This month marked a historic step for B.C.'s First Nations as they took some health programs into their own hands. But not all members are excited by the move.
On Oct. 1, Health Canada's First Nations Inuit Health (FNIH) services were transferred to the First Nations Health Authority (FNHA). Two years in the making, the move allows First Nations to participate in the design and delivery of health care and builds on a partnership with the provincial health care system.
It's a big step, said Joe Gallagher, FNHA's chief executive. While the province remains the provider of critical care, programs such as immunization clinics, early childhood education and chronic disease management will be run by the First Nations authority.
"This brings all the First Nations together at one table to talk about health planning," he said.
The transfer includes 135 permanent and 30 term Health Canada staff in B.C., 208 contribution agreements with First Nations health service providers and a 2013-'14 Health Canada annual budget of $377.8 million - money that was previously dedicated to First Nations through the FNIH.
First Nations face unique health challenges, such as diabetes, Gallagher said. First Nations communities represent the youngest, fastest growing segment of Canada's population, but the same body is also getting sicker faster and dying earlier, he noted. Approximately 17.2 per cent of First Nations people living on reserve have type 2 diabetes, reports Statistics Canada.
The FNHA will take a holistic approach to wellness, Gallagher said, looking at "preventative" actions as well as ongoing care.
"We will see a lot more focus upstream measures," Gallagher said.
The FNHA is accountable to both First Nations and the federal government. The authority is required to hand over audits and reports to Ottawa as well as honouring its contribution agreements with First Nations health service providers.
"Our ultimate measure is: 'Are we improving health outcomes?'" Gallagher said.
The new health care system is a step toward self-government, a direction a lot of Squamish Nation members don't want to go, Squamish Nation member Joanne Nahannee said. Since 2011 a group of nation members are calling for the Squamish Nation chiefs and council to step down because of mistrust, she said, noting that this month, members asked for an independent audit of the nation's operations.
Some members are concerned that the lack of transparency they say they see within their government will trickle into the new health care system.
"I don't see it as a good thing at all," she said.
Squamish Nation officials did not return The Chief's request for an interview before press deadline.
