Thank you for the opportunity to be here this afternoon.
I'm speaking to you from the traditional territory of the Kwanlin Dün First Nation on the Ta'an Kwäch'än Council.
Thank you to my colleagues across the north for the important details about how the NIHB process operates in their territories. We have some similarities and some differences.
In the Yukon context, we have 14 individual first nations that operate here in the territory and reside in their traditional territories. Eleven of those first nations are self-governing under the Umbrella Final Agreement from the early 1990s. That makes us a bit different and unique compared to other parts of Canada.
While I certainly agree with my colleagues about the benefits of the NIHB process, our approach is certainly not as coordinated as, for instance, that in the Northwest Territories, which administers the federal program. Our Canadian system of health care is complex, a patchwork of policies and legislation and relationships.
We certainly submit to your committee for your consideration that a better coordinated approach is needed, but it does remain a challenge. In order to improve clarity and consistency of delivery, we are working hard here in the territory to improve our own system and certainly to make changes to the way in which NIHB operates in conjunction with the Yukon system and how we provide service delivery to individual Yukoners, which, of course, is the primary goal. That is critical.
A number of years ago, we had an independent review of Yukon's health care system, which was known as “Putting People First”. One of the recommendations from “Putting People First” was, in fact, to have a better coordinated system with the NIHB. It indicated that uncertainty in that process definitely causes inequities. The territory has the responsibility to provide universal publicly funded insured health services to all residents of the Yukon territory, including Inuit, Métis and first nations individuals. Our “Putting People First” is an example, I think, of a health transformation project, and we know others have happened across Canada. It is aimed at improving health outcomes and access to services for all Yukoners, and in the process we are now focused on determining how first nations people can be a part of implementing the “Putting People First” recommendations from a transformational standpoint.
We know that will require organizational capacity and ultimately engagement with our Yukon first nations as well as service delivery improvements, not only in the Yukon health system but in NIHB and the way in which the two interact. We're focusing on new models of health service delivery.
The current process we have, without going into too much detail, involves NIHB being a pair of last resorts with respect to determining whether or not individuals happen to be status first nations individuals or otherwise and whether or not the Yukon health care system makes looking after their costs a priority. The lack of coordination does create barriers to service consistency.
As I've noted, our own insured health services need to be improved, and we are focusing on that. The “Putting People First” focus will be for people-centred, patient-centred, client-centred, trauma-informed wraparound services across the territory. This is particularly critical at this time when better coordination will be our goal, especially as we face the substance-use health emergency here in the territory that was declared by our government on January 20.
We are seeking to provide harm-reduction strategies that are new and improved. We certainly have individuals who, for instance, would qualify to have treatment outside of the territory for addictions, which might be covered by Yukon government. They might be covered by NIHB. Those two things are not necessarily the same. The locations they might be able to go to for treatment are not necessarily the same, and that certainly provides confusion.
That whole process, those experiences and the lack of coordination, I'll say, exasperates individuals and adversely affects those Canadians who are often most in need.
Our experience here in the territory is also that individual first nations governments—of which we have 11—often end up absorbing costs for health services that are not theirs and for which other governments are provided funding, whether they be the Government of Yukon or otherwise.
I want to focus just for a moment—I know my time is running out—to come up with a few solutions.
I think language is incredibly important as we proceed to modernize our structures and make sure they are meeting the needs of Canadians.
I think we need to recognize that diverse governing structures do exist across Canada for first nations, Inuit and Métis people. Perhaps references to “traditional territory” or “self-governing first nations”, rather than just “reserve”, or “on reserve”, is just a small example. We do not have reserve land or individuals who live on reserve here in the territory and, unfortunately, just referring to the language sometimes confuses folks.
We are very supportive of a trilateral table and tripartite conversations. I think Yukon's unique situation can contribute to some of those solutions. We are very committed to doing that work at those tables because we do think that this is a system that is ripe for improvement, but we can do that together in partnership.
There is an example of some rather successful reciprocal-type agreements that exist, for instance, with the first nations governments and Canadian provinces and territories around social assistance, as an example, so there is a framework—