Cultural safety and racismWhy do we need to think more about racism?Racism is increasingly recognized as a determinant of health. 1 The health impacts of racism are evident in all areas of medical care and surgery is no exception.The aim of this paper was to review and evaluate the types and impact of racism on healthcare. An outline is offered of racism and racial discrimination progressing to the role of institutional leadership acknowledging cultural safety as a key concept. Finally, the importance of transformative change through education, training and regulatory compliance in delivering equitable healthcare to the vulnerable needs to be acknowledged.There are a variety of definitions of racism. 1 The analogous term of racial discrimination is defined by the Australian Human Rights Commission as any distinction, exclusion, restriction or preference based on race, colour, descent, or national or ethnic origin which has the purpose or effect or nullifying or impairing the recognition, enjoyment or exercise, on an equal footing, of human rights and fundamental freedoms in the political, economic, social, cultural or any other field of public life. 2