A commentary by a professor emeritus in the University of Alberta’s school of public health, a former deputy health minister in Alberta, and a founding co-chair of the Canadian Health Leadership Network.
Ken Fyke’s June 15 commentary “Benign neglect is destroying Canada’s health system” provides a succinct account of the development of our health system and its downward spiral in public confidence and performance.
Declining public confidence in our system is not surprising given the continual and escalating difficulties with access to care, especially at the primary health level.
Fyke’s comments are a call for leadership, courage and action to reset the Canadian “health system” while retaining the basic principles of equity and fairness for all.
This type of leadership must get beyond the continual federal‑provincial/territorial disputes over funding and passionate “chest pounding” promises made during election campaigns.
There is no need for more study as we have ample reports and recommendations on the changes needed.
What we need is courage to implement actions that will transform the Canadian system from one that was designed to deal with health issues in the 1960s and 1970s to one that responds to current needs.
The continuing “benign neglect” leads to ongoing mediocre performance which in turn leads some political leaders to think the solution is to turn more to a private system.
Much of our system today is delivered by the private sector and there are possibilities for a somewhat expanded role for the private sector.
However, as evidence from around the world shows, this must be done in a well-thought-out way so public authorities define the conditions for private sector involvement and closely regulate the entire system to avoid bleeding the public system without improving overall health system performance.
Unfortunately, many political leaders and health system leaders are daunted by the challenges to make transformative change to our health system and resort to piecemeal solutions which essentially shore up a system that is not designed to meet present-day needs.
Clear evidence of this trend is in primary health where reforms have been proposed by many experts but the response has not been forthcoming.
For example the Don Schurman Cogitators circle put forward a six-point plan to all premiers and health ministers to reform primary health across Canada, and the responses are simply polite pronouncements that they agree with the direction but offer no commitment to an overall system change.
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