Lloy Wylie, an assistant professor at Western University, made the claims while speaking at Bond University on Australia’s Gold Coast.

Dr. Wylie, who has extensive experience researching health service access challenges for Indigenous people in Canada, said the Canadian health system was not a particularly welcoming place, and did not do a good job of understanding Indigenous people’s cultures.

“I think we do a good job of public relations, selling Canada as a lovely, friendly place, and I kind of see it as part of my responsibility to correct that knowledge. We actually have a lot of work to do in Canada to improve things.”

She said systemic issues were leading to inequities in Indigenous health, and these needed to be addressed.

“There’s a lot of interpersonal racism. Our care providers are nasty and mean and hostile to indigenous patients. Sometimes it’s intentional, sometimes they don’t even realise how they’re treating people, but it still causes significant issues for Indigenous patients.

“Indigenous people expect racism when they go to the health care system now.”

Central to the issues was the relationship between Indigenous people and their care providers, with some Indigenous people feeling healthcare providers were blaming them for making poor choices, and some physicians reluctant to take on Indigenous patients, due to an assumption that they came with complex health issues which the physician did not want to deal with.

“Huge negative stereotyping happens all the time by care providers, it’s quite widespread. Indigenous patients face blame for the health conditions they have,” Dr. Wylie said.

Accompanying this was inadequate access to pain management.

“Providers are reluctant to prescribe pain medication to their Indigenous clients because they assume, they have issues with addictions.”

Dr. Wylie said physicians did not value Indigenous cultures or traditions, did not know what people’s life experiences were like, and there was a general lack of knowledge and understanding about traditional healing and how there could be a relationship between traditional healing and mainstream services.

“Alternative medicines are not valued in the health care system.”

A care provider had told her they did not understand the issues or why things were different from what they had been taught through their standard educational tools and textbooks.

Dr. Wylie said Canada had a history of Indigenous children being taken from their families to go to residential schools, and a lot of Indigenous women remained reluctant to access healthcare in hospitals, because so many babies had been taken from them in hospital, a practice which she said continued to this day.

Despite these issues, Dr. Wylie said there was a willingness by many people working within the health system to improve the way they provided care to Indigenous people.

“I was really surprised, despite the people who were willing to admit that racism is rampant and a real problem, most of the care providers I talked to said, ‘I want to do a better job, we need to do a better job, our institution needs to do a better job’.”

She said some care providers did take the time to develop the required relationships and trust, despite the fact their institution did not support them to do that.

There was also a need to make space for cultural practices — new hospitals in British Columbia included an Indigenous healing room, which was available for anyone to use, but specifically featured Indigenous culture and art.

Dr. Wylie said other potential improvements included having hospital-based expertise to provide care on demand, employing more social workers and transition case managers, improving communication and coordination with community-based services, and having more accountability if people weren’t treated equally.

She also suggested more Indigenous community placements while physicians were training.

Above all, she said people needed to fully understand the importance of a change in approach.

“One of the things I really emphasise with the people I do this work with is, this isn’t just a nice thing to do, this is a matter of life and death for people in Canada, and so we need to take it seriously… this is people’s lives at stake.”