Intoxication, violence, missed appointments plague Nunavik’s medical travel system
“If this doesn’t improve, the escort policy won’t be available any more”
KUUJJUAQ—Nunavik health officials are looking to revamp the region’s patient escort policy to cut back on the high costs and risky misbehaviour of hundreds of medical patients and their escorts while visiting Montreal.
Though Nunavik has two small hospitals, one on each coast, Nunavimmiut typically travel to Montreal for specialized health care services. Patients who require help with travel or translation can bring an escort, whose role is to accompany the patient to their appointments.
But statistics gathered on Nunavimmiut on medical travel since December 2016 show an alarming number of incidents, including intoxication and drug possession, violence, missed departures and even deaths reported among patients and escorts staying at Ullivik.
In 2016-17, 5,127 Nunavimmiut patients and 2,602 escorts travelled to medical appointments in Montreal, most of them to the new 143-bed Ullivik centre, which opened its doors in the city’s Dorval neighbourhood last December.
Since December 2016, event reports at Ullivik show there were 656 incidents of intoxication among escorts and 744 incidents among patients. There were an additional 127 reports of drug and alcohol possession at the centre over that same period.
“We have some rules for patients at Ullivik—no drugs and alcohol are allowed,” Ullivik’s director Maggie Putulik told Kativik Regional Government meetings last week.
“It’s not a place for threatening other patients,” she said. “Sometimes it becomes very complicated and the police have to intervene.”
Ullivik even has a sobering-up room, where intoxicated residents must stay for a time until they can return to their room.
The event report also noted 22 incidents of violence and sexual aggression among both patients and escorts, 138 behaviour issues and 143 cases of negligence, which includes parents or caregivers leaving children at the centre when they went out.
Since last year, 40 patients staying at Ullivik have missed medical appointments.
Putulik said the centre received a letter last summer from a surgeon at the McGill University Health Centre saying the doctor no longer wanted to operate on Inuit patients because of the number of patients who had missed scheduled surgeries.
Putulik said the centre has since smoothed over tensions with the hospital, though the incidents showed a troubling level of disrespect among patients and a misunderstanding of wait times within Quebec’s health care system.
Most alarming of all, two escorts have died while they were registered to stay at Ullivik over the last year.
But just this past fall, a 36-year-old woman from Puvirnituq escorting a relative to Montreal died in the parking lot of a restaurant just blocks from Ullivik after she was struck by a truck.
Montreal police investigated the woman’s death but concluded there was no criminal element.
Time for change
Already this year, 382 Nunavik escorts have been blocked from ever escorting a medical patient again.
But health officials in Nunavik say it’s time to revisit its medical policy to prevent more issues.
“If this doesn’t improve, the escort policy won’t be available any more—simple as that,” Putulik said. “It’s very costly.”
Minnie Grey, executive director of Nunavik’s health board, estimates that it costs about $20 million a year just for airfares for both medical patients and their escorts to travel from Nunavik to Montreal.
That’s not to mention the costs associated with the hundreds of incidents that Ullivik has tracked, she said.
“So we are looking at other possibilities,” Grey said. “Instead of having escorts from the North, we could have assistants on the ground.”
Grey said the health board is considering hiring “patient navigators”—Montreal-based staff, both Inuit and non-Inuit, who could accompany medical patients who require help with transport and communication.
The health board is still lobbying for a regional hospital that could accommodate more specialized medical services in the region, to avoid having to fly thousands of Nunavimmiut south every year.
Nunavimmiut have already outgrown Ullivik’s 143 beds. The health board spent about $1.3 million this past year to rent nearby hotel rooms to accommodate all of the region’s medical patients.