Health care the Tommy Douglas way
TheStar.com – Opinions/EditorialOpinion
Published On Fri Dec 03 2010. By Carol Goar, Editorial Board
With constant reports of escalating medical costs, overcrowded hospitals, inadequate home care and prohibitively expensive drugs, it is easy to lose sight of what’s going right in Ontario’s health-care system.
One of medicare’s overlooked strengths — which got some welcome attention at Queen’s Park this week — is the network of community health centres that spans the province.
It wasn’t built by politicians, bureaucrats or systems experts. It sprang up because people wanted an alternative to impersonal, one-size-fits-all medicine.
Community health centres date back 40 years. Most began as pilot projects, designed to test medicare founder Tommy Douglas’s vision of a mature public health system that keeps people healthy as well as treating their injuries and diseases.
But once created, they quickly took root and spread. They now serve communities as diverse as Toronto’s Flemingdon Park and as remote as the logging towns north of Thunder Bay.
There are 73 community health centres in Ontario. They thrive in places where people don’t speak English; can’t navigate the province’s complex, rigidly compartmentalized medical system; or fear being judged, denigrated or chastised.
They help their patients manage everything from Type-2 diabetes to domestic violence. They welcome anyone regardless of race, language, background, socio-economic status or sexual orientation.
Most Ontarians know little or nothing about them.
That is one of the reasons the Association of Ontario Health Centres hosted a reception at the Legislature on Monday.
Health workers from these local medical-social hybrids talked about the work they do and clients they serve. They gave the audience a taste of storefront (or back-of-the-van) health care. They explained their philosophy.
And they outlined how community health centres differ from family health teams (which are doctor-driven); walk-in clinics (which provide fast, impersonal medicine); and ambulatory care centres (which are usually in hospitals or other institutional settings).
The other purpose of the gathering was to convince Health Minister Deb Matthews, her political colleagues and senior bureaucrats that community health centres deserve more funding.
No one put it that crassly. But the association’s intent was clear. It released a report entitled Addressing Ontario’s Great Health Divide, which challenged the governing Liberals to double the number of Ontarians served by community health centres over the next 10 years.
“Community health centres have been one of the great success stories of Ontario’s health system,” it said. “The time has come to start planning for more Ontarians to have access to them.”
No price tag was attached. But the cost would be substantial.
Five years ago, when George Smitherman was health minister, the province spent $74.6 million to create 49 new community health centres. That made room for an additional 200,000 users, bringing the total to 500,000.
In order to boost that to 1 million people, as the association is proposing, the government would have to invest roughly $190 million.
Although that is not a huge amount relative to the $46 billion Ontario spends on health care each year, it is a large outlay, especially for a government with an $18.7 billion deficit, facing years of tepid growth and a Conservative party that is whipping up cost-cutting fervour.
In theory, Matthews could reallocate the dollars within the health budget, but she would encounter fierce resistance from the hospitals, the doctors, the pharmaceutical companies, the nursing homes and many voters. In practice, she is likely to lie low in election year.
If Ontario’s community health centres are to have any hope of competing with these powerful entrenched interests, they have to get better at telling their story.
The good news is that they’ve begun.
The bad news is that times are tough, their patients have little electoral clout, their supporters have little financial heft and the public thinks health spending is out of control.
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