Canada’s health care system is only as strong as its weakest link,
and new polling data collected for the Canadian Medical Association
(CMA) indicate that this weakest link is probably access to care. An
Ipsos-Reid poll of 1,500 adults completed in early February found
that concerns about access are mounting and have reached their
highest level since the CMA started tracking such data five years
ago.
Release
of the poll results by President Dr. Sunil Patel during a recent
speech before 300 medical and health science students, physicians
and administrators at the University of Ottawa launched what will
evolve into a 12-month campaign to make accessibility a far bigger
blip on health care’s radar screen.
“We
will make a simple argument,” said Dr. Patel. “Accessibility is the
currency of the health care system, and if people lose faith in that
currency — in their ability to get care when they need it — the
system won’t survive. We want to ensure its survival.”
The
poll, with a margin of error of ± 2.8% 19 times out of 20,
indicates:
- Barely one in 10 Canadians
(14%) now believes that that the country has an adequate supply
of physicians, a significant decline since 1999 (35%).
- That latter finding is
reflected by data showing that 49% of Canadians, or a member of
their household, had to wait “longer than you thought was
reasonable” to see a specialist within the past year. That is up
from 31% in 1999, the year the CMA began conducting polls on
access-to-care issues.
- Similarly, 38% of respondents
offered the same response when asked about access to family
physicians, up from 21% in 1999.
- Concern about access to
advanced diagnostic procedures has also risen significantly.
When asked if they had to wait “longer than you thought was
reasonable” for these procedures in the past year, 31% of
respondents answered affirmatively this year, compared with only
14% in 1999.
Respondents’ top three
access-related concerns all revolved around human resource issues:
long wait times to see specialists and a national shortage of health
professionals (both 75%) and long wait times for ER services (74%).
The results didn’t surprise Dr. Patel, a family physician from Gimli,
Manitoba. Gimli had 11 physicians when he arrived there in 1973, and
today it has five.
Dr. Patel told the students and
MDs that the CMA has identified two immediate steps the government
could take to deal with the access issue. They are:
- Establishment of a five-year,
$1-billion Health Human Resources Fund to support creation of a
pan-Canadian human resources strategy. Dr. Patel noted that of
the $34 billion in new funding that has been promised to health
care by the federal government, only $90 million was devoted to
human resource issues.
- Noting that Ottawa has promised
a GST rebate to municipalities as part of its “new deal for
cities,” the CMA is asking for a similar financial jolt for the
health care sector. “Rebating the GST will help hospitals and
other health care institutions groaning under the weight of
ever-increasing capital costs.”
The CMA is also taking a
long-term approach by launching a year-long campaign that it hopes
will bring access issues to the top of the health care agenda. Dr.
Patel thinks the timing is perfect because a major court case
dealing with access-to-care issues arrives before the Supreme Court
of Canada in June. The CMA has already been granted intervener
status in that case (Chaoulli and Zeliotis vs. Quebec), which is
expected to garner heavy media attention.
This spring, the CMA will also
release a major study of how access issues are dealt with in other
countries and host a colloquium that will allow experts and
stakeholders to discuss the issue. The CMA also took access-related
concerns directly to politicians in its pre-budget submission to the
federal government, in which it proposed a series of short-, medium-
and long-term solutions to the human resource and infrastructure
problems that cause bottlenecks in care delivery.
Dr. Patel warns bluntly that the
access problem can only get worse: “We are already seeing major
problems today, and the demographic bulge created by the baby
boomers hasn’t even worked its way through the system.” He also
notes that the same bulge will affect the medical profession, since
the average age of Canadian physicians is 49, and 30 % are 55 or
older.
Dr. Patel says the importance of
the CMA’s National Health Access Campaign should not be
underestimated. “If we’re to restore faith in the system, improving
access has to be job one.”
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