Canadian Medical Association

On the heels of yet another summer of emergency department closures, ever-growing surgical wait lists, and millions of Canadians still unable to access primary care in a timely fashion, Canada’s health ministers will meet in Charlottetown this week to discuss next steps for our health system.  

Add to these challenges a fast-growing population and a housing affordability crisis, and the need for systemic change and investments in new health care models, such as team-based primary care, becomes all the more urgent. 

Despite all these headwinds, I am optimistic about the opportunity for a meaningful outcome at this meeting. When Canada’s premiers met in Winnipeg in July, it was clear that they all understood the gravity of the situation facing health care providers and their patients. The premiers also adopted a collaborative, constructive tone and agreed on key areas of focus including supporting a strong health workforce, enabling mobility of health workers and improving access to primary care and mental health care. The creation of a Physician Registry in the Atlantic provinces to improve mobility in eastern Canada is another promising example of how cooperation can help improve access to health care. 

We also know that federal funding is in place, waiting for the provinces to step up with their solutions for the challenges that face health providers and patients. A CMA analysis from earlier this year concluded that the federal government’s 2023 budget includes the most significant investment into health care in more than two decades.  

These are positive steps, but much more needs to be done. It has been several months since most provincial and territorial governments agreed in principle to bilateral health agreements with the federal government that included a requirement to create action plans to access a portion of the funding. Action plans are needed urgently as Canadians continue to struggle to access care. The health ministers’ meeting is an opportunity for them to show their plans and seize the moment to begin fixing our health care system. 

Canadians need to know that meaningful, positive change is coming. The results of a survey conducted in partnership with the CMA in August 2023 clearly illustrate that Canadians are losing hope: only one quarter (25%) are optimistic about health system improvements in the next two years.  

The despair is not surprising: more than 6.5 million Canadians do not have regular access to a primary care provider, and a full one third of patients who do have a health care provider struggle to be seen in a timely fashion. They must rely on routinely overburdened and under-resourced emergency departments, virtual-only clinics, or the walk-in clinics that do not provide the continuity of care a dedicated provider or team-based approach can. So it’s no wonder that over 80% of Canadians who responded to the survey believe that federal and provincial/territorial governments need to make health care a bigger priority.  

The survey results also indicate that the top priorities for Canadians are 24/7 access to emergency departments, shorter waiting times for surgery and shorter waiting lists to see a family doctor, all perfectly reasonable requests. Canadians expect their health system to be there for them, when and where they need it.  

We have consensus in this country that the status quo is not an option. We lived through what was hopefully the worst of the COVID-19 pandemic, where patients learned what health care providers have known for decades: that the system is in dire need of reform. Novel solutions such as virtual care proved critical to maintain access to care in some settings, and they showed us that change is possible.  

Finally, we have solutions that can make a difference. We need to enable the mobility of medical professionals; scale up collaborative team-based primary care; create healthier, safer work environments for health workers and reduce the administrative burden they face; and build a national health data and human resources strategy to address retention, recruitment, deployment and training of health workers – and to plan for the needs of patients now and into the future. Together, these solutions have the potential to transform our health system, improving working conditions for health care workers and access for patients.  

As Canada’s health ministers gather in Prince Edward Island this week to further discussions on the future of our health care system, I urge them to take bold action, unlock the additional federal funding and begin the difficult but necessary work of creating a more efficient and equitable health care system.  

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

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