The rest of Canada should follow Ontario by clearing the way for doctors, nurses and other health professionals to quickly work in other provinces as a way of easing staff shortages, an independent think tank states in a wide-ranging new report on fixing health care.
The Public Policy Forum says changes must begin with the “fundamental step” of getting all Canadians access to a primary care clinic within a 30-minute drive — and urges keeping an open mind to the involvement of private clinics where they can improve access and quality of care.
“Reform should move forward now wherever the will exists to act,” says the 20-page report titled Taking Back Health Care.
“It does not have to wait for an elusive grand bargain that all governments bless at the same time.”
The report’s authors include: former federal health minister Dr. Jane Philpott, now dean of health sciences at Queen’s University; David MacNaughton, former Canadian ambassador to the United States; retired University Health Network chief executive Dr. Robert Bell, a surgeon and former Ontario deputy minister of health; and Dr. Danielle Martin, a University of Toronto professor of family medicine and founder of Canadian Doctors for Medicare.
Released on Tuesday but in preparation for weeks, the report comes days after Ontario Premier Doug Ford pledged legislation to fast-track approvals of accredited doctors, nurses and other health professionals in good standing from other provinces and territories.
“They can get to work as soon as they get here,” said Ford, who also unveiled a controversial plan to move thousands more surgeries and diagnostic procedures out of hospitals and into specialized community clinics to shorten wait times because “the status quo is not working.”
The policy form report echoes that, noting “as the unprecedented challenges of COVID-19 have made clear, the status quo is not holding.”
While some critics have raised concerns Ontario’s move to fast-track health professionals could weaken care in other parts of the country, the report disagrees, saying the ability “to practice anywhere in Canada, both in person and virtually, to address shortages” is crucial .
“You shouldn’t be obstructed from access to health-care professionals by interprovincial barriers to the free movement of doctors, nurses, technicians and other health-care workers within Canada.”
The goal of a reformed health system should be “accessible, timely care enabled by the best use of delivery models, people, technology, data and infrastructure,” the report says.
“Another set of issues, distinct from what is and isn’t covered in the public system, is the role of the private sector in publicly funded service delivery. A lot of commentary reflects a less than complete grasp of the facts here,” the writers add, noting most doctors practice as private physicians but are funded by provincial health insurance.
Governments should look throughout the country and abroad to see where private clinics bolster key Canadian health-care values including public funding for “essential services” combined with equity of access and quality of service.
“Building on successful examples and applying their lessons should be part of system reform, with such partnerships neither ruled in nor ruled out simply because they involve the private sector in delivering care.”
But the report warns any such changes must be closely watched to make sure a “public/private patchwork” does not create more gaps in care.
“These changing realities require us to update and clearly articulate what should be essential services covered by our public insurance system.”
The report also comes as the federal government and provinces get closer to a deal to boost health-care funding, and suggests innovation counts as much as money.
“The solution can’t be just more dollars … Canada spends more on health (private and public combined) than most high-income countries while falling short of the equity and excellence to which we aspire.”
JOIN THE CONVERSATION