EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
Mr. Chairman there was a couple of questions there.
First of all the funds that are dedicated to the purchase of tele-health, a million dollars, that's for the purchase of the equipment, the installation and technical support for tele-health.
After saying that there are potential opportunities that Mr. Barnabas for the establishment of part-time indeed full-time positions for tele-health co-ordinators at the health centres which will become the new tele-health site and there's also job opportunities being created here.
On the specific question on physicians and doctors one of the reforms you're seeing taking place across Canada with primary care and primary health care Mr. Chairman, is to move actually from doctors specific.
Doctors don't make you better, doctors treat an illness, if you are sick you go see the doctor.
The focus should be more upstream and Mr. Chairman, that's what we are trying to bring here in Nunavut.
It's going to take some time, it's going to take several years and an investment of money to be able to build that capacity at the local level.
There is a doctor right now as you know in the High Arctic covering off several of the Member's communities from Pond Inlet and we are quite excited about that.
If there is an opportunity to place another doctor in one of our communities, we would take advantage of it but it hasn't presented itself.
As the member knows we do have a doctor in the High Arctic and it seems on all accounts to be working out very well.
Chairperson (Interpretation): Thank you.
I thank the minister for his response and his support and the doctor has been well supported.
I do not have too many questions at this time but I plan to ask some more later on I'll leave it to the other Members.
My question will be this, I know this was discussed concerning doctor training.
Are you honestly preparing to have university available where students can take medical studies for medical professions.
Mr. Chairman I'd like to thank the Member for his question and maybe an opportunity to clarify what was said that we are right now as the Member knows and this House knows is training nurses.
Full fledged nurses who will work in our health centres and that's taking place right here in Iqaluit at Nunatta Campus at Arctic College.
A question was asked by one of the Members on doctors, are we training doctors for Nunavut.
I would have to say no, we are not training doctors for Nunavut.
Doctors have to be trained and go to universities in the south.
We don't have a degree graduate university for medical sciences in Nunavut indeed there are relatively few in southern Canada.
However, I did say that any student who wanted to, who chose medicine as a career I know there are a couple from Nunavut actually pursuing medicine in the south.
That opportunity is available to them with student financial assistance and the other programs that we have in place from the Government of Nunavut and indeed from some of our land claim organizations so, I hope that helps verify the question asked by my honourable colleague.
It is so nice to have clear and precise responses and he is not just trying to be difficult to give us his responses.
That being the case anyway concerning medical practice, I think we can create educational and medical studies and not just leave them to the southern institutions.
We have many patients that need to travel and this consumes many dollars and we leave many our dollars in the south.
If you look at it in the long term I think we have to strategize now when things continue to inflate operation maintenance costs continue to inflate.
I think we should look at this in the long run and maybe support this at this time.
I would encourage the minister to seriously consider providing adequate medical practice, training, and that was my comment.
Chairperson (interpretation): Was that a question.
It was not a question, Mr. Picco if you wish to respond.
Hon. Ed Picco: I couldn’t agree any more with the member.
I can honestly say that as Minister of Health and Social Services for the Government of Nunavut it has at times been a very difficult role.
I appreciate the fine comments from my colleagues and the good natured fun and ribbings that sometimes occurs with me in particular.
So, I appreciate that and I agree and concur with the comment given by the Honourable Iqaqrialu from Uqqumiut.
Chairperson (interpretation): Anymore general comments, questions.
Next we have Mr. Puqiqnak.
Mr. Chairman I would like to ask questions of the Minister and his department concerning patients that need to travel to medical facilities especially from the Kitikmeot specifically the Nattilingmiut area.
I've seen for myself the patients that have to travel on medical it is a necessity for them to travel away from their communities to see doctors or specialists.
They are given an itinerary as to their travel dates and their return dates, they are escorted to the airports, and they can stay or be met by the people at their destination. However, many times I have seen that there is no space on the aircraft for the patients to return home on and this had been ongoing for a long time.
This has also been voiced many different times especially in the two communities that I represent.
I do not know if we can make any improvements.
I am wondering Mr. Chairman why there is always a shortage of seats for patients that are travelling.
To this day, in fact some of these patients are not in the fittest condition and this keeps happening to them is it probably because the patients are being put on standby by the departmental staff members.
They are always left behind.
Mr. Chairman first we did talk a little bit earlier today about the travel and the medical travel in particular referral at some escort travel.
One of the things that we are trying to put into place Mr. Chairman, is tele-health were we wouldn't have to send someone out to be examined by a doctor. They could stay in their community and be hooked up and see the doctor long-distance as an example of what we have been accomplishing in Pond Inlet.
So, we are hoping to bring that forth but that doesn't solve the problem that the Member is talking about right now, but what does solve that Mr. Chairman, is what we have been talking about earlier in regards to a question asked by Mr. Iqaqrialu on the escorts.
This morning, Mr. Chairman, I was reviewing the policy that we will be bringing in.
That's why I was a little bit late coming into the House.
With our senior people I sat over dinner and lunch with some of the people that are sitting with me right now to review that policy again it's a comprehensive policy, quite thick.
It was the first opportunity I had to look at it and it addresses some of the serious issues the Member has just brought up.
But if there is a specific incident Mr. Chairman, where someone was left behind like, in 99.9% of the cases with the Department of Health and Social Services our tickets are full fare tickets so, our people should not be left behind.
As you know, if the plane is full so if there's specific incidences where a patient was left behind unless that patient needed to be sequestered away from other people joining them in seats or if there was a medical condition that had to keep the person behind.
There may be extenuating circumstances but if there's actually a specific incident where one of our patients was left behind and other people flew and we had that brought forward I would take it upon the Department of Health and Social Services to investigate that situation.
As for patients who require medical apparatus, I have not noticed it with any of those patients.
But the point is that they travelled to medical facilities and they get to stay at the Kitikmeot boarding home while they are in transit.
Many people have told me that they have to wait until they can get space on the plane.
They are going to be on standby at the airport and if that's the case then they would have to go back to the boarding home and I hear this quite regularly still, even to today.
I am wondering could it be the airlines that are bumping off the patients because if you indicate they have full fare these problems should never occur.
These patients would be sure to get on the aircraft.
It seems to me the airlines are getting more powerful as they maintain a monopoly.
Hon. Ed Picco: Mr. Chairman I don't know about the specific cases the Member is talking about and that's why we asked to address it.
But we could look at for example Mr. Chairman, what could cause a person to be bumped.
When a person is medivaced out of their community of course in many cases we don't know when they are going to return so they only have a physical return ticket that says they are leaving on a Monday and coming back on a Wednesday.
The airlines on the other hand have flights booked Mondays and Tuesdays and Wednesdays and most people would have a return portion of their ticket.
So that might be a situation where someone shows up at the airport after finishing their medical appointment on a Tuesday and now they show up to leave and go home on Wednesday and other people have tickets too.
We have no control over if the airline bumps people off.
Now if the person was coming back and needed to get back to the community in most cases we found the airlines are quite conducive and try to facilitate that.
With specific incidences of being left behind I am aware of some of them being brought to my attention on further review we found that the planes were full or in the case that I just explained where they didn't have a return ticket for a specific date while the other people did.
So it would be like me showing up at the airport, Rosemary is ready to go home and she has a ticket and my ticket says that I am leaving today and she says well I want to leave today too but hers doesn't say today it's just an open ticket. So they put me on and not her because Rosemary has an open ticket and mine has a specific date.
That sometimes happens Mr. Chairman.
But if it was habitual and it was happening a lot and it was a concern, like I said if the member knew what the specific incidences and came forward with that I could go to the airlines and say here is a specific person and a specific date and a specific flight number to address that specific incident Mr. Chairman.
In the Natillik area specifically in the two communities, I have not counted the numbers but if you want statistics I can go back and get them together.
These are comments that I am making through people talking to me or hearing it on the radio there's too much of it going on.
I will give you the numbers if you should need them and also if it's possible I will give you the number of the people who have been bumped so I'll have evidence.
Just a comment Mr. Chairman.
Mr. Chairman just to confirm what the member is saying. I take the issue very seriously and it would help me that when I go back to the airlines to be able to say this person on a specific date on a specific flight number was bumped and they had a ticket.
If I just go to the airline for example and say well I hear that you are bumping people from Hard Luck Bay and they are not going into Tough Luck Harbour at a certain time or a certain location they would be able to answer to that, to that type of innuendo.
But if I'm given a particular flight numbers and dates and so on then that's something that the airlines themselves can check into and we could find out exactly what the situation is and hopefully rectify it.
So, I thank the Member for his suggestion in bringing that issue forward.
Mr. Chairman I have a few questions I guess one, my first question, I noticed in the Minister's opening comments on page 3 it talks about the introduction of financial bonuses for indeterminate nurses.
During the session in Rankin, I raised the concern of staff at the hospital that were excluded from its bonus system.
At the time I asked both the Minister of Health and the Minister of Finance, or Human Resources if something could be done on that. I would just like to ask the Health Minister if he has tried to find a way to address those issues that were raised in Rankin.
Mr. Chairman the Member brought up I think, a very serious issue and concern that I have also heard from the people in the community with regards to the bonus being paid out to the nurses.
Under the current collective agreement, I understand there is a mechanism there for a market rate supplement to be paid where a particular occupation is considered to have a shortage of that position or occupation or profession.
You can introduce a market rate to be able to secure, retain and recruit particular individuals in through that said profession in this case, Mr. Chairman, the profession of nursing has been acknowledged to be experiencing short falls in staffing and the hirings and availability of individuals to work.
Therefore and thus fits the description of the MOU for market supplement in the collective agreement and therefore and thus the money was paid out, the bonuses were paid out brought forward by the Department of Health and Social Services.
We paid out to enact the opportunity or the mechanism under the collective agreement to pay the nurses said bonus.
After saying Mr. Chairman, we are also following along the lines of what the GNWT has done with the same market supplement and the other jurisdictions.
The problem with that as the member rightfully points out, was that some of our senior people were working at the hospital for example here in Iqaluit who have been there for in some cases over 20 years and were not eligible for that bonus because they did not fall under the collective agreement description of a nurse. They were As or Certified Nursing Assistants.
I'm aware of that, the Minister of Human Resources is aware of that, and the Member had asked me questions on it in Rankin.
I had an opportunity to speak to the Minister of Human Resources about it my understanding is the discussion have to continue with the Nunavut Employees Union on the opportunity to have them include in the M.O.U. if that was agreed to.
That is where it is that is my understanding.
Maybe later with the Minister of Finance who is also in charge of the Human Resources to clarify that area.
Mr. Chairperson I know that many professions and fields and I do not know if it is recognised in the collective agreement but most job descriptions or ads that go out for recruitment indicate equivalencies will be considered.
I think I know in a lot of other fields and I am not sure if it the case if this a case where it could also be applied as a fact if say an C.N.A. have been working for in the area like the Minister indicated over 20 years.
Whether that would qualify that experience would qualify to bump them up to a different level.
I believe that was the thrust of the discussion we had in Rankin Inlet.
Again I would like to ask the minister if he has pursued that avenue with the Minister of Human Resources.
Hon. Ed Picco: Thank you, Mr. Chairperson.
Mr. Chairperson under the designation for registered nurse and you have to be registered with a nursing association and have done the academic as well as the OJT and other areas of expertise and training and technical knowledge to became an RN or registered nurse.
In the case of the CNAs there is also qualifications to be a C.N.A. After seeing that the collective agreement is very specific in its M.O.U. and under the market supplement availability with it is designation of the profession whether the market rate would be paid out.
That has been and still is the stumbling block Mr. Chairperson to be able to pay the same bonus to the CNAs or to the people that the Member is referring to.
I know the Minister of Human Resources is aware of this and has been looking at it.
My understanding is Mr. Chairperson the Nunavut employees union through the collective agreement whose the legal agent of choice under the collective agreement is to bring that argument forward to the government.
That is where it stands.
Again Mr. Chairperson I think it is fair to say that in no way that this government tried to circumvent those dedicated employees that we have at the hospital who has been there for several years.
They are friends of mine and I know that they are dedicated.
It is just one of these situations where under the current collective agreement and the exercise of the M.O.U. that was in place.
That designation fell through the cracks.
Like I said my understanding is it is in the hands of the Nunavut employees union in co-operation with the government.
We have to address it but again some clarification at a later point from the Minister responsible for collective agreements in Human Resources may be available.
Mr. Tootoo: Thank you, Mr. Chairperson.
If I understand the minister correctly, due to the collective agreement it is not really his responsibility or the government's responsibility to do anything about it.
It is something that the union will have to negotiate as part of the collective agreement.
So the minister has not really taken any steps to try to solve than other than let them know that something that has to come from the union.
My next question is regarding the P-3 initiatives.
In the media the other day the minister indicated that they could be possibly be starting the construction of the new Baffin regional hospital in Iqaluit and possibly in 18 months.
Is there any indication if it is going to happen.
I would have imagine within this next year and see some expenses to that and I am just wondering or why that is not included in the Minister department under his budget.
Thank you, Mr. Chairperson..
Chairperson (interpretation): Thank you. Mr. Picco.
I want to make it perfectly clear that the market rates were brought forward because of the pandemic shortage of nurses not only in this jurisdiction but also in other jurisdictions.
We have to compete with other jurisdictions and when they put a market rate in place we did the same thing to stay competitive in this market place.
The situation regarding the CNAs and we have only three or four about right now.
I do not want to sound callus but there was no mechanism in place for them because there is not a shortage.
And if we went ahead to designated the CNAs and I think the concern would be not only the government from the union itself is how would you handle other occupations who might say we did not get it.
The bakers, the candle stick makers, the electricians.
After saying that the m ember is correct, the discussion had to take place between the representative of the employees which is the union and the government.
That M.O.U. that is in place for our market rate supplements the one that was in place with the Government of the Northwest Territories as in place with the Government of Nunavut.
I appreciate the question on the hospital.
There is some confusion. I want to be able to once and for all say exactly what is happening with the P-3 hospital facility.
If you bear with me Mr. Chairperson, I will try to give a full briefing on it.
Mr. Chairperson years ago in 1988 there was a health transfer from the Federal government giving the responsibly for all health and welfare and the nursing stations to the Government of the Northwest Territories.
There was an agreement signed to do a renovation on the Baffin regional facility, which was built in 1962, and the Inuvik hospital facility.
Now with division Mr. Chairperson having been moved forward, the cost of that facility and over the last few years as the MLA for Iqaluit along with Mr. Barnabas and other Members of this House.
Some of the Members sitting in this House were mayors.
We have attended meetings, we have been trying to push forward the Baffin regional facility.
It was built in 1962 and at the time the population in Iqaluit was about 800.
It has more then quadrupled in that period of time.
The Baffin region population has grown from 3 thousand to 15 thousand people.
So there is no doubt in anyone’s mind that you need some type of enhanced facility here in the Baffin region.
The problem we run into Mr. Chairperson is the cost.
The total cost of the facility which about ballpark figure of 25 million.
That is the figure we are working on.
The agreements that have been discussed over the past few days are the reimbursement agreements to get onto the next stage of the project.
In the P-3 project the Baffin regional health and social services board along with the Keewatin health and social services board and the Kitikmeot health and social services board with the Government of the Northwest Territories had chosen the developers of choice being our own regional development corporations.
The next step in the Baffin region is to do some work on the lot and do some feasibility engineering studies.
That is the agreement that was signed off.
So the reason for no budget in the Department of Health and Social Services because under the private public partnership that money is brought forward and paid for by the development corporations.
So there is no money within the budget to do that from the government of Nunavut because the Qikiqtaaluk Corporation has paid for that money in this case.
In this part of the phase other things have to happen.
There has to be a program and functional review.
An architectural review, the design of the building, and then Mr. Chairperson a business case has to be brought forward saying OK this is the building you want.
This is the size you want.
Here is the cost what it is going to be.
That decision has to be made then if you move forward.
So when we talked about the time frame what we are saying is if everything worked perfectly Mr. Chairperson we might be looking at construction in 18 months, maybe 29 months, maybe 36 months.
It depends on how things go.
So that is what we were trying to explain in the reports and I hope that brings clarity. I have tried to make it short Mr. Chairperson.
That was a recapitulation of the 13 years of history here.
I tried to keep it short.
I hope that helps the Member and our media friends and the people watching at home.
The explanation on this project.
I was going to ask the Member if he could repeat part of his answer there.
I think I will pass on that one and move on to my next question.
My next question Mr. Chairperson deals with medical travel.
I believe I heard something again in the media.
In the recent past it had to deal with patients who travel to either outside their community for medical reasons.
Whether it be medivac or appointments with specialists or anything like that.
And if they either come here or go to Ottawa or Churchill or Winnipeg or Yellowknife or Edmonton for their travel.
If there delayed due to weather.
Say for example a person from Pond Inlet was suppose to go home on a flight yesterday and they tried to get in and the plane ends up not to be able to get to Pond Inlet or any other community and have to return back to Iqaluit.
Who is responsible for looking after those individuals when they come back here and they are dumped off the plane.
Is it still the responsibility of the department of health.
Thank you, Mr. Chairperson.  Chairperson (interpretation): Mr. Picco.
This has come up over the past several weeks and months.
Let us use Iqaluit for an example.
A patient who has been in Iqaluit for hospital and then flown back to their community and let us say Hall Beach.
The weather in Hall Beach is out and they come back to Iqaluit and they go back to the boarding home and the boarding home is full.
What happens.
When most cases Mr. Chairperson as you know there are several homes, mine being one of them Mr. Chairperson where we take boarders for home-stays for patients that are travelling between our communities.
That is right Mr. Chairperson, it is not the money it is just to be there to help people.
So that is what really happens.
The airlines in most cases for example First Air, my understanding is that you know you take that chance yourself.
If you are to get into a community, there is no way, you take that chance at your own risk, and they do not provide accommodations although at times they may provide a meal ticket.
So that is what usually happens Mr. Chairperson is when you come back we will take care of you if can not stay at the boarding home then we have a list of available boarding homes.