Strong turnover in the management of the Ullivik Center

Four directors have succeeded each other since 2020 at the head of the Ullivik Centre, the establishment that welcomes patients from the Far North in Dorval. This important game of musical chairs comes as a government investigation into the management of health care and expenditures in Nunavik and at the Ullivik Center has just ended. Quebec, however, refuses for the moment to disclose the conclusions.

Ariane Lacoursiere
The Press

After the departure of the former director of the Ullivik Center Maggie Putulik, in 2020, at least three interim directors succeeded each other, namely Lisa Epoo, Jane Baudoin and Hanen Ghozzi. She is currently in office awaiting a permanent appointment. The Ullivik Center found itself in the media at the end of August after the death of two users, fatally struck on nearby highways.

In October 2020, the government mandated former deputy ministers Lise Verreault and François Dion to investigate the “management and governance” of the Ullivik Center, the Nunavik Regional Health and Social Services Board (RRSSSN) and the Inuulitsivik Health Center (ISC), which serves seven municipalities in Hudson’s Bay. Investigators from the Ministry of Health (MSSS) were particularly interested in “non-insured health services” which have exploded in Nunavik in recent years. These amounts, reimbursed by Quebec given the special status of Nunavik, cover, among other things, medication, dental care, medical equipment and medical transportation (by plane) for the 13,440 Inuit beneficiaries in this very isolated territory.

Former director of human resources at the Inuulitsivik Health Centre, Yves Lemay believes that non-insured health services have for years been “a totally out of control budget” in Nunavik. Worried about poor financial management and health care in the North, he alerted the ombudsman, the Permanent Anti-Corruption Unit (UPAC) and the MSSS in 2019. Last winter, The Journal of Montreal wrote that a UPAC investigation was underway into this.

In the investigation mandate given to Mr.^me Verreault and Mr. Dion, we can read that “certain allegations regarding public integrity have been brought to the attention of the MSSS concerning various aspects of management and governance”, which “would have repercussions at the level of services offered to the population of Nunavik”. The government therefore wanted to “shed light, in complete neutrality, on these allegations”.

In the background of the investigation: the fact that the NRBHSS has asked Quebec to increase its budget envelope by $75 million between 2018 and 2025 and is asking for $922 million to finance its infrastructure, including the construction of a new hospital of 460 million in Kuujjuaq. Before granting these sums, Quebec wanted to conduct its investigation.

The report of M.^me Verrault et de M. Dion was presented on July 22 at the NRBHSS and the CSI. The spokesperson for the Régie, Kathleen Poulin, confirms that her organization “has recently taken note of the preliminary report” and that the Régie “will continue to collaborate with the MSSS as it has always done since the beginning of this investigation” . At the MSSS, it is pointed out that while certain situations forming the subject of allegations have already been corrected by the NRBHSS, “certain problematic situations remain”. Spokesperson Marie-Hélène Émond specifies that the Department offers “its collaboration and support in the development and implementation of an action plan”.

However, the Régie has “expressed a desire to be able to comment on certain aspects of the report” and the Department is awaiting these comments first. “Thus, it is not possible to respond positively to your request to obtain a copy of the report”, indicates Mr.^me Emond.

Questions from 2008

This is not the first time that the lack of control of non-insured health services in the North and at the Ullivik Center (formerly the Module du Nord Québécois) has come under the scrutiny of Quebec. In 2008, an initial investigation on this subject was conducted by the MSSS.

In a working document consulted by The Press and produced in March 2008, they spoke of the “significance of the sums” at stake. The lack of control of expenditure at the Module du Nord Québécois was exposed. Mention was made in particular of contracts awarded without a call for tenders and numerous credit cards in circulation. The document also spoke of “the almost total absence of the data required in the annual financial reports concerning mainly the number of transports carried out and the expenses, and this, for transport by aeromedical evacuations from Quebec and for air transport of elective cases”.

In 2019, another investigation was conducted by the NRBHSS into “possible administrative irregularities with regard to the management of Ullivik in general and, more specifically, with regard to the awarding and management of contracts entrusted to third parties”. . Corrective measures have since been adopted, according to the investigation mandate granted to Mr.^me Verreault and Mr. Dion.

The Press asked the MSSS for a copy of the 2008 investigation and the 2019 investigation under the Access to Information Act. Both requests were refused on the pretext that “the information concerns the administration of justice and public security and administrative or political decisions”.

Criticized services

Last winter, while the investigation of M^me Verreault et de M. Dion was in progress, Inuit patients complained about the poor quality of services received at the Ullivik Centre.

Annie Tookalok Nuktie, who lives in the village of Umiujac, goes to Ullivik quite regularly. According to her, the quality of the food has improved a little since the winter. But she regrets that the rooms are “often dirty”, that too often there is a shortage of staff and that users are sometimes discriminated against.

At the CSI, it is reported that it is currently tendering for a new food services contract in Ullivik. An advisory committee made up of Inuit representatives from Nunavik, among others, has just been put in place and will make it possible to “really understand the expectations of users”, explains the director general of the CSI, Claude Bérubé.

In addition to the changes to the management of Ullivik, important departures are also affecting the NRBHSS this summer. CEO Minnie Gray retired in July after nine years at the helm of the organization. Jennifer Munick-Watkins will succeed him. Fabien Pernet, who was regional director of strategy, organizational development and corporate affairs at the NRBHSS, also left his position in July to take on new challenges.

M^me Poulin ensures that the various changes that have occurred in recent months within Ullivik and the NRBHSS are not related to the investigation. “Know that our situation is not so different from that of other organizations in the health and social services network. Given the current context, we are facing various challenges, particularly with regard to the staff turnover rate or the labor shortage, particularly for the Ullivik management position where Inuit candidates are important. “, she says.

Nunavik is grappling with a major shortage of healthcare personnel, as revealed by The Press in August.

With the collaboration of Suzanne Colpron, The Press