Canadians have told Canada's doctors that they want better value for their health dollars through an expanded public system that treats illnesses faster and covers a wider range of services.
The majority of participants in a year-long public consultation on the health system conducted by the Canadian Medical Association said the money spent on health could be allocated more efficiently and that patients are still waiting too long for the care they need.
"They didn't say they wanted to see new money invested; they wanted to see better utilization of the existing dollars," Jeff Turnbull, president of the CMA, said Wednesday in releasing a report summarizing public input received online and through a series of town-hall meetings in six Canadian cities.
Dr. Turnbull said he was surprised by the degree of consensus expressed by Canadians regarding the state of public health care. "Canadians have a profound respect for our health-care system but they were very worried about it," he said.
Large numbers of people told the CMA that the future of medicine in this country must include healthier communities through a health promotion strategy, as well as improved access to long-term care, home-based care and pharmacare.
There was also a call for a better system of electronic records that could be accessed by patients themselves and improved support for primary care.
"We now want to use that valuable information to mobilize governments to turn their attention to a new health-care system before the current federal-provincial-territorial accord expires in 2014," said Dr. Turnbull. "The goal must be to use the next accord to transform health care so it truly serves Canadians for future generations."
Federal Health Minister Leona Aglukkaq has asked a Senate committee, rather than a committee of elected members of Parliament, to begin a study of what might replace the existing accord.
Her spokesman, Steve Outhouse, said Ms. Aglukkaq had received a copy of the CMA report but had no immediate comment. "We'll review it, as we're always interested in hearing from organizations that have suggestions on how to improve the delivery of health care in Canada," said Mr. Outhouse, "and we'll continue working with stakeholders, as well as provincial and territorial governments in this regard."
Many Canadians told the CMA they believe health care is "in distress." They said they wanted good value for health-care money, which they defined as timely access to appropriate and needed medical services as well as a system that is transparent and accountable.
But "the health-care system is fractured to such a degree that it is, in some ways, a system in name only," says the report. "From the perspective of the patient as a consumer of health care, it does a poor job of transitioning patients from one level of care to another. It does not provide patient-centred care – the care people need when they need it."
Chris Simpson, chair of the Wait Time Alliance and head of the division of cardiology at Queen's University in Kingston, said the report contains input from a large number of articulate people who described how the system continues to fail them.
"We've become very good at episodes of care. If you need one sort of medical service, we can deliver that and we can do a pretty good job of it," said Dr. Simpson.
But patients who need to see a series of practitioners must often wait between each step of their care, he said. "It's the totality of that experience, I think, that people are frustrated with," Dr. Simpson said. "There's a customer-service sense of things that we're missing in the system."