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A special review committee says Ottawa is a better choice than Montreal for the Baffin's medical services. After negotiators work out the financial details, it'll be a done deal.
ANNETTE BOURGEOIS
Nunatsiaq News
IQALUIT It's definite almost.
The Baffin health board has decided it will send patients to Ottawa for specialist services, but only if it's affordable.
Last fall the board decided to move its specialist services from Montreal to Ottawa, but NWT Health Minister Kelvin Ng asked the board to review that decision after it failed to provide satisfactory
reasons for the move during an internal health department review.
The Ottawa proposal promised improved case management in both the North and the South, which could lead to fewer southern visits and shorter hospital stays, said Dennis Patterson, the interim chair of the Baffin Regional Health and Social Services Board.
After nearly four hours of in-camera discussions late Tuesday night, board members decided to accept the recommendation of a special review committee to pursue a full-time relationship with Ottawa specialists, if it's affordable.
The committee, chaired by Joe Kunuk, a former mayor of Iqaluit, looked at proposals from Montreal's McGill University Health Centre and the Ottawa Health Services Network.
The Ottawa Health Services Network is an organization made up of several Ottawa hospitals that would provide services to Baffin residents in Ottawa and in the North.
Both proposals exceed budget
"Both the proposals were more than your board has budgeted for the coming year," Kunuk said, urging board members to have a clear understanding of the financial risk involved in the proposals.
Currently, the board hires medical specialists from Ottawa on a contract that costs either $688 per day for each medical specialist, or 60 per cent of the specialist's billings.
But that arrangement has already caused problems.
The board's chief executive officer, Ken McRury, said 50 people who arrived in Iqaluit last week to see an Ottawa specialist almost didn't get to see the doctor.
"At the very last minute, the doctor said it [the financial arrangement] wasn't enough," McRury told the board.
That's why McRury will begin negotiating with Ottawa to determine the exact cost of its service.
McRury is expected to make a report to the board within three weeks, at which time members will decide if the service is affordable. The board spends $3-$4 million of its $38 million annual budget on southern specialist services.
Long-term vision versus status quo
Kunuk said the committee agreed both Montreal and Ottawa are capable of providing the same level of medical services, but they decided on Ottawa because of the "energy" and long-term vision in Ottawa's approach.
Representatives from both Montreal and Ottawa appeared before the committee in Iqaluit last week.
"It seems to me the people from Ottawa have more long-term plans geared to Inuit," Kunuk told board members Tuesday. "McGill just wanted to carry on with what's been happening for the last 30 years."
Part of that vision, Kunuk explained, was to emphasize more social programs for Inuit, and more preventative approaches, including a program to help residents quit smoking.
"It was obvious from Ottawa they were interested in providing these services," Kunuk said "But Montreal's proposal was the service provided for the last 30 years would just continue."
Kunuk added, though, that Montreal representatives were willing to discuss what further services might be needed.
Ottawa a riskier choice
Kunuk also told health board members that the financial risk of choosing Ottawa is greater than with the Montreal service.
How much the Ottawa service will cost is the single greatest uncertainty in the Ottawa proposal.
The closure of the Baffin House patient home following a move to Ottawa for a possible April 1 start-up is another expense.
That closure could cost the board as little as $125,000 or as much as $350,000, depending on staff notices and separation packages, the board's director of finance, Gene Tomasky, told board members.
The board would not get any money from selling the building to offset this cost, since Baffin House is the property of the GNWT.
Kunuk outlined other risks, including the uncertain future of the medevac service, which is currently operated out of Montreal, and longer flights if services are offered in Ottawa.
Changes in air service
A move to Ottawa will likely mean a change in air passenger service from First Air, the airline that gets most of the health board's nearly $6 million annual medical travel budget.
The airline, the only one operating a jet service from Iqaluit to Montreal and Ottawa, currently makes four direct, non-stop flights to Ottawa a week. Flights on other days are routed through northern Quebec and Montreal.
"If the board follows through on its decision to have its health services carried out in Ottawa, there's some concerns we heard expressed here about stops in Kujjuuaq and Montreal," said First Air's eastern arctic general manager, Gilbert Normandeau, who sat in on the public part of Tuesday's meeting.
Normandeau said it's too early to speculate what changes the airline might make, but added he plans to meet with various groups to discuss what might happen.
"It's incumbent on us to consult with our other stakeholders people like the Baffin Regional Chamber of Commerce and the Iqaluit Chamber of Commerce on what exactly the impact is going to be on them," Normandeau said.
"What we don't want to end up with is a situation where helping to meet the needs of one group is going to be counter-productive to another."
The political instability in Quebec, the ever-present threat of Quebec separation, and the possible disruption of medical services to patients travelling to Montreal - reasons given for moving to Ottawa last fall were never discussed by the review committee.
Back to Nunatsiaq NewsANNETTE BOURGEOIS
Nunatsiaq News
IQALUIT Health Minister Kelvin Ng continues to fend off criticism in the legislative assembly that there's a breakdown in health care delivery across the NWT.
Kivallivik MLA Kevin O'Brien again confronted Ng with questions about health care delivery in his region. And O'Brien continues to press for a public inquiry into the Keewatin Regional Health Board's activities.
During the past several weeks, nurses in the Keewatin have spoken out through a survey about the chronic shortage of staff in health centre and the impact that's having on the delivery of health care.
"The last point of many that were registered (in the survey) is that the KRHB is a dysfunctional and terrifying organization which creates fear, panic and emotional fear in most of its employees," O'Brien said of the general feeling of nurses in the region.
Of the total number of nursing positions in the Keewatin, about 40 per cent are vacant. The number of vacancies of social services workers also stands at an alarming 40 per cent, O'Brien told the assembly.
"To ensure that once corrected, it does not occur again, we need an independent public inquiry in order to accomplish this."
O'Brien also pointed out that the nursing shortage has jeopardized the future of a mentorship program set up to help recent nursing graduates get training prior to pursuing their careers.
Ng said he's sent staff from his Yellowknife office to help the Keewatin health board get back on its feet following the resignation of the chair and dismissal of its chief executive officer.
Percy Kabloona is currently sitting in as the interim chair of the KRHB, a job that should be filled permanently within the next four to six weeks.
"In respect to the issue of recruitment and retention of nursing staff, I committed to working with the NWT Registered Nurses' Association, the NWT Health Care Association and with the department in trying to formulate a recruitment retention plan with some specific resources attached to it that the finance minister and myself could possibly put forward for our cabinet colleagues for consideration by February 15 at the latest," Ng told the assembly.
He added negotiations will also re-open soon between the KRHB and the University of Manitoba's northern medical unit.
Residents in the Mackenzie Delta are also complaining about the delivery of health care, MLA David Krutko told the health minister. And Krutko wants Ng to conduct a public inquiry into the system.
"I have been approached by the public from my communities in my riding over the Christmas holidays and they strongly suggest that a public inquiry be held on this important issue," Krukto said.
"I think the concern that the region has is because there is such a large turnover of doctors and nurses," Krutko said. "Every time they (patients) go there, they have to see a different doctor who gives them a different prescription or basically, they do not understand each other because of the cultural differences."
Krutko added his constituents have also complained of being misdiagnosed or diagnosed late.
"In regard to the large cases of cancer that seem to be in the region, where people are told that they have ulcers or they have pneumonia and the next thing they know, they have full blown cancer."
Ng said he isn't aware of any "high profile or major problems" in the Mackenzie Delta and told Krutko he won't conduct a public inquiry.
"I know that sometimes the results have not been to his (Krukto's) satisfaction in respect to some of the funding initiatives that we cannot fund all programs or quite frankly that the board itself feels that it is doing the right job in putting the dollars where they feel are the most effective," Ng said.
Baffin Central MLA Tommy Enuaraq told the minister that residents in Clyde River are also unhappy with health care delivery.
"A lot of times the nurses are working almost 24 hours a day," he said. "The community of Clyde River had asked me if I could get one extra nursing position and also one extra interpreter position for Clyde River. I had written a letter to the minister of health and social services in this matter and the minister has not replied or responded."
Ng said regional health boards, not his office, determine the number of staff within the communities.
Back to Nunatsiaq NewsNunatsiaq News
IQALUIT Deputy Premier Goo Arlooktoo says there's no reason for Health Minister Kelvin Ng to resign his portfolio.
Responding to questions in the legislative assembly last week from Mackenzie Delta MLA David Krutko, Arlooktoo said the cabinet has full confidence in Ng and his abilities.
Arlooktoo was standing in for Premier Don Morin, who was bouncing around Latin America last week with Prime Minister Jean Chretien's "Team Canada" junket.
Referring to demands made by Nunavut Tunngavik and the Kivalliq Inuit Association that Ng resign the health and social services portfolio over the recent Keewatin health care crisis, Krutko asked if the premier had discussed the issue with Ng.
But Arlooktoo as acting premier said he believes Ng has done a good job.
"I must have been asked to resign several times and so have other ministers," Arlooktoo said, provoking laughter from some members.
"[A]nd to tell you the truth in listening to members and others speak about it and raising questions and in talking to the minister of health and social services I really believe that the minister of health and social services, Mr. Ng, has done an excellent job in dealing with a very difficult situation and the government has all the confidence in his abilities in the way he has handled the situation."
Krutko then asked if there might be a cabinet shuffle in the near future, but Speaker Sam Gargan ruled his question out of order, since the question dealt with a matter governed by cabinet secrecy.
Arlooktoo also said it's unlikely that the government would issue any special statements on the matter.
Also last week, Krutko made a member's statment saying that the health care situation in his Mackenzie Delta region is also in a mess.
He said serious cancers have been misdiagnosed by inexperienced doctors and that, because of high staff turnovers, medical staff new to the North are having trouble communicating effectively with aboriginal patients.
Back to Nunatsiaq NewsBaffin MLAs Ed Picco and Tommy Enuaraq said in the legislative assembly last week that the region's teachers don't have enough money to do their jobs. Some teachers are even buying text books with their own money.
Nunatsiaq News
IQALUIT The Baffin's school system may be slowly asphyxiating due to a shortage of money to buy text books and pay teachers.
Iqaluit MLA Ed Picco and Baffin Central MLA Tommy Enuaraq raised that issue in the legislative assembly last week in a series of members' statements and questions.
But they didn't get much sympathy from Education Minister Charles Dent, who repeatedly told them that school board budgets are fixed and that there's nothing much he can do.
Picco told Dent that in recent weeks he's met with the Iqaluit Education Council, along with various teachers and parents.
"Some of the areas that need to be addressed include: lack of funding at the board level to hire extra staff to help alleviate the increased student enrolments and larger class size, the state of the curricula used and the lack of financial resources for the boards of education to implement new programs or to continue the programs now in place," Picco said.
Lack of text books
Picco said that some Iqaluit teachers are dipping into their own pockets to buy text books.
"In one case a teacher has been teaching for a long time without a curriculum or textbooks, where we have teachers buying the materials themselves out of their own pockets... That is not acceptable, Mr. Speaker, in 1998, to have teachers in the classroom having to go out and buy sets of textbooks," Picco said.
And he said Baffin teachers are having big problems implementing a new mathematics curriculum this year because many have no access to the curriculum and the text books they're supposed to use to teach it.
"There has been problems with the math curriculum, but, my God, Mr. Speaker, it cannot be possible to be in the classroom without a textbook, without the proper resources available," Picco said.
Dent responded by saying that the GNWT's education department is actually helping regional school boards carry out the new mathematics curriculum to a degree.
"The department certainly does not pretend that it contributes 100 percent of the cost of instituting the new curriculum," Dent said. "We assist the education councils to do that. One of the reasons for introducing a new curriculum is that it helps the education councils and partners to deliver a better program at the school level."
Dent: school boards must decide
Dent admitted that there have been problems with "in-servicing" and by suggesting that the introduction of new curricula may be delayed in some schools.
He also said that it's up to regional school boards to decide for themselves how best to spend the money they get from Yellowknife.
"It is then up to the divisional education councils to determine where it is appropriate to provide the supports, whether that is in the teacher-pupil ratio, whether that is in providing extra support to special needs students or whether that is in providing curricula support to a teacher," Dent said.
But Picco said that, contrary to what the GNWT says, it's not possible for educators to do more with less.
"If you are asking people to do more with less, you are going to get less done," Picco said.
Plummeting morale among Pang teachers
Baffin Central MLA didn't get any further with Dent when he complained that moral among teachers in Pangnirtung has hit an all-time low.
"There has been an increase in enrolment, but not an increase in funding to school programs," Enuaraq said. "For the last three years, there has been a drop in funding for education programs in Pangnirtung. This puts pressure on teachers to make do with very limited resources, students are not able to use programs that they were entitled to in the past."
Enuaraq also said that some teachers have lost so much income in years due to rent increases and wage cuts, they're thinking of going on welfare.
"Rent that used to be $370 is now $1,500 or even $1,600," Enuaraq said. "It is hard to maintain good staff when their salaries are not going up, but their living costs are. Local staff has been the hardest hit. Some of the local staff told me, it is better to go on welfare than teach for a living."
But Dent coldly replied that there will be no extra money to pay teachers this year.
[T]his year the average pupil-teacher ratio across the territories is 18.2 to one," Dent said. "The budget that the finance minister tabled yesterday does not envision any change in that ratio for the next fiscal year. The ratio should stay the same."
Enuaraq then asked if teachers' income could be supplemented by income support payments
"Mr. Speaker I find it difficult to think of a situation where a teacher might qualify for income support," Dent replied.
Back to Nunatsiaq NewsContrary to a report aired January 16 on CBC North, the GNWT has no plans to launch a family planning campaign this year.
Nunatsiaq News
IQALUIT Health Minister Kelvin Ng is less than pleased with CBC North.
That's because CBC's Yellowknife radio station reported several times on January 16 that the GNWT's 1998-99 budget will "include funds for a family planning campaign."
The problem, Ng says, is that no such funds exist.
"The Department of Health and Social Services was caught completely off guard, and officials placed in a position of defending a program that does not exist," Ng told MLAs last week.
"Mr. Speaker, in my opinion the reporter's actions on this story were irresponsible and consequences of his actions have been far reaching and harmful. I have personally suffered from being misrepresented on the eve of the finance minister's budget address."
Ng explained that a CBC reporter had interviewed him in November of 1997 in connection a story on the NWT's population explosion.
Ng said the reporter asked him if the GNWT had any plans to help regional health boards run family planning publicity campaigns.
"I responded by referring to the strategic investment fund Cabinet had approved and the department was planning to establish, targeted at positioning health boards to develop health promotion initiatives and programs."
But Ng said he never stated to anyone that the GNWT will include a family planning campaign in its recent budget.
"The story on January 16th used these comments and placed them in an improper context... I was not in Yellowknife on January 16, nor was I contacted by the reporter to update or comment on this issue."
Ng suggested that it may take some time to correct the erroneous information in CBC's January 16 story.
"Members of this House have been misled about the plans and activities of our government, and the public has been left with the perception we have some solution to the rapid population growth," Ng said.
Another statement soon on family planning
This Monday, however, in response to a question from Iqaluit MLA Ed Picco, Ng said he'll soon make a statement on family planning.
"[I] have already directed the department to put together a member's statement in respect to the birth rate issue and the family planning initiatives this government has undertaken," Ng said. "That statement, unfortunately, is not ready yet."
Earlier that day, Picco had urged the GNWT to start a family planning campaign, referring to the well-known fact that government revenues are not keeping up with a rapid growth in population.
"Most people are being born to younger mothers and this has increased pressure on the social envelope," Picco said.
The government should implement a territorial-wide family planning awareness campaign, and provide extra resources to communities and boards of health to address this need."
Back to Nunatsiaq NewsIqaluit MLA Ed Picco, the man who regularly challenges Finance Minister John Todd in the legislative assembly, has high praise for much of Todd's 1998-99 budget.
DWANE WILKIN
Nunatsiaq News
IQALUIT - Generally speaking, Finance Minister John Todd's last budget for the united Northwest Territories will be good for Nunavut, Iqaluit MLA Ed Picco predicted this week.
Picco lauded the finance department's plan to increase funding for a territorial food-basket program known as the Income Support Food Allowance.
And he was particularly pleased to learn that the GNWT intends to boost support to low-income families by contributing $2 million in additional funding for a new Northwest Territories Child Benefit program.
The money will be distributed by Revenue Canada and delivered in monthly payments beginning July 1, 1998, together with federal Child-Tax Benefit.
"That was one of the things I had talked about with Minister Todd, putting in some kind of tax credit for low-income families," Picco said. "He actually acted on that request, so I was very pleased to see that in there."
No new health, education spending
On the other hand, the 1998-99 budget allows for no new spending in education or health, Picco said, and it looks like GNWT employees themselves will go at least another year without a raise.
"The last time they had a pay increase was four years ago, which was 1.8 per cent, and then they suffered through the indignity of having a 6 per cent rollback in 1996," Picco said. "So I thought that Mr. Todd could have signalled that indeed, some gains have been made in collective bargaining with our employees."
On the whole, the Iqaluit MLA said he could find little to fault in what might be characterized as a conservative, no-frills pre-election spending plan.
Starting next July, all families with less than $42,000 in net income are expected to receive some financial support through the Child Benefit program.
For instance, families with net incomes of less than $20,921 per year will be eligible for a minimum of $330 per child.
In addition, families with earned income of $3,750 or more will be entitled to the Territorial Workers Supplement. The supplement will be phased in so that the maximum benefit is paid when working income reaches $10,000, and phased out as earned income increases beyond $10,000.
The maximum supplement is $605 per year for the first child, $405 for the second child and $330 for each subsequent child.
The GNWT's proposed new home-ownership incentive program shows much promise, too. But it still falls short of addressing the need to build more subsidized housing, Picco noted.
In the budget he unveiled last week, Finance Minister Todd a proposal to to spend $40 to $50 million over the next two years on programs to entice eligible northerners out of social housing and into their own homes.
"The problem is we're short about 70 social housing units in Iqaluit, alone. So that still won't fill our need," Picco said.
Back to TopBusiness leaders look forward to new opportunities building and leasing back government building projects.
DWANE WILKIN
Nunatsiaq News
IQALUIT Northern business leaders are pleased with the GNWT's plan to invite private businesses to invest in public building projects.
The move toward public-private partnerships, dubbed as "P-3s," was evident in the 1998-99 budget handed down last week in Yellowknife.
By its own estimate, the GNWT predicts that public-private partnerships will create investments of up to $100 million for each of the next two years.
That's in addition to the government's own $140-million annual capital spending program.
"There can be a lot of intellectual arguments about whether it's appropriate, socially, to have the private sector financing some of this infrastructure," says David Connelly, the president of the NWT Chamber of Commerce.
"But there's not enough cash for the government to do it all on its own, so the practical question is to have it or not to have it."
A creative alternative?
The NWT Chamber of Commerce described the move toward so-called public-private partnerships as a "creative alternative" to dependence on the mining sector, especially given the current slump in gold prices.
One form of private-public partnerships would use private money to develop large-scale transportation projects, such as deep-sea ports, airports and roads.
The government would then lease the facilities back from its private partners.
In the Baffin, the Inuit-owned Qikiqtaaluk Corporation is already negotiating such a contract to build a new regional hospital.
Financing spread out over time
The advantage of this arrangement, says Connelly, is that instead of paying 100 per cent of the cost of new infrastructure, which residents will enjoy for decades to come, financing is distributed evenly to future generations.
"It matches the expense of the infrastructure to the periods in which it's being used," Connelly said.
Greater corporate interest in large infrastructure projects can also come in the form of managment and service contracts.
This, in turn, can accelerate the transfer of technology, skills and training to the North, Connelly said.
Praise for investment tax credits
The GNWT's proposed tax-credit scheme for northern investors also earned praise from the private sector.
So did the government's commitment to encourage more private homeownership through its Accelerated Home Ownership Program, which the GNWT expects will result in the construction of 1,000 new housing units over the next two years.
"Not only are 1,000 homes good for the social side, to the extent that the components can somehow be manufactured in the Northwest Territories, and assembled in the communities, there's an opportunity there for industry, " Connelly said.
The chamber was disappointed, on the other hand, to see the GNWT still has no plans to remove the goverment's one per cent payroll tax.
According to the chamber's analysis, the tax is a expensive administrative burden, costing almost as much to collect as it generates in revenue.
"Approximately $13 million is collected, and it costs approximately $12 million to collect," Connelly said. "The economic argument is, then, wouldn't it be better to leave the $13 million out in the communities? You don't create wealth by the administration of collection."
Back to TopNunatdiaq News
IQALUIT - Here are some highlights of the GNWT's 1998/99 budget:
A Hunting Lesson
by JOHN AMAGOALIK
"Where are you guys going?" My older brother wanted to know as my cousin George and I lashed down the qamutik.
"We're going seal hunting," I answered him as I tied the final knot.
"Which way are you headed?" he asked.
"That way," I said, pointing west.
"I might see you out there," he said as he walked away. George and I hitched up the dogs and took off.
We had been travelling for just half an hour when George stopped the dogs. He took out a pair of binoculars and started scanning the ice to the south. It was the middle of June and there were plenty of seals basking and sleeping on the ice in the warm spring air.
Most of the seals were on flat smooth ice and could easily see anything approaching them.
But about a mile away we could see a group of five seals with some rough ice around them. The rough ice could be used as a screen to approach the seals for a clear close shot.
George and I flipped a coin to see who would make the first attempt. I won the toss and loaded my rifle.
I started toward the seals on foot while George prepared to make tea. The dogs were dozing in the snow.
In about 15 minutes, I was about half way to the seals. I walked crouched low and dropped to my knees every few yards whenever one of them raised its head to look around.
I was pretty young and inexperienced at stalking napping seals and was extra careful the last few hundred yards.
I crawled on my stomach until I got about 50 yards from the seals. I peeked over a ridge of rough ice and could see that the seals were unsuspecting.
I cocked my rifle and slowly raised it over the ridge of ice and took aim at the nearest seal. I was waiting for it to raise its head when I heard "Bam," "Bam," "Bam," from my left.
In what seemed like a split second, three seals lay dead and the other two dove into the water. I never had a chance to fire one shot.
I looked left and my brother stood up from behind some ice just a few yards from me. He was smiling broadly and having a little laugh. I had been so intent on the seals that I had not noticed him following me to the last half hour.
Less than a minute later, George arrived with the dogs and he and my brother had a good laugh at my expense.
A young boy had just been taught that one must always be alert and aware of what's going on around him.
Back to TopThe GNWT's last budget
Last week, Finance Minister John Todd got up to present another milestone along the long road to Nunavut.
He bequeathed upon NWT residents the last budget that a united Northwest Territories government will get to manage.
It turned out to be Todd's best budget yet. This time, he's found a little bit of money to help most of those families who have been hurt by the cutbacks he had to make in previous years. At the same time, he's still produced a small budget surplus of about $2 million.
Despite his political problems back home, while in Yellowknife Todd has done a masterful job as the NWT's finance minister. He's brought the territorial government back from the brink of a crushing deficit, and he's reduced the GNWT's long-term debt.
He couldn't have done a better job in preparing us financially for division.
First, here's the good stuff in Todd's budget:
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Last updated
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