Thank you for this invitation to present on behalf of the Canadian Nurses Association, which represents 139,000 registered nurses and nurse practitioners in Canada.
Like Mr. Blakely, I'd like to thank the committee for previous recommendations related to home care and to an accountability framework around the proposed new health accord.
Our recommendations for budget 2017 align with the federal government's priorities related to a multi-year health accord and to home care. Today I offer four recommendations to address equitable and improved access to high quality integrated health services for all Canadians.
First, we are calling for the new health accord or related provincial-territorial bilateral agreements to include a robust accountability framework or reporting system. Such a framework, which this committee supported in 2016, will benefit patients and taxpayers by showing causal relationships among inputs, activities, and population health outcomes. The framework would include reporting on health and social outcome measures derived from existing national data sources.
Provincial and territorial governments would report to the federal Minister of Health annually. Plain-language reports could be made available to the public via Health Canada's website and social media platforms.
Our second recommendation builds on the proposed investment of $3 billion in home care. Such an investment is urgently needed as there is persistent inequality in access to high-quality, publicly funded home care across Canada, while the demand for home care continues to increase.
It is well known that home care is the preferred and cost-effective option for patients and families, costing a fraction of what hospital care costs. In 2013, over 1.8 million Canadians received publicly funded home care services. The majority of these services, over 70%, were provided to seniors over the age of 65.
We recommend home care funding be allocated on a needs-based formula that accounts for demographics and population health. This approach will address the inequalities in regions such as Atlantic Canada, where currently one in five Atlantic Canadians are senior citizens. Economists at the Savoie institute at the University of Moncton have studied the aging crisis specifically in Atlantic Canada, where they estimate the number of senior citizens will be one in three within the next 20 years. They predict the rising number of seniors, many with complex care needs, will lead to economic consequences for regions that already allocate upwards of 40% of their budgets to health care.
Next month, CNA, along with our partners in the Canadian Home Care Association and The College of Family Physicians of Canada, will release a national report outlining specific actions for the federal government that build on those I am describing today. These actions, focusing on scaling and spreading promising practices, on recognizing caregivers in a variety of manners, and advanced care planning, were generated through extensive pan-Canadian consultations.
Third, CNA calls for a national caregiver strategy to provide Canadians with flexible respite care and workplace options that afford job protection for working citizens. More than 8.1 million Canadians perform caregiving duties. Over six million concurrently balance this role with employment. The cost to replace unpaid caregivers with paid care providers would exceed $25 billion annually. In 2017-18 the federal government can take a first step in implementing a caregiver strategy by engaging with employer stakeholders to develop a federal tax measure to protect workers' incomes while providing supports and guarantees for workplace leave protection.
Our final recommendation calls for the creation of a commission for integrated health care. The commission, which would have a 10-year mandate, would support the federal government's various interconnected, health-related initiatives ranging from home care, palliative care, seniors' care, indigenous health, mental health, and others. As part of its mandate, the commission could establish guiding principles to achieve better health care for all and lower per-capita costs. The commission, which would complement the new accord, could be modelled along the lines of the Mental Health Commission of Canada.
With that, I thank you, and I look forward to any questions.