Unity Health Toronto cares for more First Nations, Inuit and Métis peoples than any other health care organization in the GTA. In a recent five-year period, nearly 14 per cent of patients admitted to one of our inpatient units were Indigenous. Between 2016 and 2018, more than 25 per cent of the estimated 70,000 Indigenous adults in Toronto visited the St. Michael’s Hospital emergency department.

We know that Indigenous peoples come to us seeking care but what is the experience like when this happens? Is the care we provide consistent with our values? Do Indigenous patients feel safe? Or welcome? And how do we improve Indigenous health outcomes as we strive towards health equity?

Today, ahead of National Day for Truth and Reconciliation, we recognize the profound impact of the residential school system, honour the survivors and their families and remember the thousands of children who never made it home.

As health care providers, it’s our job to remove barriers to health care and ensure the provision of culturally safe and competent care for all First Nations, Inuit and Métis patients, residents and community members. As we continue to lean into this work, please see below for an update on our efforts to advance Indigenous health and reconciliation this past year and our commitments for the year ahead.

What we accomplished in 2022-23

Last year, Unity Health made three commitments in the areas of human resources, care pathways and Indigenous leadership and initiatives. We achieved or made significant progress on all three:

  1. We developed an Indigenous Wellness, Reconciliation and Partnerships Human Resources Strategy to advance Indigenous health and reconciliation across the organization. We announced Roberta Pike as the inaugural Director of Indigenous Wellness, Reconciliation and Partnerships, and Dr. Suzanne Shoush as the inaugural Physician Lead, Care Pathways.
  2. We established an Indigenous Care Pathways Steering Committee to help us build Indigenous Care pathways that guide our teams and provide transparency to Indigenous patients and families who come to us seeking care.
  3. We renewed the Terms of Reference for the First Nations, Inuit and Metis Community Advisory Panel (FNIM-CAP) at Unity Health. The FNIM-CAP continues to support the organization in our efforts to strengthen and harmonize Indigenous leadership and initiatives across the network.

We also:

  • Held our first Indigenous Leadership Circle – an opportunity for Unity Health leaders and Indigenous community members to discuss our progress from the past year and plans for Indigenous health and reconciliation in the year ahead. These meetings will take place quarterly.
  • Developed an updated policy on smudging – the Smudging Protocol and Burning Sacred Medicines for First Nations, Inuit and Métis Spiritual Ceremonies – which will be launched shortly.

Our commitments continue to be led by First Nations, Inuit and Métis individuals and organizations, including the new Office of Indigenous Wellness, Reconciliation and Partnerships (OIWRP).

Where we came up short

In 2021, we committed to creating Indigenous sacred spaces at Unity Health to support Indigenous spiritual practices and ceremony for patients, caregivers, staff, physicians and learners. We’re exploring spaces at St. Joseph’s Health Centre and Providence Healthcare, and recently identified a temporary location at St. Michael’s that meets most of the needs of the Indigenous community until a more permanent home can be found.

Actions that Unity Health will take in 2023-24

Truth and reconciliation requires a long-term commitment, ongoing work and continued momentum. These are the actions we pledge to take this year:

  1. Continue to develop an Indigenous Health Strategy that guides our efforts to improve Indigenous health outcomes and the provision of care to Indigenous peoples. This strategy will be aligned with the United Nations Declaration of the Rights of Indigenous Peoples and the Truth and Reconciliation Calls to Action, and informed by Medicine Wheel Teachings, Indigenous Wise Practices and concerns specific to Indigenous peoples and the Indigenous community in Tkaronto.
  2. Identify improved health human resource strategies to advance the recruitment of Indigenous peoples into all positions across the organization. Work across key portfolios to create specific Indigenous positions to fill specialized needs for care pathways. We’re in the process of recruiting for a Wellness Specialist – Emergency Department and will be posting for a Cultural and Ceremonial Facilitator and an Outreach Worker. Additional roles are being identified for the future, including mental health and addictions facilitators and clinical specialists at all three sites.
  3. Develop a corporate response to how Indigenous-identifying information gets gathered, populated and used within Unity Health, including in our new electronic patient record system.
  4. Continue to explore and implement additional professional development opportunities for Unity Health staff, physicians, learners and leaders in the area of Indigenous cultural safety.

Actions for individuals

Change starts with each of us. The following is a list of recommended activities from OIWRP to put truth and reconciliation into action in our own lives:

  1. Take the San’yas Indigenous Cultural Safety Training course. To date, approximately 600 Unity Health staff, physicians and board members have completed the San’yas course, with 150 more enrolled in the upcoming cohort. Read more about their experiences.
  2. Read and discuss the United Nations Declaration of the Rights of Indigenous Peoples and the summary report of the Truth and Reconciliation Commission. Integrate at least one Truth and Reconciliation Call to Action into your personal or professional life.
  3. Participate in a discussion circle or other reconciliation activity in your community. Circles for Reconciliation offers a 10-week opportunity for Indigenous and non-Indigenous people to participate in facilitated conversations, with the goal of building respectful relationships.
  4. Talk to friends, family and colleagues about anti-Indigenous discrimination and call out anti-Indigenous racism or unconscious bias when you witness it.
  5. Speak with colleagues about their commitments to Indigenous reconciliation. Health care workers can better support Indigenous patients within their area and review these tips for moving beyond apology and feelings to actions that address Indigenous health inequities.
  6. Read about the experiences of Indigenous people, like Jennefer Simo, Coordinator in the Security Services Department at St. Michael’s and member of the FNIM-CAP.
  7. Donate to local Indigenous organizations or support an Indigenous health or health sciences student. Become a patron of Indigenous small businesses, artists, playwrights and filmmakers.

I’d like to sincerely thank the First Nations, Inuit and Métis leaders and community members who have stepped forward to lead this important work. We’re privileged to work with and learn from this group, who are committed to helping us find solutions to provide better care experiences for First Nations, Inuit and Métis individuals and communities.


Tim Rutledge
President and CEO
Unity Health Toronto