Toronto Star – The independent investigation – touted as the first complete review of racism in a Canadian health-care system – released its report “In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care“. The investigation has found pervasive systemic racism against Indigenous people in this province based on the following findings:

1. Widespread Indigenous-specific stereotyping, racism and discrimination exist in the B.C. health care system.
2. Racism limits access to medical treatment and negatively affects the health and wellness of Indigenous peoples in B.C.
3. Indigenous women and girls are disproportionately impacted by Indigenous-specific racism in the health care system.
4. Current public health emergencies magnify racism and vulnerabilities and disproportionately impact Indigenous peoples.
5. Indigenous health care workers face significant racism and discrimination in their work and study environments
6. Current education and training programs are inadequate to address Indigenous-specific racism in health care.
7. Complaints processes in the health care system do not work for Indigenous peoples.
8. Indigenous health practices and knowledge are not integrated into the health care system in a meaningful and consistent way.
9. There is insufficient integration, or “hard-wiring” of Indigenous cultural safety throughout the health care system.
10. Indigenous structures and roles in health decision- making need to be strengthened.
11. There is no accountability for eliminating Indigenous- specific racism in the B.C. health care system, including system-wide data and monitoring of progress.

The report calls for a “Renewed Foundation” built on three foundational elements to addressing the legacy of colonialism in the health care system:

1. Racism in the health care system is a reflection of a lack of respect and implementation of the basic human rights of Indigenous peoples.
2. Racism within the health care system is integrated with, and in many aspects indivisible from, broader patterns and conditions throughout society.
3. While those who experience the problem of racism in the health care system must be intimately involved in developing solutions, we know that the responsibility and burdens of this work lie with non-Indigenous individuals, communities, organizations and governments.

“In Plain Sight” concludes with 24 detailed recommendations for stakeholders in the health-care system in BC but also emphasizes that many of the Observations, Findings and Recommendations have implications for the federal government as responsibility for health is an area of shared and overlapping jurisdiction and authority, especially in relation to Indigenous peoples. As the scope of this review was specific to B.C., Recommendations have not been directed to the federal government. However, tangible and urgent action is needed by the federal government, as well as national health organizations, to address Indigenous-specific racism in the health care system.

The Review has identified a number of areas where federal actions could be helpful to eliminate all forms of discrimination against Indigenous peoples. Examples of such necessary action include:

1. Federal legislation to specifically implement the UN Declaration to bring the federal laws, policies and practices in conformity with the Indigenous human rights, principles and standards in the UN Declaration.
2. Federal Indigenous-specific health legislation and other legislative amendments which explicitly make cultural safety a desired outcome or requirement of quality within Canada’s health care system, affirming Indigenous peoples’ individual and collective rights to health, facilitate Indigenous authority over their health services, and assure consistency with the minimum standards in the UN Declaration.
3. Federal health regulatory standards that address anti-racism, cultural humility and trauma- informed practices.
4. Active co-operation by the federal government consistent with the standards of the UN Declaration to make necessary changes to the First Nations health governance structure in B.C.
5. Direct support by national health organizations to identify measures and tools to address

https://engage.gov.bc.ca/app/uploads/sites/613/2020/11/In-Plain-Sight-Full-Report-2020.pdf