When people participate in decision-making about services their communities receive, outcomes improve.
by Adrianna Tetley, Chief Executive Officer of the Association of Ontario Health Centres
Welcome to the Association of Ontario Health Centres new blog “Transformative Change in Action.” We begin by asking: why is public debate about Ontario’s health system so focused on doctors and how much they are paid to deliver services to patients? If you agree we need to shift the conversation, join us in a province-wide social media blitz championing the change.
Here’s our concern: this past month the news has overflowed with commentary about how the provincial government and Ontario Medical Association have still not reached an agreement on physician compensation.
Our association certainly hopes this impasse ends soon. Physicians are an absolutely vital part of our health system; over 400 salaried physicians work in AOHC 108 member centres. I won’t speak for them, but I do feel confident saying there are much bigger priorities than physician compensation.
Curing our toxic culture
For starters, we need to prioritize keeping people well ̶ preventing avoidable illness and avoidable visits to doctors’ offices, emergency rooms and hospital beds. To do a better job preventing illness, we need to confront what Gabor Maté and others call our “Toxic Culture.”
Toxic culture is a societal disease that manifests itself in many different health harming ways. Far too many people suffer from poor health because they can’t afford healthy food or a safe roof over their heads. Too many suffer from stress-related illnesses because they experience racism or other forms of social exclusion. In rural or remote areas, and especially in Indigenous communities, thousands can’t access clean water or the most basic health promotion and prevention services.
Research shows that 50 per cent of population health outcomes in Canada are triggered by these toxic societal based factors. So again I’m asking: why are we always talking about what goes on in medical offices and how much doctors are paid for their services? I’m asking the same question about hospitals. Yes, both doctors and hospitals fulfill a very important role treating people when they are sick. But we need to prevent more in order to treat less. We need to create a culture of health and wellbeing that prevents avoidable illness and injury, a culture that promotes the best possible health outcomes for everyone, no matter who they are or where they live, a culture that Premier Wynne mandated her cabinet colleagues to deliver, but as yet we have not seen.
Shifting focus
To achieve this vision, federal, provincial, regional and municipal governments must break down silos and apply a health-in-all-policies approach. And our health system must lead the way applying people- and community-centred principles and practices that respond to toxic realities harming people’s health, whether it be poverty, discrimination, or other types of social, economic or environmental stresses.
A people- and community-centred approach also means jettisoning the notion that people are individualized islands to be treated as passive and patient recipients of care. Instead they need to be active participants in decision-making about what kind of services their communities should receive, and how those services should be delivered. Research demonstrates that when this happens, outcomes improve.
Reframing the debate and decision-making
This shift sounds daunting. How do we get there? Minister Hoskins can take an important step by simply changing the way he frames the conversation.
A case in point is Minister Hoskins’ “Patients First” initiative and the omnibus bill that supports it. In upcoming blog posts, we’ll report on both the positives and the negatives of this legislation, which is now under review at Queen’s Park. But the very first point we need to make is that using the term “patients” implies an ongoing focus on doctors and hospitals, and this focus will not deliver the culture of health and wellbeing we really need. Instead we propose to Minister Hoskins that he frame health system transformation using the term “People and Communities First.”
Do you agree with this first step? Then we invite you to participate in our online call using a social media application called Thunderclap. This tool enables you to use your platform of choice (Facebook, Twitter or Tumblr) to send a strong message to Minister Hoskins.
Our intent is for our “People and Communities First” message to go far and wide as our association launches Community Health and Wellbeing week (September 26 to October 1).
In the lead-up to and during the week, check this blog for stories about how health centres across the province are already applying practices that put people and communities first.
• We’ll show how our member centres are developing services and programs that address Ontario’s “Toxic Culture.”
• We’ll report on the benefits of health centres governed by the community, for the community.
• We’ll also demonstrate the value of health providers making sure the people they serve are active, not passive and patient, participants in decision-making about how to improve their health and their health system.
Thanks for joining the conversation as we shift it to: People and Communities First.