EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
I’m sure the communities and MLAs will be very happy, let’s say, in another year when we can provide them with some more detailed information about how the program and strategy is working.
For my next question, maybe the minister or the deputy minister could answer. There was supposed to be collaboration with the Department of Education working towards making Nunavut school grounds smoke-free.
I would hope that at this point, maybe one of their committee meetings or departmental meetings between DMs might have discussed this over the past year.
I would imagine it speaks to the idea of setting an example. Maybe if we could get some clarification if that started.
I thank Mr. Elliott again for asking for the level of detail that he is seeking. To be candid, we don’t know if it’s being discussed at that level. It’s a priority for our department and ADMs.
There are ADM committees.
I don’t know whatever they may discuss at ADM committees. They don’t give me their agendas. The day-to-day operations with all the departments of the Government of Nunavut are a very heavy workload.
Without having the details or reading the minutes of the ADM meetings, I can’t tell Mr. Elliott if this is being discussed.
On page 2 of the minister’s opening comments, he mentioned the Public Health Strategy. I figured my next group of questions would be based around that.
On page 95 of the business plan, one of the priorities for 2013-14, actually the top priority on the list is to “Proceed through the legislative process towards a new Public Health Act.”
Could the minister update the House on what has happened with that?
I apologize to Mr. Elliott if I took too long to get the information out of our voluminous briefing binder here.
Mr. Chairman, the Public Health Act is a very old Act. There have been extensive consultations. We’re at a point now where we’re having discussions with NTI.
It’s very likely that this is a bill where there’s more work that has to be done and consultations that it will go into the Fourth Assembly.
In regard to planning for the next, I’ll read exactly what the minister stated in his opening comments earlier this week on page 2, “planning for the next phase of the Public Health Strategy.”
Just so I don’t waste the committee’s time by pulling out the strategy and reading some of the objectives that were supposed to be completed, could the minister give an update on that, whether it has been pushed back a year like the Tobacco Reduction Framework or certain objectives within the Suicide Prevention Action Plan that haven’t been followed through either?
Maybe just give us an update today where it stands so I know where to start my line of questioning.
I thank Mr. Elliott for reminding me of what I said in page 2 of my opening comments.
I appreciate that, Mr. Elliott. The Public Health Strategy is ongoing. The evaluation framework has been completed.
We are in the process of doing some summative evaluations of the Public Health Strategy.
Under the current guidelines for the current Public Health Strategy, what are the start and finish dates that he has for the department’s goals?
The Public Health Strategy expires this year. This is what the evaluation of the Public Health Strategy is about. We will evaluate how successful it was and then we would renew it going forward.
So in terms of the next phase, what are the next phases?
Would it be community consultations, to go out and create another Public Health Strategy, or would it be, as you had mentioned, evaluate the success of the current strategy, and then move forward from there?
No, this is an internal evaluation. We will evaluate what the department can do better going forward in terms of staffing support mechanisms.
As part of H-5 under Grants and Contributions, if we turn to H-7, under Contributions under Public Health, there has been an emphasis throughout the whole government on feeding youth who go to school through either breakfast programs or different lunch programs across the territory.
I realize that in the 2011-12 year, there was $546,000 allocated for the breakfast program and I remember the review of that where we had talked about it was for additional funding for equipment and to enhance the program.  Just for the public record and communities that are applying for money to get a breakfast program or to have a breakfast program or to enhance the program, there is not an actual line item, but where would the communities apply for this funding?
As I mentioned earlier, the five-year agreement that the Government of Nunavut signed with Health Canada, I am very appreciative of Health Canada for negotiating that agreement with us.
It really helped.
Through the Department of Health, we have community agreements where they are allocated a certain amount of money, and through those agreements, most, if not all, of the communities agreed to allocate a portion of their funding to breakfast programs in their communities.
H-5. Branch Summary.
Total Operations and Maintenance. $19,369,000. (interpretation) Do you agree?
Go to H-6. Health. Branch Summary.
Total Operations and Maintenance. $237,685,000.
Prior to asking a detailed question on this page, I want to ask about the duties of our nurses and the operations of health centres in our communities.
The nurses and other personnel working at the health centre are always quite busy and experience extremely stressful situations. We salute their efforts for their dedication and we are grateful for their services.
It is unfortunate that we don’t express our gratitude often enough, so that is regrettable. We should express our thanks since they have a seemingly thankless and stressful job.
I, too, try to devise solutions or alternatives to provide more assistance to the nurses as we are all aware of their tremendous workload.
This is on top of their structured operational duties during the workday at the health centre.
With that being the case, as members of the general public who sometimes get sick, we are often asked to make appointments if we want to see a nurse at the health centre.
What seems to be problematic and which I know is often the case is when a person suffering from ill health attempts to walk in to the health centre for treatment and it is only because they are suffering that they try to go to the health centre, they are advised that they have to make an appointment within the next day or two since there are no openings available and the nurses can’t see the patient.
The only reason why a person goes to the health centre is because they feel they require medical treatment and the only option they have is to make an appointment for the following day. The person is worried about their health and that is the reason for their visitation.
How can we resolve this type of circumstance? How can we improve our health services?
I didn’t come to provide solutions for the department, but only to voice concerns. The minister and his departmental officials ought to be aware of these issues. If they paid more attention, perhaps they would have already made improvements.
Hasn’t there ever been a comprehensive review to recommend improvements?
This has come up before, I believe, last year.
These are the kinds of issues that we’re working on in the Department of Health.
Through our strategic planning, we’re looking at increasing staff in some of the health centres.
Of course, I mentioned the three nurses we’re looking at in the Baffin region. We’re looking for approval for four PYs to hire admin assistants to work in four health centres that would take the workload off the nurses.
We’re looking at job sharing. We’re looking at changes in shifts.
That may alleviate some of the pressures and provide more coverage for the communities.
In keeping this thought in mind, especially since we can’t decipher the future in our lives, most people don’t plan to get sick or even have thoughts to go to the health centre. That seems to be the only gap I see.
It seems specific to people who require an emergency appointment at the health centre, as you pity the people who were advised that they can return when room is available, either the following day or the day after, for a follow-up meeting.
Most people only visit the health centre when they are worried about a health issue and that is their last hope. This is particularly hard when parents bring their children to the health centre. As parents, we love our children and want to be properly taking care of them and to ensure they are well treated.
So when the patient arrives at the health centre and they are advised that they can’t accommodate the patient due to time constraints, how can we resolve this? Even if we increase the number of nurses working at the health centre, the policy is still set by appointment only. If this policy is still followed, that we can only be seen via appointments, it seems to minimize their health concerns.
How can we accommodate the walk-in patients and provide better health services in our communities, particularly in our smaller communities?
That is my stab at asking questions through this vein as I know for a fact that the nurses have a heavy workload already. However, when residents are required to make an emergency appointment at the health centre, I believe this requires more consideration for those patients.
How can we accommodate them further? Thank you, Mr. Chairman.
I thank Mr. Enook for the question. Mr. Chairman, we’re aware of the issue.
One of the main reasons why there are appointments is because there are so many people in the communities who need to see a nurse or doctor.
So the health centres try to schedule appointments so that people don’t come at the same time and have to sit around and wait for a doctor or nurse.
Sometimes appointments are made and people don’t come for their appointments and there are openings.
Depending on the severity of the patient walking in, I am pretty confident that the health centre will see them and not send them away and tell them to come back in three days.
Chairman: Thank you, Minister Peterson. Mr. Enook.
While we’re discussing this matter, if you can allow this question, I want to ask about these… .
I am unsure of the proper Inuktitut terminology, but perhaps I can coin them quasi-doctors. I think they are called nurse practitioners in English.
In Pond Inlet, I believe we have a resident nurse practitioner at our health centre. If I am correct in my assessment, I believe they are more qualified than a registered nurse, with more responsibilities and duties.
With respect to these particular positions, I was wondering if the department has considered increasing the number of nurse practitioners.
Chairman: Thank you, Mr. Enook. Minister Peterson.
In Pond Inlet, we do have a pilot project with a nurse practitioner. It’s a one-year pilot project, I believe.
We will be evaluating the results of that pilot project.
If the results are very positive, we would look at putting nurse practitioners in other communities in Nunavut.
I also thank Minister Peterson for that response.
As per his response that it is a pilot project with the nurse practitioner in Pond Inlet, I certainly hope that the findings are not negative or impractical.
In my opinion, I don’t see any negative connotations for a nurse practitioner as their workload or duties seem complimentary.
I certainly hope that since it is only a pilot project and more or less a feasibility study, this initiative will be moved forward. If it requires some changes, then we should just make those changes to fit our communities and other facilities.
I would like to return to this issue when patients can’t be seen immediately when they request an appointment. I want it known that this is a recurring issue in the communities, not just in Pond Inlet.
I am in no way placing the blame on our nurses, but rather, I am looking at how we can provide more assistance to them.
As part of their professional conduct, a nurse will never say that they don’t want to see a sick patient as their profession is to treat patients. However, I know that it is more to do with time constraints where they advise a sick person to return the following day or the day after. I wonder how we can provide more assistance to our local nurses since their profession is to look after people’s health issues.
I would really like to see this revisited so that Inuit patients don’t just leave the health centre when they are trying to make an appointment.
This concludes my comments on this subject and I want to move past this issue, although I want to ask another question related to this page. We are on page H-6.
I want to ask about visiting specialists or, alternatively, the health workers who visit the communities with specialized training, such as visiting optometrists or dentists for that matter.
Alternatively, those specialists who arrive in Nunavut to conduct specialist treatments in Iqaluit where patients from around the region travel down to see these specialists, at least in the Qikiqtaaluk region… . Perhaps I am mistaken in my assumption the same holds true in the Kivalliq.
I assume that a specialist also visits the region, but I imagine they go to Rankin Inlet and patients are then sent down to see the specialist. Perhaps that is done in Churchill. I really don’t know how they do it there, so I will only speak to our region.
Whenever a specialist arrives in our region, many patients from around Qikiqtaaluk are sent down to Iqaluit to see the doctor. Has this ever been reviewed?
In my opinion, I believe this is the most expensive option we have since we bring down multiple patients from all over our region to visit the specialist for their appointment.
Has the department ever taken into consideration, when it comes to certain types of specialists, to have them conduct a visitation tour of our communities instead? As an example, a specialist doctor arrives in Iqaluit singularly with the patients then travelling down to see them.
From my perspective, if this single doctor were to spend several days travelling to the communities, it would result in huge cost savings as long as their equipment is available for their use.
I am not referring to specialized medical treatment, such as surgeries or intensive care cases.
Here I refer to ear specialists as we also have to travel down to Iqaluit to visit the ear specialist for our appointments.
Has the department ever considered reversing this practice to where specialists visit communities instead as a cost-saving measure?
Just to go back to nurses, yes, our nurses are very valuable and I expect and trust that individuals in our communities are saying that they see a tremendous number of people every year in all health centres.
We have to tip our hat to the nurses, the physicians, and of course, all the health practitioners who help us in our communities and in the hospital up here.
Just to comment on the nurse practitioner, my deputy was just showing me a very early report, there are pages of statistics, it’s looking good, the nurse practitioner in Pond Inlet, so that’s very good news.
With respect to specialists and physicians going to communities, it gets difficult because the nature of the work that specialists undertake, they have specialized diagnostic equipment and that equipment would only normally be available in the hospitals here in Iqaluit or if we send them to Yellowknife or one of the larger centres down in southern Canada.
So that’s one of the reasons we can’t send specialist physicians to all communities in Nunavut.
As I indicated earlier, if it’s possible, can you at least review the possibilities of the specialists going to the communities?
I’m sure that there’s an easier way somehow.
It might not be possible to send them up to the communities, but we can look at options for cost-saving measures.
Again on the same page, H-6, Mr. Chairman, if you would direct me, please.
I’m out of time. If you would like to have another person take the floor, I do have other questions that I would like to ask.
I’m not a preacher or anything, but I would like to give another individual an opportunity and once everyone has had an opportunity, we can always go back to you.
I would like to thank the minister for being available to the members because we like to have every opportunity to ask questions to the minister.
My colleague brought it up earlier and as you probably know, we all have similar problems or concerns in the majority of the communities.
We don’t talk about it, but we end up finding that we all have similar concerns or questions.
I have some questions for the minister and his officials concerning services provided at community health centres.
I want to begin by expressing my appreciation for our health centre staff, who work long hours with not enough resources.
I want to appreciate the health centre staff in Pangnirtung first of all.
I’ll first concentrate on my community of Pangnirtung.
I have been told by my constituents about their concern regarding the process for dealing with patient appointments and walk-ins.
Quite a while back, the nurses were able to see everyone who walked into the health centre and deal with it directly.
Again I would like to touch up on that issue that Joe Enook brought up regarding obtaining appointments for non-emergency treatment. This concern is with the patients having to wait several days before they are able to obtain appointments. Again, this question was brought up earlier, but can the minister or his officials describe what guidelines or service standards health centres should be following with respect to the timeframe of obtaining non-emergency appointments?
I will wait for a response to that first of all.
Hon. Keith Peterson: Thank you, Mr. Chairman. I thank Mr. Oshutapik for his comments, questions, and I’m sure that the nurses and health practitioners in Pangnirtung appreciate his comments about the hard work that they did provide on behalf of his constituents.
I appreciate your questions.
Mr. Chairman, we’re not aware of a specific standard with respect to non-emergency medical treatment.
That’s one of the areas we want to look at, as I indicated in previous answers to the standing committee, and gathering all of this information that we can use to help us provide a higher level of service in our health centres and hospital in Nunavut.
I would also like to thank the minister for commenting on my question. (interpretation ends) I recognize that community health centres are always under pressure to do more with less.
Can the minister or his officials indicate if they are looking at increasing the number of nurses and other health care professionals working at Pangnirtung’s health centre?
I believe they were in Pangnirtung specifically where they will get, I believe, the admin assistant. The admin assistant is one of the positions we will add to the Pangnirtung Health Centre and that should help the nurses there.
Mr. Oshutapik (interpretation): Thank you, Mr. Minister and Mr. Chairman, for this opportunity.
The people of Pangnirtung are watching the proceedings. We will make sure to see how it works.
(interpretation ends) The issue of cancer screening and treatment is frequently raised with me by my constituents.
In a number of cases, people feel that cancer is not being diagnosed quickly enough at the local level.
Can the minister or his officials describe what initiatives the department is undertaking to improve cancer screening and treatment programs in Nunavut, especially in the smaller communities?
I apologize to Mr. Oshutapik for the question.
Mr. Chairman, I have always said that early diagnosis is good. It allows Nunavummiut to get treatment earlier. If patients feel unwell, we rely on them to ensure that they get themselves to the health centres and hospitals where the doctors and nurses can check them out.
If there’s a need to get some specialized physician services, then we would send the individuals to either come to Iqaluit or send them down south.
I would like to thank you for your response.
Last week, I asked questions in question period concerning the government’s purchase of new diagnostic equipment. I believe that’s CT scanning equipment.
Can the minister or his officials indicate what technological initiatives are being undertaken to help improve Nunavut’s system of cancer treatment and screening, and who is taking the technical training to operate this new diagnostic equipment?
Chairman: Thank you, Mr. Oshutapik. Minister Peterson.
The only equipment we have in Nunavut at the moment that would, from a technology perspective, assist the diagnoses of types of cancer is a mammography machine here and it’s situated in the Qikiqtani General Hospital.
It’s only used for diagnostic tests. It’s not used for screening. We just don’t have the capacity in Nunavut at this time for a full-fledged mammography screening program.
Chairman: Thank you, Minister Peterson. Mr. Oshutapik.
Mr. Oshutapik (interpretation): Thank you, Mr. Chairman. I’m sure that the other members have questions. I’ll leave it at that for now after I ask this question, Mr. Chairman.
(interpretation ends) Over the years, the Nunavut government has considered a number of different options for addressing addictions issues in the territory. In 2012-13, your department launched a 28-day mobile addictions treatment pilot program in Cambridge Bay. Can you describe the results of the evaluation of this program and if any similar programs are being considered for 2013-14?
I can speak from first-hand knowledge on that. This program was underway across the street from my office.
It started with ten participants on the program and they were supported by people in the community, including the elders.
There were classroom sessions, on-the-land sessions, and the folks came to visit me in my office. I went over to talk to and visit them at their facility. We talked about a number of things.
It was very heart-warming to see the people admitting that they had addictions problems. I had the opportunity to go out on the land with the group. I was the guide for one of the people who came from the south.
It was a very cold day, I must say.
I froze my face, you could see spots, but I didn’t lose the… . He was riding on the backseat with me, so I didn’t lose him. We went ice fishing and it was quite enjoyable.
We didn’t catch any fish, of course, but it was fun nevertheless. We talked. We were at a cabin out on the land by Mount Pelly.
Later on, I was invited as one of the guests to participate in the graduation ceremony.
I must say that it was a very emotional experience because every graduate was getting up admitting that they were alcoholics. The first thing you do is you admit that you have a drinking problem. There was a tremendous outpouring of support from the community where people in the audience, family, friends, and others got up and told their own stories about the program.
Of course, I only went as a guest, just a member of the public. Of course, they asked me to sit with the VIP section and it seemed like everybody got up and said, “There’s Keith.
He’s the Minister of Health.
We want to tell him to do more programs like this and offer more programs, not only in Cambridge Bay but across Nunavut.”
So from a personal perspective, it was very encouraging and very supportive. The community was very involved. Individuals who were in the program thought it was great.
Of course, they had to go back to their communities and we’re hopeful that they will be getting the support back in the communities from the people in their communities that were involved.
There’s an evaluation process that was commissioned later.
I met the individual who was in town to do the evaluation. He was there about a month ago. I think we just got the report, so we’re going to evaluate it.
Just from seeing it myself, people think offering these kinds of programs in their own communities is the way to go rather than sending people down south or elsewhere to take the programs.
They say that when they go elsewhere, they don’t know anybody and they’re away from their family, but when they’re in the communities or in their region, they know people and people understand the tremendous efforts they’re making. They support them and encourage them.
That’s how Nunavut communities are. We try to help each other.