EdinburghNLP/nunavut-hansard-plusplus huggingface dataset:
With that being the case, I would like to move to page H-4. We will begin the page-by-page review of the main estimates. Let us start with page H-4.
If you have any questions while I am reading the summaries, please feel free to raise your hand and the table officers will write down your names.
Branch Summary. Directorate. Total Operations and Maintenance, to be Voted. $27,280,000.
Ms. Angnakak (interpretation): I didn’t immediately agree.
Thank you to the minister and welcome to his colleagues.
My first question, and I’m just looking at your business plan just for reference under your core business, you make reference in your business plan about implementing the review of the Extended Health Benefits Policy.
Can you perhaps tell us how this review is coming along and give us an updated status on that file?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes, we will need more time in reviewing it, so we will be extending it by another year, as it is rather complex. (interpretation) Thank you, Mr. Chairman.
Can the minister explain why it’s so complex?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I will pass that off to my deputy. (interpretation) Thank you.
Chairman: Deputy Stockley.
Ms. Stockley: Thank you.
There are a number of things that need to be looked at when you look at extended health benefits.
One of the things that we needed to really delve into was a cross-jurisdictional scan, which took a lot longer to complete than we anticipated. When we got the results of the cross-jurisdictional scan of all provinces and territories, it actually became very evident that it was a very mixed bag of benefits right across the jurisdictions.
There are wide variances as to what is offered in the other jurisdictions. They can be depending the age of people who are covered.
It could be the kinds of items that are covered. It could be the kinds of health problems that are covered. It could be particular things for diabetes and particular things for cystic fibrosis.
It very much depends on the jurisdiction.
What we got in terms of our cross-jurisdictional scan was actually very helpful, but it is very complex and very deep, and we need the time to delve into it to find the right mix of benefits and the right changes that need to be done for the people of Nunavut.
I am really disappointed to hear that.
This is something I have raised in the House a number of times. It’s desperately needed.
The rates are so low. For $20 a day you give elders to go when they’re on medical travel and they don’t have their own insurance, their rates are really low.
What are you going to do in the meantime while you’re conducting this research for those who need the service now?
Hon. Paul Okalik: Yes, what we are offering will continue and at the same time, we are continuing with the work that needs to be done to make sure we come up with the best plan for our territory. (interpretation) Thank you, Mr. Chairman.
I don’t accept that.
Why does it take what everybody else has to figure out what we want? Don’t you know what the needs are here? We have elders who are in need.
Why does it take you to go everywhere else in Canada and figure this out?
Why can’t you figure it out here and take half the time?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We are doing our best to make sure we come up with the best plan for our territory. (interpretation) Thank you, Mr. Chairman.
Are you telling me that this is the very best you can do for elders right now? Is this the service that you’re going to provide them?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) No, we are trying to find the best plan for our territory for our elders in the territory. (interpretation) Thank you, Mr. Chairman.
Perhaps if I can make a request, you can request to break down this research so that if you want to find out other information about diabetes and whatever it was that you were saying, the other thing, if you can look at perhaps helping elders now that need to travel outside of this territory who don’t have insurance, can you at least address that part so that we can get something in place sooner than a year?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Yes, what we are doing is doing what we can and offering what we can for now.
We are always looking for ways to improve our services for our territory and for our residents, so we will continue to find ways and hopefully it will be done sooner than a year.
We’re trying to find something. (interpretation) Thank you, Mr. Chairman.
I understand that you are trying to do the best in research, but what I was asking for I don’t believe I got an answer. Can you look at just that portion?
Can you divide it up and look at that portion and see what you can do so that you can meet some of the elder needs now while you’re doing all that other research?
Is this possible, yes or no?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) We will need more money if we’re going to extend benefits right now. The budget that we have does not accommodate it for now, but we are open to finding ways to try and get a new plan in place within the extended period. (interpretation) Thank you, Mr. Chairman.
I am open for appropriation financial requests.
I’ll go on to my next question.
What goals has your department set in regard to your human resource plan?
I’m just looking at this from your Directorate plan where you have human resource development.
I think that over the years, there has been a lot of talk about hiring more Inuit nurses and there have been some challenges there.
What goals have you set for this area?
I wonder which section the member is referring to in her question. Is it under the business plan and, if so, on what page? Can she clarify the section she is referring to so that we can provide a faster response?
I have no idea what she is referring to.
Ms. Angnakak, can you clarify that, (interpretation ends) please.
I am reading from the business plan and it says, “Review the department’s human resources plan.”
I’m wondering, now that that is being reviewed or in the process… .
Chairman: Excuse me. Ms. Angnakak, can you give us the page number, please. (interpretation) Thank you.
Ms. Angnakak: I’m sorry.
I’m on page 105 of the business plan at the top.
It just says, “Review the department’s human resources plan,” and we are under H-4, which is the Directorate.
In the Directorate, it does say that part of the Directorate’s responsibilities is human resource development.
I’m thinking about your human resource development and I’m wondering: what is the mindset? What are you thinking?
What goals have you set when it comes to human resources, either at the hospital, to provide more services in Inuktitut, or in your department?
Can you talk a little bit more about that?
Chairman (interpretation): Thank you, Ms. Angnakak, for that clarification.
We continue to make plans and it’s an ongoing process in human resource development, particularly with respect to Inuit staff, as we are lacking there.
We continue to look at ways to hire more Inuit, but again, we need to conduct more research.
We want to complete our Inuit employment plans and to work with our existing staff to provide more training, especially on day-to-day operations. We want to ensure that we provide opportunities, especially with new training courses being developed for our employees.
My next question is in regard to human resource development.
I would like know more about what the department is doing in regard to mental health workers.
Can you tell us how many mental health workers we have in Nunavut and, if so, where are they employed?
Minister Okalik, can you answer the question, please.
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Thanks to my colleague, Minister Ell, we went through a supplementary appropriation and we now have mental health nurses in every community in Nunavut. (interpretation) Thank you, Mr. Chairman.
Can the minister tell us if that is enough? Is the need being met? Is this one mental health worker in every community?
What about Iqaluit? How many do we have here?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) It is a good start. I must say that there is a lot more to do, as evidenced by a lot of issues that we face in our territory.
In Iqaluit, there is the Akausisarvik, which has numerous workers, life skills workers, a psychiatric nurse, a youth counsellor, a manager, and we also have the Grinnell Place, which offers counselling for mental issues, so we have a number of employees here in Iqaluit.
Throughout the territory, there is a need for more and more work needs to be done. (interpretation) Thank you, Mr. Chairman.
Ms. Angnakak: Thank you, Mr. Chairman. I agree with the minister that there is a need for more mental health workers in every community.
What is the department doing to address this need?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I think it will take a lot more time to answer that, as we require more planning.
We have a good foundation here in Iqaluit.
If we can spread that to other communities, I think it will definitely assist the territory. (interpretation) Thank you, Mr. Chairman.
Chairman: Thank you, Mr. Minister. Ms. Angnakak.
Can the minister tell us if their department has a strategy in place in regard to hiring and how they are going to hire?
Do you already have a strategy in how you are going to hire more mental health workers or nurses or doctors?
Is there such a thing in place or not?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) As I said, the hiring of mental health workers is a very good start and we need to do more work.
We will take a bit more time to do more work and the work needs to be done. (interpretation) Thank you, Mr. Chairman.
Ms. Angnakak: I’m going to go on to my last question for this section.
What is the status of the Qikiqtani hospital board review and has your department conducted consultations on this issue yet?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) Not yet. (interpretation) Thank you.
Ms. Angnakak: Can the minister tell us what the expected timeframe is for this?
Hon. Paul Okalik: As she may be aware, we have a lot of pressing matters at health. Mental health is my priority. We have a bit of time in reviewing the operations of one hospital for one community.
My territory deserves a lot more help in terms of mental health. That’s my focus. That is our government priority.
I have to find a way to address that. That’s the direction I have given to the department. In the meantime, we will continue to do work on other areas, such as reviewing the operations of the hospital. (interpretation) Thank you, Mr. Chairman.
I appreciate the answer, but I must say that the hospital affects more than Iqaluit; it affects especially the Baffin and some with the Kivalliq, I believe.
An agreement was made in this House through a motion that it would be ready for the fall.
If it is going to take as much time as you are saying the extended health benefits is going to take in order to come up with a plan, I’m just encouraging you to maybe start looking at this now.
I am hoping that proper consultations can be done in the communities because they are going to be affected as well and it is the communities that have been calling for this.
They want a board in place. That is where I coming from on this.
Chairman (interpretation): Thank you, Ms. Angnakak. I didn’t really hear a question in that commentary. (interpretation ends) Hon. Minister, (interpretation) if you wish to respond, I give you the discretion to respond. I didn’t hear a specific question.
I believe it was a suggestion as opposed to a question.
Ms. Angnakak, are you done with this page?
Thank you. Mr. Hickes.
I just have a couple of things here.
To start with, with the number of the new positions that are being requested for funding, one of my written questions to the departments in the last sitting was to the Minister of Finance regarding the amounts paid to overtime for all the departments and agencies across the territory.
On average, they total a little over $20 million a year, almost $21 million a year, and over half of that comes from the Department of Health.
How does the minister see the impact of these new positions influencing the amount of overtime that is going to be expended by his department?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) These positions will definitely assist us in reducing the burden faced throughout Nunavut.
At the same time, we will continue to look for ways to reduce overtime and that will take a little bit of time.
There are labour negotiations that are occurring, so that will take a bit of time to resolve.
Those things will impact the proposals that we are working on for reducing overtime for health care workers in our territory. (interpretation) Thank you, Mr. Chairman.
Prior to moving on to Mr. Hickes, let me remind you that if you and your staff wish to speak amongst each other, it is allowed in order to ensure that there is a proper response, but be aware that you press the mute button so that we don’t hear your ongoing conversation or deliberations on the response.
You don’t have to press the mute button. I like hearing some of the background information.
Ms. Angnakak: We don’t mind either.
Just in a quick calculation, I pulled out my calculator that Mr. Peterson says I am famous for, and out of the salary just for health care delivery, which again I hate using the word “assume,” but I’m going to say it anyway, that probably the majority of the overtime comes from.
It’s 15 percent of that overall budget from last year just in overtime increases.
Now, a lot of our health care professionals, especially in some of the smaller communities, rely upon this overtime almost as an expected benefit, I’m going say, of working in some remote locations.
As you previously stated and as we all are very much aware, there are ongoing issues with filling some of these health care professional positions at the community level whereas agency nurses are being used or maybe more casual type positions are being used.
Is this going to further hinder recruiting to fill these positions with indeterminate employees?
Hon. Paul Okalik (interpretation): I apologize. I will have my deputy respond to that question.
Chairman (interpretation): I will allow Ms. Stockley to respond.
Ms. Stockley: Thank you for your question.
There are a number of components to look at when you are looking at overtime and we have been “up to our elbows” looking at ways to understand what’s going on with regard to the overtime.
In some areas, there are vacancies. Clearly, the people who are already there would be working extra hours to provide the health care that is needed because the demands to the health system don’t decrease if you have vacancies.
We’re trying to be creative in order to get people who already live in communities into various, different kinds of roles into the communities to be able to provide health care services.
That’s where we’re looking for mental health workers and we’re looking for people to be able to staff, for example, the new eight beds in Cambridge Bay.
Some of the positions that you’re seeing that Health has asked for in this budget are positions that are already filled by casuals. The work is being done and we’re just trying to give them the opportunity to have a full-time job with benefits, and so on.
Chairman: Thank you, Ms. Stockley.
I’m trying to phrase this question in my head and that’s why I’m hesitating for a moment, Mr. Chairman.
When you’re looking at expanding some of the roles, especially at the community level, you talk of hiring from within the community.
I saw an article recently talking about LPNs, or licensed practical nurses, and I happen to know a couple.
From what I understand, the level of care that they provide, in some cases, is exceptional or at least it’s equal to a lot of the nursing positions that are in the community.
Are these all nursing positions that you’re looking at putting out to the community or are there LPNs associated with that to ease in the hiring process?
Hon. Paul Okalik (interpretation): Thank you. (interpretation ends) As I alluded to in my opening comments, we’re hiring nurse practitioners and this will definitely assist us in delivering a broader service level to the communities and at the same time, definitely assist those nurses in those communities in providing service and reducing the burden that they face throughout those communities.
It’s a very good start.
We tried it out in Pond Inlet and it worked out well. (interpretation) Thank you, Mr. Chairman.
I’ll leave the overtime alone for now; I may come back to it at a future point.
One of the things also in one of the written questions that I had from the last session specifically to the Department of Health, I had asked a question talking about all the indeterminate, casual, contract, and internal assignment positions. I’ll be honest, I’m concerned.
I understand internal assignments and the necessity of bringing in experienced workers, whether they be from another department or even internally, to alleviate some of the stresses for the department, but at the same time, as they’re just internal transfers, there’s an end date to their sitting in there.
In the document that I received, there were ten positions just in Iqaluit alone. I won’t go into the other communities right now.
Of those, seven positions are at a senior level. The director of finance, the director of mental health and addictions, a territorial director of medical affairs, executive director, Iqaluit Health Services, director of support services, and senior financial analysts: these are all very senior positions within the department.
I’m just wondering what strategy that the department has to fill these positions on an indeterminate basis so that there can be some positive developments for staffing and department continuity.
We’re talking about a lot of the work that it’s taking the department and a lot of the work we’re giving you guys.
When you’re dealing with the people who are there on a temporary basis, it’s got to create challenges. What is the plan to fill these positions indeterminately?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I fully agree with you.
There’s the issue of stability that we want to assure all employees that their work is valued and that they deserve permanency in terms of indeterminate employment.
We are working with the Department of Finance to make sure that we fill these with indeterminate positions and create stability and make sure that these positions will be there for the long haul that we really need to work on.
I look forward to more indeterminate positions as opposed to internal transfers or casuals for that matter. (interpretation) Thank you, Mr. Chairman.
I assure you that I’m not trying to knock the people who are in those positions right now. I’m sure they would appreciate some continuity in their employment as well.
Along the same line, the minister brought up the use of casuals.
That was another component of the information that I had received from the minister in my written response. I’m going to use Iqaluit again as an example because that’s the community that I represent a portion of.
There are 86 casuals employed by the Department of Health and of those, I’m going to say that over a quarter of them are fairly senior positions.
You’re talking facility managers, the manager of rehabilitation, the territorial lead for long-term care and planning, the regional medical travel specialist, the health records coordinator, the mental health consultant.
The list goes on and on and on. These are, again, fairly senior positions where the level of expertise is needed.
Again, when you’ve got somebody in a casual position, there is nothing stopping them from applying for other positions, again leading to that discontinuity of service that can be provided to the directorate from their staff.
I understand that the minister, in his earlier response, was saying that they’re working towards and trying to develop more indeterminate positions, but I guess you guys have delegated HR authority.
I would like to see a little bit more action in filling these positions.
If the people who are in the positions are audiologists, I don’t know of many audiologists here in Iqaluit.
There are direct appointment processes. There are advertising and competition processes to fill these positions whereas residents of Nunavut get priority hiring. Can the minister maybe explain some the actions that are going to be happening in the near future on that, Mr. Chairman?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) I think, with this budget, we will create 16 permanent interpreter positions, for example, which were more or less casual positions.
That will help in terms of reducing the burden on casuals and creating more indeterminate positions.
In terms of the reference to Health having control over HR matters, it’s in relation to nursing only. The rest of the positions have to be worked out through Finance. It’s one area that we continue to work with Finance to make sure that we come out with the best plan for our workforce and our department.
I think that with this budget, it will definitely help us in creating more positions and more permanency. (interpretation) Thank you, Mr. Chairman.
I’m going to go to the business plan on page 104, under the Priorities (2014-15), the very last bullet on that page. It talks about exploring and developing “a framework for enhancing performance management and accountability.”
In the departmental statement, it says that the “material has been created to support managers and employees” and saying that “…job descriptions have been converted to a generic format.”
Going back to performance management, the material itself, maybe the minister could give me a little bit of detail so that I can kind of know where I’m going along this line of thought of what that performance management and accountability structure is.
Hon. Paul Okalik: Yes, we have hired a new director of human resources who has been very helpful and is working on trying to make sure that new initiatives are in place to address the higher priority areas in nursing as well as beneficiary hiring and addressing the health and safety of our workers throughout the territory. (interpretation) Thank you, Mr. Chairman.
I didn’t have a chance to go through my written response, but hopefully that is an indeterminate position.
Mr. Chairman, I would like to ask a question regarding patient relations, which I believe falls under this category, but if I could just get the Chair’s confirmation, please.
Chairman: I don’t see it anywhere else, so give it a try and let the Chair rule you out.
Go ahead, Mr. Hickes.
I wasn’t positive whether it would be under this or under Public Health, so I appreciate the leeway.
The patient relations office has been in place for a little while now.
I have sent a number of constituents and put them in contact with that office.
They’re not always happy with the response that they get, but they’re satisfied with the service that they’re given through that office.
What I would like to hear from the minister is: what kind of tracking is done on the volume of calls that office receives and what type of issues is that office predominantly dealing with?
Hon. Paul Okalik (interpretation): Thank you, Mr. Chairman. (interpretation ends) From April 1, 2014 to January 22, 2015, there were 147 concerns addressed through that office, so there is tracking that occurs. (interpretation) Thank you, Mr. Chairman.
Maybe if the minister could elaborate a little on the focus of some of those issues that are being brought to the concern of the patient relations office.