Baffin board to start talks on Ottawa medical service

ANNETTE BOURGEOIS
Nunatsiaq News

IQALUIT ­ It’s definite ­ almost.

The Baffin health board has decided it will send patients to Ottawa for specialist services, but only if it’s affordable.

Last fall the board decided to move its specialist services from Montreal to Ottawa, but NWT Health Minister Kelvin Ng asked the board to review that decision after it failed to provide satisfactory

reasons for the move during an internal health department review.

The Ottawa proposal promised improved case management in both the North and the South, which could lead to fewer southern visits and shorter hospital stays, said Dennis Patterson, the interim chair of the Baffin Regional Health and Social Services Board.

After nearly four hours of in-camera discussions late Tuesday night, board members decided to accept the recommendation of a special review committee to pursue a full-time relationship with Ottawa specialists, if it’s affordable.

The committee, chaired by Joe Kunuk, a former mayor of Iqaluit, looked at proposals from Montreal’s McGill University Health Centre and the Ottawa Health Services Network.

The Ottawa Health Services Network is an organization made up of several Ottawa hospitals that would provide services to Baffin residents in Ottawa and in the North.

Both proposals exceed budget

“Both the proposals were more than your board has budgeted for the coming year,” Kunuk said, urging board members to have a clear understanding of the financial risk involved in the proposals.

Currently, the board hires medical specialists from Ottawa on a contract that costs either $688 per day for each medical specialist, or 60 per cent of the specialist’s billings.

But that arrangement has already caused problems.

The board’s chief executive officer, Ken McRury, said 50 people who arrived in Iqaluit last week to see an Ottawa specialist almost didn’t get to see the doctor.

“At the very last minute, the doctor said it [the financial arrangement] wasn’t enough,” McRury told the board.

That’s why McRury will begin negotiating with Ottawa to determine the exact cost of its service.

McRury is expected to make a report to the board within three weeks, at which time members will decide if the service is affordable. The board spends $3-$4 million of its $38 million annual budget on southern specialist services.

Long-term vision versus status quo

Kunuk said the committee agreed both Montreal and Ottawa are capable of providing the same level of medical services, but they decided on Ottawa because of the “energy” and long-term vision in Ottawa’s approach.

Representatives from both Montreal and Ottawa appeared before the committee in Iqaluit last week.

“It seems to me the people from Ottawa have more long-term plans geared to Inuit,” Kunuk told board members Tuesday. “McGill just wanted to carry on with what’s been happening for the last 30 years.”

Part of that vision, Kunuk explained, was to emphasize more social programs for Inuit, and more preventative approaches, including a program to help residents quit smoking.

“It was obvious from Ottawa they were interested in providing these services,” Kunuk said “But Montreal’s proposal was the service provided for the last 30 years would just continue.”

Kunuk added, though, that Montreal representatives were willing to discuss what further services might be needed.

Ottawa a riskier choice

Kunuk also told health board members that the financial risk of choosing Ottawa is greater than with the Montreal service.

How much the Ottawa service will cost is the single greatest uncertainty in the Ottawa proposal.

The closure of the Baffin House patient home following a move to Ottawa for a possible April 1 start-up is another expense.

That closure could cost the board as little as $125,000 or as much as $350,000, depending on staff notices and separation packages, the board’s director of finance, Gene Tomasky, told board members.

The board would not get any money from selling the building to offset this cost, since Baffin House is the property of the GNWT.

Kunuk outlined other risks, including the uncertain future of the medevac service, which is currently operated out of Montreal, and longer flights if services are offered in Ottawa.

Changes in air service

A move to Ottawa will likely mean a change in air passenger service from First Air, the airline that gets most of the health board’s nearly $6 million annual medical travel budget.

The airline, the only one operating a jet service from Iqaluit to Montreal and Ottawa, currently makes four direct, non-stop flights to Ottawa a week. Flights on other days are routed through northern Quebec and Montreal.

“If the board follows through on its decision to have its health services carried out in Ottawa, there’s some concerns we heard expressed here about stops in Kujjuuaq and Montreal,” said First Air’s eastern arctic general manager, Gilbert Normandeau, who sat in on the public part of Tuesday’s meeting.

Normandeau said it’s too early to speculate what changes the airline might make, but added he plans to meet with various groups to discuss what might happen.

“It’s incumbent on us to consult with our other stakeholders ­ people like the Baffin Regional Chamber of Commerce and the Iqaluit Chamber of Commerce ­ on what exactly the impact is going to be on them,” Normandeau said.

“What we don’t want to end up with is a situation where helping to meet the needs of one group is going to be counter-productive to another.”

The political instability in Quebec, the ever-present threat of Quebec separation, and the possible disruption of medical services to patients travelling to Montreal – reasons given for moving to Ottawa last fall ­ were never discussed by the review committee.