I want to thank everyone for joining us today, and I'd like to welcome our guests, who have travelled to Ottawa to be with us for this meeting. On behalf of the committee, please accept my warm welcome and sincere thanks for making time for us today.
With us today are Alvin Fiddler, Grand Chief of the Nishnawbe Aski Nation; Jonathan Solomon, Grand Chief of the Mushkegowuk Council; Isadore Day, Ontario Regional Chief; and John Cutfeet, Board Chair of the Sioux Lookout First Nations Health Authority. Also joining us is Dr. Mike Kirlew. I am going to ask the committee's indulgence in adding Dr. Kirlew as a fifth speaker. The speakers have agreed to share the time equally among the five, so we won't add any additional speaking time, if that suits the committee.
Some hon. members: Agreed.
The Chair: Okay, wonderful.
We want to make sure that we make the most of your time, so I will ask you each to speak for no more than eight minutes, cumulatively 40 minutes for five speakers. I will indicate seven minutes and eight minutes, and please do your best to make your closing sentence. I will hold our committee members to the same standard when they ask their questions. That way we can ensure fairness and give everyone a chance to be heard and to ask questions.
Let's move speedily along. I would like to begin with Grand Chief Jonathan Solomon.
, which means hello in my language.
Parliamentarians, it is a great honour and privilege to speak to you about the state of health in our region.
My name is Jonathan Solomon, Grand Chief of Mushkegowuk Council. As a grand chief, I am elected by the Mushkegowuk: the people. I speak on behalf of the Mushkegowuk people, who have bestowed upon me to be their grand chief.
The Mushkegowuk Council has seven first nations members and a total population of over 15,000. I am from Kashechewan First Nation, where I was raised and where I raised my family.
Foremost I am a father, and a grandfather to 13 adorable grandchildren, whom I adore and love so much. Back home, my people are out on the land with their families and friends for the spring hunt. I would be out there right now, but instead I am here, because the well-being of my people is of the utmost importance.
My ancestor, my great-grandfather, Andrew Wesley, signed a treaty known as James Bay Treaty No. 9, in 1905, with the government in Fort Albany, Ontario. In that treaty, in black and white, it promises happiness and prosperity.
In 1867, when Canada wanted to become a country, they made a pledge to protect the tribes of Indians in the former Rupert's Land. Now, 149 years later, look at what it has done to the tribes of this country. We have been sodomized, marginalized, and colonized within our own house.
In 1920 the commissioner, Duncan Campbell Scott, wanted to get rid of the Indian problem. Mr. Scott, who sat and spoke to my great-grandfather Andrew Wesley, now wanted to get rid of Mr. Wesley and his future generation. To put it mildly, it was a betrayal. He probably looked him straight in the eye and made mention of happiness and prosperity. Then he turned around and made a law where the kids would be taken from the arms of mom and dad and put into an institution known as residential schools. This is what we have been up against since 1867.
Sadly the legacy of Duncan Campbell Scott is still alive and well. We can break that cycle.
To begin with, the health system is broken. As provincial minister of health Dr. Hoskins puts it, “We have failed you. We have failed the North”. Minister Philpott admitted the system is failing.
We have known all this time, for far too long, that the problems may be too complex, but hopefully it will not be a hindrance. We cannot, with a sober mind, think it's working. People, my people, are falling through the cracks.
It's 2016, and we ought to start thinking it's 2016. It is obvious the present system is not working. It's failing my people. Furthermore we cannot put aside the mental aspect when we talk about health. We cannot put it aside until later on.
We all know the situation in Attawapiskat, my member first nation of Mushkegowuk Council here in Ontario, in Cross Lake, Manitoba, and many other first nations across this country. We have read research after research of the demographics. By putting aside real, tangible solutions, we are taking a high risk, if status quo is the only option. Now is the time to roll up our sleeves and put aside political stripes. We must begin to move the yardstick forward. 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: the people. Program after program has been studied, and progress after progress to study a particular program in Parliament has gone on for far too long. Government decisions on what's best for Mushkegowuk people are not working. Instead, the gap in services is getting wider and wider, and doing more harm than good.
For the last few days, I've been getting email after email from Canadians who care. Internationally they are saddened by the situation of my people and the people of Canada. They care. They want to help. They are expecting the government to step up to the plate and work with us.
There are a lot of Canadians who do care. They want my youth to have the same opportunity that their children have and have taken for granted. They want health care for my people. They want my people to live with hope and certainty, without despair and hopelessness. They want my people to have optimism and certainty. They want my people to thrive. Is that too much to ask for? All we ever wanted was to have the same opportunities as every other average Canadian citizen—nothing more, nothing less.
Before I close, Mushkegowuk Council had their own inquiry on the epidemic of suicides from 2006—sadly, to this date, we are still losing people to suicide—and Mushkegowuk chiefs and first nations communities had to do something. We reached out to the government of the day then, to no avail. This report was entitled “Nobody Wants to Die. They Want the Pain to Stop.” It tells the real stories of my young people and the people of Mushkegowuk. In this report, there is hope through the stories, although the stories are tragic and real.
The question I put forward to you is this. Will you be our partners to raise the despair to hope? My hand is reaching out. My people are reaching out. Will you stand with us, shoulder to shoulder? Opportunity is knocking on our doors. Will it be opened or will it be left closed, as since time immemorial?
A leader said that sometimes they get the feeling that as a leader they have failed to provide a vision for the future of the people. They think sometimes they spend too much time talking about a past that is full of treachery, full of pain, and full of suffering. Investing in the Mushkegowuk young people is an investment in the future, an investment in the well-being of thriving communities in Mushkegowuk and across the country.
Thank you very much.
I, too, want to acknowledge we are gathered here today in the traditional territory of the Algonquin Nation, so I thank them for allowing us to have this gathering in their territory today.
I also acknowledge my friends and colleagues who are with me. I also acknowledge all of you, members of the committee, and also the staff members and support people who are sitting around the room.
My name is Alvin Fiddler. I am from a small community in northern Ontario, the Nishnawbe Aski Nation called Muskrat Dam. I was elected as the grand chief in August of last year.
I want to begin by apologizing to our staff at NAN. They worked so hard to make speaking notes for me, and they also made a presentation, which I will submit to the committee later on. I just want to take this time to talk to you and to visit with you, since we don't have too many opportunities like this for us to engage in dialogue directly with parliamentarians and committees such as yours.
I want to begin by reading a letter that was written by one of our chiefs, Chief Wayne Moonias of Neskantaga First Nation. He wanted to be here to talk to you directly, but there was a death in the community. One of the elders passed away in Neskantaga. He's also preparing for Minister Bennett's visit this Saturday. It's a lengthy letter. I just want to read a portion of it.
Just so you know who Wayne Moonias is, he is the Chief of Neskantaga. Neskantaga is right in the heart of the Nishnawbe Aski Nation. It's in the Ring of Fire area. Neskantaga is probably the closest community to that Ring of Fire. Neskantaga is a small community of about 300 people.
Some of you are probably aware of the circumstances and the situation in that community. They've had numerous suicides over the last two years. They've been on a boil water advisory for 23 years straight. I believe, as Chief Moonias says, he holds that record. It's a record that none of our chiefs and none of our communities want to hold. This is what he says in his letter, when he's talking about the Ring of Fire:
||The so-called Ring of Fire, a mining development of historic proportions, is located with within our traditional territory. It is a shared territory with two other First Nations, but Neskantaga First Nation is the only community up-river of the development on the same Attawapiskat watershed.
He goes on to talk about his community.
||However, I need to tell you, that there are communities that live, eat, and use this territory since time-immemorial.
||1. But let me tell you what it means to live in Neskantaga First Nation.
||Neskantaga holds the record for the longest boil water advisory of any First Nation in Canada, dating back to 1995: “one of the longest human rights violations in Canadian history.”
||The failure of Canada to deliver safe drinking water to my community is what I call “program abuse”. The Minister of Indigenous Affairs has promised us a new water treatment plant, but we still have no firm timeline for when the government will deliver on the promise. Unfortunately, the water crisis is only one of many emergencies in Neskantaga.
Then he talks about the number of suicides they've had over the last five years. There have been 10 completed suicides in his community and numerous attempts. And there are other deaths due to violence and other circumstances. There are heavy losses.
He's also reaching out to Canada as a treaty partner and that's why I'm here as well. We are not here as a stakeholder or part of an interest group. We signed Treaty No. 9 in 1905 and 1906, and then the adhesion of that treaty was made in 1929 and 1930. NAN also represents six Treaty No. 5 communities that fall within the Ontario border.
I want to take this opportunity to speak about my role as the Grand Chief of NAN. As I said, I was elected in August of last year. I cannot count how many funerals I've gone to in our communities, whether it's suicides or house fires.
I was in Pikangikum, on Sunday, with my friend and colleague, Regional Chief Day, to pay our respects to that community as they laid to rest nine of their community members that died in a house fire two weeks ago. Three of them were children, four and five years of age, and the youngest was four months old. That's the reality for many of our communities, the social conditions, the challenges that exist. Whether it's the suicide epidemic or water situation, or overcrowding, that is the daily life of our community members right across the NAN territory.
I've talked a lot over the last two weeks about Pikangikum. While the focus is on the tragic fire, I talk about the good things as well, the good things that are happening in our communities. That's what we need to invest in. That's where Canada needs to look. If they're serious about rebuilding that relationship with us, we're open to that as well. But it has to be respectful. It has to be done in a way that benefits us as well. I think for far too long we've been left out, whatever processes were developed.
The last thing I want to say is that numerous studies have been done on our communities. Far too many. This one was from last year, last April. The Auditor General of Canada released a report on health care in the North, in NAN territory, and also in northern Manitoba. I remember coming to Ottawa to receive this report. That evening I received a call from one of our chiefs in the Keewaywin First Nation telling me that a 10-year-old boy committed suicide. This report, for the most part, has been sitting on a shelf somewhere. There's been very little action on the part of this government to implement the recommendations and the actions this report calls for.
To me, when you know of a situation, when you're aware something bad is happening, and you do nothing, that is neglect. I don't know what else you would call it. That's just negligence.
I want to ask one of our colleagues, Dr. Mike Kirlew, to talk about what this means, the inaction or the neglect on the ground in our communities. I want Dr. Kirlew to take a few moments and talk about what we mean by that.
, everyone. My name is Mike Kirlew. I'm a physician. I work in the Sioux Lookout region. I work in the small community of Wapekeka, about 550 kilometres northwest of Sioux Lookout. I've been there for about 10 years, and in my 10 years I can say that first nations individuals who live on reserve receive a standard of health care that's far inferior to what other people get—not just a little inferior, far inferior.
The grand chief had mentioned the Auditor General's report. The Auditor General's report made a statement. It said:
||...Health Canada did not have reasonable assurance that eligible first nations individuals living in remote communities in Manitoba and Ontario had access to clinical and client care services and medical transportation benefits....
What does that look like on the ground? What is the real life on the ground? Let me paint you a couple of pictures.
Imagine a young person who breaks a leg. He or she comes in to the clinic and the leg is on a virtual right angle, and you do not have adequate supplies of the pain medication that is needed. It takes nine and a half hours for that medevac to come in, and the entire time, because that supply of morphine is not there in sufficient quantities, you hear that person screaming—the entire time. That is the reality.
What is another reality? Let's say you have an individual who needs to get a tube down his or her throat because of a very severe infection, a bad pneumonia. You will not have enough medication to treat that person appropriately, and there's a good chance that you will run out. You can see that person with that tube in his or her mouth, as you hold his or her hands down so he or she doesn't reach and grab for it. The person tears. The person remembers.
It means that you run out of oxygen or have to use techniques to ration the oxygen. You see children gasping for breath. We run out of a medication called Ventolin. That's an asthma medication that helps open up the airways for children and adults with severe asthma. If you run out of that, they gasp for hours until the plane arrives. Imagine those of us sitting here as parents, if we're watching our children and that's what's happening to them. They're gasping.
At Sioux Lookout, the biggest concern of women who are pregnant is whether they are going to have an escort. Are they going to have to go and deliver their baby by themselves, or will they have somebody to at least hold their hand? That's my patients' number one fear, that they're going to deliver alone. Or will they be denied an escort?
For my patients who are palliative, their biggest fear is that they will die alone, that there's no one from their community to hold their hand—no one. No one to hold your hand. From the moment that you are born to the moment you die, your life is dominated by non-insured—dominated. That is unacceptable.
I see parents who recognize their kids might have learning difficulties, might have developmental difficulties, and there's no way to get them any services—very little. Time goes on, and they're more and more delayed.
That is the reality. That is what that statement means. That is what that statement looks like on the ground.
Section 12 of the non-insured health benefits policy states that non-insured will not cover certain types of travel. It even mentions that it is impossible to appeal this. The very first thing that it excludes says that they will not cover travel for compassionate reasons, period. We will not cover for compassionate reasons.
In health care, compassion is not something we should innoculate our health care system against. When we start losing our compassion, we lose our humanity. People are suffering, and children are dying every single day. That's what that statement by the Auditor General means.
There needs to be drastic change quickly. The longer we wait, the more people will die. The more time we wait, the more children will die. I appeal to you today, not as politicians, not as members of political parties, but as mothers, fathers, brothers, sisters, aunts, and uncles. Let's return the humanity to this process. This process needs that humanity.
[Witness speaks in Oji-Cree language
I greet you all from Kitchenuhmaykoosib Inninuwug, that's about 600 km northwest of Thunder Bay. My name is John Cutfeet and I chair the board of the Sioux Lookout First Nations Health Authority.
Thank you for this opportunity to speak to the committee members. Meegwetch.
A number of years ago, an elder who was part of the group that lobbied for the inclusion of section 35 of the Canadian Constitution told me that after many hours, days, and weeks of negotiating for the inclusion of the recognition of aboriginal treaty rights in the highest law of the land, with a lot of resistance from the political leaders of the day, he couldn't understand why he felt exhausted, and why he would break down and cry for seemingly no reason at all. This elder was a strong man, a strong person, who stood up for indigenous rights when the Constitution was being repatriated back to Canada. If he was so strong, why then would he be breaking down and shedding tears for reasons he did not understand?
He told me that he sought and received professional counselling and the advice of elders for his situation. This gentleman was also a survivor of the residential school system. Through professional counselling and elder support, he found out that he was suffering from post-traumatic stress disorder, consistent with what is seen with with people who have been in war zones.
He said an elder told him that, “From the day we are born to the time we die, we're born into a war zone. The system fights with us to take away or control our daily existence.”
From the day we are born to the time we die, our lives are impacted by the Indian Act, another unilaterally imposed piece of legislation. We are born into a war zone with third world living conditions and widespread mental health issues from an unending cycle of intergenerational trauma. We see levels of PTSD in our people that are consistent with what is seen in war zones, and the war continues against our people to this very day.
I would like to acknowledge all those who have needlessly died at the hands of this health care system. Their deaths and suffering directly resulted from denials of care. There are many tragic stories. Here are a few.
Two children of four and five years old died in 2014 from the easily treatable disease of strep throat. They were turned away despite the efforts of their loving parents, and did not receive a simple dose of antibiotics. As one leader said, “We're tired of the Tylenol nurses and doctors, as this egregious system is killing our people needlessly.”
The health care system for indigenous people is atrocious and dysfunctional.
The late Laura Shewaybick's last experience with our health care system involved a nursing a station running out of oxygen, followed by racism and insensitivity in a hospital.
Over 25 years ago, a woman gave birth in an outhouse after being repeatedly turned away at the nursing station.
Most recently, in my home community of Kitchenuhmaykoosib Inninuwug there was a young lady who called the nursing station saying that she needed a checkup and that something was happening to her; she was expecting a baby. She described her symptoms over the phone to the nurse and the nurse said, “You have a bladder infection.”
The young lady asked if she could come in and get a checkup. The nurse replied that there was “no need to. You have a bladder infection.” All this was over the phone.
She went in anyway and asked again if she could get a checkup. The answer was, “No need. You have a bladder infection.” She was sent home. Two hours later, she gave birth to the first of two babies in a toilet bowl. What's really sad about this is that, three weeks later, they found the remnants of a third baby they didn't even know about.
As Canadians, we should all feel the shame of not being able to tell her that anything has changed in health care in 25 years.
Every day we witness travesties in health care delivery, and every day lives are being adversely impacted by health care policy. The system fights us and denies us our basic human right to health care. Our treaty rights and aboriginal rights continue to be undermined by various government legislation and policies. Failure to change this legislative violence imposed upon our people will result in continued and regular denial of care. Unless something changes, these tragedies will continue. Why do I call it legislative violence? When you take away all opportunity for people to provide input into certain health care initiatives, that is violence because you take away the right of a person to be able to be meaningfully involved.
The discriminatory policies and practices are so deeply entrenched that they're often difficult for those who live this reality on a daily basis to recognize that this is not normal and is not acceptable. As for those in the general public who are outside the system, the reality is either unknown or unfathomable.
If these real-life stories are not enough for you, then listen to the multiple reports that have been issued over and over again. These include the Scott-McKay-Bain health panel report, the NAN youth forum on suicide, and the report Grand Chief Solomon just mentioned in which was stated, “nobody wants to die: they want the pain to stop”. Of course there were the Royal Commission on Aboriginal Peoples report, the Truth and Reconciliation Commission's report, the Auditor General's report, and the UN Special Rapporteur's report on the rights of indigenous people.
It is painfully clear the system has failed our people, yet we continue to do things the same way over and over again. Einstein defined this as “insanity”, doing the same thing over and over and expecting new results. We need to do things very differently, and we need to see results. We need to change the way health care is delivered to the indigenous peoples at the community level. This requires a substantial transformation of the health care system. Redesigning the system is a large task, but ending the discriminatory and inequitable practices that cause suffering to our people is something that can and must be done immediately.
One of the first places to start would be to take a good hard look at the non-insured health benefits program. Every day 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. The needless deaths of children was nothing short of a travesty that Canada as a country and as individuals should be ashamed of. 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.
I hear talk about a new relationship, but that new relationship that we can all be proud of must be free from the shackles of colonialism.
: Meegwetch. Boozhoo, Wachiya, Sekoh
. Good afternoon.
First of all, I want to acknowledge the creator, creation, the prayers, and the protocols that were offered today for all of our people. I want to acknowledge the traditional territory of the indigenous people—the Algonquins and the Anishnawbe. I want to acknowledge these lands on which this important meeting is taking place.
I want to acknowledge and thank the Standing Committee on Aboriginal Affairs and Northern Development for listening to these important presentations on health. I want to also acknowledge and commend my peers, the first nations leadership from Nishnawbe Aski Nation and their health officials for their tireless efforts. I can speak volumes about the work and the efforts of my colleagues. I want to tell you their expertise is second to none.
The Mushkegowuk people in the Attawapiskat First Nation are experiencing a glaring social crisis that cannot be ignored. I want to make reference to something that John Cutfeet just indicated with respect to post-traumatic stress disorder. I want to possibly give you something to think about. This is a notion that I don't think most people look at—collective post-traumatic stress disorder. It is something that might be understood by the South Africans who experienced apartheid, or possibly the Jewish community who felt post-traumatic stress during the Holocaust and thereafter. I believe that's what we're dealing with in a lot of respects with the health issues faced by first nations in this country.
The first nations health crisis can no longer be out of sight, out of mind, nor should it be treated with band-aid solutions. I want to expand, to offer the committee a glimpse of a 10-year-old boy. Also, let me tell you that Alvin and I also attended a funeral for a 10-year-old girl. Both of them committed suicide. This is within the last year.
The 10-year-old boy, his suicide was a direct result of travel cuts. There was no money to take care of this boy. The mother was an opiate addict on a methadone program, a very aggressive program. The father was a diabetic who had amputations, who needed to go out of the community to get the health care he needed. So the family was in a state of chaos. There were no mental health services for this boy, no respite care. The parents try to do what they can, the older parents, but they couldn't do anything. The boy ended up getting bullied, developing mental health issues, and decided to take his own life. This is a travesty. This is happening here. These are the sorts of stories behind these numbers.
We are here not only to describe the crippling reality. We are also here to offer real solutions. As Ontario Regional Chief in the Assembly of First Nations' national portfolio on health, I am advocating for immediate and strategic investments that must be done in full partnership between first nations, the Province of Ontario, and Canada. I am submitting that full support of the Nishnawbe Aski Nation's five recommendations being presented here today be accepted as a way forward. The proposed solutions are not unreasonable. The proposals come from them and their citizens. The point is that the community knows what the solutions are. We need the partnerships. We need the investments.
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 the areas most in need. This is a critical element that Ontario already has come to bat on. Canada, we must extend these efforts across all first nations in 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 a comprehensive health action plan that includes all relevant ministries and government mandates. This means that we are calling for an immediate adjustment to the federal 2016 budget under the social development of health federal framework.
Again, we know there are investments made in health, but it's very clear that there are going to be adjustments needed to the current budget.
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 is 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. I want to let you know that you will be receiving a memorandum to cabinet on the health crisis of first nations in Canada.
We clearly cannot be doing things that have been done before. This fashioned way of expecting that ministries are going to fully understand our situation...well, we have to come forward. We have not yet been engaged in a wholesome way to be able to describe what the solutions might be.
Allow me to expand some points. 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 just mentioned. Number two is eliminating abject poverty through investments in housing, healthy and affordable food, infrastructure, education, and training. Number three, immediately implementing mental health and addictions services to address the youth suicide crisis, prescription drug abuse, and mental wellness. Number four is recognizing first nations authority over land and resources, as recognized within our territories. And number five is 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. New water and waste water funding will be $2.24 billion over five years; new education funding will total $2.6 billion over five years as well.
First of all, let me point out that the new funding for first nations is $8.4 billion spread out over five years. That works out to just $1.68 billion per year. 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.
It is now 2016. Last year said the most important relationship for him and his government is with indigenous peoples. Every single minister has a mandate letter that emphasizes the need to work with indigenous peoples as a top priority. I have great respect for and . They are both deeply committed to ending the poor health, poverty, and despair that grips far too many of our communities. I want to further underscore that we also, in Ontario, have a very significant and strong relationship with the Liberal government. In this case, we have a political accord, and this minister, through this very structured relationship process, is coming to bat on health issues. That's what enabled him to come to the community in that very direct fashion and put the investments on the table.
Again, we must acknowledge that this is about framing the relationship, framing those investments and the plan going forward.
In terms of immediate needs or immediate steps we could take now, when we look at communities like Attawapiskat or Pikangikum, our immediate priority is always to ensure that they have the supports that they need at that moment, whether it's mental health supports, counselling, therapists, or child psychologists to go there and hopefully stabilize the situation on the ground. That's obviously our number one priority, to support our communities that are in crisis now.
In terms of other measures that we can take, I want to ask this committee to work with 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. I'm going to ask my friend, Dr. Kirlew, to expand on that. We need to look at access, especially with our children who are living in remote areas. If we cannot bring that service, that treatment, or whatever it is that they need to their community, we need to bring them out, so that they get it somewhere else.
This speaks to Jordan's principle. There was a private member's bill that Parliament adopted, which is great, but we need to make that into law. We need to move beyond the jurisdictional wrangling that many of our kids and our families find themselves in daily. We need to improve that access now.
I'm going to ask Dr. Kirlew to briefly expand on what I mean by access.
We have Jordan's principle, but the problem is we don't have Jordan's practice. We need Jordan's practice.
Children are being left behind. I have no way of getting children that I see out for access to developmental services, essential services such as speech language pathology or occupational therapy. I am very limited in what I can do, because non-insured...does not pay for the travel out.
I would think a first step would be that we not put any barriers for children to access care. If that's children accessing mental health services, let's not put any barriers. If it's children accessing developmental services, such as speech language pathology or occupational therapy, let's not put any barriers to care.
There's another practice that happens routinely, and it's that 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 of examples of policy changes that would at least help start pointing us in the right direction. Right now, children do not have access to their essential services. There is going to need to be significant health care transformation. My question is what I should do in the meantime. I have children who cannot speak now. I have children with autistic spectrum disorder who have zero access to service. What do I do now?
I think the practice of denying pregnant women escorts needs to stop immediately. There is no basis for that in medical science, in medical theory, or even basic human decency. Which one of us would want to deliver a child by ourselves, not having our partner or our support person there? I think that practice needs to stop.
Very quickly then, Mr. Chair, just as a short history bite, the NNADAP program back in the seventies was one of those moments in time where the federal government and first nations across this country said we need help. Cabinet actually went forward and they helped with the investment in an NNADAP program, which still exists.
However, with the evolution and the challenges over the years, with the changing face of addiction and mental health, this NNADAP program needed to be reviewed from time to time. We're dealing with pay equity. We need pay equity in the communities with respect to addictions workers.
As well, Mr. Chair, what has happened is that with the NNADAP program, there's a review called Honouring our Strengths. Basically there was no money under the former Conservative government for this review. It was get the review done, see what you can do at the community level. What was created was Honouring our Strengths.
One of the things that came out of that process was the first nation mental wellness continuum framework. What we're told, and we're hearing it right across our communities, is that this framework works.
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.
I want to thank you, gentlemen, for your powerful words.
I'm going to start with a technical question to the doctor and then go to Grand Chief Solomon because of his expertise in the region I come from.
Doctor, I get messages on Facebook from mothers in motels in Timmins asking me to get them an extra day of treatment before their child goes home. Then I see the kids in the community, and they're like a mess because that day wasn't enough. Then their pictures are on Facebook, and people are asking, “How did this happen?”
I remember talking to Chief Solomon and saying, “Am I remembering this correctly, Chief, or is this some kind of nightmare I had where the nurses were carrying water in buckets from the river to the nurses' station in Kashechewan?” He said, “No, that was true. That happened.”
I hear you, and you're talking about telehealth. We don't have telephones. This is 2016.
Children are dying because they don't have pain medication, because they don't have Ventolin. I think we have to say that it's not good enough to say we're going to study this. We need change immediately, and I hear the call that this budget has to be augmented immediately because children are dying.
If you could give us one recommendation to give power to the doctors so they could not be overridden by the bureaucrats to deny children their services, what would that tool be that you need as a doctor when you say that child is going to get that extra time in a hospital, they're going to get the extra support here? What is it you need as authority so you can override those bureaucrats in Ottawa?
That's a very good point.
I've surveyed a number of my colleagues, and they described oftentimes the relationship with non-insured health benefits as adversarial.
When I look at the provincial system, for example, the system has a ministry in Ontario and has a Ministry of Health transportation grant. For example, if you live in a small town in Ontario and you don't have access to that particular service or diagnostic test, you have a government program that operates provincially that essentially helps fund your travel there.
When I compare those two forms, the Ministry of Health travel grant versus the non-insured form, there are stark differences. First things first, the Ministry of Health travel grant does not ask for a diagnosis. Non-insured insists on a diagnosis, a reason for visits. Why? Why does non-insured health benefits need to know why a person is getting an MRI? Isn't that confidential between that patient and their physician? There's no mention of that in the provincial health travel grant. You simply sign as a physician and say that this person has an appointment with the specialist, and the same thing applies to escorts. Why? Why does non-insured have to know why a person requires an escort? Isn't that between patients and their clinician?
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. Oftentimes my colleagues and I feel we're being “policed” by non-insured health benefits, but that is not their role.
The same thing applies when you look at the process by which they approve medication. It's archaic. It's time-consuming. It introduces unnecessary delays and it does not meet its goal of ensuring that patients get the right medication in the right time.
In the provincial system, you have a three-letter code that you write on the prescription. You go and you get your medication that day. For the non-insured system for the same medication, a piece of paper gets generated in Ottawa, and it's back-and-forth faxes between the physician and Ottawa to decide on whether or not that medication is.... Why are both systems so different?
I've spoken to people about this before, and they say, “Well, you know what, Dr. Kirlew? It's just different.” It's not different; it's inferior. There's one system that you have—
I'm sorry, I didn't want to interrupt you, but I need to ask Chief Solomon about this because of Jordan's principle. If we look at the human rights tribunal, this is systemic discrimination against children, denying them service. Chief Solomon and I have been to two funerals this year. I know that you have been to many more.
I was in a community where I was talking to one of the teachers, and we couldn't get counselling for a child because they had been turned down by the federal government because they couldn't prove it was necessary, and this was a child's life.
I want to ask you if there's one thing we can do today to say, “This discrimination has to stop. Jordan's principle becomes Jordan's practice.”
Chief Solomon, what do you think?
Again, the meeting was very well attended. The responses from both the federal and provincial governments clearly were something we haven't seen in a long, long time. The former Conservative government did not respond in that way.
And why I say that, and what's most important to recognize here, is that as we've been under a 2% cap, and as we've seen funding cuts over the last decade you will see a culmination of issues that have backed up. 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.
I'll leave it at this, that what is also missing.... Again, we talk about the social determinants of health. Health is one file, but we can no longer deal with first nations health in silos. We can no longer expect that the ministry of infrastructure or economic development or education cannot have a fulsome discussion and dialogue, which first nations would be part of, in order to determine a framework for the social determinants of health. That's why I'm bringing forward to the committee today a framework that looks at the social determinants of health, a health and social policy framework.
The last thing I'll say is that, again, I'm bringing this to the committee because it's essential to ensure that we are effective, that we're economical, and that we're efficient with the time that's needed because people are dying today. This is why you will see a memo to cabinet come forward that speaks to the emergency health crisis of first nations, not just in this region, not just in Ontario, but across Canada.
Thank you, Grand Chief Solomon.
I'm going to point out one thing with regard to your previous question. The cost of doing nothing is huge. We need to look at the impact of the last 10 years, set that aside, and begin to do some damage control there.
With respect to what's been done and what's working, again, turning to our communities and recognizing that we've got the best of the best on the ground. They're strong. They're resilient. They know the people.
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; 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.
One of the demographics that go unnoticed is people with disabilities. We need to recognize that in our communities, we have so many that are so underfunded, under-focused. These people are suffering in silence. We need to focus on people with disabilities as well.
Thank you to the panel for presenting.
I'm from the Northwest Territories, so I've heard a lot about the issues you're talking about. I have a lot of similarities in my area. The suicide rate in the Northwest Territories is double the national average.
It's the year 2016, and suicide and self-inflicted injuries are among the leading causes of death among our aboriginal people. It is amazing that this is still happening.
As we start to talk about the whole issue of suicide, we know that people who die from suicide or who attempt suicide are people who are usually overwhelmed. They're feeling hopeless and helpless. They're in the pit of despair. Look at aboriginal communities and the high unemployment. A lot of communities I represent have well over 60% unemployment.
Also, we have people who are addicted to drugs and alcohol because of trauma and post-traumatic stress disorder, and we don't have services to deal with that. On a daily basis in my community, I hear air medevacs coming and going. It's really scary to see that happening, because these are communities where I have relatives. These are my people.
I know why we don't have the services. We have people who come in, professionals who want to help, and they realize the health services are not there for their children. We have teachers who come for the short term and leave. The RCMP come and then leave. They're not going to stay in a community where there are no services and the education system is failing them.
The band councils in the communities right across Canada have been cut to the bone. NGOs have been cut to where they can't operate. Who is left to deal with the issues in our communities? The chiefs? All they're given is a title. They don't have a budget to work with, really. There's no pot of money you can dip into to help the communities. We share a lot of the problems.
One of the things that I was getting a little nervous about in your presentation was that were talking about the social side of things, but I think that in order to deal with some of the problems that have plagued the communities—and I heard this during my campaign—we have to face it and move forward with a multipronged approach. Economic development is one of the things that I would really like to see. We have good people in our communities. We have smart people in our communities. We have people who are wanting to work. We are lacking infrastructure, so why don't we try to approach it on that front? I'm really interested in hearing about how you would see the economic side of things helping communities to move forward and bringing pride back into the communities.
There are two ways to approach this. We can continue to subsidize communities and try to put in social programs, or we can build pride in our people by providing them work, developing skills, and creating opportunity for them so that they can build their own houses and can do a lot of things on their own. Right now, that opportunity is missing. I'm really keen to hear from you. You mentioned it a bit and it caught my ear.
Thank you for your time. I'd like to say thank you to our guests today as well. All of your presentations are overwhelming.
Dr. Kirlew, I want to thank you for your dedication to these communities, despite challenging conditions. Your speech today was heard and felt.
A couple of days ago, we had an emergency debate—I'd like to say an emergency discussion—that all parties attended, which was called by our colleague from Timmins—James Bay. Throughout the evening you heard, not blame placed, but talking about action. I think we need to lead from our heart. If I am listening to Grand Chief Solomon and the words he is saying, we have to understand a little more. I am not sure that an hour, or an hour and a half, or eight minutes of presentation give us that understanding of what exactly is going on.
I want to say that $8.4 billion has been committed. If you heard my speech, I did challenge that this is spread out over five years, and we need money spent now; we need a plan formulated now. We need to deal with the immediate emergency. We need to look at the mental health issues, including all the issues that are affecting our communities across Canada.
In your opinion, what are some immediate steps that we can take today to provide action that provides hope and also ensures that the money that is pledged will get to those who need it the most?
Thank you, all of you, for being here today. Thank you so much for sharing your concerns, for sharing your stories. They're very informative and very heartfelt.
To me, so many questions have been asked that have been very specific. I'd like to try to take it to a different level. I can't imagine what it's like being in your communities. The only way that I can relate is when you talk about the urban versus rural reality. I have a very rural riding. I know that so many times they try to overlay urban methods and processes onto the rural areas, and you're right, it doesn't work. Rural people know how best to serve rural people in the most effective way.
When the minister was here, I posed the question to her. We have this operational budget and we have this grant budget. The grant budget is massive, and the operational budget is a pittance. How do people serve their people when their hands are tied because they have to apply for these grants? I imagine that you would agree that if we could take that massive grant budget and put it into the operational side, and say, here is the budget you have to work with; you set the priorities as to how you feel that budget should be allocated.... In other words, it's self-determination.
I guess I'd like to ask you this. It's something I am certainly going to advocate for, and I hope the committee will come along on this at some point. If you had that ability, how would you prioritize that this money would be spent in your communities? I know it's a huge question, but I hope you can try to address that.
I'm thinking of Nadine Tookate in Attawapiskat. I asked her what she wanted to be, and she said she wanted to be prime minister. She will be the prime minister, if she's given the support.
We have two options. We have these incredible young people who are such drivers in the communities, and we have the ones who have been left on their own and ground down. When I hear that such and such is not possible in this budget, I think of the Prime Minister's response to Syria. Nobody was responding to Syria. The whole world was wringing their hands. Suddenly it became an international urgency.
Well, this is an international urgency. I don't know, Chief Solomon, how many people are calling you from around the world, but people are asking what's going on in our country. How could this happen?
I heard Chief Day say to augment the budget. The Prime Minister put $1 billion on the table, which wasn't in any budget, to help Syria. I would like to see this, and I think it's our call. We have to rip up that first nations non-insured health benefits program. It has to stop, because it's not just bureaucratic—it's discriminatory. But it could happen. We could get the word that it's going to happen. Augment that budget, and not just mildly. This is an urgent case.
What will it take to deal with the crisis so that we have medicine in the nurses unit, so that we have proper telephones, and so that there's an x-ray machine in Kashechewan so they don't have to fly people out with a broken leg? What will it take to give us the mental health services? That is the question.
If we have the political will, we can transform this country, and it can be done right here in this building.
I'd like to thank you very much for being with us today. I'm grateful for the opportunity.
If I've understood what was said in previous discussions about health care in the field, a lot of policies aren't materializing and the administration can't effectively take care of your needs. I am a mother of four children. They are grown up now, but I can't imagine seeing them suffer. It's incomprehensible that, in a country like Canada, you don't have the medication you need and that people don't have access to basic care. Given everything we are doing, do you think we will be able to resolve these problems in the long term? I understand that there are things to resolve.
You spoke a little earlier about infrastructure, and you said that we have to fix this situation first. What is your priority in terms of infrastructure? There are problems with water and housing, but what do we need to do quickly? You shouldn't have to wait another year or two. How many young people have to suffer? I think efforts have been made in the area of mental health care following the emergency this week, but long-term efforts are also needed.
I'd like to hear your thoughts on this. From listening to all the discussions we've had since the beginning and the questions my colleagues have asked, I understand that you need to be there to make decisions and find solutions. It's an open question.
I reflected a little bit on Chief Day's comments. We had the inauspicious 140th anniversary of the Indian Act. I can remember tearing my hair out over the benefits program in the eighties in terms of how complicated it was. I think we have something a bit more complicated than just...10 years...
I look at some of the things that were in the communities I represent. I'm very proud of the First Nations Health Authority and some of the really good work that has been done. I just wanted to perhaps push back very gently. We have a huge, complex problem. Just from the far-ranging discussion today, including crisis response, primary care services, economic development, and the structure of systems, we see how many aspects there are. I think that framework the minister talks about creating is going to be incredibly important.
I want to quickly pick up on Mr. McLeod's comments. I was interested to hear about the De Beers diamond mine. I know that in British Columbia, and we represent all Canadians, but sometimes you know the communities you live in better than you know some of the other provinces. They do have royalty-sharing agreements. If a new mine goes in, and the provincial government has royalty sharing. I know that in communities where that has been part of their agreements, it's made a tremendous difference.
I think one question is whether that is happening in your communities. This is in addition to any agreements they would have made with the company.
I also know that there is a fairly large group that was very interested in the government strictly backstopping the opportunities to be a partner through equity investments. That was perhaps a disappointment for me in this budget, because they're actually backstopping a loan. But it would create enormous opportunities if there's new development in terms of that equity partnership. I guess we've gone from 100,000 to individual patients. I would appreciate some comment in terms of some of these concepts, and what those opportunities might bring for future, especially as it relates to economic.....
[Member speaks in his native language]
I think Chief Day has spoken about the political accord they have in Ontario and how that's brought immediate action on the ground.
I'm fortunate enough to come from a region where we have a comprehensive land claims agreement. That James Bay and Northern Quebec Agreement is a global approach, a comprehensive approach: housing, infrastructure, policing, justice, economic development.
We're talking short term, I recognize, but shouldn't the long term be one of the models we could consider? We don't have to necessarily take everything, but at least the principles around an agreement like the James Bay and Northern Quebec Agreement.