Transcript BC Tripartite First Nations Health Plan: Basis for a

BC Tripartite First Nations Health:
Basis for a Framework Agreement
on Health Governance
UBC Learning Circle
September 29, 2010
Presented by: Ian Potter
Chief Federal Negotiator, Health Canada
TRIPARTITE FIRST NATIONS HEALTH
PLAN: BASIS AGREEMENT
• On July 26, 2010, lead negotiators
from Health Canada, the British
Columbia (BC) Ministry of Healthy
Living and Sport and the First Nations
Health Council initialled a Basis for a
Framework Agreement on Health
Governance.
• This is a political agreement with no legal commitment, but a
political statement of the intent of the three parties.
• This is part of a broader commitment made in the Tripartite First
Nations Health Plan, to help close the gaps in health status
between BC First Nations and other British Columbians.
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EVOLVING TO A NEW GOVERNANCE
STRUCTURE
• The Basis Agreement is the result of many years of
discussions among BC First Nations leadership and the
federal and provincial governments.
• Builds on the Transfer Policy process.
• New administrative arrangement with a First Nations Health
Authority (FNHA) taking over the policy, program and
service delivery role now played by Health Canada for BC
First Nations.
• The FNHA is part of a new governance structure for First
Nations health.
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COMPARISON OF CURRENT
& PROPOSED ELEMENTS
Elements
Current
Proposed
Policies & Programs
- Decisions are made in
Ottawa by federal
government
- Decisions are made in
BC by BC First Nations
Regional Management
- Accountable to Ottawa
- Accountable to BC
First Nations
Health Services
- Limited to federal
policies
- Little integration with
regional health system
-New partnership with
Regional Health
Authorities
-Service designed to
meet the needs of
First Nations
Funding
- Year by year allocation
uncertain
- 10 years certainty
- Guaranteed annual
growth
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BENEFITS OF THIS APPROACH
• Research has shown that health improves when individuals
have greater control over the programs, processes and events
that affect them.
• BC First Nations will have more control over the health
programs and services that are intended to serve them. BC
First Nations will have the ability to:
– reshape health programs and policies to better meet their needs; and,
– increase control and resources to design a health system that is
consistent with their cultures and values, resulting in a more holistic and
wellness-oriented system.
• Support for the health services work of individual First Nations
communities.
• A more accessible, comprehensive, caring and compassionate
system.
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KEY ELEMENTS
OF THE BASIS AGREEMENT
• An administrative arrangement in health
• Transfer of community programs and services
• Transfer of the Non-Insured Health Benefits Program
• Includes all funding directly or indirectly attributed to
First Nations health in BC
• New relationship based on reciprocal accountability
• New arrangements between First Nations and the Province
and its health authorities
• Recognizes importance of the social determinants of health
• Does not end the federal fiduciary relationship with
First Nations
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NEXT STEPS
• Currently working on the Framework Agreement
(legal agreement)
• Transfer of regional office up to a maximum two years after
signing Framework Agreement.
• Joint management of BC FNIH will occur after the Framework
Agreement is signed and prior to transfer.
• Work will continue on capacity building and opportunities
for shared learning.
• A jointly developed Implementation Plan will guide transfer
and ensure a well managed and smooth transition.
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