Keeping more services at home could ease medical travel woes

By Elaine Anselmi

Updated Friday, Jan. 31, at 4:35 p.m.

By this summer, Nunavik will have cleared the first hurdle on the way to seeing a regional hospital built.

This would increase the number of medical services accessible in the North and cut down on the southern medical travel that’s become so problematic for Nunavimmiut.

“The idea of the regional hospital is a way to deliver those specialized services in Nunavik, and that’s the way this process has been shaped,” said Fabien Pernet, assistant to the executive director of the Nunavik Regional Board of Health and Social Services.

“We have moved forward with the project of the clinical plan itself, for the regional hospital.”

The clinical plan is the first of several steps necessary to get such a project through Quebec’s Ministry of Health and Social Services, Pernet explained.

More than 60 interviews were conducted with Nunavimmiut in 2019 for the clinical plan, and information on the health system and how it is used in Nunavik has been gathered since 2017.

The plan includes things like demographics, the prevalence of different diseases and hospitalization rates. It also goes into the current state of services in Nunavik, what is offered and what is needed.

The actual writing of the plan started this past fall and continues.

“That’s what we’re currently doing,” Pernet said. “It is advanced, we have someone currently writing it and have all the necessary information. We’re aiming to have the clinical plan submitted this summer to the ministry.”

What’s here and what’s to come in Nunavik health care

Right now, there are 25 beds at both the Ungava Tulattavik Health Centre in Kuujjuaq and the Inuulitsivik Health Centre in Puvirnituq. Pernet said the plan is to increase capacity, rather than replace what is already there.

The health board is aiming for a 50-bed regional hospital and has submitted plans for two 32-bed long-term care facilities.

After the plan is submitted, the province will analyze it and suggest where anything needs to be added or cut.

“One of the ways we wish to fast-track the project is that we have regular meetings now with the Ministry of Health and Social Services in which we present the progress we’ve made in drafting the clinical plan,” said Pernet.

“We share information and gather it to make sure we have comments from them as we go.”

This is to ensure the plan is on track, rather than having surprises after it’s submitted and the ministry responds.

With the regional hospital clinical plan still in the works, Pernet couldn’t offer specifics on what services would ultimately be provided. That could change, depending on the ministry’s response.

Pernet said the specialties currently offered in the region are psychiatry, gynecology, pediatrics, general internal medicine, ophthalmology, orthopedics and anesthesiology for minor surgeries. But this is offered on a rolling basis, with specialists travelling in and out of the region.

“Those services would be the basis for the regional hospital, but we would be able to increase access to those basic services,” Pernet said.

Being able to offer CT scans in medical emergencies, and more lab testing within Nunavik would be other priority areas, he said.

But a clinical plan doesn’t include physical plans, like the scale or design of the building, or even a proposed location. That’s part of the second step of the process, said Pernet.

More services could mean less medical travel

Between the 2017-18 and 2018-19 fiscal years, there was an increase of 16 per cent in elective appointments in the south, said Pernet. Those are services that are offered in Nunavik, but not on a regular basis, so the patient travels south for more immediate access.

Pernet said certain procedures and services would still require travel, but the new hospital could take some of the pressure off the medical travel system.

There have been several issues with medical boarding in Montreal.

In November, Nunatsiaq News reported sightings of bedbugs in patients’ rooms at the Quality Hotel in Dorval. A block of 39 rooms is reserved in the hotel for overflow patients from the purpose-built medical boarding home in Montreal, Ullivik.

Most recently, CTV News spoke with medical boarders at the Quality Hotel who complained of discriminatory treatment by hotel staff and unclean rooms.

Ben Watt, communications officer for the health board, told Nunatsiaq News the board was “well aware of the challenges with hotel accommodation for patients from Nunavik. Ullivik has been overcapacity on an annual basis since its opening.”

He said since the board became aware of recent complaints, management of overnight stays had tightened up, reducing the need for overflow rooms. That included coordinating transportation differently and efforts to increase followups with patients in the North, rather than in the south.

“Since December 20 and for four weeks, no overflow hotel room has been used,” Watt said. “The use of hotels is currently increasing again, based on an increase in appointments granted to Nunavik patients.”

He said the recent complaints have been dealt with and any regular complaints lead to check-ins and conversations with the hotel’s management.

“In the long term, the development of a range of specialized services accessible in Nunavik will make it possible to limit our dependence on specialized services given by establishments in Montreal,” he said.

And by developing the clinical plan for a regional hospital, he said the need for specialized services in Nunavik can be recognized by the provincial government.

Information about the plans for two regional long-term-care facilities was received post publication.