News at Medicine - December 2020 - Reimagining health and health care

Reimagining health and health care
December 10, 2020
A recently announced task force has hit the ground running with the mission of reimagining health and health care in Newfoundland and Labrador.
On Nov. 5, 2020, Premier Andrew Furey and the Honourable John Haggie, Minister of Health and Community Services, announced that Dr. Pat Parfrey, professor in the Discipline of Family Medicine and clinical epidemiologist, and Sister Elizabeth Davis, congregational leader of the Sisters of Mercy of Newfoundland and Labrador, will co-chair a task force on health, known as Health Accord NL.
Their vision is two-fold: To create awareness of, and interventions in, the social factors that influence health; and to achieve better balance and higher quality in community based care (primary health care, elder care, social care) and acute hospital services.
To do this, Health Accord NL is focusing on the social and economic factors that influence people’s health.
Perception versus reality
In 2017, 20 per cent of the NL population was 65 years old and older. That’s projected to reach 34 per cent by 2038. NL also has the highest rate of some chronic diseases such as cancer, cardiac disease and stroke. According to statistics, NL also has highest rate of chronic disease in seniors and the lowest life expectancy of any province in Canada. That’s a heavy lift.
Despite those statistics, Sister Elizabeth believes there are disparities between how Newfoundlanders and Labradorians view their health, versus the reality. “This denial may be related to their happiness in the place they live and their relationships with family and friends that outweighs the health issues,” she said.
Since 1981, social spending has increased by 6 per cent, while health spending in the province has increased by 232 per cent even though social factors, rather than the health care system, are likely to have a higher impact on health outcomes.
“The current health system is over 50 years old, is institution-based and is targeted at a different demography than today’s population,” Dr. Parfrey explained. “We are asking citizens to reimagine a modern health system that is more community-based and targeted at the current population of more seniors, fewer children and fewer people in rural communities.”
Cultural change
According to Dr. Parfrey and Sister Elizabeth, culture change means changing behaviours and choices but it also means looking at other populations as examples of what we can do differently.
“An understanding of our own population is as important as taking lessons from other communities. In our research we have used Australia as a marker for what change is necessary and possible in our health system and Norway as a country who have integrated social changes into their polity,” noted Sister Elizabeth.
“It is a myth that every locality can have a doctor and every region a full-service hospital in order to have good health care,” added Dr. Parfrey, who is also the clinical lead for Quality of Care NL and Choosing Wisely NL. “The more reasonable and realistic objective is that every citizen has a link to continuing care and to good quality acute hospital care. This would be facilitated by digital technology and by hub-and-spoke connections to both community care and hospital care.”
Ten year plan
Health Accord NL is planning to deliver a 10-Year Health Accord with short, medium, and long-term goals, developed in consultation with communities, Indigenous leaders and health care professionals.
There are six committees established for Health Accord NL: Aging Population, Digital Technology, Hospital Services, Primary Health Care, Quality Health Care and Social Determinants of Health.
Once committees are set up, the first step is letting people of the province know about the existing evidence on the status of our health and health system as well as to challenge communities to help them reimagine new ways to improve both health and health care.
There are virtual town halls planned in multiple areas in December to move from visioning better health and social systems to finding ways to make the new vision happen. There’s also a website:
Memorial involvement
Quality of Care NL, a Memorial based program, is helping produce the evidence on health system performance and quality of care, and will provide the secretariat for the Task Force. The Faculty of Medicine has faculty, staff and learners on committees and will bring its experience on promoting health, delivering care and educating providers, as well as its role in strengthening the province’s health and health system. Other faculties such as the Faculties of Nursing and Business, the Schools of Social Work and Human Kinetics and Recreation as well as the Genesis Centre are involved as influencers in social factors impacting health.
There are six committees established for Health Accord NL. They are Aging Population; Digital Technology; Hospital Services, chaired by Dr. Sean Connors, clinical chief of the Cardiac Care Program with Eastern Health and an associate professor of medicine; Primary Health Care, chaired by Dr. Shanda Slipp, a family physician in Corner Brook, graduate of Memorial University and cabinet member of the Western Stream FM residency program; Quality Health Care, chaired by Dr. Parfrey; and Social Determinants of Health, chaired by Sister Elizabeth.
Other Faculty of Medicine faculty, residents and staff involved in Health Accord NL are Dean Margaret Steele, Drs. Steve Darcy, Thomas Piggott, Brenda Wilson, Nicole Stockley, Michael Jong, Carmel Casey, Greg Browne, Gabe Woollam, Dave Caroll, Kim Babb, Roger Butler, John Jeddore, Melissa Skanes, Ed Randell, Jared Butler, Kris Aubrey-Bassler, Brenda Barrett, as well as Ms. Cheryl Etchegary, Mr. Owen Parfrey and Mr. Pablo Navarro.