A months-long independent investigation into B.C.’s healthcare system has found that there is widespread and insidious problems of stereotyping, racism and profiling towards Indigenous people.
An investigation into racism within the healthcare system – spearheaded by Mary Ellen Turpel-Lafond – launched earlier this year after “highly disturbing” allegations of a racist game guessing blood alcohol levels of indigenous patients being played in B.C. Emergency Rooms.
Saanich Peninsula Hospital was one facility named in allegations of the game.
“Our detailed examination of those allegations found no evidence of an organized game as originally depicted,” said Mary Ellen Turpel-Lafond, independent reviewer. “Hwever, and this is a significant however, our review…. found much more widespread and insidious problem.”
Turpel-Lafond only found evidence of episodic reports of guessing games, but she revealed that, after analyzing health sector data and collecting the voices of nearly 9,000 British Columbians, the review found “clear evidence” of a lack of cultural safety and “hundreds of examples of prejudice and racism” throughout the system.
84 per cent of indigenous respondents in a survey reported some form of discrimination in health care and 52 per cent indigenous health workers faced racial prejudice.
“Indigenous people and health-care workers have spoken clearly – racism is an ugly and undeniable problem in B.C. health care that must be urgently addressed,” said Mary Ellen Turpel-Lafond, independent reviewer. “This report provides a blueprint for fundamental changes to beliefs, behaviours and systems that are necessary in order for us to root out racism and discrimination and ensure that the basic human rights of Indigenous people to respect, dignity and equitable health care are upheld.”
Turpel-Lafond emphasized during a press conference on Nov. 30 that there is a problem that needs to be addressed.
“It doesn’t mean every Indigenous person who gets health care will experience direct or indirect racism, but it does mean that any Indigenous person could experience it – anywhere in the system,” the investigation concluded.
“We are relived,” said Leslie Varley from the B.C. Association of Aboriginal Friendship Centre. The organization was involved in calling on the province to investigate the allegations.
“This is out in the open, it is really time for transparency and accountability, but those findings for us, we have known this, every indigenous person has known this, all of our lives, all of our grandparents lives we have known this.”
They have launched an independent way to report racist incidents in the healthcare system. The “Safespace Networks” can be found on their website
Saanich North and the Islands Green Party MLA Adam Olsen is also a member Tsartlip First Nation, right around the coroner from Saanich Peninsula Hospital.
“The stories that come into my office and that come to me, is that people are making decisions on whether or not to go get healthcare, because they may or may not be up to the kind of treatment,” he said.
Olsen adds that racism in healthcare is just the tip of the iceberg…
“Its across all ministries, its across the entire institution, its how the institution is formed, how its formed at its very core.”
Health Minister Adrian dix apologized on behalf of the province and says he will appoint a task force responsible for implementing the report’s recommendations
In an online survey – launched in July – investigators asked respondents about the impact of discriminatory behaviours or actions on patients and their family members. The survey sought the experiences of a wide range of providers – from physicians, nurses, paramedics and health-sciences professionals, to clerks, cleaning staff and food-services employees.
The findings of the survey, released on Monday, suggested that 84 per cent of Indigenous respondents reported some form of discrimination in healthcare. Only 16 per cent said they had never experienced direct racism within the healthcare system.
Additionally, 52 per cent of Indigenous healthcare workers reported personally experiencing racial prejudice at work – the majority in the form of discriminatory comments by colleagues, according to the investigation report.
More than one-third of non-Indigenous health care workers personally witnessed racism or discrimination directed to Indigenous patients.
Investigators say that 531 healthcare workers (13 per cent), who responded to the survey, made racist comments in the survey itself.
Lastly, the survey found that the top reported reasons for racism persisting in the healthcare system were employees not willing to speak up and a lack of accountability by leadership to stop discriminatory behaviour.
“I am afraid to go to any hospital. When I do have to, I dress up like I’m going to church [in order to receive proper treatment] It’s ridiculous,” one respondent wrote.
“I avoid the hospital at all costs because as an Indigenous person, I feel unsafe and feel like they won’t bother treating me,” wrote another.
One of the key inciting incidents that sparked an investigation was due to allegations made about a racist game being played by healthcare workers.
The allegations suggested that some emergency room staff in the province had been accused of playing a ‘Price is Right’ style of game where they attempted to guess the blood alcohol level of patients, particularly of Indigenous people.
In regards to these allegations, Turpel-Lafond says the investigation found no evidence to substantiate the claim of these games being played in B.C. hospital emergency departments. Turpel-Lafond noted that if such games did occur in the past, they are not occurring today.
“There are episodic, anecdotal reports that resemble these allegations, none could be described as prevalent, widespread or targeting only Indigenous patients,” the investigation report reads.
Turpel-Lafond says that guessing by medical professionals of various patient levels, including blood alcohol, is routine and may be clinically appropriate. She added, however, that the review did find extensive profiling of Indigenous patients, based on stereotypes about addictions.
Despite finding no evidence on allegations about racist games, the investigative team revealed on Monday that there is still widespread racism within the healthcare system.
According to the findings of the investigation, racism is limiting access to medical treatment and negatively affecting the health and wellness of Indigenous peoples across the province.
The report suggests that Indigenous women and girls are “seriously disproportionately” impacted as a result of current stereotypes and racism within healthcare, while students and healthcare workers face “significant racism and discrimination” in their work and study environments.
Turpel-Lafond says the type of prejudices and stereotyping that is occurring within the healthcare system is leading to poor care at the point of service.
“It looks like abusive interactions at the point of care…it results in denial and delay of service, it results in ignoring and shunning, inappropriate pain management, medical mistakes…and a disdain by some healthcare workers for cultural protocols,” she said during a press conference on Monday.
Additionally, Turpel-Lafond says that public health emergencies are magnifying racism and disproportionately impacting Indigenous peoples.
After analyzing the health system data, investigators concluded that the current education and training programs are inadequate, complaints processes do not work for Indigenous peoples and Indigenous health practices and knowledge are not integrated into medical processes.
The report also highlighted that there is “no accountability for eliminating Indigenous-specific racism, including system-wide data and monitoring of progress.”
Turpel-Lafond and her team outlined 24 separate recommendations as a result of the investigation’s findings that focus on three categories: system reform, changing behaviours, and changing beliefs.
Ten of the recommendations are focused on improving accountability, legislative changes, governance structures, standards, complaints processes, physical spaces, and measurement and reporting.
Nine recommendations are focused on increased Indigenous leadership and health professionals, and specific efforts needed in health emergencies, mental health and wellness, and for Indigenous women.
Four recommendations surround mandatory health professional education, better public education about Indigenous history and health, and a new School for Indigenous Medicine.
In a press release sent out by Métis Nation British Columbia (MNBC), the Indigenous group is calling on the B.C. government to “urgently implement” all the recommendations outlined in Turpel-Lafond’s report.
A full list of recommendations as well as the full investigative report can be found here.