To fix Canada’s crumbling healthcare system, we must learn from the pandemic

Sarah Allyn

It is becoming increasingly clear to both researchers and the public that Canada’s health care system needs urgent action to address several critical challenges. Strains already existed even before the COVID-19 pandemic. Continuing long-term and acute care is inadequate as the population grows and ages. The increasing burden of chronic and multiple diseases. Unequitable access to quality care. A labor force struggling to meet demand. These strains have now reached breaking point and are affecting all parts of our healthcare system, including hospitals and the people who work there.

Change is difficult, but it is clear that business as usual cannot continue. Continued investment in health will not solve the problem unless we change how health care is financed, governed and delivered. By learning from the experience of the pandemic, we can find new ways to build more sustainable and resilient health systems.

We released the report on November 16th. Sustainability and resilience in Canada’s healthcare system – As part of a new research initiative with the Partnership for Sustainability and Resilience of Health Systems (PHSSR), a global collaboration among academic, non-governmental, life sciences, healthcare, and business organizations. Using a framework developed by the London School of Economics and drawing on input from an expert panel of health system decision makers, leaders and researchers across Canada, the report presents a comprehensive analysis of Canada’s economy across seven major domains. It identifies the strengths, weaknesses, opportunities, and risks of the healthcare system.

None of the findings should surprise anyone who works for or has had any relationship with the Canadian health care system. The report recognizes that the government spends a lot on health care each year, and the Council of Canada believes that over the next 10 years it will take We anticipate the need to continue to substantially increase spending. But money is not the only thing needed to strengthen Canada’s ailing healthcare system. As such, the report creates a set of recommendations that focus on systemic changes that can be implemented quickly if all healthcare partners work together and work together.

Some of the recommendations relate directly to hospitals, but there are others, such as primary and long-term care reforms that, if implemented, would help ensure patients receive care in the most appropriate settings. . This report urges the Government to implement a Pan-Canadian Health Data Strategy that supports the effective creation, exchange and use of vital health data for the benefit of Canadians and the health systems on which they depend. I’m looking for It also emphasizes the importance of adopting integrated, interoperable electronic patient record systems to support the transition from provider-centric data to patient-centric data. An enhanced data infrastructure across Canada is essential for better health system planning, including the workforce, and for monitoring and improving performance.

A key issue in ensuring the long-term sustainability and resilience of Canada’s healthcare system is how to support healthcare workers and address shortages, burnout and other challenges. Recognizing the increased stress from staffing shortages and the additional burden created by COVID-19, the report recommends improving working conditions and increasing access to mental health support services. It also calls for action to combat systemic discrimination and racism in the health system, strengthen educational pathways for health workers in indigenous and racialized low-income communities, and address inequalities in the system. I’m here.

Note that there is no Canada-wide approach to long-term workforce planning, despite calls from professionals and health professionals. Instead, workforce data and plans remain at the state or territory level and vary widely by jurisdiction and health profession. The report calls for stronger integrated health workforce planning and assessment, and a stronger workforce data infrastructure across occupations, sectors and jurisdictions. This may be supported by agencies or bodies across Canada.

The report also examines governance within the health system and calls for greater transparency in decision-making and public reporting of health system performance, both at the system level and at the organizational or practice level, including hospitals. Public reporting, enabled by high-quality data across all parts of the system, can help inform and empower patients and communities. It can also make governments more accountable to their citizens for how their tax money is spent, and more accountable to providers and organizations for the value provided by those investments.

The report also looks at ways to strengthen community care and keep people out of hospitals as much as possible, with a particular focus on primary and home care. The report calls for innovative strategies and expanding team-based models among primary care professionals to prioritize underserved communities and optimize the available workforce. increase. It improves working conditions with benefits and adequate wages, educational standards and full-time employment opportunities, as well as adopting a life course perspective to plan and invest in high-quality long-term care through a range of services and supports. I recommend taking it. , for elderly care workers, including unregulated workers.

The report makes a total of 29 recommendations across seven areas to improve the sustainability and resilience of Canada’s health system. The hope of this project is that practical, action-oriented recommendations will be seriously considered by government and health sector stakeholders. Their implementation requires a concerted effort by all involved.

Our healthcare system has failed to evolve to meet the needs of Canadian patients and the healthcare professionals who care for them.

We know we need to do things differently.

I know it’s not easy.

We also know that without some change we will never be prepared for the next crisis and will never build the sustainable and resilient healthcare system that Canadians need and expect.

To read the full Canadian report, please visit https://www.phssr.org/findings.

Sara Allin is an associate professor at the Institute for Health Policy, Management and Evaluation at the University of Toronto. She is the director of the North American Astronomical Observatory on Health Systems and Policy.and Principal Investigator, Sustainability and Resilience in the Canadian Health System

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