First Nations pharmacist says Sask. should extend consultation program to include Indigenous people

Canada's first self-identified First Nations doctor of pharmacy says a program funded by Saskatchewan is discriminatory toward Indigenous people.

"When the system treats people differently based on their racialized identity or ethnicity that would be systemic racism. So the system is being racist," said Swidrovich, an assistant professor in the College of Pharmacy and Nutrition at the University of Saskatchewan and a Saulteaux member of Yellowquill First Nation.

The Saskatchewan Medication Assessment Program (SMAP), a provincially funded program that began in 2013, allows those with a valid Saskatchewan health card to access a one-hour consultation with a pharmacist to review a person's medical history and medication. The assessment helps the patient understand their medical history and allows for pharmacists answer questions about side effects, medication interaction and what the medications do.

Criteria for the program include being over the age of 65 years-old, be taking five or more long-term medications, have a chronic disease or have been recently discharged from a hospital.

According to the Saskatchewan government website, people whose health services are covered by the federal government — including First Nations and Inuit people, those covered by the Department of Veterans Affairs or Worker's Compensation, those in federal penitentiaries, RCMP officers and refugees — are not eligible for drug plans and benefits from Saskatchewan Health.

Swidrovich said not including First Nations people in all of the services the province has to offer may contribute to the gap in health outcomes between Indigenous and non-Indigenous people.

"We're certainly not making it any better and we're not really reducing that gap," Swidrovich said. "In fact we're probably widening the gap by not including First Nations and Inuit people in the comprehensive services that pharmacies have to offer."

Swidrovich began a petition in April requesting that Indigenous services cover the pharmaceutical cost to allow SMAP services be covered for First Nations and Inuit people in the province.

"I think that all pharmacists are willing to do, you know what's absolutely necessary for anyone, but this is a special service where people often will have to book and appointment that leave certain people out," Swidrovich said.

Swidrovich's petition garnered nearly 1,000 in 30 days. After being ratified it was presented to the House of Commons last week. The Minister of Indigenous Services now has approximately 45 days to respond.

Kristjana Gudmundson, director of professional practice at the Pharmacy Association of Saskatchewan, said the organization will always advocate for people in the province to receive pharmacy services.

"Aside from this program there are other pharmacy services that are provided that are paid for by the drug plan to all residents of Saskatchewan," she said.

Gudmundson said that not being covered by the province does not mean someone cannot consult a pharmacist. She said people can still pay for consultation services.

"We understand the complexities of it." said Gudmundson. "But we're going to make sure that there is informed consent. If somebody were to choose to pay for it or use some other things that we are going to have those discussions and see if there's any way that we can help them."

Dmitry Kalinovsky/Shutterstock
Dmitry Kalinovsky/Shutterstock

Swidrovich said his petition is a step in the direction of reconciliation.

"We still have a lot of work to do in the health profession beyond policy and coverage and this is just one way," he said.