First Nations health transformation in British Columbia

Disparities within the current healthcare system lead to health inequities. Closing gaps in health outcomes can only be achieved by addressing the cultural, social, economic and historical disadvantages that have led to intergenerational trauma. These barriers continue to impact the health and wellness of First Nations people today.

To make significant improvements in overall health outcomes for First Nations, the federal government is transforming its role in health from designing and delivering health programs and services to being a funding and governance partner with First Nations. Health transformation is a collaborative process between First Nations, the Government of Canada and provinces/territories that establishes new partnerships based on reciprocal accountability so that decisions about health for First Nations can be made by First Nations.

Starting in 2013, the First Nations Health Authority (FNHA) took over responsibility from the federal government for the planning, management, and delivery of health programs for First Nations in BC. The transfer was guided by the First Nations Health Council (FNHC) and established in a series of tripartite agreements with the Government of Canada and the Province that created an unprecedented First Nations health governance structure—the first in Canada and one of only a few in the world:

• Political representation and advocacy through FNHC
• Planning, management and delivery of health programs and services through FNHA
• Technical advice and counsel from the First Nations Health Directors Association

This First Nations health governance structure works in partnership with BC First Nations to achieve a shared vision of healthy, self-determining and vibrant BC First Nations children, families and communities.

Associated links:

• Indigenous health care in Canada
• First Nations Health Authority

Health care funding – Indigenous health

The Government of Canada is working with Indigenous partners and communities to support improved access to high-quality, culturally appropriate health services that respect traditional knowledge and practices, and promote Indigenous control of health services.

The Government of Canada is committed to addressing the social determinants of health and advancing self-determination in alignment with the United Nations Declaration on the Rights of Indigenous Peoples.

Each year, the government invests approximately $5 billion in Indigenous health. Investments announced since 2021 include (but are not limited to):

• $100 million over three years to promote mental health and prevent mental illness in populations most affected by the COVID-19 pandemic, including Indigenous Peoples;
• $354 million over five years to increase the number of nurses and other medical professionals in remote and isolated First Nations communities;
• $250 million over five years to further support recruitment and retention of health professionals on reserves;
• $825 million over three years for distinctions-based mental health and wellness strategies;
• $127 million over three years to foster health systems free from racism and discrimination; and
• $107 million over three years to continue efforts to transform how health services are designed and delivered by First Nations communities.

Through Budget 2023, the federal government is increasing health funding to provinces and territories by $196.1 billion over 10 years, including $46.2 billion in new funding. This funding includes:

• $810.6 million over five years to support medical travel and maintain medically necessary services through the Non-Insured Health Benefits Program, including mental health services, dental and vision care, and medications; and
• $16.2 million over three years for interventions that will contribute to the goal of eliminating tuberculosis across Inuit Nunangat by 2030.

The Government of Canada is also investing an additional $2 billion over 10 years through a new Indigenous Health Equity Fund to help ensure access to quality and culturally safe health care services, in line with the priorities of Indigenous partners.

This new Fund will be distributed to First Nations, Inuit and Métis communities to support Indigenous-led regional and community health priorities.

In alignment with the United Nations Declaration on the Rights of Indigenous Peoples and in support of self-determination, the Government of Canada will work with First Nations, Inuit and Métis partners across the country on the design and implementation of the Fund.