In what the Yukon government is terming a “monumental” advancement in the territory’s health care system on “an incredibly important day,” the Health Authority Act was tabled in the legislature Monday.

A health authority is an arm’s-length agency that supports a system-wide perspective that enables better planning, improves efficiency and allows for innovative healthy system delivery methods. It strives to reduce the number of “silos” patients encounter in the system to a more streamlined approach to all facets of care.

An authority defines the roles and responsibilities, identifies the scope of programs and services and establishes principles for how the authority conducts its operations and interacts within the health and social services sector.

Developing an authority for the Yukon is a key recommendation from the Putting People First report, informed by extensive engagements with Yukoners.

Shäw Kwä’ą is the Yukon First Nations name proposed for the health authority. It means “it is all well, it is all good,” and embodies health and wellness in Southern Tutchone.

During a technical briefing held by government representatives Monday afternoon, reporters were told of a quintet of the reform’s overall aims:

• enhance patient experience;

• advance health equity;

• value for money;

• improve population health; and

• improve staff experience.

These “have become our guidepoint and our north star,” said Tiffany Boyd, the co-chair of the Health Transformation Advisory Committee and the deputy minister of Health and Social Services.

“This is the first step in a very long journey together.”

Stephen Mills, the commitee’s co-chair, called Monday “an incredibly important day for all of us.”

He compared the process to building a house.

“A health authority provides the framework foundation,” he said.

“ ... The legislation will not solve all the problems. There is a lot to build on this foundation.”

While the Health minister and the department will decide the “what” and the “how,” of the changes, Mills added, “Shäw Kwä’ą will define the ‘who’ and ‘how’ of (service) delivery.”

The proposed legislation sets the legal framework to create Shäw Kwä’ą (Health and Wellness Yukon Santé et mieux-être Yukon), the Yukon’s first health authority.

It sets the framework in which the health authority will govern and operate, addressing such essential areas as:

• Inclusive governance: Collaborating with Yukon First Nations to establish foundational governance frameworks and principles to address systemic racism, cultural safety and inclusive care.

• Equitable care: Involving patients, Yukoners and the workforce in how Shäw Kwä’ą (Health and Wellness Yukon) operates.

• Enhanced accountability: Establishing transparent mechanisms for accountability within Health and Wellness Yukon.

• Clear responsibilities: Defining program, service and functional responsibilities for both the Department of Health and Social Services and Health and Wellness Yukon.

The proposed Health Authority Act defines guiding principles for cultural safety, patient safety and quality assurance.

It prioritizes health promotion, disease and injury prevention, support for health care workers, innovation, continuous quality improvement and better health outcomes for Yukoners.

“Most of the work will be done in consultation and seeking consensus with Yukon First Nations,” Boyd said. “It will take time and it will take partnership.”

The 2024-25 fiscal year budget, tabled last Thursday, provides $9.4 million to continue the work to transform the health system and establish the health authority.

Today’s health care system was essentially designed some 70 years ago, Health and Social Services Minister Tracy-Anne McPhee told a news conference following the briefing.

“We heard that while the system has many strengths, there were some areas that could be improved,” McPhee said. “This is a blueprint for us going forward; this is people-centered.”

Still to come are extensive consultations with health care practitioners and the unions that represent many of them, she added.

“But this must be patient-centred.We need to break the system in order to rebuild it.”

That requires maintaining today’s services while planning for reforms, she noted.

“This is an extraordinary ask of anyone who is involved. This is a new beginning and a collective effort.”

McPhee anticipates many good ideas coming forward that will be examined and refined.

“None of it is carved in stone,” she said.

To implement what the minister called an “integrated care” system, some Health department employees will be transferred to the Health Authority.

“The Government of Yukon is committed to working collaboratively with Yukon First Nations leadership and other health partners to create an effective, efficient, integrated and population-centred health and social services system based on equity and respect for all Yukoners,” the government and the Council of Yukon First Nations said in a joint statement.

“While the proposed legislation is a crucial step to enable health system change, significant work to build and operationalize the new health authority, a process that may take up to three years, will begin once the act is passed.”

McPhee added, “This framework legislation, developed in partnership with Yukon First Nations and input from health system partners, is groundbreaking for the Yukon.

“This legislation sets the stage for creating a collective vision of a modern and responsive health care system to serve the needs of all Yukoners.”

Pauline Frost chairs the Chiefs Committee on Health, and and is the chief of the Vuntut Gwitchin First Nation.

“I would not be sitting here today had it not been for all the Yukoners speaking out on things like equity,” she said at the news conference.

“We heard directly from Yukon First Nations about the inequities they are experiencing.”

Frost kept hearing expressions of dismay that in such a small jurisdiction as the territory, “we are not providing the health care system we need. It was terrible. It was a system that was not being evaluated.”

Getting to this point, Frost noted, “took mere months. It is an indication of how important this is to us.

“The system we design has to be free of discrimination. We want a system that is integrated between all nationalities and all cultures. We are at the cusp of something amazing in the Yukon.”

First Nations would also like to see politics “removed from the conversation” in favour of “a clean lense,” Frost added. “I look forward to the coming months.”

Mills backed up Frost’s observations about discrimination in some components of the health care system.

“How do we look at removing systemic racism from the health care system?” he asked at the briefing.

Frost said in the YG/CYFN statement, “The Chiefs Committee on Health and the Health Transformation Advisory Committee are dedicated to advancing health transformation in the territory, in order to ensure that all Yukoners have better access to healthcare that is culturally safe and person-centred.

“The collaboration and consultation that occurred between Yukon First Nations and the Government of Yukon in developing this framework legislation showcases the advancements and innovations that are possible when we work together.

“We feel this legislation will set an important foundation for the work to come as we continue to collaboratively build Shäw Kwä’ą.”

McPhee had high praise for the numerous people who have paved the way for Monday’s announcement.

“We gave them almost no time to get us here,” she said. “It is truly amazing we are sitting here today.

The Health Authority Act was created in collaboration with the Yukon First Nations governments, senior officials, health system partners and providers.

The Chiefs Committee on Health provided oversight, and the 2020 Putting People First report’s two phases of public engagement provided further guidance in developing the act’s framework.

Besides the Yukon, Nunavut has been the only other Canadian jurisdiction without a health authority.

“A number of jurisdictions are looking at amalgamating several health authorities into one health authority,” Boyd noted.