Landmark agreement begins hard work of health care service

First Nations in British Columbia are a step closer to their goal of developing a First Nations Health Authority with the signing of a legal agreement between Canada, the province, and the First Nations Health Society at a ceremony held in the Squamish Nation longhouse on Oct. 13.

Dignitaries, including Health Canada Minister Leona Aglukkaq, provincial Minister of Health Mike de Jong, National Chief of the Assembly of First Nations Shawn Atleo, and a number of First Nations chiefs, gathered to participate in the signing of the landmark agreement.
The agreement is a first in Canada, intended to provide greater decision-making for First Nations regarding how health services and programs are planned, designed, managed and delivered to First Nations people.

A prayer song was offered, with a blessing bestowed on the visitors to the longhouse that day.

Elder Tiyaltelut, Audrey Rivers, gave a blessing that honored the past, present and future generations—the leaders. She also asked for the safety and health of the children.

The ceremony began when a sacred space was created in the longhouse with blankets placed on the dirt floor. Signers, blanketed in red, except for First Nations Health Council Chair Doug Kelly, who wore a traditional wool blanket, were drummed into the venue and circled the building twice. They were then stood on the blankets where they were introduced.

“BC First Nations wish to be fully involved in decision-making regarding the health of their people,” reads the agreement, so the parties will work together to create a new health governance structure that will result in a more integrated health system that reflects the cultures and perspectives of BC First Nations and incorporates First Nations’ models of wellness.

The new health governance structure will be composed of a First Nations Health Authority; a Tripartite Committee on First Nations Health; the First Nations Health Council; and the First Nations Health Directors Association.

The First Nations Health Society will now work to establish a First Nations Health Authority over the course of two years. This authority will plan, design, manage, deliver and fund the delivery of health programs for First Nations in B.C.

The federal government, the province, and other health funding will be provided into the future for this work. As part of their work, the authority will, among other things, collect and maintain clinical information and patient records and develop protocols for the sharing of patient records and information with BC’s Ministry of Health and other BC health authorities.

Over time, the authority will redesign health programs and services that replace federal health programs to better meet the health and wellness needs of First Nations people.

There is also a community engagement component of the new agreement as the authority takes shape.

Signing the agreement for Canada was Aglukkaq. In the Inuktitut language Aglukkaq said “Today is a very happy occasion.”

She acknowledged former federal minister of Health Tony Clement for his “innovative” BC Tripartite Framework Agreement on First Nations Health Governance, signed in 2007, the goal of which was to improve the health and wellbeing of First Nations in B.C., and close the gap in health between First Nations people and other British Columbians. That tripartite agreement provided a blueprint that guides the development of the new health governance structure.

Aglukkaq said the First Nations Health Authority is the heart of this new governance structure for health programs and services managed by First Nations people for First Nations people.

She said the work forward won’t be easy, but “I know we can and will do it. The results will be worth it.”

Minister de Jong signed on behalf of the province and described the “big history” of First Nations/newcomer relations as the trail that led to the agreement.

Some of that history is very sad, he said, with the European’s arrival and the devastating effects it had on the Indigenous populations.

Contact marked the beginning of many difficult years, he said, with great injustices. He said the agreement signed that day allows for something “as fundamental as letting a people take charge of their health care again… That’s big history.”

“We are doing it first and the rest of the country is watching this longhouse today.”

De Jong said it was the people who would breathe life into the agreement, because “the days of a First Nations child that cannot be expected to live as long as any other child must end.” He said the agreement would make that happen.

Grand Chief Doug Kelly of the Sto:lo Nation signed on behalf of the First Nations Health Council. He thanked the Squamish Nation for opening their house for the business of the day. It was sacred ground upon which to come together to bring the spirits of the ancestors to witness the event.

And it was their late great leader Joe Mathias who discussed the need for healthy communities. Kelly said no matter how hard one negotiates such things as treaties, it would not achieve healthy communities, and healthy communities are necessary for any self-government agreement to be successful.

Kelly said First Nations leaders met in May to discuss the agreement and overwhelmingly approved moving forward on it.

“There are hard times coming,” he explained, with British Columbia and Canada both looking to reduce budgets as they battle deficits.

The chiefs chose the certainty of the funding being promised over the uncertainty of what might be promised in the future.

“We know how much will be invested over five years,” adding it was time to begin to manage change rather than have change manage First Nations.

National Chief Atleo, A-in-chut, witnessed Kelly’s signature on the document. A-in-chut said the ceremony signaled a brighter future going forward.

“We know how much it means to see the people return to a place of health and balance.” He said it will take an incredible effort, but by working together, the partnership of First Nations, Canada and B.C. will be able to smash the status quo.

Atleo said the day was about understanding the past, knowing what the current reality is, and imagining what’s possible. And it all begins with listening to the people, who should have a role in deciding their health in the future.

Douglas White III of the First Nations Summit, a member of the Snuneymuxw First Nation, said he felt “good in my heart” to witness the events of the day. He expressed his deepest congratulations to the people who had worked on the agreement over so many years. He said that by working together, the damage of the past can be repaired.

Union of BC Indian Chiefs President Stewart Phillip said it was incredible the distance that had been traveled by First Nations in B.C. since 2007.

He reflected on the animosity that permeated discussions before 2005, when disparate First Nations groups around the province were at odds with each other’s agendas. Putting that aside was deeply personal for him, Phillip said, after the deaths of men in his community, gunned down and killed in a drug trade turf war.

“I knew in my heart that we did not have the luxury of squabbling,” he said.

In his work as a marriage commissioner Phillip said the bride, groom and their families are always happy and smiling during the ceremony, and he tells them that these special moments of celebration are “a gim’me.” It’s up to them to take the “brilliant light” of those moments into their hearts and use it as strength when they come to the difficult times and the hard work that is inevitably ahead.

He said it was going to take an enormous effort on everyone’s part to make the agreement that was signed work going forward.

Namgis First Nation Chief Bill Cranmer offered a prayer song to join the spirits of the people and call on the Creator to continue to work with them to improve the situation for First Nations.

Nuu-chah-nulth Tribal Council President Clifford Atleo Sr. described the coming work as a “huge, huge task” that would require the input of all Nuu-chah-nulth people. He was excited by the possibility of having health delivery and service shift from Health Canada to First Nations control.

Photo caption: BC First Nations cemented an historic agreement to take over health care services for their citizens. A tripartite health agreement was signed by Health Canada’s Leona Agulkkaq, BC’s health minister Mike de Jong, and representatives of the First Nations Health Council and First Nations Health Society on Oct. 13.