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The Globe and Mail

Philpott may be right person to improve Indigenous health delivery

Globe and Mail writer Andre Picard.

The Globe and Mail

When Justin Trudeau appointed his first cabinet in November, 2015, he took a chance by appointing a rookie MP, Jane Philpott, as minister of health.

But her performance was stellar, and almost flawless.

Many were shocked to see Dr. Philpott lose the health portfolio in Monday's mini cabinet shuffle.

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But this is not a demotion.

The PM is taking a competent minister and giving her more responsibility and an even more daunting task in an area where the government is floundering.

In her new role as Minister of Indigenous Services, Dr. Philpott will still play a central role in health-care, but focus specifically on improving care for the country's 1.4 million First Nations, Inuit and Métis people.

Indigenous health is an area where the Liberal government has promised much and done little. It needs to reconcile talk and action.

Dr. Philpott may be the right person to do so. After all, she has handled a number of high-profile and politically delicate files.

She helped the government fashion and sell small-c conservative legislation on assisted death, action made necessary when the Supreme Court struck down provisions of the Criminal Code that made assisted suicide illegal.

Dr. Philpott also helped Ottawa negotiate and sign a health accord with all 13 provinces and territories by reaching separate but similar agreements with each jurisdiction. This kind of deal-making will be the cornerstone to reforming Indigenous health delivery in hundreds of disparate communities.

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She also guided a sea change in the federal government's response to illicit drugs, approving 14 new drug consumption sites, allowing the importation of medical-grade heroin and promoting a pragmatic harm-reduction message that is not always an easy sell with the public.

Just as importantly, but far from the public eye, Dr. Philpott did a tremendous job of boosting morale at Health Canada and the Public Health Agency of Canada, departments that had been neglected and marginalized for a decade under the previous government.

Such internal work will be even more challenging in her new role, because Indigenous and Northern Affairs Canada – which will be replaced by two new ministries, Crown-Indigenous Relations and Northern Affairs and Indigenous Services – has for far too long had a confrontational and condescending relationship with the people it is supposed to serve, and needs a good housecleaning.

The minister also begins her new role with a huge albatross around her neck, the Trudeau government's inexplicable legal battle against a January, 2016, Canadian Human Rights Tribunal ruling that found Ottawa is discriminating against First Nations children by failing to provide them with the same level of social and health services that are available to other Canadian kids.

In a prescient speech last week to the Canadian Medical Association's annual conference, Dr. Philpott said: "Of all the challenges that confront me as federal health minister, the most daunting is the need to address ... deplorable gaps in health outcomes faced by First Nations, Inuit and Métis peoples in Canada."

She added that poor health outcomes were a "direct result of government policies in our collective past, including the policy of residential schools" and that the way to improve Indigenous health was by focusing on social inequities such as housing, employment, education, community infrastructure and more.

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While Dr. Philpott's new title is Minister of Indigenous Services, her unofficial title will certainly be Minister of Social Determinants of Health.

Those are words Canadians are going to be hearing a lot more often in the months and years to come.

Meanwhile, new federal Health Minister Ginette Petitpas Taylor inherits a department that is stable and largely problem free.

Yet a couple of hot button issues will test her mettle.

Proposed tax reforms to professional corporations have infuriated Canada's doctors, 60 per cent of whom are incorporated.

Ms. Petitpas Taylor's previous role, Parliamentary secretary to the Minister of Finance, will help her with the technical details of that complex file, but it will not help her assuage the anger of the medical profession.

The new Health Minister will also have to be alert and responsive to the ever-problematic opioids epidemic, and to navigate the legalization of marijuana, which takes effect on July 1, 2018.

Like most health files she will have to handle, the work overlaps with that of public health and politicians in several departments federally, and many provincial and territorial jurisdictions.

If there is a lesson that Ms. Petitpas Taylor can take from her predecessor, it is to consult extensively and have the patience of Job.

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