If I might add, I had the good fortune to work at Health Canada at the time when it was rolling out the primary health care transition fund, and I would certainly agree with John. I think there were some incremental changes at making primary care--not primary health care, but primary care--more efficient and effective. I think it was not successful in terms of major reform, because the move to teams, a team-based approach, which is in document after document after document for the last thirty years, has not happened. I think one of the huge barriers to that happening is the remuneration system that's in place. You can't incent one category of health professional--physicians in this case--for doing certain things on a fee-for-service basis and then have other staff on salary. Such a huge challenge, I think, needs a common remuneration system or your teams will not get off the ground.
In my judgment, where the problem stalled out was that a lot of provincial medical agreements were not so much for reforming the system but were more dealing with issues of compensation for physicians.