Making sure everyone has access to primary health care – a doctor, nurse practitioner and health team – is now everyone’s political responsibility. Let’s share the best solutions, too
By Sarah Hobbs, CEO, Alliance for Healthier Communities
While there are a lot of voices speaking up on health care at the moment, everyone in Canada can certainly agree on one thing: the status quo isn’t working and needs to change. When it comes to access to a family doctor or nurse practitioner and primary health care team, the conversation about solutions is starting to shift – and now we need commitments from all governments to truly make primary health care the foundation of Canada’s health systems. How can we get there? What does success look like?
These days, it is abundantly clear to each and every person living in Canada who still doesn’t have a family doctor or nurse practitioner, or those who are facing losing one because of retirement or staffing shortages, that having a quarterback for your health and wellbeing isn’t a luxury: it’s one of the key elements of being well, aging well, and being able to avoid illness, both physical and mental. Of course, what’s even better than a reliable quarterback is having access to a whole team – that means additional family doctors and nurse practitioners to help cover off vacations, parental leaves, and to plan for clinicians’ retirements without interruptions of care. But it also crucially means coordinated access to the other primary health care team members, like nurses, social workers, dietitians, pharmacists, physiotherapists, and health promoters. For patients, this can be life-changing care. For providers, this can mean spending more time on what they do best – caring for patients.
The just-announced Ottawa-Ontario health care funding agreement will see nearly $74 billion in federal funding over 10 years in Ontario for health care services, and of that, $8.4 billion targeted to meet the commitments of a new bilateral agreement focused on the four shared health care priority areas.
First among those priorities is “access to high-quality family health services when people need them, including in rural and remote areas, and for underserved communities.”
For many people across Canada, there is a sigh of collective relief that their governments are demonstrating that they understand all people need a trusted family health provider to turn to, whether for basic health needs, or during a crisis like a pandemic, to manage chronic conditions, or to connect to mental health care, among some of the most common services.
For people who face the most significant barriers to health and highest risks for chronic disease and illness, connection to a local community health team can literally be the difference between life and death.
Community health centres, which the Ontario health system helped introduce and has innovated in Canada for over 50 years, deliver better outcomes for people with the most complex health and social needs, which helps all people living in Canada by avoiding additional pressures on the acute, long term care and home care systems.
It’s encouraging that within the recently released Ontario health care plan, $30 million is committed to expanding these types of team-based care. This is a great start. But we need to ensure we do enough to reach every person in Ontario, to make sure no community is left behind.
With more than $8 billion in new funding to work with, Ontario needs to make a firm and tangible commitment to community- and team-based primary health care as the foundation of a health system that keeps people well and living in their homes and communities. That means supporting and expanding existing teams, and recruiting and building new ones where the needs are highest.
There’s another key element to team-based care, and that is its direct connection to health equity, and ensuring that the people who face barriers to health and wellbeing, who are at increased risk of illness and chronic disease, don’t fall through the cracks. What we know right now is that, when people fall through the cracks, that’s when our acute care systems, our emergency systems, and the fabric of our society itself, start to break down. We can and must do better. And we know how.
We know that more community-governed team-based care is what’s needed for Indigenous health, for Francophone health, for rural, remote and Northern health, for Black health, for 2SLGBTQ+ health. In Ontario, team-based care models like Community Health Centres, Indigenous Primary Health Care Organizations, Nurse Practitioner-Led Clinics and others serve patients that are 70% more complex than the average person in Ontario. Despite this complexity, those models save the acute system $27 million each year. Tailoring community health to the specific needs of communities means better outcomes. Again and again, evidence shows that team-based care, taken with a culturally safe, holistic and wraparound approach, can make a massive difference – in people’s lives, for providers’ practices, and for the health system overall in terms of chronic diseases and usage.
The time is now to be bold in Ontario and across Canada to deliver health care better and more equitably. We need to be creative, innovative and follow the best evidence that community-based and community-led team-based primary health care can drive better health outcomes, especially for those facing barriers. We know this is what will keep more people out of the hospital, living in their communities and enjoying healthy lives longer.