UN official says Canada must view health as a right

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This article was published 15/11/2018 (1993 days ago), so information in it may no longer be current.

OTTAWA — A United Nations official says Ottawa should freeze health transfers to provinces that don’t uphold human rights, citing issues such as how First Nations access services in Manitoba.

“The quality of health services in Canada is very good — if you can access them,” said Dainius Puras, the UN’s special rapporteur on the right to physical and mental health.

Puras spoke with reporters Friday, ending an 11-day tour that took him to Winnipeg, Vancouver and Montreal.

“Canada has yet to take the leap, to comprehensively incorporate a right-to-health perspective, fully embracing the understanding that health — beyond a public service — is a human right.”

He found barriers to how “vulnerable” people access health care, such as undocumented migrants, the poor and disabled, drug users and people with autism. He was most concerned by access to mental-health services and how health systems treat Indigenous people.

Puras spoke with residents of Red Sucker Lake, which sits in Manitoba’s northeast flank, about the difficulty in being flown to Winnipeg for medical treatment. The month-long stays for treatments such as dialysis disrupts their lives by keeping them away from traditional activities.

He also said stereotypes and a lack of cultural understanding impede treatment for First Nations and Métis patients, including those who live in Winnipeg and fall entirely under the provincial system.

“I have a feeling there’s a lack of trust between Indigenous Peoples and those who want to help them,” he said. “Indigenous Peoples maybe feel that they are not fully involved; that their views are not fully taken into account. So, this can be an obstacle.”

Further, Puras said Canadians have a patchwork medical system, with “discrepancies” in the quality of how provinces offer care, plus a separate federal system for reserves. He said those who move often have to wait three months to qualify for health cards, preventing them from seeking treatment when they notice early symptoms.

That’s why he suggests Ottawa reduce, or even stop, its cash transfers for provinces that provide unequal access to health care, or that do nothing about these gaps.

“The federal government could strengthen its public-health approach with a human rights-based criteria, that permits the withholding or reduction of federal transfers when human rights elements are not protected, respected or fulfilled,” he said.

“We have to take seriously not only the needs but the rights of people.”

Manitoba officials referred queries to the federal government. “The province looks forward to the United Nations special rapporteur’s final report,” wrote a spokesman who withheld his name.

Puras said Canadian doctors overprescribe antidepressants and other drugs in cases where counselling might better solve mental-health issues, but is inaccessible for patients. However, he was quick to note communities plagued by suicide crises require better living standards and opportunities and not just counselling.

Similarly, he said waiting times in Winnipeg emergency rooms and across Canada could likely be weaned down if the country spent more on prevention. “I strongly advise to invest in health promotion and primary care, which is the real safeguard, to protect specialized care from unneeded referrals,” he said.

He praised the Choosing Wisely Canada campaign, which has physicians and patients trying to cut down on unnecessary tests, treatments and procedures. Puras also hailed civil-society groups for filling gaps left by government health systems, such as the Actionmarguerite palliative care centre in St. Boniface and downtown drug programming for youth by Ndinawe.

Puras noted Canada has opted against ratifying a UN protocol that would provide an extra, international venue for citizens to complain about alleged violations of their right to health care.

It will take Puras months to analyze his trip, largely because he received reams of data that are aggregated in a way that can produce meaningful findings — another fault he found with Canada’s health system.

He will make his report public around May, after consulting with Ottawa, before formally presenting it in June, “and then it’s up to Canada how to use it.”

dylan.robertson@freepress.mb.ca