Government & policy
Ontario scores high in health delivery
WINNIPEG – A new report by the
Winnipeg-based Frontier Centre for Public Policy rates Ontario as the
top province when it comes to the delivery of healthcare from the point
of view of the consumer. At the bottom of the list was Newfoundland.
The Frontier Centre for Public Policy, created in 1997, is an
independent think tank (www.fcpp.org)
It conducts policy studies on various social and economic issues,
including healthcare, education, aboriginals, poverty and housing.
The Frontier Centre for Public Policy produced its first-annual Canada
Health Consumer Index in partnership with the Health Consumer Powerhouse
(HCP) in Brussels. The Index was written by Rebecca Walberg, the
Frontier Centre’s Director of Health Policy, and HCP’s Arne Bjornberg.
(Earlier this year, the Frontier Centre and HCP released the first
Euro-Canada Health Consumer Index, which compared the health care
systems in Canada and 29 European countries. Canada placed 23rd.)
The Canada Health Consumer Index ranking for the provinces is as
3. Nova Scotia
4. New Brunswick
The study assessed factors such as: access to primary care, home
care and long-term care; wait times for various levels of diagnosis,
care and treatment; medical outcomes, infection and mortality rates;
'generosity', meaning the range of services covered by the public health
systems in the 10 provinces; as well as patient rights and the use of
information sources, including the use of electronic health records and
easily understood medication formularies.
In the Frontier Centre’s
Canadian study, Ontario emerges as the clear winner. A mediocre
performance on wait times is more than balanced
out by a good showing for outcomes and first-place finishes for patient’
rights, primary care and generosity.
With more attention paid to waiting times, especially for specialist
consultations and radiation therapy for cancer, and reduced incidences
of nosocomial infection (a problem Ontario hospitals share with
Quebec’s), Ontario could lead in all five categories.
While there is room for improvement in all sub-disciplines, it is
encouraging that Canada’s most populous province is setting a good
example in many respects for the efficient provision of healthcare.
British Columbia and Nova Scotia are both noticeably behind Ontario, but
they take second and third place in overall rankings. British Columbia’s
performance with regard to generosity, waiting times and primary care is
average, but a strong culture of patient rights and a tie for first
place with Nova Scotia for outcomes lift it to second place. Nova
Scotia’s scores are more erratic. Ranked last for patient rights and
second last for primary care, Nova Scotia is second best for generosity
and waiting times and shares first place for outcomes.
New Brunswick and Alberta round out the top half for overall
performance. New Brunswick ties for second best in terms of providing
primary care and otherwise is consistently in the middle of the pack.
Alberta has an above average score for outcomes, but the second-worst
score for waiting times; this is not unexpected in a province whose
population has grown more quickly than its healthcare infrastructure and
personnel levels have.
The other three sub-disciplines show Alberta to be approximately
average. Prince Edward Island gains its sixth place finish on the
strength of second best scores for outcomes and waiting times.
PEI ranks below average on primary care and second from the bottom for
patient rights and finishes last for generosity. This score is the
lowest by a significant margin. PEI is one of only two provinces that
did not score a single green in the generosity sub-discipline, with
three reds and only two indicators that rise to a middling score.
While no two provinces have identical scores for overall performance, it
must be pointed out that just as Ontario stands a cut above the rest, so
do the bottom four provinces function at a separate level from the rest
of the country.
They are spread across a range of only 21 points out of a possible
While there are differences in how Manitoba, Quebec, Saskatchewan and
Newfoundland arrived at their positions at the bottom of the list, small
differences in weighting would change this order, and more properly,
these four provinces should be understood as contending closely for last