First Nations denied high quality, equitable access to the health products and services by Health Canada

From AFN Press release

By AFN Ontario Regional Chief Stan Beardy

December 19, 2013

Taking Action to Address the Crisis in the Non-Insured Health Benefits Program

Regional Roundtables and National Policy Forum Scheduled for 2014

The Non‐nsured Health Benefits (NIHB) program is in profound crisis and requires an immediate and fundamental transformation. This crisis cannot be overstated. The outcomes gap between First Nations and non‐First Nations health continues to widen. First Nations are being denied high quality, equitable access to the health products and services that non‐Indigenous Canadians take for granted. NIHB is guided by the principle of "cost containment" rather than improving health outcomes.

As National Chief Atleo has stated, "Gaps in access to health services and outcomes is a critical concern and must compel action. This situation directly affects children and families and it demands commitment and attention to address urgent needs and achieve sustainable long term solutions. The health and well‐being of our Nations is at stake ‐ this affects all of our peoples and all of Canada. "

Last week at the Assembly of First Nations Special Chief's Assembly (SCA), the AFN Chiefs Committee on Health (CCOH), the National First Nations Health Technician Network (NFNHTN) and the AFN NIHB Caucus met to discuss issues around Health Canada's NIHB Program. These sessions culminated in a plenary panel for the Chiefs‐in‐Assembly where leadership spoke strongly about taking action to advocate and mobilize First Nations for change. The AFN, in cooperation with numerous regional organizations, is undertaking a renewed campaign to demand fundamental changes to the NIHB program and focus on creating a concrete plan of action.

AFN Ontario Regional Chief Stan Beardy stated, "We encourage all First Nations and those who believe in fairness to join the AFN over the next several months to raise the profile of the NIHB file with policy‐makers, politicians, mainstream Canadians, the media and other allied health organizations. Further, rather than just identify the problems we will work to create solutions. I commend the AFN Chiefs Committee onHealth fortheir dedication and effortsto advance this important cause with First Nations and all Canadians. It is important for Chiefs across Canada to ensure they have strong, consistent representation on the AFN's CCOH in order to take action for change."

The AFN is seeking to increase political pressure to achieve real change in the NIHB program through engagement and action at both the national and regional levels. Regional Roundtables will be hosted by regional First Nations organizations (with support from the AFN) between January and the end of February, 2014. The goal of these Roundtables is to hear regional input about our challenges with NIHB but, most importantly, obtain regionally inclusive solutions and options on how we can implement these solutions. Following the Regional Roundtables, the AFN will host a two day National Policy Forum on NIHB in March 2014, in Ottawa. Registration will be open to participants of the Regional Roundtables, leadership, Elders, First Nations health directors and medical practitioners serving First Nations communities. Together, we will decide on the best options and actions to facilitate and create change in the NIHB program. Input and solutions derived from the 10 regional roundtables will feed into a policy position ocument/directional concrete action plan that can be used by communities, regions, leadership and others to take action on addressing the disparities associated with NIHB. t/directional concrete action plan that can be used by communities, regions, leadership and others to take action on addressing the disparities associated with NIHB.

This action plan will include the development of a legislative/legal strategy and a communications strategy utilizing both traditional and new media tools, and will explore partnerships with national associations and organizations to generate increased political pressure to move the plan forward. Developing these key partnerships is already well underway. In fact, Dr. Peter Doig, president of the Canadian Dental Association, attended the NIHB plenary at the recent SCA in order to demonstrate his organization's commitment to working together.

The AFN encourages Chiefs and First Nations citizens to become politically engaged on the topic of NIHB. Together, we will ensure that Canada fulfills its moral, legal and Treaty obligation to First Nations health. Stay tuned for more details on the upcoming Regional Roundtables and National Forum on NIHB.

AFN Ontario Regional Chief Stan Beardy
Portfolio Holder for Health
Chair, Chiefs Committee on Health




Ring of Fire boom may strain First Nations services, memo warns

Existing mental health and social programs may not meet increased need, officials told

The Canadian Press Posted: Jan 03, 2014 

Fort Hope First Nation is one of the communities seeking a role in developing the much-touted Ring of Fire project in northern Ontario. An internal Health Canada memo warned last May that a mining boom in the area could put pressure on Ottawa's ability to provide sufficient mental health and social services to First Nations in the area.

Fort Hope First Nation is one of the communities seeking a role in developing the much-touted Ring of Fire project in northern Ontario. An internal Health Canada memo warned last May that a mining boom in the area could put pressure on Ottawa's ability to provide sufficient mental health and social services to First Nations in the area. (Ryan Remiorz/Canadian Press)

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The federal government may struggle to keep up with a growing need for mental-health and other social services in First Nations communities located within a massive mineral find in northern Ontario, according to a newly released document.

Senior officials at Health Canada were cautioned last May that their existing social programs to help aboriginal communities in the Ring of Fire may not be sufficient to meet increased demand.

"Though supports are available, it is not clear whether current programming will be sufficient to meet emerging needs," says a memo to the deputy and associate deputy ministers.

The Neskantaga First Nation declared a state of emergency last April over a spate of suicides - and the officials were warned Ottawa could face heightened pressure to provide similar support services to other communities as the area undergoes further development.

"Other communities located adjacent to the Ring of Fire development may have similar complex needs, and the increased activity in this region may place additional pressure upon the federal government for further action," the document says.

The Canadian Press obtained the memo under the Access to Information Act.

Social infrastructure building

Several federal departments are working with local First Nations and the Ontario government on community health, social services and skills training. Health Canada has funded projects in nine First Nations communities to try to curb prescription drug abuse. There's also work underway to address mental-health issues and prevent suicides.

Addressing these social problems is necessary if First Nations are going to be involved in the Ring of Fire project, the document says.

"Physical and mental health are determinants for job and economic readiness," it says.


The mineral-rich region known as the Ring of Fire in Northern Ontario. (CBC)

"Recognizing the impact that socio-economic challenges have on economic development, the government of Canada has prioritized the building of social infrastructure in these communities as a critical precursor to supporting their participation in the opportunities afforded by the Ring of Fire developments."

The Ring of Fire, located more than 500 kilometres northeast of Thunder Bay, Ont., is a treasure trove of minerals and contains the largest deposit of chromite - a key ingredient in stainless steel - ever discovered in North America.

Both the federal and provincial governments have high hopes for billions of dollars of investment in the Ring of Fire - development they hope will bring prosperity to struggling First Nations and royalties to their own coffers.

Federal and provincial ministers have compared the region to the Alberta oilsands in terms of its potential to produce wealth and development.

No one from Health Canada was immediately available to discuss the memo.



Aboriginal Canadians face racism, stereotyping in urban health care: report

Health Council of Canada report cover

The cover image from the report 'Empathy, dignity, and respect: Creating cultural safety for Aboriginal people in urban health care' released by the Health Council of Canada on Dec. 11, 2012. (Health Council of Canada)

Diana Mehta, The Canadian Press 

Published Tuesday, December 11, 2012

TORONTO -- A new report suggests aboriginal Canadians frequently face racism and stereotyping when using health care services in urban centres, a situation which can breed a degree of mistrust deep enough for some to avoid seeking professional help when sick.

The 74-page document, titled "Empathy, dignity, and respect: Creating cultural safety for Aboriginal people in urban health care," was released by the Health Council of Canada on Tuesday.

The independent national agency is now calling for "culturally competent" care and environments in which aboriginal patients can be treated with understanding and respect.


"When aboriginal patients present themselves -- whether it's in an emergency room or in any health centre -- they're not necessarily seen for who they are and consequently they're not respected, they're not engaged as fellow human beings and as a result the care they get suffers," John G. Abbott, CEO of the Health Council of Canada told The Canadian Press.

"I think this is one area which has been under reported, understated in the Canadian health care system."

According to the report, while factors like poverty and the impact of colonization are known to have an impact on aboriginal health, a "Western approach to health care" often reinforces stereotypes which alienate and intimidate some patients.

As some aboriginal patients avoid seeking care or drop out of treatment programs, the report says ailments are diagnosed later, when they are harder to treat, and the benefits of preventative care measures, like immunizations and screening tests, may be missed.

"If they're not feeling safe or respected, they're not going to communicate as effectively as they should, and they're not going to follow up on their treatment plan and they're not going to come back," said Abbott.

The report was based on meetings with health care providers across the country, many of whom were aboriginal.

In one example shared with researchers, the report said some aboriginal patients were refused painkillers even when in severe pain because of a belief they were at a higher risk of becoming addicted or were already abusing prescription drugs.

In another, the report said an aboriginal man who was beaten and bloodied was brought to an emergency room where he was not allowed to lie on a bed. When a doctor asked why, the report said a nurse explained that the man was dirty and would return to the street to engage in the same risky behaviour that had landed him in hospital. In fact, the report said, the patient was employed, owned a home, and had been attacked on his way home from work.

"Part of it is ignorance...some of it racism...part of it is just general stereotyping," said Abbott in detailing the possible reasons for the way many aboriginal patients say they are treated.

"There is inefficient attention paid to training people on the front lines in particular to really be receptive to a different culture and a different way of life, particularly when they're dealing with healthcare."

The situation is all the more concerning because aboriginal people often have poorer health and shorter life expectancies than other Canadians, he said.

The report -- which points out that aboriginal patients often felt most safe when they had some sort of interaction with aboriginal staff -- suggests having aboriginal patient navigators and cultural interpreters in place to support patients and healthcare providers, measures which have been a success in some Canadian facilities.

It also suggests an increased emphasis on aboriginal history and cultural sensitivity during post-secondary and on-the-job training of those in the health sector.

"This is a fairly complicated issue, but there are solutions. But they need to happen at the front line and they need to be supported continuously. It's not so much an issue of money as it is an issue of leadership," Abbott said.

"Many Canadians come up through the mainstream western European model of health care and then when an aboriginal person comes in ... they're just not exposed to their way of life, their thinking, they're approach to health care."

The report does point out that cultural competency and cultural safety are becoming a priority for many governments and health care providers, and said many people interviewed while research was being conducted expressed a sense of "hope and anticipation."

The report will be presented to health officials at provincial and federal levels, and will be shared with health-care providers as well.

"Individual initiatives are certainly good in themselves but I think each provincial government as well as the federal government...they really need to put in the policies and programs that make sure this issue is addressed," Abbott said.

"(We must) get to a zero tolerance on this particular aspect of health care."