Philpott: A call to end #racism in Canada’s health care systems

Of note the emphasis on practical initiatives:

I wish I could say with certainty that the death of 37-year-old Joyce Echaquan will be a wake-up call for health systems in Canada. It should be. But history gives us no confidence to make such a claim. Joyce Echaquan is not the first person to die as a direct or indirect result of racism in Canadian health care systems. Tragically she won’t be the last. But her death comes at a point in our history where Canadians may be more attuned to the dangers of systemic racism than we were, for example, when 45-year-old Brian Sinclair died in a Winnipeg hospital in 2008.

We must seize this moment in history and act to prevent more senseless deaths. There is no better place to start than with changing the way we train health professionals. A 2019 international consensus statement on Indigenous health equity notes that “Medical education institutions must acknowledge their historical and contemporary role in the colonial project and engage in an institutional decolonization process.”

Here at Queen’s University, our principal, Patrick Deane, has not shied away from declaring that racism and other forms of oppression, including colonialism, “deeply affect our institution, as they do the systems and formations of our society at large.” Such a categorical admission of institutional racism from the leader of a prominent post-secondary institution is not something we heard a decade ago. The open admission that an organization like ours is plagued with structural injustices, which permit some to be privileged and others to be harmed, is an essential step on our journey to changing those deep-rooted patterns of injustice. That kind of openness leads me to think that we are at a point in time when we can more effectively take on racism and colonialism in health care; in hopes that Joyce Echaquan’s death will not be in vain.

There is no single intervention that leads to the reduction or the elimination of racism and colonialism in health systems or in the training of health professionals. We need comprehensive and collaborative cultural transformation. We don’t need more studies; we need action on a suite of reforms. Steps have been laid out in multiple reports including the Calls to Action of the Truth and Reconciliation Commission and the Calls for Justice from the Inquiry on Missing and Murdered Indigenous Women and Girls. The Association of Medical Faculties of Canada tabled its own commitment last year entitled a Joint Commitment to Action on Indigenous Health.

As dean of the Faculty of Health Sciences at Queen’s, I’m determined to work with my colleagues to breathe life into those reports. We have hired new staff including an elder-in-residence to provide ceremonial and cultural supports. Last week we opened an Office of Equity, Diversity, and Inclusion and we now have over 150 volunteers from students, staff, and faculty participating in a Dean’s Action Table on Equity, Diversity, and Inclusion.

We have an obligation to expand the Indigenous health workforce by increasing the number of First Nations, Inuit and Métis students in medicine, nursing and rehabilitation therapy. Indigenous Peoples must see themselves reflected in the health professionals who treat them. We must continue to identify structural biases in our admissions processes and make amendments, accordingly, including diversifying the membership of admissions committees and introducing cultural safety training for their members.

We’ve already changed the focus of the Queen’s Accelerated Route to Medical School to enable 10 students who identify as Indigenous or Black to begin a pathway to medical education that addresses some of the well-known systemic barriers to access. We know this means we’ll need a broad community of support for growing numbers of Indigenous and Black students on campus and in our health professions programs, but we’ve already taken steps to enable that, by hiring mentors such as Wendy Phillips, elder-in-residence and former MP Celina Caesar-Chavannes, senior advisor on equity, diversity and inclusion.

Just as important as the diversity of our student body is what we teach our students. Our curricula must include Indigenous perspectives of history and culture. It should include concepts of power, privilege and conflict resolution. This work is underway. We have professional development courses in cultural safety, anti-racism and anti-oppression. We have started to diversify our workforce, recognizing the importance of having staff and faculty from under-represented groups in leadership positions and on decision-making bodies.

We also need tools to help us identify personal, institutional and systemic forms of racism. As we use these tools, there will be an obligation to act on what we learn, with cycles of self-reflection and informed action. Increasingly, we must learn safe and effective ways to speak up when we recognize bias, harassment, and micro-aggressions.

Speaking up is the minimum response. Our collective goal is to change the entrenched patterns of injustice in our health systems. In some cases, it’s a matter of life or death.

Source: A call to end racism in Canada’s health care systems

Queen’s launching new program to train immigration and citizenship consultants

Interesting back and forth between the lawyers and academics quoted. Although I am not a great fan of consultants compared to lawyers, given the history of poor and, in some cases, fraudulent representation, the program is professionally designed given the people involved:

On Aug. 1, Queen’s University will launch a graduate diploma in immigration and citizenship law. The program will be the only English-language educational pathway to becoming a regulated immigration consultant.

Queen’s developed the program and won a competitive bid with immigration consulting’s national regulator and will be the sole accredited English provider of the program.

Ravi Jain, national chair of the Canadian Bar Association Immigration Law Section, says the program should not exist, arguing it lends credibility to an industry that has been marred by incompetence and misconduct since its inception.

“By continuing to facilitate immigration consultants to be engaged in the practice of immigration law, it does it does actual Queen’s law JD students a disservice,” says Jain, who is certified by the Law Society of Ontario as a specialist in immigration law and is partner at Green and Spiegel LLP, in Toronto.

“This program is a terrible idea. Graduates will claim that they have ‘gone to law school.’ The public will be even further confused. Most think that they are hiring lawyers when they hire immigration consultants,” says Jain. “Immigration consultants have a horrific history in Canada.”

Queen’s Law Dean Mark Walters says the problems known in the industry is one of the reasons his school launched the program.

“We all appreciate that at present, the profession of immigration consultant is not well regulated, and that there have been abuses in the system and concerns legitimately raised. And that’s, in fact, why we’re involved,” Walters says.

Associate Professor at Queen’s Law and expert in immigration and refugee law Sharry Aiken says the federal government decided long ago that there was a place in the immigration administrative process for consultants.

“It’s a profession that’s here to stay. And the key is to ensure that it’s properly regulated and that the people in that profession are professionals and trained as such,” she says. “It’s a massive system and non-lawyers can perform a really important role to ensuring that vulnerable people get proper advice and assistance as they work their way through elaborate administrative system.”

The program at Queen’s comes after the regulation of immigration consultants has gone through three different stages. In 2001, the Supreme Court of Canada case Law Society of British Columbia v. Mangat ruled it was not a breach of the Legal Profession Act for non-lawyer consultants to represent people in immigration hearings in B.C. Since then, the door has been open for the non-lawyer consultants to serve clients looking to relocate to Canada.

The first governing body — the Canadian Society of Immigration Consultants — eventually attracted a parliamentary review in 2010 due to lack of policing and professional and ethical standards. The Immigration Consultants of Canada Regulatory Council followed but problems persisted, and another parliamentary review took place in 2017. The Standing Committee on Citizenship and Immigration produced a report: “Starting Again: Improving Government Oversight of Immigration Consultants.” The report showed misconduct was still prevalent, with international students, live-in caregivers and temporary foreign workers being the most vulnerable to abuse. The committee’s witnesses repeatedly accused the ICCRC of failing to deal with unauthorized practitioners, known as ghost consultants.

The 2017 report produced the College of Immigration and Citizenship Consultants Act, which turned the ICCRC into a new self-regulatory College of Immigration and Citizenship Consultants — instituting a licensing regime, code of conduct, complaints and discipline committees and putting the board of directors under the guidance of the minister of immigration, refugees and citizenship.

While the argument in favour of including consultants in the immigration system involves the need to increase access to justice, Jain says that the immigration bar is uniquely accessible to the public they serve. Jain calls the access to justice argument “absolutely ridiculous.”

“I would ask the dean and others to point me to evidence that there are problems with respect to immigrants and refugees retaining lawyers,” Jain says. “The average income of an immigration lawyer is about $75,000. People go into it out of humanitarian instinct and there’s lots of pro bono work and low-bono work where there are very low fees. So, there’s no evidence of an access problem. None, whatsoever.”

He adds that the issue raises the question of why society deems immigrants and refugees, who are particularly vulnerable, to not need the help of a trained lawyer.

“Why should immigrants and refugees be told that they don’t need a proper lawyer? It’s only the marginalized and the racialized that are told that, in our society. It’s never the other areas of law. And so, I just find that argument to be highly problematic.”

Aiken says that many other areas of law also use paralegals and consultants play “a very important role in access to justice for vulnerable communities.” She adds that the new iteration of the regulatory body, past forms of which have been “plagued with structural deficits” has made positive changes, including an expanded regulatory authority to discipline members and other new enforcement powers.

Before setting up the Queen’s program, Aiken established a National Advisory Committee, which included members of the immigration bar including past chair of the Canadian Bar Association national section for Citizenship and Immigration Robin Seligman and Lobat Sadrehashemi past president of the Canadian Association of Refugee Lawyers.

Source: Queen’s launching new program to train immigration and citizenship consultants

Racists, dummies and bad costumes: Robyn Urback

Always good to have nuance rather than the automatic reactions:

There is, however, nuance to be found under the impassioned name-calling being sputtered from both sides. It involves the recognition, for one, that most of these students probably aren’t frothing racists, but rather, just uninformed dolts who didn’t read the news last Halloween, and who don’t understand why someone might take offence to them wearing a symbol of profound religious or cultural meaning as a costume.

It also involves the recognition that while some people might not have a problem with students dressed as people of other cultures, there are very legitimate, genuine reasons why Mexican prisoner or Tibetan monk costumes would be considered offensive. Some of those reasons are more obvious than others (see: Mexican prisoner), but just because it might take a bit of digging to find the “offence” doesn’t mean it’s any less real.

All that said, we will certainly never get anywhere if the impulse, from all ends, is to sprint to the extreme each and every time this comes up. So, how about next October, instead of the conversation going as it did this time — “This is shockingly racist!” then “Pft, crybabies…” —  we opt instead for, “Hey, I don’t think you’re a Nazi, but maybe dress as a cat next time?” followed by “OK”?

Maybe then we’ll have a shot at getting through the year without playing out the same tedious routine.

Multiculturalism Policies in Contemporary Democracies

Map2010The comparative work by Keith Banting and Will Kymlicka of Queen’s University. A wealth of detailed and general information in this site.

Expect that Australia’s score will change following the change in government.

Multiculturalism Policies in Contemporary Democracies – Home.