News at Medicine - May 2013 - Health care reforms not keeping pace with needs of Canadians, says report

Health care reforms not keeping pace with needs of Canadians, says report
May 24, 2013
The Health Council of Canada has released Progress Report 2013: Health care renewal in Canada. The report highlights the progress achieved by governments in five key areas: wait times, primary health care and electronic health records, pharmaceuticals management, disease prevention/health promotion and Aboriginal health.
The report finds that, overall, efforts at reform are not keeping pace with the changing health care needs of Canadians. There is variability of access to services across the country.

“Regardless of where you live in Canada, Canadians should be able to access a primary care provider when care is needed, they should have timely access to surgeries, and the cost of medications should not cause undue financial hardship,” said Dr. Jack Kitts, chair of the Health Council of Canada. “However, because of the variability across the country, this is not the case.”
To achieve better health care for all Canadians, the report calls for governments to set clear policy goals with clear lines of responsibility, to continue the spread of innovative practices, and to support collaborative efforts across all jurisdictions, including the federal government.
“Progress is made when comprehensive strategies with clear targets are put in place,” says Dr. Kitts. “And once those strategies are in place, we need to constantly monitor the performance of the governments and Canadians need to hold them accountable.”
The report points out that Canadian premiers have begun working together on select initiatives, such as the joint pricing of prescription drugs, which saves significant health care dollars. The Health Council recommends this continue, because when governments work together with common goals, the quality of health care and access to it improve for all Canadians.
Along with the need for accountability and collaboration, the report also calls for the sharing of innovative practices. “Sharing innovative practices allows provinces to implement programs we know are making a difference without having to ‘reinvent the wheel’,” said John G. Abbott, CEO of the Health Council of Canada. “The Health Council helps identify and expand the reach of innovative practices across the country through our Health Innovation Portal – a database of over 360 innovative practices.”
An example of an innovative practice highlighted in the report is the First Nations Health Authority in British Columbia, which was established in 2012 and puts health care delivery and decision-making in the hands of First Nations people. This shift is the result of several agreements made between BC First Nations and the provincial and federal governments, in efforts to close gaps in health status between First Nations people and other residents of British Columbia.
Key report findings include:
Wait times: In the early years of the health accords, provinces were able to reduce wait times, however, in more recent years, progress has stalled. In some priority areas, a smaller percentage of people are receiving care within benchmarks (e.g., hip/knee replacement surgery saw a decrease of 4% of surgeries performed within pan-Canadian benchmark).
• Primary health care and electronic health records: Canadians have not received the promised 24/7 access to primary health care service. Governments have invested in primary care reform across the country, but the need for sustainable, system-level change remains. Although progress has been made overall in implementing electronic health and medical records, governments must consider mandating their use to speed up the implementation across Canada.
• Pharmaceuticals management: Jurisdictions have collaborated on lowering prescription drug prices, however, there is still no commitment to a National Pharmaceuticals strategy, which has led to variations in drug coverage and scopes of practice by pharmacists across provinces.
• Disease prevention/health promotion: Governments have moved forward in developing healthy living strategies, but there are no targets or methods of consistent evaluation of these strategies to really measure their impact. Also, there are few examples of successful whole-of-government approaches that expand beyond the ministries of health to include finance, transportation, and community services, among others.
• Aboriginal health: The gap between health outcomes of Aboriginal and non-Aboriginal Canadians remains wide. Some provinces and territories have started developing partnerships and collaborative models where Aboriginal communities and governments work together to close the gap. There is a need for ongoing commitment from all governments to work with Aboriginal communities to ensure targets and accountabilities are defined and met.
Progress Report 2013: Health Care Renewal in Canada also includes jurisdictional profiles on how each province, territory and the federal government performed within each of the five key areas assessed in the report. Progress Report 2013 is the third installment in a series of reports that looks at key health care topics as it relates to the 2003/2004 accords. To access Progress Report 2011 or Progress Report 2012, visit
Created by the 2003 First Ministers’ Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on innovative practices across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.

To read commentary from guest bloggers, including heath care users and health industry leaders, or to download the full report/appendix visit: