Nunavut had a choice
When called upon to provide health care to Palluq Manning of Cape Dorset, the Government of Nunavut had a choice.
They could have chosen to treat him, for instance, like a human being.
But common sense and compassion, as it so often does, eluded the Government of Nunavut. Instead, they chose to treat him as a cost-centre, an inconvenient financial burden fit only to be transported to another place, dumped onto another government, then forgotten.
In a June 27 letter that GN officials are either too gutless or too stupid to own up to, a health bureaucrat by the name of Wayne Govereau told Manning that his current predicament “requires you to become an Ontario resident and therefore qualifies you to be financially supported under the Ontario system.”
Is that so?
Manning was last medevaced to Ottawa less than a year before the letter was written, in mid-July, 2004. At that time, he appeared to have already been under Nunavut’s care for a substantial period of time, even though he spent most of his time in Ottawa. Between 2002 and 2003, he was able to stay at Larga Baffin, a privatized patient home in Ottawa paid for by the Nunavut government. There, he recieved outpatient treatment for his failing kidneys, and occasionally returned home to Nunavut. For a period of time in 2005, he again stayed at Larga Baffin.
For at least two years, Manning resided mostly in Ottawa and Nunavut took responsibility for all or most of his care. But all that changed last July, when Manning collapsed into a coma while visiting Iqaluit and was medevaced to Ottawa, where he remained unconscious for about seven months.
After emerging from his ordeal, during which his bowels burst and he suffered three heart attacks, Manning discovered that his ailing body had become too inconveniently expensive for Nunavut to maintain any more. He needs access to an expensive dialysis machine to do the work that his kidneys cannot do for themselves. He needs a regular supply of colostomy bags. He also needs a secure place to live, and transportation several times a week to get to and from his medical appointments.
He also discovered that his home territory wants nothing to do with him anymore.
On the surface, Nunavut’s decision to dump Manning onto the Ontario health care system appears to be legally correct, and, conincidentally, points up yet another serious weakness in the land claim agreement. “All of the benefits you would receive through your Nunavut Land Claims Agreement status would only cover you if you lived in Nunavut,” Wayne Govereau said in his letter.
But that doesn’t explain how or why Nunavut was able to pay for Manning’s care during much of the two-year period prior to his last collapse. It was only when he was unconscious, and unable to comprehend what was being done to him, that Nunavut officials decided to wash their hands of him.
It doesn’t explain why he had to pay $2,400 for medically necessary colostomy bags – on a disability income of $700 a month. On the face of it, that particular blunder looks like a violation of the Canada Health Act.
And it doesn’t explain why numerous other Nunavut residents are able to stay in the South for many years as long-term care patients – at Nunavut’s expense.
The evidence suggests, therefore, that Nunavut assumed a duty of care, and then reneged on it. To us, that sounds like a dereliction of duty that’s worthy of a lawsuit.
To be fair, health care is the most difficult service that the Nunavut government is required to provide. Nunavut’s population is one of the unhealthiest in Canada, and costs, especially for patient travel, are enormous.
At the same time, Nunavut health officials are under constant pressure to control those costs. The health and social services department now eats up more than one-quarter of the GN’s annual budget. For the 2005-06 fiscal year, the department expects to spend $240.6 million. You can count on that figure ballooning to at least $260 million, or more, by next April. It always does. And there’s never quite enough money.
And there are no clear answers to the constitutional question of who should assume the fiduciary duty to pay for Inuit health care. The federal government’s Non-Insured Health Benefits program, or NIHB, is supposed to take care of people like Manning – but in his case it didn’t.
But those realities don’t excuse the callous manner in which GN health officials treated Palluq Manning.
As a diabetic, and with a pair of kidneys that are nearly dead, Manning needs a proper diet to survive. Right now, staff at Nunavut’s Baffin Larga are forced to break their own rules just to feed him. And all sick people need rest and a secure place to live. Manning, however, is homeless – and no one from either Nunavut or Ontario seems able to find him a place to live.
The Nunavut government has a rare talent for inflicting painful embarrassments upon itself. In this case, its blundering has brought an ailing man to the brink of suicide, and his friends to say things like “They don’t want to help Inuit.”
It’s sad indeed to see that the territorial government that Inuit surrendered their aboriginal title for in 1992 is now so eager to abandon its own people. JB