Thank you. Happy anniversary day.
My name is Dr. Cathy Kells. I'm a practising cardiologist in Halifax and serve as president of the Canadian Cardiovascular Society. As such, I represent over 2,500 doctors across Canada, including cardiologists, heart surgeons and scientists who care for Canadians with heart disease. I appeared before this committee last year to recommend that the federal government invest a modest $2.5 million annually for five years to sustain a national cardiac benchmarking program. This program highlights pockets of excellence of care in Canada and demonstrates areas where there are gaps in care so efforts can then be made to focus on improvement.
There's currently no pan-Canadian system that does this despite the $25 billion that we spend annually on cardiac care. In 2017 this committee understood the importance of accountability and made it a top recommendation for funding. Unfortunately it was not included in the final federal budget, so, at your invitation, I am back.
Our inability to measure and compare access to care and results is like running a multi-billion dollar business without knowing our inventory and whether customers got the right product, whether it had a positive or negative impact, or whether the competition is doing it better. Cardiac data collection systems do exist in some provinces, but the systems don't communicate with each other. Many centres especially in small provinces have no ability to compare their outcomes with those of any other centre. This results in each centre operating in a vacuum while believing that they're providing excellent care but having no way to know if this is actually true.
Just this past weekend, a family doctor from Kensington, P.E.I., asked me if heart attack patients from P.E.I. do worse than those from Nova Scotia because of the long transport times to reach the centre. The truth is I don't know. We have no data.
Countries that systematically report on quality indicators have achieved the best results for quality and cost-effectiveness, and Canada is being left behind. Cardiovascular care costs will top $30 billion by 2020. With an aging population and disparities in access to care, this issue needs urgent attention. The solution is a pan-Canadian, transparent benchmarking program.
Recognizing this, the Public Health Agency of Canada funded us, the CCS, to develop this system. We engaged clinicians and partnered with the existing organizations, agreed upon what to measure, how to measure it, and how to communicate it back to providers to inform improvements. We now have a tested model with public reports like this one right here that we give back to the heart specialists and care teams across the country.
When the federal funding ended in 2016, we tapped our own resources to continue the project because we believe the data is essential to improving care. Now our discretionary funds are depleted and we are at a crossroads: either secure funds or end the work.
You might ask why CIHI or another Canadian health organization has not taken this on. The answer is that we collaborate extensively with them, but no current C-organization has this vital service within its current mandate. CIHI reports on administrative data but not on clinical outcomes like quality of life, access to specialist care, or adherence to medications. Individual provinces have similarly declined to take this on.
We're aware of the federal review of pan-Canadian health organizations, and this may lead to a reorganization and shifting of resources. However, this will take considerable time to build. Our hope for the long term is that our program will reside within a pan-Canadian entity and can serve as a model and expand to additional disease areas like diabetes or COPD. Until then, we strongly believe we cannot lose the gains we have made. We must sustain the project and we want to work with Health Canada to determine the long-term model.
In summary, imagine a country in which the government and the taxpayers know that our health care dollars are being utilized to deliver the best care in the most cost-effective way, and in which questions about why women and indigenous people with heart attacks don't have as good outcomes as do white men can be answered just by looking at the data.
Imagine if we have a system to determine whether new programs, such as a national pharmacare program, change outcomes after implementation. We actually have this program. We just need to not throw it out while we wait for reorganization. The CCS recommendation for budget 2019 is for federal investment of $2.5 million per annum for five years to sustain this program and provide bridge funding as we work with our partners in Health Canada for the future.
Thank you very much.