INAN Committee Report

A Missed Opportunity: The Conservative Party of Canada’s Dissenting Report for the Study of Long-Term Care On-Reserve

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Cathy McLeod, Member of Parliament for Kamloops – Thompson – Cariboo

Kevin Waugh, Member of Parliament for Saskatoon – Grasswood

Arnold Viersen, Member of Parliament for Peace River – Westlock

As the Conservative members of the Standing Committee on Indigenous and Northern Affairs (INAN), we recognize the need to understand issues facing elderly Indigenous people in Canada, and take practical steps to improve long-term care on- and off-reserve.

That is why, on February 1, 2018, we supported the passage of the following motion:

• That, pursuant to Standing Order 108(2), the Committee undertake a comprehensive study of long-term care on reserve; that the scope of the study include and not be limited to, elder care, persons living with chronic illness, palliative and hospice care and culturally relevant practices and programs; and that the witness list include First Nation community representatives, First Nation organizations responsible for delivering long-term care services, and groups and organizations affiliated with service delivery; and that the Committee report its findings to the House.

The Committee’s final report contains several parts with which we agree. We believe recommendations 4, 7, 8, 9 and 10 are valuable suggestions for the federal government to consider: 

• Recommendation 4: That Indigenous Services Canada work with First Nations and the provinces and territories to take immediate measures to encourage the implementation of culturally appropriate programming and service delivery including traditional foods in long‑term care facilities and as part of home care and community-based care on reserve.
• Recommendation 7: That Indigenous Services Canada, in partnership with First Nations and other relevant federal departments, improve access to post-secondary health education and occupational training for First Nations learners to provide more opportunities for First Nations people to deliver health care on reserve.
• Recommendation 8: That Indigenous Services Canada co-ordinate with First Nations and the provinces and territories to clarify their respective roles and responsibilities for continuing care on reserves.
• Recommendation 9: That the Minister of Indigenous Services Canada facilitate tripartite meetings between the federal government, provinces and territories and First Nations representatives to address the jurisdictional challenges that exist regarding the delivery of home and community care, palliative care and long-term care services on reserves.
• Recommendation 10: Based on the principles of OCAP™ (ownership, control, access and possession) trademarked by the First Nations Information and Governance Centre, that Indigenous Services Canada work with First Nations and provinces and territories to develop and implement an integrated data collection protocol specific to the health and well-being of First Nations; and that this data be used to inform the provision of evidence-based health services on reserves.

On Recommendation 9, the Committee heard testimony for this study, and in studies previously, of jurisdictional issues that Indigenous people face. Far too many fall through the cracks between municipal, provincial/territorial and federal services, and work must be done to better coordinate responsibilities.

Further, we agree with the Committee that palliative care is a critical service, and should be eligible under the First Nations and Inuit Home and Community Care Program. This is consistent with a recommendation made by Conservative members in the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities, who called on the federal government to make “palliative care available to every Canadian resident who needs it.”

We would support Recommendation 2, if revised to state the following:

• Recommendation 2: That Indigenous Services Canada evaluate the current needs regarding in-home respite care under the First Nations and Inuit Home and Community Care Program and report publicly on it.

A baseline of information would be critical before next steps for funding are determined.

Finally, the implementation of a training program in Recommendation 5 should be amended to support an opt-in training program rather than a mandatory one, since this would be under provincial and territorial jurisdiction:

• Recommendation 5: That Indigenous Services Canada work with First Nations and provincial and territorial partners to develop and implement a training program for Indigenous and non-Indigenous health professionals providing continuing care on reserve about the values, culture and history of Indigenous peoples.

However, while we agree with several of the final recommendations, the Committee failed to live up to its goals for an ambitious and thorough study.

Only eight meetings were held in total, the majority rushed at the end of the spring 2018 Parliamentary session. It was only after MP Cathy McLeod moved a motion to extend that study that additional meetings were added for September 2018. The few topics that were discussed were examined only at a surface level.

The Committee did not do its due diligence with regard to elder care at home, palliative care and culturally-appropriate support for chronic disease. The challenges of rural and remote communities were hardly touched upon. No travel was undertaken for Members of the Committee to witnesses what takes place in communities.

The final report could never be accurately described, as was relayed in the original motion, as “comprehensive”.

With Canada’s aging population, a study of these issues would be of vital importance. According to Statistics Canada’s 2016 census, “the proportion of the First Nations, Métis and Inuit populations 65 years of age and older could more than double by 2036.” Parliament now has before it an opportunity to undertake a comprehensive examination of what services are available to Indigenous peoples, both on- and off-reserve, and recommend specific, practical actions for improvement.

However, we are profoundly disappointed that the majority of the Committee failed to comprehend the complexity and importance of these issues. It is our hope that a future Committee will properly undertake the work this Committee neglected.