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What the Auditor General Study Tells Us on Improving the Lives of First Nations Peoples

by mmnationtalk on February 2, 2016848 Views

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In October of 2014 members of the First Nations Health Authority (FNHA), First Nations Health Council and First Nations Health Directors Association were invited to participate in an Office of the Auditor General study to inform Parliament about the efforts undertaken by British Columbia First Nations, Health Canada, and the Province of British Columbia to establish the FNHA in BC.

The First Nations Health Governance Structure in BC welcomed the study and viewed it as both a useful third party assessment and an opportunity to share our experience with First Nations from across Canada considering similar changes to their health care services. Our leadership spent over 50 hours with the Auditor General over two weeks at our head offices on Coast Salish Territory discussing our journey.

We discussed our governance structure, our consensus building process, our directives, and our current and future operating plans. The report confirms a key success factor resulting from the process was the acknowledgement by BC and Canada that First Nations are entitled to same level of health services as all provincial residents. This is an important recognition for First Nations communities across Canada and particularly timely considering the Canadian Human Rights Tribunal ruling last week that affirms inequity between on-reserve communities and other Canadians, and that action is needed in this regard.

Health service gaps exist and have been exacerbated for First Nations communities by a federal obligation for healthcare through the Indian Act and due to the boundaries of on-reserve and off-reserve service delivery. However, under the Canada Health Act, each province is responsible for health services for all citizens residing within its boundaries. Thus emerges a jurisdictional mix of responsibility and accountability that can leave First Nations communities lost in the middle of distant partners.

The events that led to the creation of Jordon’s Principal and that continue impact child welfare for First Nations children on-reserve are expressly related to the same jurisdictional issues found within their health care services across Canada. Previous studies by the Auditor General have recommended a new approach for First Nations control of their health services, working in partnership with federal and provincial governments.

This report endorses the BC Tripartite health transfer process as a sound approach to overcoming the structural impediments which result in poorer health outcomes for First Nations and acknowledges that ultimately FNHA is improving local service delivery on-the-ground in First Nations communities in BC with our partners.

For the benefit of other First Nations communities across the country, this report confirms that the consensus building work of BC First Nations was unprecedented in this country and that the ability for First Nations to “speak with one voice” has been instrumental to the success of our work in BC. The work of the FNHA and our partner organizations is more than providing direct health services. The overarching objective is to return decision-making to First Nations people and communities and to create a more culturally safe health system not only for First Nations but for all people living in BC.

The report confirms that the FNHA has met all Health Canada accountability requirements in a timely and diligent manner. Our operations as analyzed by the Auditor General reflect those of an evolving, first of-its-kind organization. Like all organizations we have areas to improve upon, this work is well underway.

The FNHA accepts the Auditor General recommendations and look forward to reporting on progress resulting from this report. We are a learning organization and will continue our work to build a First Nations Health Authority that meets the needs and expectations of our Communities and our partners that have entrusted us with this important work.

Joe Gallagher, Chief Executive Officer, First Nations Health Authority

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