EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
I will ask the Mayor of Iqaluit and if she has no objection, then I would welcome him to attend.
It looks like I will have to buy some hot dogs and coffee this week before the meeting.
Mr. Speaker, my next question for the minister; she had indicated that there is a regular audit going on by the department on the City. Can she indicate when she expects to have that audit completed?
Hon. Levinia Brown: Yes, thank you for that question.
I think I should be maybe more clear. Further to my comments in Inuktitut, our review is happening, annual review of the City of Iqaluit financial statements. However, they have their own auditors that provide those services, and that is what we are waiting for.
We should have that report before the end of March and once we have that report, we will be able to assess further their situation.
I know all the homeowners and probably everyone here in Iqaluit will be eagerly awaiting the results of the audit that the City is having done, and also the review that the department is doing on the City.
Would the minister commit to providing the results of the audit and the review to me and the other Members of the Legislative Assembly in Iqaluit here as well?
I will follow the procedure, whatever the procedure is, or the policy, I will abide by that. The Municipality of Iqaluit is another level of government, same as here and all governments here in the territories. If I am allowed to do that as a member, I will do so, but I will check the procedures and policies first to make sure that I am not breaking any of them.
Speaker (interpretation): Thank you. Oral Question Period is now over.
Tabled Document 083 – 2(3): Kitikmeot Inuit Association 2006 Newsletter (Peterson)
I would like to table the Kitikmeot Inuit Association Winter 2006 Newsletter.
I would urge the ministers to read through this; it contains some very good information.
Motion 011 – 2(3): Legislative Assembly Appointments – Notice (Tootoo)
I give notice that on Monday, March 6, 2006, I will move the following motion:
NOW THEREFORE I MOVE, seconded by the Honourable Member for Rankin Inlet North, that Peter Kilabuk, the Member for Pangnirtung be appointed Deputy Speaker and that the appointment of Patterk Netser, Member for Nanulik be revoked.
AND FURTHER I MOVE, a tough one Mr. Speaker, that the Honourable Edward Walter Picco, Member for Iqaluit East be appointed to the Management Services Board, and I’m sorry Mr. Speaker, and that the appointment of Peter Kilabuk be revoked.
AND FURTHER Mr. Speaker, another tough one, I move that the Honourable Edward Picco, Member for Iqaluit East be appointed to the Standing Committee on Rules, Procedures, and Privileges and that the appointment of the Honourable Leona Aglukkaq be revoked, and I’m sorry I missed it myself when I’m the Chair of that committee.
AND FURTHER Mr. Speaker, I MOVE that Peter Kilabuk, the Member for Pangnirtung be appointed as a member for the Standing Committees Ajauqtiit and Health and Education and that he appointed as an alternate member of the Standing Committee of Government Operations and Accountability and that the appointments of Patterk Netser as a member and alternate member of those standing committees be revoked.
Bill 9, An Act to Amend the Exemptions Act; Bill 12, Appropriation (Operations and Maintenance) Act, 2006-07 with Mr. Arreak in the Chair.
We will take a break and resume at one o’clock.
>>House recessed at 11:50 and Committee resumed at 13:09
Chairman (Mr. Arreak): I will call the committee meeting to order. In Committee of the Whole, we have the following items to deal with: Bill 12 and Bill 9.
What is the wish of the committee? Mr. Evyagotailak, I can see your hand very clearly.
We will to proceed with Bill 12 and the Main Estimates and Business Plan for the Department of Health and Social Services, and then if time permits, continue to the Department of Executive and Intergovernmental Affairs.
Chairman: Thank you, Mr. Evyagotailak. Are we in agreement?
Minister, you were at the witness table yesterday.
Do you want to go back there?
Does the committee agree that the Minister of Health and Social Services and her witnesses take the stand?
Chairman: Madame Minister, please introduce your staff.
To my left is Dave Ramsden, Deputy Minister of Health, and to my right is Eric Whitworth, Acting Assistant Deputy Minister for Health.
I would like to make another reminder for the committee. I would like to remind members not to ask questions which are seen as hypothetical or which are seeking an opinion. That has been happening during some of our meetings.
We were on page H-12. Health and Social Services.
Just a reminder, when I did my Member’s Statement this morning, this is the team for Cape Dorset going to Alaska along with kids from different communities that are going to Alaska for the under-18 soccer team. So that is the team from Cape Dorset along with their coaches.
Chairman: Thank you very much, Mr. Akesuk and good luck to the team.
We are dealing with Health and Social Services. Health Protection. I think Mr. Curley had a question on this page.
Main Estimates. Health Protection.
Welcome to the minister and her officials again.
I had a question on the business plan page H-22, regarding the Tuberculosis Program. I see it’s on page H-12 of the main estimates.
The budget for the Tuberculosis Program has increased from $198,000 to $280,000. Could the minister give us an update on why there is an increase?
The difference is that there’s an increase in the PY for the delivery of the Tuberculosis Program and the return of a licensed practitioner to carry out that function.
Can the minister tell us what the current situation is concerning tuberculosis rates in the territory?
I will get Mr. Ramsden to respond to that.
Mr. Ramsden: Mr. Chairman, I don’t have specific rates of incidence with me. Departments experienced, over the last year, in working with communities and western specialists in this area, that the rate of incidence has flattened off and the follow-up treatment is actually proving to be effective.
We are actually feeling more confident that the repeat rate is actually coming down.
I thank Mr. Ramsden for the information.
It just seemed that when you increased the budget for tuberculosis, it implies that there is a problem, but perhaps the reason you are increasing it is the more that you are trying to keep it under control and keep it flat.
Is that a fair assumption?
Mr. Ramsden: The budget growth simply reflects the fact that we have got people that are devoted to follow-ups, and then the tuberculosis programming is specifically budgeted there. So we have just added part of our resources to that area.
So it’s not linked to the number of people with TB, it’s simply linked to us putting some people focused on TB treatment and follow-ups in that program.
Mr. Peterson: Thank you, Mr. Chairman. I thank Mr. Ramsden.
Can the minister or Mr. Ramsden provide a bit of an outline on how treatment is given to people who are diagnosed with tuberculosis? Are they treated in Nunavut? Are they treated in their communities, or do they have to be sent to the south for treatment?
Mr. Ramsden: I have to caution, Mr. Chairman, that I can’t speak with the depth of knowledge of the Chief Medical Officer of Health here.
He and his deputy are the ones that oversee this program, along with specialized TB nurses.
I do know that the vast majority of the follow-up work that we do is done right in a person’s community.
So we have staff who are right in that person’s community.
So from time-to-time, there is some screening work that gets done in a hospital setting in terms of x-rays, that type of intervention, but most of the follow-up is done at home.
I have no further questions on that page.
I would like to welcome the minister and her officials here, along with the team from...uh oh, I’m in trouble.
I thought I was on mute there, I apologize for that, Mr. Chairman.
It’s going there right now.
It’s okay; I’ll call you back later.
Mr. Chairman, I welcome the team from Cape Dorset here and wish them the best of luck in the Arctic Winter Games.
Mr. Chairman, in this section under Health Protection, there is funding for a number of things and one of them is public health.
This funding has dropped since last year and I am just wondering, given the growth of communities throughout the territory, one would think that the workload and the work needed to be done by public health units in the communities would be increasing.
I am just wondering if I can get an explanation from the minister’s officials on why we are seeing a decrease here and what the workloads are like in the communities.
Are they having problems because of the increased population in the communities?
Page H-12 shows an increase overall, so I am not sure if we are on the same page the member is referring to. Overall, there has been an increase in the budget allocated under Health Protection.
I would just like to clarify the breakdown of that page in the business plan on H-21. It shows a decrease of approximately $30,000 in public health. Last year was $2,375,000 and, and this year it is $2,343,000.
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. I apologize for that.
In the changes, there is a realignment of budgets to expenditure patterns and NEU benefits increase impacts.
So there was just realignment between the two areas; between the amounts.
Yes, that’s stamped as the great amount.
To realign the other part of my question, I guess, was given the population growth, here in Iqaluit, as an example, it has been quite substantial, and as well as almost all the decentralized communities.
Is your department seeing that there is more of a demand on these services in the community?
Are they looking at any plans of trying to address that through any kind of forced growth situation or problem within that area of the department?
In the overall health protection/health promotion, I stated in the House before that there has to be more emphasis placed in the whole area of promotion and prevention working with the communities, not just within the departments, but working with community agencies like our committees of health councils in the whole area of prevention, education, and so on.
So within the department, we have a section for health protection as outlined, but at the same time, we are also focusing our resources to do the prevention/promotion side using the resources that we have within each community through the committees and through our CHRs and so on.
I recognize the importance that this division plays in making or working towards healthy communities and that is the overall plan for the government.
It is one area that we are also going to be working on in developing a Public Health Strategy for Nunavut. One of the priorities we have outlined in our business plan is to develop a Public Health Strategy for Nunavut within the year. That will involve consulting with the communities of what they see as being the solutions, as well as the areas that we need to focus on at the community level.
That broader plan will also be a plan the department will use to tailor more of its resources towards the prevention side of initiatives within the department.
Mr. Tootoo: Thank you, Mr. Chairman. I can appreciate, as a former Minister of Health used to say you always have to look upriver or upstream to address problems. I would think that under public health, when you indicate the services offered through the health centres include infant and child health, school health, and healthy adult programs, and one of these programs indicates they aim at protection, education, and promotion goals to improve health of Nunavummiut.
If that’s the direction that the minister has indicated that they want to go in, is this not the division and the people that the department would work through to try and get that message out there for them? If that’s the case, how come that’s a decrease in funding there? Are they looking at any increases because these are the people that are on the ground, in the communities, actually working with and talking with people of all ages at the community level?
Chairman: Thank you, Mr. Tootoo. Minister Aglukkaq.
To go back to the member’s question, in the area of health promotion and protection, looking at this section on this particular page, it does not capture all the other things that we are engaged in as a department related to trying to educate or prevent illnesses from happening.
I’ll use one example: the efforts of the department around youth smoking. There are a number of strategies that the department is involved in; in trying to reduce the numbers of smokers in Nunavut, as one example. The other area the department is working on is in the whole area of dental decay prevention, the FASD Initiative, nutrition, and a number of other things.
So it does not capture all of that within this particular area.
At the same time, we also recognize the work of the Public Health Strategy. A lot of that work, which is a very important piece of health promotion and prevention of illness, in the next year or so, will identify where we need to focus our resources Nunavut-wide, and what some of those solutions may be at the community level.
Keeping healthy communities is not the role of one agency, but definitely a lead role from our organization to pull in other partners in the whole area of prevention and promotion.
The work in the next year under one of our strategies outlined in the business plan is to develop a Public Health Strategy that includes health protection and it will give an expansion of this initiative or this section.
Kind of, I guess.
I just want to go back to an earlier question that I asked. I’m just wondering again, given some of the forced growth issues in the communities, Iqaluit, and most of the decentralized communities, does the department have any concerns, or have they been getting any indication from the people in the Public Health Division and public health centres across the territory that they are starting to have too much of a workload with the limited resources that they have? Are they looking at expanding on that because of forced growth and workload issues?
In September, October, and December, I had a number of meetings with a number of agencies, but particularly, I had a big interest in meeting with the Committees of Council of every community.
I met with the Committees of Council chairs in each region. One of the things that I wanted to find out from those groups is how we can better be plugged into the work, whatever work that they were engaged in, but at the same time, I also wanted to hear what some of the community issues or priorities were and how we, as an organization, can work better with those agencies around prevention, around promotion.
There is some work in that to try and revitalize or review their terms of reference to strengthen their role and to develop a better working partnership with the Committees of Council, through their health centres, through the social workers, through the Hamlet in each community.
Have I had concerns about the forced growth? Absolutely; we heard some of those issues expressed by social workers in the last few years and I have said the last couple days in this House that currently, as it is, there are a number of issues that we need to try and address.
At the same time, I have also committed through this House that we need to examine how we allocate our resources and our positions based on a number of growth factors, not only in the area of population, but also in situations where there has been an increase in cases, whether they be foster care and foster children and so on.
I have committed to looking at that and reporting back to the House sometime in the summer once we have had a chance to go through and consult with the professionals that deliver the programs on our behalf, but that’s just one area. There is also the issue around the hospital that has been going through forced growth challenges.
There are a number of pieces that we are examining that we need to look at the basis of the organization that delivers those programs on our behalf and position our organization so that it is able to respond to the challenges that they will be getting from the communities and the population.
Maybe I will get more specific. When I talk about, in this area of public health, I am not questioning or wondering about social workers or social services end of things. It’s more on the public health nurses.
Members have raised here in the House, over the last week or so, a lot of concerns in regard to elders, and these nurses in the communities are the ones that go around and visit and look after those elders in our communities.
That is specifically the area; we have an aging population, of where I am getting at as far as seeing if there is an increase for public health nurses as a result of the increasing workload.
One of the examples of an initiative recently was the opening of the public health office centre for Iqaluit, recognizing that there is pressure placed in that particular area. The idea of opening that centre here in Iqaluit was to also respond more to the community of Iqaluit.
There have been some increases there, but overall, there is pressure in all our sectors in health centres across Nunavut. Part of the pressures also has to do with the fact that we are challenged with recruiting nurses and so on.
So it’s not just the population demand, it is also trying to balance filling those jobs to provide the services is also a challenge that we face.
I would like to thank the minister for that answer. I’m just wondering if the minister is aware or do her officials know how many public health nurses working in the communities that we have.
How many of those are filled and how many are vacant?
I don’t have the specific numbers, but resources in the communities are both...there’s none dedicated for that. The nurses that are in the communities provide both services.
Chairman: Thank you. We are still on page H-12.
Mr. Tootoo: Thank you, Mr. Chairman. I’m just wondering and I don’t need it right now, but if the minister could provide that listing given that she indicated that some communities don’t have specific public health nurses that go out to deal just with communities, with the elders, and not under community.
Could she provide a list of how many public health workers or nurses that they have, by community, throughout the territory, along with which ones are filled, numbers that are filled and numbers that are vacant?
And that’s not something that I need today, but if she’s willing to commit to providing that information to the House.
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. First of all, before I respond, I need to clarify. In Iqaluit and in Rankin Inlet, there are dedicated public health nurses.
In the rest of the communities, the nurses provide that service and I will commit to providing the information the member has asked for. Thank you, Mr. Chairman.
I look forward to receiving that information.
Also under this section, environmental health falls under it and again on H-21 of their business plan.
In there, it indicates a drop in funding. I’m just wondering: what initiatives will the department put in place to ensure that the communities are not put at risk by a reduction in the environmental health services?
The difference there is just basically to realign the budget expenditures’ patterns to the benefits. It’s basically just identifying more the expenditure patterns than correcting that on record, but there have been no reductions in the service or PYs under Environmental Health Protection.
Chairman: Thank you, Minister. Mr. Tootoo.
I just wonder if the minister could indicate, I don’t know if she did that with public health, or was there realignment and maybe that’s the same thing under Communicable Disease Controls and the Chief Medical Officer of Health, and also the tuberculosis, oh no, I’m sorry not the Tuberculosis Program, but those are the areas in this item that are decreasing.
Are they all because of realignment; if so, if she could indicate where that money was being realigned to?
In all those instances under Chief Medical Officer, we had moved one PY to Health Protection, as an example. Under Communicable Disease Controls, there was a change upwards for NEU benefits increase. In Environmental, we realigned the budget expenditure patterns and the NEU benefits increases or decreases to reflect more of the expenditure patterns in that area.
In the areas under Public Health: realigned again the budgets to expenditure patterns and NEU benefits from public health. There was an increase in the health protection side and in the area of tuberculosis there was also an increase.
So all around in this section, there were movements in different sections and that was more to align the budgets to the expenditure patterns.
I wish I could say he is wearing a nice shirt, but he is not.
Also on the business plan on H-22, as far as priorities go, it indicates that the department in the coming fiscal year is going to finalize a territorial pandemic plan and emergency preparedness planning.
I wonder if the minister could indicate what they have done to date on that. If the plan just needs to be finalized now, what kind of costs have we incurred in getting that ready?
Did the member make a reference to a particular page?
Mr. Tootoo, clarify your question.
That was H-22, it is under the business plan, and it is under the priorities of 2006-07, the first one.
Our page numbers are different. On ours it was on 23.
I mentioned earlier, the department is participating in high level planning on the pandemic influenza plan.
The chief medical health officer participates on a National Planning Strategy with the Public Health Agency of Canada.
The development of that response plan has to also involve the national response to any pandemic that may hit Canada or North America. Part of the work also involves in us getting the vaccine in our territory in order to respond.
We are also working with not just health, but also the various agencies that are responsible for emergency response, such as Community and Government Services responsibility. We are a part of that team. The other plan was to help on the Public Health Agency of Canada to come up to Nunavut to talk about the national plan and develop a communication strategy.
The work, in partnership with Community and Government Services, will unfold to also involve responding at the community level.
So the work is still a work in progress and again, this is a priority that we have identified for this coming fiscal year and the work that we need to do to communicate this response strategy.
At the same time, we also need to test that response and do some tests with the communities, with CGS and emergency response teams. It’s one initiative that we’re involved in.
The other area that we’re also involved in is that as a Department of Health, we will have to be responding to treating people that may be infected by influenza.
So we are looking at developing plans internally on how to keep our individual health care providers, what would happen in a case if they also got sick themselves and who would do the treating of these patients.
That kind of work has to involve many agencies and the support of the national public health agency. We are part of that bigger and broader plan.
Once that plan is in place, we will be able to communicate the steps, and whose role it is to respond to what once it is unfolded.
At this point in time, it is still a work in progress and it involves many players. And even as I speak today, the chief medical health officer is in conferences in Vancouver just on that very issue.
So it is important and we are participating at a high level and within our own territory in developing that plan to respond.
Again, it says, “Finalize the territorial plans.” So I would assume that a considerable amount of work there, her draft plan was in place already.
Would the minister be willing to commit to providing, to the House here, a copy of what they have to date under the total realization that it is a draft and not finalized yet so that members may have a look at it and perhaps provide some positive input to it?