Nunavut’s health boards must go
Nunavut’s regional health boards are an idea whose time has passed.
At its earliest opportunity, the Nunavut government should abolish them, and place Nunavut’s health care system under the direct control of Nunavut’s Department of Health and Social Services.
At the same time, employees of Nunavut’s three health boards should be absorbed into the health department, and if necessary, reassigned where their skills are most needed. Each of the former health boards would then operate under the direction of a regional superintendent of health and social services, who would report directly to Nunavut’s deputy minister of health and social services.
In eliminating the three health boards, the people of Nunavut would not lose any power or control over the health care system. Health board members are not elected by the communities they are supposed to represent. They are appointed by the territorial minister of health, and are therefore accountable only to the health minister.
This is not self-government. This is a cynical neo-colonialist illusion that has outlived whatever usefulness it may have once had.
Nunavut will soon have 19 democratically elected MLAs, along with a premier and cabinet who will require the support of those MLAs to hold their jobs. It is Nunavut’s elected MLAs who ought to represent the people of Nunavut in health care issues, not appointed board members.
In losing the three health boards, the people of Nunavut would gain a health care system that is simpler, easy to understand, and under the direct control of Nunavut’s elected government.
When things go wrong, the public will know who is accountable: Nunavut’s elected MLAs and cabinet ministers. They will know who to complain to, and who to lobby: Nunavut’s elected MLAs and cabinet ministers.
If it turns out that your MLA doesn’t handle health issues to your satisfaction, you can use your voting power to elect a better MLA next time around.
At the same time, the Nunavut government, and its health department administrators will still need advice on how best to run the health system. Elected MLAs, and in some cases, elected community mayors and municipal counselors can provide that advice.
At other times, they may need the advice of those who specialize in health and social issues, especially health care professionals. One option that the Nunavut government should consider is the creation of a Nunavut-wide health advisory council.
Such a body should include representatives from the health care and social work professions: nurse practitioners, midwives, doctors, public health workers, social workers, and counselors; a representative from the Nunavut Social Development Council; and at least one representative from each of the three regional Inuit associations.
This body should meet at least three times a year, in each of the three regions of Nunavut. They should meet in public, and they should be directed, and encouraged, to pass resolutions advising the government on long-term health and health-related social issues. Members of the Nunavut health advisory council should receive no honoraria — just travel and simple expenses.
It’s crucial that Nunavut’s health department pay greater heed to the valuable opinions of those who actually know how to provide health care. Those opinions are rarely heard in our health care debates, mostly because health care professionals know they are likely to be severely disciplined by petty officials who don’t even know the difference between an IV and a catheter.
This week, we have witnessed the latest in a long series of embarrassing fiascos to befall Nunavut’s health boards: the near financial collapse of the Keewatin’s patient home in Winnipeg.
Let this fiasco be the last. The people of Nunavut deserve better. JB