It's 'like having a very powerful friend standing beside you.'

After lurching from crisis to crisis for years, Puvirnituq's Inuulitsivik hospital is now under a form of trusteeship – although Quebec prefers to call the new management "close observation."

People in the Hudson Bay communities of Nunavik won't see any change when they come to the hospital or nursing stations for care, said Dr. Vania Jiminez, Inuulitsivik's new director of professional services.

But Jiminez said in the long run health delivery should improve as the hospital and health board run more efficiently and peaceably.

In May, Jiminez pleaded with Quebec health minister Philippe Couillard to intervene.

That's when Inuulitsivik was faced with a situation that Jiminez compared to an abscess ready to burst: the director of nursing had quit, along with several nurses, and the doctors were overwhelmed.

Jiminez said "a climate of mistrust" also undermined staff and management relations, and she worried this combination of few resources and tension would put the delivery of health services at risk.

Jiminez asked Couillard to help to reinstate "some order, some credibility and some trust."

Jiminez told Nunatsiaq News that Couillard didn't want to see a formal trusteeship for the troubled hospital.

Jiminez described the present arrangement as "like having a very powerful friend standing beside you and helping you check every piece and put order in the house."

But, no matter what you want to call Quebec's increased administrative role, Jiminez doesn't dispute the gravity of Inuulitsivik's problems that brought the situation to a head.

This summer, Couillard named a deputy minister, Maurice Boisvert, as an informal trustee for Inuulitsivik. Boisvert and his team of advisers, whose three members visit frequently, are working with Inuulitsivik's management and board to find long-term solutions to the hospital's problems.

The Inuulitsivik health board has 400 employees working at the 25-bed Inuulitsivik hospital in Puvirnituq as well as in health and social services clinics in seven communities along Nunavik's Hudson Bay coast and at a rehabilitation centre in Inukjuak.

Since the stepped-up assistance started, Jiminez said "things are going relatively well" and medical staffing is more stable.

Quebec now plans to invest time and money into Inuulitsivik to find ways to deliver culturally-appropriate health care, she said. Money for training local residents to take over as many jobs as possible will be part of this effort.

"We want for once to do it right," Jiminez said.

Last year, Inuulitsivik started to seriously chop costs, trim personnel and reduce its accumulated deficit of nearly $60 million, leaving staff and the public to worry how this cost-cutting would affect services.

Noah Inukpuk, Inuulitsivik's director general, said implementation of this financial recovery plan is still underway.

"But we have to be careful not to cut the services," he said.

Inukpuk said government advisers are preparing a report for the board of directors in November.

Inukpuk said Marty Croituru, a consultant who was in Puvirnituq to carry out the recovery plan, was "let go" in April.

Shortly afterwards – even before Jiminez asked the Quebec health department for help, financial experts recommended the hospital be put into trusteeship.

But financial losses and staff turmoil are not the only woes recently faced by Inuulitsivik.

The past two years have also been marked by a bitter dispute between management and the board of directors.

Last year, a Quebec judge found that Inuulitsivik's board of directors acted properly in 2005 when they dismissed from their board Harry Tulugak, a prominent Nunavik leader who faced a number of allegations of sexual harassment of female employees and financial impropriety.

Tulugak, one of the negotiators for Nunavik's new regional government, also served as interim director general of the Inuulitsivik Health Centre from August, 1997, to January, 1988, and, apart from a three-year absence, was a member of the Inuulitsivik board between 1994 and 2005.

The reorganization of the hospital now underway may re-open the door to Tulugak and former employees, such as Aani Tulugak, a former general director of the hospital as well as the Hudson Bay's youth protection services.

The move to place a hospital under trusteeship is rare in Quebec, generally made when the health and safety of patients is at stake.

Banks often ask for the courts to impose trusteeship – which is also known as receivership – as a result of bankruptcy, and it means control is handed over to an administrator or trustee as a last-ditch effort to save the business or organization.

Couillard has described trusteeship as the "an atomic bomb" – or the last resort – of a public administration, and he's only put two other hospitals into trusteeship since he became minister.

The Laval university hospital centre was put under trusteeship because a large number of doctors had quit the establishment.

And earlier this year, Coulliard put the Lower North Shore's hospital in Blanc-Sablon under trusteeship after conflict between the public and board of directors about the firing of a doctor over allegations of harassment and intimidation.

Several years ago the Saint-Charles-Borromée in Montreal was put into trusteeship after complaints of staff mistreating its handicapped clientele.

But the case of Inuulitsivik is different from these hospitals, Jiminez said. That's because someday soon Inuit, not Qallunaat from southern Quebec, will be in charge of the region's health and social services system.