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December 6, 2002
Romanow inspires hope for
better health care in Nunavut
But provincial-federal
wrangling could sink health-care agreement
JIM
BELL
If Dr. Sandy Macdonald
had an extra $2 million, he knows exactly what hed spend it on
at least eight more doctors for Nunavut.
"In Baffin alone,
I could hire four to five more family physicians right now," said Macdonald,
Nunavuts director of medical services and telehealth.
Thats just one example
of the hope that Roy Romanows report on the future of Canadas health-care
system has inspired among health-care providers in Nunavut and elsewhere.
Romanows 356-page
report, which took 18-months and $15-million to complete, was tabled last week
in the House of Commons.
Its 46 recommendations
include a proposal calling on Ottawa to spend $1.5 billion over two years to
improve access to health care for Canadians living in rural and remote regions
of the country.
Romanow said part of that
money should be used to recruit and retain more doctors and nurses, and that
part of it should be used to develop telehealth systems.
Macdonald said thats
just what Nunavut would like to do to improve health services for Nunavummiut.
One benefit of having more doctors is that more Nunavut residents would get
early and accurate diagnoses of their illnesses, he said.
Another benefit is that
it would relieve the constant overwork and strain that Nunavuts current
cadre of family physicians must now cope with, he said. And with better working
conditions, more doctors would be persuaded to stay in Nunavut, develop long-term
relationships with patients, and learn more about Nunavuts unique health
issues.
Romanow made other spending
recommendations that could bring concrete benefits to ordinary people in Nunavut:
$1.5 billion to purchase diagnostic devices like MRIs, $2.5 billion for primary-care
delivery, and $2 billion to create a national home-care program.
But if Canadas cantankerous
provincial premiers cant agree on a health-care reform package with the
federal government at a meeting that will likely be held near the end of January,
those dreams could all be dashed, and Nunavuts Third World health-care
system could continue to suffer.
"Its just a
report. Theres no guarantee that it [the money] will be there," Premier
Paul Okalik cautioned last week.
Several premiers dont
like Romanows insistence that provincial and territorial governments be
accountable to Ottawa for the money that Ottawa gives them for health care,
saying Ottawa shouldnt use its spending power to mess around in areas
of provincial jurisdiction.
For example, members of
all three parties in the Quebec National Assembly voted unanimously last week
to denounce the Romanows report as an attack on Quebec.
Quebec Premier Bernard
Landry even said that Quebec might not accept more federal money if Ottawa insists
on dictating how it would be spent. That means theres a chance that Nunavik
residents may not ever benefit from the Romanow reports recommendations.
But Okalik, who will represent
Nunavut at that potentially historic federal-provincial-territorial gathering
next month, will take a different position.
He, and Nunavuts
health minister, Ed Picco, each said last week that Nunavut supports most parts
of the Romanow report, including its powerful affirmations in favour of a single-payer
universal health-care system for Canada, and its criticisms of private, for-profit
health care.
But Okalik said other barriers
that must be overcome before Nunavut may benefit from new federal health-care
spending are Ottawas per capita method of distributing money, and Ottawas
indifference to the recognition of Inuit as an aboriginal people.
To deal with the first
barrier, Nunavut will ask for "base" amounts based on need, with an
additional amount distributed per capita.
This is intended to avoid
a repeat occurrence of the pittance that Nunavut received in September 2000.
The territory got only $3 million out of an annual federal health funding increase
of $4.5 billion.
To the deal with the second
barrier, Okalik said he will continue to insist that Ottawa treat Inuit with
the same generosity as First Nations.
"I will be taking
the same position that I acknowledged before. We should not be treated differently
and get less benefits than other aborginal peoples of Canada," Okalik said.
So if Okalik can get that
message through the din of what could be a nasty, noisy federal-provincial turf
war, Nunavut residents may one day get the improved health services they hope
for.
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