Amagoalik controversy rooted in dissolution of health and social services boards

Dennis Patterson

Recent news stories about a beloved Inuit elder John Amagoalik seeking support from the Government of Nunavut to return and remain home in his autumn years drew me back to 1999: the first months of the promising new Nunavut government, in which we all had so much hope.

What happened in 1999 which may have led us to this situation?

Well, the first major law of the new Nunavut government proudly led by Nunavut’s first Inuk lawyer, then-premier Paul Okalik, was the Boards of Management Dissolution Act, which with one stroke, without consultation, dissolved all three existing regional health and social services boards in the brand new territory. (Disclosure: I was Chair of the Baffin board at the time this drastic decision was made — the only non-Inuk member of our 13-person board.)

Those boards were dominated by respected Inuit elders from every community in each of Nunavut’s three regions. We had been well trained in governance — the Carver Model — by the N.W.T. government and had done good work in four previous years under the Government of the Northwest Territories until being abruptly told we were no longer needed by the brand new Nunavut government.

In the Kitikmeot, the board had successfully pushed for a new regional health centre in Cambridge Bay that provided elder care to keep elderly residents in their homeland.

In the Kivalliq, the health board oversaw the first midwifery program to allow women to give birth closer to home, reviving traditional practices.

In the Qikiqtani Region, the health board made the bold decision to move southern medical services from Montreal to Ottawa, removing an additional language barrier for Inuit patients from Nunavut’s largest region. The board also chose the site and functional program which reflected Inuit values — for a new regional hospital, retaining and renovating the old hospital for administrative support.

Health boards run mostly by Inuit helped make those big decisions happen.

So in 1999, soon after the establishment of the shiny new Inuit-led Nunavut government, I remember Inuit board members being incredulous that their new government would do such a thing without even consulting them, instead relying on a quick and dirty desktop study by a now-defunct colonial federal agency — Consulting and Audit Canada — which justified that extreme action as a cost-saving measure, even though we all knew that the vast bulk of the budget was tied up in nurses’ salaries and medevac costs.

That reckless decision to dissolve the health boards also disrespected a condition of the transfers of health services from the federal to the territorial government in 1988. When Health was transferred to the GNWT  from the federal government, federal health minister Jake Epp made it a condition of the transfer that the territory had to agree to create health boards to ensure community input.

So when respected Inuit from communities in all three regions of Nunavut heard that their new government no longer required their advice, it was surprising and devastating.

I never understood why the new Nunavut government would deprive itself of the very valuable traditional knowledge of those respected (mostly) Inuit who served on those boards, representing each one of Nunavut’s communities in each region. Instead, the government promised to establish advisory local health committees in every community, which never materialized.

Our duties overseeing the operations and developing policies for health and social services in our regions were then taken over  by a well intentioned but utterly overwhelmed Nunavut minister of health and social services, originally from Newfoundland, who was married to an Inuk from Qikiqtani.

Even though he promised to be accessible, being the first one in his office at seven every morning, it was too much even for one workaholic and sincere minister to run those very important and culturally sensitive departments. He was overwhelmed by those huge responsibilities and ended his political career, exhausted,  after only two terms.

The negative impact of that inexplicable decision by the government of Paul Okalik is still felt  to this day and I believe is reflected in the current uncertain situation of John Amagoalik.

Would an Inuit-led health and social services board have ensured the provision of required homecare for a respected Inuit elder statesman?

If Inuit-led health boards had been allowed to continue instead of being dissolved in 1999, would they by now have revised budgetary priorities and programs and established new policies and programs to support homecare for Inuit elders wherever possible?

The Hon. Dennis Patterson represented Nunavut in the Senate from 2008 to 2023. He was premier of the Northwest Territories from 1987 to 1991, and played a key role in the Nunavut land claim agreement.