Indigenous Services Minister Marc Miller said Friday that the federal government can only do so much to address systemic racism in the health-care system, and that it’s up to the provinces to do much of that work.
“The reality is health is a jurisdiction that is jealously guarded by provinces,” Miller told reporters at a news conference.
“We need their help to reform it. We cannot reform the licensing bodies. We do not have the power. The Supreme Court has said it clearly in black and white. We need their help.”
Miller’s comments came after a virtual meeting Friday with other federal ministers and about 400 people, including Indigenous leaders and health-care professionals, to discuss experiences of racism and solutions. Miller said the group will reconvene with an action plan in January.
Earlier Friday, Prime Minister Justin Trudeau also said the provinces need to play a role, but said he was confident that local leaders will join federal efforts.
“Right across the country, all premiers have condemned racism,” Trudeau said at a separate news conference in Ottawa.
“There’s still more work to do, obviously, but we are confident that we’re going to be able to make significant improvements in the health care accessed by Indigenous Peoples,” he said.
The issue of anti-Indigenous racism in health care gained new attention from outrage over the treatment of Joyce Echaquan, who used her phone to livestream hospital staff using racist slurs against her as she lay dying in a Joliette, Que., hospital last month.
Other provinces have seen their own issues. On Friday, a Manitoba First Nations elder came forward saying she was questioned about her alcohol use during a stay at a Winnipeg hospital for a bacterial skin infection, even though she doesn’t drink.
In British Columbia, an independent investigator is looking into allegations that emergency room staff were placing bets on Indigenous patients’ blood alcohol levels. The investigation has since found racist “incidents” in every health region in the province.
B.C.’s health minister said when the investigation was launched this past summer that the province is committed to putting in place the recommendations brought forward.
“This report will be acted on. That is essential, that is important, and that is why we’re asking, in particular, Indigenous people across British Columbia, but also health professionals to engage with this so we can make our health care system better and safer for everybody,” said Adrian Dix, who is currently seeking re-election in the Oct. 24 provincial election.
Grand Chief Stewart Phillip, president of the Union of BC Indian Chiefs, said the comments from Miller and Trudeau were disappointing to hear.
“We’ve been dealing with the same political football game for the last 40, 50 years, and both levels of government keep attempting to pass the buck back and forth,” he told Global News.
“What we need here is a very real, genuine commitment to legislative reform on both the federal and provincial levels … that compels the feds and the province to meet certain funding levels and levels of service. And through that legislation they could be held accountable.”
Rebecca Kudloo, the president of Pauktuutit Inuit Women of Canada, told the Canadian Press that Friday’s meeting was a good start.
“The barriers to good health care is a problem,” Kudloo said in an interview. “The lack of cultural training for health service providers is a problem. We’re sometimes treated like we don’t have feelings.”
Kudloo lives in Baker Lake, Nunavut, where there is only one health centre staffed with nurse practitioners most of the time. People in her community often need to travel to Winnipeg or Iqaluit to get medical services.
She said that the government is offering Indigenous people encouraging words but little concrete action.
Miller said provinces are eager to address systemic racism in the health-care system and “it would be careless to suggest” Ottawa would hold back federal health transfers from the provinces and territories during the COVID-19 pandemic.
“But what we need to do is ensure that when federal money is invested according to its constitutional power, it is done in a fashion that reflects our values and our moral and legal duty to serve Indigenous Peoples and to ensure that they have first-class health care in the best country in the world.”
Health Minister Patty Hajdu told reporters the federal government was “open to looking at all tools” to help combat systemic racism, not ruling out updating the language in the Canada Health Act to establish a standard of care for Indigenous patients.
“The system is not broken. It’s created this way,” she said. “The systems and the people in them are incentivized to stay the same.”
She also suggested the federal government can use its financial leverage as positive reinforcement too.
“When we think about health transfers, often they’re thought of in a punitive fashion, but I think we also have to have the promotion of systemic change as well as the punishment of bad behaviour,” she said.
Miller said he ultimately holds the provinces “in good faith” to join Ottawa in whatever reforms are deemed necessary through continued meetings with Indigenous and health-care leaders.
“We know that they will do it because it’s about our identity as Canadians, but also about Indigenous peoples with respect that we still have a lot to learn and a lot of gaps to close,” he said. “But we started by starting.
“There are measures perhaps that need to be taken in more immediate fashion, but again, I think this is something that all Canadians are waiting for answers for and we’re eager to provide.”
— With files from the Canadian Press