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Fix the Foundation, says the Health Council of Canada in its New Report on Primary Health Care and Home Care

TORONTO, Jan. 30 - The vast majority of Canadians (96 per cent) report having either a regular medical doctor (86 per cent), or regular place they go for primary health care (10 per cent). Those numbers may sound comforting, but the Health Council's latest report reveals that care is not always well coordinated, comprehensive, or available when needed.

Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada, released today along with the results of a new public survey commissioned by the Health Council, evaluates renewal efforts in the province and territories and calls for action to accelerate primary health care and home care renewal efforts across Canada.

According to the Health Council’s survey (called the Canadian Survey of Experiences with Primary Health Care), one-quarter of people who needed care for minor health problems had difficulty getting timely appointments. The report also cites data from an international study which suggests that more Canadians (30 per cent) wait six or more days to get an appointment with their regular doctor than residents of the six other countries studied (20 per cent in the US; 12 per cent in the UK; 10 per cent in Australia).

Report

Backgrounder: Regional

Backgrounder: Survey

Also, more than one-third of people who used an emergency department believe their conditions could have been treated by their family doctor if he or she had been available. “Clearly, all Canadians are not getting timely access to the right care providers when they need it,” said Dr. Don Juzwishin, CEO of the Health Council of Canada.

While 73 per cent of participants rate their primary health care provider as excellent or very good, the picture is less rosy when they are asked more detailed questions. For example, many participants say not all doctors explain test results and 21 per cent say their health care providers rarely or never explain possible side effects of medication. One-quarter (25 per cent) report that their doctors rarely or never talk to them about lifestyle changes or activities that could prevent illness and improve their health.

The survey, conducted by Statistics Canada in early 2007, is the first of its kind to examine the public’s experiences with the health care system during the previous year. Some 2,200 people participated.

“Our report highlights the many initiatives to improve access to care for patients who need it. But when the Health Council asked provincial and territorial governments about their efforts to renew health care delivery, many said that barriers such as funding and human resource issues prevent them from fully realizing their visions,” said Dr. Jeanne Besner, Chair of the Health Council of Canada. “Canadians continue to tell us reform is needed. We must find ways around these barriers to ensure Canadians receive accessible, comprehensive and well-coordinated care, which we know is possible.”

Fixing the Foundation finds similar issues with respect to home care. In 2005, two to five per cent of Canadians used home care services while three to four per cent of seniors (65+) said they needed home care services they did not receive. Although most governments have met commitments made in 2004 to provide two weeks of publicly funded home care services for patients who meet specific criteria, the Health Council says that this is still not enough. In 2006, one in four Canadians said they cared for a family member or close friend with a serious health problem in the last 12 months, with 22 per cent of those caregivers missing one or more months of work and 41 per cent using personal savings.

While acknowledging that efforts are underway to improve access to and quality of both home and primary health care, the Health Council recommends several measures to accelerate change, including:

24/7 access to health information and care providers

Changing the way doctors book their schedules and offering more after-hours flexibility has been shown to provide better access for patients; these successful initiatives should be adopted more widely. In addition, although most jurisdictions offer 24/7 access through the use of telephone health lines, family doctors rarely learn that their patients have called health lines or visited after-hours clinics. Formal systems must be put in place to communicate this information.

Electronic patient records

Electronic health records and e-prescribing improve coordination of care and reduce problems such as medication errors. Unfortunately, a majority of physicians across Canada still rely on hand-written records. More than $1 billion has been spent on implementing electronic health records, but to date only five per cent of Canadians have one; the Health Council urges all jurisdictions to make this a priority.

Interprofessional primary care teams

Teams ensure that patients receive care from the most appropriate health care professional, achieving more efficient use of resources and reducing wait times. While the number and breadth of interprofessional teams is growing in all jurisdictions, the vast majority of Canadians still receive primary health care from doctors in traditional practices. According to the Health Council’s survey, only a third of patients say a nurse who works with their primary care provider is regularly involved in their care, and even fewer (17 per cent) report that other health professionals such as nutritionists work in the same office. Jurisdictions are urged to increase the use of teams for Canadians who would most benefit, particularly those with chronic health conditions.

Expansion of home care

The Health Council urges all jurisdictions to expand their coverage of home care services and make this expansion a focal point of their health care renewal strategies. To read the Health Council of Canada’s report Fixing the Foundation: An Update on Primary Health Care and Home Care Renewal in Canada and the data supplement, Canadian Survey of Experiences with Primary Health Care in 2007, visit: www.healthcouncilcanada.ca.

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Background

The Health Council of Canada, created by the 2003 First Ministers’ Accord on Health Care Renewal is mandated to monitor and report on the progress of health care renewal in Canada. The 26 Councillors were appointed by the participating provinces, territories and the Government of Canada and have expertise and broad experience in community care, Aboriginal health, nursing, health education and administration, finance, medicine and pharmacy.

For information:

Marta Marychuk, Health Council of Canada
Phone (416) 480-7085
Cell (416) 428-8423
mmarychuk@healthcouncilcanada.ca.

Rachel Sa, Public Relations Post
Phone (416) 777-0368
rachel@prpost.ca.