John W Murray
APTN Investigates
A general practitioner who works with Indigenous patients is skeptical about a new Health Canada policy that allows travel companions for pregnant Status Indian and Inuit women.
Dr. Mike Kirlew, a Sioux Lookout, Ont. doctor told APTN Investigates he believes the policy is just another band aid on a system that needs major surgery.
He wonders if the policy is something the federal government really feels is innovative.
“Do we honestly think that this would win a health care innovation award,” he said.
APTN Investigates is digging into Non-Insured Health Benefits (NIHB) and First Nations healthcare as part of a report called Surviving Bureaucracy airing Friday April 21.
Health Canada announced on April 9 they would allow partners or coaches to travel with mothers-to-be who leave northern communities to give birth but Kirlew said it’s been a mainstream policy for four decades.
He said Health Canada and First Nations must strive for health care excellence overall instead of what he calls “incremental changes.”
“That’s not innovative. It’s not particularly a ‘high five moment’,” he said, adding he is still grateful for the decision.
He said there is greater clarity in policies and provincial legislation for mainstream Canadians than exists for Indigenous peoples.
“If you have grey areas, people die in grey areas,” he said, adding legislation should clearly define health policy.
“There is no law that says that Health Canada has to provide any minimum service on a reserve,” he said.
Kirlew says clearly defined policy and protocol, like counting tools and gauze in surgery, have contributed to better patient outcomes.
“You could go in to any hospital in the province and they will say this is our policy for counting pieces of equipment,” he said. “This is our policy for sterilizing a piece of equipment. It is clear. You can get a policy. You can watch workers. And they are trained in adhering to that policy.”
Kirlew said provincial systems are always operating on a mantra of “excellence,” often codifying it their own mission statements.
For example, Covenant Health in Alberta states their organization will “serve through excellence in care.”
Winnipeg’s Seven Oaks General Hospital’s mission statement states their intent is to “to provide exceptional care.”
But nothing similar exists for nursing stations and federal healthcare.
Dr. Kirlew advised Indigenous people and communities to reach that bar.
“Don’t shortchange yourself by saying we want health care, it’s a treaty right to excellent healthcare, just like everyone else gets,” he said.
He suggested the federal government needs to be challenged to reach for excellence as well, and pointed out Indigenous peoples are set up to fail in the current system.
“It’s pointed towards crisis; it’s pointed towards illness,” he said. “It’s pointed towards making sure you are born marginalized, making sure that you live marginalized, and making sure you die marginalized.”
