Romanow inspires hope for better health care in Nunavut

If Dr. Sandy Macdonald had an extra $2 million, he knows exactly what he’d spend it on — at least eight more doctors for Nunavut.

“In Baffin alone, I could hire four to five more family physicians right now,” said Macdonald, Nunavut’s director of medical services and telehealth.

That’s just one example of the hope that Roy Romanow’s report on the future of Canada’s health-care system has inspired among health-care providers in Nunavut and elsewhere.

Romanow’s 356-page report, which took 18-months and $15-million to complete, was tabled last week in the House of Commons.

Its 46 recommendations include a proposal calling on Ottawa to spend $1.5 billion over two years to improve access to health care for Canadians living in rural and remote regions of the country.

Romanow said part of that money should be used to recruit and retain more doctors and nurses, and that part of it should be used to develop telehealth systems.

Macdonald said that’s just what Nunavut would like to do to improve health services for Nunavummiut. One benefit of having more doctors is that more Nunavut residents would get early and accurate diagnoses of their illnesses, he said.

Another benefit is that it would relieve the constant overwork and strain that Nunavut’s current cadre of family physicians must now cope with, he said. And with better working conditions, more doctors would be persuaded to stay in Nunavut, develop long-term relationships with patients, and learn more about Nunavut’s unique health issues.

Romanow made other spending recommendations that could bring concrete benefits to ordinary people in Nunavut: $1.5 billion to purchase diagnostic devices like MRIs, $2.5 billion for primary-care delivery, and $2 billion to create a national home-care program.

But if Canada’s cantankerous provincial premiers can’t agree on a health-care reform package with the federal government at a meeting that will likely be held near the end of January, those dreams could all be dashed, and Nunavut’s Third World health-care system could continue to suffer.

“It’s just a report. There’s no guarantee that it [the money] will be there,” Premier Paul Okalik cautioned last week.

Several premiers don’t like Romanow’s insistence that provincial and territorial governments be accountable to Ottawa for the money that Ottawa gives them for health care, saying Ottawa shouldn’t use its spending power to mess around in areas of provincial jurisdiction.

For example, members of all three parties in the Quebec National Assembly voted unanimously last week to denounce the Romanow’s report as an attack on Quebec.

Quebec Premier Bernard Landry even said that Quebec might not accept more federal money if Ottawa insists on dictating how it would be spent. That means there’s a chance that Nunavik residents may not ever benefit from the Romanow report’s recommendations.

But Okalik, who will represent Nunavut at that potentially historic federal-provincial-territorial gathering next month, will take a different position.

He, and Nunavut’s health minister, Ed Picco, each said last week that Nunavut supports most parts of the Romanow report, including its powerful affirmations in favour of a single-payer universal health-care system for Canada, and its criticisms of private, for-profit health care.

But Okalik said other barriers that must be overcome before Nunavut may benefit from new federal health-care spending are Ottawa’s per capita method of distributing money, and Ottawa’s indifference to the recognition of Inuit as an aboriginal people.

To deal with the first barrier, Nunavut will ask for “base” amounts based on need, with an additional amount distributed per capita.

This is intended to avoid a repeat occurrence of the pittance that Nunavut received in September 2000. The territory got only $3 million out of an annual federal health funding increase of $4.5 billion.

To the deal with the second barrier, Okalik said he will continue to insist that Ottawa treat Inuit with the same generosity as First Nations.

“I will be taking the same position that I acknowledged before. We should not be treated differently and get less benefits than other aborginal peoples of Canada,” Okalik said.

So if Okalik can get that message through the din of what could be a nasty, noisy federal-provincial turf war, Nunavut residents may one day get the improved health services they hope for.