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Northwest Territories

The federal government has in the past defined involvement in Indigenous health at the federal or provincial/territorial level: “The federal government provides some health services to First Nations on reserve and Inuit, including public health activities, health promotion and the detection and mitigation of hazards to health in the environment” (Health Canada, 2005, p.3).

“The majority of health services available to Inuit, Métis, non-status Indians and status Indians living away from communities are provided by the provinces and territories in the same manner that services are available to all citizens. Some provinces/territories provide innovative, culturally-specific programs and services to meet the particular health needs of First Nations, Inuit and Métis” (Health Canada, 2005, p.7).

In 2017, the federal government embarked on an important restructuration. Indigenous Services Canada was co-created with Crown-Indigenous Relations and Northern Affairs Canada from what was formerly Indigenous and Northern Affairs Canada and the First Nations and Inuit Health Branch of Health Canada. It collaborates with partners in linking First Nations, Inuit and Metis with high quality services (Indigenous Services Canada, 2013, 2018, 2019). As of 2019, the process of transitioning previous programs to Indigenous Services Canada is in progress.

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Territorial
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The Department of Health and Social Services is responsible for promoting, protecting and providing for the health and well-being of the people of the Northwest Territories (Government of the Northwest Territories, n.d.-a).

Furthermore, the Northwest Territories is the only jurisdiction in Canada that provides a supplementary health benefits program specifically for Métis residents. “The Government of the Northwest Territories (GNWT) sponsors the Métis Health Benefits program to provide registered Indigenous Métis residents of the Northwest Territories access to a range of benefits not covered by hospital and medical care insurance” (Government of the Northwest Territories, n.d.-b).

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Regional
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The Northwest Territories has been the site of many self-government agreements, which include health provisions:

  • The Sahtu Dene & Métis Comprehensive Land Claim Agreement (1993) “includes a provision entrenching the right of signatory First Nations to negotiate individual self-government agreements that include health services …[and are] mindful of public health and public safety” (Sahtu Dene and Metis Land Claim Settlement Act, 1994 in National Collaborating Centre for Aboriginal Health, 2011, p. 48).
  • The Tlicho Agreement (2003) “provides certain rights and benefits respecting land and resources for the Tlicho and self-government to Tlicho Citizens as well as governmental powers and authorities (...). Health services are explicitly cited” (Government of Canada, Government of Northwest Territories, & Tlicho, 2003 in National Collaborating Centre for Aboriginal Health, 2011, p. 50).
  • The Inuvialuit Final Agreement “provide[s] rights, benefits and compensation in exchange for the interest of the Inuvialuit in the Northwest Territories and Yukon Territory (…) The agreement established the Inuvialuit Social Development Program, mandated to improve health, education, housing and standards of living of the Inuvialuit. Specific areas of concern include housing, health, welfare, mental health education, elders and the maintenance of traditional practices and perspectives within the Inuvialuit Settlement Region. Canada agrees to provide special funding to contribute to the accomplishment of these social goals by the Inuvialuit. Under this agreement, public health remains an area of Territorial jurisdiction” (Indian and Northern Affairs Canada, 1984 in National Collaborating Centre for Aboriginal Health, 2011, p. 46).

The Northwest Territories' healthcare system was previously managed through regional authorities. These were amalgamated in 2016 through the creation of the Northwest Territories Health and Social Services Authority (NTHSSA). However, as a result of self-government agreements, some health and social services authorities managed by First Nations and Inuvialuit, remain in place. The Hay River Health and Social Services Authority (HRHSSA) remains outside of the NTHSSA, as does the Tłįchǫ Community Services Agency (TCSA) as per the terms of the Tłįchǫ Land Claims and Self-Government Agreement. The NTHSSA, HRHSSA, and TCSA, collectively referred to as the Authorities, are one integrated territorial health and social services system, functioning under a one-system approach and under a single governance structure (Government of the Northwest Territories, n.d.-c, p.7).

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References
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  1. Sahtu Dene and Metis Land Claim Settlement Act. 1994, S.C. 1994, c. 27. Retrieved from: http://laws-lois.justice.gc.ca/PDF/S-1.5.pdf

  2. Government of Canada, Government of Northwest Territories & Tłįchǫ. (2003). Tłįchǫ Agreement. Retrieved from: http://www.aadnc-aandc.gc.ca/DAM/DAM-INTER-HQ/STAGING/texte-text/ccl_fagr_nwts_tliagr_tliagr_1302089608774_eng.pdf

  3. Government of the Northwest - Health and Social Services. (n.d.-a). About Us. Retrieved from: https://www.hss.gov.nt.ca/en/about-us

  4. Government of the Northwest Territories – Health and Social Services. (n.d.-b). Applying for Métis Health Benefits. Retrieved from:  https://www.hss.gov.nt.ca/en/services/supplementary-health-benefits/metis-health-benefits

  5. Government of the Northwest Territories. (n.d.-c). Caring for our people. Strategic plan for the NWT health and social services system 2017 to 2020. Retrieved from: https://www.hss.gov.nt.ca/sites/hss/files/resources/caring-our-people-strategic-plan-2017-2020.pdf

  6. Health Canada. (2005). Blueprint on Aboriginal Health. A 10-year Transformative Plan. Retrieved from: https://www.canada.ca/en/health-canada/services/publications/health-system-services/blueprint-aboriginal-health-10-year-transformative-plan.html

  7. Indian and Northern Affairs Canada. (1984). The Western Arctic Claim. The Inuvialuit Final Agreement. Retrieved from: http://www.eco.gov.yk.ca/pdf/wesar_e.pdf

  8. Indigenous Services Canada. (2013). First Nations and Inuit Health Branch. Retrieved from: https://www.canada.ca/en/indigenous-services-canada/corporate/first-nations-inuit-health-branch.html

  9. Indigenous Services Canada. (2018). Indigenous Services Canada - Departmental Plan 2018-2019. Retrieved from: https://www.sac-isc.gc.ca/eng/1523374573623/1523904791460

  10. Indigenous Services Canada. (2019). Indigenous Services Canada. Retrieved from: https://www.canada.ca/en/indigenous-services-canada.html

  11. National Collaborating Centre for Aboriginal Health. (2011). Looking for Aboriginal health in legislation and policies, 1970 to 2008: The policy synthesis project. Prince George, BC. Retrieved from: http://ccnsa.ca/docs/1833_synthesisproject_V2.pdf

 

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