By Sally Barnes
Every once in a while, a common-sense solution to a political mess emerges and two such gems caught my attention recently.
One involves health care policy and the other concerns rat carcasses in Ottawa.
In both cases, the outcomes will depend on public support to get any action.
While fiery rhetoric for partisan gain dominates and snarls our legislatures and monopolizes the headlines, a group of healthcare experts has quietly produced a significant plan to deal with the healthcare crisis that is harming millions of Canadians.
“Enough is enough. Let’s fix the healthcare system so that people will get what they need,” says Dr. Jane Philpott, the co-author of a new report from the Public Policy Forum by 12 of the most highly recognized healthcare experts in the country.
(Full disclosure: I am a huge fan of Philpott. She shone as federal health minister, she has worked on the front lines as a family doctor and it was a real coup for Queen’s University to hire her as Dean of the Faculty of Health Sciences when she left Ottawa.)
The report is plain-spoken and comes right to the heart of the problem–the serious lack of primary health care —and how to solve it.
Philpott believes Canadians deserve to expect access to primary health care the same way families moving to a new community can expect access to a public school.
The Angus Reid Institute reported last September that Canada has six million people without a family physician (and the situation has worsened since.)
(In Kingston alone, an estimated 8,000 to 10,000 people have been added to that number in recent weeks due to the retirement of several family practitioners.)
That is nothing short of a crisis. Just ask any of the millions who have health issues and are left out in the cold.
Strangely, there has not been a great public hue and cry about the shortage of physicians and the overall state of health care. Just about every family I know has been affected by at least one of many failures of our healthcare system. Philpott obviously agrees, having made the recent comment that if six million children were without schools there would rightly be public outrage.
The report begins with an honest appraisal of our health system and calls for a complete overhaul beginning with a team-based approach to delivering care that would be more accessible and affordable than the current system.
“We’ve had this collective national myth that we’ve got the best health care system in the world when in fact we pay more than most countries in the world per capita for our health system and rank well down the ranks in terms of outcomes that Canadians are getting for that,” says the report.
The health care experts believe that putting money into a team-based approach will not only improve health care but also save money.
They have calculated what the government now spends on health care per person and the reduced cost of a better, reformed system.
Under the team-based system, the report says everyone would have access to a “primary care home” where a person would be directly connected in a timely way to the most appropriate health care professional such as a nurse practitioner, social worker, pharmacist, or physician depending on their need and urgency.
It is based on the belief that all people deserve timely health care—not necessarily with a physician but a physician if necessary.
Right now, patients have to navigate a system with many separate, disconnected parts. The report says a team-based approach would connect all those pieces together in one place, reducing, for example, patient frustration and duplication of referrals, lab work, and X-rays.
A national data collection process would make patient information readily available, and track trends and outcomes.
The report also calls for licensing doctors on a national instead of provincial basis to increase flexibility to work across provincial lines and help address pressure on primary care professionals.
It would also free up time for patient care by cutting the administrative workload of clinicians, reducing red tape, and streamlining and automating processes including mandatory centralized intake for referrals. (Instead of waiting months to see a specialist chosen by your doctor, you would be on a central list and eligible to see the first specialist available in your area.)
The report, titled Taking Back Health Care, is a good read—totally free of the usual bureaucratic jargon so often used by government and groups like this. It pulls no punches and provides realistic solutions.
The authors consider this a hopeful time for their work, given that even as we speak the federal and provincial governments are hard at work deciding how much money will be spent on health care and how.
Hopefully, this new report will get into the hands and heads of those making the decisions and help produce the reform Canadians so desperately need and deserve.
Meanwhile, a Calgary columnist has devised a solution to the thorny issue of what to do with the crumbling and rat-infested Prime Minister’s official residence at 24 Sussex Drive in Ottawa. The property is an embarrassment to Canada and a result of a long line of prime ministers passing the buck to avoid blame for the high price of restoration or replacement
Prime ministers beginning with Louis St. Laurent (1948-1957) and ending with Stephen Harper (2006-2015) have lived there but there have been no major renovations for 50 years. Even Pierre Trudeau’s swimming pool needs fixing. Rat carcasses in the walls now make the house a health hazard.
The stone mansion of 24 rooms overlooking the Ottawa River was built in 1867 and has been vacant since the Harper years. Prime Minister Justin Trudeau refused to move in when he was elected and his family resides in Rideau Cottage with its paltry 14 rooms on the grounds of the sprawling Governor General’s posh residence.
The Bidens welcome foreign dignitaries at the front portals of the venerable White House. The Trudeaus recently greeted the Bidens on the front steps of the Cottage. How quaint! How perfectly Canadian!
Arguments over 24 Sussex have been consistent over the years. Some say tear it down and start all over. Others scream that it must be restored. Either decision is costly and controversial.
Catherine Ford of the Calgary Herald has a proposal to take the partisanship out of the debate. As someone who has covered politics as a reporter, Ford recognizes what she calls “the weak-kneed” succession of politicians who have lived at 24 Sussex with its leaky plumbing, antiquated kitchen, and resident mice and refused to support and defend its restoration.
She suggests the formation of a committee of former prime ministers to break the current logjam in public opinion and government action. The members would have nothing to gain or lose by their involvement and all are people who love their country and agree this issue should be resolved.
After all, these ex-politicians helped create the problem by not acting to preserve and protect the historic residence in which they lived while in office. This gives them a second chance. Redemption.
As Ford points out, “The only modern prime minister not alive is John Turner. That leaves at least six, which seems an appropriate number around a table.”
I see this proposal as an opportunity to show some much-needed leadership and non-partisan co-operation in this country.
Public cynicism about politics and politicians and democracy itself is at a record high and the coming together of our former prime ministers on an issue like this could be a real shot in the arm.
A few phone calls from the right people could make Catherine Ford’s proposal happen.
Sally Barnes has enjoyed a distinguished career as a writer, journalist and author. Her work has been recognized in a number of ways, including receiving a Southam Fellowship in Journalism at Massey College at the University of Toronto. A self-confessed political junkie, she has worked in the back-rooms for several Ontario premiers. In addition to a number of other community contributions, Sally Barnes served a term as president of the Ontario Council on the Status of Women. She is a former business colleague of Doppler’s publisher, Hugh Mackenzie, and lives in Kingston, Ontario. You can find her online at sallybarnesauthor.com.
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Great article Sally
Mrs Philpot was one of the best Liberal MP’s by far. This report is very thorough and spells out some of the problems that are health care system is plagued with. Will any of these recommendations be implemented? It is beginning to look as though the people in charge of our health care system in Canada lack the empathy and conviction needed to modernize our system. We are becoming a country that talks a lot and achieves very little. Is that cause for concern or the new norm in Canada?
If the extensive and very expensive cross country Romanow report on healthcare was found we could dust it off and address the areas of concern outlined in that report that we paid for years ago. Btw there was over 50 recommendations in the report and none were implemented. Now are system is plagued with personnel problems at every level. Maybe someone should have dusted it off sooner and read it over and implemented some of the recommendations.
Is political will standing in the way of our ability to modernize our health care system? When will all Canadians have equal access to healthcare?
Is the health of our great nation in jeopardy due to inaction and incompetence?
Ms. Barnes, perhaps we can agree with questioning the public’s concern about our healthcare system.
To further add to your discussion, here are some further thoughts.
We know that health care is primarily under provincial jurisdiction.
In Toronto Star article of today, “Ford’s health care a wildly bad deal” (author Linda McQuaig). She states, “it baffles me the way some political developments turn into scandals while other clearly scandalous developments turn out to be political nothing-burgers. … for instance, dramatic numbers showing that privatized health care is more expensive than public health care – not just by a little bit, but wildly more expensive. …Ford has been barreling forward with plans to significantly increase health care privatization – plans he never revealed before his re-election.
…fresh evidence from Quebec government data, released last month show that surgeries at private clinics consistently cost the government more, often twice as much.”
She continues to make the case by looking at nursing wages. Ford’s cap of nursing wage cap was struck down, he merely appealed the ruling, a legal delay tactic we have seen used in excess in the US.
The optics are clear – starve the public system, open the door to rabid privatization, draw nursing staff from the public system, then pay private clinics from the public taxpayers More to provide the same services. “Most of this excess pay [given to private agencies for nurses] ends up in the hands of private agencies, which as middlemen, are scooping up tens of millions of dollars of public money.”
Finally, “Ford and his ministers…seem unaware that they are elected to be guardians of the public interest”. Ford Conservatives and guardians of public interest? These two things don’t go together, as an old Sesame Street song goes.