How BC First Nations and partners are leading health systems transformation

Transcription

1 How BC First Nations and partners are leading health systems transformation Presented by Joe Gallagher Chief Executive Officer, First Nations Health Authority 1

2 British Columbia- Quick Facts - 26 Cultural Groups - 32 Aboriginal Languages Communities (or First Nations) - 155,020 Status First Nations - 69,470 Métis - 1,570 Inuit % of BC's status First Nations population live off-reserve - First Nations are 5.4% of BC s population of 4,400,057 - Almost 45% of our population is <25 years old - Approx.60% of the First Nations languages of Canada are spoken in BC

3 It starts with me BC First Nations Perspective on Wellness holistic Our vision of health and wellness comes from the ancestors and is relational Colonization interrupted this worldview

4 Indian Act and Reserve System Terra Nullius Policy and legislation to remove First Nations people from the land

5 Residential Schools, Indian Hospitals, 60 s Scoop Policy and legislation designed to Kill the Indian in the child

6 What was the impetus for change? Socio-economic and health status of First Nations Limited First Nation involvement and decisionmaking Health Services- Access and quality issues Parallel System- lack of integration Inefficiency / Limited Capacity- FNIHB policies not a good fit for BC BC was prepared to enter into a new relationship

7 How did we get there? A series of Political, Legal, Operational Agreements incrementally building a true health partnership

8 Building the First Nations Health Governance Structure- a partnership with ourselves Culture Dialogue Consensus building

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10 Our Common Foundation Our Vision Healthy, self-determining and vibrant, BC First Nations children, families and communities Our Values Respect, Discipline, Relationships, Culture, Excellence & Fairness Our Directives 1. Community Driven, Nation Based 2. Increase First Nations Decision- Making 3. Improve Services 4. Foster Meaningful Collaboration and Partnerships 5. Develop Human and Economic Capacity 6. Be without Prejudice to First Nations Interests 7. Function at a High Operational Standard 10

11 Creating the First Nations Health Authority Our transformation is not into something new, our transformation is to our ways of our people, through our language, our songs, our ceremonies, that s our transformation to transform ourselves to the strength of our people. - Kukp7i Christian Splat sin First Nation

12 Where does the FNHA fit? The FNHA occupies a completely unique place within the health system, in some ways, the FNHA is like the Ministry of Health and Health Canada, in that the FNHA undertakes strategic policy and planning development for the full First Nations health system. In some ways, the FNHA is like the Provincial Health Services Authority, in that the FNHA delivers some services to the entire First Nations population across the province, and provides certain shared services across BC First Nations health centres. In some ways, the FNHA is like Regional Health Authorities in that the FNHA undertakes local and regional health services planning and delivery

13 Since Transfer: October 1,

14 Federal/Provincial Relations Federal Provincial Senior ADM, FNIHB and FNHA CEO Shared Vision & Common Understanding senior leadership vision of the partnership and key strategic priorities and areas of work FNIHB Directors General and FNHA Vice-Presidents forum workplans and targets as a collective group as well as between individual VP-DGs Joint Project Board decision-making MSP Agreement Relationships with colleges and professional associations (ie BC Dental)

15 First Nations and Regional Health Authorities 5 of 5 Regional Partnership Accords Unique approach in each region (7 Nation model, 3 family model) Political Agreement first

16 FNHA and Health Authorities Operationalize regional political commitments Work with First Nations in each region to advance a regional agenda Translator for new health service conversation Work with PHSA for province-wide services

17 Control: Who Really Makes the Decisions 1. Control who makes the final decision influencing outcome? 2. Influences family, friends, co-workers, religion, values, money 3. Real opportunities to influence health costs/outcomes influence on the choices made behavioural change 4. Current Model tests, diagnosis, treatment (meds or procedures) Dr. Douglas Eby, Southcentral Foundation

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20 Cultural Competency for Health Professionals

21 Innovation Equation Working together First Nations working together through the Perspective on Wellness + With Our Partners Province of BC Health Canada Regional health authorities Health Profession colleges = Culturally Safe services Transformation and innovation Best of Modern and Traditional Medicine

22 Lessons Learned There are no Shortcuts Much can be achieved within existing jurisdiction We can t do this alone Governance Matters Define the Agenda

23 Questions?