Issues Highlighted by the Romanow Report

The report identifies significant problems in the way that aboriginal health is managed. Surprisingly, this is largely not due to a lack of funding; there is simply a mismanagement of assets. Funding sources are fragmented and there is no established system to provide care. In addition, there are extensive equity concerns due to this fragmentation of funding and differential care available to different Aboriginal communities.
As a result, the report suggests that new administration procedures be put in place. Integration of on-reserve healthcare into the current system is not a popular option amongst aboriginal leaders, although serves as a reasonable option for urban aboriginal healthcare. Specifically, the report suggests the formation of Aboriginal Partnerships that are an administrative authority composed of representatives from different levels of government and the aboriginal community.
These partnerships may work in a method similar to a regional health authority. They will serve as an organization with a specific health goal, such as organizing the public health and primary care for a community. The partnership will be granted federal funds to pursue these health goals in a manner that Partnership executives agree upon. Aboriginal representation in the Partnership ensures that these services are fitting with the cultural needs of the Aboriginal community. Partnerships will also interface with the existing health system to coordinate access to resources such as diagnostics and specialized care.
In an urban setting, the Partnership will serve as a voluntary health organization that coordinates access to specific health facilities such as primary care and diagnostics. The Partnership will have similar representation from Aboriginal community ensuring that services provided in the urban environment are still sensitive to Aboriginal cultural and linguistic concerns. Partnerships are especially needed in urban settings due to the specific needs of urban Aboriginals for problems such as diabetes and addiction. Furthermore, Partnerships may serve as an additional urban community organization that interfaces with other such Aboriginal organizations to serve as activists for the socioeconomic status of Aboriginals.
An important point stressed by the Romanow report is that healthcare initiatives must be accountable towards the taxpayer and consumer. Aboriginal health is no different; Partnerships must be closely monitored and their effect on health outcomes determined. Changes in policy may be necessitated as this is a new approach