Nunavut MLAs ask questions about who can get a medical travel escort
Some elders don't want medical travel escorts anymore, minister says
Hudson Bay MLA Allan Rumbolt is baffled by what he called the Government of Nunavut’s sudden revisions to the health department’s medical travel policy.
Rumbolt, in a member’s statement and questions to Health Minister Monica Ell March 6, asked why the government made changes to the policy, and why they didn’t make the public aware of them.
Rumbolt said one of his constituents raised the issue with him, leaving him “very surprised.”
“A number of criteria under the government’s medical travel policy have quietly been changed,” Rumbolt said in a member’s statement.
“I would suggest that any changes to these policies should not be kept secret from the people who are most affected — the medical clients themselves,” Rumbolt said.
Ell said the health department made the changes in June 2013 and that the new guidelines expire March 31, 2018.
She said health officials are “well aware” of the new travel policy.
Before the change, elders aged 65 and older automatically received an escort to help them on medical trips outside of Nunavut. But this is not the government’s policy any more.
That’s because some elders don’t want an escort, Ell said.
A Health Council of Canada report released last November said medical escorts some times take advantage of patients.
One informant in that report said patients “often have little say in who does the escorting, or they choose someone who takes advantage of them.”
Other escorts “disappear into town” and spend money that’s provided to them, the report said.
But Rumbolt said the new criteria gives “no consideration to our elders” and the “focus has shifted to unilingual Inuit who are travelling to an approved centre where interpreter services are not available.”
Ell said the changes make the policy more consistent for those travelling south for medical care.
“The purpose of revising the client travel policy and guidelines is to ensure that client medical travel is applied consistently in each region across the territory,” Ell said.
MLAs have been complaining about a lack of consistency in the policy since 2012.
The GN’s health website lists four criteria to qualify for a medical escort.
• you need the legal consent of your parent or guardian;
• you have a mental or physical condition that makes you unable to travel alone;
• you are a unilingual Inuit-language speaking client and there is no interpreter in the health facility where your appointment is booked; or;
• you need an escort to take medical instructions for home medical or nursing procedures.
The policy says doctors or nurses recommend who should get a medical escort and that regional directors of health make the approvals.
Aivillik MLA Steven Mapsalak followed up Rumbolt’s questions with some of his own, including who decides to reject or approve requests from clients seeking medical travel escorts.
Ell repeated that a nurse or doctor makes the recommendations and regional directors of health make the approvals.
“Denials can be appealed to regional directors. Patient relations also assists with complaints related to medical travel,” Ell said.
And Ell said appeals “take a very short time.”
“It might take a few days to come to a conclusion,” she said.
Tununiq MLA Joe Enook weighed in on the debate as well, asking what would happen to an unescorted elder if there were an emergency on an aircraft headed south.
Ell said that is a hypothetical question and that the policy can be reviewed any time.
To read a summary of the Nunavut government’s policy for medical travel by patient escorts, visit this page.