The Southern Chiefs’ Organization (SCO) and the federal government have reached an agreement over health care intended to place authority in the hands of First Nations.
Grand Chief Jerry Daniels and Pine Creek First Nation Chief Karen Batson, along with Minister of Indigenous Services Canada Marc Miller, signed the memorandum of understanding Thursday via the Zoom platform due to COVID-19 travel restrictions.
Daniels told The Brandon Sun after the signing ceremony that the agreement means decision-making and spending will ultimately transfer from the federal department’s First Nations and Inuit Health Branch to First Nation jurisdiction.
"We’re just structuring that right now," Daniels said.
"We have staff in all of our communities. We’ll be offering a basket of services, all of the services that will be needed and the additional services that are underfunded — the gaps in health care. At a community level, we’re filling those gaps. That’s the objective here."
Daniels told the House of Commons standing committee on health in April that when it comes to accessing health-care services and professionals, Indigenous peoples are the most marginalized in the country with the poorest health outcomes.
Since late 2018, the SCO has intended to change that bleak reality and looked to the example of British Columbia’s First Nations Health Authority, which is the gateway to health and wellness for more than 200 First Nations in that province.
"We’re already starting to do the transfer, so little by little. We’re looking at the next six months to a year to get agreements in principle in place and start to have FNIB (First Nations and Inuit Health Branch) vacate the region, similar to what was done in B.C.," Daniels said.
Daniels’ hope for First Nations patients is that they have confidence that they will be provided the best care possible. He said First Nations’ control of strategic decision-making and spending will change the system dramatically.
"If a hospital has a history of systemic discrimination, we can find alternatives. That just takes genuine partners at the table," he said.
Systemic discrimination of Indigenous people in the health-care system is a widely studied phenomenon, with numerous published reports outlining the overwhelming array of hurtful and dangerous practices that place Indigenous lives in jeopardy. One example is "Ignored to Death: Systemic Racism in the Canadian Healthcare System," by Brenda Gunn, an associate professor of law at the University of Manitoba.
"We want the best service possible, and we’re not going to take anything less," Daniels said.
Batson has worked as a psychiatric nurse for more than 30 years, in institutions, in communities and in private practice. Before she became chief, she taught at Brandon University’s faculty of health. She told the Sun there’s a lot of hard work ahead.
"It’s a large undertaking," she said.
"The current system is not working for First Nations people. The health-care system was designed to provide care typically based on a medical model and colonial values. When we look at the bigger picture, health and social determinants within First Nation communities, those have a direct impact on overall health and well-being."
Batson spoke of housing, education, employment and health-service deficits, all of which impact on physical health, mental health and overall well-being. She said the signing of the memorandum of understanding opens the door for partnerships and envisioning a new health-care structure that is culturally safe, community-led and responsive to the true health needs of First Nations people in southern Manitoba.
"There are definite gaps in health status between regular Canadians and Indigenous peoples," Batson said.
"It’s not only about dealing with chronic illness. It’s also about prevention, primary care. … More comprehensive."
She added it was nice to have the formal signing ceremony Thursday, which indicates health transformation for southern-Manitoba Indigenous people is moving forward, especially that the government seems to want to work in partnership to address all the dimensions of health.
The SCO will be working with the communities that are ready to move on the restructuring. Each of the 34 communities represented by the organization is at a different level and has different perspectives.
"We’ll work with those that want to move forward, who want to work collectively, and have confidence in the work that we’re doing," Daniels said.
"We’re confident that as we move forward the tangible objectives that we’re going to be able to achieve is going to bring more of our communities to the table, and maybe even communities outside of the region who may want to be part of our process."
Daniels quoted an Anishinaabe saying: We’re here to make this world a better place.
"This is a part of it," he said.
» Michele LeTourneau covers Indigenous matters for The Brandon Sun under the Local Journalism Initiative, a federally funded program that supports the creation of original civic journalism.