Mushkegowuk Council: Jonathan Solomon, Grand Chief

The health system is broken. … We must begin a plan that is sustainable and viable. The policies and legislation have only marginalized the First Nations of this country, which includes Mushkegowuk.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief (written submission)

We strongly recommend the following actions be taken immediately by the Government of Canada:

• Health Canada, NAN and MKO jointly develop a course of action to fully implement the recommendations made by The Auditor General of Canada outlined in the 2015 Spring report Access to Health Services for Remote First Nations Communities. This work will consider the relationship to any process arising from the NAN and Health Canada and MOHLTC ministers meeting in March 31, 2016.
• Health Canada to acknowledge that the present policies, services delivery and funding models are failing First Nations. The Auditor General of Canada supports that Health Canada does not consider the health needs of the community. An overall health system transformation is required. As per the March 31, 2016 meeting, Health Canada and MOHLTC must work collaboratively with NAN on a long term process towards solutions beginning with urgent priorities that need expedient solutions, and intermediate and long term health and infrastructure needs in a framework to be designed and implemented along NAN and various First Nation health organizations within NAN territory. This collaborative framework will include a health transformation system component and will consider models envisioned by Weeneebayko Area Health Authority, Sioux Lookout First Nations Health Authority and other First Nation health entities.
• The Minister of Indian Affairs Canada participates along with NAN and Health Canada in an ongoing political oversight body to the process as proposed by NAN at the March 31, 2016 meeting. It is imperative that INAC be part of this process as water and housing situations in the NAN communities are detrimental to the health of our people.
• NAN and Mushkegowuk Council leadership work in collaboration with Health Canada, INAC and other departments to establish a Special Emergency Suicide Task Force to address the growing suicide epidemic in NAN territory. Health Canada and INAC must provide the resources to support this process.
• NAN leads a collaborative process with Health Canada and Ontario that will redefine Jordan’s Principle. The result of this work will form a basis for which Canada will create legislation that will compel other jurisdictions to a uniform implementation process. Health Canada and MOHLTC must provide the resources to support this process.

Neskatanga First Nation: Wayne Moonias, Chief (written submission)

As members of Parliament you can advocate for the creation of a federal assistance program, a social emergency program, designed to help First Nation communities get immediate support when they declare a social emergency and to be back on their feet after the crisis.

The program would be intended to provide the supports necessary for returning the community to a pre-crisis condition. Members can advocate for investments in strengthening the ability of first responders, their organizations, and local institutions to help First Nation communities prepare for and cope with future crises. … The current policies under Non-Insured Health Benefits are a barrier to prevention.

A new financial regime is equally needed for First Nations. Communities like Neskantaga, many who are in some form of financial intervention, do not have the tools to address these crises and it is only getting worse – more social deficits are creating more fiscal deficits.

Finally, there has to be recognition of the principle of First Nation consent. We need legislation, policy development and economic development that respects First Nation jurisdiction over their traditional territories. This policy will require work with the provinces.

Sioux Lookout First Nations Health Authority: Dr. Michael Kirlew

Section 12 of the non-insured health benefits policy states that non-insured will not cover certain types of travel. … There needs to be drastic change quickly.

Sioux Lookout First Nations Health Authority: John Cutfeet, Board Chair

We need to change the way health care is delivered at the community level to the Indigenous peoples. This requires a substantial transformation of the health care system. … One of the first places to start would be to take a good hard look at the non-insured health benefits policy. Every day that this policy is in place is another day that people are being discriminated against and another day that it lives on in this nation’s conscience. … We call on you to drive the legislative and policy changes that will immediately end these discriminatory practices and that will build the foundation for a reformed health care system and a new relationship.

Chiefs of Ontario: Isadore Day, Ontario Regional Chief

Here are some of the supporting recommendations to further strengthen the Nishnawbe Aski Nation’s proposals. The first one that I’d like to offer the Committee is immediate funding flow to areas in most need. … This means equitable health care access at the community level and where it’s most needed.

The second recommendation is that a social determinants framework be the basis for comprehensive health action plan that includes all relevant line ministries and government mandates, which means that we are calling for an immediate adjustment to the federal 2016 Budget under the social development of health federal framework.

Third is that the Truth and Reconciliation Commission’s 94 calls for action related to health be the foundation for a successful and immediate implementation plan. This would require a formal mechanism, which wasn’t part of the federal budget.

The fourth one, longer-term solutions can only be realized through full engagement, with a seat at the table in the current health accord negotiations with the provinces and territories. This participation must be based on the nation-to-nation relationship.

Finally, and most vital, this set of recommendations will come in the form of a memorandum to Cabinet that will call for a binding partnership on dealing with the First Nations health crisis that is currently responsible for the high mortality rates of First Nations across this country. I want to underscore that last recommendation.

Since last fall the Chiefs of Ontario have presented five key areas that must be immediately addressed by the federal government. The first one is ending the First Nations health crisis, which can only be addressed by fixing the water crisis, ensuring access to health services, and fixing health benefits for First Nations, as my esteemed colleague had just mentioned; two, eliminating abject poverty through investments in housing, healthy and affordable food, infrastructure, education, and training; three, immediately implementing mental health and addictions services to address the youth suicide crisis, prescription drug abuse, and mental wellness; four, recognizing First Nations authority over land and resources, as recognized within our territories; and five, access to new technologies such as broadband Internet and green energy in order to eliminate the reliance on diesel-powered electricity.

Last month’s federal budget is a good start on two fronts: addressing the water crisis and beginning to inject necessary funding for our children’s education. … My point is this: we must look at this year’s budget and concentrate on health. If we didn’t see the investments there, we must move.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief

I want to ask this Committee to work with Minister Philpott and Health Canada on some of the policies we referenced in our presentation, for example, to lift the travel restrictions on non-insured, especially when it comes to children.

This speaks to Jordan’s principle. That was a private member’s bill that Parliament adopted, which is great, but we need to make that into law.

Sioux Lookout First Nations Health Authority: Dr. Michael Kirlew

We have Jordan’s Principle, but the problem is we don’t have Jordan’s practice. We need Jordan’s practice.

I would think a first step would be that we not put any barriers for children to access care. … There’s another practice that happens routinely, and it’s children who are unregistered are denied their transportation out. That practice needs to stop immediately. Let’s worry about the registration and the paperwork when we get the child, and get the child care first. … Those are just a couple examples of policy changes that would at least help start pointing us in the right direction.

I think the practice of denying pregnant women escorts needs to stop immediately.

Chiefs of Ontario: Isadore Day, Ontario Regional Chief

Just as we’ve seen here days ago, with the investment made by the provincial government, we need those immediate, on-the-ground investments. What we’re asking for here is that the Committee support 80 mental wellness teams, 80 community health teams on the ground, today, at a cost of $500,000 per team. That’s what can be done today.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief

What we’re saying is that we need to transform the health care system, and it has to be a collaborative effort where First Nations sit with the appropriate federal officials, and also the appropriate provincial officials, for us to design the system that will finally work for our communities.

Sioux Lookout First Nations Health Authority: Dr. Michael Kirlew

I think that could be part of a solution for sure, with being able to implement high-quality telehealth. We have to understand that telehealth is meant as a plus. … I look at it in terms of telehealth being something that can help me as a clinician to provide A-plus care and to help give my patients more access to a physician or more access to a health care provider.

I’ve surveyed a number of my colleagues and they described often times the relationship with non-insured health benefits as adversarial. … The problem is that non-insured is trying to insert itself in the doctor–patient relationship inappropriately and that needs to stop. It needs to stop inserting itself in that doctor–patient relationship.

Chiefs of Ontario: Isadore Day, Ontario Regional Chief

We’ve not done a full health economic assessment in terms of what’s needed. That’s clearly an area that this Committee can help with and endorse and move forward because you will find that it’s not only the systemic pieces, but there are some glaring areas that need immediate funding, as my colleague suggests.

Through the Honouring Our Strengths Framework that looked at addictions and mental health, there’s been some good work done with nothing, but now we need the investment. In AFN’s budget submission on mental wellness, it included mental wellness teams to reach all communities; new funding for 80 new teams, at $500,000 each; crisis response teams via the expansion of a National Aboriginal Youth Prevention Strategy; capital to ensure safety and maintenance of national native drug and alcohol programs and treatment centres; and capital for five new treatment centres, healing centres, as per the TRC Calls for Action; extension of the Indian Residential Schools’ resolution health support programs, also to be utilized during the missing and murdered Indigenous women inquiry process.

Mushkegowuk Council: Jonathan Solomon, Grand Chief

We need to start investing in infrastructure, because the home environment impacts the well-being of an individual, or even an institution like a school, or even a health centre. These are the centre of the communities. If you are sharing a room with 14 or 15 other people, and you are going to school and if you have homework, and don’t have time to do that homework, it is going to impact you mentally.

We need to start investing in infrastructure and also in the mental aspect of it. We need to start investing in mental health, not only for adults. We have to have a mental health program for the children, because right now there’s nothing for them. The only thing that’s available for them is the child protection agency that’s in our region and once you mention child protection agency, the first thing that comes into their mind is they are going to lose their children. That’s the first thing that enters their mind. We have to invest in the young people to have a brighter future, so they have hope and certainty, and the family circle will grow to a better future.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief

I think that’s one reason we’re here today, to appeal to you, the Committee, to work with us in implementing these reports, like the one I referenced. This came out last year, April 25. It’s almost a year. There’s so very little follow-up to that. I think we need to agree on certain things. One of them could be that we immediately agree on how we will implement these recommendations that are a continuous report. That’s just one report. There are others.

Chiefs of Ontario: Isadore Day, Ontario Regional Chief

We need to transition into a transformative health framework in this country. We need to recognize that First Nations need to be part of the health accord process.

We need to recognize that there’s a very broken system we need to mitigate now. I think we need to get a commitment to augment the 2016 Budget, and we need to put a price tag on those very big, damaged, broken areas that need mitigation funding. Let’s begin to do the assessment in terms of what are the financial and fiscal resources needed to do that over the next three years.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief

When it comes to talking about issues that impact our communities, whether it’s climate change, whether it’s education, health care, we need to be there. We need to be involved. We need to be meaningfully engaged in the process because what you develop in Ottawa, whether it’s policy, legislation, law, it impacts us in ways that sometimes put lives at risk, or sometimes we lose people. I think it’s important that we have a dialogue like this, but we need to carry that forward in a meaningful way.

We need to go further and collaborate on a framework, a process, that we can use moving forward, which includes us. We need to be in whatever process it is. Whatever table is developed, we need to be there.

Mushkegowuk Council: Jonathan Solomon, Grand Chief

My colleague here said we need to fix the system first. That’s what needs to happen. We need to fix the oppression, the policies and legislation that have been oppressing our people from the start. That’s what needs to happen. Then we can sit around like this and start prioritizing what do we do with infrastructure, what do we do with health, what do we do with the social aspect of it.

Nishnawbe Aski Nation: Alvin Fiddler, Grand Chief

If we’re going to be talking about investing in our communities and infrastructure for our communities, we need that power. We need a power source that will be able to accommodate and support that expansion and investment.

Sioux Lookout First Nations Health Authority: John Cutfeet, Board Chair

One of the important things I want to point out here is that we need a funding framework from both levels of government to connect remote communities to the grid and get them off diesel. A funding framework with the support of both levels of government is very important.