Ed Picco on Health and Social Services Budget: Full Text

OPENING COMMENTS FOR THE DEPARTMENT OF HEALTH & SOCIAL SERVICES BUDGET 1999-2000

Mr. Chairman and Honourable Members of the Legislative Assembly, I am pleased to present to you the 1999-2000 Main Estimates for the Department of Health and Social Services.

I would like to introduce:

Mr. Ken MacRury, Deputy Minister and Ms. Rosemary Cooper, Assistant Deputy Minister

INTRODUCTION

Health and social services is important to all of us and to each of our families. This department faces a range of issues that affect every person every day across Nunavut. The 1999-2000 main estimates reflect a departmental move towards a promotion and prevention oriented delivery system in Nunavut. The department, in partnership with communities, families and individuals is striving to create a system that is more reflective of Nunavut realities and responsive to the people of Nunavut.

THE BUSINESS PLAN

The business plan we submitted outlines critical issues facing the Department of Health and Social Services. We face serious challenges in addressing these issues. The changes required will not come easily and quickly, although we have taken early steps in making the required changes to the department. I will mention at this time that the amalgamation of the three Regional Health and Social Services Boards into the department is a step in the right direction, which the members of this house have supported.

Our business plan contains a vision which calls for the department to deliver programs and services that are:

People oriented;
Culturally sensitive;
Provide for a continuum of care;
Provide a seamless service;
Is sustainable over the long term;
Builds responsibility in individuals, families, and communities, and is;
Prevention-oriented.
The health status indicators for Nunavut are best described as being dramatic. Nunavut faces a great challenge in improving the health status indicators and I know with time we will make changes that will improve the status of health in Nunavut. I believe that the creation of Nunavut is an opportunity that must be used to initiate health and social service reform.

Our approach to health and social service reform uses a community development approach. To achieve successful community development we will initiate healthy public policy. To achieve Inuit employment targets mandated in the Nunavut Land Claims Agreement, we will initiate a long term strategy for the training of Inuit health and social service providers. This will result in service delivery that reflects the culture, values and beliefs of the majority of our population. In order to achieve this we require partnerships with other departments, non-governmental organizations, volunteer organizations, communities and others committed to the wellbeing of Nunavut residents.

It is important to realize that Nunavut is experiencing a rapid population growth with approximately 50% of the population under 25 years of age, a situation unique in Canada. Individuals in this age group place the highest demands on health and social services. We must be in a position to meet these requirements.

We need new ways of doing things in Nunavut. Health and wellbeing require approaches and ways of delivering care that go beyond illness, hospital and professional services. We must see a shift from acute care services to health promotion and prevention of all illnesses. We need to enhance Community Based Initiatives that utilize and integrate Inuit Qaujimajatuqangit with contemporary knowledge, modern science, community wisdom and local solutions. Integrated and comprehensive prevention and promotion efforts are required.

In Nunavut we require a modern information technology system. Nunavut comprises 24% of Canada’s landmass. As you all know we are required to deliver services in 26 widely dispersed communities. Through technology, we have an opportunity for creative responses to service delivery, education of health professionals and learning from each other. We must also provide the opportunity for quality care, cost-effectiveness and very timely services delivered over vast distances. The technologies of Telehealth applications will realize substantial financial savings over time.

Heavy demands will be placed on the available financial resources of the department and of this government by:

An increasing population;
A focus on integrated prevention and promotion efforts;
Acquisition of new diagnostic tools, and;
Acute care services.
The challenges we face in the Department of Health and Social Services are extensive. We are building a competent professional, integrated team that will deliver the very best service to the residents of Nunavut within available resources. I trust that this Assembly will look favourably on the Budget that I am about to present.

THE BUDGET

The Health and Social Services Budget is divided into two main categories: Operations and Maintenance (O&M) and Capital.

OPERATIONS AND MAINTENANCE

The budget for the department is detailed on page 10-3, which indicates our total operation and maintenance budget is $117,427,000.

Our original budget request was based on a detailed analysis of the requirement to provide an enhanced service to the residents of Nunavut. The reduction from the original request was based on the realities of the amount of funds available to all departments and to the government of Nunavut as a whole. We will try to minimize the impacts on service delivery to the best of our ability while living within the allocated amount. However, this may result in a budget that requires a significant increase over time.

The Operations and Maintenance Budget is divided as per the pie graph on page 10-3. You will note that primary and acute care programs account for 50% ($59.8 million) of the budget. These programs are currently delivered by the 3 regional health and social service boards.

An additional 27.7% ($33.2 million) is allocated to health care insurance, which in reality, are also primary and acute care expenses generated outside of Nunavut, by the Iqaluit Hospital and by fee-for-service doctors. These are paid by our government under the Health Care Insurance Program.

The directorate of the department is currently composed of 15 positions out of a planned total staff complement of 72 and 40% of the current staff are Inuit. All of the expenses associated with these positions, including such things as travel, office supplies, computers, telephones, are within the 10.6% ($2.6 million) allocation. We also include in the directorate some program delivery expenses, which are delivered directly from headquarters.

Community Health programs at 8.2% ($9.7 million) and Childrens programs at 3.5% ($4.2 million) round out the total Operations and Maintenance budget.

CAPITAL

The Department of Health and Social Services has a small Capital Budget, totaling $2,188,000. There are a number of capital projects that fall within this budget and we will provide more detail about those as we progress.

The Department of Health and Social Services is working with the Department of Finance in constructing a Health Centre in Arviat this year. This project is being financed as a P3 project and will not be reflected in our Capital budget.

CONCLUSION

Mr. Chairman and Honourable Members, this concludes the formal part of my presentation today. We will be pleased to answer any questions you may have about the budget for the department of health and social services. I would also welcome your comments on how we will work together to build a stronger health and social services system in Nunavut.