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The Globe and Mail

Cuts at Health Canada reduce scrutiny of first-nations spending

Health Minister Leona Aglukkaq speaks at the University of Ottawa Heart Institute on March 15, 2012.

Sean Kilpatrick/Sean Kilpatrick/The Canadian Press

First nations that have proven themselves to be good managers of federal health dollars will face less oversight as part of the Conservative government's cost-cutting efforts.

Health Canada says it doesn't make sense to require first nations with a good track record of fiscal accountability to go through an entire 150-step process to get approval for grants and contributions.

"This is part of the spending review. We are looking for ways to do things more efficiently," said Steve Outhouse, a spokesman for Health Minister Leona Aglukkaq.

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The First Nations and Inuit Health Branch is one of the largest divisions of Health Canada, he explained, "and one of the complaints we hear from first nations – some of them on a fairly regular basis – is that they spend more time reporting to Health Canada that they do actually delivering health services to the community."

There will still have to be accountability for the funds and proper reporting, but the government is looking for ways to streamline that, Mr. Outhouse said

The move to cut red tape comes at the same time as the government has handed "surplus" notices to three of the five people in a unit within Health Canada that helped first nations assume more responsibility for their own health programs as part of a move to self-government. They have been told their jobs will disappear within 120 days.

One Health Canada employee who works closely with the affected unit said the department wants first nations across Canada to move to a funding model that has been adopted in British Columbia, which gives them a larger role in delivery of their own health care and greater integration with the provincial system.

First-nations health falls within the federal government's jurisdiction and, while some reserves want more autonomy over health care, they don't want to simply see the responsibility downloaded from Ottawa to the provinces, the worker said. "They want the money in their own communities so they can run their own programs," he said.

David McLaren, president of the First Nations Health Management Association, said any reduction in the reporting requirements for funding will be welcome. "Over the past 10 years, speaking from experience, our communities have gained a lot of capacity in regards to management, efficiency, and basically getting a better bang for our dollar," Mr. McLaren said.

Keith Leclaire, another member of the association, said it would be "very useful" for individual first nations to reduce their workload and focus on their own identified health priorities, rather than having the priorities dictated by Ottawa.

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"I guess the big thing that I am really looking at right now is to try and make sure that there is a responsibility maintained with the federal government so it's not an offloading to the provinces," Mr. Leclaire said.

Health Canada says it wants to end the requirement for first nations to meet multiple times with government officials to renew a funding agreements. It wants to create more standardized operating procedures. And there would be more long-term funding available.

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