How does the NWT’s healthcare compare to the rest of Canada?

Healthcare in the NWT has its fair share of issues, from staffing to access to primary care to medical travel. But how does it hold up when compared to the rest of the country?

Cabin Radio talked to healthcare workers across the NWT and Canada to learn whether patients are experiencing better care elsewhere – or whether aspects of the territory’s healthcare are still in decent shape compared to other parts of the country.

We’re going to look at staffing levels, morale among workers, primary healthcare and access to care.

Some aspects of this article are informed by our reporting earlier this week looking at the NWT’s vision for primary care and how physicians are faring right now.

We’ve then spoken with experts elsewhere in the country to understand how the picture looks in other place.

Staffing vacancies

“Things are, broadly speaking, challenging for all involved in the healthcare system,” said Dr Sarah Cook, a member of the NWT Medical Association’s board.

The association represents the territory’s physicians and Cook is a former territorial medical director, a position with significant oversight over the NWT’s healthcare system.

Informed by Cook’s insight, we’ll look specifically at how many physicians the territory has, though staffing shortages exist across the spectrum, including nurses and other positions.

Currently, Cook said, there are close to 50-percent vacancy rates for both local family physicians and specialists in the territory, and it’s getting worse.

“As you lose more people, the people who are left behind have a larger burden,” Cook said. “At some point, that becomes a tipping point that it’s very hard to recover from.”

In December, the association surveyed its members. Of the respondents, 64 percent said they had considered leaving or decided to leave the Northwest Territories.

It’s “tough to say” how many of them would really follow through on that, Cook said. “But I think that is a really big red flag. It’s an alarm that we need to listen to.”

The shortage of family physicians is not unique to the Northwest Territories.

“Our healthcare systems are challenged everywhere,” Cook said. “I think that’s evidenced by the often-cited statistic that 6.5 million Canadians don’t have a family physician in Canada right now, and another six million patients have a family physician who’s going to retire in the next five years.”

“There’s a looming crisis in primary care across the country,” Cook continued. “It’s also difficult to compare, I think, between provinces and territories on a really broad scale… I wouldn’t say that it’s necessarily significantly worse here.”

While the NWT doesn’t currently have the number of physicians it would like, Cook work can be done to explore ways physicians can work differently, or ways teams can work together better in an interdisciplinary setting. (The NWT’s health authority says it is doing that work.)

“That’s a national conversation that’s happening, for sure,” Cook said.

“We have an ability to move forward with that, I think, more easily here than other places… we definitely have many pieces in place that would allow us to be a high-performing healthcare system.”

Dr Rithesh Ram is the Alberta representative for the Society of Rural Physicians of Canada. He said staffing issues are a significant problem among physicians, nursing staff and others, no matter where in the country you are.

“Rural and remote areas in Canada have been challenged with being in a ‘crisis’ for decades,” Ram said.

“We’ve managed to essentially just make do and recover ourselves forward to ensure that the majority of the communities are still… having their healthcare needs met,” he continued, adding: “It’s only gone worse over those decades.”

A January 2025 report published by Health Canada – titled Caring for Canadians: Canada’s Future Health Workforce – found huge gaps between the number of healthcare workers the national system desires and the number actually available.

The report stated there is a current need for almost 23,000 more family physicians across Canada. That would be a 49-percent increase on the present supply, the report added.

The same report said the country needs:

• 14,000 more licensed practical nurses (a 12-percent increase);
• 2,700 more nurse practitioners (a 35-percent increase);
• 28,000 more registered nurses (a 10-percent increase);
• 500 more registered psychiatric nurses (an eight-percent increase);
• 2,000 more occupational therapists (a 12-percent increase);
• 2,600 more physiotherapists (a 10-percent increase); and
• 1,700 more pharmacists (a five-percent increase).

In 2022, the number of graduates across those professions in Canada was as follows:

• 6,295 licensed practical nurses;
• 550 nurse practitioners;
• 8,992 registered nurses;
• 336 registered psychiatric nurses;
• 873 occupational therapists;
• 770 physiotherapists;
• 1,217 pharmacists; and
• just 1,362 family physicians.

The report notes the shortage of physicians in Canada is “not surprising as Canada has been underproducing medical graduates for decades.”

At the rate Canada is currently producing new family physicians, those figures suggest the country may never eradicate the existing physician shortage.

Staff morale

Vacancies tend to affect the happiness of the remaining staff trying to get more done with less. As a result, morale is one of the primary issues impacting healthcare staff – and poor morale can, in turn, lead to higher vacancy rates.

In 2022, Canadian nursing unions estimated that anywhere from one-third to two-thirds of newly graduated nurses will leave the field within the first two years of entering the profession.

Comparatively, in 2022, data suggested more than three-quarters of the NWT’s nurses had considered quitting in the past two years.

Beyond understaffing, nurses report issues like a lack of control over their schedules, constantly being asked to pick up additional shifts, limited resources and workplace violence, all of which can contribute to burnout.

“Many professions are in a situation of shortage,” said Dr Ivy Bourgeault, who leads the Canadian Health Workforce Network, which advocates for data-informed approaches to staffing – or what it calls “knowledge mobilization.”

Even if your particular profession isn’t short staffed, most healthcare is delivered in teams, Bourgeault said, adding: “If you have instability in one professional group, it causes an impact or a ripple effect on other professions.”

“Everybody has been impacted by shortages, by moral distress,” Bourgeault said. “This existed prior to the pandemic and it’s just been exacerbated by the pandemic.”

Bourgeault attributes much of the issue to a lack of planning and healthcare systems’ constant reactivity to crises.

“We understand the role of planning that we haven’t been doing for the health workforce,” Bourgeault said. “We are seeing the consequences of that in the stress and overload they are experiencing.”

For the healthcare staff who are left in the middle, that means stress and overload. Some respond by leaving the profession altogether, through early retirement or shifting careers.

Others cope “by shifting and working in the private sector,” Bourgeault said. “That happens through nursing agencies and other types of agencies, [like] social workers.”

While agency nurses have only been used in the NWT for the past few years, even their use in that period has been controversial.

Having staff leaving in such high numbers isn’t sustainable. Bourgeault stresses the importance of focusing efforts on retention. “We have a crisis upon us, and we have to keep the folks in the system in whatever way possible.”

Dr Gavin Parker is the president of the Society of Rural Physicians of Canada and a rural family physician in Pincher Creek, Alberta. He’s seen how staff burnout directly impacts patient experience.

“I always knew we kind-of didn’t treat our customers the best in healthcare,” Parker said.

“I’ve seen my colleagues yell at people for coming to the emergency room.

“I understand that healthcare is a resource, and resources are limited… and you want to guide people into appropriate ways to use it. But imagine yelling at somebody who’s sick and scared.”

Physicians are “totally burnt out,” Parker said, “and overwhelmed by administrative requirements.”

He said he has seen colleagues sacrifice time with family and their personal lives to make sure patients were provided with care.

A paperwork mishap once meant an emergency room shift would have no cover, he said, providing an example. The community’s medical director gave up her Friday night and drove in from Lethbridge to keep the ER open.

“The whole system is predicated on people being willing to kill themselves to make it work,” Parker said.

Primary healthcare

Problems in primary health care and a patient’s experience can vary depending on where you are in the NWT.

“In Yellowknife, the challenges are about access,” said Dr Claudia Kraft, territorial medical director of the NWT’s health authority. “We all know it can be really difficult to find your way to the right healthcare provider in Yellowknife.”

That’s part of what prompted a shift last summer in Yellowknife’s primary care model.

Previously, Yellowknife residents were placed on one of 10 different healthcare teams – or on a 2,000-person waitlist that was years long.

In the new model, staff have been redeployed into four larger teams. Every resident can be assigned to one of those teams rather than left on a waitlist.

The NWT Medical Association has expressed concerns about the new care model, questioning where resources and staffing were coming from to make it work while providing safe and sustainable care. The College and Association of Nurses of the Northwest Territories and Nunavut has echoed that concern and requested adequate staffing levels as well as a safe and supportive working environment.

Kraft said the new model will be “a bigger change for Yellowknifers” who may be “accustomed to that old-school model where the physician is at the centre, directing their care.”

“What we’re looking to implement is the patient is at the centre with all the resources of the team and, when what’s needed is a doctor, then the doctor is brought into the team,” Kraft said.

“Not everybody needs to see a doctor … for care that could be done perfectly well by a community health nurse.”

Outside Yellowknife, Kraft said, access to care in small communities can be more straightforward – go to the health centre or health cabin, speak with a nurse – but the concern becomes access to the same care you could expect in the NWT capital.

Across Canada, in rural and remote areas, “patients definitely have reduced access to primary care,” Ram said. “I would say that’s nationally.”

It means worse outcomes for patients, Ram said.

“There’s lots of research, lots of data that’s been coming out over the last few years, that if you don’t have the ability for appropriate access, then you’re going to have poor health outcomes,” said Ram.

“You’re going to have cancer being not infrequently diagnosed in the emerge … and those are things that are happening because the access to primary care isn’t there.”

Measuring access

You can’t provide every type of care to everybody where they are. “But what I always want to get to,” said Ram, “is where we can provide the baseline.”

That includes access to primary care, appropriate screening, general surgery and obstetrics.

“I don’t want to see anyone having to travel beyond their community in order to have a baby,” Ram said. “To me, it’s basic treatment that should be happening. Unfortunately, we’re not there.”

In the last year, the Inuvik obstetrics unit has gone through repeated shutdowns, sending expecting families to Yellowknife instead. Stanton Territorial Hospital itself didn’t have enough staff to handle births for more than two months between December 2021 and February 2022, sending families to Edmonton during that time.

“If you are pregnant in a rural community, you and your child, statistically, are going to have worse outcomes,” Parker said. Patient access to care gets worse the more remote you get, Parker said, and additional disparities exist between Indigenous and non-Indigenous patients.

There is some data to back up suggestions that while vacancy rates and morale may be a similar picture across Canada, access to care is meaningfully worse in the North.

For example, the Canadian Institute for Health Information published an analysis on travel burden in December 2024.

The institute examined inpatient hospitalizations between 2018-19 and 2022-23, categorizing travel burden based on factors including the distance between the patient’s home and the hospital where care was provided, whether the hospitalization was planned or unplanned, and the patient’s age.

On average, the study found, one in 11 people hospitalized in Canada had a high or very high travel burden. For people in rural and remote areas, that was one in four.

The CIHI data reported “considerable variation in travel burden across provinces and territories,” with residents of Ontario and Quebec having the lowest travel burden.

The NWT’s was the second highest, at 51.1 percent of patients studied experiencing a high or very high travel burden. Nunavut was the highest at 87.9 percent.

Wait times

How long do NWT residents wait to receive care for priority treatment and other types of care, compared to the rest of Canada?

CIHI data from 2023-24 found that on average across Canada, 94 percent of patients receive cancer radiation treatment within four weeks.

While comparable NWT-specific data isn’t available, the Canadian Cancer Survivor Network notes that patients with cancer in the Northwest Territories are often referred to the Cross Cancer Institute in Alberta for treatment.

“This means that wait times in the Northwest Territories not only rely on their own healthcare system, but also on the system in Alberta,” the network noted.

“Benchmarks have been set in both Alberta and the NWT and patients with cancer can expect to be treated within four weeks.”

A 2023 NWT cancer care patient satisfaction survey reported that patients were largely satisfied with the territory’s cancer care services.

Compared to pre-pandemic periods, Canadians are waiting longer on average for priority procedures like hip and knee placements, cancer surgeries and diagnostic imaging. The only priority procedure that has returned to pre-pandemic levels is cataract surgery.

According to CIHI data, median wait times in 2023 across Canada were 22 days for breast cancer surgery, 28 days for bladder cancer surgery, 23 days for colorectal cancer surgery, and 26 days for lung cancer surgery. Comparatively, according to the NTHSSA, Stanton Territorial Hospital does colorectal cancer surgeries as soon as possible, typically within 1-2 weeks, and limited types of bladder cancer surgeries within 1-4 weeks. They do not do breast cancer operations.

In a six-month period from April to September 2023, CIHI said Canada-wide “median wait times were seven days longer for MRI scans and four days longer for CT scans” than pre-pandemic, while “fewer patients received a hip or knee replacement within the recommended six months” compared to the same period in 2019.

In the NWT, the NTHSSA said CT scans are typically scheduled on a priority basis, depending on the needs. Priority 1 exams are done within 24 hours, priority 2 exams are typically done within seven days, priority 3 exams are typically done within 30 days, and priority 4 are typically done within 60 days; according to the NTHSSA, wait times for priority 3 and 4 scans are currently exceeding these targets. MRI scans are not performed in the NWT but sent to Alberta, and scheduled through “the applicable Alberta site,” the NTHSSA said.

Across Canada, just 66 percent of patients receive a hip replacement and 59 percent a knee replacement within the benchmark of 26 weeks. According to the NTHSSA, for joint replacements (including hip and knee surgeries), the average wait time in the territory is 26 to 52 weeks.

Wait times for community mental health counselling vary widely across the country. In 2023-24, the Canada average was that clients have to wait an average of 25 calendar days for their first scheduled appointment for ongoing community mental health services. One in 10 Canadians wait more than 20 weeks for that appointment. The NWT’s average is just four days.   

For home care, from 2023-24, the median number of calendar days that clients waited for their first home care service averaged three days across Canada and just one day in the NWT.  One in 10 Canadians must wait about a month for home care.