Action not words (en francais)

After years of inaction the Paul Martin Liberal government trumpeted the Kelowna accord as the First Nations "fix for a generation".

The Conservative government has committed to the goals of the Kelowna accord, but rather than blindly funding yet more initiatives, will work on fixing the delivery systems to ensure money and programs actually do what they are intended to do. While some progress has been made, the Auditor found that the progress on 15 of 37 key recommendations from the 2000 and 2003 audits were unsatisfactory.

Six years and the recommendations that most effect the lives of First Nations people have not been dealt with. Simply throwing $5.1 billion more dollars at the problem will not fix things.

What we examined

In this follow-up audit, we examined the progress of five federal organizations in implementing 37 recommendations we made between 2000 and 2003 on First Nations issues. The recommendations were included in chapters that covered housing on reserves, economic development, third-party intervention, health care, the food mail program, comprehensive land claims, and reporting requirements for First Nations. We also identified factors that appear to have been critical in successfully implementing our recommendations.

What we found

• Overall, the federal government's progress in addressing our 37 recommendations on First Nations issues has been unsatisfactory. While the issues are extremely complex, federal organizations had agreed with most of our recommendations and had committed to taking action. We found their progress on 15 of our recommendations to have been unsatisfactory. These are generally the recommendations that are most important to the lives and well-being of First Nations people. We found that little had been done to deal with the serious problem of mould in houses on reserves. We also found that progress has been unsatisfactory in analyzing patterns of prescription drug use and drug-related deaths among First Nations people, implementing comprehensive land claim agreements, eliminating unnecessary reporting required of First Nations communities, and addressing gaps in the Third Party Manager Policy.

Here's a good example:

5.30 In our 2004 audit of the management of federal drug benefits programs, we found that Health Canada had not conducted any analysis of prescription drug use since 1999. Instead, it had spent the previous four years trying to obtain client consent. It had obtained consent for only about 25 percent of clients before stopping this effort in March 2004. We found that the number of clients obtaining more than 50 prescriptions over a three-month period (a criterion used by some provincial bodies to identify cases for review) had almost tripled compared with what we found in our 2000 audit.

This program as of 2000 had annual expenditures of $530 million. Further:

5.33 In this audit, we found that Health Canada still does not gather data on prescription drug-related deaths. Nor has it sought enabling legislation for its Non-Insured Health Benefits program. In November 2004, the Department resumed its analysis of prescription drug use, but, at the time of our audit, it was not yet able to identify reductions of inappropriate prescription drug use due to its intervention. Its current approach is only to seek consent, on a case-by-case basis, from those clients for whom the Department has not already done so, before informing health providers or pharmacists of concerns related to prescription drugs. There is still no enabling legislation for the Non-Insured Health Benefits program, and the rights and obligations of the Department and its clients have not been defined.

On mouldy housing:

However, without management's sustained attention, facilitated by a strategy or action plan, the scale of the problem has not been identified, priorities for action have not been established, and no overall plan for co-ordinating federal organizations' efforts or monitoring overall progress has been developed. Without a strategy and action plan to address this problem, First Nations communities may continue to experience premature deterioration of their housing stock and negative health effects on their people