A review of anti-Indigenous racism in B.C.’s health-care system will go far beyond allegations of racist “games” in emergency rooms, independent investigator Mary Ellen Turpel-Lafond said Thursday.
Turpel-Lafond promised a far-reaching investigation into systemic racism in health care and the effects on the care received by Indigenous people.
“This investigation is not trying to determine whether racism exists in B.C.’s health-care system,” she said. “It does exist, just as it does in every aspect of Canadian society,” she said.
“We want to gauge through this investigation and this process the range and extent of that racism, both individual and systemic, and how it affects the quality of health care for Indigenous people in this province,” said Turpel-Lafond, who often clashed with the BC Liberal government as B.C.’s first Representative for Children and Youth.
Investigators are asking Indigenous people to share their experiences of racism and stigma in health care through a survey. The investigation has also set up an email address and phone line so people — including health-care workers — can report their experiences. Mental health supports will be available for people sharing their stories, she said.
Turpel-Lafond and her team, which includes former provincial health officer Dr. Perry Kendall and Indigenous health and nursing expert Dr. Margaret Moss, will first focus on specific reports of racism in B.C. emergency departments.
There are credible reports of egregious behaviour in every health region of B.C., Turpel-Lafond said, and she expects the number of reports to grow as the survey gets under way.
“Despite having no formal presence until today, our investigation has already received countless phone calls and emails from people sharing their stories,” said Turpel-Lafond, a member of the Muskeg Lake Cree Nation in Saskatchewan. “Our investigation will no doubt uncover some difficult truths.”
Racism in health care undermines patient trust in care and in turn their outcomes.
Fear of stigma and racism often drives Indigenous and racialized patients to avoid seeking care until a condition is much worse, and assumptions about substance use among Indigenous people may lead to misdiagnosis and poor treatment.
The goal of the probe is not to “name and shame” individual health-care providers, Turpel-Lafond said, but to understand the systems that allow that behaviour to continue.
“There are individual acts that happen when one chooses to play a ‘game,’” said Turpel-Lafond.
“But when you have an environment where it is tolerated and people are bystanders and do not act, that becomes institutional and systemic.”
Turpel-Lafond says speaking frankly with physicians, nurses and other health-care providers will be essential to the investigation’s success.
Health Minister Adrian Dix has promised there will be no professional retaliation against those who do speak out.
Turpel-Lafond said the investigation could lead to broad changes.
“Ultimately it is about building up the confidence for Indigenous people in B.C.’s health-care system and to ensure they will feel safe and that they are treated appropriately, respectfully, with dignity, equality and fundamental respect for their human rights,” she said.
The investigation is being done with the full support and collaboration of the Union of BC Indian Chiefs, the BC Assembly of First Nations, the First Nations Health Authority, the Métis Nation BC, the First Nations Health Council and a number of regulatory colleges for health-care professionals in the province, she said.
Turpel-Lafond expects to present a preliminary report on the initial allegations within months. The investigation will then focus on the systemic aspects of the problem and bring forward recommendations to address them in additional reports, she said.
“We must not have any stone unturned on this issue,” she said.