EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
It is not clear whether the department intends to build a new treatment facility in the territory.
Committee members will be closely monitoring developments in this area.
Issues such as suicide, substance abuse, and domestic violence are significant factors affecting health and well-being across the territory.
Committee members have expressed concern at the continued shortage of dedicated full-time social and mental health workers in some communities.
The committee recognizes that social workers in Nunavut require a broad range of training and experience, as well as a certain level of cultural awareness and sensitivity.
The department faces some difficulties in recruiting individuals who meet these criteria.
However, members strongly urge the department to focus on providing adequate services to help address deep-rooted social problems and assist individuals and their families to work through them.
The committee notes that the Department of Health and Social Services intends to develop a policy called the “Family Violence Shelters for Women Policy.”
Members encourage the minister to work with his colleague, the Minister of Justice, to ensure that such efforts are coordinated with the ongoing implementation of the Family Abuse Intervention Act.
Mr. Chairman, the standing committee has discussed the difficulties faced by constituents in having their concerns or complaints addressed and resolved by the Department of Health and Social Services.
For example, members continue to receive complaints from constituents about the operations of the department’s Medical Travel Office located in Pangnirtung despite the fact that this issue has been raised on numerous occasions.
Members are of the view that a clear, formal, and straightforward process must be established whereby Nunavummiut can bring forward complaints and concerns relating to health care and social services and have them formally responded to in a timely manner.
Mr. Chairman, the committee has noted that the department continues to implement electronic health information systems for data collection, case management, and evaluation.
This follows the trend across Canada.
Members continue to look forward to seeing improvements in analyzing and communicating trends in the health status of our population as the department works towards addressing specific health issues across the territory.
I anticipate that individual members will also have questions and comments as we proceed. (interpretation) Thank you very much, Mr. Chairman.
Chairman (interpretation): Thank you, Mr. Aupaluktuq. Please note that the Minister of Health and Social Services already made his opening remarks.
Minister Curley, do you have officials that you would like to bring to the witness table?
Hon. Tagak Curley: Thank you. (interpretation) Mr. Chairman, yes, my officials are here. (interpretation ends) Thank you.
Do you agree to have the minister’s officials at the witness table?
Chairman (interpretation): The committee has agreed.
Sergeant-at-Arms, please escort the witnesses in. I would like to welcome the officials who will be at the witness table.
While we are waiting for them to settle down, I will ask the minister to introduce his officials.
Minister Curley, if you could introduce your officials, although we know who they are.
Hon. Tagak Curley (interpretation): Just a moment, please.
We are just preparing to sit down.
To my left is my Deputy Minister, Mr. Alex Campbell, and to my right is Debora Voth, Executive Director of Corporate Services.
Before we begin, I would like to remind my colleagues of the following: according to Rule 77(1), you have 10 minutes to speak, and according to Rule 77(2), subject to the discretion of the Chair, a member may speak more than once to a matter under discussion but not until every member wishing to speak has spoken.
I suggest to the members that wherever possible you ask detailed questions during the page-by-page review of the departmental estimates.
Do any of my colleagues have general comments?
Mr. Fred Schell.
In the opening remarks, you had mentioned that you’re going to have a policy in regard to family violence shelters for women.
I know in the budget, you have money for a women’s shelter.
My question, which I have been bringing up for three years as mayor and now an MLA, is: is there any money in that budget for the women’s shelter in Cape Dorset?
Chairman (interpretation): Thank you. (interpretation ends) You remind me of Shell Canada, sorry.
Hon. Tagak Curley: Thank you. (interpretation) You caught me off guard as I thought I was going to do my opening comments. I can respond to the member’s question in regard to the funding for women’s shelters.
As I stated in my opening comments, we have to work on the plans. We were in Cape Dorset last winter and there is a requirement for a women’s shelter there.
There is a building but there is no funding allotted to it.
Once we start considering the policy, we will also consider Cape Dorset because we can say that in the Baffin region, there is only one women’s shelter.
The proposed estimates… my colleagues were able to concur with me that we need to support the women who need to go to a women’s shelter.
Yes, we will consider Cape Dorset when we start working on the policy.
Mr. Schell, are you finished?
Are there any questions on the opening comments? Mr. Ningeongan, you had your hand up.
In the minister’s opening comments, I’m not exactly sure which paragraph it was, but it’s stated in the standing committee’s opening comments that health committees are provided funding at the community level.
Mr. Chairman, I have noted that it seems like the funding hasn’t changed for quite a few years.
It might not be in the minister’s opening comments, but I do want to ask if they’re going to provide additional funding to health committees.
I believe that he is referring to details on H-9, but would you like to respond to that question, minister?
I would like to thank the member for raising that.
I asked that very question when we were being briefed.
I would first like to say, Mr. Chairman, that we will have to look into that further.
They’re under the umbrella of municipalities.
In turn, the hamlet councils provide funding to those local committees.
For that reason, I believe we need to discuss this matter with the municipalities to get the details to make sure exactly how it’s going to be done.
When I spoke to the deputies last winter, I believe that there’s room for improvement because sometimes they work on such issues and they don’t make a report to us when they should be making their report to the municipalities.
This process has to be streamlined.
I believe that we will have to consider that during the drafting of the policy and your comments will be taken into consideration and will be beneficial to the development of the policy. We provide minimum funding in the amount of $5,000 per community and some communities receive a little more.
His comments are very clear.
I believe that the minister is aware but I want him to know that this spring, a federal government official came to Coral Harbour to start planning for a Brighter Futures program in our community.
I believe that it would be better if there was a better working relationship amongst individuals, hamlet councils, the government, and the aboriginal health funding agencies. More cooperation would also be beneficial to the communities.
Although I didn’t hear a question, minister, would you like to respond to that comment?
Hon. Tagak Curley: Thank you. (interpretation) Mr. Chairman, in regard to his comment, we understand that the federal government has a five-year funding arrangement for aboriginal health and it’s going to lapse next year.
NTI has received funds and they do provide public health funds for courses at Nunavut Arctic College for nursing and we are very pleased that they provide funding for public health.
Alex, the deputy minister, can elaborate further on this.
I just wanted to point out that the aboriginal health funding will lapse next year, but we would like to see the continuation of that funding by the federal government as it will end next year.
Mr. Chairman, with your indulgence, I would like Mr. Alex Campbell to elaborate further.
Mr. Campbell, would you like to supplement his response?
Mr. Campbell: Qujannamiik, Mr. Chairman.
The minister is, in fact, right that one of the programs that we’re trying to renegotiate with the federal government goes by the acronym THSSI.
I forget the exact name of the program right now, but under that program, there is a territorial access funding that we do apply for some of these programs that we have with communities and that portion of the funding is expiring next March.
We also have ongoing Vote 4 funding arrangements and contribution agreements with Health Canada on other programs as well. Last year, we received about $13 million for those types of different programs that we give support as well to communities.
So there are pots of money at the federal level, in any case, that we will continue to support.
That was a good question.
I hope those funds will be renewed.
Mr. Ningark has a question.
Mr. Ningark, you now have the floor.
In the minister’s opening comments on page 2, all of what is there in regard to health is very clear.
We all know the cost of health in all of Canada is continually rising with air travel costs increasing and the need to constantly bring in nurses from the south.
Health care, Mr. Chairman, is very important. Sometimes those who are sick, who come down with the flu, as the minister used to say when he was a regular member, there are cases where the medical professionals would tell their clients that they were okay and will only need to take Tylenol.
There have been a lot of those cases and possibly, the only way they could see the nurse would be if they had a serious illness.
I would like to ask the minister how we can become more cost-effective without cutting back on services.
What cost-cutting measures could be implemented within your department without affecting essential services?
Minister Curley, can you try and answer the question?
I understand the question very clearly. Just a few days ago, I touched up on an issue of our staff and I had a meeting with the officials in our department to make sure that illnesses are detected and that clients are properly taken care of, not just being told that they’re perfectly fine and sent home with Tylenol.
And yes, I honestly believe that there have been such cases. Some call in and they are told, “Come in tomorrow and we will check you out,” and there are some cases of patients not willing to go back to the nursing station or the health centre because they’re not made to feel welcome in those facilities.
Headquarters is responsible for the nurses, so I will urge those officials to make sure that proper services are provided.
As politicians, it’s not our responsibility, but I will make sure that this directive goes out possibly by way of correspondence.
There are communities without doctors and all of our health centres have nurses.
We need to medevac patients to larger centres only when serious illnesses are involved.
We have to constantly think about cost-saving measures because we have a limited budget.
If there’s an increase in airfares or the price of gasoline, we can say that there’s an immediate jump in expenditures, but we need to take cost-cutting measures.
For example, in Igloolik, we now have a long-term care facility.
We would like to see a cut in the amount of elders travelling, but at this point, we can’t say this is exactly what we’re going to be doing or if this is how we’re planning cost-saving measures.
Mr. Ningark, do you have a supplementary?
Yes, we are politicians and we can help the minister in any way we can to cut costs.
I’m sure that there are unforeseen expenditures in any given year.
For example, in Kugaaruk, only rarely do we hear about nurses coming in to do practicum.
The smaller communities need fully skilled nurses wherever possible, who have worked in big centres, and are experienced to make sure that proper services are available, especially in the smaller communities.
We don’t want to see just nurses practicing in our smaller communities especially.
They should do more thorough diagnoses and mentor Inuit caregivers. I really would like to see mentoring done more in the smaller communities.
That’s just a comment that I wanted to make.
That was a good comment.
Are there any further comments?
We will now go to the page-by-page review of the departmental estimates starting on H-4.
Directorate. Department of Health and Social Services.
Total Operations and Maintenance. $25,240,000.
I see a hand up.
In past years, the Department of Health and Social Services has repeatedly overspent on its budget. Almost every year, supplementary appropriations are brought forward to account for over-expenditures.
Do you think that your budget for 2009-2010 is realistic? What steps are you taking to ensure that the department’s expenditures stay within budget?
Chairman (interpretation): Thank you. (interpretation ends) I remind you that Shell Canada is my Airmiles station.
Hon. Tagak Curley (interpretation): Mr. Chairman, I agree with the first part of his question.
Alex will elaborate on the other part of the question. (interpretation ends) Thank you.
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) Thanks for the question.
As the members have indicated, we’re all continually going to FMB and the members here for supplementary funding.
Right now, we have developed business cases that we think we can deliver on for this fiscal year.
There are other initiatives that were submitted by our departmental staff that were considered as we proceeded towards developing the business plan as well as the main estimates.
There are a number of other initiatives that we have pushed back at the department until we’re able to first of all substantiate some of the expenditures that are occurring in the department right now and whether or not we can afford some of those new initiatives.
I can also tell the members that there are four areas that we’re continually challenged as a department - agency nurse contracts is one area, medical travel is another area, out-of-territory services for Nunavummiut is another area, and then out-of-territory hospital expenditures.
Those are demand-driven expenditure items that, from year to year, fluctuate and it’s very hard right now to predict what the actual expenditures for those areas will be this coming year.
We do have a number of initiatives.
As the members appreciate by now, we have the Nursing Recruitment and Retention Strategy that has been a year in the making now and by the fall, we should have a good indication as to how that program is working at least for one year.
We’re developing programs like that that we’re trying to be more strategic in the way we spend our budget.
The other thing I wanted to mention as well is the department is undertaking a bit of an assessment of where we’re at with our level of service delivery within the department and the communities. We’re going to determine a base of where we should be at and then have a more strategic direction that we would be proposing through the minister to the members here some time in the next year or so.
Thanks Mr. Chairman.
In regard to agency nurses now, we had a medevac last week into Cape Dorset and I asked the medic how things were going and he said that they were extremely busy.
For a two-week period, they just about flew everyday into Pond Inlet once or twice a day.
He made a comment which I found a little alarming.
He was saying that he could sure tell where there are agency nurses.
So he was kind of insinuating that they made all of these trips into Pond Inlet because there are a lot of agency nurses there.
Forty-five percent of the nursing positions are still vacant and less than half of these are staffed by agency nurses.
Have the numbers changed since January of 2009 and if so, how many positions are currently filled with agency nurses, how many are filled with indeterminate staff, and how many positions are still vacant?
Chairman (interpretation): Thank you, Mr. Schell. (interpretation ends) Mr. Campbell, would you make an attempt to answer that very detailed question.
Right now, we have a total of 46 agency nurses who are currently on contract in the department.
We have 224 nurse PYs on payroll and the breakdown of that is: we have 65 in Iqaluit; in Baffin, we have 52 nurses allocated; in the Kivalliq, we have 61; and in the Kitikmeot, we have 46, for a total of 224 PYs.
Out of that, we have six beneficiaries working, we have 122 indeterminate nurses, and as we speak right now, we have 102 vacancies.
Chairman (interpretation): Thank you. (interpretation ends) Mr. Schell, you got your response?
Mr. Rumbolt, you’re up next.
According to the draft main estimates, your department plans to have a total of 987 PYs in 2009-2010, compared to a total of 940 in 2008-09.
Given the difficulties facing your department in filling current positions, why are so many new positions necessary?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) We have a number of positions that we will be creating for the continuing care centres for Igloolik as well as Gjoa Haven that are accounted in those numbers.
We have a number of PYs as well that will be created under the Public Health Strategy. I think we have a couple of public health nurses that we are going to be staffing up this year.
As was mentioned in the opening statement by the minister, there is going to be a division that is going to be established in the department, the Mental Health and Addictions Division. There’s going to be a total of five PYs there once we’re up and fully running in that division.
This year, with the proposals, we would be hiring three PYs.
So there is a number of PYs that make up those 987 PYs.
Are there any more questions for the department?
As Mr. Schell indicated, he was referring to agency nurses and I would like clarification on agency nurses.
These nurses are brought in from outside the territory at a high cost, but at the same time, we want Inuit to work at the health centres.
Who decides where the agency nurses are going to come from and who decides if we are going to be using agency nurses?
Who will be responding to this question?
Mr. Campbell, do you want to respond?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) I don’t know the exact number, but I think we have eight agency nurse contract providers that we do have down south that we contract regularly.
We have a standing offer list of, I believe, eight agency nurses and they’re the ones that we provide the requests to when we require nurses in communities due to vacancy or workload, or just to cover off when the nurses are on vacation.
So most of the credentialling of the nurses is done nationally and now, we do also have an office that do recognizes these nurses as well when they come into the territory.
Chairman: Meegwich, Mr. Campbell.
Again, in regard to agency nurses, the Government of Nunavut’s Department of Health and Social Services is responsible for nurses. These agency nurses are not from Canada.
How much has the Government of Nunavut paid to date to get the agency nurses here?
Minister Curley, can you try and answer that question?
We have used agency nurses for about four or five years. In Canada and possibly at the international level, there was a severe shortage of nursing professionals.
In the last two years, we went down to Asia to look for nurses.
But to date, we can see that the number of agency nurses is decreasing. For example, in Nunavut, we have 18 who completed the Nursing Program.
When the nurses are going to be sent to communities, they will need two years of experience. For that reason, it’s extremely hard in some of the smaller communities.
What we can say is that if we had an adequate number of nurses in Canada, we would be required to use agency nurses. We don’t want to use agency nurses, but we do have to use them in times of shortage and emergencies.
How much has it cost the Government of Nunavut to date?
I can say it was expensive.
I don’t know if the deputy minister has any specific details, but I’m sure Mr. Campbell could enlighten us.
Chairman (interpretation): Thank you, Minister Curley. (interpretation ends) Mr. Campbell, do you have anything to add?
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) I will give some of the approximate figures from the year before.
Three years ago, we spent $18 million for agency nurses.
Last year, we spent roughly $16 million, so it went down. This year, it has gone back up to about $20 million as of March 31, which is the projection right now.
So those are the current figures that I have at this point, Mr. Chairman.
I was watching APTN and there was a commercial there where there were interviews of young Inuit who had completed the Nursing Program.
They were urging other young Nunavummiut to get into the program.
I do know that the Department of Health and Social Services is trying to help the people of Nunavut and also encouraging people to become (interpretation ends) Nunavut health professionals. (interpretation) We support and I think you stated, but I didn’t see the numbers about how many Inuit nurses that we have here.
Minister Curley, if you would respond.
To your first question in regard to the Nursing Program and for your information, since Nunavut was created, we have trained 18 nursing graduates and I think it’s a four-year program.
They don’t all work here in Nunavut, so it’s creating a little glitch.
They do their training up here and then move down south to continue their careers.
So there’s a little bit of a problem there.
In regard to your question, I would like Mr. Campbell to respond if it’s okay with you, Mr. Chairman. (interpretation ends) Thank you.
Go ahead, Mr. Campbell.
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) Presently, we have six beneficiaries working in the department.
Mr. Schell would like to ask a question.
I would like to ask the minister what the current status of the boarding home contracts in Yellowknife, Edmonton, Winnipeg, and Ottawa are.
Which one of you would like to respond?
I’ll start with the boarding home in Ottawa.
The new boarding home in Ottawa was completed just about a month ago.
I guess they finished moving into the new facility.
So there is a new facility in Ottawa that’s in operation right now and the official opening is planned for later this summer.
The one in Yellowknife is currently under construction. It’s my understanding that the construction should be finished some time this summer or early fall.
As soon as the materials start arriving, they will start putting in the pilings to start construction on the one in Iqaluit.
Mr. Schell: You forgot about Winnipeg.
Chairman (interpretation): Thank you, Mr. Schell. (interpretation ends) I think that happens to be Mr. Schell’s hometown and close to your hometown, Mr. Campbell, if you want to respond to that.
Mr. Campbell (interpretation): Thank you, Mr. Chairman. (interpretation ends) For Winnipeg, we have an existing facility there and we have a current operator there.
We’re continually monitoring the facility and trying to improve some of the services that are provided in the Kivalliq Inuit Centre in Winnipeg, but we do have a current operator there.
Chairman: (interpretation) Thank you, Mr. Campbell.
Mr. Schell: Thank you, Mr. Chairman. I have one more question here.
Funding for accommodation for Inuit medical clients is covered under the Non-Insured Health Benefits Program.
The level of compensation for private households to take in medical clients as boarders has remained at a consistently low rate of $50 a night for several years.
What efforts has your department made to negotiate a better rate for private homeowners who provide boarding for medical clients?
Chairman: Excellent question, Mr. Schell.
I believe I asked that question last fall or earlier this year to Minister Curley.
I hope that the minister has a good reply now.
Minister... oh, he wants to refer it to one of his officials.
Ms. Voth.
Ms. Voth: Thank you, Mr. Chairman.