Indian Health Transfer Policy

The Canadian Indian Health Transfer Policy provides a framework for the assumption of control of health services by Indigenous peoples in Canada and set forth a developmental approach to transfer centred on the concept of self-determination in health. Through this process, the decision to enter into transfer discussions with Health Canada rests with each community. Once involved in transfer, communities are able to take control of health program responsibilities at a pace determined by their individual circumstances and health management capabilities.

To put health transfer in context, it is useful to understand from a historical perspective how First Nations, Inuit, Métis and the Canadian federal government through Indian and Northern Affairs have worked together to respond to Indigenous peoples expressed desire to manage and control their own health programs.

The White Paper was a federal government policy paper which proposed to remove the status of treaty individuals under the Indian Act and to discontinue special services so identified, advocating the increased assimilation of Indigenous people into the culture of Canada.

The Red Paper was an Indigenous response to the White Paper emphasizing federal responsibility for health care for First Nations peoples and emphasizing plans to strengthen community control of their lives and of government-delivered community programs.

The White and Red Papers served as an impetus for the collaborative effort of the federal government and Indigenous peoples to begin serious planning for the future.

This resulted in the 1975 paper, The Canadian Government/The Canadian Indian Relationships, which defined a policy framework for strengthening the control of programs and services by Indigenous peoples. In the health sector, under contribution agreements 75 percent of the bands became responsible for such programs as the Native Alcohol and Drug Abuse Program and the Community Health Representative Program.

The stated goal of the Indian Health Policy adopted by the federal government on September 19, 1979, was "to achieve an increasing level of health in Indian communities, generated and maintained by the Indian communities themselves". In this regard, the policy emphasized the historic responsibilities of both federal and provincial governments to provide health services to Indigenous peoples in Canada. It removed the issue of treaty rights from health policy considerations.

The policy reasoned that improvements to the health status of Indigenous peoples should be built on three pillars: (1) community development, both socio-economic and cultural/spiritual, to remove the conditions which limit the attainment of well-being; (2) the traditional trust relationship between Indian people and the federal government; and (3) the interrelated Canadian health system, with its federal, provincial, municipal, Indigenous and private sectors.