First Nations leaders pan Trudeau letter ducking request for seat at health-care talks

First Nations leaders are denouncing the prime minister’s pledge to advocate for Indigenous people during health-care talks with premiers this week — offered in lieu of an actual seat at the table — as an insult.

An exchange of letters between Justin Trudeau and RoseAnne Archibald shows the Assembly of First Nations national chief two weeks ago formally asked to be present during the discussions now unfolding at downtown Ottawa’s Delta Hotel.

The premiers are seeking a multibillion-dollar boost to health-care cash the federal government transfers to provinces and territories, but Ottawa says new money must come with conditions governing how premiers can spend it.

In-person First Nations attendance at the meetings is “imperative to ensuring First Nations are no longer an afterthought in Canada’s health-care system” given the complexities First Nations people face when trying to access care, Archibald’s Jan. 27 letter said.

First Nations people face significant health disparities for a variety of reasons, “all of which have been, and continue to be, exacerbated by years of policy inequity and government neglect,” the letter said, adding First Nations must also navigate a complicated patchwork of systems, jurisdictions and policies.

“By working together directly with myself and Canada’s First Ministers, your government has the opportunity, and obligation, to effectively dismantle these policy barriers and inefficiencies for the long-term,” Archibald wrote.

But in a Feb. 3 response obtained by CBC News, Trudeau sidestepped the request entirely, pledging only to advocate for Indigenous inclusion in the health-care system, and to press the premiers on that point.

Trudeau’s letter said the Tuesday gathering “is a working meeting” to discuss existing policies around health-care delivery in provinces and territories and not, as it’s been dubbed, a formal first ministers’ meeting.

“When we schedule the next First Ministers’ Meeting, we will include Indigenous participation,” the letter said, calling equal access to health care for all — including Indigenous peoples — a priority, but not an area exclusively under federal jurisdiction.

“With this, it is my expectation that going forward Indigenous peoples from each province and territory are included in health-care discussions,” Trudeau wrote.

Comment ‘not reconciliation:’ chief

First Nations leaders are responding by panning the pledge.

“We’ll not be ‘advocated for’ while we wait outside of rooms where we belong,” Archibald stated in a news release Monday, calling Trudeau’s commitment to reconciliation “performative.”

Ontario Regional Chief Glen Hare, who advocates for more than 130 First Nations in the province, called the response “a complete insult.”

At a news conference Tuesday on Parliament Hill, called to demand a nation-to-nation meeting on the issue, Gaius Wesley, chief of the Cree community of Kashechewan in northern Ontario, said the response is “not reconciliation.”

“It’s very inappropriate for the prime minister to say that he will represent the First Nations at these tables. It needs to be a First Nation leader,” he told reporters.

“It’s a wrong step the prime minister has taken.”

Wesley joined Grand Chief Alison Linklater of Mushkegowuk Council, who represents eight Cree communities in the northeastern part of Ontario, and NDP MP Charlie Angus, who represents the riding in the House of Commons.

Linklater called it disappointing to hear Ottawa saying it can advocate for First Nations in these meetings, especially northern ones.

“How can they say they can advocate for us and say what’s best for us? It’s totally way off base. Are they trying to fix us again?” Linklater said.

“That needs to stop. They need to have true partnership, nation-to-nation relationships with us.”

Struggles greater in the North

If the health-care system is buckling in southern parts of the country, Linklater and Wesley painted a grim portrait of an inefficient system, even deadly in some far northern parts.

People face arbitrary bureaucratic hurdles, confusing programs, jurisdictional bickering, pricey medevacs for routine procedures and forced relocations for specialized treatments, the chiefs said.

Patients with life-threatening illnesses are sent off with Tylenol as overworked and understaffed nursing stations struggle with supply shortages linked to remoteness and expensive shipping costs, the chiefs said.

“A lot of our people have died because of the system that the government continues to operate on reserves,” said Wesley.

Their demands for a nation-to-nation meeting with Trudeau echo similar calls for inclusion from chiefs in Saskatchewan and Manitoba. The Métis National Council also expressed “frustration and disappointment” with the exclusion.

Angus likewise criticized Ottawa’s approach and said Canada should focus on reforming the system on reserves rather than pressing for First Nations to take it over.

“I think what the federal government would love to do is devolve a broken system,” Angus said.

“But what they don’t want to do is put the money on the table to have equity.”