CMHA Ontario supports the view that provinces and territories are co-owners of a national healthcare system, with a shared responsibility to meet the needs of Canadians, as outlined in the Health Council of Canada’s new report on health care reform. On September 19, 2013, the Health Council of Canada (HCC) released its latest report entitled, Better health, better care, better value for all: Refocusing health care reform in Canada. This work provides a critical look at the past decade of health care reform in Canada including the successes, failures and lessons learned. The report comes in the wake of the federal government’s announcement that it will be winding down the work of the Health Council when the 2003 and 2004 health accords end in 2014.
The report finds that despite increased health spending from $124 billion in 2003 to approximately $207 billion in 2012, the desired outcomes of the last decade have not been achieved. Canada’s performance has come up short in patient care and health outcomes, especially when compared to other high income countries. According to the HCC, while hospital care, drugs and physician pay remain the largest portions of Canada’s health care spending Canada ranks poorly in how individuals experience their care.
Although wait times, drug coverage, primary care reform and physicians’ use of electronic health records have moderately improved, the HCC finds that, overall, Canada’s health system cannot be described as high performing. Further action is needed to address missed opportunities including the need for after-hours care, Canadians’ ability to get same day/next-day appointments, access to drugs and elective surgery and home care. More specifically, increasing the availability of long-term home care services for those with chronic conditions, including mental health issues, is essential in meeting the growing demand for these services. This is critical in light of the increase in the number of Canadians with two or more chronic conditions to 31% in 2010.
In order to address these issues, the Health Council of Canada calls for a system level approach for the future of health care reform in Canada, structured around the Institute for Healthcare Improvement’s Triple Aim framework. This framework simultaneously aims to improve the experience of care, improve the health of populations, and reduce per capita costs of health care. Additionally, the Health Council emphasizes the need to advance equity in order to achieve health system transformation in Canada. Despite the initial focus on equity in the health accords, health inequities continue to exist after a decade of reform.
CMHA Ontario is heeding the call for action by:
- Embedding equity in our ongoing mental health policy and planning work by conceptualizing and defining the relationship between equity and mental health. Many individuals experience both mental health issues and other inequities, such as poverty or racialization. Overlapping or intersecting experiences of mental health issues and other inequities deepen and reinforce one another, creating additional challenges at the individual, service delivery and health system level.
- Engaging our branches and other community mental health and addictions agencies in ongoing Quality Improvement (QI) initiatives by offering education to support enhanced QI activities. This project aims to share successful QI initiatives among branches and develop an on-line resource that includes pertinent information and tools to support health service providers in implementing quality into their services and organizations.
- Identifying system issues experienced by people with concurrent disorders in our recent report “Concurrent Disorder Services in Ontario: An Environmental Scan” created in collaboration with Addictions & Mental Health Ontario. System navigation and service coordination are just some of the challenges faced by people with concurrent disorders. This agenda-setting document outlines the need for further attention to providing adequate access and transitioning through multiple services for this population.
For more information about CMHA Ontario’s work, please visit the current issues section of our website.
To read the Health Council of Canada report, Better health, better care, better value for all: Refocusing health care reform in Canada, please visit the HCC website.