Nunavut’s privacy boss runs into hurdles at health department

Elaine Keenan Bengts, who is privacy commissioner for both Nunavut and the Northwest Territories, told MLAs at Nunavut’s legislature Sept. 13 that a privacy audit of the Qikiqtani Hospital in Iqaluit was sometimes thwarted by upper level staff in Nunavut’s health department. (PHOTO BY THOMAS ROHNER)

Despite plenty of public scrutiny in the past year, Nunavut’s health department continues to resist improvements to its communication practices, especially when it comes to keeping and sharing health records.

That became clear when Nunavut’s privacy commissioner tried to audit the Qikiqtani General Hospital in Iqaluit earlier this year—departmental managers resisted the commissioner’s requests for information, even though the audit was backed by the Legislative Assembly.

And the department, already criticized for creating silos of information, is only reluctantly introducing health-specific privacy legislation, even though the legislation aims to improve sharing medical information for improved healthcare delivery.

All that was revealed by Nunavut’s Information and Privacy Commissioner, Elaine Kennan Bengts, who appeared before Nunavut MLAs Sept. 13 at the Legislative Assembly in Iqaluit.

The Standing Committee on Public Accounts, Independent Officers and Other Entities asked Keenan Bengts to conduct a privacy audit in the 2015-16 fiscal year on a public body of her choosing.

“I chose the Qikiqtani General Hospital for this review largely because it is a large public body which collects large quantities of the most sensitive personal information about Nunavummiut,” Keenan Bengts said in her opening remarks.

Keenan Bengts appeared before a committee of legislators to present her 2015/16 annual report and answered questions for more than three hours.

Her annual report, submitted in July to Nunavut MLAs, includes a brief summary of her privacy audit of the Iqaluit hospital, which will be tabled in the upcoming fall sitting of the legislature.

“We found that the staff and management [at the hospital] were very open and went out of their way to get us what we needed,” the commissioner said.

“The department was a bit less inviting or interested in having us there. They were a bit more reluctant. It took us more digging to get what we needed from them.”

Although the commissioner’s summary did not include formal recommendations, MLAs asked Keenan Bengts about the audit.

“Our government departments should not be obstructing any audit, when they have an opportunity to improve the way any service is run. They shouldn’t obstruct anything when the goal is improvement,” Tununiq MLA Joe Enook said.

Enook asked the commissioner for an example of how the health department was difficult to deal with during her audit.

“It took us until two weeks ago to be able to finally get an interview with the assistant deputy minister, whereas when we were here in June in the hospital, we invited her to meet with us and she couldn’t or wouldn’t—I don’t know which,” Keenan Bengts said.

And it was only through another source that the commissioner discovered and obtained a set of privacy directives drafted “some years ago.”

“We got all the information we needed in the end, but some of it came to us in a roundabout way.”

The Access to Information and Protection of Privacy Act is not well-suited for health care purposes, which is why every other Canadian jurisdiction has already implemented healthcare-specific privacy legislation, Keenan Bengts said.

Health care-specific legislation provides not only privacy protections for personal health information but allows for the exchange of that information in a timely and effective way to improve the delivery of healthcare services, she said.

“Many bureaucrats in health care see privacy as something they have to deal with because they have to deal with it, not because it’s important to deal with,” said the commissioner, adding that she meets a similar reluctance from healthcare bureaucrats in the Northwest Territories.

Keenan Bengts said health officials told her an electronic record-keeping system, called Medetech, is being rolled out to all health centres by the end of 2017.

“I don’t know whether or not that will come to fruition, but that’s what I was told.”

Health centres in Nunavut still use a paper-record-keeping system, while the Iqaluit hospital has a combination of electronic and paper systems that sometimes creates duplicate copies of records.

Keenan Bengts, who said she will retire as Nunavut’s Information and Privacy Commissioner in 2020, provided other highlights of her annual report Sept. 13, including recommendations to:

• hire a deputy commissioner and investigator in 2017 with the possible aim of establishing an Iqaluit office by 2020;

• bring local District Education Authorities and municipalities under privacy legislation as public bodies; and,

• encourage the government to undertake a comprehensive review to modernize the Access to Information and Protection to Privacy Act, which the commissioner plans to submit formal recommendations on in her 2016/17 report.

Senior government officials will appear before the standing committee Sept. 14 to answer questions from MLAs about the ATIPP Act.

The same committee is scheduled to begin hearings on the Representative of Children and Youth Office on Sept. 15.