Thank you.
One of the guiding principles of our health intervention with first nations and Inuit is to ensure that the nations themselves have the greatest possible control over their health services, whether it be delivery, organization or design. Across the country, a number of nations have taken over parts of the program, with far more autonomy. The two examples you mentioned are more at the community level.
On a larger scale, British Columbia now has a health agency that manages that type of service. This covers the 200 first nations in the province. The agency has the flexibility to change the program if it wants to. The Inuit of Nunatsiavut also have an arrangement of this kind. This sort of change is allowed.
However, it is important to be careful with smaller public insurance plans. The fact that many clients are asking for very expensive drugs—such as the ones I mentioned earlier—can very quickly put the plan at risk. The risks are higher for those plans. Mechanisms must therefore be found to support first nations and organizations that assume those responsibilities. We must ensure that they do not become financially fragile because of new drug claims that they cannot afford. We are working closely with those organizations to ensure that the model remains viable.
In some cases, our department continues to provide support services. For instance, in the case of our British Columbia partners who have taken over the program, the department continues to process some of the claims as a service provider at this time. We expect the organization to transfer the management of its pharmacy program to the provincial program over the next few years.