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Management of Programs for First Nations

Main Points

What we examined

In this follow-up audit, we examined the progress of five federal organizations in implementing 37 recommendations we made between 2000 and 2003 on First Nations issues. The recommendations were included in chapters that covered housing on reserves, economic development, third-party intervention, health care, the food mail program, comprehensive land claims, and reporting requirements for First Nations. We also identified factors that appear to have been critical in successfully implementing our recommendations.

Why it's important

According to numerous sources, including the Royal Commission on Aboriginal Peoples, Canada's First Nations communities face persistent challenges such as high rates of unemployment, poverty, and health problems. The federal government is responsible for fulfilling treaty and fiduciary responsibilities to First Nations people—lawful obligations that arise from treaties, the Indian Act, and other legislation. It is also responsible for delivering to First Nations communities social and economic programs that can directly improve the lives of the people living there—programs similar to those provided by the provinces, territories, and municipalities elsewhere in Canada. However, even though the federal government spends billions of dollars a year—just over $8 billion in 2004–05—on 360 programs and services targeted to Aboriginal peoples that address issues such as housing, health care, education, and economic development, the conditions in many First Nations communities and of many Aboriginal peoples remain significantly below the national average.

What we found

• Overall, the federal government's progress in addressing our 37 recommendations on First Nations issues has been unsatisfactory. While the issues are extremely complex, federal organizations had agreed with most of our recommendations and had committed to taking action. We found their progress on 15 of our recommendations to have been unsatisfactory. These are generally the recommendations that are most important to the lives and well-being of First Nations people. We found that little had been done to deal with the serious problem of mould in houses on reserves. We also found that progress has been unsatisfactory in analyzing patterns of prescription drug use and drug-related deaths among First Nations people, implementing comprehensive land claim agreements, eliminating unnecessary reporting required of First Nations communities, and addressing gaps in the Third Party Manager Policy.
• Progress to date has been satisfactory on 22 of our recommendations, although in most cases implementation is not yet complete. These recommendations tend to be more administrative in nature and have less direct impact on the lives of First Nations people. For example, we found that housing programs are now better integrated and many elements are now better managed by the responsible organizations.
• In this audit, we identified seven factors that appear to have been critical in the successful implementation of our recommendations. We found that organizations were more likely to have made satisfactory progress if programs and initiatives were well co-ordinated, received the sustained attention of management, and involved meaningful consultation with First Nations. In many cases, success in implementing our recommendations was linked to the capacity of First Nations to carry out programs in their own communities and to the presence of First Nations institutions that supported the communities' economic and social development. Further, ensuring that programs and initiatives were based on appropriate legislation helped to clarify roles and responsibilities, eligibility issues, and other program elements. Finally, the different roles of Indian and Northern Affairs Canada create at least the appearance of a conflict between the Department's fiduciary responsibilities for First Nations and its obligations to act on behalf of the Crown—a conflict that has an impact on the implementation of our recommendations.

The government has responded. The government agrees that the seven factors identified by the Auditor General are important and that where satisfactory progress has been made on the Auditor General's recommendations, one or more of these factors were present. The government's overall response is included at the end of the chapter.

Introduction

5.1 According to numerous reports, including the Royal Commission Report on Aboriginal Peoples, First Nations people generally face far greater challenges than those faced by the wider Canadian society. While recent years have seen improvements in levels of education and economic development, high levels of unemployment, poverty, and health problems continue to pose challenges.

5.2 The federal government has established many programs and services for First Nations communities. The Treasury Board Secretariat reports that 34 federal organizations fund 360 programs and services directed to First Nations, Inuit, and Métis communities. Many of the programs directed to First Nations often parallel those delivered by provinces and municipalities in non-First Nations communities. These include programs focussed on education, health care, social assistance, and community infrastructure such as roads. Program delivery is sometimes challenging given that, according to Indian and Northern Affairs Canada data, about 60 percent of First Nations communities have fewer than 500 residents, just under 40 percent of the Status Indian population is under the age of 20, and just over 45 percent of Status Indians live in rural areas and almost 21 percent live in special access zones or remote zones.

5.3 According to the Treasury Board Secretariat, the federal government spent almost $8.2 billion in 2004–05 on these programs and services targeted to Aboriginal peoples. Much of this funding—almost $5.1 billion—was administered by Indian and Northern Affairs Canada. Health Canada spent about $1.7 billion on health benefits for First Nations people living on and off reserves and for Inuit. Other federal organizations collectively spent over $1.4 billion.

5.4 Funding for First Nations programs has increased in recent years, but not at a rate equal to population growth. Indian and Northern Affairs Canada's funding increased by only 1.6 percent, excluding inflation, in the five years from 1999 to 2004, while Canada's Status Indian population, according to the Department, increased by 11.2 percent.

Canada's relationship with First Nations has changed

5.5 The federal government has had responsibility for "Indians, and Lands reserved for the Indians" since the British North America Act of 1867. The Indian Act, first enacted in 1876, establishes the framework for this relationship, as do historic treaties. The Act sets out conditions affecting almost all aspects of life in First Nations communities and gives the Minister of Indian Affairs ultimate decision-making power.

5.6 The government's relationship with First Nations has changed substantially over the decades. Initially, the federal government, primarily through Indian and Northern Affairs Canada and then Health Canada, delivered programs and services directly to First Nations communities. Over time, this changed as the federal government started to delegate the administration of programs to First Nations. In the 1980s, this process accelerated as the government began to transfer or devolve more responsibility to First Nations. While First Nations now deliver many of the programs funded by the federal government, they continue to operate under delegated authority, and the ultimate responsibility for programs still rests with the departments' ministers. The relationship is still evolving, with continued emphasis on the transfer of program administration to First Nations and self-government initiatives. The relationship between Canada and First Nations is considered by the courts as sui generis, meaning special and unique.

The federal government has added responsibilities over time

5.7 The Indian Act was enacted at a time when the federal and provincial governments provided far fewer programs and services to Canadians than they do today. The same holds true for historic treaties. Since then, governments, in particular provincial governments, have assumed greater responsibilities for their citizens, through legislation and regulations, in areas such as education, health care, social housing, employment, quality of drinking water, and the environment. The federal government has also gradually assumed a variety of additional responsibilities for First Nations, often parallel to those of the provinces. Many of these are carried out through programs that are the responsibility of one department—Indian and Northern Affairs Canada.

5.8 Indian and Northern Affairs Canada carries out many roles related to First Nations on behalf of the Government of Canada. These roles include negotiating and implementing land claim agreements and the inherent right of self-government; litigating actions on a wide range of issues from Aboriginal rights and title to trust-funds management; managing a wide range of programs; developing strategies, programs, and policies; and fulfilling Canada's obligations under treaties and the Indian Act.

The government continues to search for solutions to long-standing problems

5.9 Over the past 35 years, the federal government has repeatedly acknowledged the need for meaningful change and a new relationship in order to correct long-standing problems. Beginning with the White Paper on Aboriginal Issues in 1969, the federal government has made numerous attempts to redefine its relationship with First Nations people and Inuit; several of these attempts were in reaction to First Nations themselves putting pressure on the government for changes. Other efforts include a Native Agenda in 1990; a Royal Commission on Aboriginal Peoples (RCAP), reporting in 1996; Gathering Strength: Canada's Aboriginal Action Plan, the government's response to the RCAP report, in 1998; the Canada-Aboriginal Peoples Roundtable, which began in 2004; and the First Ministers' Meeting on Aboriginal Issues, in November 2005. Despite these efforts, long-standing problems remain.

Focus of the audit

5.10 Since 2000, we have issued several chapters on programs and services for First Nations. In this audit, we assessed how the federal government has responded to our recommendations in several of those chapters, and we identified seven factors that appear to have been critical in successfully implementing our recommendations and realizing meaningful change.

5.11 We examined progress made by five federal organizations—Indian and Northern Affairs Canada, Health Canada, Canada Mortgage and Housing Corporation, the Treasury Board Secretariat, and Industry Canada—in responding to 37 recommendations in seven chapters completed between 2000 and 2003. Some of these chapters have also led to hearings by the House of Commons Standing Committee on Public Accounts, which subsequently led to the Committee's publishing reports containing recommendations. We followed up on recommendations in three reports from the Committee; these correspond to 21 of our recommendations. While we are not the auditors of First Nations, we did consult with a limited number of First Nations representatives. More details on the audit objectives, scope, approach, and criteria are included in About the Audit at the end of the chapter.

Observations and Recommendations

5.12 We expected that federal organizations would have made significant progress in implementing the 37 recommendations in seven chapters published between 2000 and 2003. We assessed the organizations' progress in implementing each recommendation as either satisfactory or unsatisfactory, taking into consideration the complexity of each recommendation and the time elapsed since we made the recommendation (Exhibit 5.1).

5.13 Overall, we were not satisfied with the progress made by the five federal organizations. We found that they made unsatisfactory progress in implementing 15 recommendations—generally those most likely to improve the lives of First Nations peoples. Although progress in implementing 22 recommendations was satisfactory, implementation was not complete for all but 3 of them. These 22 recommendations tend to be more administrative in nature and to have less direct impact on the lives of First Nations people.

Progress being realized

5.14 Our recommendations cover a wide range of programs and issues. Some of these recommendations are more administrative in nature, requiring federal organizations to take action on issues directly under their control. We found that the five organizations we examined are making satisfactory progress in implementing the majority of these, such as those related to the improved administration of health programs. Other recommendations are more complex and often require federal organizations to work closely with First Nations to develop the means to implement them. We found that federal organizations have been less successful in implementing many of these recommendations.

5.15 Improvements to First Nations programs have resulted from the implementation of recommendations in three areas: health programs, on-reserve housing, and the establishment of institutions to support First Nations economic development. However, much remains to be done to fully implement these recommendations.

Improvements have been made in administering health programs funded through agreements

5.16 Health Canada has made satisfactory progress in implementing the majority of recommendations we made in our 2000 audit, which focussed on managing programs funded through agreements. Since 2000, we have seen some significant improvements in the administration of these programs. For example, after several years of effort, Health Canada revised its medical transportation policy to clarify program eligibility and benefits. The Department also implemented a risk-based audit framework to better manage its medical transportation benefits.

5.17 The preparation and use of community health plans have also improved. As part of the process for transferring health programs to communities, First Nations are required to develop community health plans. These are intended to identify community health-related priorities, programs to be undertaken, and the roles and responsibilities of the Medical Officer of Health Services and other professionals. These health plans are to be prepared prior to Health Canada entering into or renewing transfer agreements with First Nations.

5.18 In 1997 we found that renewed transfer agreements were often not based on updated community health plans, and we recommended that this basic requirement be met before any new and renewed transfer agreements were signed. In 2000 we looked at this issue again and found that Health Canada was still sometimes approving transfer agreements without updated community health plans. Without such plans, Health Canada had little assurance that health funding was being effectively targeted to community health priorities.

5.19 In this audit, we found that the administration of program requirements has improved in several respects. Community health plans are now updated, and First Nations conduct audits prior to renewal of transfer agreements. Health Canada also revised the terms and conditions for community health programs to ensure that requirements are adhered to. More generally, Health Canada has increased the controls in its administration of transfer and contribution agreements to ensure that funding is used effectively and targeted to community practices. Again, while progress is satisfactory, the original recommendations, except for one, have not been fully implemented.

Improvements have been made in managing First Nations housing programs

5.20 Numerous studies have noted that poor housing negatively affects the health, education, and overall social conditions of individuals and communities on reserves. In 2001 Indian and Northern Affairs Canada estimated a shortage of about 8,500 on-reserve housing units and that an additional 44 percent of the existing 89,000 houses on reserves required renovations. According to the Department, the housing stock generally deteriorates more rapidly on reserves, due mainly to substandard construction practices or materials, lack of proper maintenance, and overcrowding.

5.21 In 2003 we audited the federal government's delivery of housing programs on First Nations reserves. We found that Indian and Northern Affairs Canada and Canada Mortgage and Housing Corporation (CMHC) had not clearly defined what the programs were intended to achieve in terms of reducing the critical housing shortage; nor had these organizations defined a time frame for achieving this. We also found that the funding mechanisms and programs were very complex and that the Department, CMHC, and First Nations did not agree on their respective roles and responsibilities.

5.22 In this audit, we found that the programs are now better integrated. This was achieved in consultation with First Nations, in response to their concerns. We also found that Indian and Northern Affairs Canada and CMHC had strengthened the management of many elements of their housing programs.

5.23 For example, to help facilitate the implementation of the Department's housing policy, CMHC worked with participating First Nations to develop community housing plans that link housing funds and programs with training, job creation, work opportunity programs, and economic development activities. In 2003 we found that these plans were not being used as intended and their implementation was not being monitored. In this audit, we found that Indian and Northern Affairs Canada and CMHC are now using community housing plans to identify the housing stock and as a tool to make decisions on new units to be built or units to be renovated. While this represents considerable progress, serious problems, notably mould contamination, remain (see paragraphs 5.34 to 5.36).

The government has established more institutional arrangements for economic development

5.24 The 1996 Royal Commission Report on Aboriginal Peoples documented substantial gaps between Aboriginal and non-Aboriginal peoples in Canada for key economic indicators. In 2003 we examined the role of institutional arrangements in sustaining economic development. We identified various barriers to economic development, such as First Nations' lack of access to economic development resources, lack of access to federal business support, and lack of approaches to institutional development. We recommended that the federal government support First Nations in identifying, planning, and implementing institutional arrangements, appropriate to First Nations' economic development arrangements, circumstances, and visions.

5.25 In this audit, we found that the federal government has developed a new program structure to provide greater flexibility in responding to communities' economic development requests. In consultation with First Nations, it has also identified, planned, legislated, and begun to establish four new First Nations institutions, which, among other things, are intended to provide First Nations with the access to private capital enjoyed by other governments.

5.26 We view the establishment of institutions as an important step in assisting First Nations' economic development. Considering other audits we have reported in recent years (Drinking Water in First Nations Communities, 2005 Report of the Commissioner of the Environment and Sustainable Development; Indian and Northern Affairs Canada—Education Program and Post-Secondary Student Support, November 2004 Report of the Auditor General), we believe additional opportunities may exist for creating institutions in areas such as health and safety, and education.

Urgent action needed to implement key recommendations

5.27 We found that some of the recommendations that would likely make a significant difference in the lives and well-being of First Nations people and Inuit were not being implemented or that progress was unsatisfactory. These include recommendations on conducting prescription drug use analysis and analyzing prescription drug-related deaths, developing a strategy and action plan for addressing mould in houses on reserves, eliminating unnecessary reporting required of First Nations communities, implementing land claim agreements, and addressing gaps in the Third Party Manager Policy.

Inadequate monitoring of prescription drug use continues

5.28 Through its Non-Insured Health Benefits program, Health Canada funds prescription drugs for eligible First Nations people living on and off reserves and for Inuit. In 1997 and in subsequent audits, we identified that the Department was slow to intervene where potentially inappropriate use of prescription drugs was observed and that it was not monitoring the number of prescription drug-related deaths of those covered by its drug benefits program.

5.29 In our 2000 audit, we found that Health Canada had started conducting analysis of prescription drug use. This intervention, involving follow-up with clients, physicians, pharmacists, and professional bodies, had some positive impact. However, the Department stopped conducting this analysis in May 1999 because management was unsure of the appropriateness of doing so without either a legislative mandate that would explicitly allow for this type of analysis, or client consent, which would grant permission to the Department to analyze private health information. We also found that the Department had not analyzed data on drug-related deaths of its clients. In 2001 officials informed the Public Accounts Committee that it expected to resume analysis of prescription drug use for 70 percent of its clients within the year, after it had received consent. Even though we identified publicly reported information on prescription drug-related deaths of First Nations people—information that was available to Health Canada, the Department told the Committee that it was not within its purview to gather data on deaths related to prescription drugs.

5.30 In our 2004 audit of the management of federal drug benefits programs, we found that Health Canada had not conducted any analysis of prescription drug use since 1999. Instead, it had spent the previous four years trying to obtain client consent. It had obtained consent for only about 25 percent of clients before stopping this effort in March 2004. We found that the number of clients obtaining more than 50 prescriptions over a three-month period (a criterion used by some provincial bodies to identify cases for review) had almost tripled compared with what we found in our 2000 audit.

5.31 Part of the reason that Health Canada sought consent before conducting analysis of prescription drug use was that it did not have a legislative base for its program, which would have identified rights and obligations of the Department and its clients. We first identified this issue in a 1993 audit, in which we found that the program's authority was unclear due to the absence of specific enabling legislation. We found that the Non-Insured Health Benefits program lacked definitions of purpose, expected results, and anticipated outcomes. We recommended that Health Canada seek from the government a renewed mandate for the Non-Insured Health Benefits program to clarify the authority base, purpose, and objective of the program.

5.32 In 1997 we found that, instead of seeking enabling legislation, the Department had proposed only a renewed policy mandate. This did not address the need to clarify the authority base, rights, and obligations of the Department. In 2000 we again observed that there was still no specific legislation for the Non-Insured Health Benefits program, even though the program entailed more than $530 million in annual expenditures.

5.33 In this audit, we found that Health Canada still does not gather data on prescription drug-related deaths. Nor has it sought enabling legislation for its Non-Insured Health Benefits program. In November 2004, the Department resumed its analysis of prescription drug use, but, at the time of our audit, it was not yet able to identify reductions of inappropriate prescription drug use due to its intervention. Its current approach is only to seek consent, on a case-by-case basis, from those clients for whom the Department has not already done so, before informing health providers or pharmacists of concerns related to prescription drugs. There is still no enabling legislation for the Non-Insured Health Benefits program, and the rights and obligations of the Department and its clients have not been defined.

Mould contamination in houses on reserves continues to be a significant problem

5.34 Mould is a fungus that, under certain conditions, produces poisonous substances that can cause headaches, dizziness, and nausea. Indian and Northern Affairs Canada has identified the main factors contributing to mould in housing as a lack of proper care and maintenance, inadequate air circulation and ventilation, poor site selection and drainage, overcrowding, and improper construction. For several years, mould contamination has been identified as a serious health and safety problem in First Nations communities.

5.35 In 2003 we found that Indian and Northern Affairs Canada, Canada Mortgage and Housing Corporation, and Health Canada organized and were participating in a committee intended to address the mould problem. However, none of these federal organizations had fully assessed the extent of mould contamination in houses on reserves and the full cost of remediation, or developed a comprehensive strategy or action plan to address the problem.

5.36 In this audit, we again found that despite the activities of the committee, no federal organization has taken responsibility for assessing the extent of the problem and developing a comprehensive strategy for addressing it. Although Health Canada is responsible for health and safety, its programming is restricted to research and expert inspections when called upon to determine if the dwelling is fit to live in and advise on the corrective action required. Canada Mortgage and Housing Corporation provides education and training workshops, and Indian and Northern Affairs Canada provides financial contributions to support housing renovations, including activities to correct mould buildup. However, without management's sustained attention, facilitated by a strategy or action plan, the scale of the problem has not been identified, priorities for action have not been established, and no overall plan for co-ordinating federal organizations' efforts or monitoring overall progress has been developed. Without a strategy and action plan to address this problem, First Nations communities may continue to experience premature deterioration of their housing stock and negative health effects on their people.

Reporting requirements still need to be overhauled

5.37 In 2002 we looked at the amount of reporting required of First Nations by federal organizations. We estimated that four federal organizations required at least 168 reports annually from First Nations communities—many with fewer than 500 residents. We found that many of these reports were unnecessary and, moreover, were not used by the federal government. We recommended that the government review reporting requirements and eliminate those that were duplicate or unnecessary, use the most efficient procedures to submit and process reports required from First Nations, and undertake a review of program authorities.

5.38 After more than a year of little progress by federal departments to reduce the reporting burden in response to our recommendations, the Treasury Board Secretariat took the lead to organize interdepartmental sessions and to map out the extent of federal involvement with First Nations. As a result, it determined that 34 federal organizations currently deliver 360 programs and services targeted to Aboriginal peoples. It also linked funding to programs and, for the first time, was able to report on programming by federal organizations.

5.39 This broad analysis by the Treasury Board Secretariat confirms the seriousness of the problem we identified in 2002. In our current audit, we found that meaningful action by the federal government is still needed to reduce the unnecessary reporting burden placed on First Nations communities and to develop more efficient procedures for obtaining information required. Officials told us that Indian and Northern Affairs Canada alone obtains more than 60,000 reports a year from over 600 First Nations. As we noted in 2002, the resources devoted to the current reporting system could be better used to provide direct support to communities.

Deficiencies in implementing comprehensive land claim agreements persist

5.40 Comprehensive land claims relate to Aboriginal rights and title to land that have not been dealt with by treaties or other legal means. Settling comprehensive land claims involves negotiating and implementing complex, modern treaties. In 1998 we audited Indian and Northern Affairs Canada's role in reaching and implementing comprehensive land claim agreements. Among other things, we found that implementation plans were inadequate or non-existent, and we observed that the Department tracked only activities and processes, not results produced and costs incurred. We recommended that the Department strengthen implementation plans, improve reporting, and conduct evaluations of the implementation of land claim agreements.

5.41 The Public Accounts Committee issued several recommendations after considering our audit. These recommendations directed the Department to establish indicators and a timetable for measuring and reporting the economic benefits produced as a direct result of settlements; include specific provisions for timely and periodic impact evaluations; provide information in its annual performance report on the outcomes achieved as a result of comprehensive land claim agreements; and specify how it would improve its monitoring of, evaluation of, and reporting on the implementation of comprehensive land claim agreements.

5.42 The Department responded that it would develop an evaluation framework to evaluate the social and economic benefits of land claim agreements, and it would consider including such information in its performance report. It further stated that it expected to have made significant progress by December 1999 in developing a multi-year plan to evaluate the implementation of land claim agreements.

5.43 In 2001 we followed up on this audit and found that the Department needed to continue its efforts to strengthen implementation plans and accelerate its efforts to evaluate the implementation of agreements. We also noted the difficulty in achieving certainty and the length of time needed to reach agreements. In addition, in a 2003 audit of Indian and Northern Affairs Canada's management of the land claim agreements for Inuit of Nunavut and the Gwich'in of the Northwest Territories, we noted that managing land claims well means focussing not only on meeting specific obligations of the claims but on achieving measurable results against objectives.

5.44 In our current audit, we found that in 2004 the Department had published guidelines for implementation in response to our 1998 recommendation that the Department strengthen implementation plans, improve reporting, and conduct evaluations of the implementation of land claim agreements. These guidelines refer to the need for the government to track obligations and activities, but they do not propose that implementation plans focus on objectives and measuring results.

5.45 We also reviewed the implementation plans for three agreements signed in 2005, with a view to determining whether they focus on objectives and results, not only on obligations and activities supporting obligations. We found that the plans do not set out objectives, such as reducing unemployment rates to specified levels, but rather commit the federal government to specified activities supporting obligations, such as establishing a community services agency. The Department maintains, however, that the primary role of implementation plans is to ensure that all obligations of the parties are identified and addressed through agreed-upon activities, and that it is pursuing the measurement and reporting of results outside the medium of implementation plans (for example, promoting results-based management in annual reports produced by implementation committees through conducting results-based planning and reporting workshops).

5.46 Indian and Northern Affairs Canada has not evaluated the implementation of land claim agreements, as we recommended in 1998. Only in 2002 did the Department prepare a Comprehensive Claims Evaluation Framework. It now has a draft plan for evaluating the impacts of comprehensive land claim agreements. The plan indicates that a pilot evaluation of a land claim agreement will be completed by February 2007. In our opinion, without a focus on objectives and results, along with the evaluation of their attainment and impacts, the federal government does not have a means of measuring, reporting, and ensuring the successful implementation of land claim agreements.

Gaps in the Third Party Manager Policy have not been addressed

5.47 When a First Nations community delivering a program or service under a funding arrangement with Indian and Northern Affairs Canada fails to meet its obligations, the Minister has the right to intervene. At the highest level of intervention, the Department selects a third party to take over the management of the funding arrangement until the problems are resolved. In 2003 we identified various deficiencies in the Department's administration of the third-party management process. One of these was the lack of a strategy for building the capacity of First Nations management to end third-party management.

5.48 We recommended that the Department address missing elements from its Third Party Manager Policy, adopted in 2003—namely, provision for a dispute resolution mechanism, building of capacity of chiefs and councils, and provision for First Nations input in the third-party manager selection process.

5.49 In this audit, we found that the Department has not revised its 2003 policy. Instead it has proposed to have provisions for these missing elements in a new policy expected in April 2006. Similarly, the Department has not evaluated the effectiveness of third-party manager intervention as we had recommended. As such, the new policy being developed does not benefit from a formal evaluation of the third-party management process. Further, the present policy still does not include a strategy to build the capacity of First Nations management to end third-party management.

Critical Factors

Factors that appear to have been critical in implementing our recommendations

5.50 As a result of our follow-up audit work, as well as interviews with senior officials across the federal government, we identified seven factors that appear to have either enabled the successful implementation of our recommendations or, by their absence, hindered their implementation and, in turn, impeded significant change in the lives of First Nations people and Inuit.

Sustained management attention

5.51 Management's sustained attention is critical to realizing substantive change in government generally. We saw this in Health Canada's revisions to its medical transportation policy and audit processes. Similarly, it is because of management attention that federal organizations have finally started to take action to begin implementing recommendations in two cases where progress has not been satisfactory. In the first case, after five-and a-half years of not conducting analysis of prescription drug use, the focussed attention of senior management resulted in Health Canada implementing a new program for analysis of prescription drug use. In the second case, the Treasury Board Secretariat took responsibility in 2004 to begin rethinking how government programs and services are structured, in the context of the expenditure and management reviews launched in Budgets 2003 and 2004. This initiative responded to the concerns raised in our 2002 chapter on streamlining First Nations reporting to federal organizations. Officials we interviewed emphasized that sustained attention on the part of senior management will be required to effect lasting change. While much remains to be done in both these areas (analysis of prescription drug use and structuring of government programs and services), the continued attention, leadership, and commitment of senior management to sustained action are required if the government is to successfully implement all our recommendations and make First Nations programs more effective.

Co-ordination of government programs

5.52 Co-ordination among federal organizations delivering similar programs is crucial to efficient and effective programming and to implementing many of our recommendations. These recommendations point to the need for organizations to co-ordinate their programs and the requirements they place on First Nations. Senior federal officials we interviewed emphasized that the lack of a co-ordinated approach to First Nations programs is often a problem. They also noted that programs, many of which are similar, are typically "stove-piped"—that is, they are narrowly defined and often overlap and duplicate each other. We also noted this in our 2002 chapter on streamlining First Nations reporting to federal organizations and in our 2003 chapter on housing on reserves. However, efforts related to some of our recommendations (for example, those on the administration of the housing and economic development programs) indicate that it is possible for federal organizations, working with First Nations, to co-ordinate the planning, management, and delivery of programs.

Meaningful consultation with First Nations

5.53 We found that meaningful consultation often contributes to or results in significant change. Meaningful consultation refers to open engagement and dialogue between the federal government and First Nations on the objectives to be achieved and the means of attaining these. More than half of our recommendations highlight the importance of organizations moving forward in consultation with First Nations. For the most part, we found that federal organizations made satisfactory progress in implementing recommendations that included engaging in meaningful consultation with First Nations (for example, many of the recommendations in our 2003 chapter on housing on reserves).

5.54 We also found that the absence of meaningful consultation can impede successful implementation of our recommendations. For example, in its efforts to conduct analysis of prescription drug use, Health Canada sought to obtain consent from clients to conduct analysis using their private drug records. This initiative resulted in the Department obtaining consent from only about 25 percent of its First Nations clients after four years of effort, by the time the initiative was cancelled in March 2004. First Nations attributed this failure to Health Canada's not taking into account the need for community engagement in monitoring and addressing risks associated with prescription drug use.

Developing capacity within First Nations

5.55 The federal government's success in implementing many of our recommendations has depended in large part on the capacity of the First Nations to carry out the implementation of programs in their communities. In our chapters on housing on reserves, third-party intervention, and economic development, we noted the need for more effective capacity development of First Nations. The government agreed with our recommendations and has started to work with First Nations to develop the institutions required to provide them with the technical support they need to deliver effective programs. Federal officials we interviewed stressed the importance of capacity building and development as a means to improve delivery of programs.

Establishing First Nations institutions

5.56 We found that establishing First Nations institutions is important to improve the health and the economic and social development of First Nations communities. Several senior officials we interviewed noted the importance of developing a stable and professional First Nations public service to administer programs devolved by the federal government, and that establishing First Nations institutions could facilitate this. As referred to earlier (paragraph 5.25), the four First Nations institutions recently developed hold promise for greater investment and economic opportunities in First Nations communities. Given the need and importance of such institutions, and the interest of First Nations in developing them, the opportunity exists to establish more of these institutions.

Appropriate legislative base for programs

5.57 A legislative base for programs clarifies respective roles and responsibilities, eligibility, and other program elements. For example, in the area of prescription drug use analysis and the potential for serious harm caused by the misuse of prescription drugs, we noted the absence of specific enabling legislation and recommended that the Department seek a renewed mandate to clarify the authority base, purpose, and objective of the program. In this case, the absence of a legislative base caused confusion among government officials and clients about the jurisdiction, allocation of responsibilities, and rights of the Department and clients. We noted that Health Canada has not sought a legislative mandate for its Non-Insured Health Benefits program. Senior officials have also noted the importance of such a mandate for identifying and clarifying the rights and obligations of both the federal organization and its clientele.

5.58 The Indian Act, established in 1876, is widely considered to be an outdated piece of legislation that, for the most part, does not address current issues. Housing, education, and health and safety are examples of areas where legislation now exists provincially but where there is little federal legislation that applies to First Nations.

5.59 In other cases, new legislation has served to provide a sound foundation for initiatives. The government has brought forward legislation for the successful conclusion of land claims and the development of new institutions. In addition, Indian and Northern Affairs Canada and First Nations have also co-operated in developing the First Nations Land Management Act, First Nations Oil and Gas and Moneys Management Act, and the First Nations Commercial and Industrial Development Act. We found that the processes leading to the successful legislation in these instances had the following common elements: First Nations proposed the legislation to address roadblocks to progress they had identified, and the legislation resulted from successful negotiations and addressed First Nations needs. We noted that the legislation assisted the federal government in meeting its stated policy objectives, and the legislation includes the provision for optional participation of individual First Nations.

Conflicting roles of Indian and Northern Affairs Canada

5.60 In many of the areas we examined in this audit, Indian and Northern Affairs Canada relates to First Nations in several different roles, sometimes at cross-purposes with one another. Senior government officials told us that they recognize that there is at least the appearance of conflict in the many roles that the Department is required to fulfill.

5.61 We noted this potential for conflict in the Department's roles in the area of negotiating and implementing land claim agreements, where the legalistic and narrow interpretation used to negotiate land claim agreements seems to have spilled over into their implementation. In our past work, we found that Indian and Northern Affairs Canada took the position that its responsibilities related to the implementation of land claim agreements should be defined by what the agreements state its obligations to be. First Nations have said that there must be a federal commitment to achieve the broad objectives of the land claim agreements and self-government agreements within the context of the new relationships, as opposed to the federal government strictly complying with narrowly defined obligations. We believe that these differing roles of the Department create at least the appearance of a conflict and may have resulted in an erosion of trust between the Department and First Nations over time.

Conclusion

5.62 Federal organizations have made unsatisfactory progress in implementing almost half of our recommendations, generally those addressing issues having the greatest impact on the lives of First Nations people and Inuit. These include recommendations on analyzing prescription drug use and related deaths, developing a strategy and action plan for addressing mould in houses on reserves, eliminating the requirements for unnecessary reports from First Nations communities, implementing comprehensive land claim agreements, and addressing gaps in the Third Party Manager Policy.

5.63 Federal organizations are making satisfactory progress in implementing other recommendations; however, most of these are not yet fully implemented. These recommendations tend to be more administrative in nature and have less direct impact on the lives of First Nations people and Inuit.

5.64 We identified seven factors that appear to have been critical in the successful implementation of our recommendations. These include the sustained attention of management, co-ordination of government programs, meaningful consultation with First Nations, development of First Nations capacity, establishment of First Nations institutions, development of an appropriate legislative base for programs, and consideration of the conflicting roles of Indian and Northern Affairs Canada. In our view, ensuring that these factors are fully considered when adjusting existing programs and implementing new ones will make a significant difference in the lives of Aboriginal people.

Government's overall response. The Government of Canada agrees that the seven factors identified by the Auditor General are important. It is clear that where satisfactory progress has been made on the Auditor General's recommendations, one or more of these factors were present. In addition, they constitute an increasingly important part of the government's approach for the broader Aboriginal agenda. Examples include the following:

• The First Ministers Meeting of 24–25 November 2005 in Kelowna, British Columbia demonstrated a willingness of the federal, provincial, and territorial governments and national Aboriginal organizations to develop a common Aboriginal agenda for the future in important areas such as housing, health, education, and economic opportunities. Moving forward will continue to require sustained management attention.
• The Aboriginal Horizontal Framework initiative of the Treasury Board Secretariat provides an excellent base for determining the effectiveness of government programs and increasing the level of co-ordination to minimize gaps and overlap.
• The consensus-based decision making displayed at the Kelowna First Ministers Meeting by leaders of federal, provincial, and territorial governments and national Aboriginal organizations is a prime example of meaningful consultation with First Nations and other partners, including Aboriginal partners.
• Progress made in establishing legislative authorities in partnership with First Nations through the First Nations Oil and Gas and Moneys Management Act, the First Nations Fiscal and Statistical Management Act and the First Nations Commercial and Industrial Development Act contributes to the establishment of appropriate First Nation institutions and will assist in developing the capacity of First Nations.
• With respect to the last two critical factors cited, namely the establishment of a legislative base for programming, and addressing the conflicting roles of Indian and Northern Affairs, the federal government continues to examine new approaches to improving the way its responsibilities are delivered and has made important recent advancements in legislative and regulatory renewal on reserve, in partnership with First Nations.

While the government's actions are consistent with the factors identified, resolving Aboriginal issues remains an extremely difficult challenge, characterized by complex jurisdictional issues. Taking on major reforms is complex, requires staging over time, and is supported by the establishment of strong governance and accountability measures in First Nations communities. As First Nations communities are unique in their history, geography, socio-economic conditions, internal capacity, vision, and priorities, our approaches must be tailored to meet these diverse and distinctive attributes of First Nations people.

The Government of Canada is pleased to continue to take the critical factors into account when developing approaches aimed at securing a better future for Aboriginal peoples.

About the Audit

Objectives

Our audit objectives were

• to assess the progress that Indian and Northern Affairs Canada, Health Canada, Canada Mortgage and Housing Corporation, the Treasury Board Secretariat, and Industry Canada have made in implementing our recommendations in seven previous reports on First Nations programs; and
• to identify, as a result of this assessment, the factors that enabled or impeded federal organizations in their efforts to implement our recommendations.

Scope and approach

This follow-up audit assessed the progress of the five above-noted federal organizations in responding to 37 recommendations in seven reports of the Office of the Auditor General published from October 2000 to November 2003. We did not follow up on the progress of two additional recommendations made in the reports as they are not currently applicable. The seven reports are the following:

• October 2000, Chapter 15, First Nations Health Follow-Up
• November 2001, Chapter 12, Follow-Up of Recommendations in Previous Reports: Indian and Northern Affairs Canada—Comprehensive Land Claims (1998, Chapter 14)
• December 2002, Chapter 1, Streamlining First Nations Reporting to Federal Organizations
• December 2002, Chapter 11, Other Audit Observations: Indian and Northern Affairs Canada—Food Mail Program
• http://www.oag-bvg.gc.ca/domino/media.nsf/html/20060506pr_e.html