Thank you.
Thank you for having me here today. The CMA appreciates the opportunity to present to the Standing Committee on Health, and I thank you for placing me to the left of Michael McBane.
To quote from the accord in 2004:
First ministers remain committed to achieving results, recognizing that making health care sustainable and able to adapt to the ever-changing needs of Canadians will take time, sustained commitment, and adequate resources.
Based on the last three years, all too few of the accord's commitments have been kept.
Going back 74 years, in 1934, some 12 years before Sir William Beveridge's plan for a national health service in Britain, the Canadian Medical Association produced guidelines for a Canadian national health program funded and administered by the state. The Beveridge NHS plan was a partial template for Canadian medicare.
The NHS has recently undergone renewal and has evolved for the better. Patients have reaped rewards as wait lists have been effectively eliminated in just four years. Universal health care and excellent access can co-exist. We in Canada still cling to a system modelled on the old NHS. Our system needs to be more efficient, effective, and responsible. My presentation will focus on wait times and access, the shortage of doctors, and patient focus, care, and funding.
I'd like to emphasize that progress on wait times has been limited and is not consistent across the country. Provider and capacity shortages continue to be major barriers to access. Medically harmful wait times are not necessary. Wait times lead to human suffering and also carry severe economic costs. Just this year, we released a report showing that the economic cost, in 2007 alone, of patients waiting longer than medically recommended was $14.8 billion. That stunning total was for just four procedures identified as priorities in the 10-year plan. Imagine the cost if all the thousands of procedures were included.
A million Canadians continue to suffer on wait lists because of deficiencies in our system, and this is unacceptable. We need to break the back of wait times for the sake of our patients and for the economic health of Canada. This will require leadership, a revolutionary change in focus, and sustainable investments.
While the first ministers acknowledged the need to increase the supply of health professionals, not enough has been done. Canada is 26,000 doctors short of the average in developed countries and ranks 24th in doctors per population. The poll released by the Canadian Medical Association today found that Canada's doctor shortage ranked second to the economy in importance, and 91% of Canadians say the doctor shortage will influence their vote in an election. Political parties that ignore this issue in the next election could pay a price at the polls. We must increase the numbers, and we must be self-sufficient in the supply of health professionals.
In the 10-year, $40 billion plan to strengthen health care, the needs for improved efficiency, productivity, and performance were not adequately addressed. We must invest in health information technology; we currently spend only one-third of the OECD average in our hospitals. Many countries have systems that provide universal care, have no wait lists, and cost the same or less to run compared to ours.
Wait lists can and must be eliminated. We have to make the system work for patients, not the other way around. We must reposition patients at the centre of our health system and have the funds follow the patient—patient-focused funding.
The system of block funding for our health institutions must be changed. Block funding blocks access. As patients become a value to an institution rather than a cost, productivity and efficiency will improve and wait lists will fall. Canada remains the last country in the developed world to almost exclusively fund hospitals with block funding. In England, patient-focused funding helped eliminate wait lists in less than four years.
Why do we continue to keep patients on wait lists when research shows it's cheaper to eliminate the wait lists? Our system is encompassed in a vicious circle whereby rationing of services leads to limited access, reductions in the workforce, limited investment in technology, long wait lists that negatively impact the economy, resulting in funding pressures that force rationing, so completing the circle. Patient-focused funding can break that circle.
The 2004 first ministers accord was supposed to lead to a fix for a generation. It must not take a generation to fix.
Thank you.