British Columbia

1 year after review of anti-Indigenous racism in B.C. health care, author says little progress has been made

In the year since a review recommended two dozen steps to address widespread systemic racism against Indigenous people in the B.C. health-care system, its author says officials haven't made as much progress because governments aren't structured to work together as they should.

'Ineffective collaboration' between governments has slowed improvement where it's most needed, author says

Mary Ellen Turpel-Lafond is pictured after releasing her final report in February on anti-Indigenous racism in B.C.'s health-care system. The initial review, called In Plain Sight, was released on Nov. 30, 2020. (Mike McArthur/CBC)

In the year since a review recommended two dozen steps to address widespread systemic racism against Indigenous people in the B.C. health-care system, its author says progress has been slow because governments still aren't structured to work together properly.

A follow-up progress report on Tuesday found First Nations, Metis and provincial government leaders have made some headway on roughly a quarter of the recommendations, but "ineffective collaboration has slowed improvement where it is needed the most."

"It is important to use this progress as motivation for the work ahead. At the same time, we must not congratulate ourselves on a job well done," said Mary EllenTurpel-Lafond, the former judge who released the original review of the system last year.

"The fundamental issues remain in plain sight."

The review released last year found racism, stereotyping and discrimination against Indigenous peoples in the B.C. health-care system are widespread and potentially deadly.

The report, called In Plain Sight, was based on first-hand accounts from thousands of patients, witnesses and health-care workers. Eighty-four per cent said they'd experienced discrimination.

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The review made 24 recommendations for change. In a follow-up assessment published Tuesday, Turpel-Lafond said only seven have seen signs of progress in the year since.

Other recommendations have seen "little, if any" movement at all.

Some of the progress has been caught up in bureaucracy, she said. For example, one recommendation called for officials to create an expert team to lead the charge on the earliest recommendations — but leaders can't decide who should be on the team.

"Much of the past year has been spent trying to figure out who sits on what committees," wrote Turpel-Lafond. 

"In the meantime, Indigenous Peoples have continued to be disproportionately harmed and oppressed, and they continue to die as a result of the impacts of racism and the twin public health emergencies."

UNDRIP obligations not being met

The assessment also found recommendations to uphold obligations set out in the Declaration on the Rights of Indigenous Peoples (UNDRIP) have not been put into practice.

The declaration lays out aspects of Indigenous human rights, like the rights to traditional medicine, health-care free of discrimination and protection from violence — particularly for elders, women and children.

The lack of progress on UNDRIP isn't unique to health-care, Turpel Lafond noted. She said she's received "many complaints" about Indigenous-specific racism from other sectors like education and child care.

The province has drafted a plan to fully implement all 24 recommendations from the original health-care review, Turpel-Lafond wrote, but said it would take five years to complete.

After In Plain Sight was released last year, Health Minister Adrian Dix formally apologized to those who'd experienced racism while trying to access the health-care system.

On Tuesday, Dix said the province had taken important steps but there is more work to do.

He noted that Dawn Thomas is in the role of acting associate deputy minister Indigenous Health and will lead a task force responsible for implementing the recommendations, which include legislative, policy and structural changes focused on changing systems, behaviours and beliefs. 

He said the one year anniversary of the report was an important time to reflect "on the impact of racism on Indigenous Peoples and their health, and to recommit ourselves to eradicating racism in health care."

"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 in the statement.

B.C. Health Minister Adrian Dix pictured on Aug. 13, 2020. After In Plain Sight's release last year, Dix offered an "unequivocal apology" to Indigenous people who'd experienced racism within the health-care system. (Michael McArthur/CBC)

To make quicker progress, Turpel-Lafond said, the province needs to "realign" its relationship with Indigenous governments so Indigenous leaders can be in health leadership and decision-making positions, holding the province accountable.

"Urgent streamlining is needed to empower and resource those who are carrying out the work," she wrote.

"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."

With files from Chantelle Bellrichard