The need for beds at Larga Kitikmeot in Yellowknife is too much for the medical boarding home to meet at times, and the growth of tourism in the NWT capital is leaving fewer accommodations alternatives.
"The hotels are booked. We know that they're booked," said Casey Adlem, president and general manager of Larga Kitikmeot. "There's no beds in Yellowknife, so we have to work with the Government of Nunavut to manage the number of guests who come to Yellowknife for medical. The impact this year seems to be larger than in previous years... we're trying to manage it as best we can."
As a result of the strain, some Kitikmeot residents are having to wait longer to see a doctor or specialist.
Andrea McFaul, director of travel programs with the Department of Health, said the GN is aware of the issue. Discussions are taking place within the government about possibilities for booking some additional medical specialist appointments in Edmonton, she said.
Dorcas Evalik of Cambridge Bay said she had to delay her Yellowknife medical appointment – one she described as important – by almost a month, from late August to late September, due to an inability to find alternative accommodations.
She said she checked with the nurse-in-charge about options prior to Sept. 25 but was told Larga was still full.
"I would like to see that they get another building or make the Larga bigger for all medical patients and escorts," Evalik said. "They should have a different building for pregnant women and escorts, to make more room for the current Larga building."
Evalik was one of several people who spoke of difficulties finding a room in Yellowknife when the topic was raised by a distraught individual on Facebook earlier this month.
There are dozens of times per year when the Larga Kitikmeot's 58 beds are fully occupied, Adlem said. The increasing number of medical escorts for prenatal patients is indeed another factor, she acknowledged. The federal government announced a change in policy in April 2017, covering expenses so Indigenous mothers-to-be in the territories can have an escort when flying south to give birth.
"It's dramatically increased since then," said Adlem of the number of escorts.
She understands the policy decision to assist pregnant women, who are otherwise giving birth in a distant place all alone, but Adlem wonders if "anyone understood how much it would affect day-to-day operations" of the boarding home.
Medical boarding home owners Nunasi Corporation and Kitikmeot Corporation are considering options for expanding in Yellowknife, but the owners must take into account that the existing 10-year contract expires in 2019 and the next contract will only be a five-year term, Adlem explained.
"If you do a contract for five years, it doesn't really leave the owners time to recoup (millions of dollars in expansion costs)," she said, adding that Health Canada is ultimately responsible for the contracts and related funding.
Other variables beyond Larga's control are periods when many people fall ill at the same time, spiking demand, and when medical specialists from the south schedule visits to Yellowknife, Adlem noted.
She said the situation at the Larga Edmonton is similar, but the difference there is the abundance of hotel options. In Yellowknife, despite a new hotel opening about a year ago and another one expanding, aurora-viewing tourists still test the limits of the available hotels rooms during the winter, according to Adlem.
She credited the Government of Nunavut for doing its best to prioritize medical patients according to urgency.
McFaul said when the Larga is fully booked, patients should still be able to stay at billets, hotels and bed and breakfasts while still maintaining access to full support services, common areas, meals and ground transportation from the medical boarding home.
"On occasion, clients have decided to stay with friends and family instead of staying at the alternative billet, hotel or B&Bs," McFaul stated, adding that patients shouldn't incur any costs during approved medical travel.
Kitikmeot medical patients accounted for 17,058 overnight stays – including patients making multiple trips – in 2017-18. The number of people who could have been accommodated at the Kitikmeot Larga for the year, if filled to capacity every night, would have been 21,170.
"(The Department of) Health meets regularly with each boarding home to ensure the contract service requirements are being met and that our clients receive the necessary benefits," McFaul said.
Jeannie Ehaloak, Cambridge Bay MLA, told Nunavut News that she will try to assist her constituents in this matter, but it's "the first I have heard or seen about it. That's all I have to say for now."