Society of Rural Physicians of Canada


President’s message

Margaret Tromp, MD
Picton, Ont.

Correspondence to:
Margaret Tromp

Can J Rural Med 2019;
V25(1) Winter 2020


President's message. 
Access or continuity?

Margaret Tromp, MD, FCFP, FRRMS
[full text]

Message du président. 
Accès ou continuité?

Margaret Tromp, MD, FCFP, FRRMS
[texte intégral]

Care delayed is care denied

Rural physicians are daily witnesses to the effects of the disparities in social determinants of health on their rural and indigenous patients and communities.

On 6 September 2019, the Canadian Human Rights Tribunal (CHRT) ordered the federal government to compensate thousands of indigenous children who were taken into care unnecessarily. The CHRT said that the Canadian government was ‘willful and reckless’ in its discrimination against indigenous children living on reserves. One month later, the federal government announced it would appeal the ruling.

Cindy Blackstock, a plenary speaker at the 2015 Society of Rural Physicians of Canada Rural and Remote conference, gave a moving account of the dispute between federal and provincial funders that made it impossible for Jordan Anderson, a child with a chronic terminal illness, to return to his home on a reserve in Manitoba. She emphasised the continuing disparities in funding, documented for nearly 20 years, for indigenous children living on reserve versus children living off reserve. In 2000, a national review concluded that the First Nations Child and Family Services agencies received 22% less funding per child than the average province. Inadequate funding particularly affects the provision of ‘least disruptive measures’, those measures that are provided to children at significant risk of maltreatment so that they can remain safely in their homes. Right now in Canada, three times as many First Nations children are separated from their families as were in residential schools.

In 2006, the Assembly of First Nations and the First Nations Child and Family Caring Society of Canada launched a formal human rights complaint. In January 2016, the CHRT ruled that the federal government knowingly underfunded child welfare and medical services for 165,000 First Nations children living on reserves. The Tribunal has subsequently  issued eight non‑compliance orders because so little action has been taken by the federal government.

The recent Tribunal ruling was a follow‑up to the original one and specified monetary compensation for the indigenous children and families that were separated in acontext of inadequately funded social services.

On October 6, the federal government launched an appeal to the CHRT decision, saying that ‘irreparable harm to Canada and the public interest if the stay is not granted exceeds the harm to the Respondents if the stay is granted’. Unfortunately, this means that these disparities will continue for the foreseeable future, as will their negative health effects. Can Canada do better?

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