Thank you, Madam Chair.
I am going to give my presentation in English rather than in French so that it is shorter. But I am always prepared to answer questions in French.
Thank you very much for this opportunity, and congratulations to the committee for doing this review. We view the accord as one of the very fundamental pieces of the health system right now. It's important that we maintain vigilance on it.
The Canadian Healthcare Association was very active during the 2004 proceedings. We contributed, we believe, to positive outcomes of the accord, including the predictable funding and direction for setting benchmarks. This 10-year plan that we're reviewing has been instrumental in putting Canada's health care system back on track. However, the system is not yet where we need it to be. As we review the accord, we'd like to emphasize that the delivery of services is not only about access and quantity but also about safety and quality. We have four items to bring to your attention in today's session.
The first is wait times. Our Wait Time Alliance colleagues are going to speak on this in much more detail. While we're prepared to respond to any questions, at this point we'll simply emphasize two points: first, the five priorities identified in the accord are a beginning, not an end; second, appropriateness and quality of care must also be a priority, even as we address access and quality.
The second issue is health human resources. The shortage of health human resources is not just a Canadian problem; it's international in scope. It remains serious, and it points to a crisis. The pan-Canadian framework on health human resources, developed under the auspices of the FPT advisory committee on health delivery and human resources, is a strong and necessary framework. We are, however, concerned that its implementation is not receiving the attention and support from all stakeholders that it must have to succeed. In particular, Canada requires multi-stakeholder coordination of our HHR activities that transcends geographic, professional, and political boundaries in order to address the critical issues related to health human resources.
The third issue is electronic health records. EHR is pivotal for moving forward on health renewal priorities. I'd like to quote the 2004 accord, which said that the accord is committed to:
realize a vision of the Electronic Health Record through an ambitious plan and associated investment.
Canada Health Infoway investments now total $1.6 billion. However, the return on investment is estimated to have gross benefits exceeding investment dollars by an eight to one margin and to generate close to $40 billion in savings. CHA would like to reiterate its position that resources for an EHR must be allocated to allow for equitable coverage of all Canadians.
Our third point of emphasis is home care. The 2004 accord provided funding for post-acute and palliative home care. While that is a tremendously positive start, we think it is narrow and unrealistic as a view of home care in Canada. CHA continues to advocate for programs to provide both acute care replacement services and long-term home care. In the studies we reviewed, chronic home care was demonstrated to be significantly less costly than care in a long-term care facility. However, most home care is provided by informal, or unpaid, caregivers. One very impressive statistic tells us that 41% of Canadians who had to respond to home care needs within their family were forced to use personal savings just to survive. Canada's approach to home care must include continuing care as well as post-acute care.
Our fourth and final item for today is federal fiscal responsibility. Canadians legitimately expect to have access to comparable health services, regardless of the jurisdiction in which they reside, and the Canada Health Act commits to this. Since jurisdiction over health delivery is a provincial–territorial responsibility, some argue that the federal government should provide only the funding, without linking it to conditions or objectives. However, the federal government has a constitutional right, and some would say a duty, to use its spending power to achieve health objectives for the good of all Canadians. The people of this country rightfully expect pan-Canadian objectives to be developed and supported by all levels of government, and they are less concerned, frankly, about the ultimate source of the funding. Any move to minimize federal responsibility would have a negative impact on future pan-Canadian programs. These programs include a national pharmaceutical strategy, appropriate health human resources, and an EHR—all of which were identified in the accord. CHA would add home care to this list.
In conclusion, with respect to HHR, a strategy does exist. It needs our attention, all-stakeholder buy-in, prioritized funding, and most of all pan-Canadian coordination. With respect to the electronic health record, it is emerging in a fragmented manner that will not serve Canadians well.
To truly address patient safety and create efficiencies in the system, we must commit to a pan-Canadian HHR.
Home care—