Public Accounts Committee on March 3rd, 2022

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

Right on. That's good.

I have a follow-up question for the deputy minister. It's in regard to exhibit 11.2 and why Manitoba received exponentially more PPE than all the other provinces.

[Christiane Fox]

Northern Manitoba and Ontario were probably our most challenged communities in terms of the outbreak. Not only would they have received more PPE as a result of.... There were communities like Norway House, Shamattawa or Red Sucker Lake that seemed to be in a continuous mode of outbreak. We would get the numbers down, and numbers would go up again. They likely received more PPE as a result of the outbreaks and the needs within the community.

Many of those communities would also decide, at times, to accommodate their most vulnerable populations outside community, for example, in Winnipeg, Thompson and various areas, so PPE would be delivered not just to the communities but also to the isolation centres. That's another reason.

Many of those communities also made requests for assistance, so the military was sent in. We needed to ensure that, throughout all of those peak periods, those supports were there not just for the community members but the staff, including the first nations pandemic response team or the AMC ambassadors, who were deployed into community.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

In paragraph 11.58, the AG notes that the department chartered dedicated air services to transport nearly 5,400 passengers from April 2020 to March 2021.

Can the department share more on information on this, such as the airline used and the costs associated with this program?

[Christiane Fox]

I can get the committee the final costs. It's actually something that's still ongoing in some parts of the country, specifically for the Sioux Lookout First Nations Health Authority communities in northern Ontario.

The decision to provide this service was in consultation with our first nations partners, who felt there was a risk with our health human resources flying commercially to get to and from their communities. Therefore, to minimize that risk, they suggested that charters be deployed with which we agreed.

It was also a means not only to get our health human resources into communities but also to transport some PPE and fast-track the delivery of urgent items. We did have over 5,400 HHR travel on that system into 51 communities. It was done in order to protect our nursing workforce, to protect communities and to ensure no disruption in travel in light of what was happening at airlines at that moment.

In terms of where we're at, we do have a contract now that we can draw on should we need to resume the service, or if ever there is a requirement for either a future wave or variant. For the time being, we have the possibility of extension. However, we will get you the exact figures and who the contractor was.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

On that last point, regarding the contractor, was this a sole-source contract, or was this something you put out to tender for competition?

[Christiane Fox]

We've spent $51 million to date, just for your awareness. I just saw that detail in my notes.

I'll turn it over to Robin Buckland to speak to the contracting process.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

If you could include, Ms. Buckland, whether it was a sole-source or open-source contract?

[Robin Buckland, Director General and Chief Nursing Officer, Department of Indigenous Services]

I don't have the details in terms of whether it was sole-sourced or open-sourced, but we did work with Public Services and Procurement Canada. We went through all the appropriate processes to put that contract in place. As soon as I have it, I will give you that information if it was sole-sourced or done by a competitive process.

[Jeremy Patzer, Conservative, Cypress Hills—Grasslands, SK]

It's very important to make sure that, at the end of the day, we got the right bang for the buck for taxpayers while still providing a high-quality service that was clearly needed. Most Canadians would agree with the fact that the service provided was needed, but at the end of the day, when we say sole-source contracts, it sometimes gets people a bit excited for certain reasons.

[The Chair, Conservative, John Williamson]

Thank you, Mr. Patzer.

Ms. Bradford, you have five minutes.

[Valerie Bradford, Liberal, Kitchener South—Hespeler, ON]

Thank you so much.

Thank you to our expert witnesses today. It's been fascinating.

There's no question that COVID was a great learning opportunity for all of us, and perhaps no more so than at Indigenous Services Canada.

I'm going to direct my questions to Deputy Minister Fox. Basically, the Auditor General's report identified two areas of concern and improvement. The first one being PPE. That was clearly the more easy one to address.

The workforce issues are much more complicated and complex, particularly in health care and isolated areas with which you are dealing. I know that many employers offer isolation pay and bonuses to attract people to these remote communities, because their living conditions aren't as desirable, and of course the isolation. Does your department do that?

[Christiane Fox]

Yes, we do. We obviously have to work within our collective bargaining agreement, but these are challenging positions and, in terms of incentivizing our nursing staff and helping in the recruitment, we do provide some incentives. We can provide the committee with a bit more detail on that.

I think you're right to note that these are quite challenging postings. At times, it means that people need to be away from their families for two to four weeks, especially during the pandemic. Sometimes our nursing staff was up in remote and rural communities for a longer period of time to try to limit that back-and-forth, which was another personal sacrifice they had to make to respond to the COVID-19 pandemic.

[Valerie Bradford, Liberal, Kitchener South—Hespeler, ON]

It's not just the living conditions. It's also the working conditions. That's the other problem. I know that very often you hear about maybe only two nurses for an entire community, and they're carrying the whole load without backup and without people there to support them.

I know there has been a lot of work on digital backup and on supporting health care practitioners with video. Was that utilized at all so that people could maybe do a video consultation to see what was going on with a particular patient who might be more challenging?

[Christiane Fox]

Absolutely, and I personally visited some of our nursing stations and saw that very equipment, where you have an emergency room within the nursing station and there will be a 24-7 unit connected to a major hospital so that outreach to a physician to support the nursing staff on the ground can be done. In some of the nursing stations, we've also been able to add equipment like X-ray machines, which in the past weren't there. That just helps with medevac in reducing the burden on unnecessary travel for appointments.

I do think that virtual care is an area we absolutely have to look into. There are really innovative robotics technologies when it comes to virtual care in the north that I think would be really interesting to think about using more broadly in our northern communities, both indigenous and non-indigenous.

[Valerie Bradford, Liberal, Kitchener South—Hespeler, ON]

I agree. It's so disruptive to have to relocate patients when they're in a critical care situation away from their family support network. We want to avoid that, not just from a cost-effective perspective, but it's obviously better care if you don't have to do that.

One thing you did address—and I think we're all aware of this—is that the fatigue and mental wellness of the nursing workforce are a great concern. Can you tell me how this is being addressed? What support mechanisms are in place for helping with the mental health situation of some of these overtaxed, exhausted, burnt-out health care practitioners?

[Christiane Fox]

It's something that definitely keeps me up at night. We have formal processes and systems in place with employee assistance and a dedicated support service exclusively for our nursing staff, which is not common to all of our employees across the system and which I think is important.

We need to have regular conversations with our nurses, and that's through town halls and it's through direct contact. I reach out from time to time directly to a nurse, after either an incident or a challenging situation, and make sure to visit our nurses in communities so that I can hear from them about what goes well and what doesn't go so well.

I think that part of that mental health and wellness and those supports is going to be key. They are exhausted, so we're trying to find ways to have that surge capacity, which is why I talked about the mobile health surge team and, when our teams are exhausted and mental health and wellness are at risk, having the ability to replace them and have people recoup. I think every regional executive responsible for health is having those discussions directly with our nursing staff.

Highlighting what they do, when I joined this department I did the nursing awards, which is something we do to recognize the heroic efforts of our nurses. Someone said, “If you save a life, you're a hero, and if you save over a hundred, you're a nurse.” That stuck with me, because that's what they do every day. I just wanted to share that.

[The Chair, Conservative, John Williamson]

Thank you. That is a lovely way to end today's meeting.

I want to thank everyone for appearing today.

I want to thank our team for working out the technical bugs.

Deputy Minister Fox, I should say as well that your previous minister, Dominic LeBlanc, speaks very highly of your capabilities. I did not want you to think I was suggesting that your dad's legacy in any way overshadowed how this committee viewed your work. I think you've proven that today. I just wanted to pass on your previous minister's remarks as well.

[Christiane Fox]

Thank you very much, Chair.

[The Chair, Conservative, John Williamson]

Again, thanks to all our witnesses for appearing and for being ready to appear today.

I will now close the public portion of our meeting and suspend for about two minutes to give our committee members a moment before we go in camera.

Thank you again.

[Proceedings continue in camera]