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First Nations patients in B.C. still face racism in health care, despite some improvements: Turpel-Lafond

One year after her scathing report "In Plain Sight," documenting racism in hospitals, Mary Ellen Turpel-Lafond says problems persist.

Mary Ellen Turpel-Lafond, independent investigator, provides an update on her investigation into allegations of racist practices in B.C.'s health-care system on July 9, 2020.

Apologies have been issued and some improvements had been made, but much more work is needed to make B.C.’s health care system less racist, says the author of a scathing 2020 report.

“I continue to receive complaints about racism, and the inadequacy of the complaints process,” said Mary Ellen Turpel-Lafond, a UBC law professor hired by the province last year to investigate the discrimination faced by Indigenous people when they sought medical help.

“I’m pleased with some of the progress I’ve seen … and at the same time I think there’s a lot to be done.”

One year ago, Turpel-Lafond, B.C.’s former children’s representative, documented in her “In Plain Sight” report the “widespread stereotyping, racism and profiling of Indigenous people,” that limited access to medical treatment, disproportionately affected Indigenous women, and led to discrimination against Indigenous health-care workers.

The 236-page report prompted Health Minister Adrian Dix to apologize for the system’s failings, create new Aboriginal liaison positions for each of the five health authorities, and name a new associate deputy minister of health in charge of addressing the problem.

On Tuesday, Turpel-Lafond released an update on the progress made on the report’s 24 recommendations. So far there have been the apologies issued by health system leaders, the hiring of more Indigenous senior leaders in health care, protecting Indigenous identity under the B.C. Human Rights Code, and discussions about an Indigenous wellness and welcoming centre at the new St. Paul’s hospital.

But “the fundamental issues” she raised in her report haven’t gone away yet, she said, noting there is no easy way for Indigenous people to lodge complaints about racism, “ineffective collaboration” with Indigenous governments has slowed the pace of change, and Indigenous patients continue to face harm or death as a result.

“Either the system has not been welcoming, or has mistreated people for so long, that they’re not accessing the support they needed. And they are suffering with morbidities that could be treated, but they can’t get in or they haven’t got supportive treatment ,” said Turpel-Lafond, who is director of UBC’s residential school history and dialogue centre.

She is calling for more work to be done to improve Indigenous peoples’ access to health care, which includes:

• Better response to public health emergencies, such as work to increase vaccine confidence and better funding for mental health and addictions services.

• Indigenous-created, anti-racism training for all health workers and students, and for whistle-blower protection to be extended to the health sector so employees are willing to report any racism they witness.

• All new major health care buildings should partner with local First Nations, to ensure Indigenous human rights are built into the design.

• Accelerate the production of data about health system performance and outcomes for Indigenous patients. A synopsis of this data should be made public by Nov. 30, 2022.

In Feburary, Turpel-Lafond issued a second report that found that while Indigenous people have higher rates of chronic disease, a lower life expectancy and a higher rate of opioid deaths, they have poor access to primary health care and are often turned away from hospital emergency departments without the medical care they need.