Evidence of meeting #22 for Indigenous and Northern Affairs in the 44th Parliament, 1st session. (The original version is on Parliament’s site, as are the minutes.) The winning word was care.
A video is available from Parliament.
Liberal
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
Thank you, Mr. Chair.
I'm always glad to hear from you, Grand Chief Daniels.
As we go through this study, one of the things that keeps popping into my mind is that a lot of the challenges that are being faced are the result of someone besides first nations deciding for first nations how they should manage their health system, what to approve and what not to approve. It's not based on that community's needs or cultural values, but rather what a bureaucrat has decided should be appropriate for our communities.
With the successes I've seen around nations taking on their own jurisdiction, whether it be in education or health, is that part of the solution, Grand Chief, that we need to look at? It's giving nations the ability to take over jurisdiction of their own health with bilateral agreements between the federal government and those nations.
We've seen really good examples of how that's happened, including MK out in Nova Scotia. I wonder if you could speak to that a bit.
Southern Chiefs' Organization Inc.
I think that's the only solution at this point. The reason is that the life expectancy gap is not changing right now. It's not changing in its trajectory. It's actually getting worse. We need to be innovative in utilizing the very limited health resources that are already allocated and trying to add value to that. That's why we've tried to look internationally. That's why it's important for us to build internal capacity for ourselves and not be tied to a system that is going to look after its own and not necessarily look after us. It's not a system that has put first nations' interests at the top of the list.
We're at the margins of every socio-economic indicator that you can point to in this society. That reflects, from anybody who has independence in their political observations of health.... I think it's important to understand that. It's not going to simply change or tweak because we add a few first nations people in there.
We need to be at the nucleus of the decision-making and have control over that so we can hire the best minds and most seasoned veterans in health. They can take an approach that respects the jurisdiction and first nations patients, and does everything it can to maximize the very limited resources. We understand that's a very limited amount. We need to be able to deal with these things in a way that is going to maximize that impact. That's what we want to do.
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
Can I ask if you know of any examples of where this is working, where nations have taken over jurisdiction of health? I'm not aware of any. I thought I'd ask you.
Southern Chiefs' Organization Inc.
You'd have to go outside of Canada. Let's look at Alaska, where they're running the whole system over there with the school. I think that has been the best example for us. We went there. We saw it. We saw a patient-focused model that's about the patient. It's fulsome. It's not simply a doctor. It's all aspects of one's health, right from the day a person is born all the way until their death. It's the same health team or unit that monitors and provides that health service.
We are looking at those sorts of models to try to maximize and create a health system here in Manitoba.
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
Thank you, Grand Chief.
I have a question for you, Ms. Clark. You said at the end of your report that you had some detailed recommendations. I'm wondering if you could speak to the missing and murdered indigenous women and girls calls for justice or the TRC calls to action. What recommendations would you make for us as a committee to move forward on? Perhaps you could name a few. We have only about a minute, so perhaps you could give me the most pressing ones.
Manager, Policy and Research, Native Women's Association of Canada
Is this on the NIHB?
Manager, Policy and Research, Native Women's Association of Canada
Do you mean specifically related to MMIWG?
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
If any come to mind, yes. I don't want to put you on the spot. I know that there are 231 calls for justice and 90-some calls to action. I'm wondering if you can give us, from the NWAC's perspective, the pressing recommendations that you think we should move forward on as a committee.
Manager, Policy and Research, Native Women's Association of Canada
I don't think I can fruitfully answer that question in a minute.
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
You have some time, and you can put it in writing at a future date. I know it's a lot to ask, but as we try to get a really good study moving forward, we want to have good recommendations moving forward to our government.
Manager, Policy and Research, Native Women's Association of Canada
Absolutely.
Liberal
Jaime Battiste Liberal Sydney—Victoria, NS
If you could provide those and give it some thought, I think that would be tremendously helpful from the NWAC.
As well, make sure to tell President Whitman I said hi.
Manager, Policy and Research, Native Women's Association of Canada
Absolutely. I will.
Liberal
The Chair Liberal Marc Garneau
Thank you very much, Mr. Battiste.
Ms. Bérubé, you have the floor for two and a half minutes.
Bloc
Sylvie Bérubé Bloc Abitibi—Baie-James—Nunavik—Eeyou, QC
Thank you, Mr. Chair.
We know very well that the common threads in a number of studies on communities and indigenous affairs are remoteness and isolation.
For communities living in remote regions, as is the case in the north and in my riding, the professional pool patients have access to is considerably reduced.
My question is for the three witnesses.
Do you have any recommendations on access to medical transportation?
What can we do to cut red tape?
Liberal
The Chair Liberal Marc Garneau
Thank you, Ms. Bérubé.
We'll start with Ms. Clark, then go to Grand Chief Daniels, and then to Ms. Idlout.
Please be fairly succinct. We have only a couple of minutes.
Manager, Policy and Research, Native Women's Association of Canada
Absolutely.
I think one of the easiest ways we could cut red tape and reduce the time that goes into medical transportation would be flexibility in arrangements and having fewer levels of bureaucracy involved, as Grand Chief Daniels was saying, devolving it from what it is right now and putting it in the hands of indigenous folks. They know what they need. We should ask them. We should let them be able to decide how and what transportation looks like.
Thank you.
Southern Chiefs' Organization Inc.
I would say that you transfer jurisdiction, allowing first nations to make the decisions and find alternative ways to create and maximize the use of that funding.
Officer, Compensation and Benefits, As an Individual
I'm sorry. I don't know how to answer this question.
Liberal
The Chair Liberal Marc Garneau
We would like to know how to make medical transportation more efficient.
Ms. Idlout, the question was on whether you have any recommendations for how to make the transportation of patients from their homes to medical centres more efficient. You've spoken a lot about escorts. Are there other points you would like to bring up?