PHSA is on a journey toward eradicating Indigenous-specific racism and discrimination and advancing cultural safety and humility.
This timeline highlights key milestones and events in PHSA's journey towards eradicating Indigenous-specific racism and discrimination in the geography known colonially as British Columbia. The timeline also includes key commitments and changes that have impacted the health care system.
All
Indian hospitals in Canada either close or convert to desegregated institutions. Prior to this, at least three major Indian hospitals operated in BC - Prince Rupert (Miller Bay), Sardis (Coqualeetza), and Nanaimo.
The last residential school in BC closes – St. Mary’s residential school in Mission. There were
18 Federal-Church operated Residential Schools in BC: Ahousaht, Alberni, Alert Bay, Anahim Lake, Cariboo, Christie, Sardis (Coqualeetza), Cranbrook, Kamloops, Kitimaat, Kuper Island, Lejac, Lower Post, Lytton, Mission, Port Simpson, Sechelt, and Squamish.
The
Royal Commission on Aboriginal Peoples releases its final five-volume report. The Royal Commission was established to provide a study of the evolution of the relationship between Indigenous Peoples, the Government of Canada and Canadian society as a whole.
The Government of Canada responds to the Royal Commission on Aboriginal Peoples with the creation of the
Aboriginal Healing Foundation. The Aboriginal Healing Foundation provided community-based and Survivor-focused healing projects across Canada and built a foundation for healing support and research based on community needs and the legacies of residential schools.
- The Office of Indian Residential Schools Resolution Canada is created to manage and resolve the large number of abuse claims filed by former students against the federal government.
- The BC Provincial Health Officer issued a landmark report on the health and well-being of Indigenous people.
The Health and Well-being of Aboriginal People in British Columbia highlighted significant gaps in health outcomes. The report concluded that the risks of developing diabetes, pneumonia, or HIV/AIDS or experiencing injuries caused by motor vehicle accidents are greater for Indigenous people than for other British Columbians.
Canada, BC and First Nations Leadership Council sign the
Transformative Change Accord. The Accord recognizes the need to strengthen relationships on a government-to-government basis, and affirms the parties’ commitment to achieve three goals:
- Close the gaps between First Nations and other British Columbians in the areas of education, health, housing and economic opportunities over the next 10 years;
- Reconcile Aboriginal rights and title with those of the Crown; and,
- Establish a new relationship based on mutual respect and recognition.
- The Government of Canada and nearly 80,000 Residential School Survivors reach the
Indian Residential School Settlement Agreement in which Canada commits to individual compensation for Survivors, additional funding for the Aboriginal Healing Foundation, and the creation of the Truth and Reconciliation Commission.
- BC and First Nations leaders agree to enter into a new relationship guided by principles of trust, recognition and respect for Aboriginal rights and title.
The New Relationship focuses on closing the gaps in quality of life between First Nations and other British Columbians.
- The
First Nations Health Blueprint for British Columbia, developed by the First Nations Leadership Council, identifies a new vision for First Nations health systems, and identifies a number of gaps and barriers in health services in the areas of: delivery and access; sharing in improvements to Canadian health care; promoting health and wellbeing; monitoring progress; clarifying roles and responsibilities between governments and organizations; and developing ongoing collaborative working relationships.
- Canada, BC and First Nations Leadership Council endorse the
Transformative Change Accord: First Nations Health Plan and
First Nations Health Plan Memorandum of Understanding agreeing to develop and implement a new First Nations health governance structure in BC.
- Canada, BC and First Nations Leadership Council sign the
Tripartite First Nations Health Plan to create fundamental changes to improve First Nation health status in BC. Some of these changes include collaborating on 39 health action projects, defining principles to design a new governance system, and establishing goals for implementation.
- Implementation of the Indian Residential Schools Settlement Agreement begins, which included: a Common Experience Payment (CEP) for all eligible former students of Indian Residential Schools; an Independent Assessment Process (IAP) for claims of sexual or serious physical abuse; measures to support healing such as the Indian Residential Schools Resolution Health Support Program and an endowment to the Aboriginal Healing Foundation; commemorative activities; and, the establishment of a Truth and Reconciliation Commission (TRC).
- United Nations General Assembly adopts the
United Nations Declaration on the Rights of Indigenous Peoples (UN Declaration) without Canada, Australia, New Zealand and the United States' endorsement.
The Office of the Prime Minister of Canada issues an
apology to former students of the residential school system. The Prime Minister also delivers the apology in the House of Commons, where Indigenous leaders and Survivors stood as witnesses to the speech.
San’yas Indigenous Cultural Safety online training program is developed by PHSA, BC, regional health authorities, Métis Nation BC, Elders, and academics.
BC Tripartite Framework Agreement on First Nations Health Governance is signed and sets the beginning of First Nations, Canada and BC working together in a new First Nations Health governance structure, including the legal commitment to transfer federal programs and services to BC First Nations within two years without prejudice to title and rights.
The First Nations Health Authority (FNHA) takes over responsibility from the federal government for the planning, management, and delivery of health programs for First Nations in BC. The transfer was guided by the First Nations Health Council (FNHC) and established in a series of agreements with the Government of Canada and the Province of BC that created a new First Nations health governance structure with political representation and advocacy through the FNHC; planning, management and delivery of health programs and services through FNHA; and, technical advice and counsel from the First Nations Health Directors Association.
Registrars of all colleges in BC Health Regulators (BCHR) sign the
Declaration of Commitment – Cultural Safety and Humility in the Regulation of Health Professionals Serving First Nations and Aboriginal People in British Columbia.
- The
Declaration on the Rights of Indigenous Peoples Act passes into law in BC, which establishes the
United Nations Declaration on the Rights of Indigenous Peoples (UN Declaration/UNDRIP) as the Province’s framework for reconciliation, as called for by the Truth and Reconciliation Commission’s Calls to Action.
- The National Inquiry into Missing and Murdered Indigenous Women and Girls releases
Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls, which outlines 231 individual Calls for Justice directed at governments, institutions, social service providers, industries and all Canadian to address the root cause behind Canada’s staggering rates of violence against Indigenous women, girls and 2SLGBTQIA+ people.
- BC ends
birth alerts, or hospital alerts, an order that directed hospital staff to notify social workers when they deem there is a potential safety risk to infants at birth without the consent of the expectant parents. Birth alerts were primarily issued for marginalized women and, disproportionately, Indigenous women. Indigenous communities, organizations and Reclaiming Power and Place: The Final Report of the National Inquiry into Missing and Murdered Indigenous Women and Girls called for an end to this practice.
PHSA begins hiring
Indigenous Patient Navigators throughout the organization to offer support and guidance to Indigenous patients and families.
-
In Plain Sight report is released, addressing Indigenous-specific racism and discrimination in BC health care. Recommendations from the review stress the need for immediate, principled and comprehensive efforts to eliminate Indigenous-specific racism and discrimination against Indigenous Peoples in the health care system.
- BC’s Ministry of Health establishes the role of Associate Deputy Minister, Indigenous Health within Ministry of Health, as recommended in the In Plain Sight report.
- The Minister of Health announces the appointment of two First Nations people to all health authorities’ boards of directors.
- BC’s Office of the Human Rights Commissioner releases
Disaggregated demographic data collection in British Columbia: The grandmother perspective, which outlines a framework for disaggregated data collection that is grounded in “the grandmother perspective” offered by Gwen Phillips of the Ktunaxa Nation and recommends the development of legislation that is focused on building respectful relationships with marginalized communities to ensure that community needs and voices are meaningfully included in data collection, use and disclosure processes.
PHSA hires its first Vice President of Indigenous Health, kwunuhmen, Joe Gallagher (Tla'amin Nation).
PHSA develops guides on Land Acknowledgements, Developing Respectful Relations, Respectful Language, Facilities Design and Working with Elders and Knowledge Keepers to inform PHSA’s work.
PHSA creates Anti-Indigenous Racism Response Training (ARRT) program
This program is for all staff to further their understanding on Indigenous-specific racism and discrimination and how it shows up in the workplace.
PHSA’s Board of Directors approves and starts implementation of its first “PHSA Board of Directors Indigenous-specific Anti-racism Action Plan"
This Action Plan articulates individual and collective training / education for Board members, as well as numerous actions the Board held the organization accountable for across all its sectors (services, finance, human resources, quality, policy, etc.) to eradicate Indigenous-specific racism.
PHSA Board passes an Indigenous-specific Anti-racism staff policy, a first-of-its-kind policy in a health authority.
The policy also makes the completion of the Anti-Indigenous Racism Response Training (ARRT) and San’yas Anti-racism Indigenous Cultural Safety Program (San’yas) program mandatory for all staff. The policy opens the door for Indigenous led/centred reviews of reports of Indigenous-specific racism in the workplace.
PHSA’s Executive Leadership Team embarks on their Indigenous-specific Anti-racism Learning Journey on naming racism, understanding how racism operates in PHSA and strategies for action in eliminating Indigenous-specific racism and discrimination.
- FNHA releases Remembering Keegan: A First Nations Case Study, highlighting how Keegan Combes of Skwah First Nation passed away from a delayed diagnosis following an accidental poisoning. This case study provides an opportunity for health-care professionals to learn from and reflect on personal and systemic biases that shape their practice.
- The province releases the Declaration on the Rights of Indigenous Peoples Act Action Plan (Declaration Act Action Plan) with four themes, one of which is the eradication of Indigenous-specific racism and discrimination. The Declaration Act Action Plan articulates a clear action to implement the In Plain Sight report recommendations. It also provides direction to implement the actions from a distinctions-based approach, and to follow shared understandings, including legal plurality that recognizes that within Canada there are multiple legal orders, including Indigenous laws and legal orders with distinct roles, responsibilities and authorities.
- The Health Standards Organization releases the BC Cultural Safety and Humility Standard developed by a First Nations-led technical committee with input from Métis Nation BC. The Standard provides guidance to health organizations on the responsibility, structures and procedures that are required in governance, leadership, and service provision to establish a culture of Indigenous-specific anti-racism and Indigenous cultural safety and humility in its services and programs.
- The BC College of Physicians and Surgeons and the BC College of Nurses and Midwives lead the development of a practice standard on Indigenous Cultural Safety, Cultural Humility and Anti-Racism and the 11 regulatory colleges adopt the practice standard. The practice standard sets clear expectations for how all registrants, including physicians and surgeons, nurses, and midwives, must provide culturally safe and anti-racist care for Indigenous Peoples.
- Pope Francis visits Alberta, Quebec and Nunavut. On July 25, while in Maskwacîs, Alberta, situated on Treaty 6 territory, traditional lands of First Nations and Métis people, Pope Francis recognized the abuses experienced at residential schools that resulted in cultural destruction, loss of life, and ongoing trauma lived by Indigenous Peoples in every region of this country. Pope Francis made further remarks in Lac Ste. Anne, Alberta, Sainte-Anne-de-Beaupré, Quebec, and in Iqaluit, Nunavut.
PHSA unveiled its refreshed purpose, vision and values statements and a set of six foundational
Coast Salish teachings.
These teachings were gifted in ceremony to the organization’s Board of Directors by Coast Salish Knowledge Keeper Shane Pointe, Sulksun. The teachings inspire people to grow and serve in new ways, embracing the truth of Indigenous-specific racism, learning to incorporate lived experiences of Indigenous peoples into quality care, and using them as guidance to do our best as human beings who are relationally accountable to one another through: Thee eat “Truth”; Eyhh slaxin “Good medicine”; Nuts a maht “We are one”; Whax hooks in shqwalowin “Open your hearts and your mind”; Kwum kwum stun shqwalowin “Make up your mind to be strong”; Tee ma thit “Do your best”.
PHSA’s confirms that its first North Star priority is to eradicate Indigenous-specific racism and create an anti-racist, safe culture, free from discrimination.
PHSA signs a Letter of Understanding with Métis Nation BC to advance cultural safety and humility for Métis people accessing services through PHSA.
Sanya'k̓ula (Indigenous Recruitment and Employee Experience) establishes an Indigenous Employee Community of Practice, internal Indigenous employee newsletter, and new Indigenous employee welcome packages.
PHSA programs implement 16 program and service-area Indigenous-specific Anti-Racism Action Plans across the organization, which articulate commitments and actions to eradicate Indigenous-specific racism across the organization.
PHSA adds Indigenous leadership across the organization.
In alignment with Recommendation 14 from the In Plain Sight report, the Indigenous leadership positions include: five new Indigenous Health Executive Director positions in BC Children’s and Women’s, BC Cancer, BC Centre for Disease Control, People & Culture and BC Emergency Health Services.
PHSA refreshes its internal peer-driven recognition program to include those contributing to Indigenous-specific racism and discrimination.
The PHSA+ Awards, to include new award categories celebrating the efforts of staff and medical staff engaging in meaningful work to eradicate Indigenous-specific racism and discrimination, celebrating those who uphold the organization’s purpose, vision, values, and who are living the Coast Salish teachings gifted to PHSA by Knowledge Keeper, Sulksun, Shane Pointe.
The PHSA Board starts a book club to inform their Indigenous-specific anti-racism approach to governance responsibilities, featuring White Benevolence, True Reconciliation, Structures of Indifference and other titles.
PHSA Quality establishes the Thee Eat and Indigenous-specific Racism and Discrimination Review Committee.
This committee is responsible for the development and implementation of a culturally safe, responsive and accountable process for reviewing instances of Indigenous-specific racism and discrimination towards Indigenous patients and families. The committee accomplishes this work through establishing an intake and tracking process and ensuring a thorough review process for each event in the program/service where the Indigenous-specific racism occurred. The committee has the responsibility to approve recommendation reports from the reviews ensuring that appropriate measures have been taken to repair the harm that occurred and mitigate future harm.
Provincial Virtual Health (PVH) and Provincial Language Services (PLS) launch the “Partnering on Appropriate Virtual Care” project.
This project engages with patient partners, including a Deaf Indigenous patient, to identify requirements to promote safe, high quality, linguistically appropriate and culturally sensitive virtual health interactions between community members (patients, families, caregivers) and their healthcare team.
Provincial Language Services (PLS) completes phase 1 of the “Indigenous Language Access” project, which creates an Indigenous Language Access model (interpreting and translation).
Conversations continue with First Nations communities to conduct a pilot project that includes connection with Indigenous language keepers and Elders.
PHSA hires for a new Indigenous leadership position to support Patient Care Quality Office reviews and resolutions for Indigenous patients.
In addition, PHSA hires a new Indigenous Patient Care Specialist in its Patient Care Quality Office to manage concerns from Indigenous patients within Correctional Health Services.
PHSA implements a new process for obtaining consent from Indigenous patients and their families.
With regard to reviewing and reporting on concerns of Indigenous-specific racism, and establishes new authorization process for engaging Indigenous patients and families using verbal consent.
PHSA develops Indigenous-led resolution approach centred on the safety and self-determination of Indigenous patients filing a complaint with the Patient Care Quality Office, and partners with Indigenous Knowledge Keepers and Elders to provide traditional healing ceremonies as resolutions for Indigenous patients concluding Patient Care Quality process.
BCEHS continues expansion on the Rural Remote and Indigenous Framework (2020) to address and redress service models and to improve equitable and timely care for Indigenous Peoples in rural, remote and Indigenous communities.
BC Cancer hires eight Indigenous Patient Navigators working out of all six current BC Cancer Centers.
Chee Mamuk at BCCDC leads the project Kǝmtǝks Yakwa project (“Know or Knowledge Right Away”) and, in consultation with Indigenous partners, adopts the tagline for this project of “knowing means more choices”.
The focus of this project is to engage Indigenous communities, particularly those that are rural and remote, using a distinctions-based approach, to determine interest and acceptability of sexually transmitted and blood borne infections (STBBI) testing options.
PHSA Health Information Management (HIM) completes a review of how Indigenous self-identification data is collected by central registration services teams at PHSA sites.
This quality improvement initiative is intended to increase cultural safety for Indigenous peoples interacting with registration services at PHSA care facilities. The project includes a review of data quality, cultural safety training requirements, procedure documentation, patient-facing information, and an employee self-assessment.
