At the recent Best of Both Worlds 2017 Quality Forum in Vancouver, 23 health regulatory colleges became the first in Canada to pledge their commitment to making BC’s health system more culturally safe and effective for First Nations and aboriginal peoples. The acknowledgement of racism in health care paved the way for creation of the Declaration of Commitment, which advances cultural humility and cultural safety in health services, and was signed in 2015 by the six provincial health authorities, the BC Ministry of Health and First Nations Health Authority (FNHA).
The declaration has three main pillars: creating a climate for change; engaging and enabling stakeholders; and implementing and sustaining change. It builds on the already transformative and well-received San’yas Indigenous Cultural Safety training offered by the Provincial Health Services Authority.
Physicians and other health professionals are in a unique position to affect real change within the system; to consider how their practices can help support positive health outcomes for aboriginal peoples and to speak up and advocate when they see discrimination or bias. Change requires awareness, education, and acknowledgement. The regulatory colleges join the health authorities in creating an expectation of change among all health professionals, so that all indigenous and aboriginal persons will experience the culturally competent, safe and effective care they deserve.
The declaration is based on the guiding principle that all partners, including First Nations and aboriginal individuals, elders, families, communities, and nations must be involved in co-development of action strategies and in the decision-making process with a commitment to reciprocal accountability. This also means individuals are able to voice their perspectives, ask questions, and be respected by the health care professional on their beliefs, behaviours and values.
In taking this important step, regulatory bodies have acknowledged the problem of racism in health care and can lead with a vision of what is expected of health professionals. Hardwiring this work in the provincial health system will take time but initial strides are promising and there is enthusiasm across the country for this work that is being led in BC.
More information on the provincial work in cultural humility and cultural safety can be found on the FNHA website.