The impact of colonialism on Indigenous Peoples across this country has been and continues to be well documented. Within BC’s healthcare system, there is widespread systemic racism against Indigenous people; the anti-Indigenous racism and discrimination experienced by Indigenous clients in healthcare interactions are among the many ways we see the ongoing impacts of colonialism. These impacts have been shared with us by Indigenous Peoples through re-traumatizing inquiries, commissions, and reviews over several decades.
The history of residential schools in Canada can be traced as far back as the 17th century. Watch the short Historica Canada “Residential Schools in Canada Timeline” video to learn about the significant dates in its history – from the landing of Jesuits in what is now known as Quebec, to the release of the Truth and Reconciliation Commission of Canada’s final report in 2015.
Video: Residential Schools in Canada – A Timeline (00:05:39)
The Royal Commission was established after a 78-day armed standoff (the Oka Crisis) between the Mohawk community of Kanesatake, the Sûreté du Québec, and the Canadian army. The Commission visited 96 First Nation communities and held 178 days of public hearings. The Final Report included a 20-year agenda (1996-2016) for implementing changes to better the lives of Indigenous people.
UNDRIP (PDF) establishes a universal framework of minimum standards for the survival, dignity and well-being of the Indigenous Peoples of the world; it elaborates on existing human rights standards and fundamental freedoms as they apply to the specific situation of Indigenous Peoples.
“The Declaration provides a detailing or interpretation of the human rights enshrined in other international human rights instruments of universal resonance – as these apply to indigenous peoples and Indigenous individuals. It is in that sense that the Declaration has a binding effect for the promotion, respect and fulfillment of the rights of indigenous peoples worldwide. The Declaration is a significant tool towards eliminating human rights violations against the over 370 million indigenous people worldwide and assisting them and States in combating discrimination and marginalization.”
The TRC’s mandate was to inform all Canadians about what happened in residential schools. The Commission heard from Residential School Survivors, their families, communities, former staff and others over six years. The Commission held seven National Events, two Regional Events, and held 238 days of local hearings in 77 communities. The Commission received over 6750 statements from Survivors, members of their families and other individuals. The National Centre for Truth and Reconciliation now holds its findings and records for safekeeping.
The Commission reinforced that the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) is the framework for reconciliation at all levels and across all sectors of society. The final report documented 94 Calls to Action.
The mandate of the National Inquiry was to examine the underlying social, economic, cultural, institutional, and historical causes that contribute to the ongoing violence and particular vulnerabilities of Indigenous women and girls in Canada and to report on the systemic causes of all forms of violence against Indigenous women and girls (including sexual violence, sexual assault, child abuse, domestic violence, bullying and harassment, suicide, and self-harm).
The process included 2386 participants in the Truth Gathering Process: 15 public community hearings and three private statement-gathering events to gather stories from families and survivors, followed by nine hearings to gather testimony from those who worked in institutions, and from Experts including Elders, Knowledge Keepers, academics, legal experts, front-line workers, young people and specialists.
The MMIWG Final Report delivers 231 Calls for Justice.
In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care (PDF) is a report that makes 24 recommendations to address widespread, systemic Indigenous-specific racism in the healthcare system. The investigation and recommendations were informed by close to 9000 patients, family members, third-party witnesses and healthcare workers whose input was gathered between July 9 and August 27, 2020.
The 24 recommendations are actions in relation to Systems, Behaviours and Beliefs; many of them speak to changes required by health professions regulatory colleges (e.g. in policies and standards), changes needed to the regulatory complaints process, and the role of regulatory colleges in ensuring their registrants practice culturally safe and humble care.
Some have raised concerns about the reliance on the In Plain Sight Report, the final report of the Addressing Racism inquiry, given the questions about one of its key authors, Dr. Mary Ellen Turpel-Lafond. The In Plain Sight team was comprised of a number of recognized Indigenous advisors and leaders. While Dr. Turpel-Lafond was the chair of the investigation, the investigation as a whole is larger than her.
The report and its recommendations are a summation of thousands of Indigenous people’s experiences, stories and facts highlighting their experiences within the BC healthcare system. The report’s information, data, facts and recommendations are not contestable. Indigenous-specific racism is prevalent throughout BC’s healthcare system, and it originates in the province’s settler colonialism history.
We need to continue to recognize and honour the contributions of these individuals to the report and to use their shared knowledge and guidance to improve the healthcare system. The work stands on its own merit, and we value the evidence it has provided as we meet our obligations and commitments as a regulator to minimize the harm caused to Indigenous people by systemic racism within the BC healthcare system. (Adapted with permission from BC College of Nurses and Midwives.)
BC’s DRIPA passed into law in November 2019 and establishes the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) as the Province’s framework for reconciliation, as called for by the Truth and Reconciliation Commission’s Calls to Action. The Act requires (not a full list):
- the government to bring provincial laws into alignment with UNDRIP
- the province to develop and implement an action plan in consultation and cooperation with Indigenous Peoples to meet the objectives of UNDRIP
- regular reporting (including annual reports) to the legislature to monitor progress on the alignment of laws and implementation of the action plan
The five-year Action Plan (PDF) (2022-2027) was released on March 2022 and includes 89 priority actions towards achieving the objectives of UNDRIP. The priority actions include implementing the In Plain Sight Report recommendations towards a healthcare system that is culturally safe and free of Indigenous-specific racism (Action 3.7).
This Act and the Action Plan set the stage for systemic changes at all levels in BC. Health regulatory colleges and CPTBC are now mandated to participate in these changes. It is now the law that we do this important work.
The BC government introduced the Health Professions and Occupations Act (HPOA) (PDF) on October 19, 2022, and received Royal Assent on November 24, 2022. It is now up to the Cabinet to determine when the new Act will take effect; until it takes effect, the College continues to operate under the existing Health Professions Act.
The new Act describes various changes to the regulation of health professions, including reflecting some of the key recommendations of 2020 In Plain Sight Report and further implementing the Declaration on the Rights of Indigenous Peoples Action Plan.