Racism review finds ‘widespread, insidious problem’ in B.C. health care system

VICTORIA (NEWS 1130) – A months-long review into Indigenous-specific racism has found there’s evidence of widespread prejudice and discrimination in B.C.’s health care system, as well as a lack of cultural safety.

The review, conducted by Mary Ellen Turpel-Lafond, B.C.’s former representative for children and youth, says the problem needs to be “urgently addressed.”

“What I found, in fact, is that at the point of care, there is direct prejudice and racism touching all points of care and impacting Indigenous people in B.C.,” Turpel-Lafond says, adding while her findings don’t mean every Indigenous person will experience racism in B.C.’s health care system, any Indigenous person “could face it because it is that pervasive and entrenched in the system.”

“We should all find that conclusion deeply troubling,” Turpel-Lafond says. 

Allegations that a racist guessing game played by emergency room doctors and nurses called “Price is Right,” whereby health care workers would guess the blood-alcohol levels of patients, particularly Indigenous people, is what prompted the review.

Turpel-Lafond’s findings found there was “no evidence to substantiate the allegation that the ‘Price is Right’ game was being played in B.C. hospital emergency departments, and if such games did occur in the past, they are not occurring today.”

Her review adds there are anecdotal reports that “resemble these allegations,” however, these were not found to be widespread or only targeting Indigenous people.

Racism in B.C. health care

Two online surveys were initiated as part of the review.

The findings say 84 per cent of Indigenous people surveyed reported discrimination in health care to some degree.

When it comes to Indigenous health care workers, more than half of respondents — 52 per cent — “reported personally experiencing racial prejudice at work – the majority in the form of discriminatory comments by colleagues.”

Mary Ellen Turpel-Lafond Technical Briefing - racism review BC health

Meanwhile, more than a third of non-Indigenous health care workers reported personally witnessing racism in some form toward an Indigenous patient.

The issues associated with racism against Indigenous peoples in health care are detrimental.

“It results in denial and delay of service, it results in ignoring and shunning, inappropriate pain management, medical mistakes because people do not see what the patient and hear what the patient is saying in suggesting is the issue, and a disdain by some health care workers for cultural protocols and First Nations and Metis traditional healing practices,” Turpel-Lafond explains.

The review has also found Indigenous women and girls are disproportionately impacted by racism in health care.

Addressing racism

“I’m so thankful for the fact that Indigenous people, particularly, were keen to engage and to explain in detail what their experiences had been and say that they were so appreciative of finally having an opportunity to come forward and talk about it in a safe way,” she says.

The review puts forward a number of recommendations that “take a strong human rights approach consistent with the UN Declaration on the Rights of Indigenous People.”

They include 10 recommendations “focusing on improved accountability, legislative changes, governance structures, standards, complaints processes, physical spaces, and measurement and reporting” to deal with systems.

Ivestigation by former youth advocate Mary Ellen Turpel-Lafond into allegations of sick game of guess the blood alcohol level targetting indigenous patients in BC ERs done. She found no evidence of that but, worse, she says, widespread racismin BC health care.#bcpoli @NEWS1130 pic.twitter.com/wi7V9JlIvi

— LizaYuzda (@LizaYuzda) November 30, 2020

There are a further nine recommendations to address behaviours in the health care system, suggesting increasing the level of Indigenous leadership and health professionals, while noting “specific efforts” are needed in health emergencies, mental health and wellness, and for Indigenous women.

“I just want to be very clear that there should be no mistake made about this report: it is essential in British Columbia that everyone in the health care system must eliminate all forms of racism and discrimination against Indigenous people, and must all pull together to ensure that that is done,” Turpel-Lafond says.

Turpel-Lafond’s review recommends putting a Task Team in place to “propel implementation” of the recommendations.

“I believe Indigenous peoples will have their voices heard and amplified today, and I think that’s important for today. And I hope very much that this will be more than just one day, today. That this will begin a process of significant change in British Columbia that can mean, at the point of care, cultural safety, respect, and the elimination of all forms of discrimination against Indigenous people will be realized.”

An accompanying report is expected to be released in December. The review says implementation of recommendations should follow.

“Systemic racism exists, it persists in our health care system and it is damaging to the health and wellness of Indigenous people in our province, and in fact, I’d argue, to all people in our province,” Health Minister Adrian Dix says, adding it is his “determination” to ensure racism has no place in B.C.’s health care system.

Turpel-Lafond says she’s pleased @adriandix has committed to not only accept her report, but quickly apologize for past wrongs.

She adds she’s grateful he has “set the tone” because this isn’t just happening in health, but also education.#bced #bcpoli #InPlainSight

— Marcella Bernardo (@MBernardoNews) November 30, 2020

Starting immediately, Dix says five new Indigenous Health Liaison positions are being added in each health authority across B.C.. in addition to this, the Ministry of Health has been directed to “review medical staff bylaws to implement consistent standards for cultural safety and humility as an expectation for medical staff privileges,” Dix adds.

“I want to make an unequivocal apology as the minister of health to those who’ve experienced racism in accessing health care services in British Columbia now and in the past,” Dix says. 

Paving a way forward

A member of the First Nations Summit political executive says she believes the In Plain Sight report paves the way for ending “rampant” racism in the province’s health care system.

Cheryl Casimer says she’s not surprised by some of the testimonials heard by Turpel-Lafond because she’s lived it.

“It’s heartbreaking at first. Then I get a sense of anger. Why are Indigenous peoples being treated this way? Why are we being subjected to a lower quality of health care and patient care just because of the colour of our skin. It’s totally unacceptable. Extended family members have passed away because of being neglected in emergency rooms and went home and died. I’m glad that this report is out. I’m glad that it’s going to work towards making those systemic shifts that are required, so that nobody else has to be subjected to this.”

.@CherylCcasimer with the @FNSummit tells @news1130 "Extended family members have passed away because of being neglected in emergency rooms and went home" and she hopes today's report will "work towards making those systemic shifts that are required." #bcpoli #InPlainSight https://t.co/bB16Qrj9PU

— Marcella Bernardo (@MBernardoNews) November 30, 2020

While Turpel-Lafond says her mission was not to shame and blame racist health workers, Casimer says anyone –clearly guilty of basing the delivery of care on the colour of someone’s skin– should not be working in health care.

“In severe instances, if somebody was willfully, for example, withholding pain medication from somebody just for the sake of being mean, there should be some disciplinary action. They need to be based on facts, but I’m not suggesting what we’ve shared hasn’t been.”

She adds she believes Health Minister Adrian Dix will make good on promises to act swiftly and she hopes similar investigations will be carried out on our justice, child welfare and education systems.

Meanwhile, the Hospital Employees’ Union, which represents more than 50,000 health care workers across B.C., confirms “much work” must be done to overcome stereotypes and ensure zero-tolerance for racism in the workplace.

The HEU’s Mike Old says racism is deeply ingrained in many institutions, including healthcare.

“We all have a responsibility to root out racist behaviour when we witness it. And we must recognize our own biases and behaviours, and address them,” he adds.