EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Dr. Isaac Sobol: Nunavut has a pandemic influenza plan that was initiated in 2005 and it was reviewed in 2006. At the moment, we continue to review our pandemic influenza plan.
We have developed a new template for the community-level plan. We have an agreement with the Public Health Agency to have individuals go to every community in Nunavut to assist our local health centres to work with a revised template.
So at that level, we are well engaged in our pandemic preparedness.
When the H1N1 flu virus was first identified in Mexico, many steps were taken both at the territorial level and at the national level to prepare for the eventual spread of this virus in Canada as a whole and in Nunavut.
The department, on its initiative, had convened a health emergency preparedness team and we have been meeting regularly throughout the outbreak in Canada.
We have developed an incident command structure which has been approved by the deputy minister and which as been shared with other jurisdictions.
The chief medical officers of health, together with communicable disease specialists and the Public Health Agency, at one point, was meeting every single day to discuss the situation and to discuss guidelines for diagnosis, treatment, infection control, and public health measures.
On April 28, I distributed to all of our health centres our interim guidelines for diagnosis, treatment, infection control, and public health measures.
On the initiative of the deputy minister, we followed up the delivery of those guidelines with a video conference session with each and every one of our health centres to make sure that our health care staff were familiar with the guidelines and comfortable with the processes that we developed.
We continue to have ongoing discussion within our communities, we’ve had a follow-up video conference, and we have regular communication with nurses and health care staff across the territory as this situation progresses.
I don’t want to speak for the deputy, but he might want to speak as well with the fact that deputies have been meeting regularly, the F/T/P health deputies have been meeting on a regular basis as well. I don’t know the protocol that allows someone else to intervene in my reply.
Mr. Chairman, is it appropriate if the deputy were to give you an update on the deputy minister level of engagement during this outbreak?
Chairman: Thank you, Dr. Sobol.
Mr. Campbell, would you like to add to Dr. Sobol’s comments?
Some of the internal activities that we have undertaken in the government is we’ve got the CVS regularly updated on what the department is doing in working with the communities.
I have been updating the deputy ministers and this government on a regular basis as to the status of the H1N1 flu virus.
As Dr. Sobol has suggested, we have initiated the health emergency preparedness plan. The F/T/P deputy ministers have been regularly meeting. We had a Thursday meeting and teleconference calls happening.
Prior to that, it was daily meetings that we were doing across the country.
With respect to communications, we have provided a number of public health advisories to the communities through our communications unit. We have also been updating the health centres with some preventative measures on the types of things that they could do to prevent some of the symptoms going around in communities.
We’re also developing radio announcements that are currently being worked on right now.
We will be distributing those to every community in Nunavut to alert them on this and do some preventative measures.
That’s all I can add right now, Mr. Chairman.
I have another question here. I had the pleasure of meeting with Dr. Sobol before as mayor of Cape Dorset in regard to tuberculosis cases in Nunavut.
Statistics provided in the business plan indicate that the rate of tuberculosis in Nunavut is still much higher than the average Canadian.
What is the current status of dealing with the disease in Nunavut?
Chairman (interpretation): Thank you, Mr. Schell. (interpretation ends) Dr. Sobol, can you try and answer that?
Dr. Isaac Sobol: Could I ask for a clarification?
I believe you asked for our… Sorry, Mr. Chairman, my apologies.
Mr. Chairman, I require a clarification with respect to whether the question is addressed specifically for this virus or in a general sense, preparation for control of communicable diseases.
I think it was in reference to tuberculosis.
I know it’s a switch from H1N1 that we were talking about earlier, but if you can try and answer the issue on tuberculosis.
I think if you can, I would appreciate it. Dr. Sobol.
Dr. Isaac Sobol: So the question then is specifically about the tuberculosis program.
We do have a very effective tuberculosis program in Nunavut.
We had a review of our program last year.
Tuberculosis programs are monitored and evaluated principally on two outcome measures. Number one is the number of persons who complete treatment and number two is the number of cases of drug-resistant tuberculosis which might emerge during a tuberculosis treatment.
In both of those well accepted measures of tuberculosis control, our program stands out as being very excellent. Given the fact that we have much higher rates of tuberculosis than the rest of the country, I think our program has been exemplary.
Chairman (interpretation): Thank you, Dr. Sobol. (interpretation ends) I will allow for more questions on the H1N1 virus if there are any further questions while the doctor is here.
On Friday, there were only five confirmed cases in Nunavut and today, there are 25.
Are all 25 cases being treated in facilities outside of their home communities?
Dr. Sobol.
Dr. Isaac Sobol: That’s a good question.
On June 1, we expanded our surveillance for this particular virus.
We announced that we would do enhanced surveillance to try to find where this virus existed in Nunavut and the large number of cases that were just announced, the increase was a result of this enhanced surveillance. What we are seeing is exactly what we expected to find when we increased the testing, that we have greater numbers being reported.
Most people are being treated in their community, most cases have not required hospitalization or medical evacuation, and the good news is that, as we have seen in other jurisdictions, most cases are mild and people can recover without any intensive medical intervention.
Even those patients who were hospitalized required no intensive care unit or ventilator support and they have recovered. I would say with conservative medical measures, they’re all getting better. That’s the good news.
My final question today is: with the H1N1 virus, what is the amount of time that’s been required for people to recover from most of these cases?
Dr. Isaac Sobol: Another good question.
In general, it takes between seven and ten days for symptoms to resolve and as we have instructed our health care staff, if it’s ever possible to treat patients outside the confines of the health centre…
In fact, on first appearance of the illness, we’re asking the public to stay at home to try to treat themselves because most of these cases are mild and will be resolved without medical intervention.
If people at home are feeling like their illness is getting worse, we’re asking them to phone the health centre so the centre can be prepared to see them when they arrive, taking appropriate respiratory precautions.
So we expect that between seven and ten days would be the normal time course for symptoms to completely resolve.
Chairman (interpretation): Thank you, Dr. Sobol.
Mr. Rumbolt: I said it was my final question, but I guess it wasn’t.
With the requirement of people being treated at home, a lot of our residents live in overcrowded conditions and I’m just wondering if it’s just going to contribute to the factor of spreading the disease.
Dr. Isaac Sobol: Thank you for the question; it’s a very appropriate question.
I think those conditions apply not just to the spread of this particular virus but we feel they would apply to the spread of any respiratory communicable disease in the territory, so I believe that’s a very appropriate comment to make.
We do give advice to family members on how we might try to keep those ill individuals away from other family members in their own room and try to minimize contact with others while they’re convalescing at home.
Chairman (interpretation): Thank you, Dr. Sobol. (interpretation ends) I would ask if you could repeat the symptoms that this H1N1 virus has for the benefit of our audience again to adopt appropriate precautions.
Dr. Isaac Sobol: Thank you, Mr. Chairman.
The symptoms include fever, cough, muscle pain, which we call myalgia, a general feeling of fatigue, and in some cases, addition of nausea and vomiting or diarrhea.
So those are the signs of what we call influenza-like illness.
We have been repeating those symptoms on our public health advisories so that Nunavummiut can be well aware of what the presentation of this illness is like. We will continue to frequently produce public health advisories and other forms of messaging to the public as this outbreak continues.
Are there further questions?
I won’t say it’s my final question because I seem to keep getting more.
The people who are being treated at home, what kind of treatment are they getting?
Is it just bed rest or are they on medication?
Can you clarify, please?
Dr. Isaac Sobol: Thank you for the question.
The viral illnesses don’t respond to treatment with antibiotics. Antibiotics will kill bacteria but not viruses.
So the treatment that’s being used all across the country is what I would call supportive or conservative treatment.
That is the use of medications to reduce fever and to reduce pain, and also lots of fluids to deal with any dehydration that might occur.
So that is the standard treatment for this type of viral illness.
Are there any further questions on the H1N1 virus, otherwise known as the swine or the Mexican flu?
We want to thank Dr. Sobol for providing an educational benefit for the members and the audience that may be watching.
Thank you, Dr. Sobol.
All the best, hopefully this illness subsides soon.
We are on H-6 for the benefit of members.
It’s not a question but it’s a comment.
If I may, this is in relation to my colleague’s, Mr. Schell, comment in regard to food mail and nutrition.
I just want to inform the minister and his officials that we’re aware that the GN and your department don’t set the cost for food in stores or the Food Mail Program.
It’s just for information purposes for public health.
It’s been noted by constituents that they are aware nutritional and healthy foods seem to be expensive in comparison to less healthy foods in stores. One example that was brought to my attention was a same size cereal box of Special K, $9, Lucky Charms, $6.95.
Healthier foods appear to be maintained at the same cost, but junk food seems to have lowered in prices.
I just want to provide that information to you that this is something being observed by constituents.
Chairman: Very good comment, Mr. Aupaluktuq.
I think we can all do our part and educate everyone of healthier choices.
Hon. Tagak Curley: I think that’s good information to have. I would urge the member to continue to announce certain notices once in a while.
(interpretation ends) We’re on H-6.
Total Operations and Maintenance, to be Voted. $8,212,000. (interpretation) Do you agree?
We can now turn to page H-7, which is related to various treatments for patients.
Total Branch. $151,757,000.
Does anyone have questions on (interpretation ends) Treatment?
Over the years, the Nunavut government has considered a number of different options for addressing addiction issues in the territory.
Your department’s 2009-2010 business plan indicates that it will establish a Mental Health and Addictions Division. How will this division operate and what activities will it focus on? Will any additional service be offered to Nunavummiut to address mental health and addictions issues?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) What we’re proposing to establish in the department is a division that would be providing some high level and technical advice to both the directorate as well as the minister and then to the government, of course, on the delivery of the mental health, wellness, and addiction area.
Some of the things that we would be looking at under that division are positions for a suicide prevention specialist, a wellness type coordinator, an addictions specialist, just to name a few.
There are a number of positions that we’re proposing. We do have, in the regional offices as well as in the communities, some of these positions that are already doing this type of work.
What was mentioned was a program delivery type advisory group that would provide support first of all to the regional offices, as well as the community positions to provide guidance, support, and advice on how to deliver some of our services at the community level.
That unit would also be preparing some policies around those areas that I mentioned earlier, under wellness, suicide, addictions, and treatment as well.
So those are some of the areas that the division would be working on.
The budget for the community health centres is projected to increase by over $3 million.
What kind of initiative accounts for this increase?
Chairman (interpretation): That’s still a question on those pages.
Again, I mentioned earlier that we do have three regional health facilities that will be providing enhanced services once we have fully staffed up those positions. As well, we will have the continuing care facilities that will be staffed.
Of course, there have been some salary increases, as mentioned to me, that are also included as part of that increase, compensation and benefits for our positions in the Treatment Branch.
Chairman: Thank you, Mr. Campbell. (interpretation) Are there any more questions on this page?
It’s a question in regard to Treatment.
We often hear of Nunavut residents being required to travel outside the territory for specialized care. Some of the specialized care, for example, is CT scans, MRIs, mammograms, and dialysis, all of which use specific medical devices.
The question obviously is: does the department have any plans to invest in such devices so that Nunavut residents requiring such services would be able to receive them at home or even regionally?
The simple answer is yes. That’s our long-range plan - to eventually at least develop some of those services at the regional level, particularly dialysis equipment.
It would be something that we would be visiting over the next year.
There will be a requirement to purchase the equipment first of all, as well as to train the staff to deliver that service.
We’re also proposing to purchase a CT scanner for the hospital here in Iqaluit some time in the next several months.
Mr. Aupaluktuq: Thank you very much, Mr. Chairman.
I guess what I want to get at is in regard to transportation because it essentially affects the treatment of our constituents.
Some are unable to get to their appointments or the airport due to lack of personal transportation or in this one instance, there was no taxi fare.
So a constituent had missed an appointment and was advised that they may not be able to obtain another appointment that they had been waiting a long time for.
In the case of Baker Lake, there are still no taxi chits being provided, there are still no resolutions to provide this opportunity for our constituents to access the best or better health care treatment by being able to leave the community.
Another example is one young lady almost gave birth in the middle of winter outdoors because she was having some contractions and she was told to come on and walk down to the health centre and she barely made it there.
That was a fascinating story in our community.
In some communities, the lack of a vehicle for use by health centre staff poses a number of difficulties, especially if there is no private sector transportation.
How does the department evaluate the need for health centre vehicles and how do you prioritize their purchases?
In regard to his question, many communities have complained about the lack of transportation for patients, especially elders who have to go to the health facility, and there is no mode of transportation.
This has been told to our department a number of times and we have discussed how we could make a funding proposal within our department. But we are trying to get funding through the Non-Insured Health Benefits Program that we receive from the federal government. It’s very difficult to obtain funding through the NIHB program and it will expire next year.
We are trying to find out if we can get taxi chits. However, the agreement has been signed not only by our department but also NTI. Perhaps we can get support from NTI to get taxi chits, but we haven’t completed a review of that.
We are discussing this matter with the federal government and the Minister of Finance indicated earlier that they are still in negotiations.
We will implement these solutions as soon as we can.
With respect to transportation vehicles, our department has to discuss whether we require one or not, but it becomes difficult with liability issues when health centre staff are transporting patients.
That is where the problem lies, but I can tell you that we will review it further.
Chairman (interpretation): Thank you, Minister Curley. (interpretation ends) We are on Treatment and we are going to get into Health Insurance Programs, which is dealing with NIHB as well.
Mr. Aupaluktuq, you have another question on Treatment?
I would like to thank the minister for the response and it was a clear response.
People from Baker Lake have been concerned about that and I thank you for your response.
That was just a comment. (interpretation ends) Treatment. $151,757,000.
Chairman (interpretation): Thank you. (interpretation ends) Health Insurance Programs. $38,362,000.
I think Member Aupaluktuq already asked questions on NIHB issues and we told the minister that he can only come back to this House with a better agreement.
Otherwise, we need a new minister.
Are there any questions on Health Insurance Programs?
$38,362,000. (interpretation) Do you agree?
The minister has been properly advised and cannot return unless requested to do so.
We can go back to page H-3.
Total Health and Social Services. $258,192,000.
Do you have any closing remarks, Minister Curley?
We all know this department is quite a difficult and challenging one. You will always have opportunities to ask questions and so your period to ask questions is not limited as far as I’m concerned.
My office is quite close and I would like to thank my colleagues for coming over to my office to see me.
I also would like to thank Dr. Isaac Sobol for being here, the officials, the deputy minister, and our Executive Director of Corporate Services, Debora Voth.
While we are dealing with this file, I would like to state that all of you are welcome at any time if you would like to come and visit any of us at our offices.
Chairman (interpretation): Thank you, Minister Curley. (interpretation ends) I remember the days when our government used to be the entire government at the Department of Health.
All of the expenditure overruns would be in the $20 million range and we would have to adjust our entire budget to try and accommodate health.
This is a far improvement from those days, so I applaud your officials for trying to contain the budget for health. Good work.
(interpretation) We have concluded the department.
Are the members in agreement that the Department of Health and Social Services is concluded?
Chairman (interpretation): The members have agreed.
Thank you and your officials.
We have concluded that department, so we can now move on to another department.
The next department that we’re going to deal with is the Department of Community and Government Services.
Minister Kusugak, you can now make your opening comments.
Bill 01 – Appropriation (Operations & Maintenance) Act, 2009-2010 – Community and Government Services – Consideration in Committee
I am pleased to appear before you today to review the 2009-2010 Main Estimates for the Department of Community and Government Services.
Mr. Chairman, the Department of Community and Government Services plays many roles in the delivery of programs and services throughout the territory.
We assist local governments and provide services to the government departments in areas such as asset management and contracting and procurement.
CGS is also responsible for the purchase, supply, and storage of petroleum products for the territory.
One of our most important roles is via the Office of the Fire Marshal for issues of public safety.
Mr. Chairman, if we include petroleum products, our department has a budget exceeding $360 million with 330 positions in 14 communities.
In our business plan, we are proposing to increase our budget estimates this year in a number of areas to compensate for forced growth.
For example, we are proposing to increase funding for municipalities by $4 million to help cover utilities.
We are also proposing an increase to the funding for the municipal insurance program (NAMIX) from $200,000 to $850,000 to reflect the higher replacement costs in the North.
Mr. Chairman, another important increase is in the total funding being proposed for the Senior and Disabled Tax Relief Program from $40,000 to $60,000.
Finally, on the municipal side, we are proposing to introduce a mobile equipment grant for hamlets so they purchase or lease heavy equipment on an annual basis.
(interpretation ends) In recognition of the training needs in Nunavut, we are proposing to increase the Technical Services Bursary from a total of $45,000 to $80,000. We also propose an increase in our contribution to Nunavut Arctic College for training in the informatics field. We would like to add an additional $240,000.
Mr. Chairman, we continue to offer over 6,500 training days a year to municipal employees through our collaboration with the Municipal Training Organization (MTO) to meet municipal needs as well.
CGS continues to invest significant resources to ensure that we continue to improve services and programs to our clients.
Over the past several years, we have greatly improved the GN’s procurement and contracting processes and the annual reporting of these activities to the Legislative Assembly.
(interpretation) Mr. Chairman, the efforts we are making to improve services will continue and I commit to keeping all the members up to date on our activities and the results of our efforts.
In the Petroleum Products Division, we continue to manage Nunavut’s fuel requirements on behalf of the government.
As you are aware, global oil markets continue to be very unpredictable with the past year seeing record highs and lows in fuel prices worldwide.
Mr. Chairman, the Petroleum Products Division has no control over the costs.
However, we were able to capitalize on lower prices this year by initiating the early purchase of 35.5 million litres of diesel and 16.5 million litres of gasoline for the eastern Arctic fuel resupply.
Normally, our purchase of fuel would begin in late June and last through early November.
This early purchase initiative saved the GN in excess of $18 million compared to last year’s costs per litre.
We are currently investigating a second bulk purchase to further insulate the territory from possible fuel price escalation and the volatility of the Canadian dollar against US currency.
(interpretation ends) An example of another recent improvement can be found in the bundling and/or unbundling of our transportation and supply activities in the purchasing of fuel products and delivery to communities.
This has increased competition for our supply and resupply tenders and has resulted in a significant improvement in competitive pricing.
Mr. Chairman, our department continues to pursue substantial energy management initiatives, including such measures as improving the efficiency of building designs, lighting and heating systems, and the overall maintenance and operation of these assets.
All of these efforts, Mr. Chairman, are aimed at reducing the costs associated with utilities for Government of Nunavut owned and operated assets.