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First Report of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine: Alliance for Healthier Communities welcomes emphasis on shifting to primary health care in community
The Alliance for Healthier Communities welcomes the first report of the Premier’s Council on Improving Healthcare and Ending Hallway Medicine.
A coalition of over 100 Community Health Centres, Nurse Practitioner-Led Clinics, Aboriginal Health Access Centres and Community-Governed Family Health Teams, we are Ontario’s voice for health equity through comprehensive, community-governed primary health care.
“Shifting the emphasis in health care from hospitals and institutions to people and communities is the right thing to do,” said Alliance for Healthier Communities CEO Adrianna Tetley. “We are pleased to support this report’s movement toward fair access to health care across diverse communities; a focus on mental health, health promotion, prevention and the determinants of health; and the local wraparound supports and seamless transitions that put people first.”
In particular, the Alliance supports the following directions in the Council’s first report:
- Primary health care in community: The data supports the Council’s finding that “too many patients are going to hospitals for conditions that could be treated in primary or community care settings or prevented altogether.” A shift away from hospital hallways and into community provides the kind of health care that the Council report calls “high-value, instead of high-cost.”
- Fair access to health care: People living across Ontario have different health and mortality outcomes based on factors including geography, gender identity, sexual orientation, racialization, language and socioeconomic status. We are pleased to see the Council’s report acknowledge the need to directly target solutions to each community, and “consider the unique health care needs and cultural considerations of distinct populations in the province, including, Indigenous people and French-speaking individuals.” We will continue to foreground the importance of action on the intersectional health and social needs of racialized, LGBTQ, and new immigrant individuals and communities.
- Mental health, health promotion, prevention and the determinants of health: Community primary health care providers agree that team-based, patient-focused, wraparound care should consider mental health and “the impact of the social determinants of health, and providing more proactive health care interventions.”
- Care coordination: We share the Council’s frustration at “the separation between the coordinator role and front-line care.” Alliance members are ready to incorporate care coordination and social prescribing into primary care, and to supporting warm and efficient transitions with appropriate technologies, in order to support people throughout their interactions with the health and social systems.
- Integrated health care delivery: Through innovative local partnerships such as “Advancing Access to Team-Based Care" (connecting non-team physicians with interprofessional primary health care team support for their most complex clients, particularly in support of mental health and addictions care) and Social Prescribing (connecting people to non-health services that support their health and wellbeing while reducing health care utilization), the Alliance for Healthier Communities is leading the way on what the Council’s report calls “examples of innovation” and “teams that are working seamlessly together to provide wrap-around services for patients with complex needs.”
As the Council moves into its second report and makes recommendations regarding the future of Ontario’s health system, here are two vital principles for consideration:
- Current community capacity is both strong and flexible: Primary care, mental health & addictions and community services already have the capacity to support an increased role for community, primary care, prevention and the determinants of health in Ontario’s health services mix. Modest investments targeted toward the Ontario residents facing the biggest barriers to health and wellbeing can support this necessary shift within our existing public health care environment.
- Population needs-based planning and accountability must put service and health outcomes before structure and streamlining: Across Canada, efforts by other provinces to regionalize health systems without first integrating services have universally failed. That’s why service integration must precede governance integration to ensure any consolidation occurs in a locally appropriate and forward-moving direction. Ontario must leverage the good will and energy of front-line health service providers to help develop the local partnerships that put the accountability for health outcomes of whole patients and communities – not institutions, providers or single diseases – first.
“The Alliance for Healthier Communities will continue engaging with this government to ensure that health equity, community governance and comprehensive primary health care are represented in the solutions proposed in the next report,” said Tetley. “We need to all work together to transform our health care system with people and communities at the centre.”