Tag Archives: ‘Systemic

Health care system was designed to subject Indigenous people to systemic racism: Hajdu

The systemic racism endured by Indigenous people in Canada’s health care system exists because the system was designed that way, Health Minister Patty Hajdu said today after a meeting with representatives from the provinces, Indigenous groups and the health care sector.

“Sadly this is not shocking to me,” Hajdu said. “Racism is not an accident. The system is not broken. It was created this way. And the people in the system are incentivized to stay the same.”

Hajdu made the comments after attending a meeting with Indigenous Services Minister Marc Miller, Northern Affairs Minister Daniel Vandal and Crown-Indigenous Relations Minister Carolyn Bennett to discuss racism in Canada’s health care system.

The meeting with some 400 participants from across the country was called following the death of Indigenous mother of seven Joyce Echaquan, who died in a Quebec hospital last month.

Echaquan, 37, recorded some of the last moments of her life on a video later released on Facebook. The video captured Echaquan screaming in distress, along with the voices of staff members making degrading comments, calling her stupid and saying she would be better off dead.

“It’s always a very powerful experience to be trusted to hear these very personal experiences and there’s so much to reflect on. I have a deep gratitude for all speakers who shared fearlessly about their personal experiences of racism in the health care system and in the health care education process,” Hajdu said.

Those who attended today’s meeting will reconvene in January, when they are expected to bring “concrete plans for training, prevention, health care data, wraparound services and accountability,” Hajdu said.

Miller said that while the responsibility for delivering health care to Indigenous Canadians is shared between the federal and provincial governments, systemic reform should not happen without Indigenous leaders playing a key role in shaping the process. 

While widespread reforms likely will have to wait until after the January meeting, Miller said that things can be done right away to improve the system for Indigenous patients, such as requiring greater accountability from health care providers and introducing better sensitivity training. 

Federal and provincial responsibilities

“It is time for all of us, regardless of our jurisdiction, to step up and use the power that each of us has to insist that systemic violence of Indigenous peoples end,” Hajdu said. 

Miller said that federal investments in health care have to respect provincial jurisdiction.

“The reality is that health is a jurisdiction that is jealously guarded by provinces,” he said. “We need their help to reform it. We cannot reform the licensing bodies. We do not have the power, the Supreme Court has said it clearly in black and white.”

Assembly of First Nations National Chief Perry Bellegarde said the meeting — which he described as a listening session — left those who took part with no doubts about the scope of the problem. 

Watch: ‘Systemic change takes more than fear.’ – Minister of Health Patty Hajdu:

Health Minister says she wants to hear from provincial leaders, Indigenous partners and health professionals about how the government should address systemic racism in the healthcare system. 1:29

“There is systemic racism, there is systemic discrimination. let’s deal with it, let’s put an action plan in place so that it no longer persists in 2020 and beyond, because we’re all in this together,” he said.

“Nobody should be afraid to go into that system because of racism or discrimination or they’re gonna be treated differently, and we need to feel good about getting the proper healthcare, each and every one of us.”

“It was not an isolated incident,” Hajdu said. “It is not a few bad apples. It is a system that not just turns a blind eye but implicitly endorses and reinforces this behaviour many times over. And Joyce in the middle of her deep pain showed something that so many people would prefer to ignore. So she gave Canada a gift that has to be honoured no matter how difficult it is to receive it.

“We as leaders cannot let her gift of bravery go to waste.”

Watch: Miller says reforms to system, must be done with Indigenous representatives:

Indigenous Minister Marc Miller says reforms to Canada’s healthcare system, must be done with full consultations and participation from Indigenous representatives. 1:49

Prime Minister Justin Trudeau suggested today that the government could introduce specific Indigenous health care legislation.

“All premiers have condemned racism and there is still more work to do, obviously. But we are confident that we’ll be able to make significant improvements in the health care access by Indigenous peoples,” he told a news conference in Ottawa.

“As we did with the question of child and family services, we will be sitting down in partnership with Indigenous communities and Indigenous leaders to help design the principles that should underline better health outcomes and services for Indigenous peoples.”

The provinces are seeking billions more dollars in health transfers from the federal government, with Trudeau promising a first ministers conference on the subject soon.

On Thursday, Miller said the federal government is ready to use its financial leverage over the health system to fight anti-Indigenous racism in health care, but ruled out holding back federal transfers as a tactic to ensure that happens.

Miller said he doesn’t think it’s helpful to try to punish provinces for inadequate action on racism, especially in the middle of a pandemic, but the federal government has a moral duty to set and maintain standards.

Watch: Quebec launches inquiry into Joyce Echaquan’s death:

Protests were held in Montreal as Quebec announced a public inquiry in the racist verbal abuse of Joyce Echaquan at the Joliette Hospital during her final hours. Activists for Indigenous women say her experience was typical of the abuse Indigenous women encounter in health care. 2:03

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Federal ministers, Indigenous leaders plan to discuss systemic racism in health system

Indigenous Services Minister Marc Miller says he plans to hold a high-level meeting of federal ministers and Indigenous leaders to address racism in the health system following Joyce Echaquan’s death in a Quebec hospital last month.

The meeting, said Miller, will include Crown-Indigenous Relations Minister Carolyn Bennett, Health Minister Patty Hajdu, Justice Minister David Lametti and Minister of Rural Economic Development Maryam Monsef.

“We do recognize, however, that this discussion requires the contribution of Indigenous partners and we will be reaching out to them today to convene an urgent meeting to address racism experienced by Indigenous peoples in Canada’s health care system,” Miller said. 

The virtual meeting is to take place on Oct. 16, CBC News has learned.

Aside from ministers and Indigenous leaders, meeting participants will include Indigenous health care officials, provincial representatives, Indigenous health and civil society organizations and provincial and federal health care organizations.

Sources have told CBC that this meeting will focus on the lived experiences of those working in Indigenous health care and will lead into a second meeting in January.

Echaquan, 37, a mother of seven, died last month in a hospital in Joliette, Que., about 74 kilometres north of Montreal, after recording some of the last moments of her life on a video later released on Facebook.

The video captured Echaquan screaming in distress, along with the voices of staff members insulting her. Hospital staff are heard making degrading comments, calling her stupid and saying she would be better off dead.

“Everyone should feel safe when visiting a hospital or physician’s office. It is … therefore important to remind everyone that during this pandemic, keeping Indigenous communities safe, Indigenous people safe and healthy, is my utmost priority,” Miller said.


Indigenous Services Minister Marc Miller responds to a question during a news conference on October 8, 2020 in Ottawa. (Adrian Wyld/The Canadian Press)

Miller said he and Bennett met with Echaquan’s family. He said that one of her sons got down on his knees to beg the two ministers to deliver justice.

“Carolyn and I should have got down on our knees and begged them for forgiveness for a system that failed them,” Miller said. “That’s what I remember from this meeting.”

A role for all levels of government

Miller praised the Quebec provincial government for launching inquiries into the incident but said all levels of government have a duty to respond.

“There’s a role for the federal government to play here, there’s a role for all governments and there’s a role for every Canadian in addressing systemic racism in our society,” he said. 

Why in the hell would I go and get a flu vaccine if I was going to be treated like garbage?– Indigenous Services Minister Marc Miller

Miller added that he’s following the direction given to his department in the throne speech to “co-develop distinctions-based Indigenous health legislation with First Nations, Inuit and Métis and a distinctions-based mental health and wellness strategy.”

The minister also said that, despite reporting an infection rate that is one third that of non-Indigenous Canadians, Indigenous communities are now seeing increases in their COVID caseloads and the coming flu season will not make flattening the curve any easier. 

Miller said that over the last six weeks, the number of active cases in First Nations communities rose steadily from 19 to 98.

“Given what we have seen in the last two weeks, there is little doubt that the second wave of COVID-19 will hit Indigenous people harder than the first wave,” he said.

Miller said that while the flu vaccine is the most effective way to prevent flu and flu-related complications, the uptake for the flu vaccine is lower for indigenous people that it is for non-Indigenous Canadians.

“Why in the hell would I go and get a flu vaccine if I was going to be treated like garbage?” Miller said. “You wouldn’t. You’d just say, ‘I am not going to do it.'”

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‘Systemic vulnerabilities’ let killer nurse Elizabeth Wettlaufer keep on killing — report

Ontario must increase funding and staffing at the province’s nursing homes to help prevent future serial killers from harming the most vulnerable, the final report into former nurse Elizabeth Wettlaufer’s crimes recommends. 

And nursing homes must limit their use of temp agency nurses and improve how medication is stored and tracked. 

Those are just some of the 91 recommendations made by Justice Eileen Gillese in her four-volume report, stemming from the Public Inquiry into the Safety and Security of Residents in the Long-term Care Homes System. 

“We cannot assume that because Wettlaufer is behind bars, the threat to the safety and security of those receiving care in the long-term care system has passed,” Gillese said in her public remarks today in Woodstock, Ont., where Wettlaufer committed most of her crimes. 

“People are now worried about whether the long-term care system can safely provide care for their loved ones and for themselves as they age.” 

Wettlaufer was a nurse in the province’s nursing homes and, at the end of her career, a home-care nurse.

She committed her crimes from 2007 to 2016, mainly at Caressant Care nursing home in Woodstock, Ont. Her killings would not have come to light had she not confessed. 


Elizabeth Wettlaufer is escorted from the courthouse in Woodstock, Ont., on Jan. 13, 2017. In January, 2018, she confessed to at least one more assault on a patient in her care. (Dave Chidley/Canadian Press)

“There is no simple ‘fix’ in terms of avoiding similar tragedies in the future,” Gillese said. 

“The offences were a result of systemic vulnerabilities in the long-term care system and not the failures of any individual or organization within it. Systemic issues demand systemic responses.” 

Gillese’s recommendations focus on how to prevent, deter and detect health-care serial killers, as well as how to create enough awareness about the possibility that a health-care practitioner could be harming patients. 

“While the long-term care system is strained, it is not broken,” Gillese said, adding that the regulatory regime that governs the system and the people who work within it provide a “solid foundation” from which to address the systemic issues. 

The recommendations

Gillese’s recommendations will take political will and money. Among them:

  • The ministry of Long-Term Care should conduct a study to determine adequate staffing levels on day, evening and night shifts — and report on that study by July 31, 2020.
  • Increase funding for staffing as determined by that study. At times, Wettlaufer was the only nurse working on a night shift, overseeing 99 patients with no oversight.
  • Increase the number of registered nurses and registered practical nurses in long-term care homes. 
  • Limit the use of temp-agency nurses, who go into long-term care homes with little knowledge of the residents and procedures, to fill staffing holes. Wettlaufer worked as an agency nurse when she tried to kill a patient in a Paris, Ont., nursing home in 2015.
  • Give grants ranging from $ 50,000 to $ 200,000 per long-term care home, depending on the size, to improve the infrastructure around medication, including how it is stored and tracked. That could include installing glass doors or windows onto medication rooms, installing security cameras in rooms where medication is stored or hiring a staff pharmacist. Wettlaufer herself told inquiry lawyers in an interview that glass doors on medication rooms would have made accessing insulin more difficult.
  • Give long-term care homes more flexibility to use funds to pay for a broad spectrum of staff, including porters or pharmacists.
  • Increase funding for training, education and professional development for everyone who provides care to residents in nursing homes. 
  • Make free counselling services available for two years to Wettlaufer’s lone surviving victim, the victims’ families and their loved ones.

Ontario’ Long-Term Care Minister Marilee Fullerton said later Wednesday that the province will act on the first two recommendations of Justice Eileen Gillese’s 91 recommendations to fix long-term care immediately. 

Government responds

The government will review the long-term care system and will spend the next year acting on the recommendations contained in the report. It will deliver an update on its progress next year, as requested by Gillese. 

That review will come with new funding for the province’s long-term care facilities. 

“This will be a government-wide approach. It will not be limited to one ministry,” Fullerton said. 

The province will also provide free counselling for the next two years for Wettlaufer’s surviving victim and the family and loved ones of her victims, Fullerton said. 

“Today is a solemn day, and I want to acknowledge the pain and the trauma and the impact this has had in the province,” Fullerton said. “To the families, I want to say, your loved ones mattered, they had meaning, and they will make a difference.”

More robust investigations

Gillese recommends the College of Nurses of Ontario, the profession’s regulatory body, educate its members about the possibility of health care serial killers, and encourage nurses to work in long-term care homes. 

The Office of the Chief Coroner is asked to redesign how it records patient deaths and to create a more robust investigation process for deaths, and to increase the number of death investigations it conducts in long-term care homes.

The coroner’s office should also train staff within the homes on how to assess whether a resident’s death is outside of the norm or “sudden and unexpected.” 

During the course of the inquiry, the commission heard that some coroners thought no death in a nursing home was “sudden and unexpected” because of the complex health needs of residents, and therefore didn’t prompt any investigations. 

Gillese didn’t touch on the role the Ontario Nurses Association, the union that represents nurses, played in the system. During the inquiry, there was a lot of testimony about ONA’s role in grieving Wettlaufer’s suspensions and eventual firing. Gillese said the union’s role was outside the scope of her report.

Gillese dedicates her report to Wettlaufer’s victims and their loved ones, saying “they serve as a catalyst for real and lasting improvements to the care and safety of all those in Ontario’s long-term care system,” she said. “Your pain, loss and grief are not in vain.”

To the nurses who work in long-term care homes, Gillese says, “In opening our eyes to the one nurse who harmed, we must not forget the work of the many who are a credit to their profession.”

The two-year inquiry was launched in August 2017 to look at the events that led to Wettlaufer’s offences and the contributing factors that allowed the crimes to happen, and to make recommendations to prevent similar crimes. 

The report examined how Wettlaufer, a nurse at several long-term care facilities in southwestern Ontario, was able to access lethal doses of insulin to kill her patients, to steal opioids to feed her own addiction and to continue being employed despite numerous reported flaws in her work. 

She committed her crimes between 2007 and 2016, with most of the murders happening at Caressant Care in Woodstock, a city about 140 kilometres southwest of Toronto. 

Wettlaufer quit her nursing job in 2016, checked herself into a psychiatric hospital and confessed her crimes

She pleaded guilty in 2017 to eight counts of first-degree murder, four counts of attempted murder and two counts of aggravated assault.

Wettlaufer, who is now 52, is serving eight concurrent life sentences, with no chance of parole for 25 years. 

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