Inuulitsivik makes cuts to stave off receivership

KUUJJUAQ – Workers at the Inuulitsivik health board were shocked to learn two weeks ago that they will pay the price for the board’s accumulated deficit of nearly $60 million.

“What will it take for the board of directors of Inuulitsivik to realize that their hospital is under siege and that their staff are falling into pieces?” asks an employee, who leaked information to Nunatsiaq News about job cuts and other cost-saving measures.

Lurching from one crisis to the next, the Inuulitsivik board has been close to collapse for years.

The latest announcement of cutbacks is just the most recent blow to Inuulitsivik employees, who in past years have suffered huge payroll errors and an exodus of management, staff and board members.

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

On March 24, Inuulitsivik employees learned Inuulitsivik’s board of directors plans to:

* cut three jobs, including a psychologist, programming agent, and nurse educator;
* transfer another psychologist’s position to Youth Protection Services;
* cut five floating positions;
* cut second on-call nurses in Umiujaq and Ivujivik;
* cut extra interpreters in Salluit and Inukjuak;
* cut two nursing jobs at the Inuulitsivik hospital;
* cut 1.5 full-time jobs at the northern module in Montreal.

Current staff loads are being re-organized so remaining workers pick up any slack, travel for training is cut in half, and everyone is being told to turn down the heat to cut energy costs.

Workers say Inuulitsivik’s board of directors repeatedly promised them that there would be no staff cuts as a result of the deficit.

They maintain the proposed cutbacks are unfair, because management positions have been added at the same time as front-line health positions are cut.

They say they’re worried that, as a result of the cuts, there will be no psychologists at Inuulitsivik and fewer nurses available to deal with urgent cases – and they claim there has been no evaluation on the impact of these cuts to health care.

“Is it by cutting the services that we will serve the population better?” asks an employee who wishes to remain anonymous “for obvious reasons.”

Staff is also up in arms over the continued presence of Marty Croituru, who, they allege, has instituted a kind of “dictatorship” at the hospital. A specialist in security measures as well as a martial arts master, Croituru was hired by Inuulitsivik’s board of directors to evaluate the roles and performance of all hospital staff.

“It feels like China or Africa around here… everybody is afraid of the dictators in place.”

Others say Croituru is well-educated and skilled in his evaluations, but that he has no pity for those who don’t do their job – be they Inuit or non-Inuit. The board of directors, they say, should be commended, not criticized for taking action.

Staff were told cutbacks are necessary because if they were not brought in, Quebec’s health department, le Ministère de la santé et des services sociaux, would step in, put the hospital under receivership, and then recommend even more severe measures.

In announcing these cuts and changes, management told staff that, with the “compression” measures to reduce expenses in place, Quebec’s health department might increase the board’s financing, refund the accumulated deficit and “our relations with the MSSS should be better.”

Inuulitsivik’s accumulated deficit was $27 million in 1999-2000. It now stands at $59 million.

This is how the deficit doubled over five years:

* Quebec’s health department gives the board a basic operating budget every year, and then Inuulitsivik prepares its budget, which always goes over the allowable amount;
* Every year, the health department officially lets Inuulitisivik continue running a deficit, but even this approved deficit isn’t enough to cover Inuulitsivik’s expenses and so the deficit grows;
* The health department has been covering Inuulitsivik’s deficit every year, but it charges interest, which adds even more money to the accumulated deficit.

Some say Inuulitsivik’s accumulated deficit would be lower if Quebec adjusted the region’s budget every year, taking into account the higher cost of operations in Nunavik.

“I think the regional health board also should be held responsible for allowing the situation for going on for so many years,” said a health professional, who asked that his name be withheld in Nunatsiaq News.

An injection of several million dollars in 2004-05 temporarily reduced Inuulitsivik’s deficit in 2004-05, but this money had only a short-lived effect.

According to charts used in the presentation to Inuulitsivik employees, with the exception of 2004-05, spending exceeded revenue by three to 10 per cent every year for the past six years.

Coming into this difficult situation is a new executive director, Noah Inukpuk of Umiujaq, who replaces Eli Weetaluktuk, who was fired last year.