Indigenous and Northern Affairs committee  To give a little bit of context, around 20 years ago there was an agreement between the federal government and the territorial government about the transfer of primary health care services responsibility to the Northwest Territory government. Health Canada's first nations and Inuit health branch doesn't provide community-based health services in this territory.

Indigenous and Northern Affairs committee  There will be one.

Indigenous and Northern Affairs committee  Mr. Chair, members of the committee, thank you for inviting Health Canada's first nations and Inuit health branch for this briefing on first nations and Inuit health programs. Health Canada is committed to ensuring that first nations and Inuit communities and individuals are receiving a range of health programs and services that are responsive to their needs.

Public Accounts committee  I will ask Valerie to get on this one.

Public Accounts committee  I agree with you, we need to have a comprehensive approach based on determinants of health. We are working on providing health care services and we are working on prevention and promotion. We need to change people's lifestyles, encourage physical activity and support good nutrition.

Public Accounts committee  I may conclude? I was going to add that we work to ensure that these aspects are linked to our work. We work on community planning with the communities so that we can develop new strategies. We talked about accommodation and water quality. We have to solve these problems because if we want better health results, we obviously can't only focus on health services.

Public Accounts committee  And we have to support the process when there is a joint priority, to make it happen.

Public Accounts committee  It's not a question of non-compliant medication being distributed, but of the number of Health Canada nurses who were working in remote nursing stations who have the training concerning controlled medications. It is possible to renew that training. I will ask Robin to confirm if that happens every year or every two years.

Public Accounts committee  That is not really a satisfactory result, and I think that we admitted that in our response. The Auditor General's report, which was based on a sample from Manitoba and Ontario, gave us an overall compliance grade of 1%, but that was a very small sample. After having reviewed our files and attempted to provide a certain level of training, we now have 46% of nurses in nursing stations who have completed the five points of training which are listed in the policy.

Public Accounts committee  Nurses are an important part of the health services provided in remote communities. But they are not the only part of the services provided. We provide funding for a certain number of programs. You mentioned nutrition. We fund a prenatal nutrition program. We also fund nutrition education programs and the diabetes prevention program and the diabetes support program.

Public Accounts committee  Thank you. One of the things we have done for almost 15 years now is we have invested in health human resources not only to attract people from the south to working in first nation communities, but also to increase the number of aboriginal health workers. This has been an important investment for the branch.

Public Accounts committee  There are housing arrangements in most communities. Health Canada has built with the first nations a nursing residence near the nursing station, and those are considered to be facilities we support. They are owned by first nations, but we invest in there and nurses have access to these residences.

Public Accounts committee  We have an oral health initiative that focuses on zero to seven-year-olds, mainly focusing on prevention to avoid decay, dealing with early problems, putting sealant on teeth to prevent further problems in the future, and changing behaviour. We rely heavily on dental hygienists to practise in the community.

Public Accounts committee  I agree with some of his points, obviously, that work in the communities is challenging. It's not an easy task. The isolation factor, as I mentioned before, with its small teams and lack of connection, is a challenge. The infrastructure is a challenge as well, because it is really far to go there and to have problems fixed.

Public Accounts committee  As part of the recruitment and retention strategy, one thing we are trying to do more and more is inform the nurses about the working conditions and the type of work they will be asked to do in the communities. We want to make that when we invest in training and integrating these people into the health team, they will stay in the business, and there won't be surprises for them up there.