Thank you, Mr. Speaker. I’d like to take this opportunity to thank the Member for promoting the importance of safety in our health and social services workplace. I’d also like to take this opportunity to acknowledge just how incredibly important this issue is not only at Stanton but for staff in all of our facilities across the
entire Northwest Territories. I totally agree that our workers deserve a safe workplace that is free from the threat of physical assault. At the same time, we need to ensure that our patients and our clients deserve to receive treatment in a caring and supportive atmosphere.
This is what makes it so challenging in finding an appropriate balance to this incredibly difficult situation. The motion suggests that all workers in the Northwest Territories deserve a safe workplace that is free from threat or physical assault. We absolutely agree. The safety and security of staff, patients, residents and clients in the health care facilities is one of my number one concerns. Our staff are our most valuable resource. Workers not only deserve to work in a safe workplace but are entitled to a safe workplace. Safety and security of workers dealing with violence in health care settings is a challenge not only at Stanton but across the Northwest Territories as well as across Canada. Every situation and facility brings its own unique challenges. Many of us have seen the facilities that we have and know that every facility is different. We need to ensure that our staff are safe, and we are taking steps today to make this happen.
The motion also suggests that non-violent crisis intervention is not adequate or appropriate protection of staff and patients in the face of violent physical attack. I don’t agree that non-violent crisis intervention is not the appropriate philosophy for our facilities. The Non-Violent Crisis Intervention Program is considered a worldwide standard for crisis prevention and intervention training with a core philosophy of providing care, welfare, safety and security of everyone involved in crisis situations. The program’s proven strategies give human service providers and educators the skills to safely and effectively respond to anxious, hostile or violent behaviour while balancing the responsibilities of care. But I do agree that it can’t work unless it includes proper training, clear expectations about the performance of security guards and clear procedures for dealing with situations where violence escalates. Stanton is currently taking steps to make the improvements in this particular area.
The movers suggest that contracted security personnel and other staff at Stanton Territorial Hospital and territorial health care facilities are not trained to protect employees, patients, themselves or others from violent people. Our staff and security personnel have been provided with training on basic techniques to deal with most scenarios, to restrain individuals and to escape harm.
We acknowledge the concern that not all episodes of violence can be prevented and that in certain situations of extreme violence or escalation, such as the event that we had in November, a more physical approach to restraint or intervention may
be warranted. The security contract includes standing orders outlining the responsibilities of security guards in a variety of situations. The orders with respect to the guards in the emergency department indicate that a guard will assist in patient restraint and surveillance in the emergency department under the direction of a charge nurse and within limits of the NVCI training.
Stanton and the security contractor are exploring how training for security guards can be improved to help them respond to a situation where an individual becomes aggressive, violent or difficult to manage. This level of response is one of the gaps that we are working to address in collaboration with the department and with the input of our front-line emergency department staff who have been involved.
Stanton and the security contractor, in partnership, will be sending three employees to investigate a higher level of training that may be adopted. They will attend the next available course offered in Canada, which is April 15 to 17 of 2015. It’s a little ways off, but it’s the earliest one that can be delivered. These individuals will provide their recommendations on the applicability of this course within our setting. Techniques learned in this course can be incorporated into training for select staff to supplement and augment existing training.
The mover also says that the staff of the territorial health care facilities are currently at high risk of physical and mental harm, with recent violent incidents at Stanton Hospital causing injury, including post-traumatic stress disorder to three health care workers, as well as property damage.
The well-being of our staff is always, as I have previously indicated, a priority and I recognize that those who have suffered harm in the provision of care to our residents. Supports are available for our staff involved in violent situations, including an immediate debrief and incident investigation as well as an offer of immediate medical and psychological supports for our impacted staff.
We also routinely offer information from the Employee and Family Assistance Program, EFAP, through the Department of Human Resources, to help them deal with any issues including anxiety resulting from any incident that they have been involved with.
Unfortunately, we must also acknowledge there’s a certain amount of risk inherent in working in the provision of health services. As a system, we do need to take steps to minimize the risk of harm to our staff. The working group established to review safety and security policies and provisions will inform and help prioritize steps we need to take system-wide, not just at Stanton.
This may include physical improvements to helping social services facilities, improved procedures for
staff safety, staff training and awareness or provisions for security personnel in some of our facilities outside of Yellowknife.
Mr. Speaker, the motion goes further to suggest the RCMP response times have not always been prompt enough to intervene during violent episodes. There is no doubt the typical response times for RCMP to attend the hospital in the case of a violent episode can pose a risk. Stanton’s senior management have met with the RCMP to explore how they can work together more effectively. In recognition of this gap, we will be putting interim measures in place to assure higher levels of intervention is available to assist until the RCMP arrive. I will go into that a little later.
In the longer term, enhanced training and clarification of roles and responsibilities will be addressed with the security staff as well as the staff within the facility. That has already been done.
The mover states that the Union of Northern Workers has expressed grave concerns about the lack of protection afforded to its members at Stanton Territorial Hospital and the anxiety members subsequently experience. Stanton has been working with the UNW, local 11, to follow examples of committees where there is joint participation. The joint consultation committee is made up of executive members of the union Local 11, who are elected by-annually, and members of Stanton’s senior management team. The terms of reference for this committee state that the union local executive members shall consist of, as a minimum, the local president, the members of the local executive and other members of the local executive that may be deemed necessary or required.
We also have the Joint Occupational Health and Safety Committee which is comprised of elected members of union Local 11 and Stanton management representatives. The terms of reference indicate the committee shall be compromised of five representatives elected by the UNW Local 11 members.
Stanton has also established a violence committee with managers and front-line staff. The Department of Health and Social Safety and Security Working Group have front-line staff from Stanton who are members of the UNW. Further, the Workplace Safety and Compensation Commission, WSCC, regularly inspects Stanton to make recommendations to provide a safe workplace.
In relation to the two incidents reported in the media, WSCC completed two safety inspections and Stanton has complied with all the directions as a result of these inspections. Stanton will continue to engage UNW members and executive as we move forward on all these different initiatives.
The mover also states that a recommendation from a 2011 inquiry into an incident in 2009 fell onto the Department of Health and Social Services to consider hiring trained, in-house special constables with legislative powers to train and assist in direct patient care. The internal investigation into an incident in 2011 resulted in recommendations to implement a model which would involve legislation to establish a special category of security officer. After careful consideration both in 2011 and again more recently, it was determined that this was not required in the Northwest Territories. The Criminal Code of Canada provides for individuals to exercise a reasonable amount of force to ensure their safety and security and that of their property. This allows Stanton to expand the scope of physical intervention provided by its security contractor within existing legislative framework.
As a note, Mr. Speaker, in response to the 2011 review, Stanton did take measures to increase security throughout the hospital including increased security guard coverage in the emergency department, installations of doors, locks and alarms, and training and improved operational response for incidents of violence. Mr. Speaker, clearly, based on November, more needed to be done.
The mover has also said that security personnel at Stanton Hospital should be full-fledged government employees to ensure long-term job security and retention of experienced, well-trained employees. This request to bring security personnel into the GNWT public service is a new ask and hasn’t been raised with my office until this motion. We have not considered bringing security personnel at territorial facilities into the public service. However, as a result of this motion, we will take a look at it. I do have to just say, Mr. Speaker, it would have to be done within the fiscal reality that we have today and the cost of bringing in a security team as full-fledged employees of the GNWT could be incredibly expensive and could take away from some of the program areas we are also delivering, but we will do the work. We will do the analysis. I think it’s worth it.
The mover of the motion also strongly recommended that the Department of Health and Social Services clarify procedures for Stanton Territorial Hospital employees to follow when violent incidents occur, including procedures expressly for the use of physical restraint in these cases.
Since the very disturbing incident in the emergency department last November, Stanton has again increased security coverage in the emergency department, installed safety devices including one-way windows and bathroom locks, implemented enhanced reporting procedures for situations involving violence. A number of the structural
changes were actually recommended by staff of the emergency department and acted on immediately.
In addition, an external security expert has been retained to conduct a review of Stanton’s physical layout and security policies and procedures. Their initial recommendations will look at immediate improvements for physical security provisions. An initial report will be received at the end of this month, followed by a full report with final recommendations to be received in March.
The mover of the motion also recommended that the Department of Health and Social Services direct Stanton Territorial Hospital management to hire security personnel with recognized training in non-violent crisis intervention and physical restraint techniques. Security guards with a higher level of training will be placed in the emergency department this week, in fact, today, until such time as enhanced training is completed for all security guards and policies and procedures have been updated. Security guards are being trained on the health care facility training courses, and over the longer term Stanton is working with its security contractors to tighten up policies and procedures and to offer a higher level of training which includes physical restraint to all security guards within the facility.
The mover of the motion recommended, furthermore, that security personnel at territorial health care facilities be hired as full-fledged employees of the Government of the Northwest Territories guaranteeing continuity of service and benefits resulted from accumulated experience, institutional memory and professional training. As I’ve already mentioned, we have not considered bringing security personnel at a territorial health care facility into the public service, but as a result of this motion we will certainly be taking a look at it.
In conclusion, Mr. Speaker, the mover of the motion recommended that the Department of Health and Social Services review its policies and procedures pertaining to security at territorial health care facilities, including long-term care and extended care facilities, and report back to the House within 120 days. I have already established a working group consisting of the departments of Justice and Health and Social Services as well as Stanton Territorial Health and Social Services to do this work. This group will build upon the good work being done at a local level at Stanton and its dedicated employees with a focus on the safety and security provisions and policies to include all health and social services operations. We are also collaborating with other government departments, including Human Resources, Justice and Public Works and Services, for a broader look at safety and security in the government facilities across the Northwest Territories.
Mr. Speaker, we want the same thing at the end of the day. We want safe, secure facilities where a patient can receive the best care and our staff are safe. However, as this is a recommendation to government, Cabinet will be abstaining and we will be reporting back within 120 days. Thank you once again, Mr. Speaker.