Union of BC Indian Chiefs (UBCIC), Vancouver Coastal Health (VCH), and the Provincial Health Services Authority (PHSA) reach a settlement agreement to improve supports for Indigenous peoples through their liver transplant care journeys

The amendments made to clinical guidelines are intended to guide health care providers to better recognize and consider the historical experience and generational trauma of Indigenous peoples when supporting each Indigenous patient through their transplant care journey. 

This means that if barriers to transplant eligibility and priority for Indigenous patients experiencing liver failure are identified, best efforts will be made to assist patients to mitigate or eliminate those barriers. This includes supporting Indigenous patients in accessing any needed psychosocial or financial supports throughout the referral, transplant eligibility review, and transplant processes.

 “As the recipient of a liver transplant myself, I am deeply proud of our joint work to ensure that Indigenous peoples have equitable access to liver transplantation,” said Grand Chief Stewart Phillip, UBCIC President. “PHSA and VCH has committed to making its best efforts to ensure that barriers resulting from historical oppression of Indigenous patients will not be an obstacle to the provision of health care. We intend to keep a close watch on liver transplant outcomes to make sure that best efforts are indeed taken to ensure that Indigenous patients receive the health care to which they are entitled.”

Additional guideline amendments were made concerning all patients with primary biliary cholangitis (PBC), auto-immune hepatitis (AIH), or other cholestatic liver diseases who are referred for transplant.  PBC is an autoimmune disease disproportionately affecting Indigenous people, particularly Coastal First Nations people, at approximately eight times the likelihood of non-Indigenous people, and nine out of 10 PBC patients are female.  The updated guidelines recognize that in addition to clinical scores, the patient’s overall condition is considered when evaluating priority for transplant. 

“On behalf of PHSA and the BC Transplant program, I extend my gratitude to Grand Chief Stewart Phillip and the Union of BC Indian Chiefs for working collaboratively with us to bring meaningful and positive change to our liver transplant program” said Penny Ballem, interim President and CEO, PHSA. “We recognize the historic harms and challenges Indigenous people have confronted and, in many cases, continue to face when accessing health care in BC. These changes reflect our commitment to Reconciliation and our ongoing efforts to create a safe and equitable health care system that serves all people living in British Columbia.” 

BC’s liver transplant guidelines are based on available evidence, considerations and expert opinions.  The VCH Liver Transplant Program and BC Transplant (a program of PHSA) are committed to making regular updates as needed based on evolving clinical evidence, program quality and outcomes monitoring, practice changes and constructive feedback.

“VCH is pleased to have reached an agreement with UBCIC that advances equitable access to care,” said Vivian Eliopoulos, President and CEO, VCH. “As an organization, we are committed to the timely delivery of safe, quality care for everyone, including the Indigenous communities we serve throughout the region. VCH will continue to work collaboratively to improve BC’s organ donation and transplantation system, including opportunities to better support Indigenous patients throughout their care journey.” 

UBCIC acknowledges the indispensable role of community champion David Dennis, Huu-ay-aht First Nation, who raised concerns about inequities with a liver transplant policy and fought courageously for fairness and equality in organ transplant rights until his passing in 2020.

UBCIC, PHSA and VCH continue to work together to ensure that equitable access to health care services for Indigenous people in British Columbia, and to identify and address barriers to health care access for Indigenous persons.

BC Transplant, a program of the Provincial Health Services Authority (PHSA), provides provincial oversight for all aspects of organ donation and transplantation in BC. With compassion, collaboration and innovation, we will save lives and offer hope through organ donation and transplantation. BC's three transplant centres are BC Children's Hospital, St. Paul's Hospital and Vancouver General Hospital. Transplant patients receive follow-up care at the transplant centres or at one of eight regional clinics close to their home community. For more information, visit www.transplant.bc.ca or follow us @BC_Transplant.

The Provincial Health Services Authority (PHSA) provides specialized health care services and programs to communities across British Columbia, the territories of many distinct First Nations. We are grateful to all the First Nations who have cared for and nurtured this land for all time, including the xʷməθkwəy̓əm (Musqueam), Sḵwx̱wú7mesh Úxwumixw (Squamish), and səlil̓w̓ətaɬ (Tsleil-Waututh) First Nations on whose unceded and ancestral territory our head office is located. We work in partnership with other B.C. health authorities and the provincial government to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca or follow us @PHSAofBC. 

Vancouver Coastal Health (VCH) is committed to delivering exceptional care to 1.25 million people, including the First Nations, Métis and Inuit within the traditional territories of the Heiltsuk, Kitasoo-Xai'xais, Lil'wat, Musqueam, N'Quatqua, Nuxalk, Samahquam, shíshálh, Skatin, Squamish, Tla'amin, Tsleil-Waututh, Wuikinuxv, and Xa'xtsa. Learn more at vch.ca

The Union of BC Indian Chiefs is an NGO in Special Consultative Status with the Economic and Social Council of the United Nations. For further information, please visit www.ubcic.bc.ca. 

Media

Provincial Health Services Authority
phsacomm@phsa.ca
778-867-7472

Vancouver Coastal Health
media@vch.ca
604-202-2012

Union of BC Indian Chiefs 
Andrea Glickman, Policy Director
andrea@ubcic.bc.ca