Thank you very much.
I am here as a dual representative: as the deputy chief medical officer at first nations and Inuit health branch headquarters in Ottawa, but also as the vice president of the Indigenous Physicians Association of Canada.
The Indigenous Physicians Association of Canada is invested in supporting indigenous physicians across the country, indigenous patients and clients and indigenous health and transforming the system. We understand that the colonial experience and the “health interrupted” of indigenous peoples are major factors in their unwellness. We advocate for self-determination and governance, or indigenous control over indigenous health services, recognizing that health services, access to health services and health services as a determinant of health are in a spectrum of the social determinants of indigenous health, which I'm sure you have heard about quite often here.
There are a few items that the Indigenous Physicians Association of Canada would like to touch upon, such as the need for good, distinctions-based first nations, Inuit and Métis public health data—or, really, just health data—so that we get a clearer picture of where we're working and how our clients are doing, which will point us in a direction of wellness.
There are many areas where indigenous peoples need help and support, but here are a few. One is communicable diseases. Also, mental health and wellness have been identified quite early as a need, particularly by the chiefs of Canada. Others are social determinants of health, such as housing, and, of course, the areas where we work: in communities, or within the territories of first nations, Inuit and Métis, and within our clinics and hospitals.
You've probably heard by now about a number of aspects of the non-insured health benefits program, but I wanted to touch upon a few areas where we often complain or hear complaints.
One is the NIHB program appeals process. If coverage for a benefit through the health benefits program is denied, clients, parents, legal guardians or a representative of a client may appeal the decisions. There are three levels of appeal available. Appeals are assessed by a different program official at each appeal level. The NIHB program aims to send clients a written explanation of the decision for an appeal within 30 business days 80% of the time under normal circumstances after receiving completed appeal documents.
The First Nations Health Authority of B.C. understood that the timeliness of the appeals program was difficult and endeavoured to do quality improvement so that the period of time for response and for appeals was considerably shortened.
Next is medical transportation to access traditional healers. The non-insured health benefits also support access to traditional healing services through the medical transportation benefit, which provides eligible clients with coverage for transportation to access health services not available locally, including traditional healing services.
In terms of catheters, they were a topic of discussion a couple of years ago, but this bears reiterating. Items covered under the NIHB program's medical supplies and equipment benefit are intended to address our clients' medical needs in relation to basic activities of daily living, such as eating, bathing, dressing, toileting and transferring. In 2017, NIHB increased coverage for disposable intermittent urinary catheters to four per day and removed the prior approval requirement.
The non-insured health benefits program reviews its services and coverage regularly. We have a non-insured health benefits oral health advisory committee, which is made up of several dentists. Their bios are available on our website.
Our drugs and therapeutics advisory committee includes seven physicians and a few lay people and is chaired by Dr. Derek Jorgenson and vice-chaired by Dr. Marlyn Cook, an indigenous physician from Manitoba.
We also have a medical supplies and equipment advisory committee, which includes vision care experts, a registered nurse, a family physician, a public health physician, a health economist, an ophthalmologist, a podiatrist, etc.
As a side note, I absolutely understand that quality control and the improvement of the quality of services for first nations, Inuit and Métis are an important aspect of system transformation. We take that transformation seriously and understand that consultation with health experts and health leaders, like the indigenous physicians here, is extremely important. This is beside speaking to indigenous clients and indigenous leaders, like chiefs.
I'll end my statement there. I'm happy for discussion.
Thanks very much.