EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Going on to the next question, there is a growing need for more 24-hour care facilities across Nunavut. The department plans to open a seven-bedroom long-term care unit in the Kitikmeot health centre in the spring of 2017.
What other steps have been taken to address this need and plan for additional facilities of this kind in the near future across Nunavut?
The occurrence of what happened in Cambridge Bay with the ability to add those beds to an existing structure was kind of unique.
When the building was built, there were different needs that were anticipated or different programs that were anticipated to be provided out of that building.
It was underutilized, so it gave us an opportunity to be able to expand the services in a distinct footprint of the building. We were able to upgrade and renovate to meet the building codes and the security codes that are needed to provide care in a facility like that.
That was quite a unique circumstance.
Typically, when we’re looking at building infrastructure, you want to make it use-specific. When you’re looking at building a health centre, you build a health centre. When you’re looking at building a long-term care home, you build a long-term care home.
It is something that we can keep in the back of our mind if there’s a way of conjoining services like that, but typically you’re looking at different building codes for different structures. If you take the strictest building code and put that throughout the entire building, it increases the cost quite substantially.
Even as of now, in our designs we look at trying to eliminate or have different wings of different uses to try to reduce our costs as much as we can.
We realize the value of infrastructure dollars in Nunavut and how hard those dollars need to work for Nunavummiut.
We take all considerations in when we’re building infrastructure to make sure that we’re getting the maximum impact of those dollars being spent.
The next name on the list, Mr. Rumbolt.
First I would like to start by thanking Mr. Mikkungwak for asking several questions on my behalf about the health centre in my community.
I can only hope he’s equally enthusiastic about other infrastructure issues I have in my community and help me along the way.
Mr. Chairman, I have been lobbying a long time to get a new health centre in Sanikiluaq and it’s a good feeling to finally see it making some progress. I won’t have too many questions on that issue here today.
I will start by asking: with the preplanning dollars that you’re asking for and with the money that is spent to date, can you give us some details on what exactly what this $1 million will buy plus the money that was put to a preplanning study in previous years?
I normally don’t like to do this, but just because of the complexity of the response of all the levels that are taken into consideration, with your permission, Mr. Chairman, I would like to allow Mr. Babstock to respond to that.
Mr. Babstock.
Mr. Babstock: Thank you very much, Mr. Chairman.
The money that’s allocated for preplanning will go towards various aspects of consultant work to identify those build versus renovate decisions, coming up with the needed estimates that we can bring forward to complete the construction project.
Has it gotten to the point where you have chosen a site location for the new health centre?
From what I understand from discussions with the Municipality of Sanikiluaq, there are two potential locations. They’re just doing a final analysis and that will be part of the decision when they’re going through the design itself.
Like we spoke about earlier, there is a common design element to it, but the footprint still has to be taken into consideration, the geotechnical assessments and the environmental assessments.
I understand the need for all this prep work and it’s probably money well spent in order to do so.
I’ll probably also give a word of advice. Once you choose a location for the new health centres, keep consulting with the community because Sanikiluaq gets a lot of snow and if you don’t orientate your building properly on a lot, you will spend a lot of money clearing snow. That’s something to keep in mind.
You mentioned a minute ago about common design. Also in your opening comments you talked about enhancing the design.
I wonder if you can briefly describe some of the enhancements to the design.
Hon. George Hickes: Thank you, Mr. Chairman, for this.
I do have a basic knowledge of it. When we’re looking at the common design model, there are common elements, like I had stated earlier, but there are also community-specific initiatives and programs that are anticipated to be offered, even such as what the member just made in his comment and recommendation to the department on the design part of how it’s situated on the footprint of the lot and where it’s located.
All those are taken into consideration.
I do appreciate the member’s comment and advice on that.
I’m sure my officials here have already made note of that and I look forward to the continued relationship to make sure that when we build something like this in a community, those factors are taken into consideration.
Again I would like to thank Mr. Mikkungwak for asking my question on the staff housing needs for the new health centre. I’ll take it a little further.
The current health centre has their accommodations within the building upstairs.
It is my understanding that the new health centre will have separate accommodations, not within the building.
Is it your intent to have the new staff housing in close proximity of the health centre or will it be located farther away from the community?
The reason I ask that is because, when your health centre staff housing is not connected to your building, you could run into the issue of staff being able to get to the health centre in an emergency situation.
That’s why I asked: in what proximity to the health centre do you hope to have the staff housing?
I thank the member for raising that concern.
Again, when we looked at separating the staff housing component from the facility, like I had mentioned earlier, there are different building codes associated with the health centre and different types of health care facilities.
You would end up having to build the residence to that level of code, which saves us a lot of money by having the residence separate from the facility itself.
That being said, the intention is to have the staff housing on the same lot as the health centre or at the very least right adjacent to it.
Another thing that our current health centre has is out at the back of the building, it has a garage that is used for various purposes, sometimes to park their vehicle and for storage.
Is there any intention with the new health centre if the department will be considering having a garage for their vehicles?
These monies would allow us to go to the design type phase where, again, we take community needs into account. I can’t commit one way or the other on that. Typically that’s not a part of construction of health centres, but all avenues are considered when we look at something like that.
In discussions with the community, it might be something... .
I know my staff here have already made a note of it.
That being said, it’s not a necessary part of a health centre. I’ll leave it at that.
I understand the fact that a garage may not be a priority when it comes to replacing a health centre.
The point I’m trying to make is they currently have a garage near the health centre and if the new health centre is built without a garage, then you’re actually losing a piece of infrastructure away from what they previously had. That’s why I brought that up.
To move away from that, also part of your budget is small capital.
With the acquisition, I’ll use vehicles for example, I know the process when an old or used vehicle becomes surplus.
I know it’s your department’s responsibility to contact CGS and surplus the vehicle. It’s CGS’ responsibility to put it out for tender or find a way to make use of that vehicle.
About a year ago I brought it to the department’s attention that the health centre in Sanikiluaq had a couple of surplus vehicles. I think it’s at least a year later.
These two vehicles and the tags have been outdated now for at least two or three years. They’re still sitting behind the health centre.
Has your department contacted CGS to surplus these vehicles yet?
I can’t answer that question specifically.
I’ve got some things buzzing back here, though. As part of the capital asset discussions with Community and Government Services, that should have occurred.
I would have to look into those specific vehicles and get back to the member on that topic.
The minister said it should have happened. Yes, it should have happened like three years ago.
I have seen vehicles get destroyed where they sit so long, not necessarily your department but other departments too, where they’re left so long before they’re considered a surplus and disposed of properly.
I would just encourage you. I don’t know where the stall is in the process, but it just seems that either the departments, not necessarily your department, are not letting CGS know or they’re letting CGS know and CGS is not going forward with it.
I’m not sure where the stumbling block is and I’ll just leave it at that as a comment and just encourage that in the future we really look at that as an issue, not only in my community but probably a lot of other communities.
Hon. George Hickes: I thank the member for that comment.
I didn’t realize it was such a widespread issue, but it’s definitely something my officials are taking notes of right now and we will endeavour to do a better job in the future.
I just have two questions and hopefully both of them are yes.
Today I talked about the health centres working on their own defibrillator, the heart machine. They made it workable.
I’m just wondering if you’re able to replace that machine as soon as possible.
I have to commend those nurses in Gjoa Haven on their electrical skills.
I hope they didn’t get shocked in the process and that’s not their job.
It’s our job to make sure that they’ve got the equipment needed to do their jobs.
When we’re talking in a capital budget request process such as what we’re going through today, that’s exactly why we have an ongoing lifecycle component to our budget where we can deal with equipment replacement as needs arise.
You may have the projected list that we have in front of you. I believe we provided it to you at the standing committee meeting, but again that’s a projected list.
It has identified needs to date and even that was done back in March. The needs change almost on a daily basis.
It’s something that we will look into immediately on that defibrillator in Gjoa Haven to make sure that it meets the requirements so that those nurses can do their job.
My other question is, I visited the continuing care centre before I came to the sitting in Gjoa Haven and they gave me a tour.
They have only ten beds available and they tell me that they have a long waiting list, not only from outside of Gjoa Haven but there are getting to be more from Gjoa Haven that need to be housed in that continuing care centre.
Apparently the tenth bed was supposed to be used for emergencies only, but it’s now being used as a regular bed.
You talked about renovating buildings. Have you thought about renovating the one in Gjoa Haven?
I thank the member for his concern for his residents in Gjoa Haven.
The facility has a fantastic reputation on the level of care that they’re providing.
When we’re looking at, again, capital planning processes, very similar to what we’ve got in our proposed planning projects of Igloolik, an extension on the continuing care centre there, it would be a natural progression.
When we look at addressing needs across the territory, we’re always looking for opportunities, again, to raise or increase the capacity of the care that we provide to keep people in Nunavut.
I campaigned on that.
I believe that we need to provide as much care in-territory as we can.
I understand there are fiscal restraints to that, as I talked about earlier, but it’s something that we’re always aware of and will continue to be aware of as a department.
If there are opportunities to increase the capacity of an existing facility that’s not that old and it can be done with the good value for the tax dollar that we use, we will obviously explore it.
I’m going to go back to page 2 of your opening remarks when you talk about the $27.7 million that was used to build the Arctic Bay Community Heath Centre and out of that, you have the detached five-plex staff housing. I think, originally in the plan, you were going to have the staff housing as part of the centre and then that was taken out and now the five-plex is different.
Out of that $27.7 million, how much did the five-plex cost?
Chairman (Mr. Akoak): Minister Hickes.
If I recall, the number is correct. $2.8 million was transferred over to the Nunavut Housing Corporation. To be exact, $2,819,000 was transferred to NHC to do that construction.
If I understand correctly, the design for the Arctic Bay Health Centre was done through a common design.
Yes, it was. It was based on Naujaat that was one of the first common designs that we used.
From what you have in your opening comments, you stated that Sanikiluaq is the next community and that you’re “looking to further enhance the design of new health centres to better meet the needs of the department and communities.” You’re requesting $1 million to do this for the design phase.
I have a couple of questions about this statement. One, when you look at the common design aspect, I guess, has anybody actually tallied how much we’re saving by using this approach?
This is a fairly new initiative.
Now, when we’re looking at our design and any improvements to that design, every time we build a health centre, we’re going to get some lessons learned on how to streamline processes to find efficiencies in not only the design but maybe the construction itself.
We do know that just through the design process, you’re not having to redesign a whole facility. We’ve got common elements that we do use from design to design.
That is where the common design context comes from. There’s still uniqueness and there’s still a need for a design cost to meet the needs of each community.
There are common elements, but it’s not like we’re taking one building design and putting it in every community. We have to still meet the individual needs of the community.
It reduces our design costs, but it doesn’t eliminate them.
I’m not an architect and I don’t know a lot about this area, but when I think about a common design and then your statement of having to make changes every time, I understand why, because the layout of the land and the community is different.
I’m not really convinced that it actually saves a lot of money just because of those changes.
You’re asking for $1 million to fund the design phase of one project.
A million dollars is a lot of money in my opinion and it seems about the range of what you would probably pay an architect for that kind of scale.
If we talk about common design, I thought maybe it would be so much lower.
A million dollars is still a lot of money for a common design.
I guess that’s for this one Sanikiluaq project.
I just want your comments on that. A million dollars for a common design seems like an awful lot to me.
Is it going to be $1 million every time we want to build a health centre?
I appreciate the member’s concern. When we’re looking at developing infrastructure in any capacity, not just a health centre, there are still the environmental studies, there are the geotechnical studies, and those are constant costs no matter what.
When you’re talking about the design cost itself, it’s not anticipated to save millions of dollars per unit on this common design.
Over the course of evolution of the design it may be able to… . We’re in the third generation right now of this common design model. We’re still discovering what savings are actually realized out of this.
It’s a fairly new process, but I do know that when you’re talking of a common use facility like a health centre, you still have your basic components of need.
Having that commonality and then branching out with the uniqueness of each community, like I said, you’re not going to eliminate design costs, but you are going to reduce them.
They’re not going to have to design each lab room or each filing room or each exam room or the different uses that we do encounter in a health centre.
It alleviates a lot of the design challenges.
There is still uniqueness that we have to make sure that we’re meeting each community’s needs as well. A health centre in Naujaat may not be the right health centre in Sanikiluaq. We have to make adjustments for the community needs.
I would like to go on to something else. It’s actually on page 1 of your opening comments. You say that there’s “62 percent of the department’s community health centres are 20 years of age or older.”
It reminds me of our power plants that are 40 and over. I don’t think we want to get to that point in Nunavut where we’re not doing anything about the aging infrastructure.
What is the strategy to address this growing need? You’ve got 62 percent. That’s a pretty high amount, I think.
How are you going to address this?
When we’re talking about that amount of buildings across the territory, it’s the majority of our stock of health centres.
Now that being said, some are in different levels of conditions.
Some have aged quite well, maybe in lower-traffic communities where population growth hasn’t been maybe as dramatic as it has in some communities like the member from Baker Lake.
When you’re talking common design, you look at a lot of the health centres across the territory that are existing were built over a fairly similar time frame, where the residences are on top and the same kind of style of build. They were built to that community of that day’s needs. Again, construction methods have changed dramatically and technologies have advanced.
We want to make sure that we’re getting the most efficient expenditure of our capital dollars as we can.
We do have a priority listing, like I talked to earlier, of facilities that we have identified that need replacement faster than others.
We have to prioritize. Again, if somebody gave me that pot of gold at the end of the rainbow, we wouldn’t even have the capacity to replace all those health centres at once anyway. We have to take a deliberate and positive approach to utilizing the dollars that you guys and the capital planning process allows us to.
I want to go into actually what the chair was talking a little bit about continuing care centres. Obviously that’s a real interest of mine.
We all know there’s a real growing need for more 24-hour care facilities across Nunavut. We know that the Kitikmeot is about to open a seven-bed long-term care unit.
What other steps are you doing to address this need?
In Iqaluit we have a big need here. The current one that we have, the levels of care that it’s able to offer are fairly low, so a lot of people have to go away.
Our facility in Iqaluit holds a lot of Nunavummiut but from other communities, so my constituents have come to me and said, “Where do we go?”
I’m interested in your comments on what the next steps are.
I have said this publicly and I have talked to the member about this topic to quite an extent.
Again, I keep going back to the challenge that we have fiscally of making sure that all needs of Nunavummiut are covered across all departmental needs.
I share the member’s concern. Long-term care and continuing care is an ever-growing need of Nunavummiut and Iqaluit as a large centre is, I think, even more exaggerated.
That’s where I believe opportunities arise, like I had mentioned with the boarding homes, of partnerships and some of our long-term continuing care facilities are run by societies and it’s a fee-for-service base under contracted services, which alleviates some of the pressure on the government to provide the capital dollars for infrastructure such as that.
I know the member is very engaged in projects such as that for Iqaluit and I look forward to seeing more information on such proposals to maximize the benefit to the residents of Nunavut.
I commend the member for the efforts that she has undertaken and I know she has been working very tirelessly at it and will continue to do so.
Like I said, I have always been open to examine any opportunities for partnerships to be able to provide care for Nunavummiut.
I am very encouraged to hear you say those words because one of the greatest fears that we have as volunteers of big projects like the one that I’m in involved in is that we’re not going to get the support.
Even though we work very hard, we might not get that support.
It’s encouraging to really hear that because it makes us want to do even more, where we work harder towards our initiative, towards our goal, and so that is encouraging.
I don’t think I have any more questions, Mr. Chairman. That’s my last one.
Chairman: Is that just a comment?
The next person on the list is Mr. Shooyook, but at first we will take a five-minute break.
>>Committee recessed at 17:00 and resumed at 17:09
The next name on the list... .
Sorry. We’re on Health.
Directorate. Total Capital Expenditures.
Mr. Shooyook (interpretation): Thank you, Mr. Chairman. I welcome the minister and his officials.
I have some questions on your opening comments regarding Arctic Bay.
The construction of the Arctic Bay Health Centre is on its last phase.
I believe there is $50,000 to complete the project.
Is that amount going to be enough to go right up to the completion stage? I would first like to get clarification on that.
With most capital projects like this there’s typically a small amount at the end just to cover any closing costs to the project and that’s all this budget is allocated to.
It’s within the contracted parameters; we don’t anticipate any increase cost to that.
I was concerned because some construction is halted before it’s completed.
Below that is this $27 million, which I believe is for the multiplex staff housing unit.
The construction material just came in this fall on the ship.
What’s going to happen to the construction of the multiplex unit? Do we first have to approve the funding before construction starts?
Can you give us an update on what’s happening to that unit?
Hon. George Hickes: Thank you, Mr. Chairman. I would like to thank the member for that question.
When we did this project, we carved out the $2.8 million and provided it to the Nunavut Housing Corporation to construct the five-plex for staff housing for the health centre.
The majority of the construction materials, like the member said, have arrived, not all of them have arrived in the community, and the anticipated completion date is the end of next summer for that building in time for the building opening for the health centre.
I also thank the minister, but his response triggered another concern, as I assumed a complete construction package for the five-plex unit. Apparently only certain materials were shipped up.
With the mention of the staff housing unit construction not commencing until this summer, does this mean that our local nurses will face more housing issues prior to the construction of the units or will they be housed in the old nursing centre for the time being?
What will happen with the nurses who work at our health centre?
It’s anticipated that the five-plex would be complete by the time the health centre opens up.
If that doesn’t occur for some undetermined reason, we will make whatever necessary arrangements for the staff.
I’m always concerned about the design phase of any building.
I understood that you would like to save costs by having a common design for the health centres, which is what I expected.
However, there is always $1 million set aside for the common design since it came in.
I’m getting confused because it’s always coming in at $1 million, even though you said that you would save costs by using a common design.
Can you explain exactly what you use that $1 million for?
When we’re looking at multi-year projects like this, chunks of money are taken in blocks.