Question Period Note: Advancing Reconciliation in Canada's Health System

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• Systemic racism has no place in Canada. Unfortunately, Indigenous Peoples continue to experience racism, discrimination, stigma and bias in many facets, including when interacting with the health systems, which has been well documented in a number of reports. There are ongoing domestic and international calls for Canada to implement measures that address racism and discrimination in the health systems and to demonstrate timely and meaningful progress. .
KEY MESSAGES
• The federal government is committed to take action to foster health systems free from barriers, including racism and discrimination.
• Through Budget 2021, the Government is investing funding to support Indigenous communities and organizations and other health system partners in the development of measures to address anti-Indigenous racism in health systems. This includes support for activities such as anti-racism and discrimination training, tools and resources for health professionals, and standards and guidelines for cultural safety.
• On February 7, 2023, the Government announced that it will be working with Indigenous partners to distribute an additional $2 billion over 10 years on a distinctions basis to address the challenges faced by Indigenous Peoples in accessing quality and culturally safe health care services.
• The Government of Canada acknowledges that Indigenous Peoples are best placed to determine and address their health-related needs. These investments will ensure that First Nations, Inuit and Métis Peoples are engaged in actions to provide fair and equitable access to quality and culturally safe health care services.
IF PRESSED …
• Health Canada continues to work with Indigenous and health system partners to identify and support Indigenous-led solutions to eliminate anti-Indigenous racism and discrimination across Canada’s health systems.

In September 2020, the death of Joyce Echaquan, an Atikamekw woman from Manawan, Quebec, sparked widespread indignation, media attention, a public coroner’s inquest, and a lawsuit from Echaquan's family against the hospital where she suffered racist insults from hospital staff before she died in Joliette, QC. On November 16th, 2020, the Manawan Atikamekw Council and the Council of the Atikamekw Nation submitted Joyce’s Principle to the Prime Minister, as well as federal, provincial, and territorial ministers. Joyce’s Principle demands that all Indigenous Peoples have an equal right to the highest standard of physical and mental health, with a right to traditional medicines, in line with the United Nations Declaration on the Rights of Indigenous Peoples.

In response to Joyce Echaquan’s death, Ministers Miller, Bennett, Vandal and Hajdu held three National Dialogues on October 16th, 2020, January 27-28th, 2021, and June 28-29th, 2021, to listen to Indigenous patients and health service providers regarding their lived experiences with racism, to provide federal, provincial, and territorial governments and health system partners a platform to present their past, ongoing, and planned actions to address anti-Indigenous racism in the health systems, and to hear recommendations from Indigenous representatives and health system partners.

At the January meeting, Minister Hajdu announced $4M in funding to a National Consortium of Indigenous Medical Education to work on improving the experiences of Indigenous Peoples in medical school/practices. Minister Miller also announced plans to begin co-developing distinctions-based Indigenous health legislation and funding of $2M to the Atikamekw Nation and Manawan First Nation to implement Joyce’s Principle.

Following the January National Dialogue, FPT leaders released a joint statement to express a collective commitment to working with Indigenous communities, organizations, and leadership to address Indigenous-specific racism in the health systems.

The June 2021 National Dialogue included breakout sessions where recommendations were heard from Indigenous representatives and health system partners on the following thematic areas: increasing Indigenous representation in postsecondary health education, cultural safety and humility, traditional approaches to health, and safe patient navigation. During the meeting, the Government of Canada publicly announced funding for specific initiatives to address anti-Indigenous racism in Canada’s health systems, including Budget 2021 funding for Health Canada’s new Addressing Racism and Discrimination in Canada’s Health Systems Program. Early findings from the January and June 2021 National Dialogues demonstrate the importance of ensuring accountability and distinctions-based approaches.

While the federal government is working with Indigenous partners on a number of health policy initiatives, dedicated work must be undertaken to directly address anti-Indigenous racism in the health systems. The Government has committed to responding to a number of high profile reports and recommendations to address anti-racism, cultural safety, and safe and equitable care, including the Truth and Reconciliation Commission’s Calls to Action and the Inquiry into Missing and Murdered Indigenous Women and Girls’ Calls for Justice. In addition, there are proposed class action lawsuits on forced and coerced sterilization of Indigenous women in multiple jurisdictions, and both the House of Commons Standing Committee on Health (HESA) and the Standing Senate Committee on Human Rights (RIDR) have tabled their studies between 2019 and 2022. The latest Senate report provides various recommendations to the Government to further advance reconciliation. The Government’s response is underway and is expected to be tabled in the Senate in Winter 2023.

Addressing Racism and Discrimination in Canada’s Health Systems Program
Through Budget 2021, Health Canada received $14.9 million over three years to establish the new Addressing Racism and Discrimination in Canada’s Health Systems Program, which provides contribution funding for projects that address systemic racism and discrimination in Canada’s health systems in a way that is informed by the lived experiences of Indigenous, racialized, and marginalized communities. The Program’s inaugural open Call for Proposals, for $13M in project funding, closed on May 25, 2022. The Call for Proposals targeted proposals addressing anti-Indigenous racism, with priority given to projects that develop and implement cultural safety training and/or accreditation requirements and/or that integrate culturally-safe care, including traditional approaches to health, into acute care settings. Announcements are expected in winter 2023.

The Government’s commitment to engage with Indigenous Peoples has placed a heavy burden on Indigenous organizations who may not have the capacity to participate in the multiple engagement requests from the federal government, including Health Canada. A targeted Call for Proposals was launched in summer 2022 to provide National Indigenous Organizations with funding to enhance their capacity to engage on identified health priorities, including: Primary and Virtual Care; Mental Health and Substance Use; Data and Digital Health; Long-Term Care and Supportive Care; Health Human Resources; and Dental Care. Announcements are expected in winter 2023.

On February 7, 2023, the Government announced that it will be working with Indigenous partners to distribute an additional $2 billion over 10 years on a distinctions basis to address the challenges faced by Indigenous Peoples in accessing quality and culturally safe health care services. The Indigenous-specific funding stream will be distributed on a distinctions basis through a health equity fund. The Minister of Indigenous Services, the Minister of Crown-Indigenous Relations, and the Minister of Northern Affairs will work with Indigenous partners to prioritize investments.

Prior to these investments, there was no federal funding available to specifically address anti-Indigenous racism in the health systems. Further to these short-term investments, the Government of Canada is committed to developing a long-term approach to addressing racism and discrimination against Indigenous, racialized, and marginalized populations in health systems.

• Budget 2021 announced $126.7 million over three years, beginning in 2021-22, for Health Canada and Indigenous Services Canada to take action to foster health systems free from racism and discrimination where Indigenous peoples are respected and safe.
• On February 7, 2023, the Government announced that it will be working with Indigenous partners to distribute an additional $2 billion over 10 years on a distinctions basis to ensure that Indigenous peoples have fair and equitable access to quality and culturally safe health care services.