An open letter to Canadians: Fixing health care starts now — and with you

Our health-care system belongs to all of us. It is not a possession of politicians, or the property of stakeholders claiming special status to speak in its interest. They are the custodians, the guardians to whom we have entrusted the system’s welfare.

The owners are the 39 million Canadians who increasingly feel disenchanted and disenfranchised by what until recently has served as a shining light of our nationhood. Their disappointment has approached a dangerous breaking point. It is well past time for the bold actions that will restore confidence and ensure excellence in what has been — and can again be — this country’s pride and joy.

We confront this objective as a group of reform-minded Canadians with deep roots in health care. We have come together — practitioners, administrators, and policy, academic and technology leaders — in a shared determination to fix what’s broken. The pandemic has placed tremendous pressure on the system. As the unprecedented challenges of COVID-19 have made clear, the status quo is not holding.

Patience and indifference toward political battles over funding have run out. Reforms needed to secure the future of Canadian health care are well known. In fact, some are already being implemented here and there, but they need to be adopted at scale. Widespread reform can’t wait any longer.

Here are the core assumptions we believe can drive reform in a manner that unites us — and breaks old deadlocks:

• Health care lies at the heart of our identity, our society, our well-being and our economy. But we are asking too much of the dedicated professionals who deliver the goods every day.
• Reform must be centred on people, not only those who require care, but also before people ever become patients. This sounds obvious but is too often ignored.
• It is our right to expect a system that is equitable, accessible and of the highest quality.
• Reform really starts with the expectations of Canadians, and decision-makers should work back from there. We need to modernize our definitions of the services every health-care user should be able to access and make the changes necessary to deliver on those expectations.
• You should have access to a primary-care team within a 30-minute drive of where you live or work.
• You should be fully empowered to help care for loved ones.
• You shouldn’t be obstructed from access to health-care professionals by inter-provincial barriers to the free movement of doctors, nurses, technicians and other health-care workers within Canada.
• Individuals own their own health data; it is unconscionable and self-defeating for access to it to be denied or limited.

These priorities and principles should guide reform, which can and must be accelerated now. It doesn’t have to wait for a grand bargain that all governments bless at the same time. Reform should move forward now wherever the will exists to act. Ambition, purpose, urgency and leadership are required — along with the support of all of health care’s owners.

Are you in?

In the coming months, we will focus on reform that can happen now in areas including primary care, data and digital technology, care and wellness of older people, and mental health services.

Read the report. Follow our progress.

About us:

Our project, The Future of Health Care, is co-ordinated by the Public Policy Forum, an independent applied policy think tank that works with all orders of government and a broad cross-section of involved parties. This is not another research exercise. It will lean on many existing and insightful studies, as well as our first-hand knowledge and experience.

The Public Policy Forum has published our scene-setting paper that spells out the urgent opportunity for reform, and how to accelerate it.

About the signatories:

• Dr. Bob Bell, Professor Emeritus, Department of Surgery, Temerty Faculty of Medicine, University of Toronto
• Georgina Black, Vice Chair & Managing Partner Government, Health & Life Sciences, Deloitte Canada
• Jodi Butts
• Dr. Vivek Goel, President and Vice-Chancellor, Professor, Schools of Pharmacy and Public Health Sciences, University of Waterloo
• Dr. Alika Lafontaine, President, Canadian Medical Association
• David MacNaughton, President, Palantir Technologies Canada
• Dr. Danielle Martin, Professor, Department of Family & Community Medicine, Temerty Faculty of Medicine, University of Toronto
• Dr. Jane Philpott, Dean, Queen’s University Health Science
• Dr. Verna Yiu, Interim Provost and Vice-President (Academic), University of Alberta