Developing a New First Nations Health Governance System: Creation of an Independent, First Nations Run Organization

Abstract

In 2011 a tripartite agreement between the province of British Columbia (BC), Health Canada, and First Nations leaders created the First Nations Health Authority (FNHA): a unique approach to First Nations health governance. The creation of the FNHA came after almost ten years of discussion and agreements between the three parties. The goal of the FNHA is to address health disparities between First Nations and other residents of BC, as well as increase the voice of First Nations people in the health system. The issues that led to the creation of the FNHA came onto the government's agenda due to an increased knowledge of the health crises facing BC First Nations, and a growing interest throughout Canada in increasing First Nations autonomy and input. In 2013 Health Canada transferred authority over all First Nations health programming to the FNHA, with the hope that an independent, First Nations run organization would better address the health-related needs of First Nations people. While evaluation of the FNHA is limited presently, since it only released its first five-year plan just over a year ago, a 2015 report by the Auditor General gives some insight into how the FNHA is functioning. If the FNHA can overcome a few weaknesses and threats to its stability, it has the potential to guide First Nations self-determination with respect to health care in Canada.

Keywords

• Indigenous health
• British Columbia
• First Nations
• autonomy
• health governance