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Strengthening Primary Care Key to Rebuilding Canada’s Crumbling Healthcare System

November 15/2022

A new report on the sustainability and resilience of Canada’s healthcare system has sounded the alarm that the current healthcare model is incapable of making the changes necessary to address the challenges faced today and will not withstand the next crisis.

The Sustainability and Resilience in the Canadian Health System report was developed by IHPME Prof. Sara Allin as part of a new research initiative with the Partnership for Health System Sustainability and Resilience (PHSSR) – a global collaboration between academic, non-governmental, life sciences, healthcare and business organizations. The Canadian assessment is one of more than 20 studies, either underway or complete, in over 20 countries worldwide, including England, France and Germany.

Leveraging a framework developed by the London School of Economics and Political Science, the report identifies the strengths, weaknesses, opportunities and risks of the Canadian healthcare system across seven key domains: health system governance; health system financing; health system workforce; medicines and technology; health service delivery; population health; and environmental sustainability.

According to the report, one of the areas requiring an immediate overhaul is Canada’s primary care system. Reforming how we govern, fund and organize primary care, and investing in team-based primary care models, can improve access to integrated healthcare preventative, diagnostic, treatment, and palliative services. It could also significantly improve quality of care, increase efficiency, reduce wait times and lead to better patient outcomes.

“Our healthcare system is a relic of the 1960s. The needs of Canadian patients and the healthcare professionals who care for them have evolved,” says  Allin, director of IHPME’s North American Observatory on Health Systems and Policies. “Many Canadians cannot access primary care and waitlists for specialists are too long, meaning that many patients are much sicker when they finally access care. Our hospitals have become an overrun and expensive safety net for those who cannot get timely access to care. The current Canadian healthcare system is unsustainable.”

Investing in multidisciplinary team-based primary care and enabling team members to work within their full scope of practice could take the burden off other parts of the system and improve quality of care for Canadians. Team-based care is a model of healthcare delivery where many health professionals, such as family physicians, nurses, dietitians, social workers and others work together in one setting to support the unique needs of each patient. Team-based primary care models are shown to lead to fewer hospitalizations and reduce emergency department visits for people with chronic illnesses.[i] They can also help coordinate the care of their patients as they navigate the health system.

The report also calls for the immediate implementation of a Pan-Canadian Health Data Strategy, including a database of Canada’s health human resources, finding that the health and social data used to inform policy decision-making are fragmented, not readily available for researchers and decision makers, and inconsistent across the country. In fact, this lack of health workforce data, strategies and projections severely limited Canada’s ability to plan for the unprecedented health human resource challenges throughout the pandemic.

“Given the current healthcare crisis and the obvious need for urgent action, and given how difficult major change is, I hope that all stakeholders in our healthcare ecosystem can come together to collaborate on solutions to ensure our system is able to address the needs of today and able to withstand future shocks and stresses over the long-term,” says Allin. “As it stands right now, we will certainly not be ready for the next crisis.”

In addition to existing challenges and public health emergencies, the pandemic also highlighted the vulnerability of health systems to shocks, such as weather or climate disasters, conflict and other crises. These findings underscore the importance of investing in primary care and implementing a Pan-Canadian Health Data Strategy to better position the health system for current and future crises.

Established in 2020, the PHSSR seeks to work with local academics, governments, policymakers and other stakeholders to build knowledge and guide action through research reports that offer evidence-informed policy recommendations to improve healthcare system sustainability and resilience.