MLAs do four-day dump on health minister
Aglukkaq fends off numerous complaints
Leona Aglukkaq, the health minister, spent four afternoons fending off criticism in the committee of the whole and during daily question periods in the Nunavut legislature last week.
MLAs questioned Aglukkaq and her top officials about the money they’re spending and shortfalls in various services.
The most prickly discussions focused on:
MLAs Tagak Curley of Rankin Inlet North and Keith Peterson of Cambridge Bay wanted to know why the brand-new health centres in their communities aren’t able to supply the health services they are supposed to.
Curley said some very ill people still can’t receive care in Rankin Inlet’s 10-bed, $13-million health centre, which opened in October 2005. Among other things, the Kivalliq health centre was to offer palliative care, for patients who are terminally ill and cannot be treated at home.
Curley cited the case of a man suffering from injuries sustained in a beating who had to wait until 6 a.m. before receiving medical attention. Curley said he was not kept in the hospital.
“He was sent home and he couldn’t even swallow,” Curley said.
In another case, he said an elder was also sent home instead of being kept for observations overnight.
“Those individuals should be able to occupy those beds. Why is it that we are not using those beds when that facility was extremely expensive to build in the first place?”
Aglukkaq admitted the Kivalliq health centre is not a “24-7 hospital type arrangement,” although she said there had been improvements to ultrasound and radiology services, to special medical clinics and the maternity unit.
Meanwhile, the $19.5-million Kitikmeot health centre in Cambridge Bay is able to supply only 70 per cent of the services it is designed for, and cannot offer obstetrics or acute care. The centre is supposed to have four doctors and 20 nurses. Instead, it has only has one doctor, and is short many nurses.
Dave Richardson, an assistant deputy minister, said the full range of services aren’t offered because there’s no place to house the necessary staff. He said the health department needs “roughly 20 units in Cambridge Bay and Rankin Inlet” to house all new staff members.
Algukkaq said the Nunavut Housing Corp. is supposed to find this housing.
The health department is asking for an additional $256,000, which Aglukkaq said will be used to pay doctors more money to practice in Nunavut.
Patient boarding homes
The health department will spend more than $16 million this year on patient boarding homes, but numerous complaints about service continue to plague the department.
Rankin North MLA Tagak Curley said the Winnipeg patient boarding home for patients from the Kivalliq “is used as a gambling house” and that managers turn a blind eye to the gambling. Quttiktuq MLA Levi Barnabas complained about a lack of activities, such as visits to museums, at Larga Baffin in Ottawa.
Iqaluit Centre MLA Hunter Tootoo asked for a letter of apology from the health department to be sent to an eldery disabled woman who was lodged on the second floor of a motel in Ottawa (see Nunatsiaq News, March 9).
“Is it acceptable to us? No. But what other alternatives did we have?” Aglukkaq said. She acknowledged the “urgency of the situation” in Ottawa, which leads to chronic overcrowding at the Larga Baffin patient residence, and said her department is working with Nunasi Corp. to build a larger patient home in Ottawa.
Bad dental care
Rankin Inlet North MLA Tagak Curley said dentists working in the Kivalliq supply substandard care and use poor materials. He slammed Aglukkaq’s lack of an explanation. “As a minister, you have to be ahead of everything. You should have an idea of what they use,” he said.
Lack of long-term care
Tagak Curley, the MLA for Rankin Inlet North, deplored the lack of residential mental health care in his community and throughout the territory, saying “the government appears to completely ignore the plight of those with special needs.”
Long-term residential care is costing the health department $2.1 million more in 2007.
Health officials said there are 200 Nunavummiut who are receiving this long-term care outside Nunavut. Seventy patients are receiving long-term care inside Nunavut, including those at women’s shelters.
Iqaluit Centre MLA Hunter Tootoo wanted to know why the health department asked for more money last year to hire staff at the Baffin Regional Hospital after its accreditation was pulled. That’s because these additional jobs still haven’t been filled, and the hospital remains without accreditation.
The Baffin region’s health system flunked an accreditation review in September 2005 because of a long list of failings, which a report warned could lead to harmed patients, demoralized staff, and legal liability for the Nunavut government.
The report, by the Canadian Council on Health Services Accreditation, was released in the legislative assembly last March.
Aglukkaq said the GN had filled half of 26 extra jobs her department had created to improve conditions.
She said “the challenge arrived when we discovered that there was not enough space in the hospital to provide all the services which were identified in the report.” She also said the Canadian accreditation organization decided to change its standards – “so it will be more than the 18 months” before the hospital is reviewed again for accreditation.
Cost of medical travel
In 2006, 33,000 trips for patients and escorts to travel outside the territory for treatment cost the health department $16 million in the Baffin, $20 million in the Kivalliq, and $10 million in the Kitikmeot.
Aglukkaq said her department is looking at ways to reduce the cost of travel from Sanikiluaq to Winnipeg, which now runs about $15,000 per trip. She suggested patients from the islands could be sent to Iqaluit or Ottawa instead. But Hudson Bay MLA Peter Kattuk said his constituents should be consulted first.
On March 26 in the legislature, Iqaluit Centre MLA Hunter Tootoo asked Aglukkaq why Kivalliq patients and escorts accounted for more than 40 per cent of the medical travel trips last year. Aglukkaq said the numbers reflect the needs in each region, but she also said there has been “a disparity” in how the medical travel policy is implemented.
With $40 million budgeted towards medical travel, she said there is “a huge amount of money spent before we treat a sick person.”
Poor financial management?
Iqaluit Centre MLA Hunter Tootoo said financial staff with the health department are leaving through a “revolving door,” leading to poor financial management.
Tootoo said the health department’s budget of more than $225 million was “totally out of control again,” even after having its base funding increased by $20 million a couple of years ago.
The department got another $2 million last year to meet accreditation standards at the Baffin Regional Hospital, and now the department wants $10 million more for its needs, he said.
Tootoo said he had “very serious concerns” about financial controls in the department. He also questioned why 17 employees are being transferred from the health department to the finance department and whether this move would endanger their jobs.
Aglukkaq admitted the volume of accounting work took up “a lot of time and energy… with the this change and the support of the Department of Finance, we will be able to address those more accurately.”