Co-developing distinctions-based Indigenous health legislation
Together with Indigenous partners and the provinces and territories, we are co-developing new distinctions-based Indigenous health legislation to improve access to high-quality, culturally relevant health services.
Current status: Open
The Minister of Indigenous Services publicly launched the engagement on January 28, 2021.
On this page
Why
As indicated in the September 2020 Speech from the Throne, the Government of Canada is committed to walking a shared path of reconciliation with Indigenous peoples and remains focused on implementing the commitments made in 2019.
The Government of Canada acknowledges the challenges faced by Indigenous peoples, including First Nations, Inuit and Métis in accessing culturally safe care. Canada is committed to working in partnership to advance the priorities Indigenous peoples put forward when it comes to health care. The mandate letter for the Minister of Indigenous Services commits to "fully implement Joyce's Principle and ensure it guides work to co-develop distinctions-based Indigenous health legislation to foster health systems that will respect and ensure the safety and well-being of Indigenous Peoples." It is part of the Government of Canada's commitment to address the social determinants of health and advance self-determination in alignment with the United Nations Declaration on the Rights of Indigenous Peoples.
The co-development of distinctions-based Indigenous health legislation is an opportunity to:
- establish overarching principles as the foundation of federal health services for Indigenous peoples
- support the transformation of health service delivery through collaboration with Indigenous organizations in the development, provision and improvement of services to increase Indigenous-led health service delivery
- continue to advance the Government of Canada's commitment to reconciliation and a renewed nation-to-nation, Inuit-Crown and government-to-government relationship with Indigenous peoples based on the recognition of rights, respect, co-operation and partnership
What co-development means
Co-development is a collaborative approach that acknowledges the distinct nature and lived experience of First Nations, Inuit and Métis. This approach is guided by:
- the Truth and Reconciliation Commission's Calls to Action
- the United Nations Declaration on the Rights of Indigenous peoples
- the Calls for Justice in the final report of the National Inquiry into Missing and Murdered Indigenous Women and Girls
- the Principles respecting the Government of Canada's relationship with Indigenous peoples
Co-development will happen in 2 stages:
- broad engagement with First Nations, Inuit, Métis, provinces and territories, subject matter experts and other groups to determine the co-development pathway
- co-development of legislative options
Learn more about how legislation is developed:
Who
The Government of Canada will engage:
- national and regional Indigenous organizations
- First Nations, Inuit and Métis leadership
- self-governing Indigenous governments and Treaty nations
- Indigenous women's organizations
- provinces and territories
- subject matter experts
- health professionals
- other groups
What
We will work together with Indigenous partners to:
- co-develop an approach to engagement
- co-develop options for potential federal legislation
- ensure that the distinct cultures, needs and aspirations of First Nations, Inuit and Métis are understood and reflected in any potential legislation
We will also work with the provinces and territories to make sure potential federal legislation:
- is informed by provincial and territorial perspectives
- is complementary to existing provincial and territorial health systems, self-government or tripartite models
- does not infringe on provincial jurisdiction or the territorial role in health
Principles guiding engagement
- Engagement will be inclusive, with multiple opportunities and avenues to engage or re-engage.
- Engagement will be primarily Indigenous-led. Specific engagement plans will be developed by Indigenous organizations and governments.
- Engagement will take place multilaterally with federal, provincial, territorial and Indigenous organizations and governments.
- Engagement is not endorsement. All feedback is being sought, whether it is in support of legislation or not.
- Engagement is not co-development. Engagement will inform a specific co-development process or structure for this initiative, honoured by articles 18 & 19 of the United Nations Declaration on the Rights of Indigenous Peoples.
Engagement approach
In recognition of the right to self-determination, engagement is being led primarily by First Nations, Inuit and Métis Nation partners at the national, regional and sub-regional levels.
ISC is also hosting sessions to complement the First Nations, Inuit and Métis Nation-led sessions. Multiple streams of engagement are underway.
| Engagement stream | Participants |
|---|---|
| Stream 1: Regional engagement |
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| Stream 2: Targeted outreach |
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| Stream 3: National engagement |
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| Stream 4: Seeking Wisdom: Open Dialogue |
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| Stream 5: Provincial/territorial engagement |
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| Stream 6: IHL inbox |
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If you feel that there are groups, organizations or individuals missing from the engagement streams above, please Contact us.
About Indigenous health care in Canada
The organization of Canada's health care system is largely determined by the Canadian Constitution. Roles and responsibilities are divided between the federal, provincial and territorial governments. Generally, provinces and territories have primary jurisdiction over the administration and delivery of health care services. Indigenous communities also play an important role in the delivery of health services and programming.
The federal government exercises a role in health care primarily through the use of the federal spending power. For example, the Canada Health Act is Canada's legislation that imposes national standards on provincial health care insurance plans as a condition of accepting a federal contribution to the cost of those plans.
With respect to health care for Indigenous peoples, which include First Nations, Inuit and Métis, the federal, provincial and territorial levels of government share some degree of jurisdiction. Indigenous peoples are included in the per capita allocations of funding from the federal fiscal transfer and are entitled to access insured provincial and territorial health services as residents of a province or territory. Indigenous Services Canada funds or directly provides services for First Nations and Inuit that supplement those provided by provinces and territories, including primary health care, health promotion and supplementary health benefits. The federal role is guided by the 1979 Indian Health Policy's 3 pillars:
- special relationship with "Indians"
- inter-relationships with provincial and territorial health systems
- community development
The term "Indian" is only used when referring to or citing the 1979 Indian Health Policy.
Any federal legislation in the area of health care must be developed in consultation with provincial and territorial governments and with careful attention to the constitutional division of powers.
Learn more:
How to participate
There are 2 ways to participate:
- attend an engagement session. Please contact us to learn more
- send comments directly by email or mail to the address listed in contact us
Indigenous Services Canada has developed an engagement guide designed for individuals, Indigenous governments, organizations or communities to help guide their engagement sessions and personal reflections regarding the co-development of distinctions-based Indigenous health legislation. You may wish to consult the guide to inform your participation in an engagement session or your direct comments via correspondence. It is not meant to be a restrictive tool and can be used or disregarded at your discretion. Please share your thoughts however you prefer.
This engagement guide contains:
- background information
- a short list of existing literature
- proposed engagement questions
- a template for submitting feedback from your session to the Government of Canada
What we're hearing
- 2 Spirit Health Legislation Project: Final Report
- A New Trail to Blaze: Moving toward an Equitable Access to Healthcare in Urban Areas for Indigenous People
- An Open Dialogue on Indigenous Health Legislation: Summary report
- Indigenous Youth Reforming Healthcare
- Inuit Sexual and Reproductive Health: Supporting Inuit Families and Communities
- Our Health, Our Voice: Advocating for Urban Indigenous People in Distinctions-based Healthcare Legislation
The national report summarizing feedback received from engagement sessions, What we heard: Visions for Distinctions-based Indigenous Health Legislation, is now available:
- online, as an executive summary
- in full, by request to lsa-ihl@sac-isc.gc.ca
Contact us
Indigenous Services Canada
Distinctions-based Indigenous Health Legislation
10 Rue Wellington Suite 1455
Mail Stop 1921C
Gatineau QC K1A 0H4
Email: lsa-ihl@sac-isc.gc.ca