Indigenous and Northern Affairs Committee on April 14th, 2016

[The Chair, Liberal, Andy Fillmore]

We'll come to order.

I want to thank everyone for joining us today, and I'd like to welcome our guests, who have travelled to Ottawa to be with us for this meeting. On behalf of the committee, please accept my warm welcome and sincere thanks for making time for us today.

With us today are Alvin Fiddler, Grand Chief of the Nishnawbe Aski Nation; Jonathan Solomon, Grand Chief of the Mushkegowuk Council; Isadore Day, Ontario Regional Chief; and John Cutfeet, Board Chair of the Sioux Lookout First Nations Health Authority. Also joining us is Dr. Mike Kirlew. I am going to ask the committee's indulgence in adding Dr. Kirlew as a fifth speaker. The speakers have agreed to share the time equally among the five, so we won't add any additional speaking time, if that suits the committee.

[Some hon. members]

Agreed.

[The Chair, Liberal, Andy Fillmore]

Okay, wonderful.

We want to make sure that we make the most of your time, so I will ask you each to speak for no more than eight minutes, cumulatively 40 minutes for five speakers. I will indicate seven minutes and eight minutes, and please do your best to make your closing sentence. I will hold our committee members to the same standard when they ask their questions. That way we can ensure fairness and give everyone a chance to be heard and to ask questions.

Let's move speedily along. I would like to begin with Grand Chief Jonathan Solomon.

[Grand Chief Jonathan Solomon, Grand Chief, Mushkegowuk Council]

Wachiya, which means hello in my language.

Parliamentarians, it is a great honour and privilege to speak to you about the state of health in our region.

My name is Jonathan Solomon, Grand Chief of Mushkegowuk Council. As a grand chief, I am elected by the Mushkegowuk: the people. I speak on behalf of the Mushkegowuk people, who have bestowed upon me to be their grand chief.

The Mushkegowuk Council has seven first nations members and a total population of over 15,000. I am from Kashechewan First Nation, where I was raised and where I raised my family.

Foremost I am a father, and a grandfather to 13 adorable grandchildren, whom I adore and love so much. Back home, my people are out on the land with their families and friends for the spring hunt. I would be out there right now, but instead I am here, because the well-being of my people is of the utmost importance.

My ancestor, my great-grandfather, Andrew Wesley, signed a treaty known as James Bay Treaty No. 9, in 1905, with the government in Fort Albany, Ontario. In that treaty, in black and white, it promises happiness and prosperity.

In 1867, when Canada wanted to become a country, they made a pledge to protect the tribes of Indians in the former Rupert's Land. Now, 149 years later, look at what it has done to the tribes of this country. We have been sodomized, marginalized, and colonized within our own house.

In 1920 the commissioner, Duncan Campbell Scott, wanted to get rid of the Indian problem. Mr. Scott, who sat and spoke to my great-grandfather Andrew Wesley, now wanted to get rid of Mr. Wesley and his future generation. To put it mildly, it was a betrayal. He probably looked him straight in the eye and made mention of happiness and prosperity. Then he turned around and made a law where the kids would be taken from the arms of mom and dad and put into an institution known as residential schools. This is what we have been up against since 1867.

Sadly the legacy of Duncan Campbell Scott is still alive and well. We can break that cycle.

To begin with, the health system is broken. As provincial minister of health Dr. Hoskins puts it, “We have failed you. We have failed the North”. Minister Philpott admitted the system is failing.

We have known all this time, for far too long, that the problems may be too complex, but hopefully it will not be a hindrance. We cannot, with a sober mind, think it's working. People, my people, are falling through the cracks.

It's 2016, and we ought to start thinking it's 2016. It is obvious the present system is not working. It's failing my people. Furthermore we cannot put aside the mental aspect when we talk about health. We cannot put it aside until later on.

We all know the situation in Attawapiskat, my member first nation of Mushkegowuk Council here in Ontario, in Cross Lake, Manitoba, and many other first nations across this country. We have read research after research of the demographics. By putting aside real, tangible solutions, we are taking a high risk, if status quo is the only option. Now is the time to roll up our sleeves and put aside political stripes. We must begin to move the yardstick forward. We must begin a plan that is sustainable and viable.

The policies and legislation have only marginalized the first nations of this country, which includes Mushkegowuk: the people. Program after program has been studied, and progress after progress to study a particular program in Parliament has gone on for far too long. Government decisions on what's best for Mushkegowuk people are not working. Instead, the gap in services is getting wider and wider, and doing more harm than good.

For the last few days, I've been getting email after email from Canadians who care. Internationally they are saddened by the situation of my people and the people of Canada. They care. They want to help. They are expecting the government to step up to the plate and work with us.

There are a lot of Canadians who do care. They want my youth to have the same opportunity that their children have and have taken for granted. They want health care for my people. They want my people to live with hope and certainty, without despair and hopelessness. They want my people to have optimism and certainty. They want my people to thrive. Is that too much to ask for? All we ever wanted was to have the same opportunities as every other average Canadian citizen—nothing more, nothing less.

Before I close, Mushkegowuk Council had their own inquiry on the epidemic of suicides from 2006—sadly, to this date, we are still losing people to suicide—and Mushkegowuk chiefs and first nations communities had to do something. We reached out to the government of the day then, to no avail. This report was entitled “Nobody Wants to Die. They Want the Pain to Stop.” It tells the real stories of my young people and the people of Mushkegowuk. In this report, there is hope through the stories, although the stories are tragic and real.

The question I put forward to you is this. Will you be our partners to raise the despair to hope? My hand is reaching out. My people are reaching out. Will you stand with us, shoulder to shoulder? Opportunity is knocking on our doors. Will it be opened or will it be left closed, as since time immemorial?

A leader said that sometimes they get the feeling that as a leader they have failed to provide a vision for the future of the people. They think sometimes they spend too much time talking about a past that is full of treachery, full of pain, and full of suffering. Investing in the Mushkegowuk young people is an investment in the future, an investment in the well-being of thriving communities in Mushkegowuk and across the country.

Thank you very much.

[The Chair, Liberal, Andy Fillmore]

Thank you very much for that.

In my haste to get the meeting started, I neglected to acknowledge that we're very grateful to be meeting today on the unceded territory of the Algonquin people.

Grand Chief Fiddler, would you like to proceed?

[Grand Chief Alvin Fiddler, Grand Chief, Nishnawbe Aski Nation]

Meegwetch.

I, too, want to acknowledge we are gathered here today in the traditional territory of the Algonquin Nation, so I thank them for allowing us to have this gathering in their territory today.

I also acknowledge my friends and colleagues who are with me. I also acknowledge all of you, members of the committee, and also the staff members and support people who are sitting around the room.

My name is Alvin Fiddler. I am from a small community in northern Ontario, the Nishnawbe Aski Nation called Muskrat Dam. I was elected as the grand chief in August of last year.

I want to begin by apologizing to our staff at NAN. They worked so hard to make speaking notes for me, and they also made a presentation, which I will submit to the committee later on. I just want to take this time to talk to you and to visit with you, since we don't have too many opportunities like this for us to engage in dialogue directly with parliamentarians and committees such as yours.

I want to begin by reading a letter that was written by one of our chiefs, Chief Wayne Moonias of Neskantaga First Nation. He wanted to be here to talk to you directly, but there was a death in the community. One of the elders passed away in Neskantaga. He's also preparing for Minister Bennett's visit this Saturday. It's a lengthy letter. I just want to read a portion of it.

Just so you know who Wayne Moonias is, he is the Chief of Neskantaga. Neskantaga is right in the heart of the Nishnawbe Aski Nation. It's in the Ring of Fire area. Neskantaga is probably the closest community to that Ring of Fire. Neskantaga is a small community of about 300 people.

Some of you are probably aware of the circumstances and the situation in that community. They've had numerous suicides over the last two years. They've been on a boil water advisory for 23 years straight. I believe, as Chief Moonias says, he holds that record. It's a record that none of our chiefs and none of our communities want to hold. This is what he says in his letter, when he's talking about the Ring of Fire:

The so-called Ring of Fire, a mining development of historic proportions, is located with within our traditional territory. It is a shared territory with two other First Nations, but Neskantaga First Nation is the only community up-river of the development on the same Attawapiskat watershed.

He goes on to talk about his community.

However, I need to tell you, that there are communities that live, eat, and use this territory since time-immemorial. 1. But let me tell you what it means to live in Neskantaga First Nation. Neskantaga holds the record for the longest boil water advisory of any First Nation in Canada, dating back to 1995: “one of the longest human rights violations in Canadian history.” The failure of Canada to deliver safe drinking water to my community is what I call “program abuse”. The Minister of Indigenous Affairs has promised us a new water treatment plant, but we still have no firm timeline for when the government will deliver on the promise. Unfortunately, the water crisis is only one of many emergencies in Neskantaga.

Then he talks about the number of suicides they've had over the last five years. There have been 10 completed suicides in his community and numerous attempts. And there are other deaths due to violence and other circumstances. There are heavy losses.

He's also reaching out to Canada as a treaty partner and that's why I'm here as well. We are not here as a stakeholder or part of an interest group. We signed Treaty No. 9 in 1905 and 1906, and then the adhesion of that treaty was made in 1929 and 1930. NAN also represents six Treaty No. 5 communities that fall within the Ontario border.

I want to take this opportunity to speak about my role as the Grand Chief of NAN. As I said, I was elected in August of last year. I cannot count how many funerals I've gone to in our communities, whether it's suicides or house fires.

I was in Pikangikum, on Sunday, with my friend and colleague, Regional Chief Day, to pay our respects to that community as they laid to rest nine of their community members that died in a house fire two weeks ago. Three of them were children, four and five years of age, and the youngest was four months old. That's the reality for many of our communities, the social conditions, the challenges that exist. Whether it's the suicide epidemic or water situation, or overcrowding, that is the daily life of our community members right across the NAN territory.

I've talked a lot over the last two weeks about Pikangikum. While the focus is on the tragic fire, I talk about the good things as well, the good things that are happening in our communities. That's what we need to invest in. That's where Canada needs to look. If they're serious about rebuilding that relationship with us, we're open to that as well. But it has to be respectful. It has to be done in a way that benefits us as well. I think for far too long we've been left out, whatever processes were developed.

The last thing I want to say is that numerous studies have been done on our communities. Far too many. This one was from last year, last April. The Auditor General of Canada released a report on health care in the North, in NAN territory, and also in northern Manitoba. I remember coming to Ottawa to receive this report. That evening I received a call from one of our chiefs in the Keewaywin First Nation telling me that a 10-year-old boy committed suicide. This report, for the most part, has been sitting on a shelf somewhere. There's been very little action on the part of this government to implement the recommendations and the actions this report calls for.

To me, when you know of a situation, when you're aware something bad is happening, and you do nothing, that is neglect. I don't know what else you would call it. That's just negligence.

I want to ask one of our colleagues, Dr. Mike Kirlew, to talk about what this means, the inaction or the neglect on the ground in our communities. I want Dr. Kirlew to take a few moments and talk about what we mean by that.

Meegwetch.

[The Chair, Liberal, Andy Fillmore]

Thank you, Grand Chief Fiddler.

Dr. Kirlew, you have eight minutes.

[Dr. Michael Kirlew, Doctor, Sioux Lookout First Nations Health Authority]

Bonjour, everyone. My name is Mike Kirlew. I'm a physician. I work in the Sioux Lookout region. I work in the small community of Wapekeka, about 550 kilometres northwest of Sioux Lookout. I've been there for about 10 years, and in my 10 years I can say that first nations individuals who live on reserve receive a standard of health care that's far inferior to what other people get—not just a little inferior, far inferior.

The grand chief had mentioned the Auditor General's report. The Auditor General's report made a statement. It said:

...Health Canada did not have reasonable assurance that eligible first nations individuals living in remote communities in Manitoba and Ontario had access to clinical and client care services and medical transportation benefits....

What does that look like on the ground? What is the real life on the ground? Let me paint you a couple of pictures.

Imagine a young person who breaks a leg. He or she comes in to the clinic and the leg is on a virtual right angle, and you do not have adequate supplies of the pain medication that is needed. It takes nine and a half hours for that medevac to come in, and the entire time, because that supply of morphine is not there in sufficient quantities, you hear that person screaming—the entire time. That is the reality.

What is another reality? Let's say you have an individual who needs to get a tube down his or her throat because of a very severe infection, a bad pneumonia. You will not have enough medication to treat that person appropriately, and there's a good chance that you will run out. You can see that person with that tube in his or her mouth, as you hold his or her hands down so he or she doesn't reach and grab for it. The person tears. The person remembers.

It means that you run out of oxygen or have to use techniques to ration the oxygen. You see children gasping for breath. We run out of a medication called Ventolin. That's an asthma medication that helps open up the airways for children and adults with severe asthma. If you run out of that, they gasp for hours until the plane arrives. Imagine those of us sitting here as parents, if we're watching our children and that's what's happening to them. They're gasping.

At Sioux Lookout, the biggest concern of women who are pregnant is whether they are going to have an escort. Are they going to have to go and deliver their baby by themselves, or will they have somebody to at least hold their hand? That's my patients' number one fear, that they're going to deliver alone. Or will they be denied an escort?

For my patients who are palliative, their biggest fear is that they will die alone, that there's no one from their community to hold their hand—no one. No one to hold your hand. From the moment that you are born to the moment you die, your life is dominated by non-insured—dominated. That is unacceptable.

I see parents who recognize their kids might have learning difficulties, might have developmental difficulties, and there's no way to get them any services—very little. Time goes on, and they're more and more delayed.

That is the reality. That is what that statement means. That is what that statement looks like on the ground.

Section 12 of the non-insured health benefits policy states that non-insured will not cover certain types of travel. It even mentions that it is impossible to appeal this. The very first thing that it excludes says that they will not cover travel for compassionate reasons, period. We will not cover for compassionate reasons.

In health care, compassion is not something we should innoculate our health care system against. When we start losing our compassion, we lose our humanity. People are suffering, and children are dying every single day. That's what that statement by the Auditor General means.

There needs to be drastic change quickly. The longer we wait, the more people will die. The more time we wait, the more children will die. I appeal to you today, not as politicians, not as members of political parties, but as mothers, fathers, brothers, sisters, aunts, and uncles. Let's return the humanity to this process. This process needs that humanity.

[The Chair, Liberal, Andy Fillmore]

Mr. Kirlew, much appreciated.

John Cutfeet, would you like to speak to the committee?

[John Cutfeet, Board Chair, Sioux Lookout First Nations Health Authority]

[Witness speaks in Oji-Cree language]

I greet you all from Kitchenuhmaykoosib Inninuwug, that's about 600 km northwest of Thunder Bay. My name is John Cutfeet and I chair the board of the Sioux Lookout First Nations Health Authority.

Thank you for this opportunity to speak to the committee members. Meegwetch.

A number of years ago, an elder who was part of the group that lobbied for the inclusion of section 35 of the Canadian Constitution told me that after many hours, days, and weeks of negotiating for the inclusion of the recognition of aboriginal treaty rights in the highest law of the land, with a lot of resistance from the political leaders of the day, he couldn't understand why he felt exhausted, and why he would break down and cry for seemingly no reason at all. This elder was a strong man, a strong person, who stood up for indigenous rights when the Constitution was being repatriated back to Canada. If he was so strong, why then would he be breaking down and shedding tears for reasons he did not understand?

He told me that he sought and received professional counselling and the advice of elders for his situation. This gentleman was also a survivor of the residential school system. Through professional counselling and elder support, he found out that he was suffering from post-traumatic stress disorder, consistent with what is seen with with people who have been in war zones.

He said an elder told him that, “From the day we are born to the time we die, we're born into a war zone. The system fights with us to take away or control our daily existence.”

From the day we are born to the time we die, our lives are impacted by the Indian Act, another unilaterally imposed piece of legislation. We are born into a war zone with third world living conditions and widespread mental health issues from an unending cycle of intergenerational trauma. We see levels of PTSD in our people that are consistent with what is seen in war zones, and the war continues against our people to this very day.

I would like to acknowledge all those who have needlessly died at the hands of this health care system. Their deaths and suffering directly resulted from denials of care. There are many tragic stories. Here are a few.

Two children of four and five years old died in 2014 from the easily treatable disease of strep throat. They were turned away despite the efforts of their loving parents, and did not receive a simple dose of antibiotics. As one leader said, “We're tired of the Tylenol nurses and doctors, as this egregious system is killing our people needlessly.”

The health care system for indigenous people is atrocious and dysfunctional.

The late Laura Shewaybick's last experience with our health care system involved a nursing a station running out of oxygen, followed by racism and insensitivity in a hospital.

Over 25 years ago, a woman gave birth in an outhouse after being repeatedly turned away at the nursing station.

Most recently, in my home community of Kitchenuhmaykoosib Inninuwug there was a young lady who called the nursing station saying that she needed a checkup and that something was happening to her; she was expecting a baby. She described her symptoms over the phone to the nurse and the nurse said, “You have a bladder infection.”

The young lady asked if she could come in and get a checkup. The nurse replied that there was “no need to. You have a bladder infection.” All this was over the phone.

She went in anyway and asked again if she could get a checkup. The answer was, “No need. You have a bladder infection.” She was sent home. Two hours later, she gave birth to the first of two babies in a toilet bowl. What's really sad about this is that, three weeks later, they found the remnants of a third baby they didn't even know about.

As Canadians, we should all feel the shame of not being able to tell her that anything has changed in health care in 25 years.

Every day we witness travesties in health care delivery, and every day lives are being adversely impacted by health care policy. The system fights us and denies us our basic human right to health care. Our treaty rights and aboriginal rights continue to be undermined by various government legislation and policies. Failure to change this legislative violence imposed upon our people will result in continued and regular denial of care. Unless something changes, these tragedies will continue. Why do I call it legislative violence? When you take away all opportunity for people to provide input into certain health care initiatives, that is violence because you take away the right of a person to be able to be meaningfully involved.

The discriminatory policies and practices are so deeply entrenched that they're often difficult for those who live this reality on a daily basis to recognize that this is not normal and is not acceptable. As for those in the general public who are outside the system, the reality is either unknown or unfathomable.

If these real-life stories are not enough for you, then listen to the multiple reports that have been issued over and over again. These include the Scott-McKay-Bain health panel report, the NAN youth forum on suicide, and the report Grand Chief Solomon just mentioned in which was stated, “nobody wants to die: they want the pain to stop”. Of course there were the Royal Commission on Aboriginal Peoples report, the Truth and Reconciliation Commission's report, the Auditor General's report, and the UN Special Rapporteur's report on the rights of indigenous people.

It is painfully clear the system has failed our people, yet we continue to do things the same way over and over again. Einstein defined this as “insanity”, doing the same thing over and over and expecting new results. We need to do things very differently, and we need to see results. We need to change the way health care is delivered to the indigenous peoples at the community level. This requires a substantial transformation of the health care system. Redesigning the system is a large task, but ending the discriminatory and inequitable practices that cause suffering to our people is something that can and must be done immediately.

One of the first places to start would be to take a good hard look at the non-insured health benefits program. Every day this policy is in place is another day that people are being discriminated against and another day that it lives on in this nation's conscience. The needless deaths of children was nothing short of a travesty that Canada as a country and as individuals should be ashamed of. We call on you to drive the legislative and policy changes that will immediately end these discriminatory practices and that will build the foundation for a reformed health care system and a new relationship.

I hear talk about a new relationship, but that new relationship that we can all be proud of must be free from the shackles of colonialism.

Meegwetch.

[The Chair, Liberal, Andy Fillmore]

Thank you very much, Mr. Cutfeet.

Our final speaker is Chief Isadore Day.

[Chief Isadore Day, Ontario Regional Chief]

Meegwetch. Boozhoo, Wachiya, Sekoh. Good afternoon.

First of all, I want to acknowledge the creator, creation, the prayers, and the protocols that were offered today for all of our people. I want to acknowledge the traditional territory of the indigenous people—the Algonquins and the Anishnawbe. I want to acknowledge these lands on which this important meeting is taking place.

I want to acknowledge and thank the Standing Committee on Aboriginal Affairs and Northern Development for listening to these important presentations on health. I want to also acknowledge and commend my peers, the first nations leadership from Nishnawbe Aski Nation and their health officials for their tireless efforts. I can speak volumes about the work and the efforts of my colleagues. I want to tell you their expertise is second to none.

The Mushkegowuk people in the Attawapiskat First Nation are experiencing a glaring social crisis that cannot be ignored. I want to make reference to something that John Cutfeet just indicated with respect to post-traumatic stress disorder. I want to possibly give you something to think about. This is a notion that I don't think most people look at—collective post-traumatic stress disorder. It is something that might be understood by the South Africans who experienced apartheid, or possibly the Jewish community who felt post-traumatic stress during the Holocaust and thereafter. I believe that's what we're dealing with in a lot of respects with the health issues faced by first nations in this country.

The first nations health crisis can no longer be out of sight, out of mind, nor should it be treated with band-aid solutions. I want to expand, to offer the committee a glimpse of a 10-year-old boy. Also, let me tell you that Alvin and I also attended a funeral for a 10-year-old girl. Both of them committed suicide. This is within the last year.

The 10-year-old boy, his suicide was a direct result of travel cuts. There was no money to take care of this boy. The mother was an opiate addict on a methadone program, a very aggressive program. The father was a diabetic who had amputations, who needed to go out of the community to get the health care he needed. So the family was in a state of chaos. There were no mental health services for this boy, no respite care. The parents try to do what they can, the older parents, but they couldn't do anything. The boy ended up getting bullied, developing mental health issues, and decided to take his own life. This is a travesty. This is happening here. These are the sorts of stories behind these numbers.

We are here not only to describe the crippling reality. We are also here to offer real solutions. As Ontario Regional Chief in the Assembly of First Nations' national portfolio on health, I am advocating for immediate and strategic investments that must be done in full partnership between first nations, the Province of Ontario, and Canada. I am submitting that full support of the Nishnawbe Aski Nation's five recommendations being presented here today be accepted as a way forward. The proposed solutions are not unreasonable. The proposals come from them and their citizens. The point is that the community knows what the solutions are. We need the partnerships. We need the investments.

Here are some of the supporting recommendations to further strengthen the Nishnawbe Aski Nation's proposals. The first one that I'd like to offer the committee is immediate funding flow to the areas most in need. This is a critical element that Ontario already has come to bat on. Canada, we must extend these efforts across all first nations in need. This means equitable health care access at the community level and where it's most needed.

The second recommendation is that a social determinants framework be the basis for a comprehensive health action plan that includes all relevant ministries and government mandates. This means that we are calling for an immediate adjustment to the federal 2016 budget under the social development of health federal framework.

Again, we know there are investments made in health, but it's very clear that there are going to be adjustments needed to the current budget.

Third is that the Truth and Reconciliation Commission's 94 calls for action related to health be the foundation for a successful and immediate implementation plan. This would require a formal mechanism, which wasn't part of the federal budget.

The fourth one is longer-term solutions can only be realized through full engagement, with a seat at the table in the current health accord negotiations with the provinces and territories. This participation must be based on the nation-to-nation relationship.

Finally, and most vital, this set of recommendations will come in the form of a memorandum to cabinet that will call for a binding partnership on dealing with the first nations health crisis that is currently responsible for the high mortality rates of first nations across this country. I want to underscore that last recommendation. I want to let you know that you will be receiving a memorandum to cabinet on the health crisis of first nations in Canada.

We clearly cannot be doing things that have been done before. This fashioned way of expecting that ministries are going to fully understand our situation...well, we have to come forward. We have not yet been engaged in a wholesome way to be able to describe what the solutions might be.

Allow me to expand some points. Since last fall the Chiefs of Ontario have presented five key areas that must be immediately addressed by the federal government. The first one is ending the first nations health crisis, which can only be addressed by fixing the water crisis, ensuring access to health services, and fixing health benefits for first nations, as my esteemed colleague just mentioned. Number two is eliminating abject poverty through investments in housing, healthy and affordable food, infrastructure, education, and training. Number three, immediately implementing mental health and addictions services to address the youth suicide crisis, prescription drug abuse, and mental wellness. Number four is recognizing first nations authority over land and resources, as recognized within our territories. And number five is access to new technologies such as broadband Internet and green energy in order to eliminate the reliance on diesel-powered electricity.

Last month's federal budget is a good start on two fronts: addressing the water crisis and beginning to inject necessary funding for our children's education. New water and waste water funding will be $2.24 billion over five years; new education funding will total $2.6 billion over five years as well.

First of all, let me point out that the new funding for first nations is $8.4 billion spread out over five years. That works out to just $1.68 billion per year. My point is this. We must look at this year's budget and concentrate on health. If we didn't see the investments there, we must move.

It is now 2016. Last year Prime Minister Trudeau said the most important relationship for him and his government is with indigenous peoples. Every single minister has a mandate letter that emphasizes the need to work with indigenous peoples as a top priority. I have great respect for Hon. Jane Philpott and Minister Carolyn Bennett. They are both deeply committed to ending the poor health, poverty, and despair that grips far too many of our communities. I want to further underscore that we also, in Ontario, have a very significant and strong relationship with the Liberal government. In this case, we have a political accord, and this minister, through this very structured relationship process, is coming to bat on health issues. That's what enabled him to come to the community in that very direct fashion and put the investments on the table.

Again, we must acknowledge that this is about framing the relationship, framing those investments and the plan going forward.

[The Chair, Liberal, Andy Fillmore]

Thanks, Chief Day. We really have to finish up there.

[Chief Isadore Day]

With my last couple of points, then, Mr. Chair, I'll conclude. As leaders, we all aspire to some of the main tenets in serving our constituents: to be fearless builders, to increase the quality of life of our people, and to set out the petitions that we've done today to this committee. We are asking you to help us save lives and to help build our nations right across this country.

Our thoughts and prayers continue to be with all of our families who still suffer under a broken first nations health care system. Meegwetch.

[The Chair, Liberal, Andy Fillmore]

Thank you very much, Chief Day.

We're going to move right into the round of questions. I know that committee members are anxious and have many thoughtful questions to ask you.

We have the first round of four questioners. Each questioner has a duration of seven minutes, and that includes the question and the answer. I'm going to use the same system of cards, so I would ask both the committee members and our guests to pay attention to the cards, as you have been doing. Thanks very much.

The first question is coming from Gary Anandasangaree.

[Gary Anandasangaree, Liberal, Scarborough—Rouge Park, ON]

I'd like to sincerely thank the panel for taking the time to come here. I know this is probably not the first time you've been here making submissions. I can understand the great level of anxiety and frustration that you've encountered over the years. I, too, share those frustrations.

I know there are a number of very important suggestions that are being made with respect to what I believe are mid-term and long-term options and solutions, or at least the framework where we can address issues in the mid term and long term. I'm not as clear in terms of what the immediate and the short-term solutions are and I'd really like to get a better sense of that.

I know you've alluded to it, but I really would like to get it pinned down in terms of the next few weeks, the next few months, maybe within the year. Any funding that's proposed or that's going to come through, for it to filter through, I suspect, won't happen in the next six months or even a year.

That's what I would like to get a sense of from all of you. I won't really go into a second round because it's a big question and you can all try to answer from your vantage point.

[Grand Chief Alvin Fiddler]

In terms of immediate needs or immediate steps we could take now, when we look at communities like Attawapiskat or Pikangikum, our immediate priority is always to ensure that they have the supports that they need at that moment, whether it's mental health supports, counselling, therapists, or child psychologists to go there and hopefully stabilize the situation on the ground. That's obviously our number one priority, to support our communities that are in crisis now.

In terms of other measures that we can take, I want to ask this committee to work with Minister Philpott and Health Canada on some of the policies we referenced in our presentation, for example, to lift the travel restrictions on non-insured, especially when it comes to children. I'm going to ask my friend, Dr. Kirlew, to expand on that. We need to look at access, especially with our children who are living in remote areas. If we cannot bring that service, that treatment, or whatever it is that they need to their community, we need to bring them out, so that they get it somewhere else.

This speaks to Jordan's principle. There was a private member's bill that Parliament adopted, which is great, but we need to make that into law. We need to move beyond the jurisdictional wrangling that many of our kids and our families find themselves in daily. We need to improve that access now.

I'm going to ask Dr. Kirlew to briefly expand on what I mean by access.

[Dr. Michael Kirlew]

We have Jordan's principle, but the problem is we don't have Jordan's practice. We need Jordan's practice.

Children are being left behind. I have no way of getting children that I see out for access to developmental services, essential services such as speech language pathology or occupational therapy. I am very limited in what I can do, because non-insured...does not pay for the travel out.

I would think a first step would be that we not put any barriers for children to access care. If that's children accessing mental health services, let's not put any barriers. If it's children accessing developmental services, such as speech language pathology or occupational therapy, let's not put any barriers to care.

There's another practice that happens routinely, and it's that children who are unregistered are denied their transportation out. That practice needs to stop immediately. Let's worry about the registration and the paperwork when we get the child, and get the child care first.

Those are just a couple of examples of policy changes that would at least help start pointing us in the right direction. Right now, children do not have access to their essential services. There is going to need to be significant health care transformation. My question is what I should do in the meantime. I have children who cannot speak now. I have children with autistic spectrum disorder who have zero access to service. What do I do now?

I think the practice of denying pregnant women escorts needs to stop immediately. There is no basis for that in medical science, in medical theory, or even basic human decency. Which one of us would want to deliver a child by ourselves, not having our partner or our support person there? I think that practice needs to stop.

[The Chair, Liberal, Andy Fillmore]

There's a minute left.

Chief.

[Chief Isadore Day]

Very quickly then, Mr. Chair, just as a short history bite, the NNADAP program back in the seventies was one of those moments in time where the federal government and first nations across this country said we need help. Cabinet actually went forward and they helped with the investment in an NNADAP program, which still exists.

However, with the evolution and the challenges over the years, with the changing face of addiction and mental health, this NNADAP program needed to be reviewed from time to time. We're dealing with pay equity. We need pay equity in the communities with respect to addictions workers.

As well, Mr. Chair, what has happened is that with the NNADAP program, there's a review called Honouring our Strengths. Basically there was no money under the former Conservative government for this review. It was get the review done, see what you can do at the community level. What was created was Honouring our Strengths.

One of the things that came out of that process was the first nation mental wellness continuum framework. What we're told, and we're hearing it right across our communities, is that this framework works.

Just as we've seen here days ago with the investment made by the provincial government, we need those immediate, on-the-ground investments. What we're asking for here is that the committee support 80 mental wellness teams, 80 community health teams on the ground today, at a cost of $500,000 per team. That's what can be done today.

[The Chair, Liberal, Andy Fillmore]

Thank you very much.

The next question is for Cathy McLeod.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

Thank you, Mr. Chair. Thank you all for some very powerful presentations about the very difficult challenges that you face every day.

I think across the country the way things are structured is a little different. I'm just trying to understand a little better. For example, in British Columbia, to a fairly large degree, for the decisions around policy the money is transferred in a pot, and then the communities actually have a lot more opportunity in terms of decision-making around policy.

My question is where, in that structural sense, your communities are at, and where do you need to be? To me that was always.... There's a pot of money and there's some best practice, and the communities make the decisions about how they support the programs and services they need.

[Chief Isadore Day]

I think it's important to note, and I know my colleague will expand on this, the situation we have right now is that various regions have access to current health care systems in urban centres and some in remote regions, but in the remote north they have very specific needs. You can no longer do business like this in terms of health. It cannot be based on budget limits. It has to look at the needs within the regions. We need regional models and frameworks that are going to address the regional needs.

[Grand Chief Alvin Fiddler]

I would like to add to my friend's response to your question about the challenge and the issue we're talking about on health care. I think the problem that we have is the health care system is based on the Indian health policy, which came out in 1979. That's close to 40 years now, and the various policies that flow from that are not based on the needs of our communities. That's something the Auditor General confirmed last year.

What we're saying is that we need to transform the health care system, and it has to be a collaborative effort where first nations sit with the appropriate federal officials, and also the appropriate provincial officials, for us to design the system that will finally work for our communities.

[Cathy McLeod, Conservative, Kamloops—Thompson—Cariboo, BC]

My next question is for Dr. Kirlew. First of all, how many of the communities have reasonable broadband?