The best kept secret in health care

TheStar.com – opinion/editorialopinion
Published On Tue Jun 14 2011.   By Carol Goar, Editorial Board

The answer is right under our noses. It’s been there for 40 years.

Yet Ottawa and the provinces continue to pour billions of dollars into a quest for more efficient ways to deliver medical services; more businesslike ways to operate the health-care system; and more effective ways to keep people out of the hospital.

If they went back to the original vision of medicare, they’d find the less expensive, less bureaucratic alternative they’re looking for. And if they looked, they’d find dozens of working models.

Community health centres are the closest thing Canada has to Tommy Douglas’s dream: a health-care system that treats people, not symptoms. They deal with the underlying causes of illness: poverty, isolation, poor diet, mental disorders. They thrive in places where people don’t speak English, don’t have access to a family doctor and don’t know how to navigate Canada’s complex, rigidly compartmentalized medical system. They welcome anyone who walks in the door regardless of race, background, socio-economic status or sexual orientation.

Unlike family health practices (which are doctor-run), ambulatory care centres (which are managed by hospitals) or walk-in clinics (which provide fast, impersonal medicine), they are guided by the needs of the community. Some emphasize mental health services. Others concentrate on prenatal care, senior care or ensuring that their clients have healthy food and decent housing.

“When you’ve seen one community health centre, you’ve seen one,” said Jack McCarthy, chair of the Canadian Alliance of Community Health Associations.

Ontario has 73 community health centres. But most people don’t know they exist and most policy-makers regard them as a minor offshoot of mainstream medicine.

In an effort to showcase their work and build public awareness, more than 1,000 community health workers from across Canada, the United States, Australia, Belgium and the Netherlands gathered in Toronto last week. They shared their success stories and their frustrations.

“You guys are leading the way,” said Anita Mononian, chair of the National Association of Community Health Centers in the U.S. In her country, only 23 million people — 7 per cent of the population — are served by community health centres.

But even in Ontario, they are struggling to make inroads against the entrenched interests — hospitals, doctors, pharmaceutical companies and marketers of high-tech medical equipment — that claim most of the province’s $47 billion health budget.

Community health centres haven’t received any increase in funding since 2005, when George Smitherman was health minister. “We need to tell our story better,” said Adrianna Tetley, executive director of the Association of Ontario Health Centres. “We need to show we are saving the health system money down the road.”

Health Minister Deb Matthews, who spoke at the final session of the conference, was full of praise for community health centres. “What you do is not just the right thing to do for people in need, it is the right economic choice for government to make,” she said. “There is a special place in my heart for people who are drawn to community health centres.”

Regrettably, this has never been reflected in her spending priorities. And she offered no hope of more resources in the future.

Only two federal MPs — both New Democrats — and two journalists were there. Neither of the provincial opposition parties sent representatives.

But there were a few signs that the message is beginning to get through. The conference was sponsored by a chartered bank, a major law firm, a computer giant and three national insurance companies. Dozens of exhibitors — from architects to physiotherapists — set up booths.

The movement is still a long way from its breakthrough moment. But its leaders are learning to reach out and showing that the world wants what Canada has.

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