A Tla’amin (Sliammon) First Nation community member heads up the first and only first nations health authority in Canada.
Joe Gallagher is chief executive officer of First Nations Health Authority (FNHA), which, on October 1, took over health services, programs, employees and resources from the federal government, which is responsible for health services on reserves.
Gallagher left Tla’amin in 2005 to take a senior management position with Health Canada in its first nations programs. He had been Tla’amin’s chief treaty negotiator, a file he worked on for 10 years.
A new relationship between BC first nations, the province and the federal government was forged in 2005 with the signing of the Transformative Change Accord. The first plan to come from the accord was the first nations health plan, followed by a series of agreements that led to the creation of FNHA. Gallagher has been involved with the agreements from the beginning and was identified as the person who would supply, from the operational level, the support to implement the plan.
Now, as chief executive officer of FNHA, Gallagher has the responsibility for almost 300 staff, an annual budget of $377.8 million and capital resources including nursing stations and office space throughout the province.
FNHA plans, designs, manages and funds the delivery of first nations health programs and services in BC. The community-based services are largely focused on health promotion and disease prevention, such as primary care services, mental health and addictions programming, health infrastructure, environmental health and research and non-insured health benefits.
The work will flow not from the top down, but from the ground up, said Gallagher. “What we’re trying to move towards is delivering these services, but through a first nations decision-making structure, rather than a federal government decision-making structure,” he said. “There’s a recognition that things will work better if first nations decide for themselves how they want to do things.”
The work doesn’t replace the role or services of the provincial ministry of health and regional health authorities. FNHA collaborates, coordinates and integrates its respective health programs and services to achieve better health outcomes for BC first nations.
When he left Tla’amin, he decided to work in the health field, because health is common to all first nations communities, Gallagher said. “Our health status isn’t as good as everyone else’s, so it becomes a very interesting common denominator,” he said. “We can work to help people live well and be healthier and it just makes everything else a little bit better.”
The work is focused on health from a wellness perspective, Gallagher explained. “We want to be champions of health and wellness and partners with each of our communities and all of our first nations people in the province of British Columbia on their health and wellness journey.”
He is excited by the work, Gallagher also said. “It really is, can we help people live a little better today by helping them make better choices, perhaps, on the kinds of food they eat, the kinds of activities they partake in, understanding how to manage their stress, all those kinds of things,” he said. “Fundamentally it goes to the very individual level as well as working through the community, nations and family infrastructure we have, just to try to make a better quality of life for people.”
The kinds of services and functions that FNHA takes on from the federal government have a larger proportion of the work focused on prevention and promotion, whereas the other health authorities are focused on providing acute care systems to treat sickness, Gallagher said. “We have the opportunity to help the province, which knows that it needs to shift from such a major investment on the sickness side to more preventative, upstream measures so that it can have hopefully a more sustainable system overall,” he said. “We might be able to help put in place, through a first nations wellness concept, a model of care that is different from the way the mainstream provides it, which can be beneficial for all British Columbians.”
