A commentary by a former deputy health minister in British Columbia and Saskatchewan. He served on two royal commissions on health care and was awarded the Order of Canada for innovative leadership and dedication to overcoming the most challenging issues in our health system.
Ambitious political leadership is needed to restore Canada’s health system, besmirched by crowded emergency rooms, hallway medicine, long wait times, lack of family physicians, demoralized health professionals and angry citizens.
Meaningful dialogue and primary care reform are crucial to fixing a myriad of issues in health care, the toxic drug crisis and looming health issues from climate change.
Political leaders’ superficial response to daily crises fosters political polarization instead of substantive health policy reform, and leaves Canada trapped in a cycle of blame, denial, and ineffective solutions perpetuating unnecessary suffering and deaths, as well as inefficiency in the health system.
Jonathan Manthorpe, in his book On Canadian Democracy, depicts, “Canada as not so much a country as a loose association of antagonistic and predatory governments and administrative bodies all competing to make life as frustrating and complicated for their citizens as possible.”
In my view, political leaders need citizens’ support to be bold, to be ambitious and to lead others to support decisions that will benefit Canadians. I believe ambitious political leadership is needed in many areas and most especially to dispel the haunting spectre that is reducing citizens’ confidence in our health system.
Today, political leaders in B.C. and Canada have an opportunity to reverse years in a wasteland of justifying outdated health policy.
For the past 30 years, rather than primary care reform, Canadians have endured political ineptitude as the provinces blame Ottawa, Ottawa responds with a truckload of money, and the provinces grab it and run, with no enduring accountability for meaningful change.
Today’s politicians have a wealth of meaningful recommendations, provided by citizens and health leaders, to restore effective health services in Canada by creating a solid foundation of primary care services.
Looking at Canada’s hospital and medical care insurance development, the most valuable feature we see in those golden years from the 1940s to 1980s was ambitious political leadership at the federal and provincial levels. Politicians in all parties were focused on Canadians’ demands, that their health needs be addressed, and were willing to work together for the benefit of citizens.
Driven to address citizens’ needs, political leaders cooperated across party lines to achieve meaningful health legislation and policy.
The health system served Canadians well 30 years ago, but we can’t make that claim today. Our seniors’ care is poor compared to peer countries, mainly because it is not available when it is needed.
Seniors in Canada today are the citizens who in their younger years saw the importance and demanded that political leaders create a universal health system.
All political parties wanted health services to benefit the country as well as individual citizens.
They chose a single payer system because it was the most cost-effective way to provide insurance and the most equitable and fair way to ensure people who were less well-off would be served as well as others.
Unfortunately, Canada did not respond, like our more successful peer countries, to move to new models as health needs changed.
Today’s health needs have changed from acute illnesses like infections to chronic conditions, like diabetes and cancer, and issues relating to aging, poverty and climate change.
Medicare was designed for yesterday and served us well insuring hospital and physician services. Today we must move to an appropriate model with primary care as the foundation of our health system.
We need political leaders to acknowledge shortfalls, review the evidence, communicate the options for public consideration and legislate primary care to be accessible to every citizen.
The Canada Health Act, the basis for Medicare, lacks enduring accountability and two of its fundamental principles, accessibility and comprehensiveness, are being ignored every day, in every province. Along with the Canada Health Act, a Primary Care Act with enduring accountability is needed to establish primary care as the foundation of the health system and ensure primary care is accessible to all citizens.
Much more could be accomplished within the system by changing the way we do things. Hospitals have functioned with multidisciplinary teams for years. We need to bring these skills to our community and into our homes 24/7 to meet current needs, and indeed to save our health system, in British Columbia and Canada.
Some think the solution is more private care and others think the solution is more government funding. The fix is neither less government nor more government — it is better government!
The key question is: Could ambitious political leadership restore our health system? Could politicians who are focused on the needs of citizens, public interest, honesty, and openness garner cooperation from other party politicians and be supported by Canadian citizens to survive, i.e., win an election? Many believe it can be done.
The first step is to reform primary care. As Dr. Jane Philpott, former federal health minister and currently dean of the Faculty of Health Science and director of the School of Medicine at Queens University, states in her book, Health for All, we must guarantee everyone in Canada has access to primary care with multidisciplinary teams to provide health services when they are needed.
Primary care services would be much like our primary school system. Canada has a proud history of primary schooling being a right for all children.
The same could be accomplished for primary care neighbourhood centres, Philpott calls them primary care homes, with multidisciplinary teams of family physicians, nurse practitioners, pharmacists and other health professionals as required.
Organizing primary care appropriately would restore confidence in the health system because hospitals and long-term care would function smoothly, and staff and services would be in place to address the toxic drug crisis and the looming issues from climate change.
This must begin with ambitious political leadership vividly displayed in leaders like Tommy Douglas, John Diefenbaker, Lester Pearson and Monique Begin.
The legislative body that provides ambitious political leadership to make meaningful reforms in primary care for the benefit of all Canadians will create a new and meaningful legacy for Canada.
Can ambitious political leadership restore Canada’s health system? It can, and it will depend on you and me to demand it.
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