Social Policy in Ontario

Can the doctor in the House rebuild health care?

Posted on December 22, 2015 in Health Debates

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TheGlobeandMail.com – Globe Debate
Dec. 22, 2015.   Lawrence Martin

Canada’s first Health and Welfare ministry was created in 1944. Since that time we have not had – until now – one medical doctor serve in the portfolio. Jane Philpott, named to the post by Justin Trudeau, has been practising medicine in one form or another for 30 years.

Before her, our health ministers were predominantly lawyers. The first lawyer-health minister I interviewed was the late John Munro, who served under Justin Trudeau’s father. Mr. Munro was a guy with a big social conscience, but had about as many credentials on medical questions as a stevedore. While I was preparing to see him, someone told me he had been a three-pack-a-day man but was now down to two. “You’ll hear the hacking and wheezing a block away.”

If job qualifications mean anything, things are looking up. Besides her experience as a family physician, the 55-year-old Ms. Philpott has been a hospital administrator, has founded an organization to battle the AIDS epidemic and has spent many years on the African continent in Niger training health workers.

She’s new to politics, but not to challenges. In Niger, one in every four kids don’t live to see their fifth birthday. In that country, Ms. Philpott’s daughter Emily died tragically from a bacterial infection at the age of two.

In taking over the heath portfolio, she is charged with fixing a Canadian system that in a study by the Commonwealth Fund last year ranked 10th in performance of 11 advanced industrial countries surveyed. That was a “shock to the system,” Ms. Philpott said. “And I think that’s actually great for helping us to say, ‘Hey, it’s time we started looking at some alternative models.’”

Our system is outdated, she said, based on a model created a half century ago. It’s one Ottawa has thrown a lot of money at, but the government’s current fiscal constraints, the new minister added, inhibit such expenditures.

The Conservatives took a hands-off approach to health care and put in place plans to scale back the rate of Canada Health Transfer payments to the provinces. On the funding level question, Ms. Philpott didn’t want to commit one way or another but cautioned, “I don’t know that the Canada Health Transfer is the best way for us to increase our investment.” She said she didn’t want to be investing new money in the system for open-ended purposes.

Despite all the problems, this minister, who comes across as calm and measured, is confident that “significant changes to the system” can be made. One reason is a highly unusual set of circumstances that finds all provincial governments in the Liberal or NDP corner. “We’re in a place where there is a huge appetite for collaboration. There is a lot of alignment in terms of our objectives.”

In the past, Ottawa has had little say over how its billions are spent. The funding issue, as indicated by questions raised by provincial finance ministers on the health-transfer program the past couple of days, won’t be easily resolved. But on finding a consensual approach on questions of reforming the system, there is considerable optimism.

Ms. Philpott’s top priority is to move the system away from the old model of care delivery in hospitals to primary care in the homes. Ottawa is investing $3-billion in home-care services, such as more access to high-quality caregivers and financial supports for family care. She will work with the provinces, many of which have already been pursuing long-overdue reforms, to “find new models for care delivery.”

Money isn’t the cure-all, Ms. Philpott said. A great thing about the focus on primary care, she believes, is that it will lessen financial pressures.

After a decade of a laissez-faire approach from Ottawa, there is at least hope that a turn for the better can be made. There is agreement, given reports such as the Commonwealth Fund’s, that big change is needed. There is philosophical compatibility with the provincial governments, and there is, at long last for our health portfolio, a doctor in the house.

< http://www.theglobeandmail.com/globe-debate/can-the-doctor-in-the-house-rebuild-health-care/article27898323/ >

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