GN ignored report’s advice on management board for Qikiqtani hospital

In 2011, the Government of Nunavut hired Ken Lovely, a veteran territorial civil servant who is now part of the Millenium Partners consultancy, to advise them on how to restructure. But after he advised them to create a board of management for the Qikiqitani hospital in Iqaluit, they ignored it. (FILE PHOTO)

The Government of Nunavut ignored a recommendation from a private consultant in 2011 to put the Qikiqtani General Hospital in Iqaluit under the direction of an arms-length board of management.

Instead, the GN committed in November 2014 to reviewing the possible merits of such a board — but only after repeated demands from an Iqaluit MLA.

That review, scheduled to be tabled at the 2015 fall sitting, is now past due.

“The accepted mechanism for governing and operating hospitals across the country and in most developed nations is through a board of management,” says a 2011 report commissioned by the GN and written by Ken Lovely of the Millenium Partners consulting firm.

“The Qikiqtani General Hospital has been hampered by its current status as a government-run operation, and this should be corrected by placing it at arms-length from government.”

Government bureaucracies slow down the response-time that acute-care facilities, such as the Iqaluit hospital, require to operate efficiently, Lovely said.

“Hospitals must have control of their own hiring and have the flexibility to respond to emergency situations without reference to outside authorities,” his report said.

Another significant advantage of hospitals not under the direct control of a government is the ability to fund-raise as a charitable organization, Lovely wrote.

Iqaluit-Niaqunnguu MLA Pat Angnakak repeatedly pointed out these same advantages in the Legislative Assembly.

For example, fundraising would allow the hospital to secure medical equipment in a more timely fashion without having to wait for the GN’s budget cycle, Angnakak said during the fall 2014 sitting of the assembly.

And the Baffin region’s hospital would greatly improve its overall operations if managed by a board made up of people “from different walks of life… who bring their expertise, knowledge and business savvy to the operation of a critical service,” Angnakak said.

Later that same sitting, Angnakak and fellow Iqaluit MLA George Hickes introduced a successful motion to have the health department undertake a comprehensive review of the merits of a hospital management board.

Monica Ell, then the GN’s health minister, asked for an amendment to the motion — which passed — pushing the government’s deadline to table the review in the legislature to the fall 2015 sitting.

But when Angnakak asked for the results of that review on Nov. 6, 2015, the current health minister, Paul Okalik, said he looks “forward to introducing that [review] in the near future.”

The former Iqaluit hospital, which forms a wing of the newer facility, had been operated by the Baffin Regional Health Board until 2000.

That health board was one of three regional health boards that existed under the Government of the Northwest Territories prior to 1999. After division of the NWT, the Government of Nunavut dissolved the three health boards and put itself directly in charge of health and social services.

But Lovely wrote in 2011 that there are important differences between the now-defunct regional health boards and the kind of management board the Qikiqtani hospital should have.

Regional health boards “focused on bringing their community or regional concerns to the forefront,” Lovely said, while “a hospital board of management oversees the operation of the hospital and makes management decisions very similar to the way a town or city council operates.”

The regional health centres in Rankin Inlet and Cambridge Bay should continue to be overseen by the government, as these centres are not acute-care facilities, Lovely wrote.

A hospital management board for the Qikiqtani hospital would also help in the accreditation process for the hospital, and would still be accountable to the public.

“The Qikiqtani General Hospital would be placed at arms-length from government and be provided with funding through contributions. A board of management appointed by the minster of health would oversee the hospital with accountability to the public and the minister,” Lovely wrote.

The GN asked Lovely in 2011 to recommend improvements to its structure, programs and processes in order to improve efficiency and cut costs.

The 60-page report deals extensively with the GN’s chronic capacity problems.

Angnakak asked the minister responsible for human resources, Keith Peterson, during the fall 2015 sitting to table this report, but Peterson refused.

Nunatsiaq News obtained a copy of the report after filing a request under the Access to Information and Protection of Privacy Act in late 2015.