EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Mr. Curley: I alluded to an article; I’m not sure if it was specifically a federal government article, but it was an article by an individual that wrote a certain document.
I think the story is still the same that because of federal government restraints, whether it is funding or what’s funded, or territorial funding, we can’t do a thing. I believe the message is still the same: “Not now.”
Our question and the patients’ question is: “But when will that happen?”
We had an individual not long ago, two weeks ago that was severely, severely beaten by a local gang in Rankin Inlet. They phoned the RCMP here; the RCMP locally couldn’t answer it. So they ended up taking the young man home.
The 18 year old man, because they couldn’t find the police, he barely made it to the phone; his face was kicked, beaten with a bat, and his head was almost the size of a football.
In my view, a person like that should have been medivaced, or put into the hospital but by six o’clock in the morning the local hospital started answering calls, and finally they took him there.
But it’s that kind of thing that requires treatment and they’re not getting it. He was sent home and couldn’t even swallow food.
I went to see that individual and I was embarrassed to see that person who needed intravenous because he couldn’t swallow, whether it is liquid or not, was sent home.
Why is that done, Madame Minister?
I think I have to be very careful in discussing individual patients’ conditions in the House.
Individual medical cases are confidential to the person and, in my view, should not be discussed in the political arena.
I would ask the members to share with me, confidentially, that individual’s name and when it happened, and I will be happy to follow-up as to what happened in that instance, if that is the case I will follow-up.
I don’t know what happened in that case and I cannot answer that in the House, I’m not aware of the situation, and I’m not a doctor or a nurse to be able to answer those specifics of why that was the case.
Again, each patient’s condition is on a patient-by-patient basis and I would ask members to respect the confidentiality of individuals’ medical conditions and raise those issues with me confidentially on the side and I will be happy to follow-up to see what happened in that instance.
It concerns me as to what you’re saying and that’s a concern.
If the patient required treatment, then the treatment should have been provided, but I can’t say yes, or no, or why because I don’t know the specifics of that particular person’s health condition and what had happened, and so on.
Mr. Curley, we are dealing with main estimates for 2007-08.
Ask your questions on Directorate, please.
Mr. Curley: Mr. Chairman, the Directorate is responsible for restraint spending, putting patients into the hospital, I don’t think it’s a local decision.
I alluded to the information that I read once that the authorities have instructed the local doctor not to receive any patients and care for them at this hospital, unless it’s a very urgent and emergency basis.
Madame, you wanted to know exactly where that came from. I’ll tell you. It’s exactly the same as what’s happening today.
This was 73 years ago, written by Dr. Livingston, who was based in Rankin Inlet and Chesterfield Inlet. Why is that situation still happening today?
No care for patients when the facility is there.
When are we going to start using that local hospital so that we don’t just waste infrastructure sitting there wasting time when the patients really need care?
We have the facilities.
I can’t respond to an article written 73 years ago.
I can respond to the services that are provided in the health centres. There is service being provided in the health centres in every community.
We spend $40 million transporting patients when they need care that we cannot provide in our communities by region.
We are trying to expand the services in Rankin Inlet and we have done so in some areas, but we’re not there yet. As we move forward in addressing some of the challenges, I addressed earlier, around housing, around the boarding homes, around the challenge of finding doctors that can work in Nunavut, and nurses, then we can phase in some of those programs.
We are competing in Canada where we have a national shortage.
To answer the question when is very difficult when there are no people to fill those jobs, not just in Nunavut, but in Canada.
As it is right now, we provide services where it’s available in our communities, and if it’s not available in our communities we send them to the nearest facility that provides that care; whether that is Ottawa, Iqaluit, Winnipeg, Churchill, Yellowknife, or Edmonton.
So we are working towards trying to enhance services, and will continue to do so. It won’t happen overnight but the facility is being used and we have enhanced some of the services in Rankin Inlet.
Mr. Curley, we are dealing with the Directorate 2007-08.
Mr. Curley: Thank you, for reminding me. The Directorate says it provides leadership and direction for the department, including health services and health workers.
I’d like to ask the minister exactly when she will come up with the implementation plan to start using this $25 million facility on 24-hour care basis.
I recognize that we want to open all facilities and the challenge we have as a government is financial resources.
I think the Minister of Finance has spoken very clearly to the House about the challenges that we face and the Department of Health is a part of that. As resources become available we hope to be advancing to be able to open all the facilities.
When exactly the dates; I don’t have that, but I want to say to the House that we recognize that and are trying to move forward with the limited resources that we have to work with within the Department of Health.
I’d like to thank the minister for some of the statements that she made to the House, not only for the people of Rankin Inlet, but for Kivallirmiut with the health centre in Rankin Inlet is supposed to be used for. I think they are asking for your leadership. The Minister of Finance may say this but you have an obligation to implement the healthcare needs of Nunavut.
So I was asking will you be tabling a strategy of exactly when the healthcare officials, including housing, or incentives to lure people to come to the north and to open up the facilities for people in the Kivalliq.
I would be prepared to discuss that. I think we discussed those types of initiatives in various means.
The supp bill will speak to the issue around physicians that we’re discussing. You know our package was not competitive in Canada to recruit physicians.
To some extent that will support the initiatives that we’re trying to undertake in enhancing services in those facilities throughout Nunavut without coming up with a strategic plan for Rankin Inlet, but rather as a government we are trying to deal with physicians, as an example.
The other area that we’re working very hard is to train our own nurses to fill some of those jobs, and so on.
I can provide an update to the member around Rankin Inlet and implementation plan, or plan to try and enhance the services for Rankin Inlet.
At this time, Mr. Curley, I would like to take a 20-minute break, and we’ll be back.
>>Committee recessed at 17:40 and resumed at 18:06
Chairman: I would like to get back to our meeting.
I have used my discretion.
If a member wishes to ask additional questions on this matter in order for the members to continue asking questions on this matter, in accordance with Rule 18(1), the member requests unanimous consent.
Mr. Curley: Mr. Chairman, I never asked for unanimous consent.
We will carry on. Page H-8.
Total Operations and Maintenance. $42,969,000.
I just have one quick question here. There is an increase for around $1 million for contract services.
I just wanted to ask what that is for.
That increase was to address the increases to residential fare and group home rates that provide services to Nunavummiut, and in most cases that is out of jurisdiction services.
There was an increase that we had to address.
Would it be correct then that we’re paying $16,152,000 for people in group homes outside of the territory?
I believe that would be both out of territory and in the territory.
Does that include both adults and children’s group homes?
Does the minister have a breakdown of how much is in territory, and how much is out of territory?
Not at this time. I can provide that information to the member.
Hon. Leona Aglukkaq: As soon as I have it and hopefully before the session ends.
It’s only 6:00 and it feels like it’s 9:00.
On page H-14 of the Business Plan, under Dental Services, I would like to ask the minister; how many dental contracts does the Department of Health have across Nunavut?
I don’t have that information on the number of dental contracts we have in Nunavut. Again, I can provide that information to the member.
In Cambridge Bay we have a dental contract. I understand there was a problem with it in December that necessitated termination of one dentist which caused some difficulties for some of my constituents.
How do you monitor the dental contracts in Nunavut to ensure that they are delivering the dental services that they are contracted to provide in a caring and compassionate manner?
I will have the Assistant Deputy Minister of Operations respond to that.
The territory has a dental service specialist who is responsible for working with our staff in the field to monitor the quality of dental services. We also work with the federal government, dental consultants to monitor our services as well.
Mr. Peterson: Thank you, Mr. Chairman. I thank the Assistant Deputy Minister for that information.
When there are difficulties with a particular dentist, what procedures do you follow to ensure that dentist corrects their service or is terminated?
We receive complaints from patients about the services provided to them.
We have staff in each community who coordinate the provision of the dental services. The staff advise the contractor who may be subcontracting the work by another dentist and in consultation with that person and with our specialist, we determine the appropriate response to the complaint.
In this particular case the dentist was terminated but there was a lag time in the period between when the dentist was terminated and their next scheduled time in Cambridge Bay, which delayed patients from receiving their dental care that they were scheduled to receive.
How do you overcome those lag periods when there is a delay in providing the scheduled dental service to a community or a region?
We have a number of options to deal with patients in between visits by our dentists.
We periodically experience difficulties with the clinics due to weather and other conditions that prevent the availability of the dentist. We will, for dental service problems that need immediate intervention, we can arrange for those patients to be seen in another community.
Our community health nurses make every effort they can to deal with the situation.
We schedule the dentist to fill those gaps as quickly as we can.
Mr. Peterson: Thank you, Mr. Chairman. I thank the minister and Mr. Richardson for that answer.
On page H-15 in the business plan, under social services, it focuses on five main areas and one of the areas is adoption services.
In my riding in Cambridge Bay there have been several constituents that have come to me with problems related to adoption services. Their primary concern is that it’s taking too long to process an adoption, a custom adoption in particular.
It’s dragging on in some cases well over two years.
The adoptive mothers have already taken the child and they’re trying to complete the paperwork, and they are running into difficulties in processing the paperwork for the child.
I’d like to ask the minister, or the assistant deputy minister, if this has been a problem that has been identified in the Department of Health and what corrective measures they’re taking, or implementing to speed up the process?
Chairman: Thank you, Mr. Peterson. Mr. Richardson.
The process for completing the documentation in Nunavut is through our Vital Statistics Department in Rankin Inlet. Issues that we are aware of within Nunavut, we will address directly through that division.
We do experience problems with registrations that occur outside of the territory and sometimes they are administrative problems and sometimes there’s difficulty in completing the transaction due to failure to pay for the service outside of the territory.
Where possible, we’ll assist people to expedite this documentation.
I thank Mr. Richardson for that answer.
It just doesn’t seem right that mothers should have to come to their Members of the Legislative Assembly to get help to process the adoption of their babies.
I am wondering if the department can, at an early point, begin to work with the mothers who adopt the babies, so that they know what steps to follow throughout the process, and have some follow-up with them to ensure that the process is flowing smoothly and that they don’t have to worry that the paperwork has gone missing to the point where they have to call their Members of the Legislative Assembly after a year or two.
I am wondering if the minister, or the assistant deputy minister, could comment on that. Thank you, Mr. Chairman.
Madame Minister, go ahead.
Some of the things that we have in place to try and assist individuals with their adoption is that we have currently in every community a Custom Adoptions Commissioner; that individual is appointed to provide assistance to individuals in a community that are planning to adopt a child through the custom process, and should be there to provide guidance.
That is who the department appoints to assist individuals in the community.
I suppose we can provide more information in terms of process to clients.
Since 1999 in Nunavut we’ve processed over 1,700 applications for custom adoptions, for private adoptions, for private out of territory adoption, as well as international.
So there’s a huge volume of adoptions we process but we do try and provide information to individuals in a community through the Custom Adoptions Commissioners in each community.
I’m aware that there are Custom Adoption Commissioners in every community, or most communities in Nunavut.
But, in some instances, even the Custom Adoption Commissioners aren’t aware of the delays or the snags in the paperwork and it becomes apparent when you have to send paperwork to Rankin Inlet. If a baby was born in the Northwest Territories, for example, you have to get the birth certificate from Inuvik.
So there are all these hoops and hurdles that adoptive mothers and commissioners, as well, have to go through. There should be a way to track the paperwork to ensure that they move through the system at an orderly process. Step one, fill in the application, and two months later, you know, it’s step two, step three, step four.
The applications or paperwork could take two years or longer. I think that’s an unreasonably long time and it has caused a lot of ...concern I’m sure with some ladies and mothers in my community.
And I would like the minister and her officials to look into that if they have to provide more training to the Adoption Commissioners; have a workshop somewhere to show them how to process paperwork, show them how to do some follow-up, and work their way through the red tape; deal with Rankin Inlet, Iqaluit, and Inuvik, and wherever, that would certainly be a big help for me, and I’m sure with a lot of my colleagues on this side.
I wonder if the minister could comment.
I know in the regions and staff, they try and provide that. Certainly, we can always improve that. We’ll direct the staff to provide more information in the communities on the procedures of the step-by-step to follow.
I thank the minister for that answer, commitment, I guess, it’s a commitment of sorts.
On the same page under Residential Care, “provide the residential care for challenged adults and children within Nunavut or outside of Nunavut. The services are provided in long-term care facilities.” How many long-term care facilities do we have in Nunavut?
I have that information in my capital estimates over there, I can pick that up. But, from what I understand, I think we have about 12 facilities, off the top of my head, that we have in Nunavut for both adults and children.
Do you have the numbers available for the totals for challenged adults or children within Nunavut and outside Nunavut, what is the total numbers of persons who are in residential care in both Nunavut and in the south, I suppose?
I have the breakdown for Nunavut and I would have to get the information for the out-of-territory, but I believe we have about close to 200 out-of-territory that are receiving care. At a glance, I would say about another 100 in Nunavut.
Minister, in that particular item there, residential care, there is an increase of approximately over $2.1 million. Could you explain what accounts for the increase in that line item?
The increase related to residential care, particularly outside the territory care, the rates have increased in various jurisdictions in Canada that provides the services to the approximately 200 clients that live outside the territory.
That increase relates to some of that. One of the mental health facilities that we had also operated under contract was transferred back to the Government of Nunavut about two years ago, so that might be part of that increase as well.
I suppose we do have to look after our disadvantaged citizens whether they are in Nunavut or outside of Nunavut.
Unfortunately the costs don’t go down in those areas when southern facilities are increasing their costs.
On the same page under Women’s Initiatives, could the minister tell us how many women’s shelters there are in Nunavut?
Before I answer that, the member had asked the number of facilities in Nunavut; there are eight and two that are in the capital estimates for the Continuing Care, and right now we have approximately 70 people in care in the territory.
In terms of answering the member’s question, there are four.
I thank the minister for that follow up information and the answer to the women’s shelters.
I know we’ve talked about this quite often throughout the years about violence against women. There are 25 communities in Nunavut, but there are only four shelters.
So if a lady is sheltered with her children and there are only four facilities in four communities, where would the women and children in a community that don’t have women’s shelters go to to seek shelter from abuse?
Just to clarify for the record, the number that I provided earlier in terms 70, that was also including the capacity of the women’s shelters.
What I’m going to do is list down all the facilities and the capacity of each and provide that for the record so that it is correct information.
But, in terms of providing services to victims of violence, we ship the women and the family to the nearest centre where that service is provided.
I would like to ask the minister; if in sending women and their children to shelters, does that include sending them to other jurisdictions outside of the territory?
Hon. Leona Aglukkaq: Thank you, Mr. Chairman. That would be correct.
I know in Cambridge Bay we have a women’s shelter; it’s a three bedroom house, but it normally can only take in six or seven people at a time, maximum.
So if a facility is full, then that poses difficulty in sending people to that facility.
I wonder if the minister can give us an indication of how many women and children in Nunavut sought help in the last fiscal year to her department.
This past year I have to get the latest update on those statistics to the end of the fiscal year. I do know in the case I had mentioned before in the previous years that over 1,200 women have used this one facility that’s in Iqaluit in one fiscal year.
I can gather those statistics to see if there is a decrease in the numbers of usage in this past fiscal year since the last time I had reported in the House women that have used the facilities.
That would certainly be good information to have on the public record.
On the same page there is a description of persons with disabilities. We met with disabled groups in I think it was December or late November, about how we can help them.
I am wondering; I see we haven’t given them an increase over last year. Can the minister explain why $90,000 remains the same as last year?
The $90,000 in there is a contribution to NTI to support the PYs that are there to provide assistance to the advocacy group.
Just down at the bottom of the page a priority for 2006-07 was “discuss with the Department of Justice the transfer back of community correctional services currently delivered by social service workers. The status, the Department of Justice had deferred this initiative.”
I have raised this a few times over the years with social workers doing community justice type work and putting additional stress and strain on social workers.
Can you explain to us why the Department of Justice deferred that initiative?
I can respond from the health perspective, perhaps the Minister of Justice can respond to the other challenges they face and I think, for the record, from our perspective we are trying to address the workload of our social workers that provide probation services.
Because of limited staffing our communities through an MOU back in, I believe 1999, we took on the responsibility of probation services in the communities where there are no probation officers through Justice.
That initiative with my department and the Minister of Justice’s operations, we are trying to address some of those issues and my staff are working with the Department of Justice to try and address that gap.
As it is right now we have had it deferred because we do not have the resources to transfer that responsibility to Justice in the communities.
Just a short question to that line of questioning.
Social Services are known that sometimes we have a social worker that has never lived in Nunavut and they don’t come from the Inuit communities, how would it be, they can’t understand the language or they can’t understand the culture of the Inuit people and he is supposed to be the person advising the individual that if you live a certain way, it would be better for you.
The reason is because we have social workers that don’t live in the communities, or who don’t speak the language.
I think parole officers that deal with ex-inmates, they work for the Government of Nunavut and they make very good money.
Because they can’t understand the culture or the language of Inuit, the religious groups usually take over and they don’t get paid.
Perhaps it could be done that the social workers should be Inuit and coming from communities, and mature, because they deal with Inuit. It doesn’t matter whether they can speak English or not.
I wonder if the department could see their policy. These kinds of papers that we get from the university does not have any relevance whatsoever to the people in Nunavut.
Members, please put your hand up when the chair is going through these branch summaries. If you have any questions, please put your hand up right up right away so that we don’t go back and forth.
The department does try to recruit Inuit for various positions in the community through the process established through the Department of Human Resources; we try and follow that.
As well, we are looking at ways to incorporate Inuit Qaujimajatuqangit more, for instance, the Child Welfare Legislation, to try and Nunavutize it, update it, and to address some of the suggestions made by the members.
As it is right now, with the current legislation in place, the social workers’ main focus as per the legislation adopted by the House in the five areas are provided and I tried and explain that. It’s on H-15.
But, the social workers in most communities... (no interpretation)...(interpretation) policies have to be updated today, and looking at the Child Welfare Act, we have to follow those rules.
Also, we use information from Inuit Qaujimajatuqangit, and we are also looking to recruit staff in that area.
Also, a lot of Inuit in the small communities go see whoever they trust in the community.