Psst. It’s okay to go private
The Nunavik region’s long-suffering medical travel clients, a category of persons that includes virtually all residents, learned this past week that their regional health care brainiacs have just found a new second-hand patient hostel in Montreal.
This time, it’s an old YMCA building in lower Westmount. On the the plus side, it’s close to the children’s hospital, the Metro and various bus routes. On the down side, it’s just steps away from a notorious piece of urban blight called Cabot Park, colonized long ago by nomadic bands of crackheads, winos and dope dealers.
As an interim move, it’s still a big improvement over the last second-hand building, located on a crime-ridden stretch of St. Jacques West and a source of complaint for more than 10 years. It also makes up for last year’s Villeray Chinese hospital fiasco.
But is this a good solution to the Inuit patient home issue? No. This gesture signifies the notion that Inuit in need of health care represent an inconvenience fit only to be stuffed into low-rent warehousing and then forgotten
Is there a better solution? Yes.
But because that solution lies right under their noses, health authorities aren’t able to see it, apparently.
Here’s how it works. You issue a request for proposals that would seek a private firm, preferably a firm that is aboriginal-owned, to build and lease back to the government a new building designed for the specific purpose of housing an Inuit patient home.
After construction, the same company, or perhaps another private entitity, would be selected to operate the hostel, also under contract with government.
That’s how it’s done in the rest of the country — because it’s a service model that works.
In Ottawa, Winnipeg, Edmonton, Yellowknife and Iqaluit, privately-built and privately-operated patient hostels provide excellent hostel services to Inuit patients under leases and contracts with the Government of Nunavut.
These patient homes are staffed, primarily, by Inuit and other aboriginal people. They’re located, for the most part, in desirable neighbourhoods. All of them are secure, clean, and comfortable. Their staff take care of travelling patients from the moment they arrive at the airport to the moment they return there to fly home.
Guess what? Few, if any, Nunavut Inuit ever complain about conditions in and around their patient homes. The Nunavut health care system inspires numerous legitimate complaints about numerous serious issues, but patient homes aren’t one of them.
Larga Homes Ltd. of Edmonton deserves much of the credit for developing this model. Through joint ventures with Nunasi Corp. and regional Inuit birthright corporations, Larga is involved in all of them, except for the Tammaativvik home in Iqaluit, which is leased to the territorial government by a private developer and operated by an Iqaluit-based community group.
The use of private providers to supply ancillary services, such as accomodation and transportation, poses no threat to the NIHB or to a universal, single-payer, health care system. Indeed, the future survival of publicly-funded health care likely depends on the financial savings and improved service that private actors can bring.
Makivik Corp. is the obvious joint-venture partner for such a project. They enjoy access to the necessary capital and expertise, and they have a mandate to serve Inuit. Such a development would be best located on the west side of the island, where local councils are far less likely to be influenced by bigots and xenophobes. But if Makivik is not interested, there’s no reason why the government shouldn’t look for another provider — outside the province if necessary.
We realize, of course, that neither Nunavik nor Quebec are renowned for imaginative thinking or public policy innovation.
But when government fails its clients as badly as Quebec and Nunavik health officials have failed the people of Nunavik on the patient home issue, it’s time for government to get out of the way.JB
