Honourable senators, I am now continuing to speak in support of Senator McCallum’s motion that the Senate of Canada call on the federal government to adopt anti-racism as the sixth pillar of the Canada Health Act, prohibiting discrimination based on race and affording everyone the equal right to the protection and benefit of this law.

The facts available to us currently indicate a disproportionate burden of racism in health care imposed on patients of Indigenous origin. In just the last few months, more than 9,000 people took part in the B.C. investigation of racism directed at Indigenous people in B.C. health care systems, and more than 600 cases were reviewed.

Professor Mary Ellen Turpel-Lafond, the chair of this provincial inquiry, says the findings were disturbing. For example, 85% of Indigenous people said they had experienced racism and discrimination at the point of care. One third of non-Indigenous health care workers provided information about a racist incident they personally witnessed. Of Indigenous health care staff, 52% said they experienced direct racism from their colleagues.

The current five principles of the Canada Health Care Act are public administration, comprehensiveness, universality, portability and accessibility. While significant and essential, they seem abstract and inadequate when certain Canadians, based on prejudice against their identity, may be ignored to death, as Brian Sinclair was in Manitoba.

Allow me to quote from the open letter senators received about the death of Brian Sinclair:

There are two central yet contradictory stories about Canadian health care that dominate our nation’s history: the first is the rise of guaranteed access to health care for all Canadians, and the second is the decline in health and persistent gap in healthcare services between Indigenous and non-indigenous people in Canada.

This gap is well documented. Studies of the experience of Indigenous peoples from various regions in Canada have indicated that well over 40% have experienced unfair treatment as a result of racism. In one study, the treatment was so severe that Indigenous patients reported planning how to manage the racism they would experience before seeking emergency medical care.

On March 17 this year, Senator Yvonne Boyer rose to bring the voices of racialized women who have been sterilized without consent into this chamber. Senator Boyer reminded us that this horrific practice has affected many generations of Indigenous women and girls and, tragically, it continues to happen, with cases being reported publicly as recently as 2018. She also reminded us that there are reports from Black women, women living with disabilities and intersexed individuals who have been sterilized without consent.

Infant mortality rates, a key indicator of population health, are twice as high for Indigenous groups compared to the non-Indigenous population.

These are troubling statistics that are a composite of many factors, but we must not ignore the intersectionality. We must factor in the continuation of historical, systemic violence against Indigenous and other racialized peoples in Canada that can be seen and experienced in our health care systems today.

The 2016 report of the United Nations Expert Mechanism on the Rights of Indigenous Peoples, with a focus on children and youth, acknowledges that the right to health is an indispensable element of Indigenous peoples’ very existence and the central component of their right to self-determination.

Colleagues, it is our duty to ensure that Indigenous patients have equitable access to proficient and compassionate health care services and not continue to subject them to colonial racism still embedded in our health care systems, conscious and unconscious, when they are most vulnerable as patients.

Beyond the provision of health care, we must reflect on the social determinants of health that are more insidious in their intersectional impacts on health, including the history of colonization, cultural oppression and socio-economic disparity. Given the trust so many have in the Canada Health Act, it is assumed by many that anti-racism is woven inextricably into how health care providers understand and act upon every one of the existing five pillars of this law.

However, while it is logical that the principles of comprehensiveness and universality should automatically exclude discriminatory treatment and conduct, I am truly sad to have to state that the facts counter these comfortable assumptions. The proof is in the statistics, which tell us that what is currently in the Canada Health Act is just not enough, given that this law is at the heart of our national health care system.

Formalizing anti-racism as a pillar in the act would be explicit recognition that systemic racism exists in our health care system and would be an invitation for the development of policies and practices to reduce the prevalence and impact of racism in health care and to provide a platform for impactful regulations that strengthen equitable access to health services for all.

One element of that response could be the mandating of cultural competence and safety training, such as will be provided by the Provincial Health Services Authority in British Columbia. This includes programs that provide education on terminology, diversity, aspects of colonial history and the examination of stereotyping and cultivation of tools for communicating and building relationships with Indigenous patients as a means to make health care services more relevant, respectful and effective.

Honourable colleagues, it should not be the case that an individual seeking help at a medical facility, surrounded by medical staff, can suffer from the negligence and abuse that Joyce Echaquan documented as she lay dying in a Quebec hospital. Nor should it be possible that any wellness check results in the fatality of the person needing help. Yet in recent months, we have seen exactly that dangerous, even lethal, conduct. We can only address the systemic inequalities if we first acknowledge they exist and face how they impact on Indigenous and other racialized people, their families and communities.

Canadians regularly choose our national health care coverage as a top priority, essential to keeping Canada a strong democracy. The Canada Health Act is the federal legislative embodiment of these Canadian values and our aspirations for a stronger, healthier Canada. By supporting this motion, senators would clearly signal leadership in anti-racism action by recommending the articulation of a sixth pillar in the Canada Health Act that would result in prohibiting discrimination based on race and affording everybody the equal right to the protection and benefit of the law.

Let us welcome this opportunity to lead, by demonstrating that we go beyond words and to the action of recommending the addition of a sixth pillar to the Canada Health Act that identifies and creates a foundation for eliminating racism from our national health care systems. After all, sometimes we get to be the place of sober and innovative first thought.

Meegwetch to you, Senator McCallum, for your leadership in introducing this motion and thereby encouraging us to look more closely beyond naming a problem to envisioning a means of making crucial changes in response. Thank you. Meegwetch.