Niagara Health works to rebuild trust with Indigenous patients after inquest

ST. CATHARINES — Niagara Health is implementing cultural safety training and a new Indigenous health services plan in an effort to rebuild trust after the 2021 death of an Indigenous patient in its care.

The hospital system's efforts have drawn praise from an Indigenous umbrella group, which said other hospitals should learn from its approach.

Heather Winterstein, 24, died of septic shock with delayed treatment at the St. Catharines hospital, now known as the Marotta Family Hospital, a coroner's inquest found earlier this year.

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Testimony suggested treatment decisions by some hospital medical staff may have been influenced by Winterstein's Indigenous background, her history of substance use and anxiety.

"We cannot have another death like Heather Winterstein's," said Sean Longboat, chief executive officer of the Ontario Federation of Indigenous Friendship Centres.

After Winterstein's death, Niagara Health conducted reviews and accepted recommendations to instil cultural safety, promote an Indigenous patient navigator team and recruit Indigenous employees.

In 2024, it launched its first Indigenous health services plan to improve access, enhance cultural safety and promote traditional healing practices.

Charity Beland, manager of Indigenous Health Services and Reconciliation at Niagara Health, said cultural safety training began with leadership and is now mandatory for frontline staff.

"Last I checked, I think we were at 77 per cent completion," she said. "For a large organization we've had really, really good buy-in."

Beland, a member of Six Nations of the Grand River, Mohawk, Turtle Clan, leads a team working to create hospital settings where Indigenous people feel safe.

She said it is important not to shy away from using terms such as racism and discrimination when describing the Indigenous experience in hospitals.

"If we don't use the words and we don't use the language… then we're doing the work a disservice," Beland said.

Longboat said he is encouraged by Niagara Health's direction but noted regaining trust will take time.

"It will take time to regain Indigenous people’s trust, especially after losing a treasured family and community member like Heather Winterstein," he said in a statement.

"Trust can only be repaired through sustained action and allowing Indigenous people to exert their autonomy and self-determination in the design and delivery of health services."

In 2025, Niagara Health entered a formal partnership with the Indigenous Primary Health Care Council to develop joint initiatives aimed at improving Indigenous health outcomes.

It was the first agreement of its kind with a hospital system, Niagara Health said.

"This partnership is an important step towards creating a healthcare system that is responsive and respectful of Indigenous needs," said Caroline Lidstone-Jones, CEO of the health council.

Suzanne Shoush, a family physician and Indigenous faculty lead at the University of Toronto, testified at the inquest that bias in the healthcare system makes many Indigenous people fearful of seeking care.

She said that ingrained racism contributes to shorter lifespans, increased chance of preventable death and longer wait times for Indigenous people.

The coroner's inquest jury made 68 recommendations, most targeting Niagara Health alone or with other agencies.

Longboat said the recommendations provide a "roadmap for meaningful change" that other hospital systems should take seriously.

He said the provincial government must commit to holding itself to a higher standard to ensure the healthcare system cares for everyone.

With files from CBC News