This Listen Up! guest post is by Sally Barnes. Hugh Mackenzie will be back next week.
By Sally Barnes
No need to panic if you’re among the more than one million Ontarians who don’t have a family doctor. Or you’ve been waiting months for an MRI or to see a specialist. Granny may be stuck in an emergency department hallway but hopefully, your kids aren’t among the thousands waiting for surgeries.
Help is on the way….maybe.
There are signs that our political leaders hear the public angst over the suffering and loss of life caused by worsening conditions in our beloved public health care system. Demand for action is deafening and there are hopeful signs that an agreement to change may be reached.
The question is what change—and who has the smarts, leadership skills, and the courage to make it happen?
I believe politicians who try to hide behind ideology or defend turf wars that helped get us into this mess or who reject or delay healthcare reform will be punished mightily at the ballot box.
Lives are at stake—and so are political careers.
If ever there was a time for strong political leadership and an end to jurisdictional bickering and partisan politics in this country, this is it—in Ottawa and in all the provinces.
The federal government promises increased health funding but only if the provinces (which have jurisdiction over health care) agree to data collection that will monitor programs and track outcomes.
In other words, Ottawa wants to know how the money will be spent—and what works and what doesn’t.
The provinces jealousy protect their constitutional right to manage health care and argue that priorities vary among different regions of the country.
But surely there has to be a national perspective as well. Rather than fearing that such data might expose the shortcomings or failure of some provincial healthcare programs, data would highlight priorities and reveal best practices that can be duplicated and improved elsewhere.
It is well known that during the recent pandemic, healthcare officials were handicapped by the lack of uniform country-wide data that could have helped formulate a national picture of what was happening in Canada and how best to tackle it. The federal purchase and distribution of vaccines might be a good example.
Change advocates promise that whatever new programs or policies emerge will be monitored to ensure they adhere to the Canada Health Act and penalties will be levied in cases where restrictions on private care are violated. (I’ll leave it to others to judge the Prime Minister’s promise on this.)
In other words, the end to socialized medicine is not nigh. The capitalist hordes won’t be allowed to hijack the system. To access the many services private sector suppliers already provide (from family doctors to ambulances and pain clinics) you will continue to use your government health card and not your credit card.
Change won’t come cheap and won’t happen overnight. It will take months and even years to begin to repair the damage done by decades of failure to recognize and respond to obvious trends such as an aging population, increased immigration, pandemics, and changes in technology and the labour market.
(Did we suddenly wake up and realize we had a tsunami of old people on our hands? Was thought given to our responsibility to the unprecedented influx of immigrants? They would thankfully fill jobs and bring their skills, families, and knowledge with them but did anyone consider they would need housing and health care?)
Change for change’s sake would be wrong in the complex business of healthcare. For example, the province is somewhat responsible for the doctor shortage because when it got rid of fee-for-service for doctors and went to a system of capitation where they get a lump sum covering all their patients, work habits changed.
In many cases—certainly not all—family doctors who were working some 50 hours a week and charged per patient visit started working much fewer hours and received the same income. In effect, the policy change significantly reduced the availability of doctors.
Nobody expects miracles but everyone needs and deserves hope that things can get better.
Some signs of hope already exist. Increased responsibilities for pharmacists in Ontario (and some other provinces) is hardly earth-shaking but it’s positive change-making and our family has felt the benefits already.
Once viewed as simply dispensers of drugs, pharmacists have become an increasingly integral link in the healthcare chain, providing expertise and being accessible to their local community.
Only last evening a young pharmacist from my local drugstore called me unexpectedly and spent a half hour carefully going over all my prescriptions, making suggestions, and offering to consult with my family doctor on my behalf.
It has been a long time since a healthcare professional found time to provide me with that much attention and advice.
It was the same pharmacist who helped my husband and me get access to the drug Paxlovid at the height of the pandemic when the drug had to be prescribed by a doctor and administered soon after diagnosis of the virus.
In recent months, pharmacists in Ontario have been given the go-ahead to dispense Paxlovid on their own, along with several other specified drugs. Additional responsibilities are in the works. This will take pressure off the system and provide convenience to the public.
In other areas, there is hope for more flexibility that will erode some of the rigid rules that add to current barriers and restrictions. For example, we need changes that will allow qualified doctors, nurses, and other healthcare workers to take jobs in provinces other than where they are registered.
Our country is riddled with interprovincial barriers that have existed for decades while politicians and various professions and other special interest groups squabble over turf protection.
Failure to recognize the qualifications of foreign-trained doctors and immigration red tape that drives healthcare graduates to job offers outside the country is mind-boggling.
Like most other families, we’ve suffered from the realities of today’s healthcare situation.
As a sign of the times, my husband was informed yesterday that his long-time family doctor is soon to retire because he “can no longer keep up with the pace of family practice.” So we’ve joined the luckless legion of more than one million orphans who must rely on virtual medicine or walk-in clinics with all their shortcomings. Just getting a prescription refilled will be a challenge.
Tommy Douglas, the so-called Father of Medicare in Canada, was too wise about human nature, politics, and governance to believe his contemporaries or successors could create a perfect system.
Indeed, as Premier of Saskatchewan, he faced strong public backlash when he introduced in his province the notion of government-funded health insurance. A long and bitter province-wide strike by doctors ensued but the plan was implemented and became a prototype for the national program we know today.
I’m old enough to remember seeing in action this tiny figure of a man who left such a giant legacy of policies designed to improve the lives of generations of Canadians.
I did not know him personally but I believe the prairie preacher and politician would be shocked to see the nightmare his medicare dream has turned into today. And how worse it could become if those now sitting in the seats of power across this country can’t put their partisanship aside and get their act together.
Sally Barnes has enjoyed a distinguished career as a writer, journalist and author. Her work has been recognized in a number of ways, including receiving a Southam Fellowship in Journalism at Massey College at the University of Toronto. A self-confessed political junkie, she has worked in the back-rooms for several Ontario premiers. In addition to a number of other community contributions, Sally Barnes served a term as president of the Ontario Council on the Status of Women. She is a former business colleague of Doppler’s publisher, Hugh Mackenzie, and lives in Kingston, Ontario. You can find her online at sallybarnesauthor.com.
Don’t miss out on Doppler!
Sign up here to receive our email digest with links to our most recent stories.
Local news in your inbox three times per week!