Dissatisfaction grows among First Nations groups over Quebec Indigenous health-care bill

The Joyce's Principle Office walked out of a public hearing Wednesday morning held by a legislature committee reviewing a new bill that seeks to improve the treatment of Indigenous patients within Quebec's health-care system.

The office joined a growing chorus of First Nations groups expressing dissatisfaction with the way Bill 32 was drafted and its failure to recognize the existence of systemic racism in the province. 

"Today, I'm more proud of Quebecers than of their government," said the executive director of Joyce's Principle Office, Jennifer Petiquay-Dufresne, referring to the widespread support the group has received from the public for its work.

Joyce's Principle is a document presenting a set of measures aimed at ensuring that Indigenous people in Canada receive the highest standard of medical care free of racism and bias.  

It was created by the Atikamekw Nation following the death of Joyce Echaquan on Sept. 28, 2020, at the Joliette Hospital Center in Lanaudière, Que.

Indigenous Affairs Minister Ian Lafrenière, who introduced Bill 32, mentioned Echaquan in his opening remarks during the first hearing around the bill on Tuesday. The principle is also mentioned in the body of the bill. It has never, however, been adopted by Quebec.

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"We were profoundly disturbed to see Minister Lafrenière utter Joyce's name, objectifying her cause for his political agenda," Petiquay-Dufresne told journalists outside of Wednesday's hearing. "If we use the memory of Joyce in that way there has to be concrete [results]."

Lafrenière says naming Echaquan is necessary since, ultimately, she's "the reason why we're here." 

His bill aims to institute a "cultural safety approach" toward Indigenous patients. If adopted, it would provide a framework for health-care institutions to be more mindful of the particular realities of First Nations in Quebec.

According to Petiquay-Dufresne, however, the bill cannot produce the desired effect unless it recognizes the colonial structures ingrained in the health-care system as it exists today.

She says the government's way of working alongside Indigenous people should be reviewed so that legislation can be co-written and adequately represent the views of competent Indigenous authorities. 

For his part, Lafrenière says consultation has always been a tricky part of his portfolio. 

"On the one hand, it's not a phone call the day before you're presenting something, on the other we've got to respect the National Assembly....I can't share a proposed bill before it's presented here," he says.  

The committee also invited Dr. Stanley Vollant, an Innu surgeon from Pessamit, to Wednesday's hearing. He says he understands the frustration some groups feel about not having been consulted but says the bill, though imperfect, is ultimately a step in the right direction. He says Quebec health-care workers need to be more culturally competent.

"During my entire career I've observed inequalities in health care," he says. "It hasn't improved."

Vollant said the bill, in its current form, is too focused on individuals and should consider changing the environment in which they operate. In other words, not only should individuals recognize their hidden biases but organizations such as educational institutions should also do the same. 

Vollant said Indigenous people have to contribute to the creation of a new culturally sensitive health-care system and that involves institutions collecting feedback from Indigenous patients and treating it seriously. 

"There are people in Pessamit, from Uashat, from Manawan, who are afraid of going to the hospital and that is still true today in 2023...because they don't feel understood, respected — they feel like they're teated differently," said Vollant. "They're even afraid to die."

That fear translates into delayed care, something Vollant says needs to change.