Health care sees the biggest boost in Nunavut’s 2020-21 budget
Spending on medical travel expected to grow by $17.6 million
The Department of Health is seeing the biggest spending boost in the Government of Nunavut’s 2020-21 operating budget, which was tabled on Wednesday, Feb. 19, in the legislative assembly.
“The real focus on this budget is families and communities, foster care, shelters, and family violence, and different initiatives that we’re looking at,” said Finance Minister George Hickes in a budget lockup before the document was tabled.
The GN expects to spend $2.35 billion in the upcoming fiscal year. Of that, it’s allocating $37.9 million of new funds to the Department of Health.
The biggest single budget item is a $17.6 million boost to the medical travel fund. Spending on medical travel will grow from $90 million to $107.6 million.
Officials at the lockup said that the cost of medical travel has been increasing at a rate of 10 per cent per year, on average. Last fiscal year the medical travel budget was around $90 million, but just over $100 million was spent.
“The $17.6 million is specifically targeted to address the increased demand,” said Jeffery Chown, the deputy assistant of finance. “It’s not targeted for changes in the programs to make it more effective or efficient.”
Demand is increasing because of population growth, but also for other reasons: Nunavummiut are living longer and diagnostics are getting better, which means patients need longer terms of care, according to officials at the lockup.
The same officials said it’s always a balance between the costs and benefits of flying Nunavummiut out of the territory for care, versus increasing services so they can remain in the communities for treatment.
To increase capacity in the territory, $630,000 is being set aside to hire another registered nurse, an ultrasonographer, a central sterilizing room technician, and a “hospital maintainer” in Iqaluit.
$854,000 more will go towards hiring new staff to build community capacity to treat tuberculosis. Three public health nurses will be hired for Resolute Bay, Baker Lake and Chesterfield Inlet, and three public health assistants will be assigned to Arctic Bay, Sanikiluaq and Whale Cove.
Again on the theme of budgeting for out-of-territory services, $5.1 million is allocated to mental health treatment outside Nunavut. Officials at the budget lockup said the money is used to send clients to facilities that best suit their needs, and the locations happen to be out of the territory.
Hickes says that figuring out how to provide adequate health care in Nunavut is an ongoing challenge.
“With 25 remote communities and two million square kilometres—you guys have heard it all before,” Hickes said. “Providing health care across that vast of a geographic footprint is massive. It stretches our capacity.”
Housing is another perennial challenge for the territorial government. In the upcoming year, $6.4 million is going towards paying for the operation and maintenance of government staff and public housing, for things like renovations and fuel costs.
None of that is for new units.
In terms of actually creating new services for Nunavummiut with funds from this budget, $2.6 million is being set aside to plan and build four new shelters in Gjoa Haven, Pond Inlet, Baker Lake and Pangnirtung.
This comes out of an $8.4-million boost to Family Services for homeless shelters and family violence and youth crisis programs.
In addition, $2.1 million will go towards hiring four new workers to plan the opening of shelters in Kugluktuk and Rankin Inlet, to the operation of the low-barrier shelter in Iqaluit, and to homelessness outreach services.
Six new RCMP members will be hired this fiscal year, and six next, with $1.5 million allocated to that.
This money will also be spent to hire four Inuktitut-speaking RCMP dispatchers, meaning that after they’re hired there will be an Inuktitut-speaking dispatcher available 24 hours a day, seven days a week, for the first time in Nunavut’s history.
“The step to provide additional funding just shows how important this is,” Hickes said in the budget lockup.
The dispatchers will be based in Iqaluit, providing territory-wide services. When they start depends on when the competitions for the jobs are complete.
Per diems for families who take foster children are increasing for the first time since 2004. To determine per diems, each community is divided into one of four zones:
- Zone one will increase from $43 to $58 per child per day.
- Zone two will increase from $45 to $60 per child per day.
- Zone three will increase from $47 to $62 per child per day.
- And zone four will increase from $50 to $65 per child per day.
Which community is in what zone has also been rearranged. The changes will come into effect on April 1 of this year, and at that time the information about which zones communities are in will also be available, according to Chown.
Other items highlighted in the budget include the following:
- $1.9 million to enhance the Financial Assistance for Nunavut Students program (FANS).
- $1.5 million to enhance airport operations.
- $900,000 to hire new staff under the tuberculosis community capacity-building program.
- And $300,000 to develop a mine training strategy.
Of the territory’s anticipated $2.35 billion in revenue, the vast majority—$1.837 billion—comes from the federal government, which is 4.3 per cent more than last year. But it’s not enough, Hickes said.
“The good news is that we have gotten much better at using every federal nickel that we get our hands on,” Hickes said in his budget address to the legislative assembly. “We just need more of them—something we will discuss with the Government of Canada as we move forward.”
Hickes also said that the territorial government has got better at how it spends the money it does get from the federal government, and at finding alternative revenue sources, such as by signing third-party agreements.
This budget projects $2.33 billion to be spent on operations this upcoming fiscal year, with a $50-million contingency fund. Assuming the contingency fund is spent, the GN projects an operating deficit of about $30 million.
Hickes said it’s not a comfortable feeling to plan to spend more money that the government will make, but he said that it will allow the GN to meet the growing need for better programs and services.
“We are really focused on families, really focused on communities,” Hickes said in the budget lockup. “We recognize that Iqaluit is not the epitome of Nunavut; I’ve often said my job as minister is to give the staff the money to do their job.”
Hickes added that some days he does his job better than others.
This budget is now before the legislative assembly for approval.
Money for this and money for that.
Meanwhile, prices go up for everything, but GN employees have been working without a contract for the past year and a half.
When will the Nunavut Employees Union call a strike?
If NEU wants to strike today they should have started it 1.5 years ago. That’s how long it takes for anything to get done in that Union. Speaking from an Education background, can’t imagine the other departments are any better… GO Edmonton Football GO
Municipalities left with no new increase in 4 of the last 5 years despite a long promised municipal finance review started 5 years ago but never completed
great stress on municipalities
Increasing the budget for medical travel is a reactive policy that assumes the GN can do little or nothing to keep people healthy in their home communities without having to send people for treatment in the south. Yes the population is getting larger and older; but that does not explain the thousands and thousands of our people that are so sick they need southern hospital diagnosis and care.
In fact pretty well all of the other budget announcements above follow this trend.
A happens, B needs to be done by GN to respond, therefore there is a cost C.
The problem is that unless you do something different, A will always keep happening, you will always have to do more B, and the cost C just keeps going up and up.
What really needs to be done and what would come from a mature government is that government act to influence current affairs to avoid problems that require more government intervention.
Alaska and Greenland share similar geography, social settings and government responsibilities as Nunavut. In these jurisdictions, spending in the social envelope is lower, and it is not because problems are ignored. It is because problems are avoided. Governments in these parts of the Arctic have been around long enough to see ahead of the problems.
Before A happens, Government does B to address it, spending less C.
It is a tall order to get GN head space to this point. The GN has a huge influence on life in Nunavut and there is no reason for them to simply take life as it comes. The public should push every budget time, that at least one new spending provision be geared to be proactive.