The Role of Accounting in the Delivery of Healthcare to Canada's First Nations Population

This study examines the role that accounting plays in the delivery of health care to Canada's First Nations, using the Health Centre of the Paul Band as a case study. While prior studies of relations between government and First Nations have focused on power, this study explores how relationships are formed and sustained in a network of actors with divergent interests, and how accounting is involved. Drawing on Actor Network Theory (ANT), our study reveals that accounting functions as a control device, and plays major roles in resolving tensions in the network. Additionally, we investigate the factors that influence health care outcomes for Aboriginal people. We find that five themes bear on the outcomes of Canada's First Nations health care programs: funding, translation, compliance, enforcement and barriers. Our study contributes to accounting literature by using health care to better understand the role of accounting in an actor network that has plurality of overarching strategies. This study also makes some methodological contributions. It mitigates the tendency of previous management studies of a reductionist nature to disregard the context of the site of study as if a patient's healthcare experience is an isolatable phenomenon. Our study suggests that: 1) site-specific context shapes participation; 2) external actors have significant impacts on site of study, and 3) genealogy is relevant to the site of study