Creating and maintaining a safer complaints system for Indigenous peoples

COBC recognizes Indigenous Cultural Safety, Cultural Humility, and Anti-Racism as an essential component of fulfilling our mandate to protect the public. Indigenous peoples, including Indigenous health professionals, are disproportionately subjected to Indigenous-specific racism and other harms in BC health care systems, services, and spaces. This urgent and specific issue requires a dedicated and specific response. COBC has committed to enhancing Indigenous Anti-Racism in the regulation and provision of opticianry services—first by signing a Declaration of Commitment in 2017, and again by signing an Apology and Commitments to Action in 2021. On September 30, 2022, COBC joined 10 other health profession regulators in formally adopting  Standard 4: Indigenous Cultural Safety, Cultural Humility, and Anti-Racism with a First Nations legal ceremony on the unceded lands of the Sḵwx̱wú7mesh (Squamish), Stó:lō and Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh), and xʷməθkʷəy̓əm (Musqueam) Nations, where the COBC office also stands.

To support the fulfillment of the new standard—and increase Indigenous Anti-Racism in COBC spaces, services, and systems—we have engaged in a meaningful project that will make Indigenous Anti-Racism a foundational part of our complaints and inquiry system. This important work will create and maintain systems, services, and spaces in the complaints and inquiry process that will be more accessible, relevant, and safe for Indigenous peoples. The 2020 BC Ministry of Health report entitled In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care articulates clearly: “Finding #7. Complaints processes in the health care system do not work for Indigenous peoples” (p. 110). As articulated in this detailed report, Indigenous peoples frequently experience Indigenous-specific racism, prejudice, stereotyping, and discrimination in BC health systems, including within complaints services, which deters reporting of racist and unsafe health services.

“This has the effect of reinforcing for Indigenous individuals, and more generally for some Indigenous communities, that within the health system one may experience injustices without any opportunity for those wrongs to be addressed. This reproduces past harms and trauma that have been part of the experience of colonialism in the health care system and contributes to a lack of access and poorer health outcomes. To rectify this, an integrated, accessible and culturally appropriate Indigenous complaints process is needed” (p. 110-111).

Among the barriers that Indigenous peoples face in accessing complaints systems, lack of safety and respect are cited as the main reasons (p. 112) that some choose to avoid such systems altogether. The top three reasons for not making a complaint, as cited by Indigenous respondents, include:

  • That their complaint would not be taken seriously. (31%)
  • That they would be treated poorly or unfairly through the complaint process. (27%)
  • That they would receive worse treatment from health staff for any future medical condition. (25%)

This includes Indigenous health professionals who experience racism and other harms from fellow health professionals in their practice environments and feel they are unable to safely make complaints about racism that will be taken seriously and effectively addressed.

“The regulatory colleges appear similarly ill-equipped to address the complexity of Indigenous patient experiences when they involved other health providers, multiple settings or systemic discrimination or racism” (In Plain Sight, p. 116, 2020).

COBC takes this urgent issue very seriously and, in accordance with our commitments, we are dedicated to making important changes that will increase access, relevance, and safety for Indigenous members of the public and Indigenous health professionals who may need to access the COBC complaints and inquiry system. Since March of 2022, COBC has been working with a Cultural Safety Consultant and Project Manager to design, develop, and implement meaningful work that addresses the specific issues described by the In Plain Sight report. Meaningful changes that support Indigenous Anti-Racism in the complaints system include (but are not limited to):

  • Policies and training (for staff and Inquiry Committee members) that support Indigenous methods of communication, such as verbal testimony in place of written statements
  • Room to safely and meaningfully include Indigenous Elders, Knowledge Carriers, ceremonialists, and other community representatives and supports.
  • Incorporation of various Indigenous legal perspectives, pre-colonial laws, and governance and legal protocols as part of conflict resolution and healing processes.

COBC holds paramount Indigenous ways of knowing, being, and doing in all of this important work, while including essential Indigenous voices, perspectives, and worldviews of truth, justice, and conflict resolution and healing. Consultations with Indigenous legal experts, Indigenous members of the public, and Indigenous opticians is crucial. While there is a vast diversity of Indigenous peoples, histories, communities, languages, and laws across the lands and waters now commonly called British Columbia, the COBC complaints system will be adaptable to the specific cultural safety needs of each Indigenous person who accesses our services. This meaningful project creates and maintains the room for different Indigenous cultural safety needs to be supported in an accessible and relevant way.  

The COBC office stands in Coast Salish territory. For thousands of years prior to colonization on these lands, Coast Salish peoples codified and symbolized their values, laws, stories, histories, and more within a unique style of visual art (In Plain Sight, p. 124, 2020). As COBC embarked on the journey of decolonizing our complaints system, we recognized the power that Coast Salish visual art could have in guiding our discussions and decision making. COBC collaborated with Margaret August, Two-Spirit visual artist of the Shíshálh Nation in Coast Salish territory, to interpret the values of this project in a visual and culturally relevant way, as determined through meaningful discussions amongst our staff, Board, and Inquiry Committee. Below is this artwork.

created by Margaret August for the College of Opticians of British Columbia (2022)

COBC is honoured to present Illumination by Margaret August. This powerful Coast Salish visual art in the form of an owl represents many teachings from ancestors and the Shíshálh Nation, while also telling a story about the decolonization of the COBC complaints system. Learn more about the meaning behind this piece.

COBC welcomes input from Licensed Opticians on this important work. Questions, comments, and requests to participate in discussions about this work can be sent to COBC Manager of Inquiry and Discipline, Meagan Marsh (she/her):

Phone: (604) 742-6472
Toll-free: 1-866-949-6472


Government of British Columbia (2020) In Plain Sight: Addressing Indigenous-specific Racism and Discrimination in B.C. Health Care
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Queen’s University (n.d), Centre for Teaching and Learning, What is Decolonization? What is Indigenization?
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