Nunavut MLAs scrutinize AG’s health report, grill GN officials
“We’re talking about other people’s lives! Why did you not consider them as important? Why?”
If you’re in Nunavut May 9, you may want to tune into cable or satellite television to watch what’s going on in the Nunavut Legislative Assembly.
That’s where, starting at 9.a.m, the legislature’s standing committee will continue to ask questions about Auditor General Michael Ferguson’s highly critical report on the Nunavut health department.
Ferguson told Nunatsiaq News that it’s unusual for an auditor’s report to be looked at so exhaustively, paragraph by paragraph, all 133 of them.
But Ferguson said it’s important to make sure everyone understands the report and that the health department is held accountable.
That report, tabled this past March in the legislature, looked at the situation of front-line health care professionals in seven Nunavut communities.
Among other things, the report found high turnover among Nunavut nurses and other health professionals, compounded by limited resources and training.
These issues, the report found, compromise the quality of health care in Nunavut.
MLAs discussed only three of the auditor general’s 17 recommendations on Nunavut’s health care system May 8:
• the Department of Health should ensure that appropriate orientation and training are made available on a timely basis to its health care personnel;
• the Department of Health should put in place systems to track and monitor whether its health care personnel have taken orientation and training in a timely manner and if licences and certifications are up to date; and,
• the Department of Health should, in collaboration with the Department of Finance, develop and implement procedures for assessing and tracking the performance of casual and agency nurses.
That leaves 14 recommendations left to review.
But here’s the impression from the first three and a half hours of scrutiny in the legislature May 8: the territorial health department resembles a costly cruise ship with 38,000 people, that is, the entire population if Nunavut, on board.
And, adrift in dangerous seas, it’s now scrambling to follow directions from the auditor general to find a better course to keep passengers safe.
In their examination of the report, the 10 MLAs present—who had many questions for the auditor general and health department staff who were present—were alarmed by some of the information presented.
They worried about the health indicators that show Nunavummiut are far less healthy than other Canadians: a life expectancy 10 years lower, infant mortality five times higher, a smoking rate also five times higher, respiratory disease rates four times higher and a suicide rate six times higher.
And the MLAs wanted to know what the health department is doing about these challenges and the lack of training for front-line health care workers in important areas such as medical interpretation and the operation of X-ray machines.
“We’re talking about other people’s lives! Why did you not consider them as important? Why?” Tununiq MLA Joe Enook asked the health department’s deputy minister Colleen Stockley.
While it’s not ideal to have people in positions for which they aren’t well trained, sometimes it’s better to have someone who speaks Inuktitut and lacks training than no one at all, Stockley said.
The health department asked for $5 million for training in 2017-18 and ended up with $1.6 million, she said. It’s using that to try to catch up on cultural and professional orientation, interpretation skills and X-ray operation.
Maybe when a new territorial government comes in, the health department will see more money for training, Stockley suggested at one point.
Stockley also implied that the auditor general’s work had slowed down the health department’s progress.
“We did have to spend a significant amount of our resources,” on the audit, she said, although she admitted the report’s recommendations were, “fairly reflective of what we thought they would find.”
In its 17 recommendations, the auditor general’s report also called on the Government of Nunavut to resolve capacity problems that cripple the department.
More than 500 positions—or 46.6 per cent of the department’s permanent workforce—were vacant as of Dec. 31, 2016, the report said.
During the 2015-16 fiscal year, the Department of Health spent about $16.3 million on agency nurses—nurses hired through a contractor—along with $15 million on casual employees, the report said.
But Stockley couldn’t give new figures on vacancies or retention, only that 57 new full-time nurses had been hired since last April and that a new recruitment and retention strategy, the first since 2012, is in the works.
She said she was unable to provide more details about staffing.
“We have a little bit of a fragmented system,” she said during questioning.
The health department is now developing a “model of care” framework that should indicate to health department officials what kind of staff they need and where they should be, she said.
But even now, the department is still maintaining a hand-written ledger of what qualifications its staff hold and which ones, such as First Aid training, need to be renewed—a telling example of how far things have to go to properly monitor staff licenses and qualifications.
A request for proposals is in the works to create a computerized program.
Stockley admitted during hearings that many Nunavut patients have endured many X-rays—often poorly taken by what are called “caretakers” in the report—which “were not necessary.”
Iqaluit-Niaqunnguu MLA Pat Angnakak is chairing the standing committee.
Nunavut’s Legislative Assembly is available on local televised cable and on direct-to-home satellite services on Bell channel 513 and Shaw channel 289 or 489.
You can also read the 2017 March Report of the Auditor General of Canada, Health Care Services—Nunavut here.