Indigenous and Northern Affairs Committee on Feb. 16th, 2017

[Romeo Saganash, NDP, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Thank you, Madam Chair.

Thank you to our witnesses today for their contribution to this committee.

Dr. Lafontaine, you spoke about transformation, and for once somebody's on the same page as me on these kinds of things. I've always felt that I'm in the status quo process myself, being part of this committee. I know this committee will provide a decent report to government. As for what will happen after that, your guess is as good as mine, but it's been like that for 150 years, since Confederation. This government has not even bothered to comply with an order of the Canadian Human Right Tribunal, so what about a report from a committee?

I heard you very clearly with respect to the kind of transformation this country needs with respect to all the issues we're dealing with. It's not just suicide. There are interrelated and interlinked aspects to this crisis, including housing and everything else.

You spoke about the perpetual aspect of what we're dealing with, the colonial outcomes, and how the system needs to change. If you had to the reins of this country for a day, where would you start?

[Dr. Alika Lafontaine]

I think the first place you need to start is that people need to believe our stories. I think what often happens is these crises happen, and then they make their way out of the news, and the overall impression is the crisis must have been fixed. Well, the crisis is still happening.

The second is that the bureaucracy needs to recognize that the system is producing the very outcomes they don't like. Our bureaucrats are skilled at what they do, which is maintaining the status quo, and that's what they're tasked to do. They have to acknowledge that these crises are creating the very situations that they don't want to respond to. It's increasing their workload, it's making things more complex, and it's leading to escalation, which both the political and bureaucratic side don't want. They don't want our communities going to the media, thinking about litigation or political action or bringing in non-governmental groups.

The solution to all our problems is through transformation, but until we all start to believe the same story, there won't be any change. If I were the head of the country for a day, I'd call together all my MPs, as well as the MPs of the opposition parties, and agree on the story that's happening. Once we understand that, I think we can finally have change.

[Romeo Saganash, NDP, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Is the Indian Act part of the problem?

[Dr. Alika Lafontaine]

I think it definitely is. That is the status quo that needs to be changed, but part of it is understanding the context of the story.

[Romeo Saganash, NDP, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Thank you.

The next question will be for Mamawetan, which is a similar word in my part of the world.

There's a lot of talk about putting a national suicide prevention program in place. Other witnesses who testified before us would prefer locally led programs for suicide prevention. What kind of balance should we try to achieve between those two, and how would a national suicide prevention program help what you're doing in your part of the world?

[David Watts]

I think the key is coordination. We can be asked to run a suicide prevention program, and then the bands could be running their own different prevention programs. We need to run one program together and we need to work as one team. It needs to be all-inclusive, and we all need to be coming up with the same things. It needs to come from the grassroots. I can go onto a reserve and start preaching to people about doing this and that, but I don't live in those circumstances, so they won't hear me.

Some of the conditions on our reserves are like the third world, and they're only highlighted at times of crisis. People only actually recognize what's going on; then as soon as it's out of sight, it's out of mind. It needs to be one coordinated approach from all the different groups and it needs to come from the grassroots.

[Dr. James Irvine]

I think you're so correct regarding the importance of balance. Many communities have their own unique strengths and approaches that are valuable, so how do you incorporate the independent approaches and yet still have the capacity for working together through coordinated action? Often communities and individuals are moving back and forth, so the challenges of maximizing what we have for resources and the individual capacities and the strengths of communities is so important. That's where that national template of approach is important, with the allowance of individual community and regional collaboration and coordination.

[Romeo Saganash, NDP, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Dr. Lafontaine, do you have any comments?

[Dr. Alika Lafontaine]

I think that communities will collaborate when they have the capacity. If low staffing levels, lack of funding, or being overwhelmed by crises prevent communities from having the capacity to reach out to other communities and actually understand what they're doing, that's the reason communities turn inward. This is what I said before. It's accountability and a regional allocation responsibility, but it's not communities being uninterested and not wanting to be involved with each other. Our communities will collaborate with each other if they are properly resourced.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you. There's eight seconds.

All right, we're moving on to MP Mike Bossio.

[Mike Bossio, Liberal, Hastings—Lennox and Addington, ON]

Thank you, Madam Chair, and thank you so much, guests, for your testimony. It really links to a lot of testimony we've heard around the need for long-term stable funding that goes to the communities. With that funding, the communities are able to have community-driven priorities, rather than INAC or paternalistically driven priorities.

I think everyone would agree that a transformation needs to occur. I certainly know that's what our Prime Minister has communicated and that's what our government is trying to work towards. I guess the difficulty we've heard from a lot of the witness statements is the multi-faceted nature of the problem. Yes, we're studying the suicide crisis, but how has this been derived? It's multi-generational to trauma, residential schools, etc. However, within the communities themselves, whether it's cultural awareness, health, mental health, education, housing, food, employment, skills training and development, where would you start? I know you have to approach these problems in a multi-faceted way, but if the money was getting to the communities—and I'll direct this first to Dr. Lafontaine—where would you start to spend that money that you think would have the greatest impact and evolve towards this transformation?

[Dr. Alika Lafontaine]

We provided a costed program to both ministers last week. That was developed with the three territories. There was a desire by the bureaucracy to have that funding all pooled into a single pool. The reality is that with the way the territories work, they need their own independent pot.

If you're looking at the different slices that need to get funded, you'll see that there's the AFN, which is kind of our national body, and the territorial organizations, such as Nishnawbe Aski Nation, and then there are the tribal councils and the first nations. That funding has to be split.

Within our own health system, we have different areas that get funding: health quality councils, ministries of health, and the health regions that provide the care at the hospitals and the clinics, etc. That type of allocated funding needs to happen as well within our communities. Our communities have to work through a process of transformation to find out what levels should do what. What's important is that the communities decide what happens.

Our territorial organizations have a strong role in coordination between communities. Our communities themselves may have more of a role in clinics and direct primary care. Our tribal councils may be coordinated through regional hospitals or other types of regional programs. We already have a map for how this works, and that's the mainstream health care system. It's just that we don't apply the map in our communities.

The funding we tabled with the ministers is specific to the transformation model. That will take a period of time—not a very long period of time, but it will take time. If that gets properly funded, the answers to those questions will come out, but they will not come out with the crisis we currently have and the crisis response.

[Mike Bossio, Liberal, Hastings—Lennox and Addington, ON]

I would invite you to present that report on the transformation to the committee, if you could, which we could then embed as part of our study. If you have the ability and authority to do so, that would be invited.

It has been identified as well in much of the testimony that one of the biggest challenges in terms of this being community-driven and community-led is community employment and the lack of human resources to deliver these programs within the communities themselves. You spoke about the Nishnawbe nation and others, etc., that would be involved in helping to deliver this. Can you speak to some of the human resources aspects and the challenges around that? Also, can you even expand upon that? As part of your report, what do you see as the key challenge in delivering on this?

[Dr. Alika Lafontaine]

It relates specifically to Nishnawbe Aski Nation. The cost of the proposal looks at hiring 43 staff personnel to move the process of transformation forward. Linking that to economic development, health is big business, honestly. It's the way small communities in Saskatchewan and Alberta have maintained local economies: through hospitals and local clinics. You will have economic development as you build that staffing capacity, because those people live in communities and put that money back into the communities.

[Mike Bossio, Liberal, Hastings—Lennox and Addington, ON]

Is the staff there? That's the concern. It's about trying to attract these health care individuals, and for mental health care in particular. Across the country we have a huge issue around mental health and the delivery of services around mental health, and there are the added challenges of recruiting them to the north as well. Is that a reality that you see as well? Do you see any solutions to that?

[Dr. Alika Lafontaine]

Right now when funding comes to our communities in any of these territories, you get a back-loading of funding. You get very little funding at the beginning of the year, and then suddenly before March 31, you get told that you have three, four, or five times more funding than you had at the beginning of the year.

If you have health transformation and you're able to stabilize that funding equitably throughout the year, and that money actually goes to our communities and there's infrastructure in place to ensure that it's properly spent and allocated, you will find that people will migrate to our communities. We won't have a problem with recruitment. It's in changing the status quo.... The problem is not the fact that it's remote; it's the fact that you don't know if you're going to get paid next month because there is no funding in place until January.

[The Chair, Liberal, MaryAnn Mihychuk]

That's a very good place to end.

I want to thank you very much for participating in the video conference from La Ronge to.... I don't even know where you are. Is it Grande Prairie?

[Dr. Alika Lafontaine]

Yes, Grande Prairie.

[The Chair, Liberal, MaryAnn Mihychuk]

Thank you to the west for doing this. We appreciate it very much.

Meegwetch.

To the committee, I want to confirm that we will be back next week at 8:45, the regular time for our committee, and also that the minister has agreed to come before our committee on February 23 in relation to the supplementary estimates.

Thank you very much. The meeting is adjourned.