Indigenous and Northern Affairs Committee on April 21st, 2009

[Kathy Langlois]

And that's the process we're in right now. We're working with them. There have been no decisions made about those children. We've continued to fund the services until we can work through a process to come to the decisions, and the community is involved in that.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

I'm sorry, but I mean the broader issue about using a case-conferencing approach. It's not Norway House Cree Nation, but the broader issue around using a case-conferencing approach. I understand first nations are not happy with it and don't feel they've been appropriately consulted on that approach.

[Kathy Langlois]

That would be new information to me. Case conferencing is a way of determining needs. We can call it needs assessment or whatever, but it's best to get the health professionals who know about the needs of the child in the room together. I've not heard that first nations are not happy with the case-conferencing approach.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

If I have additional information about that, should I send it to you directly?

[Kathy Langlois]

If you wish, please do so, absolutely.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

On a broader issue, what we know is that we've got a very young population coming up. I know Mark has identified this as well. We know that this is not new information in terms of the health outcomes. This is not new. We have report after report after report.

We know the social determinants of health are critical. I know that some gaps are closing, but at the rate the gaps are closing, we're going to see another generation suffer the health outcomes that their elders suffered. What is getting in the way of a faster resolution?

[The Chair, Conservative, Bruce Stanton]

Give a brief response, please, and then we must move on.

[Michelle Kovacevic]

I think a lot of that is about roles and responsibilities across governments. That won't surprise you.

One of the huge initiatives we have in Health Canada right now is the aboriginal health transition fund, the $200 million over five years, which is project-driven, but provinces, territories, first nations, Inuit, and Métis can draw from that fund to implement services that are integrated or adapted. That forces different parties and different governments to the table. I think more of this kind of initiative, which crosses the boundaries of roles and responsibilities so things are more effectively provided, will go a long way to addressing some of that.

[The Chair, Conservative, Bruce Stanton]

Thank you, Ms. Kovacevic and Madam Crowder.

Mr. Duncan, for five minutes. This will be our last question.

[John Duncan, Conservative, Vancouver Island North, BC]

Good morning.

I noticed an overarching question from Mr. Bélanger on the spending of the department and where it's allocated. I go back to one of the slides where the non-insured health benefit package actually supplements provincial, territorial, and private insurance. If you try to get into that kind of comparison, I think it's going to be very different on reserve, off reserve, by province or territory. I'm not sure you're going to have an easy time sorting that out. I wanted to put that on the record as a comment, not so much as a question, although you can comment if you choose.

We're meeting with the Australians later today. When you read through their Closing the Gap document, which is new this year, you can see their statistics are similar to ours in so many ways. One thing they've done is to try to set some measurable targets. I'm wondering if we're headed in that same direction, to set six benchmark targets on things like life expectancy, educational attainment, employment attainment, and so on. That's my first question.

Your last slide talks about letters of intent with Mexico and Australia. I'd like to understand more. Maybe you can round that out a little.

Finally, you talk about a letter of understanding with the U.S. Is that specific to cross-border movement, or is that something different?

Those are my questions. Thank you very much.

[Kathy Langlois]

In terms of answering the targets question, setting targets is something we've had some experience in doing in working with first nations, Inuit, and Métis leaders. A number of years back we did set some targets around suicide prevention, diabetes, and some child-based targets, so we do have experience with that. The decision back then was to ensure that the targets were very stretched, such as reducing the rate of diabetes by 50% in five to ten years. They were very, very ambitious targets. I think the key is that we work in partnership with first nations, Inuit, and Métis leaders around those issues in setting targets. So it's not something we would do within Health Canada unilaterally, but we do have experience in setting targets.

In terms of the Australian situation and the letters of intent, we do have letters of intent with Mexico. I am quite familiar with that one, as I've been involved with the Mexicans. What we're doing there is focusing on issues of interest to both countries. So healthy communities are of interest to Canada, whereas health governance and indigenous control of service are of interest to Mexico. So we're having an exchange of information and building our relationships with them. Maternal child health and the work we're doing on midwifery have been of big interest to the Mexicans, and we've had opportunities to exchange information there.

We have an upcoming visit to British Columbia by the Mexicans in May to further deepen the understanding of how the systems work, but also on those specific topics. Then we'll be looking at where we go further with Mexico and whether or not we should actually have longer exchanges, where people would maybe come to work for us and vice versa. So there are things to be thought about there.

In terms of Australia, a letter of intent was signed back in 2007 with the previous government. With the new government taking office, they've said they're interested, but that at this time they're focused on domestic issues. Certainly the closing-the-gap initiative is of importance to them—which you've referenced, and which I'm sure they will be talking about when they're here.

Those are the main things. The memorandum of understanding with the Indian Health Service goes way beyond the border issues. In fact, we had focused on fetal alcohol spectrum disorder and suicide prevention as two key areas, as well as doing extensive work on sharing research agendas.

My colleague may wish to add to that.

[The Chair, Conservative, Bruce Stanton]

We're essentially out of time, unless you just have a very brief comment.

[Michelle Kovacevic]

I don't believe so at this time.

[The Chair, Conservative, Bruce Stanton]

Okay, very good.

Thank you very much. I appreciate your patience and understanding with our restricted time, and with the earlier than normal start this morning. It's greatly appreciated.

The meeting is adjourned.