Ontario needs a comprehensive network of Community Health Centres

TheStar.com – /opinion/editorialopinion
October 28, 2012.   Dr. Naila Butt

Across the GTA and throughout Ontario, thousands of people are hoping the provincial government will follow a new recommendation from the renowned Canadian Index of Well-being (CIW) and create a comprehensive network of community health centres (CHCs) across the province.

For years, dozens of communities, like mine in Markham Richmond Hill, have been advocating for access to the services and programs delivered by CHCs. Right now, there are just 73 CHCs scattered throughout the province and they deliver what so many fast-growing regions like Markham and Richmond Hill desperately need: a complete circle of support around the individuals, families and entire communities.

In its second annual report released last Tuesday, the CIW predicted that if a comprehensive network of CHCs was created across the country, the result would be “a better start for children, fewer avoidable hospital visits, better prevention and management of mental illnesses and complex chronic diseases, and improved opportunities for seniors to age at home.”

If you haven’t heard of CHCs, it’s not surprising. They serve just 4 per cent of the population. Bill Davis’s Progressive Conservative government first set them up as pilot projects in the 1980s. Salaried physicians work hand-in-hand with many other types of health providers. The mix of the interprofessional teams depends on whatever are the most urgent needs of the community. They deliver a wide array of health promotion and illness prevention services: services that support children and youth to get the best possible start in life, prevent chronic diseases, and assist seniors to age at home. Outreach workers also organize dozens of community-wide initiatives that get at the root causes of illness — causes like poverty, lack of education and social isolation. According to the CIW, this is “the most effective, efficient, and arguably the most affordable means of delivering primary health care.”

Health Minister Deb Matthews constantly praises CHCs. At a conference I recently attended, she said they “capture the very best of the health system.” So all the many communities that have submitted requests to the province for access to CHCs are wondering why there has been no response. One part of the province that is especially in need of access to CHCs is the fast growing 905 belt surrounding Toronto. In this area 635,000 people live in poverty, are newcomers to Canada or are seniors over the age of 75. Their health is at much higher risk than others, yet only 15,000 of them have access to CHCs.

With rising rates of chronic disease and depression, especially in newcomer communities, we desperately need access to the CHC comprehensive approach. When I visit the Vaughan CHC, nearly 30 kilometres away, I see first-hand what the benefits would be if our calls for a CHC in Markham Richmond Hill were answered. Health teams are proactively connecting services to those whose health is most at risk. The centre offers more than 25 programs to address the social determinants of health. There are services to counter rising rates of diabetes, academic tutoring and financial literacy programs for youth, counselling for new Canadians dealing with the stresses of settling in to a new country, and programs to support seniors aging at home so they can stay of out of long-term care facilities.

What’s more, Vaughan CHC, as well as 72 others through the province, deliver high value for money invested. Recent research from the Élisabeth Bruyère Institute shows that compared with other primary-care models, CHCs deliver superior chronic disease prevention and management. And a study from Institute for Clinical Evaluative Sciences released this past March demonstrated that even though CHCs serve people with more complex needs they do a better job than other models like family health teams keeping people out of emergency departments. In these days of fiscal restraint, the provincial government and the LHINs should take this finding very seriously.

Meanwhile community groups advocating for access to CHCs will continue their efforts. As CIW co-chairs Roy Romanow and Monique Bégin reminded us when they released their report, “the choices we make as a society will determine whether we face a distressed future or a better quality of life.” For a better quality of life, I say let’s choose a comprehensive network of community health centres.

Dr. Naila Butt is the executive director of the Social Services Network, a non-profit charitable organization delivering culturally and linguistically appropriate programs and services to the diverse South Asian community in the York Region.

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