Question Period Note: Medical transportation and counselling in Nunavut

We know that medical transportation is necessary to ensuring individuals have access to the health services they need in Nunavut.
The territorial government receives funding to run its health system through various transfer payments, and for a portion of the medical transportation costs for Inuit residents.
We will continue to support the Government of Nunavut to ensure that the Nunavummiut have access to the health services they need, now and in the long-term.

Health services in the North
The responsibility for delivering health services is shared by the federal and provincial/territorial and Indigenous governments, including the provision of mental health services. The federal government supports First Nations and Inuit community mental wellness through a number of programs and services. Specifically, through the First Nations and Inuit Health Branch, ISC supports and funds mental wellness programs and services in five key areas: community based mental wellness services; the Indian Residential Schools Resolution Health Support Program; the Non-Insured Health Benefits Program Mental Health Counselling Benefit; the First Nations and Inuit Hope for Wellness Helpline; and Jordan’s Principle – A Child First Initiative.
Since 2017, the Government of Canada has contributed $220 million over 10 years in Nunavut in the community-led Nunavut Wellness Agreement. Furthermore, Budget 2019 announced an additional investment of $50 million over 10 years to renew and expand the reach of Inuit Tapiriit Kanatami’s National Inuit Suicide Prevention Strategy.
Cancellation of Services in Nunavut
The Government of Nunavut is responsible for the delivery of health care for its citizens, including the provision of mental health services. Services are available at health centres that are located in every community.
There have been media reports of counselling service cancellations in Nunavut. Services have not been cancelled. ISC is waiting for additional information from a specific service provider prior to approving a clinic in Arctic Bay. Once ISC has approved the request and the provider has availability, the clinic’s counselling services will resume. Other existing supports remain available for clients in this community in the interim.
Through the Indian Residential Schools Resolution Health Supports Program, ISC also covers travel for clients to access counselling services as needed, to the nearest point of service within their region.
In addition, telephone counselling services are available through the Hope for Wellness Help Line, which provides immediate, telephone crisis intervention counselling support for all Indigenous Peoples, 24 hours a day, seven days a week, and can be reached at 1-855-242-3310 or online counselling service at hopeforwellness.ca.
Medical transportation in Nunavut
Nunavut is a vast territory made up of 25 small and isolated communities, none of which are connected by roads. Approximately 85% of the population is Inuit. Each community has a health centre, staffed bynurses and with locum doctor visits. There is one hospital in the Territory, located in Iqaluit, which provides services to residents of the Qikiqtani (Baffin) Region. Because of these realities, the Government of Nunavut relies heavily on medical transportation to support residents in accessing services outside of the Territory.
The Non-Insured Health Benefits Program provides a suite of medically necessary goods and services to eligible First Nations and Inuit clients. In Nunavut, these benefits are administered directly by Indigenous Services Canada, as well as via a contribution agreement with the Government of Nunavut. The agreement includes funding for medical transportation, such as accommodations, meals, and air travel. In 2018 19, the value of this agreement was $51.4 million.
Since its creation in 1999, the Government of Nunavut has charged a co-payment of $125 per direction for all air travel for residents requiring medically necessary services not available in their home communities. This co-payment, which the Non-Insured Health Benefits Program reimburses for Inuit residents, applies to air transportation that can include, for example, $2,000 scheduled flights or $30,000 medevacs. In January 2019, the Government of Nunavut announced its intention to eliminate the co-payment, as it can no longer afford to continue with this arrangement.
The Government of Nunavut is receiving $9.2 million per year in funding to off-set costs of medical transportation under Health Canada’s the Territorial Health Investment Fund (scheduled to sunset in 2020/21).

If pressed on the alleged cancellation of counselling services in Nunavut

I can assure my colleague that counselling services have not been cancelled; they continue to be available at health centres in every community in Nunavut.
This current fiscal year, $11.6 million in funding is provided directly to the Government of Nunavut and community organizations for the coordination of mental wellness teams and other mental wellness services.
Further, we have allocated $5.4 million in targeted mental health counseling funding through the Non-Insured Health Benefits Program.
We are also contributing $220 million over 10 years through the Nunavut Wellness Agreement for community wellness initiatives.
We will continue to work with partners to ensure Nunavummiut have access to the services they need.

If pressed on responsibility for medical travel costs in Nunavut

The Government of Nunavut is responsible for the provision of health services to all of its residents.
Medical transportation is a necessary, but costly, element of Nunavut’s health care system.
We are working with the Government of Nunavut on ensuring continuity of services while a longer term approach to accessing health services is developed.
Through the Nunavut Partnership Table on Health, we will continue collaborating with the Government of Nunavut and Nunavut Tunngavik Incorporated to improve access to health services.

If pressed on Nunavut Wellness Centre

I am very proud that our Government will contribute towards the establishment of a Wellness Centre in Nunavut, in partnership with the Government of Nunavut and Nunavut Tunngavik Incorporated.
The Wellness Centre is part of a made-in-Nunavut approach to address substance use and trauma.
We will continue to work with our partners to support treatment and wellness services that are Inuit-led and build on cultural strengths.