by Doug Ashbury and Jeff Colbourne
Northern News Services

NNSL (Sep 01/97) - Kivallivik MLA Kevin O'Brien has joined the list of critics calling for a public inquiry into the Keewatin Regional Health Board's decision to privatize health care.

However, the minister responsible for territorial healthcare still says no such inquiry is required, although the NWT commissioner is concerned about the situation.

Last week O'Brien called the board's decision an "outrage."

A medical services contract with the University Hospital of Manitoba's Northern Medical Unit ends Sept. 30 and a replacement service has yet to be found.

Critics also charge that some board members are in a conflict of interest over some existing board contracts.

"The minister of health and social services (Kelvin Ng) refuses to intervene and seems to have his head buried in the sand," O'Brien said Wednesday at a press conference.

O'Brien met with the NWT Commissioner Helen Maksagak, who has the power to call an inquiry, Thursday afternoon.

"I've no choice," said O'Brien. "I will be asking the commissioner to investigate the public concerns, allegations and contract practices of the Keewatin Regional Health Board, its chairman and CEO."

Reached Friday at her Yellowknife home, Maksagak said she has not had time to think about O'Brien's request, but is concerned about the issue.

She added that this is the first time she has been asked to call a public since she was appointed two and half years ago. She also expects to meet with O'Brien again within the next few weeks.

O'Brien is also calling for a review of the "derelict manner in which Ng has handled his responsibilities regarding these very critical and essential health-care concerns" and the reinstatement of the NMU contract.

O'Brien conceded the current system is not perfect but said there is no solid strategy to replace it. Severing the tie with the NMU, which is familiar with the needs of Northern patients, is a 25- to 30-year step backward, he said.

O'Brien's is the third call for a public inquiry to made in recent weeks. The first request come from the Union of Northern Workers in late July. Union president Jackie Simpson asked for the Keewatin "rat's nest" of possible conflicts of interest to be aired out.

Less than a month later, the hamlet of Rankin Inlet called for an inquiry into the health board for the same reason and because it wanted to investigate why the NMU contract was not renewed.

Prior to this request the council demanded board chair Betty Palfrey's resignation.

Meanwhile, the board is searching for another chain of medical services it can rely on. Unfortunately, the NMU won't have too many links in the new system.

Dr. Sharon Macdonald, director of the J.A. Hildes Northern Medical Unit, said several doctors will not be returning to the Keewatin to work directly for the KRHB.

"The board should not underestimate how difficult it is and how much time and energy it takes to offer these kinds of services," she said.

"There's a shortage of doctors in the Baffin and in Yellowknife. Competition for doctors is high."

Macdonald said the unit is not leaving on bad terms and staff have enjoyed working closely with the Inuit and non-Inuit for many years.

From a business point of view, however, they didn't like the way the contract was terminated. "The university and physicians are not comfortable just seeing services end," Macdonald said.

And she hinted at a potential danger to the patients when it's done in such a disorganized manner. "The abrupt ending doesn't make for an easy transfer," she concluded.

According to board chair Betty Palfrey, however, changes to medical services in the Keewatin are based on community consultation and dissatisfaction with the unit.

"A review of GP days was done over a five-year period and it was documented that each year the contractor fell short of the contracted days," said Palfrey in an open letter to the Rankin Inlet hamlet council in late July.

Another medical services audit report commissioned by the board said that the value of medical services provided was poor given that a high proportion of time was spent on medical travel and overhead.

It also stated that money was spent and employment opportunities were set up in Manitoba, not in the NWT.

The report recommended recruiting general practitioners for the region to double the physician days of service.

That is what the board is doing, but there are no signs of how or when it will be done.

The GNWT also continues to push for greater community empowerment. As a result, health boards are taking on more duties and are becoming solely accountable for their actions and decisions.

That's one of the reasons why Ng is backing the board's decision to get rid of the NMU.

Ng last week continued to reject calls for Palfrey's resignation and a public inquiry. "I don't think we're in a position to second-guess the board's decisions," he told News/North.