Health board fails communities
Thanks to the Keewatin Regional Health Board, the people of Nunavut and the Northwest Territories have now learned why the idea of abolishing health boards may not be such a bad idea.
Health boards, you may remember, were sold to us as the instrument by which aboriginal people in the NWT would gain control of the health care system.
In 1988, Jake Epp, who was then the federal health minister, and Nellie Cournoyea, who was then the NWT’s health minister, concluded the final devolution of all health responsibilities from Ottawa to the GNWT’s Yellowknife-based government, thereby ending a hideously complex set of negotiations that had gone on for nearly 10 years.
The pomposity of their signing ceremony was equalled only by the pomposity of their speeches. No more, they said, would aboriginal people be pushed around by doctors and nurses working for big bad Ottawa.
The Yellowknife government, being closer to the people, would do it better, everyone said. And being run by an aboriginal majority in its legislative assembly, the Yellowknife government would run the health system the way aborginal people want it run.
The Yellowknife government would seek to ensure the success of their new endeavour by devolving management responsibility to regional health board. The vast majority of health board directors would be aboriginal people from the small communities.
So far so good aboriginal people in charge of aboriginal health care.
Now, let’s look at how members of the Keewatin Regional Health Board have carried out this responsibility.
In the fall of 1996, they made a deal with a private company called Kiguti Dental Services, which has resulted in the elimination of four dental therapists’ jobs. The fired dental therapists will be replaced by imported southern dentists.
Here’s a list of who’s opposed to that decision. Most of them are elected officials who represent the Keewatin’s mostly aboriginal population:
The Keewatin Divisional Board of Education. They say the move jeopardizes dental care for children in the Keewatin. The education board has since announced that it wants to take the dental therapy program out of the hands of the health board.
The Hamlet of Rankin Inlet. Mayor and council say they want to run their own dental therapy program under the GNWT’s community empowerment policy.
The Hamlet of Arviat. Mayor and council say they want to run their own dental therapy program, too. And they say that they eventually want to run all health programs separately from the health board.
The Hamlet of Baker Lake. Not only do mayor and council want to run their own dental therapy program, they want to separate from the Keewatin health board as soon as possible.
The National School of Dental Therapy. This school, now run by the Saskatchewan Federated Indian College, is funded by Health Canada for the purpose of training dental therapists many of them aboriginal people to work in remote aboriginal communities. They and many others believe dental therapists can deliver dental care to aboriginal people more effectively and more cheaply than dentists. This school wants to train Inuit as dental therapists.
But the dental therapy school’s principal says the Keewatin health board’s latest decision will discourage Inuit from seeking careers as dental therapists.
Kivallivik MLA Kevin O’Brien: A rarity among most elected officials in the Keewatin, O’Brien actually takes the public interest seriously. He’s already warned the GNWT that the Kiguti deal could turn out to be a reprise of the Rankin tank farm fiasco.
The Union of Northern Workers: The UNW says the Keewatin health board has violated the GNWT’s collective agreement.
That’s who’s opposed to the health board’s deal with Kiguti. So who supports it?
Well, Health Minister Kelvin Ng says he believes the Keewatin health board made a “sound” decision. Ng even said that hamlet councils in Arviat, Baker Lake and Rankin Inlet are wrong to believe that communities may run their own health programs under the GNWT’s community empowerment policy.
Even Ng must realize that this position is utter nonsense. If communities can run their own alcohol and drug programs, surely it follows that they can run any other kind of health program.
Unfortunately for those who are opposed to the Keewatin health board decision, nothing else matters as long as Ng supports the health board.
Health board members, you see, aren’t legally or democratically accountable to the aboriginal people they’re supposed to represent. They’re accountable only to the NWT cabinet minister who appoints them.
Those who honestly believe that regional health boards have a useful role to play in Nunavut after April 1, 1999 now have a big problem on their hands. It’s called the Keewatin Regional Health Board.