Diabetes prevention strategy for First Nations failing due lack of co-ordination, report finds
The Canadian Press
The federal auditor general says two of the government's key pillars meant to improve the lives of aboriginal peoples have gone awry because of infighting, poor co-ordination and lack of planning.
Auditor General Michael Ferguson says attempts to deal with the fallout of the residential school system are a mess, as the Truth and Reconciliation Commission bickers with the federal government over what historical documents need to be provided and how they should be preserved.
And he says Ottawa's plans to deal with rising rates of diabetes — especially on First Nations reserves — are showing no results because government programs aren't working together or checking the effectiveness of their projects.
At stake are the mental and physical health of First Nations families across Canada at a time when aboriginal communities are crying out for better treatment from the federal government.
Time is running out for the Truth and Reconciliation Commission to fulfil its mandate of creating a historical record of residential schooling, which would serve as the basis for confronting the legacy left by 120 years of a system known for its emotional, physical and sexual abuse of children.
It has until July 2014 to put together a complete record, but Ferguson says work has barely begun because government departments and the commission have not been able to agree on the scope of the work.
"We are concerned that the lack of co-operation, delays and looming deadline stand in the way of creating the historical record of Indian residential schools as it was originally intended," he said.
Court battle over archives
The Truth and Reconciliation Commission is considered the cornerstone of Prime Minister Stephen Harper's apology to residential school survivors in June 2008, meant to give aboriginal families and other Canadians closure on a troubling part of our history.
Despite years of back-and-forth, the commission's work has been hampered by haggling over how far Aboriginal Affairs needs to go in digging up archived documents. The government had maintained that it only needed to hand over documentation that had already been tabled in court for survivors' lawsuits over the years.
But the commission wanted a far broader range of documents — a demand recently backed by guidance from Ontario Superior Court.
Library and Archives Canada estimates it will take $40 million and 10 years to find and digitize all the required records. The auditors say the documentation would need to be pulled from 80 different archives involving 135 schools, and would fill about 69,000 boxes.
Aboriginal Affairs Minister Bernard Valcourt said in a statement the government has already handed over 3.5 million documents, and is looking for a way to hand over the rest.
"We are working jointly with the commission to develop a project plan to fulfil document disclosure requirements," he said.
But the commission is afraid that when the government eventually gets around to sending it the paper, it will be swamped and left without enough time to handle it properly.
"My concern is that at the commission, we're going to get a document dump," commission chair Justice Murray Sinclair said in an interview.
The audit urges the commission and government departments to reach out to the survivors and aboriginal organizations to develop a practical solution soon. It also tells the commission that it needs to put together a solid plan to properly preserve the documentation. And all parties need to keep an eye on the clock.
Indeed, both Sinclair and Valcourt recognized the need to talk, and soon.
"We can work out a resolution relatively shortly if they tell us how much time they need," said Sinclair. He blamed the impasse on a shortage of government time and resources, and not on malicious intentions.
Strategy on diabetes prevention 'unco-ordinated'
Ferguson urged similar efforts to find a practical solution to the way the federal government handles diabetes, which proportionately affects two to three times as many aboriginal people as non-aboriginal.
The auditors found that the Public Health Agency of Canada, Health Canada and the Canadian Institutes of Health Research all have multimillion-dollar programs to prevent and control diabetes, but that the left hand doesn't know what the right hand is doing. Rather, each agency has its own track, and the results are fragmented and hard to evaluate.
"Activities remain largely unco-ordinated, and their impact is unknown," Ferguson said.
After seven years of contemplating how to deal with chronic disease, including diabetes, the Public Health Agency in particular "has weak management practices in place for delivering its diabetes prevention and control activities; for example, it has no strategy, priorities, deliverables, or timelines, and no performance measures," the auditors found.
About 2.4 million Canadians are living with diabetes, and about 20 per cent of cases remain undiagnosed, the audit says. Since health costs for diabetics are about three to four times greater than for people without diabetes, the strain on the health care system is considerable.
"The auditor general's report makes it clear that the Conservatives have made no progress in lowering the alarmingly high diabetes rates in Aboriginal communities," said Liberal aboriginal affairs critic MP Carolyn Bennett.
The government has agreed with all the auditor general's recommendations. Aboriginal Affairs says it will comply with the court's direction on providing residential schools documentation. And the agencies involved in diabetes programs say they are putting together a plan to co-ordinate and monitor results.
As for better co-ordinating action on diabetes, Health Minister Leona Aglukkaq said the Public Health Agency has now taken a new approach to chronic disease prevention that is based on partnerships with the private sector.
"We're encouraging innovation so that our funding has the greatest possible reach and impact for Canadians," said her statement.