Progress report on health


With Parliament back and so many issues — from opioids to mental health to cannabis legalization — on the federal policy radar, a Before the Bell panel did a health check-up on how the Trudeau Liberals are doing. The government has been giving itself good marks in its mandate tracker, particularly for the new health accords with the provinces.

But some stakeholders had mixed reviews. Bill Tholl, former HealthCareCan CEO and now a senior consultant in health policy and leadership development, said the new bilateral agreements with provinces are not the accord that the government promised.

“This is more of an example of bon cop/bad cop, with the minister of finance defending the till and the minister of health doing a good job of buying change instead of buying peace with the provinces,” said Tholl.

Peter Cleary, Senior Consultant with Santis Health, noted that these accords came at a different time than the previous one was signed in 2004, when the six per cent escalator clause was dealing with a system in crisis.

“There will always be questions if it was enough money, but it sets a template for how the government can provide funding to provinces based on priorities,” Cleary said of the new accords.

The shuffling of ministers, and moving the First Nations and Inuit Health Branch to the new Indigenous Services Canada has been seen as a positive, but only a first step. Dr. Geneviève Moineau, President & CEO of the Association of Faculties of Medicine of Canada, is glad to see Minister Jane Philpott at the head.

“Her focus on the social determinants of health as a first step is crucial,” said Moineau.

While Cleary noted that the amount of movement that the government has done in such a short period of time is incredible in and of itself, Tholl said that it’s not possible to do enough to address the health inequities facing Indigenous Canadians given the staggering numbers.

As for whether the shuffle will affect the priorities of health minister Ginette Petitpas Taylor, there is optimism that the move of Indigenous health services to its own ministry will make room for other issues such as mental health and addictions, as well as the need for more research funding.

“Pharmacare is going to start taking up a lot of the time of the government,” said Cleary, citing a committee report and moves from Ontario. “It’s a logical big policy that the new minister will have to take on.”

News that the Pan-Canadian Pharmaceutical Alliance came up with a five-year agreement with the provinces to reduce generic drug prices by up to forty percent was seen as a positive development.

“Anything that we can do in terms of bring prices down for the cost containment issue and the sustainability of the health system is a good thing,” said Pamela Fralick, President of Innovative Medicines Canada. “Frankly, we know that generic prices in Canada were higher than in most countries and there was room for movement.”

Fralick emphasized that the deal came about through dialogue, which she says has been lacking to date.

“We get it that prices are a concern,” said Fralick. “There’s no question that we want to be part of that solution. In my time with this industry, we’ve worked very hard to come up with creative ways to help governments deal with this very sustainability issue.”

Aging demographics leading to an “epidemic” of Alzheimer’s sufferers is another key concern for governments.

“It’s not a surprise that the population of baby boomers is aging,” said Pauline Tardif, CEO of the Alzheimer Society of Canada. “Suddenly there’s a sense of urgency to be able to react to that, and to adapt the healthcare system to support people living with dementia and their caregivers.”

Tardif said that many people aren’t getting diagnosed out of fear, when early detection would help them to address the symptoms of dementia. Combatting that fear will mean education.

“The stigma associated with it is the unknown,” said Tardif. “When we think of someone living with dementia, we skip to end-of-life, and we forget that the person has many years to live, often in great quality of life.”

Nursing resources are a key issue in healthcare provision around the country, and deploying them in the most effective way is going to be an ongoing challenge.

“If you look at the way the healthcare system is structured, you’d be hard-pressed to see that much has changed since the 1980s,” said Mike Villeneuve, CEO of the Canadian Nurses Association. “We [have] the best educated nursing workforce in the history of this country. You would not know that if you saw how nurses are deployed to work.”

Villeneuve pointed to the 5000 nurse practitioners around the country, able to do the primary care that a GP physician would otherwise do. He also mentioned nurse-led clinics in the UK as being efficient examples of how to better deploy resources. Part of the problem with making change, however, is institutional inertia.

“We have to understand nobody owns a competency – many people can learn it,” said Villeneuve. “The idea that nurses want to be docs or mini-docs is wrong. We want to expand nursing practice to provide more primary care.”

Conservative health critic Marilyn Gladu (Sarnia-Lambton, ON) has successfully sponsored a private member’s bill on palliative care, and noted that soon, one in every four Canadians will be a senior citizen.

“Seventy per cent of Canadians today have nothing – no access to palliative care,” said Gladu. “We certainly need more hospice infrastructure – we have less than 100 in Canada,” she added. “We are short of the service providers at all levels – we’re missing at least 400 palliative care specialists. Many nurses and doctors receive no training in palliative care.” She noted that while the government has pledged $9 billion to home and palliative care, only about $200 million has been spent so far.

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