BC Still Has Ways to Go to Eliminate Anti-Indigenous Racism in Health Care

One year after releasing the “In Plain Sight” report that detailed systemic anti-Indigenous racism in B.C. health care, report author Mary Ellen Turpel-Lafond says not nearly enough has changed for Indigenous people seeking care in the province.

Progress has been made on 10 of the report’s 24 recommendations, she reported in an update yesterday. Turpel-Lafond is B.C.’s former child and youth representative and the current director of the Indian Residential School History and Dialogue Centre.

“Like literally last week, the legislation to add Indigenous identity as a prohibited ground of discrimination was added to the B.C. Human Rights Code: that was one of the recommendations,” she said in an interview.

Other recommendations where implementation has begun include: apologies from the health sector and regulatory bodies; creating an independent chiefs’ committee to discuss the First Nations' health governance structure in the province; and hiring senior Indigenous leadership at health authorities and the Health Ministry.

But Turpel-Lafond says it’s not enough, and government and the health-care sector shouldn’t get complacent with so much left to do.

Health Minister Adrian Dix deserves credit “for his leadership to commission the report, to work on it, to assemble people and to give them authority and space to do the work,” she said. “But I think we can’t fool ourselves and think we’ve eradicated racism in health care.”

Turpel-Lafond continues to receive “disturbing complaints” about racism in health care and the ongoing “inadequacy” of the complaints process, she said, despite recommendations in her report for First Nations, Métis and settler governments to develop a strategy to improve the complaints process together.

She also noted many of the report’s recommendations were written to “establish a roadmap” for the province to implement the Declaration on the Rights of Indigenous Peoples Act in health care.

They include the right to self-determination, accessing health care free of discrimination, and having access to traditional medicines and maintaining traditional health practices.

Another area where the province is falling behind is in relationship building and co-governance between the province and Indigenous leadership.

“Fundamentally, eliminating racism — and indeed the future of reconciliation in this province — rests upon our ability to make rightful space for Indigenous decision-making and sovereignty,” Turpel-Lafond wrote in her update.

In an interview, Turpel-Lafond acknowledged that the ongoing pandemic is partially responsible for the delay in implementation. And she did not expect all 24 recommendations would be fully implemented in one year.

Nevertheless, she said she was hoping for more progress by this point. And the longer it takes to remove racism from the health-care system, the longer Indigenous people continue to suffer, she said.

“We have to create a culturally safe system, and what it means when you haven’t achieved that is the access to care, not just denial of service, but the fact that Indigenous people are not getting the health care that they need causes them to suffer with health conditions that are treatable,” she said.

“I’m not trying to be dramatic when I say racism kills people. Because they stay away from health care that they need because it’s been so offensive, unfriendly and discriminatory, and it can lead to an absolute crisis, including a shortened lifespan.”

In a statement released by the Health Ministry, Dix acknowledged the extent of work left to do to eradicate anti-Indigenous racism in the health-care system.

“Now is a time to build on what we have achieved working together to make the additional necessary changes needed to root out Indigenous-specific racism, stereotyping and discrimination in B.C.’s health-care system and ensure a culturally safe health-care system for Indigenous Peoples,” he said.

“The province remains absolutely committed to implementing all 24 recommendations of 'In Plain Sight,' and we will continue to work together with Indigenous peoples, all orders of government, health-system partners, individuals, service providers, regulatory bodies and health-system leadership to make this commitment a reality.”

Like the original “In Plain Sight” report, Turpel-Lafond’s update includes complaints she has received about anti-Indigenous racism in the education and child welfare systems, particularly in services for children with disabilities.

She echoed concerns that First Nations leadership and the BC Green Party have expressed over the recently announced new system for servicing kids with disabilities in B.C., and how it seems as though the government has not taken the experience of Indigenous children and families into account.

Turpel-Lafond noted some have called for “In Plain Sight”-style reports for education, child welfare and the justice system, where anti-Indigenous racism is also rampant.

At the very least, Dix’s colleagues need to step up to eliminate racism in their portfolios, she said.

“And as B.C. makes a commitment to anti-racism more generally in different ways and different proposals they’re bringing forward, it has to be meaningful for Indigenous people,” Turpel-Lafond said, adding it’s only meaningful if racism is eradicated.

Turpel-Lafond was not required to write this update but chose to after monitoring the recommendations’ implementation over the last year. She hopes the Health Ministry will volunteer to report on progress in the future.

In the meantime, Turpel-Lafond continues to work to eliminate racism in health care, participating yesterday in a dialogue with 600 Indigenous women in health care at the Decolonizing Wellness: Indigenous Women’s Perspectives on Health Care event hosted by the Indian Residential School History and Dialogue Centre at the University of British Columbia.

Key themes coming out of the discussion included creating different leadership models for Indigenous women in health care; how western institutions and governments meet or fail to meet the needs of Indigenous women in health care; and how Indigenous women can maintain their identity and cultural values in a westernized health-care system.

“The work that Indigenous women are doing in the system, the extent to which they embrace the report, that it created more safety for them to speak out, and we have more leadership of women in the system now” are all positive steps, Turpel-Lafond said.

“These changes are important. It doesn’t necessarily mean all of the recommendations are done, but it was big.”