Summary Of Discussions - Inuit Breakout Group

Jurisdiction and Control

Launch Question:

How will we address the issues of jurisdiction and control that are impacting on the delivery of, and access to, health services?

Participants recommended specific actions on the topic of jurisdiction and control. Developing an Inuit Health Directorate, supporting Inuit-specific policy, expanding Inuit health authorities, increasing collaboration between governments, and implementing Inuit land claims are some of the significant solutions raised in this part of the discussions. The participants worked at four tables and provided the following input:

Definition of Success

• establishment and implementation of Inuit-specific policies, Health Directorate (immediate), Federal Inuit Secretariat (short to medium term), and direct funding to appropriate Inuit organizations that is multi-year based;
• Inuit-specific data collection;
• creation of a health system that supports and communicates the needs of individuals (especially the youth) in addressing mental wellness; and
• implementation of recommendations resulting in healthy, independent individuals, families and communities both physically and mentally, who have taken ownership of personal health, community health and health care.

Clarification of Roles (Recommendations)

• federal/Provincial/territorial/Inuit are all the stakeholders (including land claim organizations and urban organizations) that need to participate in clarifying roles (and implementing Inuit-specific policy);
• all relevant stakeholders should collaborate and be brought together to complement and integrate programs and services for Inuit;
• legislation and licensing barriers require consistency and support to reduce the barriers for health professionals (e.g. in-Quebec licensing of nurses);
• the Inuit health agenda must be established by Inuit;
• establishment of an Inuit Health Directorate (with broad authority); and
• Inuit involvement in health care policy/planning/delivery is necessary regardless of geographic location (urban/political affiliations).

Implementation of Inuit Policies

• requires the acknowledgement and establishment of clearly defined Inuit-specific health policies (e.g. for Inuit midwifery);
• federal/provincial/territorial and Inuit organizations must participate in seamless policy making and implementation;
• establishment of a “single Arctic” jurisdiction policy that includes Nunavik (Northern Quebec) and Nunatsiavut (Labrador) instead of the current “North of 60” designations;
• implementation of land claims in a timely manner;
• Inuit authority and capacity to deliver and train health care workers in a culturally appropriate and specific manner; and
• collaborate and bring together all relevant stakeholders, e.g. land claim organizations/provincial/territorial/federal/urban organizations, etc. to complement and integrate programs and services for Inuit.

At the Policy Retreat the agenda should include:

• Inuit-specific health protocols and partnerships;
• Inuit-specific cultural approaches to health policy development, programs and services;
• the creation of a level playing field for Inuit and federal/provincial/territorial relationship building, partnerships and protocols;
• the creation of new common legislation that will define cross-jurisdictional authorities to advance and support Inuit health;
• submission of all recommendations from the Inuit roundtable on health to the Aboriginal Cabinet Retreat scheduled for spring 2005; and
• creation of an Inuit-specific health agenda.

A Federal Inuit Secretariat should include:

• all sectors (not just Indian and Northern Affairs Canada), including health and human resources, environment, housing, education;
• direct reporting to Cabinet;
• a direct relationship with the Prime Minister;
• Inuit staff; and
• implementation of articles in Inuit Land Claims Agreements related to Inuit employment opportunities.

Inuit control and design of the proposed Inuit Health Directorate should:

• support and implement a broad-based consultation on the design and implementation, and authorities for the Inuit Health Directorate within INAC; and
• ensure that the Inuit Health Directorate has presence in each Arctic region and staff complements in Health Canada.

Inuit-specific Authority for Funding should include:

• a funding formula for health that matches the extent of Inuit health needs and be based only on population numbers;
• legislation is needed to support multi-year and direct health funding at F/P/T levels;
• commitment from Treasury Board to support the Anew blueprint@ for Inuit health in terms of priorities and funding matters;
• flexible funding arrangements and guidelines must be established to accommodate Inuit health issues;
• funding for Inuit health that is not streamed through other levels of governments such as federal/provincial or territorial; and
• collection of Inuit-specific data that is reliable and relevant to guide and influence funding allocations.
• Inuit philosophy and focus on well-being and prevention (rather than illness):
• creation of training programs on Inuit culture and way of life in the north for health care workers from the south who come to work with Inuit communities in the north;
• build a more holistic approach and integrate these principles in all sectors, such as economic, housing and social, not just health; and
• address in concrete ways, issues related to food security (i.e., getting safe, nutritious and affordable food).

Participants agreed by consensus that all of the above recommendations are prioritised as either immediate or short-term action items.

How do we know we are making progress?

• commitment from Treasury Board to fund Inuit organizations directly and support the Aboriginal blueprint;
• commitment from the federal/provincial/territorial governments to fund Inuit agenda on a multi-year basis;
• creation of Inuit structures where the administration does not outweigh programs and services;
• resolutions and commitments by Cabinet to support the Inuit health agenda, including implementation of the Inuit Health Directorate;
• collection of Inuit-specific data to support programs/services and document evidence to shift funding to respond to Inuit needs;
• expand wording that is used by the federal government when referring to Aboriginal peoples. (e.g. on/off-reserve does not cover Inuit, therefore there is a need to specifically identify Inuit consistently in wording used in announcements, etc.); and
• Inuit will continue to meet with other Aboriginal groups on areas of common interest.

Access and Integration

Launch Question:

What are the key issues and adaptive approaches that would contribute to improved levels of access to, and integration of, health programming and services?

Definition of Success

• clear Inuit involvement in all aspects of program design, delivery and evaluation;
• accomplishing an Inuit health agenda that is based on Inuit leadership in policy, program development/design, implementation, and is broad and inclusive of Inuit all over Canada;
• less reliance on the health care system;
• implementation of an Inuit health database, increased communications, adequate human resources, mental illness programming, respect for Inuit culture, and flexible programming, and
• capacity is developed that ensures quality health delivery at a community level.

Recommendations/Actions

Inuit philosophy/knowledge:

• recognize and incorporate Inuit knowledge and practices to improve health accessibility;
• incorporate and blend Inuit traditional knowledge with western practices;
• greater emphasis on traditional teaching of Inuit knowledge in the home;
• support traditional Inuit wellness teachings and provide ongoing cultural awareness teachings; and
• educate Inuit youth through cultural and traditional teaching.

Programs and services:

• increase client support, including improved access to transportation and interpretation services;
• increase awareness of health services for all Inuit;
• provide adequate facilities and infrastructure for programs and services;
• more capacity building, training and support resources for communities;
• involve Inuit in the design and development of programs and services;
• flexible, integrated level of programming to improve delivery of comprehensive health services; and
• accessible program guidelines for all Inuit in the north and south.

Capacity building:

• capacity and educational support is needed to increase traditional Inuit skills and cultural values which enhance well-being;
• traditional Inuit medicine should be supported;
• increase skill sets in administration and policy development to increase Inuit staff in professional positions;
• be innovative in the retention and support of health professionals/staff (e.g. rotating shifts and respite); and
• provide ongoing Inuit culture approach to business in the Arctic for “southern visitors” (people who come to work in the north).

Funding:

• block and capital funding are required on a flexible and multi-year basis;
• all Inuit regions need to be made aware of funding opportunities;
• resources for Tele-Health to improve diagnosis and reduce the negative health impacts of remoteness are necessary; and
• all program criteria/guidelines must have a human resource and capital capacity-building requirement.

Research:

• Inuit-specific research (including a database) is needed to provide the baseline evidence for the development of effective, culturally appropriate programs and services;
• technology needs to be improved to provide better health care to the North;
• best practice modules should be shared among Inuit regions through the establishment of a clearinghouse;
• asset mapping and comparable analysis is needed; and
• training is required for Inuit in research skills.

Capacity and Sustainability

Launch Question:

What capacity supports are needed to ensure progress on shared health priorities and improved health status?

The participants stated that many of the capacity and sustainability issues were already addressed in the discussions related to Jurisdiction and Control, as well as Access and Integration, therefore this section covers only those areas that were not adequately covered in the other sections.

Definition of Success

• Inuit pride and ownership of health systems;
• more trained and professional Inuit servicing Inuit in the communities, with programs and services Inuit have designed and developed;
• implementation of the Inuit traditional approach to health (holistic); and
• less reporting requirements with more emphasis on delivery of programming that is flexible enough to meet the needs in each community.

Recommendations/Actions

• develop a single Inuit jurisdiction including Nunavik and Nunatsiavut instead of applying a “North of 60” approach;
• implementation of land claims;
• develop Inuit-specific cultural approaches required in health policy development, programs and services;
• create level playing field for Inuit in F/P/T relationship building, partnerships and protocols;
• develop new common legislation that will define cross-jurisdictional authorities advancing an Inuit authority (short term/immediate priority);
• submit recommendations for the 2005 Policy Retreat (short term/immediate priority);
• ensure that the Inuit Health Directorate will be present in all regions, with Inuit staff in Health Canada and INAC (short term/immediate priority); and
• develop specific legislation and obtain a Treasury Board commitment that allows the government to fund Inuit directly (short term/immediate priority).

How will we know there has been progress?

• a partnership agreement will be in place with a commitment to implement all of the above recommendations (must be a focus of the Policy Retreat agenda);
• formalize an F/P/T/Inuit partnership, including clarification of provincial and territorial jurisdictions in Quebec, Newfoundland/Labrador and Ontario, which have significant Inuit populations;
• funding will be made available to allow for broad consultation in the regions on the Inuit Health Directorate regarding the structure, mandate and implementation strategy; and
• implement existing agreements (land claims) as well as desired processes and outcomes.

Broad Determinants of Health

Launch Question:

How could a Abroad determinants of health approach@ be applied within an Inuit context?

Participants indicated that the Astovepipe@ approach prevents the development of relationships that would help establish partnerships, to work effectively on the broad determinants of health. In addressing broad determinants, participants suggested that greater access to education at all levels, both in the north and south are required. Joint partnerships and greater collaboration from all levels of governments are needed.

Recommendations/Actions

• develop a common understanding of approaches to working together, and addressing how wellness is impacted by broad determinants of health (e.g. overcrowding and violence);
• enforce processes that ensure that sectors share information across programs and government departments on the design, development and delivery of programs;
• eliminate barriers for joint partnerships at the regional/community level through flexible program guidelines (e.g. Fetal Alcohol Spectrum Disorder strategy, inclusive of Department of Education as well as Health);
• implement specific articles in Inuit comprehensive land claims agreements related to Inuit employment and training opportunities;
• develop processes where the Inuit can report directly to the Prime Minister and Cabinet; and
• provide access to educational funding (all levels) regardless of geographic location.

Working with Other Stakeholders

Launch Question:

In what areas of our recommended action and definitions of success will we work with other “stakeholders” and how will we do that?

• continue to meet with Aboriginal partners on common issues; and
• pursue and create an Inuit-specific agenda.

Inuit vision for wellness:

Physically and mentally healthy, independent individuals and families who have taken ownership of personal and community health, and Inuit-specific processes, developed and driven by Inuit, with adequate support (e.g. funding, resources, information and infrastructure) to implement the strategies developed and put into action.

Participants indicated an urgent need for multi-year, needs-based funding that is flexible, equitable and streamlined. The key objectives are to have health (physical and mental) programs and services that are fully accessible in all regions, without barriers of jurisdiction or resources.

Inuit identified some common issues and priorities among Aboriginal groups, but Inuit have recommended Inuit-specific approaches for a long time. Due to jurisdiction, geography, culture and values, Inuit-specific programs and actions are recommended to improve community wellness.

Application of the Crosscutting Lens

The Inuit breakout included the crosscutting lens in all the discussions. Inuit health policies would include all Inuit in Canada regardless of their geographical residence, gender or age. Specific strategies would be required to deal with unique needs faced within these lenses.

Table of Contents

The documentation contained on this website does not necessarily represent the views of any government or National Aboriginal Organization. The purpose of this website is to share information related to the Canada-Aboriginal Peoples Roundtable: background papers, Facilitator's sectoral and final reports, agendas and media announcements.

Top of page