Yellowknife (July 02/01) - Recommendations of a $375,000 report on health and social service fly in the face of self-government negotiations, say aboriginal leaders.

Not on the table Regardless of the aspirations of aboriginal governments, the GNWT will not be negotiating away control over health care any time soon. Long before the Cuff report arrived at the same conclusion, the territorial government believed the most pragmatic approach to health care is a centralized approach. A cabinet document entitled Fundamental Assumptions -- GNWT Policy Approach to Negotiating Self Government offers a description of the role cabinet sees the government playing once self-government is implemented. Along with highways, airports, and enforcement of territorial legislation and the Criminal Code the draft policy states the central government would retain jurisdiction over health care. Though the government may be willing to turn over control for program delivery to aboriginal governments, it is unwilling to negotiate anything other than the most minor legislative authority. The Dogrib agreement-in-principle provides for the establishment of an administrative board along the same lines as the Dogrib Community Services Board, but under the agreement the only health laws the First Nation can make are those respecting the practice of traditional medicine. There are currently no laws governing the practice of traditional medicine. The cabinet position and agreements signed to date lend credence to criticisms levelled by Thebacha MLA Michael Miltenberger. Miltenberger said the government offered the contract to produce the report to Cuff because it knew what it wanted to hear. Miltenberger, who also criticized the government for allowing only five weeks for public comment on the report, filed one of the first responses to report last Thursday. "Like so many before it, the report manages to capture the problems within the existing system, although the focus seems to be more on the boards than on the equally troubled department," Miltenberger stated.

"Our plan is to move on with what we're doing now," said Jackson Lafferty, chair of the Dogrib Community Services Board. "We don't want to pass control back to Yellowknife or Hay River."

Issues addressed in the report, which recommends health and social services be centralized, were dealt with long ago at the Beaufort-Delta self-government negotiation table, said Bob Simpson.

"We pretty well finished health and social services and child and family services negotiations two or three years ago," said Simpson, chief negotiator for the Gwich'in and Inuvialuit.

The Gwich'in and Inuvialuit have signed an agreement-in-principle on self-government. Health care is currently being negotiated as part of the Deline community self-government negotiations. A Dogrib Final Agreement on land and governance is on track to be signed this year.

Simpson said self-government negotiations in the Beaufort Delta address law-making powers in relation to social services, but added, "we're probably not going to see a dramatic shift in terms of health care" from the present system.

The review of health care, prepared by Alberta-based George B. Cuff and Associates, recommends radical changes to the present system.

Cuff suggests existing community and regional boards be scrapped and replaced by a three-tiered system that would give communities only an advisory role. A central authority that would answer to the Minister of Health and Social Services.

Simpson questioned why the government would want to tighten its grip on health care.

"They have all the control now. They still have legislative, standard-making, policy-making authority. All the boards do is carry out policy," Simpson said, adding the government allows some flexibility where program delivery is concerned.

Deh Cho Health and Social Services Board chair Allan Landry said a move to a more centralized system would be a step back to a system that is "politically and bureaucratically driven rather than community driven."

The Cuff report acknowledges self-government negotiations offer aboriginal governments "quite broad authority relative to social services and less relative to health services."

Communities would have greater access to health service under a system administered by the territorial government, the report states. Aboriginal leaders, however, say they are just as capable of governing health care in the same way.

"The thing that bothers me about this report is it doesn't give credit where credit is due," said Allan Landry, noting the Deh Cho board is running a surplus this year.