Report outlines ways to improve N.W.T.'s health-care system for Indigenous patients

A new report on health care in the N.W.T. lays out a number of ways to improve the system for Indigenous patients, by addressing systemic racism as well as underrepresentation in senior leadership positions, among other things.

The report, titled "Honouring the Voices of Indigenous Peoples," was done by a team composed of advocates and health service representatives from across the territory and backed by the non-profit Healthcare Excellence Canada with federal funding.

The original focus was on the Stanton Territorial Hospital in Yellowknife and the work being done by the Indigenous Wellness Program there, but it evolved to include insights from across the territory's health-care services. 

It's not the first analysis of longstanding issues in the territory's health-care system, so the report stresses the need to build off of existing work and implement its recommendations.

The 99-page report outlines several actions for change and steps to achieve them. It's focused on patients, staff, program design, and institutional design and leadership.

Preet Dhillon is the project manager for the report. Dhillon said its 13 recommended actions for a more culturally safe health-care system came from relationship-building and listening to community members' experiences.

"It was their honesty and their vulnerability and the strength that they have, that lie at the heart of this work. And we hold the trust that they have in us with very deep respect," said Dhillon.

"It's all of our hope that as residents engage with the report and read it, that they truly feel seen and heard and that their voices and experiences are valued and being used in a way to inform change that will ultimately support them in their future health care."

The report says that both health staff and patients want to see more Indigenous leadership in the system.

"Decisions that impact Indigenous peoples in the [Health and Social Services] system should never be made without Indigenous representation at the table," it reads.

Indigenous representation in senior staffing in health care is slim. For 2022-2023, the territorial government identified two Indigenous senior management employees out of 29 in the Northwest Territories Health and Social Services Authority (NTHSSA). Within the Department of Health and Social Services, there were two out of 17.

The report also highlights racism experienced first-hand by Indigenous people and makes recommendations to address the issue.

It describes participants who encountered "outright racism" from health staff, and encounters ranging from stereotyping comments made toward patients to neglect of care. Participants have said they've been left feeling doubted or ignored by the health care system.

"Some described instances of reporting symptoms of serious health issues, feeling that their concerns were not taken seriously at Health and Social Service facilities, and being advised to take Tylenol without receiving proper diagnosis," the report says.

Recommendations for improvement

The report lists 13 recommended actions for improvements.

One is aimed at addressing individual and systematic racism within the system. It would involve health system leaders taking three separate cultural and anti-racism training programs and developing a system to monitor training outcomes.

To increase Indigenous leadership and representation, the report recommends that NTHSSA look into creating a territorial Indigenous branch of the organization.

It also suggests strengthening support for and expanding the elder-in-residence program at Stanton Territorial Hospital, including by hiring a female elder to be a part of the program.

Fraser Lennie, the report team lead, said the report has been submitted to health officials, and that the work was done in time to be shared at the Hotıì ts'eeda annual gathering last week.

"We worked really hard to get everything ready, so that way that could be sort of our first introduction," said Lennie.