In her emergency room on Sunday Dr. Anna Reid treated patients in the throes of delirium tremens â€” severe alcohol withdrawal after a weeklong binge. One arrived with life-threatening seizures.
The incoming president of the most influential doctors’ group in the country also saw homeless patients with cellulitis â€” deep, severe and fast-spreading infections in their feet and lower legs from wearing the same pair of ripped, worn and wet shoes for more than a year.
"Those are the kinds of things I see on a daily basis," Reid says â€” homeless, addicted and mentally ill patients stranded in her Yellowknife emergency room, some of them residential school survivors who can’t function in society, she says, "because they don’t have any sense of who they are anymore."
The health divide between rich and poor perhaps gets no more blatant than in the North. "It’s in your face everywhere you turn," she says.
She doesnâ€™t paint a rosy picture
Earlier this year outgoing CMA president Dr. John Haggie accused the Harper government of gnawing away at the country’s social safety net, warning that plans to raise the pension eligibility age to 67 would force low-income seniors to choose between buying groceries or buying medicine.
Reid says the profession has become "deeply demoralized" through the years because of a "top-down, this-is-what’s-going-to-happen" approach to local health planning and a federal government that seems to be distancing itself from health care.
"I think there’s this sense that the government has withdrawn from some of its responsibility to take true leadership on the health care portfolio," she said.
Haggie is attending the Global Health Policy Summit in London. "I got, from out of nowhere, an invitation from the United Kingdom prime minister to come and meet him," Haggie said on Tuesday. "I have not got past the receptionist and staffers at the PMO (Prime Minister Stephen Harper’s office).
"Because they don’t want to talk about health care, because they think that by doing it, somehow, I might pin them as being responsible for it. The Constitution and the British North America Act and the Charter, they pin them, not me. You can’t hide and hope it will all go away."
Reid says she is "proud" to live in a country "where I know that if there’s something wrong with you, you can go to a hospital and get health care and that’s fantastic."
But she said Canadians should expect to get equal health care no matter where they live or travel in the country. Instead, she said, "It’s a different set of rules everywhere you go in the country."
"We see mental health issues â€” problems with addiction, suicide. Our suicide risk in Northwest Territories and Nunavut are many times the national average," she said.
"A lot of these issues are really worsened by a lot of the social determinants of health â€” poor economic status, poor education, poor housing. I see in my emergency room, my practice every day, huge outcomes from these health inequities."
But the problems aren’t restricted to the North. Reid has said that "cracks and chasms" exist across the country, from poor access to specialists, to medically unacceptable wait lists.
She said the federal government needs to take a larger role in setting standards and conditions for how money given to the provinces and territories is spent.
"We’re a country here, we’re all Canadians and this is federal money going out to the provinces," said Reid.
She believes in a strong publicly funded system but says Canadians must confront how to fill the gaps not covered by the Canada Health Act â€” "no pharmaceutical strategy, no long-term care strategy.
"How are we going to provide pharmaceuticals? Is it going to be a social insurance scheme? Is it going to be a private insurance plus public partnership? Society is going to have to decide how they’re going to have these services delivered."