People living in remote First Nations communities in Manitoba and Ontario aren't guaranteed to have access to clinical and client care services or medical transportation benefits, Auditor General Michael Ferguson said in his report Tuesday.

The report found serious problems, including that only one of 45 nurses in the group sampled by auditors finished all five mandatory Health Canada training courses chosen for the audit.

An internal audit raised flagged the problem five years ago.

Carolyn Bennett, the Liberal critic for aboriginal affairs, called the report "devastating."

"It's clear that this government has known about many of these issues since 2010, and it frankly looks like they have done nothing about it.… There's been no strategy."


Julie Castel was on a ventilator for about a week after she and her mother were flown out of the Pukatawagan First Nation in Manitoba in 2011. (Family photo)

Vacancies and high turnover rate in these communities mean Health Canada's first priority is having enough nurses to staff health-care stations.

Health Canada also identified 30 "deficiencies" in the nursing stations chosen for the audit. Only four were fixed, but Health Canada couldn't find paperwork to prove it.

In one case, a nursing station residence was unusable for more than two years because of a broken septic system, leading medical specialists to cancel visits.

"These numbers that we're seeing are totally unacceptable. Can we even call it a health-care system?" said David Harper, grand chief of the Manitoba Keewatinowi Okimakanak.

"Our First Nations need better access to health care, just like any other Canadian in this country."

Nishnawbe Aski Nation Deputy Grand Chief Alvin Fiddler said he was glad to see the auditors "get it," and that they put into the report what they heard from front-line workers, elders and youth.

Fiddler cited a recent loss on a remote First Nation linked to deficient health care.

"We lost two four-year-olds of strep-throat-related conditions; if they had seen a doctor or nurse … if someone had given them penicillin … but they didn't get it, and they died."

"The report confirms what we've always said — that in my view the report is a strong indictment on Canada's continued failure to provide a health-care system that is equitable, that is accessible," he said.

"We need to move beyond the report … there are conditions in our community that have an impact on our health. Poor housing conditions, lack of clean drinking water, food security," Fiddler said.

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With files from Susan Lunn