Drin Gwiinzii. Good afternoon, Mr. Chair and honourable committee members.
My name is Ken Kyikavichik, and I am the grand chief of the Gwich'in Tribal Council of the Northwest Territories. I was elected in September of 2020, and I am here speaking on behalf of the over 3,500 participants in our Gwich'in Comprehensive Land Claim Agreement, which we signed with Canada in April of 1992.
I would like to thank you for the opportunity to speak to the committee on today's topic. Today I will focus on how we, as the Gwich'in Tribal Council of the Northwest Territories, feel that the non-insured health benefits program, or NIHB for short, is failing not only our Gwich'in participants but the broader majority-indigenous population of the Northwest Territories.
The confusion and miscommunication between the NWT health care system and the NIHB leads to gaps and non-client-centred care. The issue of medical escorts is a major concern for residents of the north. Our people are often at least a full day's travel away from larger medical facilities and centres in Yellowknife and Edmonton. For specialist care, community health centres in our communities of Aklavik, Fort McPherson and Tsiigehtchic, along with our regional hospital in Inuvik, NWT, are not well equipped. As a result, our residents are required to travel to these southern locations for the care they require.
It is common for us to hear of residents who require a medical travel escort and do not receive one. This is especially concerning when we are dealing with the elderly. Some examples that we flagged in the summer of 2021 for NWT health minister Julie Green included procedures with sedation, back surgery, those in a wheelchair or walker, and those who have language and mobility issues.
When medical travel escorts are sought from the NWT Health and Social Services Authority, our people are often caught in the bureaucracy and are required to prove their conditions, otherwise this essential support is seemingly automatically denied. As one can imagine, this leaves our residents and families feeling very angry, frustrated, disappointed, stressed and ultimately hurt, as they are engulfed in the policies, procedures and red tape associated with these government benefits in the NWT.
Esteemed members of this committee, picture yourself being in what are supposed to be your golden years. Perhaps you are a residential school survivor. You are told that you require a medical procedure in the south, far away from home. You are then told that you are to be picked up by a van for transport to the nearest airport. You get to the airport often hours in advance because there are other trips to coordinate. You fly almost six hours into Edmonton through Yellowknife and then wait for the transport to your accommodations. By the time you lay your head on your pillow, as many as 16 hours may have elapsed.
You wake in the morning, and you're told where to be for pick-up for your appointment. In all of this, it is expected that you are able to speak English, but there are many in the NWT who do not speak English as a first language. You arrive at the hospital, and you wait once again for your appointment. Sometimes you may see people arrive after you and be seen before you. You wonder why, but you really don't know who to ask.
When you finally see a physician or specialist, you may be asked some uncomfortable questions about your personal life, things such as, “Do you drink?” or “Do you smoke?” You may have limited means while in the city. Many are at the complete mercy of the system, and some cannot afford things such as a good place to eat, taxis or a hotel should they get lost in the shuffle. At times, you may feel judged about your lifestyle, which is not common in southern Canada. Some of these individuals are over 80 years of age.
You see, honourable committee members, we revictimize some of our residents when there is no advocacy or support. Many NWT residents go without a medical travel escort, even when they require support. It is often those most vulnerable who are left without support and advocacy. That is the reason I am here speaking with you today, to highlight the serious issues in which that we find ourselves in the Northwest Territories.
The interpretation of “escort” and exceptions policies appear to be a flashpoint for both the Government of the NWT and the NIHB. We often hear from the GNWT that the medical travel system is not a compassionate system. That is very odd terminology to be using in a post truth and reconciliation world.
Ultimately, honourable committee members, that is what we are seeking—basic care and compassion by the Government of the NWT and for NIHB to respond appropriately to the diverse and unique medical situations of our people. We must establish a common standard for all residents of the NWT, Yukon and Nunavut.
I would like to share that, first, the provision of NIHB benefits is not working for residents of the NWT, which includes our Gwich'in participants. Second, we are also seeing and experiencing systemic denials of medical travel escorts for our people, especially those who are indigenous. Third, the medical travel system in the Northwest Territories appears to lack the compassion that is required for these very sensitive situations our residents face. Fourth, to this end, the Gwich'in Tribal Council would be pleased to share our experiences with the governments of Canada and the Northwest Territories so that we can develop a more comprehensive and coordinated NIHB system for all.
In closing, the Gwich'in Tribal Council would like to recommend that, first off, a review be undertaken that looks into how the Government of the NWT works with NIHB on the provision of medical transportation services. It is our understanding that the NWT Health and Social Services Authority administers the NIHB medical transportation on behalf of NIHB to offer a more seamless provision of services for patients from the Northwest Territories accessing care outside of their communities. We need to assess the timeliness of the program, from approval to denial, and an expedited appeal process to provide some clarity.
Second, if there are any opportunities to review the NIHB medical transportation provisions more closely, the Gwich'in Tribal Council would be open to exploring options on behalf of the government for medical transportation that includes or involves our Gwich'in participants. We recently applied for and were denied an NIHB navigator position. The reasons for this denial cited a population-based formula that dictated the creation of NIHB positions across the country. It is apparently one NIHB navigator for every 65,000 residents.
Based on the complexity of the many issues and examples that I stated today, clearly the reality for northern residents is fundamentally different from that in the south. A standard, nationwide, formulaic approach once again does not meet the needs of the residents of the north.
Hai’. Thank you for your time and the opportunity to present today.