Nunavut's health minister told regular MLAs on Tuesday that their concerns over the construction of new elder care facilities in the territory are "premature and presumptuous."

George Hickes's speech came after MLAs chose last week to defer approval of the Nunavut Health Department's capital estimates for the coming fiscal year. Hickes said he was shocked by the choice.

Last Friday, MLAs spent the morning grilling the minister on its provisions for elder care. MLAs said a long-term plan for in territory elder care doesn't mention the 44 elder care beds that Nunavut already has.

Members were concerned existing elder care homes would be closed. They asked if those centres would still be funded, repaired and kept open.

"Our government is not closing any elder care homes in Nunavut," Hickes said, earning a drum roll from MLAs. "To suggest otherwise puts fear in the hearts and minds of our elders and communities."

But a community elder centre in Baker Lake has already closed. And Gjoa Haven MLA Tony Akoak said his community elder centre is important: it employs a lot of people and one man visits his wife at the centre every day.

In his speech Tuesday that spanned nearly half an hour, Hickes defended the government's plan to build long-term care centres for elders in each of Nunavut's three regions starting with the construction of a 24-bed centre in Rankin Inlet next summer.

The Nunavut government's proposed capital estimates for the Department of Health for 2020-2021 sits at $27.5 million. Line items in the budget for elder care were a late addition, because the department was still working on a business plan for the Rankin Inlet centre.

Hickes said deferring the health department's capital budget was a mistake.

"Now our health budget is left to the waning few hours left of session for consideration where less time can be devoted to going over the finer details of this project and other priority projects like the addictions and trauma treatment centre," he said.

Iqaluit in September 2018. A 108-bed elder care facility is planned for Iqaluit. (Katherine Barton/CBC)

Private industry not interested, minister says

Nunavut does not have elder care for people with advanced dementia or for seniors who need around-the-clock care. Right now the government is working to build 24-bed, long-term care centres in Rankin Inlet and the Kitikmeot, and a 108-bed centre in Iqaluit.

The Health Department says it will need 156 long-term elder care beds by 2035. There are 33 elders from Nunavut being cared for in Ottawa.

Building the first elder care centre in Rankin Inlet is a good place to start, Hickes said, because of access to daily flights, housing for medical staff and ongoing support from regional hamlets.

"It's essential that we get moving on constructing an elder care facility in Rankin Inlet," Hickes said. "Too many of our people are sent out of Nunavut for treatment or ongoing care that could be provided in the territory."

The three elder regional centres are to be government run, because private industry doesn't want to work in Nunavut, Hickes said.

"There was less than favourable interest from industry in providing care," Hickes said. "Even large companies that provide seniors care across Canada are hesitant to take on those same risks here."

Hickes said that's why the government wants to work with communities.

But MLAs questioned the government's commitment to work with communities. They brought up a recent failed attempt to build a facility in Iqaluit.

Two years ago the not-for-profit Sailivik Society tried to open a long-term care centre in Iqaluit. MLA Pat Angnakak was part of that society, and championed the project when she was an MLA in the former assembly. The society had secured land for the building.

But Hickes said the society's business proposal wasn't finished, and that the plan needed multimillion-dollar support from the territorial government.

"I sincerely do not wish to oversimplify or undervalue the work that Sailivik had put forward in this business plan at the time, but it is important to note that building a high-level elder care facility requires very specialized building designs and standards," said Hickes.

The MLAs will come back to their review of the health capital estimates before the sitting ends on Nov. 7.