Alberta is failing the vulnerable more than ever

Homelessness so often turns tragic,

Times are bad in the inner city. There are encampments everywhere, in large part because the homeless population in Edmonton has doubled in the past four years, to almost 3,000. There isn't enough room — or safety — in the shelters, and so the dangers of the winter are magnified.

In the 15 years I've worked as a doctor here, I've never before seen so much or such severe frostbite. People come in with suppurating wounds, or mummified extremities, before the inevitable amputation. The air around my clinic smells of smoke from the fires people light to stay warm. Sometimes those turn tragic, like when one of my patients burned to death in an abandoned building. He was just one of many; over the past three years I've lost more than one in eight of my patients. Every week I wait to see which of them will be found dead.

So how did things get this way? The increase in the unhoused population is, mostly, because rents have spiked while incomes and benefits have stagnated. Benefits in particular were de-indexed from inflation before a belated reversal of course recently. Most of my patients have severe illnesses that make it impossible for them to work.

Ideally, I would have them all on assured income for the severely handicapped

(AISH), but an application for this requires support from a specialist doctor. This can be impossible to get for a patient with significant mental or cognitive issues, or who is preoccupied with trying to survive the streets. About half of my AISH applications are rejected — and I'm good at writing AISH applications. In practice, my patients are frequently reliant on income support.

Unfortunately, the core shelter benefit under income support — and this is for clients who are medically unable to work — is set at $330 per month for a single adult. This will pay for rent in exactly zero places in Alberta, but it's set at that level by the legislature.

The cutbacks to social spending we have endured in recent years can't be papered over with a surge of pre-election funding.

If you live with other people, this amount is reduced. If you are homeless, it is eliminated; as was put to me at one point by an income support worker with no sense of irony: it's because “your housing needs are met by the homeless shelter.” You used to be able to get an additional shelter allowance, but this has been tightened up considerably and is now (in my experience) available only for a few months at most.

If you try to work part-time, despite your medical issues, then your benefits are cut back dramatically. Many of the patients at my clinic rely on sex work to avoid starvation; I've seen them report their benefits being cut because prostitution counts as undeclared income.

Homelessness comes at a cost; estimates are that it “costs” the government $100,000 per year for each unhoused person in terms of health care, shelters, corrections, and other programs. As taxpayers, we should be furious about this.

Successive governments have failed to act to stem the tide of Albertans without homes. The cutbacks to social spending we have endured in recent years can't be papered over with a surge of pre-election funding. Years after its inception, Homeward Trust — a provincially funded organization — has nowhere near the capacity or the dollars to house every homeless Edmontonian. And every time I read a news release touting all the funding and all the housing strategies the government has enacted, I have to ask myself, “if they're doing so much, why am I looking at a tent city outside my window?”

It's been said that we can judge a society by how it treats its most vulnerable. By this metric Alberta has failed for my entire life, but we have never failed so obviously and so miserably as we have currently.