Nunavut Health Strategy Fails to Meet Goals: Audit

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Nunavut’s Public Health Strategy is failing to meet its goals, even though the territory has some of the most serious public health issues in Canada, according to a federal audit. 

Federal Auditor General Sheila Fraser’s office looked at how Nunavut was implementing the four-year-old strategy, which aims to address the territory’s high rates of communicable and chronic diseases, addictions, sexually transmitted infections and other health issues.

The territorial government had set aside a three-year budget of $8.8 million to help implement the strategy when it was introduced in 2007.

But the audit found that only four of the 31 action items in the Public Health Strategy had been completed as of June 2010, while one item was dropped and the remaining 26 items had not been completed.

As well, many Nunavummiut did not quite know who was responsible for ensuring the strategy’s success, according to the audit.

“When we visited communities, there were a lot of people who were … unsure [of] what they had to do with respect to the Public Health Strategy,” Michelle Salvail, a principal with the auditor general’s office, told CBC News on Friday.

“I think the [Health and Social Services] Department also will need to be … having [a] clear work plan as to who should do what and by when,” she added.

Their findings are included in Fraser’s report on Nunavut’s child and family services system, which criticizes health officials for failing to protect children in care.

Steering committee absent

Salvail, along with Fraser and other staff, were in Iqaluit late last week to discuss their findings with a committee of Nunavut MLAs.

The report said a steering committee, consisting of senior health officials from Nunavut’s three regions, was struck in December 2007 to implement the Public Health Strategy.

But the committee stopped operating in July 2008 and its members did not meet again until May 2010, the audit found.

“During the nearly two-year absence of this committee, we found that senior management had given some direction to staff regarding their responsibilities for, and the implementation of, the strategy,” the audit report states in part.

“However, throughout our audit, it was still unclear to many people we interviewed who was ultimately accountable for the implementation and success of the Public Health Strategy.”

Quttiktuq MLA Ron Elliott said given all the public health issues Nunavut faces, he is frustrated by the lack of action on the strategy.

“It’s fine to get the strategy done and to do the research and to do the consultation. But if you’re not implementing something, then the strategy’s just paper,” he said.

New manager hired

Deputy health minister Peter Ma told MLAs on Friday that the office of the chief medical officer plays a role in overseeing the Public Health Strategy.

Ma could not say why the strategy has not been fully implemented to date. Instead, he told MLAs he wants to focus on the future.

“At this point in time, I’d rather move forward and deal with the issue rather than what has happened in the past,” Ma told the committee.

Ma said a manager has been hired to move the Public Health Strategy forward, and he promises to make sure it is fully implemented by March 31, 2012.

Ma said health officials have also renewed efforts to ensure there is an effective health surveillance system to track the territory’s progress.

“There is a renewed vigour, shall we say, to ensure that information is collected and, in fact, analyzed, and that … this information is actually reported upon,” Ma said.

“It is something I’ve already spoken to our new chief medical officer of health about,” he added, referring to Dr. Geraldine Osborne, whose appointment was announced that day.

With files from the CBC’s Patricia Bell

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