The Yukon government has committed to improving healthcare in the territory by implementing all the recommendations in a recent report calling for reform, but advocates say the work has just begun.
The Yukon Medical Association said it was surprised by the government’s announcement, and has concerns about a number of the recommendations.
“The doctors of Yukon are very concerned about the announcement to accept all 76 recommendations contained in the report without properly consulting first with the YMA,” said acting president Ryan Warshawski in a statement.
“Many of these recommendations will have a direct impact on the lives and livelihoods of all Yukoners, not just doctors, and we have not yet had a chance to discuss the implications of the report with the government,” he said.
The association said it is currently in the process of critiquing the report. It still intends to present feedback to the government and “remains committed” to working with the government on implementing the report.
The Putting People First report is a 204-page document made public on May 13 that focuses on reforming the current healthcare system in the Yukon and aims to improve health outcomes while lowering costs.
“I’m really happy to be honest, I didn’t expect the government to accept all the recommendations,” said panelist Diane Strand, one of two current Yukon residents who sat on an independent five-person panel to help craft the report.
Strand said the report is wide-ranging, and it became more expansive as panelists sat down and realized how much needed to be done. Recommendations range from improved mental health support to reconciliation efforts to affordable childcare. All are interconnected.
As part of the report, panelists looked at how other communities approached care, including the Southcentral Foundation — an Alaska Native health care organization — located in Anchorage, Alaska.
“You don’t realize that things could be done differently because it’s so ingrained. To have that change happen is going to take a lot of work. It’s going to take some time and it’s going to take commitment from many people,” she said.
Chapter four of the report is dedicated to improving the health care system for First Nations people.
“Around the Yukon, it was really evident in hearing the stories from First Nations in some communities, that there was a stark difference between the First Nations people and (non-First Nations people), and the treatment that they have received. It was really quite evident,” Strand said.
Council of Yukon First Nations executive director Shadelle Chambers said she is optimistic about the reforms in the report but said it’s important that First Nations continue to have a voice as the system evolves, particularly in a new central agency like Yukon Wellness.
“Those chapter four recommendations are really important and powerful in how First Nations are involved in the delivery of healthcare for their own people,” Chambers said.
Chambers said both physical and cultural barriers currently exist to accessing care.
The report mentions both cultural humility and cultural safety — words that Strand said refer to existing racism in the system that needs to be addressed.
Many residents, both Indigenous and non-Indigenous, also live in remote communities where access to care and transportation are difficult to coordinate.
Strand gave an example of a Beaver Creek man who was booked for a 10 a.m. medical appointment in Whitehorse. More sensitivity to the needs of remote communities would ensure an afternoon appointment time that accounted for the five hour drive into town.
For most people health care services are managed by the territory. But currently, Indigenous people in the territory who have formal status under the Indian Act have their health services managed by the federal government. Chambers said the reforms need to consider how that “two-tier” system currently presents challenges for accessing care.
She also referenced the coroner’s inquest earlier this year into the death of Cynthia Blackjack, a 29-year-old Carmacks resident who died on a medevac flight to Whitehorse in 2013. The case raised a number of questions about barriers to care and systemic racism and resulted in eight recommendations for change to the health care system.
“Yukon First Nations look forward to working with the Yukon government. Let’s work together to implement the changes that are needed here,” Chambers said. “It’s a starting point for a paradigm shift for how we deliver health care in the Yukon.”
Contact Haley Ritchie at firstname.lastname@example.org