Canadian Medical Association

The first ministers’ meeting held in Ottawa on February 7 has been the subject of much media coverage. It was definitely time that Prime Minister Justin Trudeau sat down with his provincial and territorial counterparts to discuss the scope of the challenges facing the health care system across Canada. Quebec is far from the only province to be dealing with serious issues in its health care system. The bulk of the discussions essentially focused on the Canada Health Transfer and the addition of new funding.

Beyond the funding issue, we need to review how work is organized. We should deal with the problems by asking what we can do right now to optimize the health system with the resources already available. Overhauling the health care system requires that it be stabilized first: this will allow us to ensure that new funding will have the desired effects and create real value for patients and health care providers. Excessive red tape often leads to worker disengagement. We need to deal with this problem right away.

Take, for example, the administrative burden imposed on doctors. The Fédération des médecins omnipraticiens du Québec (FMOQ) recently reported that reducing the amount of time spent on administrative work from 24 percent (as it stands now) to 10 percent would be equivalent to adding 600 family doctors to Quebec’s health care system. The Canadian Federation of Independent Business has drawn similar conclusions on the negative impact of administrative red tape throughout the country. We must therefore conclude that we are not making the best use of the resources we already have—in this case, the workforce. This clearly impacts patients’ access to primary care and results in a needless increase in the use of emergency departments as the main gateway to the health care system.

Innovative solutions for work organization should also be considered. For example, the use of team-based care can be an excellent way to increase access to first-line services. Patients are mainly concerned about having timely access to a health professional—a team member who is able to meet their needs.

These are just a few examples of issues that we can deal with right now and have immense potential. Obviously, there are many challenges that remain, and funding plays a fundamental role in implementing solutions. These include the digital transition or the obsolescence of certain hospital infrastructures, which require significant cash injections.

The provinces and territories must now sign bilateral agreements with the federal government to obtain additional funding. The offer is on the table. Every day we wait is another day in which the system deteriorates further. The people we elected to lead us must remember that the ultimate goal of this exercise is the long-term improvement of the health system. The challenges before us are many. There is no more time to waste.

Jean-Joseph Condé, family doctor and member of the Canadian Medical Association’s board of directors

This commentary was initially published in Profession Santé

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