Nunavik health officials pass stricter patient escort policy

Nunavik health officials revisited the region’s escort policy in 2017, when statistics from the Ullivik patient boarding centre showed an alarming number of incidents reported by its staff. (FILE PHOTO)

KUUJJUAQ—The Nunavik Regional Board of Health and Social Services is toughening up its rules for out-of-region medical travel.

The health board met in Kangirsuk Feb. 22 and Feb. 23 to pass a resolution that clarifies which patients in the region qualify to be accompanied on medical travel, and who is eligible to accompany them.

Health officials revisited the board’s escort policy in 2017 when statistics from Nunavik’s new patient boarding centre in Montreal, Ullivik, showed hundreds of incidents reported by its staff.

The incidents included intoxication and drug possession, violence, missed appointments and missed departures, on the part of both patients and escorts.

“The fact is that we have so many escorts that aren’t complying to the rules and regulations, and not providing support to the patients they’re escorting,” said Minnie Grey, the health board’s executive director. “It’s just too much.”

Under the new policy, Nunavimmiut who require support while travelling will still be able to bring an escort, Grey clarified.

That includes patients over 65 years of age, unilingual Inuktitut speakers, women with at-risk pregnancies, cancer patients and patients with a terminal illness.

Adolescents from age 14 to 18 can request to travel with an escort if they wish.

But patients will no longer choose who will escort them, Grey said. Escorts will be selected from a standing list of people compiled by local wellness committees in each community.

Under the health board’s previous policy, escorts had to be at least 21; now the minimum age has been revised to 18.

If patients disagree or want to make a special request, the decision will fall to the director of the health centre in the region they live, either Tulattavik or Inuulitsivik.

Both health centres must first approve the health board’s new resolution before it becomes official.

To support Inuit patients while they are in Montreal, Ullivik will be hiring a number of patient navigators—other Inuit who can accompany them to appointments and translate as needed.

Grey has pegged the cost of airfare alone for both patients and escorts travelling from Nunavik to Montreal at $20 million a year. That doesn’t include the costs associated with many of the incidents Ullivik has tracked.

Since it opened in December 2016, Ullivik has reported 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.

The event report also noted 22 incidents of violence and sexual aggression among both patients and escorts over that period, 138 behaviour issues and 143 cases of negligence, which includes parents or caregivers leaving children at the centre when they went out.

Last year, 40 patients staying at Ullivik missed medical appointments, prompting a McGill University Health Centre surgeon to threaten to cancel surgeries with Nunavik patients.

Grey said it’s too soon to say what kind of savings the health board could see from its new policy.

The health board is also 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.