EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
These types of things, I think, need to be addressed and looked at, to try and make it more appropriate to suit the current demands on the facility. And keeping in mind if anything is going to be done to look at trying to make it more multi-purpose because there is going to be a new facility come on. So, space is something that is always at a premium and could always be greatly appreciated.
I think you know that these are some of the things that are going into the capital planning process pretty soon.
Hopefully, that is something that is something that is going to be looked at in there.
That’s about it for now, Mr. Chairman.
I’ll have some more questions as we go along through the budget.
Mr. Tootoo. (interpretation.) Mr. Kattuk.
Mr. Kattuk (interpretation): Thank you, Mr. Chairman.
I have a very short comment to make.
I spoke on this in my opening remarks.
The people that go to the hospitals… First of all, when we were growing up we did not really think about doctors or nurses; in those days people used a lot of traditional medicine, but today we have to go see doctors and nurses in hospitals when we are not well.
These days, it goes for everybody because we want to have a healthy lifestyle and we want to be believed when we are not well and we go see the doctors and nurses.
This is what we would like to have.
We depend on the medical people even though we weren’t like that in the past, but we are used to utilizing more doctors and nurses these days.
Also, the people who escort to the hospital. When the people have to be told the escort does not really have good knowledge and he or she has to interpret for who is terminally ill and even to go so far as to how many years or months that this individual has left; in the future, when we get Nunavut, the Inuit will live a lot better.
Right now, this is not happening, especially on the health issues.
I would like to say that I am very happy that the patients are very well looked after once they go to the hospital, although there are problems at times.
I am very happy that our patients are looked after well by both the doctors and nurses when our patients go to the hospital.
Also, the interpreters, for the future, we should start stabilizing them so that they can become professional interpreters through their communities on certain subjects.
If an interpreter is not taught or trained or doesn’t have any skills, they make mistakes.
I feel that it is very important that they are taught on certain different subjects such as health, just to take courses on health issues.
I am sure that if they have proper training in place that the future would be a lot better.
Mr. Chairman, this is all that I would like to say for now, Thank you, Mr. Chairman.
Chairperson: Thank you, Mr. Kattuk.
I would like to welcome Minister Brown and her witnesses to the Committee of the Whole meeting today.
When I was campaigning for MLA, there was one constant in my campaign when I was going door to door and talking with people about health issues.
I had a long, long, long list of health issues.
It was too long to discuss today, but I promised my constituents that I would raise some of the concerns with the minister and my colleagues.
I have been doing that through letters and meetings with the minister.
I couldn’t help but note that when you are on the outside looking in, you don’t know how these things work. But when you are on the inside now, looking at the numbers, it is quite a daunting challenge that we have ahead of us.
I am looking at the numbers from the first year, and over five years the increase was almost 100 percent in health costs.
That is going to be down this year.
It is projected to be lower but we are not getting a whole lot of new monies in to Nunavut from the federal government, so the challenge ahead of us is to somehow keep the costs down.
Otherwise, you will wait three for four years that we’ll be spending 35 to 40 percent of our available monies for health, which is very important to all of us.
We have to look after ourselves and live healthy lifestyles, but if we are spending a lot of money on health, then other areas will suffer, and that could be education.
We want to educate our youth.
We want to put money into housing because all the health issues that we talked about, starting with the homes and crowded housing, which we also all saw on the campaign trail, contribute to that.
I am encouraged by the minister’s main estimates, that they are bringing the costs down this year.
I will have some questions later on; I will focus on just exactly how the minister and her officials will keep the costs down, control costs so that you don’t spiral out of control for this year and for the future years.
Chairperson: Thank you, Mr. Peterson.
We will now proceed to a page-by-page review of the departmental estimates starting on page 5.
Page H-5. 2004-05 main estimates.
You may also refer to the business plans.
This department’s business plan starts H-1.
It is just a general overview section.
It is not specific to any particular page on here.
Mr. Chairman, I noticed it shows it in the main estimates, on page two where it has the total number of PYs, it is 784.9.
In the business plan, on the financial summary on page 31, it shows that same amount for this year’s main estimates.
And then last, it showed that there was 572.4 PYs.
That is a significant increase of over 200 PYs.
I am just wondering if we can get an explanation from the minister how come when, all is said, there are over 200 more people in the department than there were last year?
Chairperson: Madam Minister.
Hon. Levinia Brown (interpretation): Thank you, Mr. Chairman. In response to your question… But I would first of all like to apologize.
I introduced my officials and I made a mistake.
I said Tony Blais, his name is Bernie Blais.
I will give the question to Mr. Blais.
Chairperson: Thank you, Madam Minister.
Mr. Blais.
Mr. Blais: Thank you very much, Mr. Speaker.
The way of comment in regard to the PYs is that last year when I took over the department in July, the department took a major review of all of its positions, basically a line-by-line review, and what we found to some extent is that there were a lot of positions for casual staffing that were being used. Basically they were not recorded as PYs.
So, we did make the major adjustments for that in the fall and I think they have numbers now that accurately reflect our expenditures, but also the numbers of people that are actually in place today.
So, I would suggest to you that this is probably the single most important factor that has shifted.
It is not that they were not there, but that they were not being recorded because we were using casual staffing patterns to address some of the shortages that you are seeing across the department, which is in the order of about 20 or 30 percent.
Chairperson: Thank you, Mr. Blais.
I am just a Chair, just to let you know.
You could ask for the Speaker’s Chairperson, and his office, with his paycheque.
Mr. Chairman, then I guess Mr. Blais is indicating that the 200, about 212, PYs that increased over the last year were actual positions that were within the department prior to last year. But just because they were vacant and being filled by casuals, they were not recorded on the other chart.
Is that the correct indication of what he is saying?
I will once again ask Mr. Blais to respond to Mr. Tootoo’s question in regard to the actual number, and what the present status is as of today.
Chairperson: Thank you, Madam Minister. Mr. Blais.
Mr. Blais: Thank you, Mr. Chairman.
With the coming on board of the two new health centres, currently I think we are forecasting 724 PYs for this year. I also wanted to mention as well that my department was in a deficit of $34 million last year.
So, again, when you look at the deficit, it is clear that the PYs were not reflected in the real budget.
I was kind of getting to my next question in that if the department had all these people working for them that they did not know about, or did not record, it is no wonder that they were so over-expended in their previous budget.
I guess it leads to the next thing on this current.
I know that there is a significant base increase to the department this year.
One: does that cover off all the funding for the additional new PYs that they’ve discovered were there? And two: does the minister feel that they have a sufficient base now, so that maybe finally this year the Auditor General won’t give us a hard time about the Department of Health and Social Services’ over-expending again?
In regard to those questions, we don’t have enough PYs in the Department of Health and Social Services.
We had a severe shortage of employees, and starting from last year we have increased the number of employees. I will have my deputy minister make a supplement my answer.
Mr. Blais: Thank you, Mr. Chair.
The question was, do we feel that we have enough of a base this year to achieve a balanced budget.
I guess that’s what I’m assuming you’ve asked me so far, and I will respond accordingly.
We’re expecting to finish this year with about a $6.5 million deficit.
Given what we know already, it would be clear in our minds that the base we currently are looking at is not sufficient enough to provide the services that are currently being provided.
The second piece to that is that if you take away the increase for the two new health centres, which is about $3.5 million for a balance of this year, as well as the $400,000 that was transferred for the status of women to our department, basically our department is looking at a zero percent increase for the rest of the budget.
So, we are not getting any increase and we know that we’re finishing at about $186.5, even with all the measures that we have put in place so far.
The other contributing factor for that is when you look at the expenditure for out-of-territory care, that’s hospitals, medical travel, boarding homes, our estimates that we’re looking at right now are at about $71.5 million on basically a $186 million budget.
So, there are some factors; as the out-of-territory component increases, we are facing cost increases which are well beyond what other provinces and territories are facing today.
Given what we know, I think realistically we know that we will not be achieving that goal this fiscal year, the way current system is configured at this point in time.
Chairperson (interpretation): Thank you, Mr. Blais.
Mr. Blais had indicated that they’re doing a thorough reviewing of the line by line and that’s when they discovered these 200-and-some people.
Can you indicate if there were any other reviews done that identified any other things that might have led to some of the possible over-expenditures or additional costs within the department in the last year?
Hon. Levinia Brown (interpretation): In response to your question, there are a lot of factors involved.
We have a high cost of expenses.
For example, medical travel outside of Nunavut is one of the major factors of the high costs.
Another factor is housing patients outside of the territory.
I’ll give the supplement to Victor.
Mr. Victor Tootoo: Thank you, Mr. Chairman.
The remaining part of the question that I understand the member is asking is about any reviews that were undertaken in the last year.
The Financial Management Board director for the Department of Finance and the Department of Health and Social Services undertook a review of expenditures of the Department of Health and Social Services sometime, I believe, in the 2002-03 fiscal year that work began.
There were a number of initiatives that were taken. And there was a report done up for FMB on the progress by both departments of the work that was done by Financial Management Board, and that report was made available to the members today, I believe, as a result of the questions in the regular members’ caucus.
In short, some of the things that the two departments looked at were staffing levels and the use of casuals, control over the expenditures that were mentioned by the minister and the deputy and the level above those, and a look at the revenues and the outstanding audits that hadn’t been completed at that time.
I think in the last fiscal year that there were five audits that were completed, in the last year-and-a-half were completed, that brought in additional revenues to the government; that was one of the main concerns as well, of that report.
I’m going to move on to something else that I talked a little bit about in my general comments and that is on retention of nurses and the recruiting of nurses.
I’m sure that we all know in our communities’ times when someone leaves and it takes a month to fill the position.
I am just wondering if the minister’s staff is going to run it through the process that they use right now when someone leaves to hire someone else; are there any thoughts at looking at shortening or quickening that whole process to allow for shorter vacancies between staffing?
Hon. Levinia Brown.
I will reroute my question to our deputy minister, Mr. Blais.
Chairman: Mr. Blais.
There are a lot of things that the department is doing and has done to address the issue of recruitment.
The most important thing that it has done is that it is focusing now on retention, that the best recruitment you could achieve is by keeping the people you have now.
The whole direction has shifted quite dramatically, as we have not done reasonably badly in terms of recruitment.
Where our challenges are is in keeping people here once we do recruit them, so that the whole energy that is being expended is really on that part of it.
The second piece of that is we do not really have a good inventory of what our vacancy rate was.
So, we undertook that survey in each of the regions, first of all to capture the numbers of vacancies that we really had, not only in nursing but in all of the other disciplines as well. And I can tell you today that we need to recruit about 146 people this year with the two new health centres as well, which is extremely high.
The other component that we’ve achieved is in cooperation with Human Resources, that we used to have to match each posting with a number, always knowing that we would have vacancies.
Now what we’ve agreed to is we will have continuous advertising for positions without the need to always match that number because we always know we need to recruit.
So, that’s another piece of what we are currently doing as well.
At the end of the month we hope to finalize… We sent out a request for proposals about a month ago or so and we are currently in negotiations for hiring an international recruitment firm to help us recruit 146 positions that we need this year, or so.
And as well, we have four recruiters in the department, and we are sending teams now to different parts of Canada as well to recruit nurses into the territory.
In the last trip that we did we were successful in bringing three new nurses here.
So again, we’re pursuing quite a lot of different strategies in order to bring that about.
Last, but not least, the retention and recruitment committee, which actually had its first meeting in February of this year and subsequently a three day workshop a few days ago, met in order to develop a strategy or some short term goals on how we could improve both our recruitment and our retention this coming year.
Those are basically the highlights of what is happening right now, as they related to that particular question.
I certainly wish your retention and recruitment committee all the success, because I know the strains of vacancies put on the staff that are there.
I want to try and limit that as much as possible.
In the minister’s opening comments she talked about a newly negotiated hourly rate for agency nurses.
I know that is something that I had asked quite a bit about in the past to the former health minister.
I’m just wondering if in regard to the nurses, physicians, and other professionals: what agreements with respect to compensation or contract payments does the department have in place with these professionals.
Yes, there is an agreement, and it is used for the nurses, but it is going to lapse. Since it is going to lapse, I’ll ask my deputy minister to respond to that.
Chairman: Thank you, Madam Minister.
They vary according to the various disciplines.
The physicians, basically… In the last year or the last six months or so, we have been able to standardize all the contracts so that they basically are all earning fairly about the same thing.
We’ve achieved that level, finally, and the contracts are all identical to some extent, so they are all under contract.
For the agency nurses, we have eight agency nurse companies that provide services to Nunavut.
We have basically negotiated what we believe are rates that are very similar or very, very close for all eight agencies, and they are all down as well.
We are presently just finalizing that process right now.
But, we are very confident that when we finish that negotiation we will be able to get services that not only reduce costs, but where our nurses that are currently working full-time won’t be upset with people coming into Nunavut earning higher salaries than they do. So, we think we’re as close as we’re going to be in helping resolve that issue.
As for other contracts, we do get some people through the northern medical unit and, for example, we have a physiotherapist and an occupational therapist in the Kivalliq region.
We fund them through that contract.
Basically, it’s something that we negotiate up front with them at the beginning of the year.
It varies from one area to the other. But the other aspect of that, of course, is that we have an out-of-territory contract committee which is currently negotiating with all four referral centres again to see whether or not we can obtain a better agreement that is more sustainable and reflective of our needs as well.
Chair (interpretation): Thank you, Mr. Blais.
Just to let the minister and her officials know, your department is very, very important because the nurses at the medical health centers work very, very hard.
I would like to recognize them for their hard work.
When you work hard, you have to, you also work hard with them.
I’m sure your department and the nurses need to get together more often.
This is so they could feel that there’s a sense of belonging to the community.
At times, we only hear complaints about the nurses.
We have to overcome that stage.
I was very pleased about those two nurses that graduated; I’m very pleased and I duly expect to see more graduates from the nursing program.
The issue that I raised in my statement is that I’d like to see some responses in regard to the referral centre to Winnipeg and Kivalliq.
I believe that there was a lack in supervision when there was a conflict of interest.
One of the referral staff for many years where that individual was working, starting from the 1980s to the 1990s… .
When her husband was working for the competition, Skyward Aviation, they won the contract.
Can you assure me that this won’t happen again?
In response to my colleague’s comment, perhaps my assistant deputy minister will be able to respond to that question.
Although I do want to respond, I’m sure my officials have more detailed information; I’m still in the learning stages and still am not fully familiarized with the department yet.
Chair (interpretation): Thank you, Madam Minister.
The issue of conflict of interest, the department and the government takes quite seriously.
If there exists a situation where any of the members feel that it’s a conflict of interest, we would most welcome that information forthcoming from the members, and would address the issue through the conflict of interest guidelines.
I would like to ask the minister: you committed to making sure that there is no conflict of interest in the staff.
If you want to find out, you can look at the records.
The individual who was working at the referral centre is the wife of the pilot.
She has no signing authority, but she evaluates the referrals for the chartering of the airlines.
That is how the case was.
There were not too many people working in Winnipeg at the referral centre.
And I am sure you know that there has been some correspondence in regard to that, the other airline was writing a letter, not to address the conflict of interest issue as a correspondence that exists.
Chairperson: Thank you, Mr. Curley.
The issue we are dealing with, I have looked into that personally and have reviewed the correspondence.
It seemed adequate and it is the first time that I have heard that the wife of the pilot was working at the referral centre.
This has never been brought to me in the past until now.
If there is such a thing happening, if there is conflict of interest, I would like to be notified.
Perhaps my assistant deputy minister can make a supplementary response.
Chairperson: Thank you, Madam.
The member, I believe, is referring to a letter from Skyward Aviation to the Department of Health and Social Services. My understanding is that the letter and the issues addressed in that letter were responded to by the department, signed off on the letter by the deputy minister.
I do not have the dates, and if there are further outstanding issues that the airline feels are not addressed, we would welcome any correspondence or communication on those issues.
I am not sure if we are getting off track a bit, but I would like to get to the 2004-05 main estimates.
I suggest to the members that each of you answer your questions through detailed questions during the page-by-page review of the departmental estimates.
Mr. Curley: (interpretation): Thank you.
I believe we are still on Directorate; we still have Bill 3 to go line-by-line.
There were decisions.
For that reason, since we are on the page of directorate, that is why I made that comment to this issue.
If it is not in this, perhaps I can contact the Speaker.
It is a fact and it is not a rumour.
I am not talking about a rumour.
If we are going to be evaluating contracts, that the spouse, my spouse, is not allowed to work, whether it be Mr. Blais or Mr. Tootoo’s wife, should not be working there, and that’s in the guideline practices.
I believe that’s why the other airline went bankrupt, because she was evaluating the referrals and she’s still working at the referral center but her husband is no longer a pilot for the airline.
Her relative is a pilot, so I’m just trying to state that this should not be a practice.
The issues that we’re discussing right now are very, very important.
As the Minister of Health and Social Services, I will review them and look into that.
Perhaps, starting from now, there is going to be a directive for this not to happen again.
Mr. Curley (interpretation): Thank you, Mr. Chair.
When there is a request for proposals for the charters, for the medevacs… As, I think, the contract ended for Kivalliq Air not too long ago.
The contract is not renewed yet; I believe the contract ended around 2003.
The department of health wanted to invite Skyward and the competition Kivalliq Air to go through a request for proposals that… I think that the issue started around March 2004. The closing date, it was very confusing.
It was dated for February.
Requests for proposals were in March and the closing date was in February.
I would like to know the reason for this.
These are two issues that we are talking about.
We are talking about emergency medivacs and also the contract in April 2003 that was awarded to Kivalliq Air, that was last year.
The question that my colleague is asking, one of my deputies will answer that question.
This was for the contract for medivacs; the contract was awarded in 2003, in April 2003.
Supplementary to the assistant deputy minister, Mr. Blais.
I must say that I’m not aware that the department sent out any RFP or requests for proposals in March or February.
Having said that, we’ll have to go back and check to see if that is the case.
At this point in time, I’m not aware of that.
I would like you to check into this.
It was for Sanikiluaq.
We asked for quotes before it was evaluated. Both of the airlines were asked for quotes, and before they reviewed it, it was cancelled.
The referral centre in Winnipeg on April 2… . It was awarded to Kivalliq Air.
I think there are just too many signing authorities by the Financial Act.