A commitment to see Aboriginal health at par with others

[Guest]

First Nations receive least amount of health funding per person in Canada
May 11, 2006
http://www.turtleisland.org/discussion/ ... =6954#6954
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Aboriginal health a victim of the first Harper government budget . . .
May 3, 2006
http://www.turtleisland.org/discussion/ ... =6902#6902

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AFN leader makes an appeal to ensure health plan can be implemented . . .

News and Comment
by Tehaliwaskenhas
Bob Kennedy, Oneida
Copyright
Turtle Island Native Network
http://www.turtleisland.org

March 23, 2006

AFN National Chief, Phil Fontaine had the health of First Nations on his mind because Friday is World TB Day, and the national leader called for immediate action, "to eradicate this preventable disease in First Nations communities".

An AFN news release reminded us of the challenge we face. In Canada, there are approximately 1,600 new cases per year, "many of them are diagnosed in First Nations communities as a result of overcrowded housing . . . Unfortunately, TB infection rates among First Nations are 10 times higher than the Canadian population . . . In some northern communities, up to half of the population is infected".

Fontaine said he recently visited a northern community in Manitoba where there are more than 100 active cases of TB. "This is simply unbelievable and unacceptable in any community in Canada in the 21st century . . . Many of these TB victims are children and the elderly because their immune systems are the most vulnerable. They must travel to Winnipeg for a minimum of two weeks to receive treatment," explained the National Chief.

He pointed out that in 1992 Health Canada launched a National TB Elimination Strategy - to eradicate this devastating and debilitating disease by the year 2010 and this target now appears unachievable.

Fontaine again reminded Canada that the AFN has developed a First Nations Public Health Framework that addresses all aspects of health prevention and promotion. "At present, the Public Health Agency of Canada has not involved First Nations in its activities."

The good news is that TB is a preventable, treatable, curable disease. But the AFN leader said the bad news is that, "it will persist for as long as our people continue to suffer in poor living conditions . . . Last year, we presented a 10-Year Challenge to close the gap in quality of life between First Nations and Canadians. That challenge was accepted by all First Ministers and resulted in a $5.1 billion commitment to address the basic determinants of health such as housing, education, and employment. The Conservative government agrees with the 10-Year Challenge but says they do not necessarily agree with the funding commitment".

The AFN National Chief obviously aimed his words at Prime Minister Harper and his new government, "Today I call for immediate action in order to make significant strides towards improving our quality of life within the next decade. Eradicating TB - eliminating poverty and despair - begins with political will, courage, and commitment.Now is the time to stand up for First Nations’ priorities that, we hope, are shared by all Canadians".

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First Nations Health Blueprint Received Strong Endorsement
February 7, 2006
http://www.turtleisland.org/discussion/ ... =6596#6596

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September 2005

Connecting Communities For Better Health: First Nations and Inuit Telehealth Summit , Winnipeg Manitoba . . .
http://www.turtleisland.org/discussion/ ... =6092#6092

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Federal / Provincial / Territorial Conference on Healthcare

A commitment to see Aboriginal health at par with others . . .

News and Comment
by Tehaliwaskenhas
Bob Kennedy,Oneida
Copyright
Turtle Island Native Network
http://www.turtleisland.org

September 13, 2004

In ten years Aboriginal people will live as long, and have the same levels of health as other Canadians.

That remarkable commitment, along with $700 Million over five years, are part of a blueprint for addressing Aboriginal health unveiled at the health care summit in Ottawa.

It was greeted with optimsim by the leader of the Assembly of First Nations, "We are pleased with the response of the Prime Minister to our plan. An investment of $700 million dollars in the key areas of the First Nation Action plan is a very positive beginning and demonstrates the kind of commitment that we are looking for," said National Chief Phil Fontaine.
http://www.turtleisland.org/discussion/ ... =3944#3944

After he and the First Ministers met with Aboriginal leaders for three hours, Prime Minister Paul Martin called it a huge moral issue and economic issue.

"The federal government has very specific responsibilities to provide health care services directly to First Nations communities across Canada. Earlier today, as those of you watching on television may have seen, we as first ministers sat down with Aboriginal leaders to discuss the principles of a collaborative agenda to address health needs among their people.

The challenges in this regard are real and in some cases unique. Our session this morning was productive. The federal government will build on its existing contributions to Aboriginal health. We will invest directly to increase the number of doctors and nurses in Aboriginal communities.

We will also fund an increased number of clinical placements, which will bring more health professionals to First Nations and Inuit communities, as well as rural and remote regions."
http://www.turtleisland.org/discussion/ ... =3945#3945

He and the premiers and territory leaders agreed on an overall commitment to tackle the issue of disparities between Aboriginal health, and the health of the rest of the population.

The government announced a three-prong approach regarding increased funding for Aboriginal health - A flexible $200 million Aboriginal Health Transition Fund - A $100 million Aboriginal Health Human Resources Initiative, for increasing the number of Aboriginal health care professionals - A $400 fund for Aboriginal health promotion and prevention to add to current programs such as Headstart for children, and initiatives that deal with issues such as diabetes, and youth suicide.

The Metis National Council was quick to respond to, and applauded the government's blueprint for improving Aboriginal health . . .
http://www.turtleisland.org/discussion/ ... =3941#3941

Union of BC Indian Chiefs slams federal health fund as pitiful, and governments as penny pinching . . .
http://www.turtleisland.org/discussion/ ... =3949#3949

An Anishinabek Nation leader in Ontario welcomes new Native health funding but points to other needs . . .
http://www.turtleisland.org/discussion/ ... =3947#3947


For more about Aboriginal health, please visit
http://www.turtleisland.org/healing/hea ... llness.htm

[www.afn.ca]

National Chief Encouraged by Discussion with First Ministers - Calls for Full First Ministers Meeting on Aboriginal Issues

Sept. 13, 2004

Assembly of First Nations National Chief Phil Fontaine tabled the First Nations Health Action Plan with the Prime Minister, Premiers and Territorial Leaders at the First Ministers Meeting on Health taking place today in Ottawa.

"This morning's session was an important opportunity to bring focus to
the devastating health status of First Nations peoples," said National Chief
Fontaine. "That is why we presented a comprehensive action plan that includes six elements aimed at transformative change and immediate results. Our plan is supported by the pillars of sustainability and integration to create a system that gives us maximum return on our investments and works to improve the lives of our people and the health care system for all Canadians."

The six elements of the plan involve a sustainable financial base;
integrated primary and continuing care; health human resources; public health infrastructure; healing and wellness; and information and research capacity.

Prime Minister Paul Martin responded by announcing a blueprint that responds to many of the elements in the AFN's Action Plan.

The National Chief stated: "We are pleased with the response of the Prime
Minister to our plan. An investment of $700 million dollars in the key areas
of the First Nation Action plan is a very positive beginning and demonstrates the kind of commitment that we are looking for."

The Federal blueprint includes reference to the following elements of the
AFN's First Nations Health Action Plan:

- $200 million for an Aboriginal Health transition fund to ensure
improved coordination of Federal, Provincial, Territorial and First
Nation health jurisdictions.

- $100 million for Aboriginal Health Human Resources.

- $400 million directed to critical areas including diabetes, youth
suicide, maternal and child care

National Chief Fontaine stated: "We are encouraged that many of the
Premiers and Territorial Leaders agree that to be successful real solutions
require greater First Nation control of First Nations health systems."
The Prime Minister also committed to ensuring a reasonable rate of growth
in First Nation health systems.
"This commitment to sustainability is critical to us. Sustainability is
the anchor for all the improvements that must be made in the future," said the
National Chief. "First Nations must be involved directly with the federal
government in determining a 'reasonable rate of growth' based on accurate
demographics and real costs."
The National Chief stated that today's session is a positive start, but
First Nations are mindful of the Prime Minister's commitment to a "full seat
at the table" in order to make real progress and take real action.
"We are seeking fundamental change which will require partnership and
greater focus on our issues," said National Chief Fontaine. "Three hours out
of a three day meeting is clearly not enough and I called today for a full
First Ministers Meeting on our issues, including health and the determinants
of health. I am encouraged that many of the Provincial and Territorial leaders
directly offered their support for this."
It is positive that we were at the table this morning, however, we firmly
believe that we should have been included throughout the meeting.

The Assembly of First Nations is the national organization representing
First Nations citizens in Canada.



For further information: Don Kelly, AFN Communications Director,
(613) 241-6789 ext. 320 or cell: (613) 292-2787; Ian McLeod, AFN Bilingual Communications Officer, (613) 241-6789 ext. 336 or cell: (613) 859-4335; Nancy Pine, Communications Advisor, Office of the National Chief, (613) 241-6789 ext. 243 or cell: (613) 298-6382

[pmo-cpm.gc.ca]

ADDRESS BY

PRIME MINISTER PAUL MARTIN



At the First Ministers’ Meeting



September 13, 2004

Ottawa, Ontario









Check against delivery



Messieurs les premiers ministres, chères Canadiennes, chers Canadiens,

Premiers, fellow Canadians:

Medicare speaks eloquently to our values as a nation, to our priorities as a people, to both our unity of purpose and sense of self in an ever more challenging and complex world. It makes us proud.

Over the course of the past half-century, Medicare has become a vital aspect of our shared citizenship – what every Canadian can rightfully expect wherever they live, whatever their income. More than that, it is, quite simply, a good and sensible idea. And like so many good and sensible ideas, it was difficult to achieve – almost two decades from aspiration to realization. It was a hard slog.

Like those who came before us, who held the positions we now hold, we who sit around this table face a challenge: we have to renew confidence in the quality of our health care system; to ensure its sustainability; to give new resonance to the principle of equality of access to health care; to work together as true partners in a collective endeavour.

Canadians want solutions to health care problems, problems in their communities, problems that affect their families. They want to be able to see a doctor when they need one, where they need one. They want to know that the health care system will be able to provide the services they need in a timely fashion. And that it will be strong.

We recognize the need to strengthen our health system. We understand the challenge. It is a challenge that falls to us, and we must act.

Shared Strengths

As we begin our discussions, we are fortunate to have at our disposal the recommendations provided by several provincial commissions on health – including those of Ken Fyke in Saskatchewan, Michel Clair in Quebec and Don Mazankowski and Gordon Graydon in Alberta – as well as two national commissions on the state of the Canadian health care system: those of Michael Kirby and Roy Romanow.

We have come here to talk about reform. But in so doing, we must not lose sight of the fact that for the most part, and for the majority of Canadians, the health care system serves us well, efficiently delivering high-quality services. We have good reason to be optimistic.

And let me just say to my 13 counterparts -- that as prime minister, and as a former finance minister, I understand the challenges that you and your governments have had to overcome and the problems you have had to solve to maintain quality health services in an era of rising costs. It’s not been easy, and I both see and salute the good work you’ve been doing.

All Canadians should be proud of the choices we have made as a nation over the years. And all Canadians should be proud of the leadership shown by the provinces in managing and reforming health care. We have built a publicly funded and universally accessible system of health care and improved the quality of life enjoyed by the people of this country. But possessing a key to the past will not in itself allow us entry to the future.

Few would dispute the prevailing reality of our time: People in this country are increasingly anxious about their ability to get in to see the right health professional at the right time. Meanwhile, financial pressures are increasing as our population ages, as medical knowledge and specialization expands, and as beneficial but expensive new treatments become available. Plainly, costs can’t forever grow faster than government revenues.

One of the reasons Canada’s health care system stacks up so well is our particular brand of federalism. A federalism that enables us to work together toward a common goal, building on each other’s strengths, but with the flexibility to not only allow, but actually foster adaptation and innovation. Together, this makes us stronger. We benefit from each other’s ingenuity and hard work.

This sort of collaboration is not new.

Indeed, its roots can be traced back to those heated debates that preceded the creation of Medicare. Looking back to that time, what stands out is the triumph not of a provincial solution or a federal solution, but of a common Canadian solution – a commitment to national purpose and a respect for each level of government.

Canadians want to know that their governments are working together to preserve and strengthen the health care system. They’re tired of us fighting.

We at this table occupy different points along the Canadian political spectrum.

But we must be guided by the same spirit that enabled those who came before us to forge Medicare, to build health care, and in so doing to achieve that rare government initiative that not only speaks to a people, but speaks for a people.

With authority comes responsibility: Our responsibility as First Ministers is to ensure there are no second-class Canadians in terms of the scope, standard, quality and timeliness of care. It’s a responsibility that alone we cannot meet. Only together can we succeed.

The Reduction of Waiting Times

The best measure of the success of our efforts will be access – access to the right health providers, to diagnostic procedures and treatments, where needed, when needed. If we are to enhance the quality of care, if we are to increase the confidence of Canadians in the system and better address their health needs now and in the future, this is where we must focus.

Anxiety over waiting times is beginning to erode Canadians’ confidence. People worry about having to wait months to see a specialist or have a critical test. They worry about needing to wait a year or longer for the replacement of a hip or the removal of cataracts.

It’s common sense: When you treat people sooner, they get well sooner. But the reduction of waiting times is not just an important end unto itself; it is the catalyst for much broader reform and improvement within the system. It will drive positive change and spur innovation.

This is not theory, it’s fact. It’s already being demonstrated across the country. There are specific examples in which the efforts of the provinces are already paying off – the Western Canada Wait List Project, the Ontario Cardiac Care Network, the Orthopaedic Surgery Wait List Project in Nova Scotia.

And what provincial experience demonstrates is that when you begin to reduce waiting times, you get a culture change – a shift from system-based care to patient-based care. This is a transition we all aspire to achieve.

That is why we must emerge from our meetings with a solid action plan for addressing the challenge of access and waiting times.

Reducing waiting times will demand a comprehensive approach that incorporates all areas of the health system, from services and human resources to funding and accountability to citizens.

It will require accelerated reform of the care delivered to families and communities, an increase in the number of doctors, nurses and other health professionals, as well as expanded home care and pharmacare. It will require both an increase in general health financing and a dedicated special fund to take direct aim at the queues. And it will require benchmarks and credible and comparable information to measure progress and report to the public.

According to the experts, real results await us on waiting times if we have the discipline to be focused in our approach. We must measure the existing queues, find out where the bottlenecks are, and precisely target the resources required to fix the problem.

The upshot is that if we shorten waiting times systematically, smartly, relentlessly, the whole health system becomes stronger and better able to help Canadians get well and stay well.

Now, let me touch briefly on the main elements of reform.

Family and Community Care Reform

Any discussion of waiting times and of the sustainability of the health care system itself must include an examination of primary care, or family and community care - the entry point for Canadians into the health system. You talk to anyone who knows and they’ll tell you: If you want to improve the health system, you’ve got the make sure Canadians are seeing the right health professional in the right place.

That is why at our last meeting, we collectively set a target for ensuring that by 2011, at least 50 per cent of Canadians will have access to appropriate care providers on a 24/7 basis.

To help accelerate family and community care reform, the federal government established a Primary Health Care Transition Fund to encourage health professionals to come together and work in inter-disciplinary teams to deliver better quality care to their patients. It also assists in the development of tele-health and tele-medicine applications so that timely access to quality care becomes a reality for Canadians in rural and remote areas of the country.

We have also invested in the Canada Health Infoway to facilitate the creation of electronic health records that allow patients to move seamlessly across the continuum of care. This is an important demonstration of the potential that lies in achieving health solutions through Information Technology.

Provinces have made important strides to date in family and community care reform, and I believe that at this meeting we should explore how we can accelerate progress, learn from one another and share best practices – like P.E.I.’s family health centres, Alberta’s tri-partite agreements and Saskatchewan’s primary health care teams where nurse practitioners, physicians and other health providers share responsibility for patient care in community settings. We must closely examine scope of practice and the role of various health professionals in the context of our need to improve access to medical care.

I look forward to constructive proposals as to how the federal government can support such efforts.

Health Human Resources

Reform of primary care is essential. But it cannot be fully achieved in this country without an increase in the number of doctors, nurses and other health professionals.

Let’s be straightforward: we cannot magically increase the supply of doctors, nurses, surgeons, radiologists, technicians, psychologists, pharmacists and other health professionals. We all know that training health professionals takes time, which means there is no time to lose.

As part of the 2003 Accord, the federal government is investing $85-million to develop a national planning framework to accurately forecast the supply and demand for doctors, nurses and other professionals, to facilitate inter-professional education and to contribute to recruitment and retention.

We have already taken some steps in this regard, but this is only the beginning. To begin with, it is crucial that we increase the number of health professionals in Canada, and this cannot be done by acting independently. To succeed, we must work together, as a nation.

Accreditation is another route to increasing the supply of doctors, and here again we have serious work to do. When it comes to accrediting the foreign-trained professionals who already live here, we have not achieved enough in the way of progress with the licensing and regulatory bodies.

We need to end the terrible waste of scarce human resources that occurs when these professionals are unable to seek work in health care.

To that end, we as a government are committed to spending $75-million to help train 1,000 new Canadians to provide first-class primary care right across the country. But this too is only a beginning and we must, all of us, do more – on accreditation, on recruitment and on creating more spaces in our medical schools.

Home Care

Now to home care, which was part of the 2003 Health Accord. Money was dedicated to establishing a baseline national home care program – one that would make it easier for certain patients to opt to receive care at home in a more comfortable and less expensive setting, to reduce wait times by freeing up hospital beds.

This program was to be limited to patients recovering from major medical interventions like surgeries, for patients with mental health needs that would otherwise require institutional treatment, and for end-of-life care for the terminally ill.

Common sense tells us for home care to meets its objective, the quality of care available to patients at home must be equal to that obtained in a hospital.

Our Health Reform Fund was designed accordingly. And yet serious gaps still exist. Canadians have yet to see the home care vision expressed in the 2003 Accord take shape.

We simply have to do better. Think of it from a patient’s perspective: You’re in the hospital, your drugs are paid for; you go home, they’re not. Patients may prefer to get well at home; their doctor may agree it’s the best medical course. But most of the time the patients stay right where they are, and no one can blame them.

I’ve got to tell you: We need action on this. We have got to deal with the issue of first-dollar coverage and we have got to do the hard work of building on existing home care services while ridding them of inconsistencies and barriers.

Pharmaceuticals

Finally, I want to address pharmacare, as you have done in recent weeks. Pharmacare has evolved to become an integral part of the Canadian health system. It is not simply an ancillary service that can be cut off and segmented from the rest of Medicare. It’s something we’re going to have to deal with together.

That’s why we provided funds for catastrophic drug coverage in the February 2003 Accord, to help relieve pressure on provincial and territorial budgets and to assist Canadians in need.

And that is why we should work together toward a National Strategy that will contain costs, improve quality and access and, most important of all, make certain that no Canadian family ever suffers financial ruin because of the costs of needed drugs. A strategy that recognizes that both orders of government have responsibilities in this area. The federal government will continue to do its part.

We need to do more to evaluate drug safety, to support effective medication management and to modify drug approval processes to speed up access to breakthrough drugs. We can also look into the possibility of creating a national pharmaceutical scheme and implementing joint strategies for getting better value in drug procurement, for the benefit of all.

Public Health

I now want to say a few words about public health.

Public health is an essential ingredient for any successful health reform agenda.

The government has very clear and distinct responsibilities in public health, from safeguarding the blood system to establishing standards for food and drug inspection. We believe immunization is a critical aspect of health promotion, which is why we are contributing $300-million to the introduction of new and recommended childhood and adolescent vaccines.

The creation of the new Public Health Agency, along with the appointment of Canada’s first Chief Public Health Officer, will be an important step toward our shared objective of combating epidemics and other health emergencies while improving collaboration on public health issues.

I believe we need to emerge from this meeting with a commitment to work together to establish benchmarks for health outcomes, to coordinate our efforts to reduce risk factors like obesity and smoking, and to pool our resources to support public education and awareness. The benefits of such co-operation will be real and many.

Aboriginal Health

The federal government has very specific responsibilities to provide health care services directly to First Nations communities across Canada. Earlier today, as those of you watching on television may have seen, we as first ministers sat down with Aboriginal leaders to discuss the principles of a collaborative agenda to address health needs among their people.

The challenges in this regard are real and in some cases unique. Our session this morning was productive. The federal government will build on its existing contributions to Aboriginal health. We will invest directly to increase the number of doctors and nurses in Aboriginal communities.

We will also fund an increased number of clinical placements, which will bring more health professionals to First Nations and Inuit communities, as well as rural and remote regions.

The Territories

Geography is but one of the challenges facing health care services north of 60, and it is a formidable one.

Earlier, I spoke of tele-health and tele-medicine applications. These services offer real potential to improve the quality of care available to people who live in the North. And while some progress has been made here, more must be done.

We should, for instance, invest in improving transportation services in these regions, making it easier and faster for people in need to travel the distance they must to get the care they require.

A 10-Year Financial Plan

I want to turn now to the issue of funding. Let’s begin with recent history.

In 1999, the federal government committed an additional $11.5-billion over five years to health.

Eighteen months later, in 2000, it committed an additional $21-billion for health.

In 2003, we announced an investment of a furhter $35-billion over five years, and since then have added another $2-billion to that.

That’s almost $70-billion in new health funding since 1999. If money alone could improve our health care system, it surely would have succeeded by now.

Still, financing will be an important part of a reform package.

We need a long-term, 10-year financing deal that will make certain that come next fall, we are not right back here again.

Canadians do not want us to reprise and rehash the traditional arguments about money – arguments that have obscured more than they have informed. Canadians deserve more than an annual dispute about “shares” and the value of tax points.

This is not federal money and provincial money. It is Canadians’ money and there is only one taxpayer. Canadians deserve a 10-year plan that actually holds for 10 years. And that is the plan we propose here today.

First, we will fill the Romanow gap – a one-time shortfall in federal health funding that was identified in the report of the commission of Roy Romanow.

Second, we will establish next year a new base for the Canada Health Transfer consistent with the recommendations of the Romanow report.

Third, for the first time the federal government is prepared to provide an annual escalator that will ensure predictable and growing federal funding for health care.

And fourth, we will provide $4-billion in a partnership fund to deal with current backlogs and kickstart reform.

Now, some provinces have made the point that they can’t have a legitimate discussion about health reform and funding without addressing questions related to equalization. This issue was to be discussed at a subsequent meeting before the next federal budget. But we are prepared to advance that meeting, to have it now instead of at a later date.

We are committed to long-term financing because we believe that it’s the best way, the only way, to end the perennial debate over funding and enable us to stop focusing on how much money we get, and start focusing on what we get for our money. Sound and responsible fiscal management by the federal government over the course of the past decade has put us in the position to be able to do this. We have an opportunity here, and we must seize it.

To put an end to the cycle of never-ending federal-provincial meetings on health care funding, the federal government wishes to make the following proposal.

We will fill the so-called Romanow gap by increasing the base amount of our commitment.

And, for the first time, we will put in place long-term, escalating financing for health care that will enable the provinces to ensure the sustainability of Medicare and the quality of health services.

Accountability to Canadians

When it comes to health reform, Canadians expect real and meaningful accountability. They deserve to know what they should expect – and what they are getting. They deserve evidence-based benchmarks that define timely care – scientific benchmarks determined by the best advice of health professionals and established objectively. They deserve clear targets reflecting the benchmarks and provincial priorities.

And they need to see how their governments are doing and how they stack up.

We must agree on a detailed process of information, on benchmarks, on targets and accountability to Canadians. They are essential components of genuine reform.

We need good, comparable information to manage effectively. We need benchmarks to know what we should be doing. We need targets to drive change. And we need credible reports to ensure Canadians know how we are doing.

We need to safeguard not only the principles of Medicare but also the principles of accountability.

And where we have disputes, let’s formalize the mechanism that governments have already agreed to, thanks primarily to the work of Alberta.

Conclusion

The debate about health costs and reform is not new. Between 1968 and 1976, during the infancy of Medicare, there were 10 major inquiries commissioned, federal or provincial, into growing health costs and how to ensure the health system could be made sustainable. We find ourselves on familiar, if sometimes frustrating, ground.

But what is new is a kind of critical mass that we take with us into our discussions. We have in recent years witnessed the futility of annual deals, deals that were entered into with good faith. We have learned from these disappointments. And we find ourselves today presented with the opportunity to break the cycle.

Now is the time to take action. To get a handle on costs and encourage innovation and reform by taking direct aim at waiting times and improving access. We all have roles to play in achieving progress. As I indicated earlier, much of the strength of our federation lies in its flexibility within common purpose.

It is the federal government’s role to articulate national objectives and protect the national interest. It is, of course, the provinces and territories that deliver and manage health care, and in doing so tailor health services to the specific needs of their population. But it is my firm belief that some key principles transcend regional interests.

Canadians want our nation’s familiar, high-quality health care system to be there for them no matter where they go in this country.

The basis for a shared understanding — one that brings the various provincial visions together as part of a common Canadian accord — is, I believe, there. The generation that created Medicare – what they accomplished for their time now falls to us to renew in ours.

Health care is a serious issue for Canadians. We are here as their voice. We will have to answer to them.

The federal government is absolutely committed to working with you, our partners, to secure not just any plan, but a lasting and productive plan that brings real results that Canadians can see.

I look around this table and I see leaders who are committed, determined, focused. We know this is hard work. We know there is no simple solution. And heaven knows you especially are aware of the challenges. But that’s our job. That’s what we signed up for. So let’s get down to it.

Thank you.

[info@anishinabek.ca]

New Native health fund welcome, investments still needed

Statement from Deputy Grand Chief Nelson Toulouse

Sept. 13, 2004

Prime Minister Paul Martin kicked off his meeting with the country's premiers and top aboriginal leaders Monday with a $700 million plan to improve native health. The announcement included $200 million toward a health fund, and $400 million for disease and suicide prevention. He also promised an increase in annual funding to keep up with rising costs.

"We are certainly pleased with this announcement, as this new health fund
will go a long way toward improving our community health programs," said
Anishinabek Nation Deputy Grand Chief Nelson Toulouse, while attending a
province-wide Chiefs and Councils gathering in Sault Ste. Marie today.

"But on the other hand, significant investment is still needed to overcome issues such as substandard housing, overcrowding, water and sewer - all are linked to the overall health of our communities."

Deputy Grand Chief Toulouse stressed the need for First Nation inclusion
in the further development of this health fund strategy. "We must be an integral part of the decision-making process, to have a voice and the ability to set priorities for this fund," said Toulouse. "First Nations need to be a part of the decision making process at all levels. We are the people living these conditions day-to-day and ultimately, we are responsible and accountable for the health of our own people."

"Our leadership should continue to sit, face-to-face, with the First
Ministers on health, housing, economic and even constitutional issues," added Toulouse.

The Anishinabek Nation incorporated the Union of Ontario Indians as its
secretariat in 1949. The UOI is a political advocate for 42 member First
Nations across Ontario. The Union of Ontario Indians is the oldest political
organization in Ontario and can trace its roots back to the Confederacy of
Three Fires, which existed long before European contact.

For further information: Bob Goulais, Communications Officer,
(877) 702-5200, Cell: (705) 498-5250, info@anishinabek.ca

[http://www.ubcic.bc.ca]

PRESS RELEASE

FOR IMMEDIATE RELEASE
September 13, 2004

$700 Million A Drop in the Bucket

(Vancouver/Coast Salish Territory – September 13, 2004) “Prime Minister
Martin’s announcement of $700 million over five years to improve life of
Aboriginal Peoples represents a pitiful small amount in the face of the
escalating health crisis facing First Nations communities. For too long,
First Nations communities have suffered the brutal reality of the
bureaucratic penny-pinching at both the Federal and Provincial
governments when it comes to the allocation of health dollars.”

Chief Stewart Phillip, President of the Union of BC Indian Chiefs, was
responding to today’s Government of Canada’s announcement.

Chief Phillip continued, “The abysmal state of the health conditions
within our communities have been well-documented through work such as
the Aboriginal Peoples Survey of Statistics Canada and the Royal
Commission on Aboriginal Peoples, which has documented that many First
Nations are isolated communities suffering near-epidemic levels of chronic illnesses like diabetes and escalating instances of tragic suicides. Yet the Government of Canada has found it necessary to shut down local First Nations Health Offices and ask those in need to call a
1-800 number in Vancouver.”

Furthermore, the Union of BC Indian Chiefs is deeply and gravely
concerned with the idea, advanced by the BC Health Services Minister
Colin Hansen, that the transfer of Aboriginal health authority to
provincial governments would be sensible as the provinces would do a
better job delivering services than Ottawa.

“We hold the view that the Government of Canada holds a constitutionally
enshrined responsibility to deliver adequate health services directly to
Aboriginal Peoples. Clearly, the delivery of health care services to
Aboriginal communities should not be delegated to the very hands that
have systematically torn apart the health-care system of all rural British Columbians through the closing hospitals and the slashing health services.”

- 30 -

FOR MORE INFORMATION CONTACT:
Chief Stewart Phillip
President

Cell: (250) 490-5314
--

Established in 1969, the Union of British Columbia Indian Chiefs is a
political organization protecting the Aboriginal Title and Rights of our
member communities. We are based in Kamloops and have an office in
Vancouver. For further details visit our website at http://www.ubcic.bc.ca

[www.metisnation.ca]

Monday, September 13, 2004

Métis Nation makes historic breakthrough with inclusion in federal Aboriginal health blueprint. "An important first step in beginning to address the health care discrimination against the Métis Nation."

Today, at a Special Meeting between First Ministers and Aboriginal leaders in advance of the First Ministers Meeting on Health, Prime Minister Martin fundamentally altered Canada's longstanding policy on Métis health. In a proposed blueprint for Aboriginal health, the Prime Minister laid out an inclusive strategy which, for the first time ever, will include the Métis people as equal partners in federal Aboriginal health programming.

Métis National Council President Clément Chartier welcomed the Prime Minister's inclusive Aboriginal health package. "For the Métis Nation, we believe that this an important first step towards addressing the discrimination our people currently face in Canada's health care system. We embrace the opportunity to work with Canada and the provinces from Ontario westward in a 'new era' of partnership in the area of Métis health." said President Chartier.

President Chartier added, "This historic inclusion cannot be in name only. The Métis have witnessed many past initiatives where new 'Aboriginal' resources are made available to great fanfare; yet we are left on the sidelines after the communiqué has been issued. Only time will tell whether this meeting is actually a success for the Métis people."

For years, it has been understood that there is an Aboriginal health care crisis in Canada; meanwhile Métis citizens have suffered for decades because of jurisdictional wrangling between the federal and provincial governments with respect to responsibility for the Métis. Last month, President Chartier called on the Council of the Federation and the Prime Minister to end the resulting health care discrimination against the Métis Nation.

President Chartier said, "First Ministers around this table should be very aware that the final outcome of this on-going jurisdictional 'positioning' is the loss of lives within our nation and the loss of potential within this great country." He urged First Ministers to begin working with the Métis Nation, through a proposed multilateral process, in order to bring an end to Métis people being a "political football" in Canada.

The historic inclusion of the Métis in this health blueprint is timely in light of the upcoming anniversary of the Supreme Court of Canada's decision in R. v. Powley which recognized and affirmed the existence and Aboriginal rights of the Métis Nation. Although the Powley case dealt specifically with the issue of harvesting rights, the implications are much greater.

"In light of Powley, governments must understand the Métis Nation and courts will not accept federal and provincial policies that ignore the Métis Nation," said Metis National Council Vice-President Audrey Poitras who also attended the Special Meeting. Vice-President Poitras added, "We take today's announcement as a reflection of this new reality and look forward to working in partnership with Canada and the provinces from Ontario westward to deal with the Métis health care crisis."

While the commitment of resources to dealing with the Métis health care crisis is part of the solution, ensuring that the design and delivery of the blueprint meets the unique need of the Metis Nation will be key. The Métis Nation outlined the use of the extremely successful Aboriginal Human Resources Development Strategy (AHRDS) as model for the blueprint's implementation with respect to the Métis.

Métis Nation Minister of Health, David Chartrand said, "We know that Métis specific programs succeed in the Métis Nation where mainstream and pan-Aboriginal programs have failed. Utilizing the AHRDS, Métis governments across the homeland provide employment and job training opportunities that have led to thousands of Métis citizens finding jobs or gaining the skills to find better jobs. It is changing lives. We need to work with the federal government and the provinces to recreate that successful model to provide Métis-specific health care. It would not only change lives, it will save lives."

Métis Women's Secretariat spokesperson Rosemarie McPherson added, "Only by working with the Métis National Council and it's Governing Members can Canada and the provinces achieve health care solutions that work for all Métis - children, youth, elders, men and women or if they live in urban or rural communities."

President Chartier concluded by saying, "there is a lot of work ahead of us; but the Métis Nation remains optimistic that we can deal with the health care crisis by working in partnership with the federal government and the provinces."

Also at the meeting President Chartier tabled a Metis Nation Action Plan for Health which outlined existing best practices that can be built upon in the implementation of the proposed blueprint for health.

http://www.metisnation.ca/PRESS/PDFS/he ... n_plan.pdf

[Guest]

Aboriginal health care funding and training a start - CUPE

Sept. 14, 2004

The Canadian Union of Public Employees welcomed the $700 million in new federal funding for aboriginal health care announced yesterday at the first ministers' conference on health care.

The new money includes $100 million for training. "CUPE has done
pioneering work with partnership agreements that promote training and the entry of aboriginal workers into the health care sector," CUPE National
President Paul Moist said. "We look forward to contributing our experiences
and insights into this essential effort."

Moist was referring to efforts, particularly in Saskatchewan, where CUPE
has developed partnerships with aboriginal communities to actively encourage their pursuit of careers in health care.

The partnership agreements are producing positive results, CUPE
Saskatchewan President Tom Graham said, especially in the health sector where the first agreement was signed four years ago.

"We are seeing many more aboriginal workers in the health sector," Graham said. "That's important because it is a heavily unionized sector that provides good wages, benefits and opportunities for promotion."

CUPE is proud to participate in programs that create a 'representative
workforce', Graham added. "It enables aboriginal workers to mobilize their own expertise and resources to improve the health status of aboriginal communities."

CUPE represents 140,000 workers in the health care sector. They play a
crucial role in delivering quality, public health care to Canadians. With over
500,000 members, CUPE is fighting for public services and rebuilding strong communities across Canada.

For further information: Catherine Louli, cell (613) 851-0547, CUPE
Communications; David Robbins, cell (613) 878-1431, CUPE Communications

[pkyba@shaw.ca]

Hot on the heels of health care promises at the First Minister's summit in Ottawa, First Nation chief invites media to see the real world of First Nations health . . .

MEDIA ADVISORY

September 14, 2004

ATTENTION: News Editors, News Directors, Assignment Editors

First Nation's Health Threatened by Deplorable Housing Conditions!

EVENT: The National Chief of the Assembly of First Nations (AFN) , Phil Fontaine will visit Kwicksutaineuk-ah-kwaw-ah-mish First Nation on Gilford Island, to see first hand the deplorable housing conditions that threaten the health of the people living there.

National Chief Fontaine is responding to an invitation from the Kwicksutaineuk Chief, Henry Scow. AFN BC Regional Chief Shawn Atleo will also attend.

WHEN: Friday, September 24, 2004

LOCATION: Kwicksutaineuk is a small isolated community on Gilford Island off the north end of Vancouver Island. It can only be reached by water or air.

Media Access: Air transportation from Vancouver or Port Hardy will be arranged for a limited number of media representatives.

Activities: The National Chief, Phil Fontaine will inspect the conditions of the village and hear the stories of the people who live there about their plight. Media will have opportunities for one-on-one interviews with Chief Fontaine, Chief Scow and Regional Chief Shawn Atleo. Technical experts will be available to provide background information about the condition of the housing and the health implications for those who are living in them.

Schedule. A charter flight will leave Vancouver at 8:30 AM and arrive in Kwicksutaineuk at 10:15 AM. A second flight will leave Port Hardy at 9:00 AM and arrive at 10:00 AM. Visitors will be welcomed by Chief Scow and public statements will be made by dignitaries. A walkabout of the community will follow. Lunch will be served. Return flights will depart in time for arrival in Campbell River at 3:00 PM and Vancouver at 4:00 PM.

Background. The Kwicksutaineuk-ah-kwaw-ah-mish First Nation is a primary example of the disparity in housing conditions and health status, between Aboriginal people and other Canadians. A walk through the village is a journey through a bygone era of horribly constructed homes and community facilities, mostly constructed in the 1950’s and 60’s. Mold grows in virtually all of the buildings. Mold can cause allergies or respiratory disease. Respiratory problems are among the obvious, serious public health issues.

The Broughton Archipelago is rich in natural resources. Logging companies are harvesting the trees. Fish farms are threatening the wild fishery. Tourist operators do big business. The people of Kwicksutaineuk struggle with poverty, dependence on social assistance, and inadequate government programs and services.

In light of this week's First Minister's health summit in Ottawa, and talk about improving the health of Aboriginal Canadians, reporters coming to Kwicksutaineuk, will see a real life example of what the leaders discussed.

CONTACT: Paul Kyba,
Phone: 604-760-0019
E-Mail: pkyba@shaw.ca

[www.afn.ca]

AFN National Chief Congratulates First Ministers Upon Reaching Health Care Deal for all Canadians

Sept. 16, 2004

Assembly of First Nations National Chief Phil Fontaine extends congratulations to the Prime Minister, Premiers, and Territorial leaders today upon reaching a $41 billion health care funding agreement early this morning.

"I am pleased the First Ministers were able to secure a 'deal for a
decade' that will benefit all Canadians," said National Chief Fontaine.

"This historic agreement will also benefit First Nations citizens who are impacted by provincial health care systems. The 10 health care year plan announced by First Ministers mirrors the discussion of setting a 10-year goal to raise Aboriginal health levels to the standard currently enjoyed by other people in Canada."

AFN National Chief Fontaine was an active participant at the session on
Aboriginal Health, which took place with First Ministers on day one of the
discussions. At that meeting, the National Chief presented the Prime Minister, Premiers and Territorial Leaders with a detailed First Nations Health Action Plan that would address the "shameful conditions" facing First Nations people in Canada and provide a framework for a sustainable and effective health care system.

"We are pleased with the Prime Minister's response to our Action Plan and
the additional $700 million in Aboriginal health funding that supports the key elements of our plan," stated the National Chief. "We are also encouraged by the Prime Ministers commitment to further investments in First Nation health through an "escalator clause" that takes into account inflation, growing demands and increasing population. I look forward in the weeks and months ahead to working with the First Ministers and their Ministers of Health in preparation for a full First Ministers Meeting, which will focus on Aboriginal issues, particularly the determinants of health."

The Assembly of First Nations is the national organization representing
First Nations citizens in Canada.

For further information: Don Kelly, AFN Communications Director,
(613) 241-6789, ext. 320, cell.: (613) 292-2787; Ian McLeod, AFN Bilingual Communications Officer, (613) 241-6789, ext. 336, cell.: (613) 859-4335; Bryan Hendry, Communications Officer, AFN Health Secretariat, (613) 241-6789, ext. 229, cell.: (613) 293-6106; Nancy Pine, Communications Advisor, Office of the National Chief, (613) 241-6789, ext. 243, cell.: (613) 298-6382

[www.anac.on.ca]

A.N.A.C. Response to the First Minister Conference: Health Care Summit on Aboriginal People in Ottawa (September 13, 2004)

Sept. 20, 2004

The Aboriginal Nurses Association of Canada (ANAC) has representatives in each province and territory in Canada. The A.N.A.C. advocates on behalf of our membership and the people we serve to help address Aboriginal health issues.

It is imperative that the A.N.A.C. as a national organization representing frontline nurses working in Aboriginal communities, be invited to the decision-making table and allowed to participate and share our unique perspective and valuable expertise.

The Aboriginal health issues that were brought to the table at the
September 13th meeting between Aboriginal leaders and the First Ministers
provided a stark picture of the challenges faced by Aboriginal people across Canada. While there was a widespread consensus among these leaders as to the dire nature of the health crisis facing Aboriginal people, the Aboriginal Nurses Association of Canada (A.N.A.C.) was not invited to the meeting. We maintain that not all of the important Aboriginal health issues were given adequate requisite attention.

One of the issues affecting our communities today is the issue of the
recruitment and retention of nurses working in Aboriginal communities. The Canadian Nurses Association (CNA) projects that nationwide "there will be a shortage of 78,000 Registered Nurses (RN's) in 2011 and 113,000 RNs by 2016(1)". A Health Canada study found that more than 800 new Aboriginal nurses are needed in the near future.

In our submission to the Romanow Commission, the A.N.A.C. called for
"urgent action...to train...additional and sufficient numbers of young people
to replace those retiring and leaving the profession"(2) and further
recommended more development of nursing access programs, establishing satellite community-based nursing education programs, and the creation of additional bursary programs as potential strategies to recruit Aboriginal nursing students.

Moreover, the A.N.A.C. has held forums across Canada in which nurses in
Aboriginal communities identified nursing issues-i.e. a safe work environment, funding issues, personal and professional isolation, jurisdictional confusion and wage parity between band employed and Health Canada nurses -as crucial to addressing the recruitment and retention problems of nurses within Aboriginal communities.

Hence, talking about pouring more money into addressing Aboriginal health issues-without dealing with the issues that affect the recruitment and retention of primary health care givers in Aboriginal communities-is not likely to provide sustainable solutions to the problems. If we are to find
effective solutions in addressing the various health issues that face
Aboriginal people of Canada, all partners in Healthcare need to be at the
table including A.N.A.C.

(1) Human Resources Development Canada (HRDC), (2002). Building The Future - An Integrated Strategy for Nursing Human Resources in Canada. www.buildingthefuture.ca/e/nursing

(2) Aboriginal Nurses Association of Canada (2001). Submission to the Commission on the Future of Health Care In Canada. Ottawa: Canada

For further information: Dawn Bruyere RN MScN, Executive Director,
(613) 724-4677

- - - - - - -

http://www.anac.on.ca

OUR PURPOSE

The objectives first developed for the Registered Nurses of Canadian Ancestry still guide the Aboriginal Nurses Association of Canada and have remained essentially the same except for adjustments to the language of the times. These objectives in their current form commit the members of the association to the following goals:

To act as an agent in promoting and striving for better health for the Indian and Inuit people; that is, a state of complete physical, mental, social and spiritual well-being.

To conduct studies and maintain reporting, compiling and publishing of material on Aboriginal health, medicine and culture.

To encourage and facilitate Aboriginal control of Aboriginal health, and involvement and decision making on matters pertaining to health care services and delivery.

To offer assistance to government and private agencies in developing programs designed to improve health in Aboriginal health issues.

To maintain a consultative mechanism with the association, band governments and other agencies concerned with Aboriginal health issues.

To develop and encourage courses in the education system on nursing, the health professions, Aboriginal health and cross-cultural nursing.

To develop general awareness in Aboriginal and non-Aboriginal communities of the special health needs of Aboriginal People.

To conduct research on cross-cultural medicine and develop and assemble material on Aboriginal health.

To actively develop a means of recruiting more people of Aboriginal ancestry into the medical field and health professions.

To generally develop a means of recruiting more people of Aboriginal ancestry into the medical field and health professions.

To generally develop and maintain on an ongoing basis, a registry of Aboriginal Registered Nurses.

[www.hcc-ccs.ca]

Health Council Learns First Hand About Northern Health Care Challenges First Report To Canadians moving forward

IQALUIT, Sept. 23, 2004

Michael Decter, Chair of the Health Council of Canada, concluded its fourth meeting today in Iqaluit. The Council is moving forward with drafting its inaugural report to Canadians to be released in January 2005. Throughout their time in Nunavut, Councillors also learned firsthand about the challenges faced by health providers and residents in the North.

The Council discussed issues with community elders, representatives of
the health care system and government, including the Nunavut Minister of
Health Levinia Brown and Bernie Blais, Nunavut Deputy Minister of Health and Social Services. Topping the list of concerns was the need for access to treatment and the absolute necessity for health resources. In some communities medical intervention can take up to 12 hours or longer depending upon the weather and distance.

In visiting three communities in Nunavut (Iqaluit, Pangnirtung and
Kimmirut), the Council heard from residents about the challenges of providing modern health care to remote communities, the barriers presented by language differences in health care delivery; and about the critical need for nutrition education.

"This is a region that covers an area nearly as large as Manitoba with a
population of about 30,000 spread across 25 communities. We heard some very vivid examples of where great progress has been made in health care delivery.

In Iqaluit, the Embrace Life Council has done some outstanding work in trying to reduce the tragic incidence of in the North. The Closer To Home program has made great strides toward training local health care workers and developing services within the community," Mr. Decter said.

"At the same time, we are mindful of the fact that a great deal of work
remains to be done. It is an unacceptable and shameful reality that Inuit life expectancy in the North is 10 years lower than for average Canadians. The infant mortality rate is three times higher than the Canadian average and the number of years of life lost to is 10 times the Canadian average. Clearly, it is gratifying that the First Ministers recently acknowledged the need to address this situation with their recent health care agreement."

The Health Council also reviewed a comparison of the 2003 Accord and the
recent 2004 Agreement of First Ministers reached last week.

"Our mandate has been confirmed, and in some areas expanded. Reporting on access to health care in the north is a new responsibility," Mr. Decter said. In the area of waiting times, the Council intends to work closely and collaboratively with the Canadian Institute for Health Information.

"The Council got some very substantial work accomplished at the Nunavut
meeting, as we move toward our first report to Canadians on progress in health care, which will be released to Canadians in Ottawa next January," Mr. Decter said.


BACKGROUNDER

The Health Council of Canada was created as a result of the 2003 First
Ministers Health Accord, and following the recommendations of the Romanow and Kirby Reports. Chaired by Michael Decter, the 26 Council members were named by participating provinces, territories and the Government of Canada. Council expertise and broad experience includes the areas of nursing, community care, aboriginal health, health education and administration, finance, medicine and pharmacology. The Health Council of Canada will meet five times in 2004 and is planning its 2005 meetings, beginning with its meeting in Ottawa in January.

The Councillors have been at work since January 2004. The Council's
Secretariat is now fully operational at its Toronto headquarters, under the
leadership of Cathy Fooks. The staff is comprised of specialists in health
care stakeholder relations, communications and policy development drawn from across the country. They include: Donna Segal (Senior Director, Policy and Stakeholder Relations); Francesca Grosso (Senior Director, Operations and Special Projects); and Shirley Hawkins (Manager, Public Affairs).

The Health Council of Canada has received five year funding from Health
Canada that will allow the Council to fully pursue its mandate to monitor and make annual public reports on the implementation of both the 2003 First Ministers Accord and recent agreements, including accountability and
transparency provisions.

Since its inauguration in January, the Council has been involved in
collaborative fact-finding and data collection activity working with the
federal and participating provincial and territorial governments. Now the
Council is well positioned to fulfill its mandate and report to Canadians.

For further information: Media Inquiries: Paul Cantin, Media Relations
Officer, Health Council of Canada, (416) 481-7397 (ext. 2518); or Visit the Health Council of Canada Web site at www.hcc-ccs.ca

[Guest]

A commitment, " . . .to develop a blueprint by September 2005 for improving health status", of Aboriginal Canadians.

- - - - - - - -

Annual Conference of the Federal/Provincial/Territorial Ministers of Health

VANCOUVER, Oct. 17, 2004

In their first opportunity to gather after the recent First Ministers' Meeting (FMM), Canada's federal, provincial and territorial Ministers of Health have begun to work out the details behind the First Ministers' 10-Year Plan to Strengthen Health Care.

"I am pleased with the progress which has been made at this Vancouver
meeting," said BC Health Services Minister and co-chair Colin Hansen.
"The commitment and active participation of all Health Ministers has added to the momentum begun by First Ministers in September."

"We are moving forward to meet our commitments to reduce wait times,
improve access and develop a national pharmaceuticals strategy," said Federal Minister Ujjal Dosanjh, co-chair. "Canadians want real and tangible change and we will work with each other, the health care community and Canadians with that goal in mind."

Health Ministers re-affirmed the commitment made at the Special Meeting
of First Ministers and Aboriginal Leaders on September 13, 2004, to improve Aboriginal health. Ministers acknowledged the importance of ensuring input from both regional and national Aboriginal organizations in pursuit of this goal.

Health Ministers agreed that Ministers Dosanjh and Smitherman, as co-chair Ministers, will meet early in 2005 with Aboriginal leaders and co-chair Ministers of Aboriginal Affairs to initiate a process to develop a blueprint by September 2005 for improving health status.

Ministers agreed on the need to expedite the work on the federal investment of $700M in Aboriginal health and to align this investment with the priorities discussed at the First Ministers' meeting with Aboriginal leaders in September 2004.

Discussions concentrated on how to make progress on three key elements of the 10-year plan: reducing wait times; moving ahead on the national pharmaceuticals strategy; and advancing the development of public health goals and targets for the country.

NEXT STEPS IN IMPLEMENTING THE 10-YEAR PLAN

Reducing Wait Times and Improving Access
----------------------------------------

Health Ministers reaffirmed their commitment to meeting their FMM
obligations in regard to wait times and access and will meet again in January 2005 to review progress on these commitments.

National Pharmaceuticals Strategy
---------------------------------

As directed by First Ministers, Health Ministers established a Ministerial Task Force to develop and implement the national pharmaceuticals
strategy and report on progress by June 30, 2006. Federal Health Minister
Ujjal Dosanjh and BC Minister of Health Services Colin Hansen will co-chair
the Ministerial Task Force.

Public Health Goals and Targets
-------------------------------

Further to the direction from First Ministers, Ministers of Health agreed
to initiate work on public health goals and targets, which will address the
broad determinants that lead to improved health outcomes for all Canadians.
Quebec's contribution to these initiatives will correspond to the
provisions of the arrangement entitled "Asymmetrical Federalism that Respects
Quebec's Jurisdiction" which accompanies the First Ministers' 10-Year Plan to
Strengthen Health Care.

While quick action on the 10-year plan was the priority, the meeting
agenda also included ongoing federal-provincial-territorial work on other
important health care and public health initiatives.

HEALTH HUMAN RESOURCES
----------------------

Ministers approved a new approach for assessing proposals for changes in
entry-to-practice credentials for medical and health professions. This will
contribute to a sufficient supply of medical and health professionals to
provide timely and high quality care in Canada. The process will help
governments determine whether a proposed change in credentials for entry-to-
practice serves the interests of patients and the health care system. Quebec,
having its own process, will collaborate on this initiative by supporting
ongoing exchange of information.
Ministers discussed ways in which jurisdictions could collaborate further
to enhance opportunities for internationally educated health professionals to
practice in Canada to better meet the health care needs of Canadians.

OTHER PREVENTION, HEALTH PROMOTION AND PUBLIC HEALTH INITIATIVES
----------------------------------------------------------------

Ministers committed to advancing the Integrated Pan-Canadian Healthy
Living Strategy, which will focus initially on increasing physical activity,
healthy eating and their relationship to healthy weight. A Healthy Living
Strategy will be presented to Ministers of Health at their annual meeting in
September 2005.

As a key element of that strategy, Ministers announced the establishment
of the Intersectoral Healthy Living Network. The Network is composed of
members from federal, provincial and territorial bodies and intersectoral
stakeholders who work in the areas of health promotion and disease prevention.
Quebec, while not participating in the Pan-Canadian Health Living
Strategy, committed to collaborate with all of those initiatives relating to
prevention and health promotion by sharing information and best practices.
Ministers also committed to continue working with their colleagues in
Agriculture on a National Food Policy Framework. Ministers discussed the
development of a comprehensive approach to coordinating policy direction and
decision-making on food issues to further strengthen consumer confidence,
health protection and economic growth. Further discussions on the development
of a framework will take place in the coming months.
Health Ministers were also updated on the progress of Canada's emergency
preparedness and response capacity, and are pleased with the ongoing efforts
to enhance Canada's ability to prepare for and respond to a range of public
health emergencies.
The meeting was the first opportunity for Health Ministers to meet with
the Chief Public Health Officer, Dr. David Butler-Jones. Many of the
provincial, territorial and federal public health initiatives they discussed
will be supported by the new Public Health Agency of Canada.

HEALTH TECHNOLOGY STRATEGY
--------------------------

Health Ministers approved a new Canadian Health Technology Strategy. This
development arises from the 2003 Accord on Health Care Renewal's commitment to
develop a comprehensive strategy to assess the impact of health technologies
and provide advice on how to maximize their effective utilization. The
Strategy represents a collaborative approach towards ensuring that Canadians
have ongoing access to appropriate health care technology.

All Health Ministers concluded the meeting with a commitment to
strengthen publicly funded health care and continue to report to their
respective jurisdictions on progress.

The 2nd set of reports on comparable performance indicators will be
released by November 30, 2004.

Health Ministers will meet again in January 2005 to review progress.

[Health Talk]

Aboriginal health experts and government officials discuss ideas for improving the health of Aboriginal peoples

OTTAWA - Representatives of federal, provincial and territorial governments, Aboriginal organizations and communities, and Aboriginal health experts discussed approaches to improving the health of Aboriginal peoples at a meeting in Ottawa on November 4th and 5th, 2004.

The Health Sectoral Session is one of seven follow-up sessions to the Canada-Aboriginal Peoples Roundtable held on April 19, 2004. At that roundtable, the Prime Minister set out a vision that included a focus on closing the gap between Aboriginal peoples and other Canadians in key quality of life indicators, including health, education, housing and economic opportunities.

"The substantive discussions of the past two days will inform efforts among all of us who are working to improve the health of Aboriginal peoples," said Health Minister Ujjal Dosanjh.

"There is strong commitment to continue working together at all levels of government and with Aboriginal leaders, communities, health workers and health experts to improve the health of Aboriginal peoples, and ensure Aboriginal people benefit from improvements to Canadian health systems."

Discussions among the more than 100 participants at the Health Sectoral Session included issues such as health services available to Aboriginal peoples, health system delivery and accountability.

The discussions will help inform the dialogue at the Spring Policy Retreat and First Ministers' Meeting on Aboriginal issues, where governments and Aboriginal leaders will work together to improve the health of Aboriginal peoples.

Other sectoral sessions to be held between mid-November and late-January are on the themes of life-long learning, housing, economic opportunities, negotiations and accounting for results.

[Aboriginal Nurse Shortage]

The Aboriginal Nurses Association of Canada recommends a national survey to assess the nursing workforce available for Aboriginal communities

OTTAWA, Dec. 14, 2004

A new report released today by the Canadian Institutes for Health Information (CIHI) states that "Nurses are the largest group of health care providers in Canada", yet it is a workforce whose average age is rising. The report reveals that the average age of a Registered Nurse (RN) is 44.5 years; 44.4 for licensed practical nurses (LPN) and 46.2
for registered psychiatric nurses (RPN).

The report provides insight into what has been known for years: nurses
are the largest group of health care providers, and this workforce is in
jeopardy. More importantly, the report provides a foundation for further
research to address what is not known-the number of nurses working in
Aboriginal communities.

"We already know there is a serious shortage of nurses in First Nations
communities," said Assembly of First Nations National Chief Phil Fontaine.
"Last year, the Aboriginal Nurses Association of Canada estimated that at
least 800 more nurses are needed just to meet the basic needs of on-reserve First Nations. Any study of the current situation will most likely confirm that shortage and possibly identify an even greater need to address the gap."

"Aboriginal nurses are true front-line workers who travel to remote areas
in order to perform, on a daily basis, many services that would normally be handled by doctors," said National Chief Fontaine. "Aboriginal nurses face overwhelming and exhausting demands. They are working above and beyond the call of duty. We desperately need to recruit, reinforce and retain Aboriginal nurses if any progress is to be made in healing our people."

The federal $200M commitment in Aboriginal health human resources,
announced in September 2004, must address management and infrastructure requirements in First Nations communities as critical to implement new recruitment and retention strategies.

Having access to the number of nurses working in urban, rural and remote
communities is critical to planning for programs in health prevention and
promotion for the Aboriginal population. Aboriginal people are the fastest
growing population in Canada with a significant lower life expectancy due to poor health indicators.

It is also imperative that active recruitment strategies are aimed at
encouraging and supporting Aboriginal people in becoming health professionals.

As noted in the 1996 report of the Royal Commission on Aboriginal Peoples, Aboriginal control of human services is necessary because control over one's situation is a major determinant of health. President, Lisa Dutcher concludes "If there is going to be a significant positive effect on health outcomes for Aboriginal people in Canada then many more Aboriginal nurses will be required to service the growing population and to address the numerous health needs".

For further information: Dawn Bruyere, RN, MScN, Executive Director,
A.N.A.C, http://www.anac.on.ca
(613) 724-4677 Or Bryan Hendry, AFN Health and Social Communications Officer, 1-866-869-6789, ext. 229, cell (613) 293-6106

Encouraging Aboriginal people to become nurses. . .
http://www.turtleisland.org/discussion/ ... php?t=2901

More about shortage of Aboriginal health professionals . . .
http://www.turtleisland.org/photo/cmajabdocs.gif

More First Nations, Aboriginal, Native American health issues. . .
http://www.turtleisland.org/healing/hea ... llness.htm

[Advice- Aboriginal Health]

The Health Council of Canada released a report that includes advice for improving Aboriginal health care.
http://hcc-ccs.com/report/Annual_Report/1b.htm

January 27, 2005

Council Advice on Aboriginal Health

We recommend the following:

Develop an Aboriginal health work force to improve service delivery in the North — linguistic and cultural issues can be addressed and services can be provided closer to home.

Target education programs at Aboriginal youth to encourage them to consider a health career.

Develop health professions training programs that recognize traditional Aboriginal healing practices and are focused on providing services to northern and remote communities.

Develop primary health care models to address the broader social determinants of health which are particularly relevant to Aboriginal communities.

Accelerate the use of information technology to improve services in Aboriginal communities.


BACKGROUND . . .

The Health Council decided early on that our work on the health of Canadians would focus on groups most at risk — Aboriginal Peoples, children, the elderly and people with mental health challenges. This report deals only with Aboriginal Peoples. Future reports will focus on other priority groups.

First Ministers recognized the serious challenges facing Aboriginal communities and committed to reducing the gap in health status between Aboriginal and non-Aboriginal Peoples.

Aboriginal Peoples experience poorer social and economic conditions than other communities in Canada. For example:

Significantly more Aboriginal students do not complete high school as compared to all Canadians (52 per cent versus 33 per cent); The official unemployment rate of Aboriginal Peoples is significantly higher than the non-Aboriginal rate (19 per cent versus 7 per cent).

The health of First Nations, Inuit and Métis people is worse than that of the general Canadian population on virtually every measure of health and every health condition. For example:

Non-Aboriginal men live nine years longer than Aboriginal men living on reserves and four years longer than Aboriginal men living off-reserve; for females the gaps are eight and four years; The suicide rate in Inuit communities is three times that of First Nations and six times that of the general Canadian population; The infant mortality rate for First Nations is much higher than the Canadian rate (8 per 1000 live births compared to 5.5 in1999); Differences exist among First Nations, Inuit and Métis populations. For example, rates of diabetes are highest in First Nations communities whereas rates of tuberculosis are highest in Inuit communities.

Access to health care services is an issue for all Aboriginal communities, whereas we have focused particularly on the situation in Canada's northern and remote communities. We held one of our meetings in Nunavut and heard directly from community members in Iqaluit, Kimmirut and Pangnirtung. They were clear that they wanted services delivered in their communities in their own language, by their own people.

In the North, flying out of the community to get health care causes serious disruption for individuals and families. Added to this is the fact that a significant amount of territorial health spending is currently dedicated to transportation costs. These resources would be better spent on services provided closer to home, by health professionals who understand local needs. Telehealth technology has an important role to play in connecting health professionals in the North to other resources. Nunavut, for example, has placed a high priority on implementing Telehealth technology and is beginning to see benefits for patient care.

The 2004 Ten Year Plan dedicated $700 million for Aboriginal health issues — $100 million is to support health human resources. This is an important investment. There is an acute shortage of Aboriginal health professionals and a concerted effort is required to encourage Aboriginal youth to consider health careers. As well, new training programs are needed that include traditional healing practices in their curriculum. The recent announcement from Manitoba's University College of the North of a degree program in midwifery targeted at Aboriginal Peoples in remote communities is an innovative step forward.

Team based, multidisciplinary care is the stated goal for primary health care in Canada and nowhere is it more relevant than in Aboriginal communities. This broad based approach can deal with the many health, social and economic issues facing Aboriginal Peoples. One of the more successful Canadian primary health care innovations is in the Eskasoni First Nation community in Nova Scotia. An integrated public health and primary care model was created using the services of physicians, a primary care nurse, community health nurses, a prenatal care coordinator, a health educator and a pharmacist. Access to services improved as did community health outcomes and patient satisfaction.

The Council will release a longer discussion paper on issues of Aboriginal health in the spring of 2005. The paper will focus on the poor state of information about Aboriginal health and on innovative initiatives dedicated to improving community health.

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News and Comment
by Tehaliwaskenhas
Bob Kennedy,Oneida
Copyright
Turtle Island Native Network
http://www.turtleisland.org

January 28, 2005

AFN National Chief Phil Fontaine called for recognition of jurisdiction and a long-term commitment to address all health care needs of First Nations.

In response to the report of the Health Council of Canada, Fontaine pointed to the greater use of Telehealth as a way to assist remote communities.

"We are caught up in a high-tech black hole. While Infoway recognizes that telehealth could have the most benefit for First Nations located more than 90 kilometres from physician services, they do not recognize us as a -jurisdiction- and so, do not have an administrative mechanism to fund our initiatives."

The AFN leader explained that First Nations telehealth projects have survived thanks to special pilot project initiatives and linkages with provincial networks, but they are sparse and not sustained on a systematic basis.

"While the Council stressed the importance of telehealth and electronic health records to achieve a more effective and efficient Canadian health system, First Nations do not have access to the substantive investments made in Canada Health Infoway to make available these technologies for all Canadians."

In its report this week, the Health Council of Canada called for an acceleration of the use of information technology to improve services in Aboriginal communities.

The National Chief hopes to include the Council's recommendations at the First Ministers Meeting on Aboriginal Issues this Fall. He sees them as being aligned with the AFN First Nations Health Action Plan - based upon resourcing that meets the needs of First Nations, better inter-relationships between First Nations, federal and provincial/territorial systems, and the critical importance of supporting self-governing, First Nations health authorities.

"The AFN is challenging all governments to make a long-term commitment to offering equitable opportunities for health, and implementation of First Nations jurisdiction in the development of the upcoming Blueprint on Aboriginal Health."

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More about First Nations, Aboriginal healing and wellness. . .
http://www.turtleisland.org/healing/hea ... llness.htm

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Health Council of Canada . . .
http://www.hcc-ccs.com

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Health Council Sounds Alarm over Health Human Resources Shortages

OTTAWA, Jan. 27, 2005

The Canadian Medical Association (CMA) pointed today to the first-ever Report of the Health Council of Canada as further proof of the need for a concerted response to the critical shortage of health care professionals and the inadequate response by governments at all levels.

In its comprehensive examination of the health care system, the Council
states: "... there are areas where reforms need to be accelerated. Of note
are: Health human resources - nurses, doctors, pharmacists, technicians,
technologists and others need to be trained ... in sufficient numbers to meet future demands. This is an urgent priority. Without sufficient providers of care working together, all other efforts will flounder. (...)"

"We welcome the findings of this report, which reaffirm what the CMA has
been saying for many years: Canada has a dire health human resources (HHR) problem, we need more doctors, nurses, technicians, therapists, and other health care professionals," said Dr. Albert Schumacher, President of the CMA.

"There is a 'perfect storm' brewing, where the rising health care demands
of a growing and aging society collide with a shrinking supply of doctors and other professionals. This perfect storm threatens to wipe out any and all efforts to make the system work better," said Dr. Schumacher.


Here are the facts:
- Canada ranks 24th out of 30 OECD countries in terms of access to
physician;
- The OECD also predicts that, by 2016, Canada will have the worst
shortage in nurses of all OECD nations, with a shortfall of up 31%
compared to demand;
- Due to the current nursing shortage, Canadian nurses are working an
estimated 300,000 hours of overtime per week;
- Close to 4 million Canadians (one in six) don't have access to a family
physician;
- 25% of Quebec residents don't have access to a family physician;
- 60% of physicians are limiting the number of new patients they see, or
are not taking new patients at all;
- 3,800 physicians plan to retire in the next 2 years--more than double
the current rate of retirement;
- 26% of physicians plan to reduce the number of hours they work compared
with only 4% who plan to increase the number of hours.


After many years of calling for the creation of such a body, the CMA was encouraged when the Health Council of Canada was established in December 2003. The CMA considers the Council to be an essential tool to ensure the First Ministers' Accord on Health Care Renewal leads to action.

The Council's first report provides an overview of the state of health
care services throughout Canada. In addition to examining a variety of initial reforms already underway, the report addresses such issues as healthy living, pharmaceuticals management, electronic health records, and home care. It stresses the need to accelerate our collective response to HHR and other challenges.

The CMA has pointed to the fact that while Canada needs to graduate at
least 2,500 new doctors every year to meet the needs of Canadians, only an estimated 1,773 will graduate this year. Just as importantly, the average age of Canadian physicians is 49 years, while 30 percent are 55 or older. Some 3,800 Canadian doctors are expected to retire in the next two years.

"We have presented short-, medium-, and long-term solutions to the issue
of shortages in health human resources and some of these have been
acknowledged and a few have been addressed by governments. What we need most, however, is a pan-Canadian strategy to ensure we have enough medical professionals in all parts of the country," said Dr. Schumacher.

In the coming weeks the Association will also be presenting further
details on its ongoing project to address the lengthy waits experienced by
Canadians seeking health care services.

For further information: Carole Lavigne, Media Relations,
(613) 731-8610 or 1-800-663-7336, ext. 1266