Should Nunavut abolish health boards?

In appointing Yellowknife resident Dennis Patterson as interim chair of the Baffin Regional Health Board, the government of the Northwest Territories has inadvertently provided us with yet another good reason to support a good idea that most people in government have until now refused to consider.

That idea is this: That the Nunavut government should abolish its three regional health board as soon as possible after April 1, 1999.

There are those in the Baffin region who will criticize Patterson’s appointment on the grounds that he’s not a Baffin resident, and hasn’t been for years. On the other hand, there are those who support Patterson’s appointment on the grounds that his many years of experience in government 16 of which were spent as Iqaluit’s MLA will serve him well.

Both points of view, however, are irrelevant insofar as the real issue is concerned.

Health Minister Kelvin Ng is not appointing Patterson to represent the people of the Baffin region. He’s appointing him to represent the health department and the GNWT. That’s how it is and that’s how it’s always been. It’s the health minister who makes the appointments therefore it’s the health minister to whom health board chairs are accountable.

In that respect, Patterson’s status is no different than that of any other person who has served as chair of an NWT health board. Ordinary members of health boards, whether they like it or not, are in the same position, because they, too, are politically accountable only to the person who appoints them the NWT minister of health.

If you want a piece of concrete evidence to prove that such is the case, you need look no farther than at the Keewatin Regional Health Board. It’s unelected chair, Elizabeth Palfrey, has been asked to resign by many of the region’s elected leaders. The board itself has made decisions that have been denounced by most of the region’s elected bodies.

But none of that matters. Since members of the Keewatin board are accountable only to the minister of health, the minister of health may protect them for as long as it serves his interests.

Since Palfrey’s longtime business associate and political comrade in arms, Finance Minister John Todd, occupys a large space at the same cabinet table where Ng sits every day, Ng’s interest in protecting the KRHB against public opinion in the Keewatin will always be a large one.

And if the Kivalliq Inuit Association’s lawyers are right, Ng’s defence of his Keewatin health board appointees may even extend as far as violating the Territorial Hospital Insurance Services Act, and the Canada Health Act.

The most valuable lesson to be learned, perhaps, from the embarrassing problems displayed by the Keewatin and Baffin boards is that they were set up for failure in the first place.

If that’s the case, why does Nunavut need them?

As Yellowknife Centre MLA Jake Ootes pointed out in the legislative assembly recently, most Canadian jurisdictions such as New Brunswick are abandoning the idea of regionalized health care delivery. That’s because they’ve found that regional health care delivery bodies tend to create different standards of service in different regions a threat to the principles of universality and uniformity that most Canadians still demand from our health care system.

The last thing the Nunavut territory will need is different standards and systems in each of our three regions. Coppermine’s health care needs are no different than Arviat’s or Pond Inlet’s.

All the people of Nunavut, therefore, should receive the same kind of health care, delivered directly by a central authority that’s accountable to all the people of Nunavut. That means direct delivery of health care by the Nunavut territorial government’s department of health.

Under such a simplified system, elected MLAs and municipal politicians would then be expected to express the concerns of ordinary people a job that many are now doing anyway.

Lastly, the existence of regional health boards is inconsistent with current territorial government policy. Aren’t we supposed to be moving towards “strength at two levels?” That’s the slogan the GNWT used for years to explain a policy under which regional structures would disappear and all power would reside with community governments and the territorial government.

When the Nunavut Implementation Commission recommended that Nunavut’s health boards be abolished, the idea was quickly rejected.

It’s time, however, for our political leaders to take a second look at it. JB