Social Policy in Ontario

The Ontario Medical Association hosted its annual general meeting last week, which was one of the most important councils in the organization’s history. Amidst a growing health care crisis, physicians developed strategies to improve patient-centred medicine by focusing on continuity of care.

Continuity of care is the vertical integration of systems to create an environment of quality patient care over time. Simply, it is the coordination of medical services across hospitals, clinics and the community that enables individuals to receive comprehensive and efficient care.

Health-care institutions recognize continuity as a key pillar for improving patient outcomes, and many are striving to streamline their medical partnerships. However, these initiatives are impacted by the Ministry of Health, a government body lacking any resemblance of continuity over the past quarter century.

Ontario has had 12 health ministers in the past 25 years, or on average, a new official every other year. This exhausting turnover has led to the inability of the government to generate meaningful progress on health care. Worse, election cycles have undermined the implementation of any long-term strategy for health-care reform, in favour of quick fixes every four years. We are seeing more of the same now.

This is why an overhaul of provincial health-care leadership must be given serious consideration during this election. We should start with a restructuring of the Ministry of Health. In order for our health-care system to develop immunity against political epidemics, our health agency should be completely independent of the government.

This could be accomplished by assembling a coalition of health-care leaders tasked with appointing a Senator of Health. This commission should reflect the diversity of health-care, including community and academic physicians in addition to other health-care providers who represent a balance of political inclinations from across the spectrum.

This team would then conduct its own search for a senator and senator-designate, both of whom should have a robust background in health care. The senator would be granted a four-year term beginning halfway through a provincial government’s mandate, and would have the support of the senator-designate who would then take over for another four years. Each senator would be prohibited from holding elected office for a period of 10 years following his/her tenure.

Collectively, this framework offers several advantages. First, by installing leadership on a schedule that is off-cycle from elections, we would reduce the political influence on health-care decisions.

Next, by choosing a senator and senator-designate, we would create a culture of continuity for sustainable policy as part of a broader future vision. Finally, by encouraging the senator to return to health care, we would incentivize leadership to improve our system without being seduced by partisan political ambition.

Ultimately, our health-care system can only evolve to better serve our communities if we demand stable, reliable and innovative leadership. This requires a fundamental restructuring of the Ministry of Health.

We can no longer depend on the political party du jour and its revolving door of administration that is now a hallmark of our provincial health-care leadership.

Adam Kassam (@AdamKassamMD) is a medical writer and the chief resident physician in the department of Physical Medicine & Rehabilitation at Western University.

https://www.thestar.com/opinion/contributors/2018/05/06/a-prescription-for-curing-ontarios-ministry-of-health.html