Canada’s latest auditor general’s report reveals an uncomfortable truth: billions of dollars and countless commitments later, the federal government still cannot demonstrate meaningful improvement in health services for First Nations.

As a family physician working in my First Nation, Tyendinaga Mohawk Territory in southern Ontario, I see the evidence of this failure not in spreadsheets but in people — patients navigating a health system that remains structurally unequal.

Nearly 10 years after the Truth and Reconciliation Commission’s (TRC) Calls to Action, it is clear that reconciliation without accountability delivers only rhetoric, not care.

The report states:

“Increasing First Nations’ capacity to deliver programs and services within their communities is critical to improving outcomes for First Nations people and supporting reconciliation.”

Yet the same report concludes that the department has taken a “passive and siloed approach” to supporting First Nations. It found unsatisfactory progress on five of 11 recommendations first issued in 2015 regarding access to health services for remote communities.

A decade later, systemic barriers remain — geography may vary, but inequity is consistent.

Even in communities like mine, which sit within driving distance of tertiary care, accessing culturally safe services is far........

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