First Nations get second-rate care
First Nations medical patients in remote Ontario and Manitoba communities are left to deal with undertrained nurses, health and safety-code violations at nursing stations, and too much jurisdictional red tape, among other problems, according to Canada’s auditor general.
In his spring report to Parliament, Michael Ferguson laid out a litany of ways in which Health Canada is failing to provide proper health care to 54 First Nations communities. The report shows that only one in 45 nurses had completed all of the required training courses to work in challenging isolated communities.
Working in those places is difficult and often requires nurses to handle emergency situations they wouldn’t have been prepared for at nursing school. That’s why Health Canada requires five additional courses in specialized skills such as advanced cardiac and pediatric life support. Of the 45 nurses surveyed, only 12 per cent had completed the International Trauma Life Support training. Thirty-one per cent had completed the department’s training program covering the use of controlled substances in First Nations communities.
Health Canada spent $103 million in 2013-14 on clinical and client-care services at remote nursing stations across the two provinces.
These issues are not new. They were raised in 2010 by an internal Health Canada audit.
“We are concerned that this issue persists and that it could negatively affect the health services provided to First Nations individuals,” Ferguson’s report said.
In its response, Health Canada agreed that all nurses working in remote communities should complete the required training, but said that “significant vacancy and turnover rates” in the communities makes meeting that benchmark difficult. The first priority is to ensure that there are enough nurses with at least basic training, the department said.
The report also identified problems with the nursing stations themselves. In visits to the communities, the auditing team found problems including stations that lacked an emergency backup generator, improper door seals on the X-ray room, and defective locks on the nursing station itself.
In total, Health Canada could only show proof that it had addressed four out of 30 problems examined in the report.
Since 2009, Health Canada has provided $55 million for the construction or significant renovation of nine nursing stations, but the department could not demonstrate that the work had been done according to applicable building codes, the audit found.
The report also said Health Canada had not assessed the capacity of nursing stations to provide care, and didn’t take community needs into account when allocating resources.