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Government & policy

Canadians need quality, not just quicker healthcare

OTTAWA – To improve the health of the nation, Canadians need quality healthcare – not just quicker healthcare, the Health Council of Canada said in Ottawa earlier this month as it released its second annual report.

“The discussion about healthcare has focused overwhelmingly on wait times and access to care. Access is important, but it’s time to balance the discussion and devote equal attention to the quality of care we receive,” said Council Chair Michael Decter (pictured). “The Health Council of Canada believes it’s time to ask, ‘Access to what?’ Is the care that Canadians receive the quality it could be?”

The report, Healthcare Renewal in Canada: Clearing the Road to Quality, tracks how well the federal government, the provinces, and the territories have done in meeting the commitments they made to renew healthcare under the federally funded 2003 and 2004 healthcare agreements. The report also recommends how to strengthen the accountability, co-ordination and sustainability of our healthcare system.

Decter cited shortages in healthcare professionals, adverse patient events and regional disparities in care as examples of quality issues that can and must be resolved. Quality and access are linked. The landmark Baker-Norton study found that adverse events tack on an estimated 1.1 million additional hospital days. “Doing things right the first time reduces wait times,” Decter said.

“Healthcare is in fact improving across the country, but the progress is tentative and uneven. It needs to happen faster, on all fronts, and for all people – no matter where they live,” said Decter. “To widen our focus beyond access to quality, we need to ask different questions. Are we providing the safest, most appropriate care? Are we investing enough in prevention? Are we reducing inequalities in healthcare and supporting people whose health is most at risk? The answer is no, not yet. But we could.”

The Council believes there is no single route to a healthier Canada. It sets out three pathways to help steer us there: quicker access to needed care; better quality services; and improved population health that factors in the need for support inside and outside the healthcare system.

Decter said governments and healthcare providers must hasten their renewal efforts, keeping their eye firmly fixed on what will improve the quality of healthcare – and the quality of Canadians’ lives. “We’ll get safer care when there is an electronic health record for all Canadians. We’ll get more appropriate care when the right healthcare providers are available to the public in the right numbers at the right time in the right place. We’ll get better care when primary healthcare teams equipped with the right electronic tools offer effective chronic disease management and better health promotion,” he said. “And we’ll get better health for all Canadians when we pursue public policies that reduce inequalities in health among communities and populations and help people live healthier lives.”

Some of the Council’s key recommendations include:

• To improve patient safety, make accreditation for healthcare facilities mandatory, a condition of public funding. Require the public release of accreditation reports. And re-examine no-fault compensation for victims of adverse healthcare events, including the issue of job protection for whistleblowers in this effort.

• Speed up the development of electronic health records. There should be electronic health records for all Canadians by 2010. Link electronic drug information systems to electronic health records. Governments should make comprehensive, mandatory electronic drug information systems and e-prescribing a priority and integrate them into electronic health record implementation.

• Strengthen legislation to ban all forms of direct-to-consumer advertising of prescription drugs in Canada. Legislation should clearly prohibit “help-seeking” and “reminder” ads.

• Create information systems that identify patients whose waits are becoming unusually long, triggering an audit. Establish an appeal process for patients who feel they’ve waited too long. Set up a common service queue for major services so patients can be served based on their urgency, with the option of seeking physicians with shorter wait lists.

• Increase the number of inter-professional teams providing primary healthcare beyond the goal set out in the 2003 and 2004 agreements, which currently call for 50 percent of residents to have 24/7 access to healthcare teams by 2011. Make greater use of tele-triage and telehealth technologies.

• Address the needs of people without any drug coverage or without coverage that protects them from catastrophic drug costs. The National Strategy on Pharmaceuticals must provide a plan to deal with these concerns.

• The Health Council of Canada, established under the 2003 First Ministers’ Accord on healthcare Renewal following the recommendations of the Romanow and Kirby reports, is mandated to monitor and report on the progress of healthcare renewal in Canada. The 26 Councillors were appointed by the participating provinces, territories and the Government of Canada and have expertise and broad experience in community care, Aboriginal health, nursing, health education and administration, finance, medicine and pharmacy.

The Health Council of Canada
The Health Council of Canada, created by the 2003 First Ministers’ Accord on healthcare Renewal following the recommendations of the Romanow and Kirby reports, is mandated to monitor and report on the progress of healthcare renewal in Canada. The 26 Councillors, appointed by the participating provinces, territories and the Government of Canada, have expertise and broad experience in community care, Aboriginal health, nursing, health education and administration, finance, medicine and pharmacy. Funded by Health Canada, we report to the Canadian public and operate as a non-profit agency. Members of the Council are the ministers of health of British Columbia, Saskatchewan, Manitoba, Ontario, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland and Labrador, Nunavut, Northwest Territories, Yukon, and the Government of Canada. The Governments of Alberta and Quebec are not members of the Health Council of Canada. The Health Council of Canada monitors the provisions of the 2003 Accord on healthcare Renewal and the 2004 10-Year Plan to Strengthen Health Care. It provides advice on how to improve healthcare access, quality, effectiveness and population health. While many national health organizations play important roles in healthcare, including research, data collection and dissemination, quality improvement, funding and advocacy, the Council offers a unique national, system-wide perspective and impartial assessment on the status of healthcare renewal in Canada.

 

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