Federal, provincial officials discuss ways to counter anti-Indigenous racism in health care

Federal ministers are holding virtual meetings with provincial and territorial health counterparts, First Nations, Inuit and Métis Nation representatives and medical experts over the next two days to talk about anti-Indigenous racism in Canada's health-care system.

"We know going into the meeting that there is racism in the health-care system," Indigenous Services Minister Marc Miller said on Wednesday morning at a press conference in Ottawa.

"We also know that this is a jurisdiction that is jealousy guarded by provinces, but when it comes to issues like racism, systemic racism and discrimination, every leader in this country has a leadership role to play in calling it out and getting rid of it."

These conversations are meant to follow up on an urgent meeting hosted by Indigenous Services Minister Marc Miller last October in response to the death of Joyce Echaquan, a 37-year-old Atikamekw mother who filmed her last moments in a Quebec hospital. 

While that meeting focused on hearing stories about racism in the health-care system, this week's meetings are about changing the treatment many Indigenous people encounter when they seek health services.

Echaquan's viral video captured her screams of distress as hospital staff made degrading comments, calling her stupid and saying she would be better off dead. It sent shock waves across the country.

"That was the tip of the iceberg," said Ontario Sen. Yvonne Boyer, a Métis lawyer and former nurse who is taking part in the video calls today and tomorrow.

"When [Echaquan's] story came out, there were a hundred more that did not. So it's really important that we do address this."

Use Canada Health Act to force changes, says senator

Provincial and territorial health ministers have been invited to the two days of meetings, but there have been no official discussions yet with the premiers about the issue, said a senior federal government source.

Boyer — who has called on the federal government to act on reports of coerced sterilizations of Indigenous women — said federal and provincial governments need to work on relationship-building before they can move forward.

Boyer said that if the federal government can't come to an agreement with the provinces, it should strike a task force to look into addressing racism in the health care system through the Canada Health Act.

"Let's examine each one of those pillars and see if there are some [financial] sanctions we can put in place to actually force a good, hard look at how to eradicate systemic racism in the Canadian health care system," Boyer said. 

The federal source said the government is considering all options to attack the problem, but Miller said he does not agree with Boyer's task force suggestion.

"This is not a time to be holding back money, as a threat, particularly during a pandemic," Miller said.

"Maybe convince me otherwise in a couple of months, but I don't think it's the right approach. I think there are many, many more carrots than sticks out there that we haven't really examined, and this is one where we really have to exercise the spirit of cooperation."

Miller said he is "attracted" to an idea being promoted by health experts, who are calling on Ottawa to add an anti-racism pillar to the Canada Health Act, which would compel the provinces and territories to address the issue.

Some Indigenous leaders and health experts say they don't want the federal government to withhold money either.

"I would worry that this conversation would devolve very quickly into a federal and provincial and territorial fight around jurisdiction, which is often where we end up when Indigenous peoples' policy areas are discussed and it is really unfortunate," said Natan Obed, president of Inuit Tapiriit Kanatami, a national organization representing more than 65,000 Inuit living across Canada.

Self-determination seen as key

Obed said Ottawa can respect Inuit self-determination — and act against systemic racism in health care — by sending health transfers to Inuit organizations instead of letting the provinces and territories administer them.

"If you take this completely out of an Indigenous perspective — what if, to have cancer care in Ottawa, you had to go to Mexico?" Obed said.

"That really is the jurisdictional difference between coming from Grise Fiord in the High Arctic to Ottawa [for] care. I don't think Canadians realize just how ... self-determination is completely lost. Yes, we may be thankful for the care no matter where we receive it, but that does not mean we should be subjected to racism."

University of British Columbia law professor Mary Ellen Turpel Lafond recently found evidence of widespread stereotyping, racism and profiling of Indigenous peoples in an anti-Indigenous racism review of the B.C. health-care system — findings that she said could be consistent across Canada.

"Those are significant findings in British Columbia, but certainly the evidence would suggest that that may not be unique to British Columbia," Turpel-Lafond said.

In her research, Turpel-Lafond also found that the opioid epidemic and COVID-19 are disproportionately affecting Indigenous peoples, and Indigenous health care workers and students are facing significant racism in their work and study environments.

Like Obed, Turpel-Lafond said she doesn't want to see financial punishments used against the provinces but she does want to see Indigenous-specific health legislation that defines the quality of care — one that includes anti-racism tools that can measure results.

"We need to get people on-side to address it," Turpel-Lafond said. "We need to incentivize treatment."

If the two-day meeting fails to produce tangible results, it may not bode well for the success of promised federal Indigenous health legislation Ottawa is trying to co-develop with Indigenous leaders and communities, said the federal source.

The virtual conference couldn't come at a better time for the Métis Nation, which is struggling to work out health care funding arrangements between the provincial and federal governments, said David Chartrand, vice-president of the Métis National Council.

Indigenous Services' First Nations and Inuit Health Branch does not provide services or coverage for Métis people.

"There's clearly a truly different way that Métis are being treated in Canada, which is unbelievable," Chartrand said.