to a large degree jurisdictional issues which impact on accessibility to health services stem from the decades of a tug of war over which level of government is responsible for provision of services although provincial governments are required to provide equal access to health care services under the canada health act for all residents of the province including indigenous peoples living on reserves the provincial governments often take the position that the federal government is responsible for certain health services to indigenous peoples who are registered as status indians under the indian act as a result some health services not covered by the canada health act but otherwise provided by the provinces through the regional health authorities may or may not be provided to indigenous communities the provincial governments position is that the federal government has responsibility for certain health services to indigenous peoples as indians under the indian act