Senior bureaucrats tasked with providing health care to Canada's First Nations children say they have had trouble spending new money aimed at closing care gaps because the system is "broken" and there is a lack of capacity on the ground in Indigenous communities.
More than a year ago, the Canadian Human Rights Tribunal ruled that the federally run First Nations health-care system is discriminatory and demanded the government provide services to Indigenous kids at the same level as those provided by the provinces to children living off-reserve.
But as CBC News first reported Wednesday, Health Canada has spent only a quarter of the $127 million budgeted this year to implement Jordan's Principle, a federal policy that stipulates no Indigenous child should suffer denials, delays or disruptions of health services due to jurisdictional disputes.
(Unlike other children, health services for First Nations living on reserve are funded almost exclusively by the federal government.)
On Jan. 11, eight months after the new money was allocated, Health Canada filed documents with the tribunal to say it had spent only $11.5 million of the funds — or 10 per cent — helping just 1,500 First Nations kids get care.
But new numbers released Wednesday show spending has more than doubled in the past month and the government has now "identified" 3,000 children who require treatment at a cost of $30-40 million — a marked increase in a short period of time.
New numbers released
Jordan's Principle is named after Jordan River Anderson, a five-year-old boy with serious and complex medical needs who died in hospital in 2005 after a drawn-out court battle between the federal government and Manitoba over who should pay his home-care costs.
The new funding was earmarked for services previously denied by Health Canada — but covered by the provinces — such as mental health supports, home care and help for children living with disabilities, as well as for things as basic as infant formula, hearing aids and wheelchairs.
"There is really something broken with the system in terms of not being able to connect with the children." - Sony Perron, top bureaucrat at Health Canada's First Nations and Inuit health branch
Sony Perron, senior assistant deputy minister of Health Canada's First Nations and Inuit health branch, said spending got off to a slow start because the government has had problems connecting with children in need due to inadequate "case co-ordination capacity," or people on the ground.
"There is really something broken with the system in terms of not being able to connect with the children," he told CBC News. "We don't have the infrastructure to identify these children in need that are underserved."
Perron would not say if he thought spending levels to date have been acceptable, but he said Health Canada has a strong resolve to provide care to children in need.
"I totally understand the frustration," he said. "I totally understand why people are looking for solutions to problems that have been outstanding for a long time."
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Despite the obstacles, a lot of "hard work" has allowed Health Canada to double the number of children it cares for, Perron said.
The new money allocated to deal with Jordan's Principle will help Health Canada further develop its capacity to provide timely care, he added, noting that the department will have teams in place across the country by April to better identify cases.
"It's coming. It takes time."
Uneven results nationwide
While the number of First Nations children accessing care has increased under Jordan's Principle, the results are uneven across the country.
The latest numbers show that 20 children in Atlantic Canada, 18 in Alberta, 16 in Quebec, four in B.C. and two in the North have been green-lighted for treatment since the money was rolled out last July.
By comparison, 2,217 children in Manitoba, 600 in Ontario and 404 in Saskatchewan are now getting help.
"That's 3,200 kids that were not getting care a year ago … We will keep going until we identify every child that's not getting care. I'm absolutely committed to the full implementation of this," Health Minister Jane Philpott said in a scrum after Wednesday's question period, echoing her officials.
"We know that there are many more children out there that have not previously been identified. But we've got the resources for this and we are going to make sure that kids get care," she added.
"There should be absolutely no discrimination on the basis of which jurisdiction pays for the care."
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Part of the discrepancy between the provinces can be explained by the fact that Health Canada didn't have adequate data from each region, Perron said.
The department didn't know, for example, how many First Nations children were in need of assistance or how many had been turned down for provincial coverage due to the fact they were status Indians.
In the wake of Jordan's death, Manitoba was "ahead of the curve" and had better records, he said, which is why many more children in that province received home care, mobility aids and other services in the first eight months.
Jordan's Principle cases as of Jan. 11, 2017
Jordan's Principle cases as of Jan. 11, 2017 (PDF KB)
Jordan's Principle cases as of Jan. 11, 2017 (Text KB)