The newly activated First Nations Health Authority can be seen as the “next natural step” in the evolution of health service delivery for B.C. aboriginals, said Grand Chief Doug Kelly of Sto:lo Tribal Council.
Some programs delivered to aboriginals in B.C. that were a Health Canada responsibility last week, now fall under the aegis of the newly minted First Nations Health Authority.
As chair of the First Nations Health Council, Grand Chief Kelly has a mandate for advocacy and reciprocal accountability for FNHA, and as such has been front and centre as they complete a formal transfer on Oct. 1, of programs, resources, staff, assets and more.
“What we achieved today is elevating the work that began many years ago,” he said Tuesday in a phone interview with the Progress. “We have proven we could take on the responsibilities that were once Health Canada’s, and that we could blend the best of two worlds, the best of modern medicine and the best of our cultural traditions and ceremonies.”
“We knew that what we did locally we could do regionally, and what we did regionally we could do right across the province.”
The FNHA, as a result of a signed agreement, will take on delivery of health programs and services in B.C. to aboriginals living on-reserve and off. It’s everything from primary care to mental health and addictions as well as environmental health and research, and they’ll be partnering with the province as well.
It’s nothing new for Sto:lo communities, but it’s quite a feat to see it clear across the province, said Kelly.
He’ll be responsible for ensuring the work meets the expectations of chiefs, health directors and citizens.
On the website a basic question is explained: “Why a First Nations Health Authority? Statistically significant health disparities exist for First Nations people in BC and across Canada. The First Nations Health Authority aims to reform the way health care is delivered to BC First Nations to close these gaps and improve health and well being.”
And it continues: “BC First Nations, the Province of BC, and the Government of Canada have all determined that First Nations health disparities are no longer acceptable. A New Relationship between these Tripartite Partners was forged and a series of precedent-setting agreements led to the creation of a First Nations Health Authority.”
Grand Chief Kelly saw the need for this kind of self-reliant service delivery when he was the youngest chief of Soowahlie First Nation in the 1980s, in the early days of the Sto:lo Tribal Council.
With First Nations communities seeking economic development opportunities through creation of land codes, and taxation, the takeover of health service delivery is in a similar vein.
“It’s important to observe that where First Nations governments are exercising control, there are better outcomes. When they design and deliver the programming, there are better outcomes.
How will the average Sto:lo in Chilliwack notice the transfer?
“Initially we don’t want them to notice. It will be a seamless transfer with no disruption or minimal disruption in service. But in the coming months we want to transform programs and make significant improvements.
It’s about getting access to primary care and a family doctor, even for people in rural and remote communities.
He knew about the challenges rurally, but Kelly said he was surprised to learn that many First Nations people living in greater Vancouver did not have access to a family doctor. Better access means better care.
‘”The most expensive kind of health care anyone can get is inside the emergency room of the local hospital, and that’s where many are going, so we’ll make certain to move to a better form of care, and access to that care.”
The goal is to produce better outcomes.
So what will that look like?
It’s changing a sickness model of care, one that treats disease, into a wellness model.
“It’s one that not only tilts the investment toward treating illness, but also invests in health promotion and prevention of disease.”
“Health” is an outcome, Kelly said he’s come to recognize that it is an “outcome of housing, of education, of income, of strong, healthy families.”
What they’ve created with the new health authority is a way to change the very social determinants of health.
“So it doesn’t matter where people live, if they can’t access the kind of services we take for granted. We need to make those changes and we will.”