-pledging that services would be maintained at their present level, and that we would make sure no individual suffers in the process of bringing spending into line. In accordance with this declaration a new set of directives were sent out to all field officers concerning these principles.
In reply to the hon. member for Brandon-Souris (Mr. Dinsdale) I might mention that the directive dated March 6, to which he specifically referred last Monday, was sent by the director of the Manitoba zone to the Indian bands in that province only. After my predecessor's remarks to the house a further correcting directive for Manitoba was sent during the latter part of April confirming the current level of services to individuals, as it was for the rest of Canada.
Replying to the question of a lack of federal-provincial consultation as implied by the hon. member for Churchill (Mr. Simpson),
October 2, 1968
which was prompted by the remarks of the Ontario health minister, Dr. Dymond, I should like to state that the held officers of my department, Drs. Thompson in British Columbia, Rath in the prairies, Butler in Ontario, Savoie in Quebec, and Hirtle in the Atlantic provinces, are in regular informal consultation with provincial deputy ministers.
In addition our Ottawa based officials have been in contact with their provincial counterparts at the last dominion council of health, at meetings of the advisory council on hospital insurance and during the general negotiations on medicare. Furthermore, the director of Indian health has been in special consultation at various times in the recent past with the provincial health departments in Saskatchewan, Quebec, Nova Scotia and Newfoundland. I myself, since assuming this portfolio, have discussed the field of Indian health with elected representatives of the provinces of Manitoba and Saskatchewan.
To be more specific about the matter raised by the hon. member, Dr. Dymond objected to a directive dated July 19 sent by our Ontario regional director, which in effect claimed provincial discrimination against reserve Indians on the question of OMSIP. The fact is that an Indian on a reserve who earns little or no taxable income is not eligible for a free or partly subsidized OMSIP certificate whereas another citizen in this indigent status, including an Indian not on a reservation, is entitled to a free or partially subsidized OMSIP card.
It is our hope for the future that the provinces extend health and medical services to reservation Indians on the same basis as they are extended to other citizens, including the same basis for payment. We feel that Indians should be full and equal citizens of the province in which they reside, and to further this intent we expect to be discussing the whole area of Indian health with the provincial health ministers before and during a federal-provincial health conference tentatively scheduled for the end of October. Pending new arrangements, it is our firm resolve to keep up our present level of services and improve them where necessary to make sure that no Indian is inadequately treated for personal health problems.
There remain two further matters mentioned in Friday's question period to clear up. First, on doctors' fees for treating indigent Indians under federal jurisdiction, I would like to say that doctors receive about 75 per cent of the provincial fee schedule in such
Statement on Indian Health Services cases, or approximately the same rate paid by either the respective municipality or province for treating non-Indians at public expense. Where the rate differs from this principle, other arrangements are made to pick up overhead costs, such as provision of clinical space.
On the second point raised by the hon. member for Brandon-Souris, that of drugs alleged to be dispensed to Indians by lay persons, I should like to say that this program in the provinces is an extension of a program long under way in our northern regions known as the lay dispenser program, which has been in effect there for over 40 years. The persons involved, after a training program at Sioux Lookout, are sent throughout the area mentioned in a recent press release to places either too small or too mobile for a permanent nursing station. The dispensers are trained to give first aid and may dispense simple drugs only on the directions of the nurses in the area with whom they get in contact by telephone to have prescriptions given. If the case is serious the nurse has the patient sent in to the nearest nursing station.
The ranks of lay dispensers are the best we can find and include licensed practical nurses, teachers, religious sisters, Indian women and ministers' wives whom we consider qualified. My department knows of no case of injury to health caused by treatment given by these people. In fact the program has been of tangible benefit to the people involved and in many cases has hastened recovery. If the hon. member knows of any specific instances where this program has resulted in any damage to any Indian's health, we will be pleased to review them. It is our information that the person who made these charges has since stated that he was not saying any deaths had resulted, but only that they theoretically might occur. As it stands, the dispensers provide better emergency medical services than are available to many other small communities in Canada.
[DOT] (3:00 p.m.)
I and the officials of my department are aware that, like any other service, there is a need for periodic review and improvement, and that Indian and northern health services is no exception. We are now conducting that review with a view to making improvements in both services, and to this end are now and have been conducting consultations with provincial authorities and, more importantly, with the heads of the Indian organizations themselves.
October 2, 1968
Statement on Indian Health Services
Subtopic: STATEMENT RESPECTING INDIAN HEALTH SERVICES