Indigenous and Northern Affairs Committee on Nov. 30th, 2017

[Charlie Angus, NDP, Timmins—James Bay, ON]

Thank you, Madam Chair.

Minister Philpott, I'm looking at the recent Auditor General's report on the problems with the first nation and Inuit dental.... The program can't really tell where they're yielding results. They're pointing to existing deficiencies.

I refer you to one of your own departmental documents from the British Columbia region that said that in both first nations child and family services and first nations and Inuit health branch they were denying dental “even in emergency situations”. That was the B.C. report. I can give it to you if you want. They say, “More and more, dentists...refuse to deal with Health Canada directly because of very long delays in receiving payment”.

Given the fact that dentists don't want to deal with the department, do you think that is a reason we're having serious problems with the dental issues of first nation children?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

As you know, the Auditor General's report spoke to the large amount of programming we have for dental care and oral health. I certainly appreciated the Auditor General's report and had an opportunity to meet with him.

One of the challenges around oral health is that it has been severely underfunded in the past. If you look at something like the children's oral health initiative, which has been widely acclaimed as being very successful, until recently we were only able to provide it to about half the potential recipients because the program had been flatlined since its creation at $4.5 million per year. Thankfully, in last year's budget we were able to receive an investment of $45 million over five years, which will essentially roughly triple the potential opportunities of what that program can do.

Without question, there is work to be done in moving to a more outcomes-based approach of tracking the results of that program, but the department was unable to develop a new strategy and determine how that could be expanded and how they could change to something more results and outcomes based because they did not have the funding they needed to expand. Thankfully, this is done, and the department is working very actively in developing that framework.

[Charlie Angus, NDP, Timmins—James Bay, ON]

It was a real honour to have you in our community of Kashechewan. You have seen the conditions the people are facing there. We have no dental services in Kashechewan. We have children being fed Tylenol on a daily basis. I have contacted you about this, but this is ground zero of the failure to deliver programming to children in first nation communities.

How do we transform the situation in Kashechewan? If we don't have dentists going in, it doesn't matter how many studies are done; kids are suffering.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you for calling that to my attention. As a result of your speaking to me about that and other requests, I have had the opportunity to look into this situation. In fact, I had the opportunity to meet Chief Leo Friday recently with one of my assistant deputy ministers. I raised the issue of why we're having trouble getting dentists and dental care for that community.

Like many other parts of the work we do, we acknowledge that human resources are a real challenge for us, and getting these health care professionals to communities is very difficult in many cases. There is still work to be done in Kashechewan, but the senior levels of my department are working on this, to be able to address and determine how we can get better dental care in that community.

[Charlie Angus, NDP, Timmins—James Bay, ON]

Thank you very much for that.

I have one last question on dental care. You're still fighting the Shiner case. Canada spent over $110,000 fighting this young girl. The rejection rates have been 99% and 100%. This has gathered international media attention. Why?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

I'm very happy to have a further conversation with you. This actually warrants a longer conversation, but I will, as you know, be happy to clarify that access to orthodontics care is not a universal benefit in Canada. The first nations and Inuit health branch actually approves more opportunities for orthodontic care for medically necessary cases than any other public benefit plan in the country, but we don't provide, for example, access to care for cosmetic cases. I also want—please permit me—

[Charlie Angus, NDP, Timmins—James Bay, ON]

I think, just in fairness, it's not a cosmetic case when we're talking about chronic pain—

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Let me—

[Charlie Angus, NDP, Timmins—James Bay, ON]

—and someone losing her teeth, and she's 13 years old.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Let me explain to you the circumstances of this case. We have criteria, and I want to make sure that we clarify the point, and I would appreciate your not mischaracterizing the costs that the department has incurred. There is nobody fighting anyone in court. The cost that the department has incurred was to confirm that due process was followed and that the policy was followed appropriately. That has been—

[Charlie Angus, NDP, Timmins—James Bay, ON]

Are you saying you haven't spent $100,000 on legal costs?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

There have been costs in the department. When a public government establishes a benefit plan of any kind you have to have criteria.

[Charlie Angus, NDP, Timmins—James Bay, ON]

I understand but $100,000 against a girl for a case that would cost $6,000....

[Jane Philpott, Liberal, Markham—Stouffville, ON]

This has been—

[Charlie Angus, NDP, Timmins—James Bay, ON]

When you have rejection rates of 99%—

[Jane Philpott, Liberal, Markham—Stouffville, ON]

—repeatedly addressed, and it has been affirmed that the policy benefit plan has been followed appropriately. Like all other aspects of the non-insured health benefit plan, this particular part of the policy, and everything else, is something that we look at constantly to determine whether there need to be policy changes. We're in an active process of that in our government, and we look forward to further conversations about the policy.

[Charlie Angus, NDP, Timmins—James Bay, ON]

They will be back in court in January and February, so can we assume there will be more costs to Canada?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

As I said, this is something that I am following. We want to make sure we have the right and responsible policies associated with the non-insured health benefits plan, but I can assure you that the policy was followed appropriately in this case, and that's been reaffirmed on repeated occasions.

[Charlie Angus, NDP, Timmins—James Bay, ON]

In terms of the Canadian Human Rights Tribunal ruling, I'm pleased to see movement on Jordan's principle, but you're still in non-compliance on child and family services. There are still serious concerns. In Parliament, both ministers voted to move that $155 million shortfall that was identified, and that money did not flow. Actions matter in this.

Why did your department ignore the order of Parliament to flow that $155 million to get funding into a very broken and underfunded system?

[The Chair, Liberal, MaryAnn Mihychuk]

Please be very short.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Again, I'm happy to give you further details at another occasion. This is a really important issue, and you know that we have put hundreds of millions of dollars into addressing Jordan's principle and child welfare and new money that wasn't there before. There is much more work to be done on child welfare. That's why I've called an emergency meeting.

[Charlie Angus, NDP, Timmins—James Bay, ON]

The child welfare money had been identified by the Harper government. You're just following through.

[The Chair, Liberal, MaryAnn Mihychuk]

Questioning now has to move to MP Amos.

[William Amos, Liberal, Pontiac, QC]

Thank you, Madam Chair.

I'd like to pick up on the line of questioning I advanced earlier, and I'd like to maybe open the opportunity for Mr. Wild to add to this, because I know he's been involved in initial discussions around opening discussions with our Algonquin people on the Quebec side. I'm most interested to know, in the context of a negotiation, if one were to be moved forward, how the public of this region would be engaged.

[Joe Wild, Senior Assistant Deputy Minister, Treaties and Aboriginal Government, Department of Indian Affairs and Northern Development]

In terms of public engagement, there are a number of different opportunities, some of which originate from the government, some of which originate from the first nations, and some of which can originate from the public itself. In terms of the public, I think everyone's encouraged to get educated on indigenous issues in the country, and a starting point, in a lot of ways, the gateway to that, is reading the Truth and Reconciliation Commission's report. I would encourage all Canadians to make sure that they take a look at it so that they understand the things that are being raised in that report and that they take the time to review the recommendations that are in that report.

Another thing is, if a member of the public wants to figure out what role they can play and how they can engage with a first nation community, they should look at the friendship centres that exist. That's a good resource to go in and to have dialogue. If they're going to approach a first nation, do so with some humility and respect, and basically look to the first nation to give them back guidance in terms of how they would want that interaction to work with them rather than going in with their own mind made up about what they think it is that they ought to do in terms of the interaction with the first nation.

Specifically in the process, whenever we do an agreement that involves anything around indigenous title and land, there is always a consultation process that occurs as part of that. We as a government have an obligation to consult. We have to make sure that neighbouring first nations understand what's going on, particularly to ensure whether or not there's any impact on their own rights in a particular area. Also, there are usually public sessions that are held to ensure that general members of the public have an opportunity to understand what the arrangements are and what impact those arrangements are going to have.

Then in particular, if we talk about the Algonquins of Ontario, they've taken unprecedented steps, in some ways, trying to engage their community with the larger, non-indigenous community within their territory. They've done a lot of work in community outreach. They've done a lot of work to try to reassure hunters, fishers, and those who also use crown land that may be impacted by the settlement that they are going to do things in a way that will be responsible and that will still allow non-indigenous people access to resources, parks, and so on.

There are a lot of different ways this comes about and on different fronts.