier I have been approached by a Regional Inuit Organization to say look this facility is not up to snuff, we would like to have a better facility for our clientele and for our patients to travel to.
Would you be interested in looking at that.
So that is where we are right now Mr. Speaker, reviewing that proposal.
For example, Mr. Speaker, we were just in Edmonton, some of the members and myself when we opened up the new boarding home for the hospital patients that come from the Kitikmeot Region.
We also opened up a new boarding home in Ottawa run by the Larga organization for the patients from the Baffin.
It is my understanding that is the oldest facility that we have right now on the ground.
We don’t own it but we have an opportunity to look at other alternatives.
I hope that the Honourable Minister will invite me to the opening of the new boarding home in Winnipeg when he gives me an answer when he is going to build it.
Will he tell me when he is going to build it.
I am still trying to build some hospitals and Mr. Speaker, as I said earlier, I don’t build the facilities or boarding homes, the Government of Nunavut doesn’t build the boarding homes.
In these cases we are leasing, the last facility that I believe that the government owns and I stand to be corrected, was the old Baffin House in Montreal.
That was the last stand alone facility that we actually physically owned, to the best of my knowledge and understanding.
But I would suggest to you Mr. Speaker, that when a contract is awarded, a contract is awarded on the basis of the facility itself, what facility is being used and so on.
In this case, I have said, after hearing the members in this House, Mr. Arvaluk, Mr. McLean, have articulated very well that there are concerns with the facility in Winnipeg and I as minister have directed my officials and staff to look at the possibility of how we can find, if possible, find a better facility.
We are aggressively approaching that issue.
Mr. Speaker, I will be doing some written questions on the facility tomorrow to the minister’s delight, but my final question here is, if he decides to lease a new facility for the residents of the Kivalliq, will he do it through a tender process or an RFP process.
Mr. Speaker, Mr. McLean has fantastic hearing ability and maybe I am not getting through in the way I am articulating and explaining this answer.
The Government of Nunavut, we don’t lease the building, okay.
There is no O&M budget line saying that I lease that building in Winnipeg.
It is operated through the contract that the successful proponents have brought forward.
Now the successful proponents are on the ground, they have come forward and they have said, Mr. Picco, this facility is not up to snuff, what can we do about it, and I had the same concerns as they do.
So, I am approaching it based on the proposal that they've sent.
We’d probably go to an RFP or another open tender contract, following the guidelines and criteria that are set out by the Government of Nunavut.
I think that would please Mr. McLean.
And I want to assure you Mr. Speaker that we have done two reviews on the boarding home in Winnipeg.
We've done questionnaires with their clients, client satisfaction questionnaires.
We haven't had concerns about like I said before on management.
We've had concerns about the physical facility and I think the member tried to say that there was some vermin in there. I believe he was trying to say some varmints. Thank you, Mr. Speaker.
Item 6 on the Orders of the Day.
Question 096 - 1(5): Environmental Groups
I have been noticing that wildlife management seems to be working well with the government.
But I'd like to know how well they work with other organizations such as the Water Board, the Impact Review Board and others.
As mandated by the land claim agreement, we appoint members to those different organizations and I believe it is two members each to the two boards that he mentioned.
We do work with them but they do not report to us.
I understand his response and appreciate it.
As Nunavummiut, we are part of those groups and we deal with these groups.
Mr. Speaker, we need to support those organizations and work closely with them.
Would we able to work more closely with environment, wildlife and those kinds of boards.
Presently, we appoint members to those boards and we keep close contact and work closely with them.
When issues come up that we need to work on with them, then that’s what we do.
We live in the same territory, have the same concerns so, yes, we do work closely together.
Question 097 - 1(3): Staff Housing Rental Rates
Mr. Speaker, my question today is for the Minister responsible for Public Works.
Mr. Speaker, my understanding is that this department is responsible for the staff housing of government employees.
I’d like to ask the minister if she could explain a little on how the rental rates for staff housing are set.
Minister for Public Works and Services.
Hon. Manitok Thompson: Thank you, Mr. Speaker. I'm just looking at the policy here and I'm having a difficult time understanding the policy.
I've got the whole policy in front of me.
I couldn't tell the member how the rates are set.
It's seems to be a little bit complicated but I can certainly give this to the member or table the staff housing policy that was approved in principle by cabinet.
Mr. Speaker, I can appreciate the minister's answer and I can guess that it wouldn't be a simple calculation.
But Mr. Speaker, I'd like to ask the minister if she's looking into it and I would appreciate it if she would provide that information to me or the rest of the members.
I'm wondering in calculating or in the formula, I guess if it is a formula, are things like the age of the unit and the condition of the unit taken into account.
I know for example here in Iqaluit you can look at the extremes from probably some of the oldest staff housing within our territory to some of the newest.
I'm just wondering if the same formula is used on those you know old units that's used on the new units if the age and condition of the unit is taken into account in assessing the rents.
I am also aware of very old units that are being used by our teaching staff in the territory in a lot of our communities.
Then there are newer buildings that are also being used by the same teaching staff in other communities with the same salary and stuff.
What I could do is take this as notice and get more information to the member after I've got the staff to prepare it for the House.
Question 098 - 1(5): Midwifery in the Communities
I would like to direct my question to the Minister of Health & Social Services.
Midwifery was a hot topic in the past and we were told that there was going to be midwifery introduced to the communities.
Which communities have taken on the midwifery programs. Which communities are they in now.
Minister of Health & Social Services. Minister Picco.
Mr. Speaker, I'd like to begin my answer by thanking the member for his support, he's the chairman for the Standing Committee on Health and has been quite an advocate for health concerns in Nunavut and he's to be commended for that.
Mr. Speaker, we've been talking about traditional birthing practices and midwifery and indeed when I was in Pond Inlet with the member there were some questions raised about having more children, more babies being born at the local level instead of having to bring mothers out, sending them to Iqaluit or sending them to Winnipeg or Yellowknife or even Edmonton.
A project began a few years ago sponsored, I should add, by the well known Finance Minister for the Government of Nunavut when he was the Health Minister.
It seems to be a long time ago for him, I believe.
He started the birthing centre in Rankin Inlet, which was a terrific idea.
That birthing centre has moved forward, it has expanded its practice and indeed, we have employed and trained Inuit midwives in the community and it was a success.
At the present time, Mr. Speaker, that is the only community in Nunavut to my knowledge that is actually practicing midwifery in Nunavut at the present time.
Speaker (interpretation): Thank you. Nutarak.
The communities would like to see midwifery practiced in their communities because of course pregnant women have to be out of the community for a whole month before they give birth and return to their communities.
It has been the wish of the communities to practice midwifery at the community level.
Are you going to be setting up midwifery programs in the communities.
Mr. Speaker, that’s a good question.
Ideally, I think that is where we would like to be in a few years time.
However, Mr. Speaker, it seems to us and if you look at the incidence of birth over the past several years, our birth mothers are getting a lot younger.
More mothers are smoking during pregnancy and therefore the birth weights of the children are quite, quite smaller and we have tracked that.
Thirty years ago, it would be safe to say Mr. Speaker that mothers seemed to be healthier, they had a different lifestyle.
Today the majority of mothers are younger and they smoke.
So what we want to make sure of Mr. Speaker, is that if we are going to put traditional midwifery and traditional birthing practices at the community level, then not only is it safe for the mother, but it is also safe for the child.
That is the type of thing we are working on.
Hopefully, Mr. Speaker, when we get the new regional facilities, for example in the Kitikmeot region, we won’t have to send every mother outside of the community to have a baby in Yellowknife or Edmonton.
Indeed, Mr. Speaker, it would be the same case in the Keewatin Region.
We have talked about before Mr. Speaker, that I think almost a quarter of our total budget is spent on pregnancy and bringing women out of their communities, which is not acceptable.
So we are trying to move in that direction where possible.
I would like to urge all members to come straight to the point when you are asking your questions or making your responses and allow other members to ask questions.
Some of the women want to bear their children in their communities.
Is it possible to do that if it has the approval of the nurse.
Could the women have the option of staying in their community or going to the regional centre.
Mr. Speaker, at the present time at the health centres we are only set up in case of an emergency, where a lady went into early stages of labour and we had to deliver.
If a person wanted to stay in their community to have their baby they would have to have the visiting doctor to okay it and we would also have to make sure that we had the staff at the health centre to do it, that we had the incubator if that was needed and so on.
It is something Mr. Speaker that we are looking at in the Department of Health, to see if there is an opportunity at the community level to have more births.
But that is quite a ways off at the present time.
Question 099 - 1(3): Elders Teaching Midwifery
I would like to ask further questions to the Minister of Health and Social Services on the issue of midwifery, and bearing children in the community.
I was taught about how traditional midwifery went on a long time ago, and I’m astonished about the skills known through Inuit Qaujimajatuqangit.
Is it possible to set up some kind of a traditional midwifery course because they know so much, is it possible to set up those kinds of programs. Thank you, Mr. Speaker.
Minister of Health and Social Services. Minister Picco.
Mr. Speaker, we are doing that right now in Rankin as I said, we have three registered midwives, and we also have two maternity workers in Rankin.
The statistics show me that of the births in Rankin, sixteen over the past several months have actually come from outside of Rankin, so we’re actually doing that. I think what the member would like to see is, what the member of Pond Inlet has asked is, can we have more deliveries at the community levels, for example in Clyde or in Pond.
And as I said earlier, it depends on a number of factors Mr. Speaker, do we have the staff in place on the ground and do we have trained midwives or registered midwives, and at the same time, Mr. Speaker, to make sure that it’s not a high risk pregnancy and that’s something that we’re looking at.
We are also looking at what type of mechanism we could put in place to make sure, liabilities issues and so on, so it’s not just a clear cut case of saying yes or no.
That’s something that we are looking at.
Speaker (interpretation): Thank you. Mr. Iqaqrialu.
The Rankin Inlet birthing centre is okay but I’m asking about the other communities.
The communities are very far from one and other, and I do believe there are women out there who know about traditional midwifery.
Is it possible to set up some courses through Inuit Qaujimajatuqangit and can we set aside some money so that the interested people can learn about traditional midwifery. Thank you, Mr. Speaker.
Mr. Speaker, the member makes a good point and that’s something that the department would like to do is move in that direction, to actually train more women to be professional and registered midwives.
So that’s actually something we can look at.
Are you talking about traditional midwifery or modern midwifery.
Speaker (interpretation): Minister Picco.
Mr. Speaker, I think we’re talking about a mix of both.
That’s what we’ve been doing successfully in Rankin since 1993.
We had to make sure Mr. Speaker, that we’re looking at foetal care as well postnatal and prenatal care of the mother and also of the child that is born. That is what we are looking at, Mr. Speaker, so we would be interested to see if there is an opportunity to train other women in Nunavut who would like an opportunity to be trained as midwives.
I see this as complimentary Mr. Speaker, to our staff at the health centre that we have other trained people, other trained professionals on the ground who could help out in the case of a delivery.
So I think it is a good suggestion.
Question 100 - 1(5): Igloolik Health Centre Staff
Yesterday, during question period I asked the Minister for Health & Social Services some questions about the Igloolik health centre and closures.
When I asked him, Mr. Speaker, if he could send a nurse to the community, he agreed to that.
I will be asking him again if he will be sending the nurse over to the community or will he be just be reviewing it.
Minister for Health & Social Services. Minister Picco.
Mr. Speaker, I think the member has to review the Hansard and he will see I said if operational requirements dictated that we needed to send another staff person there.
I explained late yesterday and it is in the Hansard that when we contacted the Igloolik health centre yesterday, there had been several emergencies in Igloolik in the last few days.
There are four nurses on the ground in Igloolik.
One of the nurses was sick and therefore Mr. Speaker, the nursing station was closed for well baby clinics and so on.
The nursing station was closed for those types of events.
It was open for emergencies and so on.
Speaker (interpretation): Thank you, Minister. Mr. Irqittuq.
Mr. Speaker, is it normal practice to have a health centre closed during working hours.
Is it okay to do that or is there a problem with that.
What usually happens Mr. Speaker, is the nurse in charge in each of our community health centres, if they believe at that time, at that moment in time that the health centre would be better serviced, that the staff are tired, that they need a break.
Then the nurse in charge could make that decision that the centre would be closed except for emergencies only to give the staff an opportunity to rest.
As the member knows and as the members of this House know I mean the nursing staff in the community health centres are on call 24 hours a day.
In most cases they actually live in the building itself.
So we don't see that as a request that should not be granted.
So it is based on the operational requirements of the centre.
Speaker (interpretation): Thank you. Supplementary. Mr. Irqittuq.
I was trying to ask him if closing the health centre during the working hours is proper practice.
Mr. Speaker, no it is not a normal routine.
It is based on the operational requirements.
In the case if the staff are tired, like I said, if they've been overworked.
In this case, they've had several emergencies and so on, the nurse in charge decided, one of the nurses was sick and there were only three of them working, that they would close the centre for those optional healthy well baby clinic, maybe public health information things.
If there had been another emergency or whatever that someone needed to be seen, then the staff would have been working.
I hope that clarifies the situation there.
Speaker (interpretation): Your last final supplementary.
For that reason, yes, the nurses get overworked and they get stressed out.
That is indeed the case in my community.
It becomes evident that the number of nurses is inadequate because the heath centres have to be open and available to everybody, every day.
Does he agree that we have a shortage of nurses.
Mr. Speaker, the member is correct it's not acceptable to have nurses in the community overworked.
We have been successful over the last several months.
We are up to about 80 or 90% right now staffing in our stations, one of the best rates that we have had.
It's still not acceptable.
In the member's community as an example, when I first went there, 18 or 19 years ago there were two nurses, today there's still 2.5 nurses and the population has more than doubled.
So we need to be able to fund more positions for community health nurses, not only in the member’s community but in other members’ communities here in this Legislative Assembly.
That will be an opportunity for the members when we get to the Department of Health & Social Services budget, maybe that's a recommendation that he would like to make to increase the staffing at the local level.
That would be something that I would welcome, the support of these members with the budget of Health & Social Services.
Question 101 - 1(5): Administrative Duties for Nurses
I would like to direct my question to the Minister for Health & Social Services.
I think this is his day.
I would like to ask, for the social workers in the communities there's a process there where they have to apply for leave from work, they give this paperwork to the nurses.
Have you given more responsibilities to these nurses.
Mr. Speaker, to the best of my knowledge we haven't changed the job description or the responsibilities of those staff.
We do try and continue professional development, where possible, for all staff.
The Government of Nunavut itself tries to do that.
The Department of Health & Social Services is no different in that.
Ms. Williams (interpretation): Thank you, Mr. Speaker. (interpretation ends) I would like to ask my question in English maybe I was not clear.
My question is have the nurses been given more responsibility for doing administration work for the social workers, their leave forms and other administrative duties that need to be done.
Is that the nurses’ responsibility.
Mr. Speaker, in every community there's always someone who's acknowledged as the chief government bureaucrat for that department.
In some communities for example, if it is social workers, you have an area supervisor let's say for north Baffin, if the social worker was going to be leaving for maternity leave or annual leave or whatever, then they would have the authorization from their direct supervisor.
At the community level, if the person was leaving for a day or needed a leave form done for sickness then another member would have to check it off.
That could be the nurse, if the nurse for example was sick, it would be one of the other staff people on the ground that would be given that opportunity.
What we've tried to do Mr. Speaker, is limit the amount of administration for our nurses and we've come up with a new plan Mr. Speaker, where we've made a centre manager in each of the, in each of the communities.
We've started testing if for example in Cambridge Bay where we have a health centre manager and that nurse does most of the administration, paperwork and so on and then that allows the other nurses to be able to concentrate on nursing.
So that's a model that we'd like to try to implement in some of the other communities. Thank you, Mr. Speaker.
Ms. Williams (interpretation): Thank you, Mr. Speaker. (interpretation ends) I will ask then the minister, we've just heard that there's a shortage of nurses in these communities.
How can we as a government make sure that they don’t take any more responsibility, and I would also like to know what the organizational chart is like for the reporting or the administration work for the nurses with social workers.
I think there were two questions, two excellent questions.
Mr. Speaker, on the first question the member is correct.
We don’t want to be putting more, especially administrative tasks, on to our health centre staff, on to our nursing staff.
They have enough work to do at the present time.
In this region, for example, Mr. Speaker, with the deal that was cut by the Regional Health Boards, they had the nurses at one point writing all the tickets in the community.
Actually writing up the tickets for people who had to go out for medical travel.
That wasn’t acceptable and we changed that.
Mr. Speaker, on the second part, an organizational chart is a living, breathing thing.
When we incorporated the three Regional Health Boards, we had to change the whole structure of Health & Social Services, including the organizational chart.
In most cases, Mr. Speaker, we have a person on the organizational chart that the other staff in the department report to, like any other organization.
In most cases, Mr. Speaker, it is the Nurse in Charge who fills that supervisory role for the organizational chart.
In fact and probably in practice, Mr. Speaker, in most cases there would not be that direct reporting linkage.
When I visited my constituents’ communities, this was a concern and that is why I brought it up.
Also having worked as a social worker before, I think this organizational chart needs to be reviewed, and it was not acceptable to the nurses that I spoke to in those communities.
They did not take part in the designing of the organizational chart so I think we need to look at that.
I know it was passed in each hamlet as the minister told me before.
I would just ask to have this organizational chart reviewed again.
Mr. Speaker, an organizational chart is a snapshot in time of where the department is and in most cases, an organizational chart shows where the department would want to go.
For logistic reasons, Mr. Speaker, for administrative reasons you show a hierarchy within the organizational chart where people have to report or the reporting structures.