Health

Learn how the Government of Canada is responding to the Truth and Reconciliation Commission's Calls to Action 18 to 24.

18. We call upon the federal, provincial, territorial, and Aboriginal governments to acknowledge that the current state of Aboriginal health in Canada is a direct result of previous Canadian government policies, including residential schools, and to recognize and implement the health-care rights of Aboriginal people as identified in international law, constitutional law, and under the Treaties.

What's happening?

The Government of Canada recognizes that the current state of Indigenous health is a direct result of the shameful historical legacy of colonialist policies and interventions against the well-being of Indigenous peoples and communities, including Indian residential schools, the Sixties Scoop and other harmful practices. The intergenerational impacts of Indian residential schools are well documented in international and national evidence cited in Government of Canada publications and specifically recognized in partnership agreements with Indigenous governments and representatives.

The Government of Canada has committed significant new investments in Budgets 2016, 2017 and 2018 to increase the capacity of Indigenous communities to address both risk factors and impacts of health inequities resulting from the intergenerational effects of colonization. These investments include:

  • $69 million over 3 years for mental wellness teams and crisis stabilization
  • $828.2 million over 5 years for communicable diseases, primary care transformation, mental wellness, children's oral health and home and community care
  • $200 million over 5 years with $40 million ongoing to address the needs of high risk communities in the area of addictions
  • $27.5 million over 5 years for eliminating tuberculosis in Inuit Nunangat
  • $86 million for Non-Insured Health Benefits to expand access to mental health professionals, including access to traditional healers
  • making accessible to all First Nations and Inuit women who must leave their home community during their pregnancy, an escort such as a family member

These investments will result in meaningful change in Indigenous communities in terms of levels of access to services, number of community-based workers, partnerships with provincial and territorial health systems, and better linkages with the Indigenous social determinants of health. For example, the number of multidisciplinary and culturally grounded mental wellness teams will quadruple. This model is based on the First Nations Mental Wellness Continuum Framework endorsed by First Nations chiefs in assembly in 2015. The National Inuit Suicide Prevention Strategy developed by and for Inuit will be implemented. The Know Your Status First Nations community-designed and driven initiative will be replicated across all First Nations communities in Saskatchewan, an initiative that has demonstrated capacity of First Nations to exceed the 90-90-90 HIV elimination target of the World Health Organization.

In addition to these significant investments in Indigenous designed and implemented health and wellness initiatives, the Government of Canada is actively supporting Indigenous peoples to take control over health services in recognition of their rights to self-governance and self-determination. Building on the success of the British Columbia First Nations Health Authority who took over federal British Columbia operations in First Nations health in 2013, it has committed to Mental Wellness Transformation partnership with the British Columbia First Nations Health Council and the provincial government. An initial investment of $10 million over 3 years has been committed by the Government of Canada to support the aspirations of British Columbia First Nations leaders and representatives to support community-driven, nation-based plans in the area of mental health and wellness.

Budget 2018 announced $235 million to advance targeted health systems transformation initiatives launched by First Nations in several provinces. The Government of Canada has signed partnership agreements with Northern Manitoba First Nations (MKO), Northern Ontario First Nations (Nishnawbe Aski Nation and Treaty 3) and is expecting to shortly sign protocol agreements with non-self-governing First Nations of Quebec and Labrador. A Memorandum of Understanding with the Onion Lake Cree Nation was signed to establish the first treaty-relationship based funding agreement related to health, reflecting the importance of Treaty 6 and the Medicine Chest clause.

The Government of Canada will continue to pursue collaboration, both bilateral and tripartite, with First Nations across the country. In 2016, funding was provided to National Indigenous Organizations to develop distinctions-based plans for health transformation, presented to federal, provincial and territorial Health Ministers by Indigenous leaders in October 2017.

As well, the permanent bilateral mechanism process is instrumental in advancing priorities identified in these health transformation plans and joint health and wellness work plans with the Assembly of First Nations, Inuit Tapiriit Kanatami and the 4 Land Claim Organizations as well as the Métis National Council and its governing members. A Memorandum of Understanding to develop a 10-year Métis Health Accord with the Métis National Council has been signed as an outcome of this process.

In addition to investing in capacity building and actively supporting the devolution of health services, the Government of Canada recognizes that to make improvements to health outcomes for Indigenous individuals, families and communities, cultural safety and humility must be embedded in the health system and in health service delivery. Again, building on the accomplishments realized by the British Columbia First Nations Health Authority in making the health system in British Columbia more culturally safe for First Nations, the federal departments of Indigenous Services and Health, as well as the Public Health Agency of Canada, signed a Declaration of Commitment to Advance Cultural Safety and Humility in Health and Wellness Services in British Columbia on April 3, 2019.

19. We call upon the federal government, in consultation with Aboriginal peoples, to establish measurable goals to identify and close the gaps in health outcomes between Aboriginal and non-Aboriginal communities, and to publish annual progress reports and assess long-term trends. Such efforts would focus on indicators such as: infant mortality, maternal health, suicide, mental health, addictions, life expectancy, birth rates, infant and child health issues, chronic diseases, illness and injury incidence, and the availability of appropriate health services.

What's happening?

Indigenous Services Canada (ISC) is working with Indigenous organizations including the Assembly of First Nations, Inuit Tapiriit Kanatami and the 4 Land Claim Organizations, as well as the Métis National Council and its governing members to advance shared priorities focused on improving and closing the gaps in health outcomes for Indigenous peoples.

ISC has engaged with First Nations and Inuit partners in all regions to strategically allocate health funding announced in Budget 2017. These additional resources are aligned with health priorities identified by Indigenous partners. These new investments will help improve access to needed services in the area of maternal and child health, mental wellness, clinical care, home care and communicable diseases controls.

ISC, in collaboration with the First Nations Information Governance Centre, will explore the development of an information strategy to determine appropriate indicators through the First Nations Regional Health Survey. Furthermore, ISC will also work with the Inuit Tapiriit Kanatami towards the development of an Inuit Health Survey.

At the regional level, First Nations and Inuit partners, along with officials from ISC, are working within their respective jurisdictions to explore opportunities to access First Nations and Inuit specific health data.

To keep Indigenous families healthy, Budget 2018 announced $1.5 billion over 5 years, starting in fiscal year 2018 to 2019, and $149 million per year ongoing, as follows:

  • $498 million, with $97.6 million per year ongoing, to sustain access to critical medical care and services, including 24/7 nursing services in 79 remote and isolated First Nations communities
  • $200 million, with $40 million per year ongoing, to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities with high needs
  • $235 million to work with First Nations partners to transform First Nations health systems by expanding successful models of self-determination so that health programs and services are developed, delivered and controlled by and for First Nations. This investment will also support access to quality and First Nations-controlled health care in remote and isolated James Bay communities, as part of the Weeneebayko Area Health Integration Framework Agreement
  • $490 million over 2 years to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits Program
  • $109 million over 10 years, with $6 million per year ongoing, to respond to high rates of tuberculosis in Inuit communities and develop a better understanding of the unique health needs of Inuit peoples through the co-creation of a distinct Inuit Health Survey
  • $6 million over 5 years to support the Métis Nation in gathering health data and developing a health strategy

20. In order to address the jurisdictional disputes concerning Aboriginal people who do not reside on reserves, we call upon the federal government to recognize, respect, and address the distinct health needs of the Métis, Inuit, and off-reserve Aboriginal peoples.

What's happening?

In spring 2016, Health Canada provided funding to the Assembly of First Nations, Inuit Tapiriit Kanatami and the Métis National Council to develop distinctions-based health priorities that will form the basis for collaborative work and inform future federal health investments. In August 2017, the Common Statement of Principles on Shared Health Priorities included a commitment by federal, provincial and territorial governments to work with First Nations, Inuit and Métis to improve access to health services and health outcomes for Indigenous peoples.

The Government of Canada is engaging the Inuit Tapiriit Kanatami through the Inuit-Crown Partnership Committee and Métis National Council through the Canada Métis Nation Accord to advance the health priorities of Indigenous peoples who do not live on reserve. Work plans are being developed to guide future efforts on jointly identified priority areas. Regional specific Métis interests, including those related to health, are also being discussed at the Crown-Indigenous Relations and Northern Affairs-led Recognition of Indigenous Rights and Self-Determination tables with each of the Métis governing members.

Indigenous Services Canada works in close partnership with the Inuit Tapiriit Kanatami at the national level and with Inuit regional land claims organizations located in the Northern, Quebec and Atlantic regions to increase access to health services and to improve health outcomes. As part of these efforts, the department has committed to an Inuit Health Approach which states that it will "work with Inuit, territorial and provincial governments, and other federal partners to develop an approach to Inuit health that informs planning." The Inuit Tapiriit Kanatami also participates on a number of committees and working groups to collaborate on areas of mutual interest and advance Inuit health priorities.

Through a distinctions based-approach, Budget 2018 announced $1.5 billion over 5 years, starting in fiscal year 2018 to 2019, and $149 million per year ongoing, as follows:

  • $498 million, with $97.6 million per year ongoing, to sustain access to critical medical care and services, including 24/7 nursing services in 79 remote and isolated First Nations communities
  • $200 million, with $40 million per year ongoing, to enhance the delivery of culturally appropriate addictions treatment and prevention services in First Nations communities with high needs
  • $235 million to work with First Nations partners to transform First Nations health systems by expanding successful models of self-determination so that health programs and services are developed, delivered and controlled by and for First Nations. This investment will also support access to quality and First Nations-controlled health care in remote and isolated James Bay communities, as part of the Weeneebayko Area Health Integration Framework Agreement
  • $490 million over 2 years to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits program
  • $109 million over 10 years, with $6 million per year ongoing, to respond to high rates of tuberculosis in Inuit communities and develop a better understanding of the unique health needs of Inuit peoples through the co-creation of a distinct Inuit Health Survey
  • $6 million over 5 years to support the Métis Nation in gathering health data and developing a health strategy

21. We call upon the federal government to provide sustainable funding for existing and new Aboriginal healing centres to address the physical, mental, emotional, and spiritual harms caused by residential schools, and to ensure that the funding of healing centres in Nunavut and the Northwest Territories is a priority.

What's happening?

Through a combination of new Budget 2016 and Budget 2017 investments, over $350 million has been provided to support:

  • mental wellness promotion
  • services for former Indian Residential School students and their families
  • substance use and suicide prevention
  • crisis response services, treatment and aftercare in First Nations and Inuit communities

The Government of Canada also continues to work closely with the Government of the Northwest Territories to explore opportunities to support healing in a way that complements existing services and is sensitive to the Indigenous cultures in the territory.

Together with contributions from the Government of Nunavut and Inuit partners, as part of Budget 2019, the Government of Canada announced its commitment to support the construction and ongoing operation of a treatment facility in Nunavut.

Subsequently, on August 19, 2019, Indigenous Services Canada announced, in partnership with the Government of Nunavut and Nunavut Tunngavik Incorporated, that a new Nunavut Recovery Centre will be developed. The Nunavut Recovery Centre will provide a range of treatment and healing interventions that will address both addictions and trauma, and will be founded on Inuit cultural practices and values.

22. We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.

What's happening?

The Government of Canada recognizes the value and importance of Indigenous healing practices.

Through funding announced in Budget 2017 and 2018, it is providing $86 million over 5 years and $490 million over 2 years respectively, to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits. The Non-Insured Health Benefits program is working with partners to advance the implementation of these changes to benefit coverage. Non-Insured Health Benefits medical transportation benefit provides coverage to enable clients to access medically necessary health services, including services provided by traditional healers.

The Indian Residential Schools Resolution Health Support Program secured a 2-year renewal for fiscal year 2016 to 2017 and 2017 to 2018 ($116 million total) that provides access to mental health, emotional and cultural support services for eligible former residential school students and their families. The services provided are based on the specific needs of individuals, families and communities and may be provided by Elders, traditional healers, Indigenous community health workers, psychologists and social workers.

Indigenous Services Canada (ISC) is working with the National Aboriginal Council of Midwives to implement the Budget 2017 midwifery investment of $6 million over 5 years. ISC also continues to support the development of Indigenous Service Delivery Models for crisis planning, prevention, response and recovery and land-based programming, which incorporate Indigenous healing practices.

Budget 2018 announced $248.6 million over 3 years, starting in fiscal year 2018 to 2019, for services, including mental health and emotional supports to survivors and their families for the duration of the Indian Residential School Settlement.

23. We call upon all levels of government to:

  1. Increase the number of Aboriginal professionals working in the health-care field.
  2. Ensure the retention of Aboriginal health-care providers in Aboriginal communities.
  3. Provide cultural competency training for all healthcare professionals.

What's happening?

Indigenous Services Canada (ISC) participates in the Indigenous Health Human Resources Task Force under the Federal Provincial Territorial Committee on Health Workforce. The task force develops strategies for increasing the recruitment and retention of Indigenous health care professionals and supporting cultural competence training for all health care professionals. As a result of close collaboration with federal, provincial and territorial representatives, an environmental scan was conducted to take stock of current and notable past initiatives across Canada to increase the recruitment and retention of Indigenous health professionals and provide cultural safety training to health professionals working with Indigenous communities, patients and families within health care systems.

ISC included cultural competency training for new registered nurses and nurse practitioners employed by its First Nations and Inuit Health Branch. ISC also financially supports and works with the Canadian Indigenous Nurses Association and other Indigenous health organizations to explore ways to recruit and retain more Indigenous health professionals and to develop cultural competency training for all health professionals.

24. We call upon medical and nursing schools in Canada to require all students to take a course dealing with Aboriginal health issues, including the history and legacy of residential schools, the United Nations Declaration on the Rights of Indigenous Peoples, Treaties and Aboriginal rights, and Indigenous teachings and practices. This will require skills-based training in intercultural competency, conflict resolution, human rights, and anti-racism.

What's happening?

The Government of Canada is not the lead on a response for Call to Action 24.

Related links

Date modified: