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Health system check-up: Third party to examine Nunavut health operations

The Government of Nunavut has hired a consultant to redesign its healthcare delivery system. The territory will pay Health Intelligence Inc. of Toronto $472,500 to rework the department of Health’s “Model of Care” by delivering a departmental analysis containing recommendations and a work plan by the end of August.

Nunavut’s high transportation costs and the difficulty of attracting medical personnel to the territory present challenges to territorial administrators tasked with delivering health care. A 2014 CBC report raised questions about how those administrators manage the department, pointing out the circumstances surrounding the death of infant Makibi Timilak, which eventually led to the Minister of Health offering an apology.   

The call for an analysis of the department comes as Nunavut’s premier Peter Taptuna continues to grapple with the health care file. Taptuna spun a number of ministers through the revolving door of department leadership in the recent past and the Auditor General of Canada’s decision to investigate the department adds further evidence of Nunavut’s struggles with its health care system.

This spring, members of the Legislative Assembly of Nunavut voted to develop an advisory board to oversee the Qikiqtani General Hospital in Iqaluit — Nunavut’s only hospital — which is now run by the department of Health. Health Intelligence’s contract requires it to perform an organizational review of the hospital and all of Nunavut’s health centres to make recommendations on management strategies, according to request for proposal documents that the government published on its procurement website.

The contractor will also investigate opportunities for innovation through the use of information technology, mobile ultrasound, and telemedicine — technologies that could greatly benefit Nunavummiut, though slow internet speeds in the territory could make it difficult for the department to implement the technologies fully. A previous Health Intelligence investigation found that remote technologies were underused in the Yukon.

In 2014, the Yukon Government hired Health Intelligence to produce a clinical services plan in an attempt to reorganize how that territory delivers health care. The report cost $200,000 and took six months to complete.

The authors of the plan point out that “concerns about the adequacy of future physician recruitment will exacerbate shortages to a serious level” and recommended that the government set up a planning committee to monitor Yukon’s healthcare workforce and report to the Minister of Health. In a letter to the editor published by Yukon News on June 10, a Yukon doctor said that the Whitehorse General Hospital, which is run by a board of directors, still suffers a “crisis” of understaffing and bed shortages.

Northern Public Affairs asked Yukon Health and Social Services when they intend to implement the recommendations of the clinical services plan. A department spokesperson responded that the plan provided the data necessary to create Yukon’s mental wellness strategy and that the department uses the principles of “integrated services” and “patient-centred” care that are outlined in the plan “to inform the work we do.”

The Health Intelligence plan points out that Yukon’s mortality rates are “significantly” higher than the national average, costs for medical travel have increased dramatically, and that “no provider or service interview conducted during the study was silent on the enormity of the problem with, and impact of, the abuse of alcohol in Yukon Territory.” Nunavut deals with very similar problems that will likely need to be mitigated when it attempts to reorganize its health system.◉

Photo: A baby gets a flu shot at Iqaluit Public Health during a media event. Credit: Brian Pehora

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