N.W.T. Health Minister Julie Green offered an apology Wednesday to families affected by the temporary closure of birthing services at the Stanton Territorial Hospital in Yellowknife.
Green, along with Kim Riles, the chief executive officer of the Health and Social Services Authority, and Jim Antoine of the Health and Social Services Leadership Council, spoke publicly at noon to give an update on the staffing shortages at Stanton and the service reduction at the obstetrics unit.
On Wednesday, Green said the staffing situation at Stanton has exposed the harsh reality in the North that many families have to leave their home communities to give birth in an unfamiliar environment.
Health workers have built individual plans with affected families to meet their needs as much as possible, she noted, and most families will have access to resources beyond medical travel.
On Nov. 22, the government announced almost everyone planning to give birth at the hospital between Dec. 10 and Feb. 21 would instead be transferred to Edmonton, because there weren't enough nurses to staff the obstetrics unit.
The closure is expected to cost the N.W.T. government $1,125,000 in transportation and accommodations alone.
Riles thanked those people who have to go to Edmonton to give birth, because that has helped ensure obstetrics staff can deal with any emergency birthing situations that happen.
"Your travel to Alberta, or out of the N.W.T., has created the space for us to maintain that emergency capacity," she said.
Green said the Northwest Territories Health and Social Services Authority has worked with 71 clients so far to determine what benefits they might receive.
Following the news conference, she told the Legislative Assembly 13 families were above the income threshold, meaning they would have to co-pay fees such as their airfare. If those families can demonstrate a "financial hardship," there is a process they can go through to waive that fee.
Green said 31 families were covered by programs offered by their employers, and 26 qualified for non-insured health benefits.
Seven are considered low-income and will not need to co-pay.
"Most individuals will have access to programs and resources outside the medical travel program," she said.
"Even with support and best efforts from NTHSSA, I know that these are not the circumstances that families wanted and I am sorry that we are not able to live up to their expectations."
Major nursing shortage
There's a high vacancy rate at Stanton and across the N.W.T. health system in general, Green said during the news conference.
She added just seven nurses have applied for positions in the Northwest Territories since June, and only one has been hired, despite national recruiting efforts and advertising.
Green said even with existing staff stepping up to cover more shifts, the health department wasn't able to cover more than a quarter of all the obstetrics shifts in December — not enough to operate at normal service levels.
The territory turned to an external staffing agency in October, which helped identify three more nurses, whose contracts are still being confirmed.
Green said the territory needs a plan "that looks past the ongoing crisis and into the future."
Missed the update? Watch it here:
Riles said there has been foreshadowing of a health staff shortage, especially nurses, throughout her career. Now, she said the Canadian Nurses Association estimates the country will have a shortage of 60,000 nurses by 2022.
"That shortage is here and we are living in it," she said.
Riles said 22 per cent of the nursing positions at Stanton remain vacant.
She said the territory has seen a "precipitous drop" in applications and hires for health care positions, along with a drop of interest from casual staff, who have historically been relied on to cover vacant positions.
Riles pledged to work with the staff at the obstetrics unit to address their concerns.
"Everyone working together, helping each other, is how we get through this," she said.
'Optimistic' about reopening
Riles said staffing levels look better in the new year, and she's 'optimistic' the obstetrics unit will be able to reopen in February as scheduled.
"It's favourable," she said of how staff levels in January look, though she noted there will still be some vacancies.
Green said the health department has taken steps to make sure other services at Stanton operate throughout the Christmas season.
Riles said there's always the risk of that shifting, if more vacancies open, and the need to attract and retain staff can't be overstated.
What's being done?
Health officials will work over the next couple months to examine issues leading to staff shortages.
Riles said keeping current staff is their top priority.
Green said the health department is building a team with the NTHSSA to look at the current operational issues in detail, to look for the quickest path to resuming services and make sure services are sustainable in the future.
She said they are also looking at concerns about leave, workload and compensation.
"I know that we need to improve, and we need to do it quickly," she said.
She said the department has also developed specialized nursing certification training programs to help increase staff numbers. Those programs will be piloted with the obstetrics unit.
Green said the health department is also developing a human resources plan to refresh the department's recruitment efforts.
Responding to criticism that these issues have been flagged for months by health staff, Green acknowledged the territory has had staffing issues in the past, including an ICU reduction in August due to staffing, and previous surveys of staff have raised the issue.
"To say that nothing has been done and that none of the issues have been addressed over years are not an accurate statement," she said.
Riles said in the immediate term, service reductions were unavoidable though she acknowledged longstanding staff shortages and fatigue.