PHSA is on a journey toward eradicating Indigenous-specific racism and discrimination and advancing cultural safety and humility.
This timeline highlights key milestones, commitments and events in PHSA's journey to eradicate Indigenous-specific racism and discrimination in the health care system, across the land known colonially as British Columbia. A
historical timeline is also available on the Union of BC Indian Chiefs website.
All
Indian hospitals in Canada either close or convert to desegregated institutions. Prior to this, at least three major Indian hospitals operated in BC: Prince Rupert (Miller Bay), Sardis (Coqualeetza) and Nanaimo.
The last Residential School in BC closes – St. Mary’s Residential School in Mission. There were
18 Federal-Church operated Residential Schools in BC: Ahousaht, Alberni, Alert Bay, Anahim Lake, Cariboo, Christie, Sardis (Coqualeetza), Cranbrook, Kamloops, Kitimaat, Kuper Island, Lejac, Lower Post, Lytton, Mission, Port Simpson, Sechelt and Squamish.
The
Royal Commission on Aboriginal Peoples releases its final five-volume report. It was established to provide a study of the evolution of the relationship between Indigenous Peoples, the Government of Canada and Canadian society as a whole.
The Government of Canada responds to the Royal Commission on Aboriginal Peoples with the creation of the
Aboriginal Healing Foundation. The Aboriginal Healing Foundation provided community-based and Survivor-focused healing projects across Canada and built a foundation for healing support and research based on community needs and the legacies of Residential Schools.
The Government of Canada creates the Office of Indian Residential Schools Resolution Canada to manage and resolve the large number of abuse claims filed by former students against the federal government.
BC’s Provincial Health Officer issues a landmark report on the
Health and Well-being of Aboriginal People in British Columbia, highlighting significant gaps in health outcomes. The report concluded that the risks of developing diabetes, pneumonia, HIV/AIDS or experiencing injuries caused by motor vehicle accidents are greater for Indigenous Peoples than for other British Columbians.
The Province of BC, First Nations Leadership Council and Government of Canada signs the
Transformative Change Accord. It recognizes the need to strengthen relationships on a government-to-government basis, and affirms the parties’ commitment to achieve three goals:
Close the gaps between First Nations and other British Columbians in the areas of education, health, housing and economic opportunities over the next 10 years
Reconcile Aboriginal rights and title with those of the Crown
- Establish a new relationship based on mutual respect and recognition
The Government of Canada and nearly 80,000 Residential School Survivors reaches the
Indian Residential School Settlement Agreement, committing to individual compensation for Survivors, additional funding for the Aboriginal Healing Foundation, and the creation of the Truth and Reconciliation Commission.
BC and First Nations leaders agree to a new relationship guided by principles of trust, recognition and respect for Aboriginal rights and title.
The New Relationship focuses on closing the gaps in quality of life between First Nations and other British Columbians.
The First Nations Leadership Council develops the First Nations Health Blueprint for British Columbia, sharing a new vision for First Nations health systems. It identifies gaps and barriers in health services such as: delivery and access; sharing in improvements to Canadian health care; promoting health and wellbeing; monitoring progress; clarifying roles and responsibilities between governments and organizations; and developing ongoing collaborative working relationships.
Canada, BC and First Nations Leadership Council sign the
Tripartite First Nations Health Plan to create fundamental changes to improve First Nation health status in BC. The plan includes collaborating on 39 health action projects, defining principles to design a new governance system, and establishing goals for implementation.
Implementation of the Indian Residential Schools Settlement Agreement begins, which includes: a Common Experience Payment for all eligible former students of Indian Residential Schools; an Independent Assessment Process for claims of sexual or serious physical abuse; measures to support healing such as the Indian Residential Schools Resolution Health Support Program and an endowment to the Aboriginal Healing Foundation; commemorative activities; and the establishment of a Truth and Reconciliation Commission.
The Office of the Prime Minister of Canada
issues an apology to former students of the Residential School system. The Prime Minister also delivers the apology in the House of Commons, where Indigenous leaders and Survivors stood as witnesses to the speech.
San’yas Indigenous Cultural Safety online training program launches, developed by PHSA, BC Government, regional health authorities, Métis Nation BC, Elders and academics.
BC Tripartite Framework Agreement on First Nations Health Governance is signed and sets the beginning of First Nations, Canada and BC working together in a new First Nations Health governance structure, including the legal commitment to transfer federal programs and services to BC First Nations within two years without prejudice to title and rights.
The
First Nations Health Authority (FNHA) takes over responsibility from the federal government for the planning, management and delivery of health programs for First Nations in BC. The
First Nations Health Council (FNHC) guides the transfer and establishes, in a series of agreements with the Government of Canada and the Province of BC, a new First Nations health governance structure with political representation and advocacy through the FNHC; planning, management and delivery of health programs and services through FNHA; and technical advice and counsel from the First Nations Health Directors Association.
Registrars of all colleges in BC Health Regulators sign the
Declaration of Commitment – Cultural Safety and Humility in the Regulation of Health Professionals Serving First Nations and Aboriginal People in British Columbia.
First Nations Health Council, Province of BC, Government of Canada and First Nations Health Authority sign Memorandum of Understanding —
Tripartite Partnership to Improve Mental Health and Wellness Services and Achieve Progress on the Determinants of Health and Wellness — to support community-led approaches to addressing social determinants of health.
- Act as a resource and support for Indigenous patients and health care providers to ensure care is client-centred and culturally safe
- Address and/or interrupt Indigenous-specific racism
- Promote cultural safety and humility training and education for PHSA staff
In Plain Sight report is released, addressing Indigenous-specific racism and discrimination in BC’s health care system. The review’s recommendations stress the need for immediate, principled and comprehensive efforts to eliminate Indigenous-specific racism and discrimination against Indigenous Peoples in the health care system.
PHSA and the regional health authorities
issue a joint response to the report, accepting the report’s finding on Indigenous-specific racism and discrimination in BC’s health system and committing to implement all recommendations within their responsibility to lead, and committing to partner and support implementation of all others.
BC’s Ministry of Health establishes the role of Associate Deputy Minister, Indigenous Health within Ministry of Health, as recommended in the In Plain Sight report.
The Minister of Health announces the appointment of two First Nations people to all health authorities’ boards of directors.
BC’s Office of the Human Rights Commissioner releases
Disaggregated demographic data collection in British Columbia: The grandmother perspective. Grounded in “the grandmother perspective,” offered by Gwen Phillips of the Ktunaxa Nation, it recommends the development of legislation focused on building respectful relationships with marginalized communities to ensure that community needs and voices are meaningfully included in data collection, use and disclosure processes.
PHSA hires its first vice president, Indigenous Health & Cultural Safety, k’ʷunəmɛn, Joe Gallagher, of Tla'amin Nation.
Canada passes its
UN Declaration on the Rights of Indigenous Peoples Act that affirms the UN Declaration as an international human rights instrument that can help interpret and apply Canadian law. It also provides a framework to advance implementation of the UN Declaration at the federal level.
PHSA develops guides on Land Acknowledgements, Developing Respectful Relations, Respectful Language, Facilities Design and Working with Elders and Knowledge Keepers to inform the way staff approach their work across the health system.
PHSA creates an Anti-Indigenous Racism Response Training (ARRT) program for all staff to further their understanding on Indigenous-specific racism and discrimination and how it shows up in the workplace.
PHSA’s Board of Directors approves and starts implementation of their first Indigenous-specific Anti-racism Action Plan. It included individual and collective education for board members, as well as numerous actions the Board held the organization accountable for across all its sectors (services, finance, human resources, quality, policy, etc.) to eradicate Indigenous-specific racism.
PHSA Board of Directors passes an Indigenous-specific anti-racism staff policy, a first-of-its-kind policy in a health authority. The policy requires staff to complete Anti-Indigenous Racism Response Training (ARRT) and
San’yas Indigenous-specific Anti-racism training and opens the door for Indigenous led/centred reviews of reports of Indigenous-specific racism in the workplace.
PHSA’s executive leadership team embarks on their Indigenous-specific anti-racism learning journey on naming racism, understanding how racism operates in PHSA and actionable strategies to eradicate Indigenous-specific racism and discrimination.
First Nations Health Authority releases
Remembering Keegan: A First Nations Case Study, highlighting how Keegan Combes of Skwah First Nation passed away from a delayed diagnosis following an accidental poisoning. This case study provides an opportunity for health-care professionals to learn from and reflect on personal and systemic biases that shape their practice.
The BC government releases the
Declaration on the Rights of Indigenous Peoples Act Action Plan with one theme on eradicating Indigenous-specific racism and discrimination. The action plan includes implementing the In Plain Sight report recommendations. It also provides direction to implement the actions from a distinctions-based approach, and to follow shared understandings, including legal plurality that recognizes that within Canada there are multiple legal orders, including Indigenous laws and legal orders with distinct roles, responsibilities and authorities.
The Health Standards Organization releases the
BC Cultural Safety and Humility Standard developed by a First Nations-led technical committee with input from Métis Nation BC. The standard provides guidance to health organizations on the responsibility, structures and procedures that are required in governance, leadership and service provision to establish a culture of Indigenous-specific anti-racism and Indigenous cultural safety and humility in its services and programs.
Pope Francis visits Alberta, Quebec and Nunavut. On July 25, while in Maskwacîs, Alberta, situated on Treaty 6 territory, traditional lands of First Nations and Métis people, Pope Francis recognized the abuses experienced at residential schools that resulted in cultural destruction, loss of life, and ongoing trauma lived by Indigenous Peoples in every region of this country. Pope Francis made further remarks in Lac Ste. Anne, Alberta, Sainte-Anne-de-Beaupré, Quebec, and in Iqaluit, Nunavut.
PHSA unveiled its refreshed organizational purpose, vision and values statements and a set of six foundational
Coast Salish teachings.
- The teachings were gifted in ceremony to the organization’s Board of Directors by Coast Salish Knowledge Keeper, Siem Te Ta-in, Dr. Shane Pointe.
- The teachings inspire people to grow and serve in new ways, embracing the truth of Indigenous-specific racism, learning to incorporate lived experiences of Indigenous Peoples into quality care, and using them as guidance to do our best as human beings who are relationally accountable to one another: Thee eat “Truth”; Eyhh slaxin “Good medicine”; Nuts a maht “We are one”; Whax hooks in shqwalowin “Open your hearts and your mind”; Kwum kwum stun shqwalowin “Make up your mind to be strong”; Tee ma thit “Do your best”.
PHSA’s confirms that its first North Star priority is to eradicate Indigenous-specific racism and create an anti-racist, safe culture, free from discrimination.
PHSA signs a Letter of Understanding with Métis Nation BC to advance cultural safety and humility for Métis people accessing services through PHSA.
Sanya'k̓ula (Indigenous Recruitment and Employee Experience) establishes an Indigenous Employee Network, internal Indigenous employee newsletter, and new Indigenous employee welcome packages.
PHSA programs implement 16 program and service-area Indigenous-specific Anti-Racism Action Plans across the organization, which articulate commitments and actions to eradicate Indigenous-specific racism across the organization.
The Ministry of Indigenous Relations and Reconciliation releases the
Distinctions-based Approach Primer to help build understanding of the legal foundations and core elements of a distinctions-based approach in the Province’s relationships with First Nations, Métis and Inuit Peoples and communities.
The
First Nations Health Directors Association launches its
Strategic Plan, with an objective to improve First Nations’ experience in the health care system by reducing incidents of Indigenous-specific racism through collaboration with health partners and by advancing cultural safety and humility.
PHSA adds Indigenous leadership across the organization. In alignment with Recommendation 14 from the
In Plain Sight report, the Indigenous leadership positions include five new Indigenous Health executive director positions supporting:
- BC Children’s Hospital and BC Women’s Hospital + Health Centre
- BC Cancer
- BC Centre for Disease Control
- BC Emergency Health Services
- People & Culture team within PHSA
PHSA refreshes its internal peer-driven recognition program, the PHSA+ Awards, to recognize staff doing meaningful work to address Indigenous-specific racism and discrimination. New award categories celebrate Indigenous-specific anti-racism work and staff who are living the Coast Salish teachings gifted to PHSA by Knowledge Keeper, Siem Te Ta-in, Dr. Shane Pointe.
The PHSA Board of Directors starts a book club to inform their Indigenous-specific anti-racism approach to governance responsibilities, featuring White Benevolence, True Reconciliation, Structures of Indifference and other titles.
PHSA Quality establishes the Thee Eat and Indigenous-specific Racism and Discrimination Review Committee.
- This committee is responsible for developing and implementing a culturally safe, responsive and accountable process for reviewing instances of racism and discrimination towards Indigenous patients and families.
- An intake and tracking process ensures a thorough review process for each event in the program/service where the Indigenous-specific racism occurred.
- The committee approves recommendation reports from the reviews, ensuring that appropriate measures have been taken to repair the harm that occurred and mitigate future harm.
Provincial Virtual Health and Provincial Language Services launch the “Partnering on Appropriate Virtual Care” project. It engages patient partners, including a Deaf Indigenous patient, to identify requirements to promote safe, high quality, linguistically appropriate and culturally sensitive virtual health interactions between community members (patients, families, caregivers) and their health care team.
Provincial Language Services completes phase one of the “Indigenous Language Access” project, which creates an Indigenous Language Access model for interpreting and translation. Conversations continue with First Nations communities to conduct a pilot project that includes connection with Indigenous language keepers and Elders.
PHSA hires a new Indigenous leadership position to support Patient Care Quality Office reviews and resolutions for Indigenous patients. In addition, a new Indigenous patient care specialist in its Patient Care Quality Office manages concerns from Indigenous patients within Correctional Health Services.
PHSA implements a new process for obtaining consent from Indigenous patients and their families verbally, with regard to reviewing and reporting on concerns of Indigenous-specific racism.
PHSA develops an Indigenous-led resolution approach centred on the safety and self-determination of Indigenous patients filing a complaint with the Patient Care Quality Office, and partners with Indigenous Knowledge Keepers and Elders to offer traditional ceremonies as part of resolutions for Indigenous patients concluding Patient Care Quality process.
BCEHS continues expansion on the Rural Remote and Indigenous Framework (2020) to address and redress service models and to improve equitable and timely care for Indigenous Peoples in rural, remote and Indigenous communities.
BC Cancer hires eight Indigenous Patient Navigators working out of all six of its centres.
The Chee Mamuk program at BC Centre for Disease Control leads the Kǝmtǝks Yakwa project (“Know or Knowledge Right Away”) and, in consultation with Indigenous partners, adopts the tagline for this project of “knowing means more choices”. The focus of this project is to engage Indigenous communities, particularly those that are rural and remote, using a distinctions-based approach, to determine interest and acceptability of sexually transmitted and blood borne infections testing options.
PHSA Health Information Management completes a review of how Indigenous self-identification data is collected by central registration services teams. This quality improvement initiative is intended to increase cultural safety for Indigenous people interacting with registration services at PHSA care facilities. It includes a review of data quality, cultural safety training requirements, procedure documentation, patient-facing information, and an employee self-assessment.
PHSA convenes a leadership Advisory Committee for the development of the PHSA-wide Indigenous-specific Anti-Racism Strategy. The Committee develops key themes and related problem statements for the strategy to address.
PHSA updates its Indigenous-specific Anti-Racism and Discrimination Staff Policy, which promotes “speak-up culture” and details a reporting pathway for incidents of Indigenous-specific racism at PHSA via the Sanya'k̓ula team within the People & Culture department.
The Maternal-Newborn Program and Maternity Ambulatory Program at BC Women’s Hospital + Health Centre publishes an Indigenous Ceremony and Smudging Protocol, with the expectation that health care providers uphold Indigenous rights to cultural practices and ceremony (recommendation 10, In Plain Sight).
PHSA launches an Indigenous Health executive director leadership development program, Manaqi Skukum K’anamawkst Nsayka, meaning “We are Stronger Together” in Chinook Wawa, to strengthen and cultivate Indigenous leadership excellence. Chinook Wawa is a historic trade language that originated in the Pacific Northwest, combining Chinookan, Nuu-chah-nulth, English and French vocabulary.
A Nuts a Maht Healing Garden opens on the BC Children's Hospital & BC Women's Hospital + Health Centre campus, designed to offer comfort, peace of mind, and spiritual strength for all who visit.
A
public health ethics guide establishes a shared foundation for ethical reflection and decision-making across the provincial health system. Led by PHSA leadership in Clinical Ethics, Indigenous Health, BC Centre for Disease Control, along with partners from the First Nations Health Authority and the University of British Columbia, the guide considers the impacts of colonization and structural barriers experienced by members of equity-deserving groups.
PHSA continues to expand and promote its Indigenous Employee Network, growing to more than 100 self-identified Indigenous staff members. It offers community of practice events, a newsletter and weekly coffee connects.
BC Centre for Disease Control issues a formal apology and leadership commitments to First Nations, Inuit and Métis Peoples on Dec. 10, 2025. The apology was made at PHSA offices, grounded in Coast Salish protocols, and acknowledged BCCDC’s role in causing or contributing to past and present harms; explicitly linking truth-telling, public health practice and eradicating Indigenous-specific racism.
The federal government shares the
fourth progress report on implementing the federal UN Declaration Act on Aug. 20, 2025. The report tracked progress on the UN Declaration Act Action Plan’s 181 measures — with input from Indigenous partners, federal departments and agencies — and included progress such as creating an Indigenous-led Action Plan Advisory Committee and releasing the Indigenous Justice Strategy.
San’yas Indigenous-specific Anti-Racism training and the PHSA leadership cohort-based learning journey continues to be facilitated by an education team within PHSA Indigenous Health. At the end of 2025, San’yas training completion rates were 50% for unionized staff and 75% for non-contract staff; Anti-Indigenous Racism Response Training completion rates were 57% for unionized staff and 70% for non-contract staff.
Team members from PHSA Indigenous Health, BC Centre for Disease Control, and
Pacific Public Health Foundation are coming together to support the carving of a 36-foot traditional xʷməθkʷəy̓əm (Musqueam) Cedar Salish Sea-Going Canoe by artist and carver Jody Sparrow.
PHSA continues to improve Indigenous self-identification data quality, launching a new way for Indigenous staff to self-identify. The information collected will:
- Support improved recruitment, retention, and workplace experiences for Indigenous employees.
- Provide accurate data to guide our organization's journey towards eradicating Indigenous-specific racism.
PHSA launches a renewed website to promote its
San’yas Indigenous-specific Anti-Racism training across Canada, providing courses for different audiences and sectors, including health care, justice, public service and systems that support children and families.
BC’s
Health Professions and Occupations Act replaces the Health Professions Act, embedding cultural safety and anti-discrimination into health professional regulation. The Act aligns with UNDRIP, was informed by In Plain Sight, creates a new legal duty to report discrimination, enables trauma-informed and restorative complaint options, requires Indigenous support-worker options, and requires bylaws on anti-discrimination measures.
The BC government launches its first
Provincial Anti-Racism Action Plan. The plan includes commitments from core government ministries and agencies, including the health care sector, and includes health actions such as establishing a new centre for anti-racism and cultural safety within the Ministry of Health, adapting chronic-disease programs for racialized communities, and setting learning expectations for all health-care workers on Indigenous-specific racism and culturally safe care.
The BC government releases the
2025–26 Declaration Act Annual Report, documenting 2025/26 progress on the Declaration Act Action Plan. It includes health system progress such as opening Indigenous-led health facilities and implementing In Plain Sight recommendations.
PHSA approves Smudging and Burning Ceremonies Procedures for Forensic Psychiatric Hospital, Red Fish Healing Centre for Mental Health and Addiction, Heartwood Centre for Women and the Provincial Assessment Centre to uphold the inherent rights of Indigenous Peoples to access their traditional medicines and maintain their health and healing practices. The procedures guide staff in supporting access to culturally safe care through smudging ceremonies.
PHSA honours the life and legacy of Coast Salish Knowledge Keeper, Siem Te Ta-in, Dr. Shane Pointe, who passed away in the spring of 2026. His presence shaped people across PHSA in ways that will endure, including through the commitments leaders and staff made to uphold and live by the
Coast Salish teachings he gifted PHSA.
