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Activists march in a protest called ‘Justice for Joyce’ in Montreal, on Oct. 3, 2020, calling for Justice for Joyce Echaquan and an end to all systemic racism.

Graham Hughes/The Canadian Press

Health care advocates who were part of a working group that examined the 2008 death of an Indigenous man in a Winnipeg hospital are calling on the federal government to include an anti-racism pillar in the Canada Health Act.

The advocates wrote an open letter on combating systemic racism in health care that includes a request for Ottawa to make the change to the act, which lays out federal goals for publicly funded care. The letter, which went live on Oct. 21, now has more than 1,300 signatures from individuals in health care from across the country.

The letter says there are two central but contradictory stories about Canadian health care – one of “guaranteed access” to health care for all Canadians and one of the persistent gap in health care services between Indigenous and non-Indigenous people.

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“While the Canada Health Act guarantees medically necessary care to all Canadians, entrenching overarching principles of comprehensiveness, universality and accessibility, it was created and adopted with no input from First Nations, Métis and Inuit, and this legacy of exclusion continues,” the letter said.

“We call on the federal government to adopt anti-racism as a sixth pillar of the Canada Health Act."

Ottawa convenes urgent discussion on systemic racism in health care

‘A country’s shame’: Indigenous woman’s cries for help, abuse before death spur calls for action on systemic racism in health

The group includes Professors Josée Lavoie of the University of Manitoba, Mary Jane Logan McCallum of the University of Winnipeg, and Annette Browne of the University of British Columbia and lawyer Emily Hill of Aboriginal Legal Services.

The issue of systemic racism in health care, its pervasiveness and the response required by levels of government has been on the minds of politicians and policy makers in recent weeks particularly after the death of Joyce Echaquan. The 37-year-old mother and member of the Atikamekw Nation provided a public window through a Facebook live stream into the way she was demeaned at a hospital in Joliette, about 70 kilometres northeast of Montreal, before her death at the end of September.

Ms. Echaquan’s treatment and the broader issue of discrimination toward Indigenous patients in health care systems prompted an emergency meeting that was convened by Ottawa last month. In discussions that spanned hours, Indigenous health experts described the impact of racism on patients and how to address it.

The federal government wants to hold a second session in January, 2021, when it hopes governments and health care organizations will bring forward solutions.

In an interview, Prof. Lavoie said the federal government did not comment on systemic racism in health care at the time of Brian Sinclair’s death in 2008. Mr. Sinclair died at the age of 45 in a Winnipeg waiting room 34 hours after seeking medical treatment. Prof. Lavoie said the fact that the issue was recently discussed at a national level during the emergency meeting, including with professional associations, government representatives, Indigenous organizations and the family of Ms. Echaquan is a “great move forward."

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She said she is anxious to see what plans are put forward in January, adding action is required from all levels of the health care system, in every province and territory.

“It is a national story,” she said.

The federal government has also faced calls to examine changes to the Canada Health Act from the lead investigator examining allegations of racism in B.C.'s health care system, Mary Ellen Turpel-Lafond.

Prof. Turpel-Lafond of the University of British Columbia’s Peter Allard School of Law told The Globe and Mail this fall that the federal government could prescribe in the Canada Health Act that services must be delivered in a way that does not discriminate against Indigenous people and ensures their safety.

In an interview in September, Health Minister Patty Hajdu said that systemic racism in the health care system is a national problem and acknowledged that action was needed. But she said it would be premature to say what measures could be used to “accelerate work to end systemic racism in the health care sector.”

“The federal government is firmly committed to dealing with systemic racism," she said.

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Prof. Browne said she is concerned that Canadians may believe what happened to Ms. Echaquan is specific to Quebec when, in fact, it “is the tip of the iceberg.”

The kinds of practices, assumptions, stereotypes and stigma that played out in relation to Ms. Echaquan are in fact happening on an everyday basis in all areas, she said, adding the incidents captured on video helped to expose how urgent the issue of systemic racism in health care is.

Senator Yvonne Boyer, who is Métis and a former nurse and lawyer, has also studied the impacts of systemic racism in the health care system. She said she cannot think of one Indigenous person she has known in her life who has told her they had a great experience in the system.

“Not one Indigenous person has ever said that to me," she said. “You could walk into any hospital and you would see this.”

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