It's a topic of interest and passion.
It's about having some flexibility to allow communities to propose and implement innovative solutions. Whether it's transportation, dental care or other services, there are other ways of delivering services. Sometimes providing a service through the private sector, for example in the transportation sector, can lead to savings in overall costs. So, thinking about a more holistic vision for health and the basket of services could be a way to properly manage the public funds that are provided through the program. Ultimately, it's about recognizing the legitimacy of the communities, which must be at the heart of the thoughts and solutions proposed. That is a central element.
As of today, absolutely no decision, no direction, no change must be implemented within the framework of the NIHB program without first nations having had an opportunity to analyze the impacts on their populations. That is sort of what we deplore, meaning that first nations often find themselves behind decisions that are made unilaterally in the country, without being able to link services together, putting in place safety nets for people who are more vulnerable or thinking about different solutions. This is central to this reflection and to the continued work on improving the program.
There is also a need to ensure that work continues, that information is shared with professionals and that adequate support is provided to patients.
There is a one piece of data that we don't see anywhere: we don't know how many patients will ultimately not get the service. At the First Nations of Quebec and Labrador Health and Social Services Commission, we have exchanges with professionals. We have a liaison officer who provides support to communities in the Quebec region. Many professionals have told us that many patients will forego a service when they are told there are additional fees. However, that information is nowhere to be found.
Earlier, Valerie Gideon mentioned that there were 15,000 dentists enrolled in the program. However, how many of them actually follow the fee schedule for the services provided? They may be registered in the program, but are their services actually accessible to first nations populations?
This absolutely must be taken into account when considering improving the program.