Canadian Medical Association

It’s the season of wish lists for the year ahead. When it comes to the health care system, however, the exercise can seem daunting.

More than six million Canadians do not have access to a primary care provider, wait lists for tests and treatments keep growing and health care workers continue to report high levels of burnout. It’s difficult to know where to even begin to create positive change at this scale.

There is good news. The federal government has made the most significant investment in health care in more than two decades and governments of all political leanings have agreed to collaborate on system change. The new organization Health Workforce Canada will help improve data collection and sharing to support human resource planning.

We know, however, that satisfaction with the health system remains dismally low and Canadians want to see demonstrable improvements -- now. Here are four practical and achievable ways governments can make progress in 2024:

Finalize provincial/territorial health care action plans
It’s disheartening that we’re wrapping up 2023 and only British Columbia and Prince Edward Island have the action plans required to access federal funding announced back in February. We urge provinces and territories to complete their own action plans -- focused on shared national priorities such as access to primary care, but tailored to regional needs -- so they can unlock the money on the table to transform care.

Improve health workforce mobility
Enabling physicians to practise outside their home jurisdictions without additional licensing requirements can alleviate the pressure on providers in rural and remote communities, support virtual care across provincial borders and offer greater continuity and timeliness of care. The CMA has long endorsed pan-Canadian medical licensure, supported by 95% of physicians and medical learners. Health ministers have agreed to support “an agile and flexible workforce.” They don’t have to look far for a scalable model— the Atlantic provinces launched a physician registry in early 2023 that allows for practise across the region. We challenge health ministers to agree on a national framework for physician mobility. 

Limit the use of “sick notes” 
The Canadian Federation of Independent Business reports that physicians lose 18.5 million hours each year addressing unnecessary administrative tasks, equivalent to about 55 million patient visits. While some paperwork is important, unnecessary sick notes are not. Reducing physicians’ administrative burden will help free up time for the care Canadians need. Again, governments have a model: Nova Scotia announced measures earlier this year to limit the use of sick notes. Other jurisdictions should follow suit.  

Establish a climate and health secretariat
Canadians got a close-up view of the devastating link between health and climate change in 2023. The 100-bed Stanton Territorial Hospital in Yellowknife, N.W.T., had to evacuate because of summer wildfires. Our health care system is not just a victim of climate change, it’s a contributor, responsible for an estimated 4.6 per cent of national greenhouse gas emissions. Governments and health care leaders must work to “green” the health system to help reduce our carbon footprint. A climate and health secretariat could foster a pan-Canadian approach to the health impacts of climate change and support a climate-resilient, sustainable health system. We urge the government to act quickly so we can build a healthier future for our planet and our patients.

It took decades for Canada’s health system to reach the point where health care workers are routinely burning out, lengthy wait lists are the norm and millions of Canadians struggle to access care. These issues will not be resolved quickly, but governments can have a demonstratable, positive impact in 2024.

Dr. Kathleen Ross is a family physician in Coquitlam and New Westminster, B.C., and the president of the Canadian Medical Association.

This commentary originally appeared in the Toronto Star on Dec. 19, 2023. 

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