PRINT

Québec

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.

.
Provincial
.
          

At the policy level, “[t]he Secrétariat aux affaires autochtones is the primary agency responsible for ensuring communication and contact between Native peoples and the Gouvernement du Québec” (Secrétariat aux affaires Autochtones Québec, 2018a).

Québec does not have an Indigenous-specific health policy. However, “[i]n its Politique gouvernementale de prévention en santé (government preventive health policy), launched in October 2016, the Government du Québec undertook to ‘improve the living conditions of Aboriginal populations' (measure 3.6). On the basis of this policy, a 2017-2021 interministerial action plan was developed. It includes actions designed to benefit the entire population of Québec, including the First Nations and Inuit” (Secrétariat aux affaires Autochtones Québec, 2018b).

With regard to public health protection, Aboriginal communities are covered by the Public Health Act (Ministère de la Santé et des Services sociaux du Québec, 2016).

Established in 1994, the “First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) is a non-profit organisation that is responsible for supporting the efforts of the First Nations of Quebec in order to, among other things, plan and deliver culturally-appropriate and preventive health and social services programs.” Its mission is to “accompany Quebec First Nations in achieving their health, wellness, culture and self-determination goals” (First Nations of Québec and Labrador Health and Social Services Commission, 2015). One of the Commission's key roles is “to act as a technical advisor and consultant among the First Nations communities and the Assembly of First Nations of Quebec and Labrador in the areas of health and social services” (First Nations of Québec and Labrador Health and Social Services Commission, 2015).

The Indigenous health sector of the Institut national de santé publique du Québec (INSPQ) supports the development of public health expertise and knowledge among its partners in Indigenous communities. “Since the end of the 90s, the INSPQ has been working with the regional health authorities of Nunavik and the territory of Eeyou Istchee. In order to respond adequately to an increased demand for this type of collaboration, the offer of expertise and skills development is now available to partners in non-convention territories in Quebec through close collaboration with the First Nations of Quebec and Labrador Health and Social Services Commission” (Institut national de santé publique, 2019 [translation]).

.
Regional
.

The 1978 Northeastern Quebec Agreement provides a mechanism for defining the rights of the Naskapi with regard to land and resources (National Collaborating Centre for Aboriginal Health, 2011, p. 46). As a result of the Northeastern Quebec Agreement, a health and social services advisory committee was set up to represent the interests of the Naskapi. According to the Agreement, services are provided by the Québec health care system (Indian and Northern Affairs Canada, 1984; National Collaborating Centre for Aboriginal Health, 2011, p. 46).

Prior to this, the James Bay and Northern Quebec Agreement (JBNQA) was signed in 1975. It defined the rights of the Cree and Inuit in relation to land and resources (1975; National Collaborating Centre for Aboriginal Health, 2011, p. 46). The Cree Board of Health and Social Services of James Bay (CBHSSJB) and the Nunavik Regional Board of Health and Social Services (NRBHSS, initially known as the Kativik Regional Council of Health and Social Services) were created in 1978 as a result of this agreement.

The CBHSSJB “is responsible for the administration of health and social services for all persons residing either permanently or temporarily in Region 18, the administrative region of the Ministry of Health and Social Services of Quebec corresponding to the Cree territory of James Bay. [Their] mandate is defined in Chapter S-5 An Act respecting health services and social services for Cree Native Persons” (Cree Board of Health and Social Services of James Bay, 2012a). “In partnership with the Government of Québec, the Cree Health Board provides health and social services to the 9 communities of the Cree Territory of James Bay.” This includes public health functions (Cree Board of Health and Social Services of James Bay, 2012b).

The primary mandate of the NRBHSS is “to organize health and social service programs in the region (14 villages of Nunavik), evaluate those programs' effectiveness and ensure the users receive services of good quality appropriate to their needs. Further, it ensures the organization and efficient use of financial resources granted to the Nunavik region. The NRBHSS is an organization dedicated to improving the health and well-being of the populations of the 14 communities on its territory. Its overall mission is to adapt the health and social service programs to the population's needs and to the region's realities” (Nunavik Regional Board of Health and Social Services, 2018).

In addition, regional public health directors are responsible for communicating all information regarding public health protection to all Aboriginal communities on their territory, particularly with regard to epidemics and risk situations that may affect these communities (Ministère de la Santé et des Services sociaux du Québec, 2007, p. 15 [translation]). 

.
References
.
  1. (1975). The James Bay and Northern Quebec Agreement (JBNQA). Available at: http://www.naskapi.ca/documents/documents/JBNQA.pdf

  2. Cree Board of Health and Social Services of James Bay. (2012a). About us. Available at: http://www.creehealth.org/about-us

  3. Cree Board of Health and Social Services of James Bay. (2012b). Cree health. Available at: http://www.creehealth.org/

  4. First Nations of Quebec and Labrador Health and Social Services Commission. (2015). About the FNQLHSSC. Available at: http://www.cssspnql.com/en/about-us

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

  6. Indian and Northern Affairs Canada. (1984). La Convention du Nord-Est québécois, The Northeastern Quebec Agreement. Available at: http://caid.ca/AgrNorEasQueA1974.pdf

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

  8. Indigenous Services Canada. (2018). Indigenous Services Canada - Departmental Plan 2018-2019. Available at: https://www.sac-isc.gc.ca/eng/1523374573623/1523904791460

  9. Indigenous Services Canada. (2019). Indigenous Services Canada. Available at: https://www.canada.ca/en/indigenous-services-canada.html

  10. Institut national de santé publique (2019). Santé des autochtones. Available at: https://www.inspq.qc.ca/sante-des-autochtones

  11. Ministère de la Santé et des Services sociaux du Québec. (2007). Prestation et financement des services de santé et des services sociaux destinés aux Autochtones (Première Nations et Inuits) - Cadre de référence. Available at: https://www.cerp.gouv.qc.ca/fileadmin/Fichiers_clients/Documents_deposes_a_la_Commission/P-086.pdf

  12. Ministère de la Santé et des Services sociaux du Québec. (2016). Particularités des services aux Premières Nations et aux Inuits, Santé Publique. Available at: http://www.msss.gouv.qc.ca/professionnels/soins-et-services/particularites-des-services-aux-communautes-autochtones/sante-publique/

  13. National Collaborating Centre for Aboriginal Health. (2011). Looking for Aboriginal Health in Legislation and Policies, 1970 to 2008. The Policy Synthesis Project. Canada. Available at: http://www.nccah-ccnsa.ca/docs/Looking%20for%20Aboriginal%20Health%20in%20Legislation%20and%20Policies%20-%20June%202011.pdf

  14. Nunavik Regional Board of Health and Social Services. (2018). About us. Available at: https://nrbhss.ca/en/nrbhss/about-us

  15. Secrétariat aux affaires Autochtones Québec. (2018a). Ministère du Conseil exécutif. Available at: https://www.autochtones.gouv.qc.ca/index_en.asp

  16. Secrétariat aux affaires Autochtones Québec. (2018b). Do more, do better: Government Action Plan for the Social and Cultural Development of the First Nations and Inuit 2017-2022. Available at: https://www.autochtones.gouv.qc.ca/plan-action-social-culturel/prevenir-sante-autochtones-en.asp

 

PRINT