The Health Council of Canada (HCC) released a new report this week showing that Canadians’ views on access to health care and its quality vary greatly depending on where they live.
This shouldn’t come as a surprise to Canadians. Between 2000 and 2004 provincial and federal governments were meeting almost annually to discuss the growing inequality to access and quality of health care between provinces and territories. In order to correct these inequalities, the first ministers created health accords. Within these health accords were agreements between premiers and the Prime Minister to meet certain pan-Canadian standards like wait times on particular surgeries. Once these standards were met, provinces and territories would receive financial bonuses.
Our previous Health Accord (2004) which expires March 31st of this year, set standards on procedures like cataract surgeries and hip and knee replacements. Provinces did well for the first few years after the Accord at lowering wait times. But when the federal conservatives came to power the Health Accord was ignored and financial incentives were no longer given.
Ten years later, the HCC finds that we did not make the progress we should have since the last Accord. Instead of narrowing the gap between provinces and ensuring that all Canadians can access similar high quality care in a similar amount of time, many of us are just simply worse off.
If you’re interested in reading the full report, you can find it here, but I’ll take a few minutes below to summarise some of the findings I think you’ll find of most interest.
While the report shows several areas that Canada needs to make improvements in health care, it’s important to acknowledge that overall Canadians feel pretty good about the care they’re receiving. Seventy-four per cent of Canadians rate their care as very good or excellent.
However, improvements can and should be made in many areas such as:
· after-hours access to medical care (62% of Canadians find it difficult to access this)
· emergency department wait times (26% of Canadians waited 4 hours or longer)
· affordable medication (large gaps in who has access across the country)
· dental care (21% of Canadians have not visited the dentist in the past year due to cost)
The Council of Canadians and our allies across the country have been discussing many of the solutions to the problems that the HCC report highlighted. A 2014 Health Accord could address many of these issues and a return to federal leadership and pan-Canadian standards is greatly needed.
1. The expansion of Community Health Centres which ensure everyone has access to a variety of needed health care services; ideally they include dentistry, physiotherapy, diet and nutrition counselling, mental health, and social work. Community Health Centres also take some of the pressure off doctors by using more nurse practitioners and team-based practices.
2. Expanding public health care into areas such as universal pharmacare would save Canadians and our provincial health care systems $10.7 billion a year and it wouldn’t matter where you lived, everyone would have access to prescription medicines. 
3. Dental care: it’s time we put the mouth back in the body and create public dentistry. Right now each province varies widely on what ages can access public health care and which services are covered. Publicly funded dental care ranged from a low of 1.5% in Ontario to 77% in Nunavut (CCPA, 2011).
What’s missing from this report
While the report touches on the social determinants of health it does not look at people’s environment, social status or levels of poverty. We know that these areas have an incredible impact on the health of people. It’d be important for future reports to consider this.
Long-term, home care, palliative, and hospice are missing. The HCC did conduct a report earlier this year on elder care, but it would be important to include the opinions of Canadians as this current report has done.
There is no mention of vision care, an area often left out in public health care policy.
There are many solutions to the gaps in health care provision. But we need a federal government willing to discuss these solutions. Unfortunately, the Harper government has signalled that they have no intention of creating a 2014 Health Accord or meeting with the premiers to discuss the state of health care. Instead, they’ve pulled the funding from the HCC so that in the future Canadians will not have easy access to this type of information. Canadians will no longer be able to monitor the growing gap between provinces. Of course, if we don’t know what the problem is, how do we offer solutions?
The federal conservatives are hiding research from Canadians and researchers themselves to keep us out of the discussion. Just yesterday, CBC broke the story on the federal government cutting funding to Health Canada’s library and limiting access to health scientists’ research. Without access to evidence we’re left with the word of Harper who will claim to be using the evidence to form his pro-privatization policy. We cannot let this happen.
On March 31st, please join the Council of Canadians, Canadian Health Coalition, CUPE, and all of our friends and allies in a national day of action for a 2014 Health Accord. Watch Canadians.org for more information on how to get involved. We cannot let this significant date pass. Harper’s cuts to health care have been stealth like, and now we need to pull the cover off his agenda.