Health minister under fire
MLAs question quality of health care, called for review to be expanded
Michele LeTourneau
Northern News Services
Monday, March 9, 2015
IQALUIT
Health Minister Paul Okalik came under fire in the legislative assembly about the quality of care in community health centres and the scope of an independent external review into the Department of Health.
Three MLAs hammered Okalik with questions March 2, with Okalik repeatedly deferring to the review, which is to be completed in the fall.
"Concerns have been expressed that the scope of the independent external review into the death of Makibi Timilak is too narrow in that its terms of reference do not seem to allow for a review of the circumstances that led to the tragedy," said Cape Dorset MLA David Joanasie. "It has been reported in the news that the minister has stated that it is possible that 'more extensive work' could be done. Could the minister elaborate today on his comments?"
Joanasie was referencing the dismay expressed, when the review was announced the previous week, over the fact that the terms of reference seemed to gloss over what may or may not have happened at the Cape Dorset Health Centre that could have caused the infant's death. Rather, the scope is written to focus on what happened after, at the department level.
Okalik replied that the reviewer, lawyer Katherine Peterson, "can look at any particular aspect surrounding the failure of our health system that led to this death" if she wishes.
"We are open to providing the information, as we want to ensure a proper review with the right information at the end of the process," he said.
Asked if he was open to modifying the terms of reference for the review, Okalik said the Department of Health provided the scope and "we don't have much wiggle room."
However, in answer to a question from another MLA, Okalik said, "If you recall, last week, we announced the need to review operational issues of local health centres throughout Nunavut."
Quttiktuq MLA Isaac Shooyook told the story of a constituent who approached him about a health care concern, "which I fear is a common concern across many of Nunavut's communities about the quality of health care at our local community health centres."
Acknowledging that the legislative assembly was not the place to name specific patients or specific health-care professionals "who treated them or did not give that treatment," he said, "my constituent faced a serious medical urgency in his home community and when he was medevaced to the Qikiqtani General Hospital, the doctor who saw him there told my constituent to contact his MLA, who is me, about the quality of care at the local health centre."
Shooyook requested that Okalik clearly describe how the Department of Health monitors the delivery of health services and measures the quality of care at community health centres.
Okalik pointed to the review, saying "Once the review has been completed, I will be looking at ways to make improvements to the provision of health care."
He urged Nunavummiut with concerns to write their concerns and forward them to the Department of Health.
"We also have an office where people with concerns can call," said Okalik.
Baker Lake MLA Simeon Mikkungwak picked up the ball, saying Nunavummiut "are understandably concerned about their health, the health of family members, and their future," he said.
"Can the minister clearly explain what options are available to Nunavut residents who have contacted the patient relations office and the regional headquarter offices and discussed their situation with the nurses at the community health centre, but still cannot get a resolution to their problem."
Okalik stressed that he would be patient until the findings of the independent review into the Department of Health's procedures for dealing with complaints were revealed in the fall.
"Although that office can't provide a complete answer, they try to assist the person to address their concern as that is their job. This includes the role of nurses in the provision of health care and to look for the best practices through this review," he said.
"It seems obvious that recommendations will surface to improve the health care that is provided to Nunavummiut."
But Mikkungwak persisted, not satisfied with Okalik's response.
"Can the minister describe what measures are put in place to ensure that community health centre nurses and other health professionals deliver a standard quality of health service to all of Nunavut's residents," he asked.
In reply, Okalik thanked his colleagues for the increased Department of Health budget that will see more capacity in communities by way of "putting in place" nurse practitioners.
Okalik stated, during the barrage of questions directed his way, "that quite a number of health centres are operating quite well and I take pride in their provision of quality health care, but there are some health centres where errors occur.
"In those cases, we have to properly assess the situations that led to those errors. I share concerns about health care in cases where mistakes are made, as we have to address them to ensure they aren't repeated and to move forward."
